[Federal Register Volume 69, Number 150 (Thursday, August 5, 2004)]
[Proposed Rules]
[Pages 47488-47730]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-17312]



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Part II





Department of Health and Human Services





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Centers for Medicare and Medicaid Services



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42 CFR Parts 405, 410, 411, et al.



Medicare Program; Revisions to Payment Policies Under the Physician Fee 
Schedule for Calendar Year 2005; Proposed Rule

  Federal Register / Vol. 69, No. 150 / Thursday, August 5, 2004 / 
Proposed Rules  

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

42 CFR Parts 405, 410, 411, 414, 418, 424, 484, and 486

[CMS-1429-P]
RIN 0938-AM90


Medicare Program; Revisions to Payment Policies Under the 
Physician Fee Schedule for Calendar Year 2005

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

ACTION: Proposed rule.

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SUMMARY: This proposed rule would refine the resource-based practice 
expense relative value units (RVUs) and make other changes to Medicare 
Part B payment policy. The proposed policy changes concern: 
supplemental survey data for practice expense, updated geographic 
practice cost indices for physician work and practice expense, updated 
malpractice RVUs, revised requirements for supervision of therapy 
assistants, revised payment rules for low osmolar contrast media, 
changes to payment policies for physicians and practitioners managing 
dialysis patients, clarification of care plan oversight requirements, 
revised requirements for supervision of diagnostic psychological 
testing services, clarifications to the policies affecting therapy 
services, revised requirements for assignment of Medicare claims, 
addition to the list of telehealth services, and several coding issues.
    We are proposing these changes to ensure that our payment systems 
are updated to reflect changes in medical practice and the relative 
value of services. We solicit comments on these proposed policy 
changes.
    This proposed rule also addresses the following provisions of the 
Medicare Prescription Drug, Improvement, and Modernization Act of 2003 
(MMA): coverage of an initial preventive physical examination; coverage 
of cardiovascular screening blood tests; coverage of diabetes screening 
tests; incentive payment improvements for physicians in shortage areas; 
payment for covered outpatient drugs and biologicals; payment for renal 
dialysis services; coverage of routine costs associated with certain 
clinical trials of category A devices as defined by the Food and Drug 
Administration; hospice consultation service; indexing the Part B 
deductible to inflation; extension of coverage of intravenous immune 
globulin (IVIG) for the treatment in the home of primary immune 
deficiency diseases; revisions to reassignment provisions; clinical 
conditions for payment of covered items of durable medical equipment; 
and payment for diagnostic mammograms.
    In addition, we discuss physicians' services associated with drug 
administration services and payment for set-up of portable x-ray 
equipment.

DATES: To be assured consideration, comments must be received at one of 
the addresses provided below, no later than 5 p.m. on September 24, 
2004.

ADDRESSES: In commenting, please refer to file code CMS-1429-P. Because 
of staff and resource limitations, we cannot accept comments by 
facsimile (FAX) transmission.
    You may submit comments in one of three ways (no duplicates, 
please):
    1. Electronically. You may submit electronic comments on specific 
issues in this regulation to http://www.cms.hhs.gov/regulations/ecomments. (Attachments should be in Microsoft Word, WordPerfect, or 
Excel; however, we prefer Microsoft Word.)
    2. By mail. You may mail written comments (one original and two 
copies) to the following address ONLY:

Centers for Medicare & Medicaid Services, Department of Health and 
Human Services, Attention: CMS-1429-P, P.O. Box 8012, Baltimore, MD 
21244-8012.

Please allow sufficient time for mailed comments to be received before 
the close of the comment period.
    3. By hand or courier. If you prefer, you may deliver (by hand or 
courier) your written comments (one original and two copies) before the 
close of the comment period to one of the following addresses. If you 
intend to deliver your comments to the Baltimore address, please call 
telephone number (410) 786-7197 in advance to schedule your arrival 
with one of our staff members.

Room 445-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW., 
Washington, DC 20201; or 7500 Security Boulevard, Baltimore, MD 21244-
1850.

(Because access to the interior of the HHH Building is not readily 
available to persons without Federal Government identification, 
commenters are encouraged to leave their comments in the CMS drop slots 
located in the main lobby of the building. A stamp-in clock is 
available for persons wishing to retain a proof of filing by stamping 
in and retaining an extra copy of the comments being filed.)
    Comments mailed to the addresses indicated as appropriate for hand 
or courier delivery may be delayed and received after the comment 
period.
    Submission of comments on paperwork requirements. You may submit 
comments on this document's paperwork requirements by mailing your 
comments to the addresses provided at the end of the ``Collection of 
Information Requirements'' section in this document.
    For information on viewing public comments, see the beginning of 
the SUPPLEMENTARY INFORMATION section.

FOR FURTHER INFORMATION CONTACT:

Pam West (410) 786-2302 (for issues related to Practice Expense, 
Respiratory Therapy Coding, and Therapy Supervision).
Rick Ensor (410) 786-5617 (for issues related to Geographic Practice 
Cost Index (GPCI) and malpractice RVUs).
Craig Dobyski (410) 786-4584 (for issues related to list of telehealth 
services or payments for physicians and practitioners managing dialysis 
patients).
Bill Larson or Tiffany Sanders (410) 786-7176 (for issues related to 
coverage of an initial preventive physical examination).
Cathleen Scally (410) 786-5714 (for issues related to payment of an 
initial preventive physical examination).
Joyce Eng (410) 786-7176 (for issues related to coverage of 
cardiovascular screening tests).
Betty Shaw (410) 786-7176 (for issues related to coverage of diabetes 
screening tests).
Anita Greenberg (410) 786-0548 (for issues related to payment of 
cardiovascular and diabetes screening tests).
David Worgo (410) 786-5919, (for issues related to incentive payment 
improvements for physicians practicing in shortage areas).
Angela Mason or Jennifer Fan (410) 786-0548 (for issues related to 
payment for covered outpatient drugs and biologicals).
David Walczak (410) 786-4475 (for issues related to reassignment 
provisions).
Henry Richter (410) 786-4562 (for issues related to payments for ESRD 
facilities).
Steve Berkowitz (410) 786-7176 (for issues related to coverage of 
routine costs associated with certain clinical trials of category A 
devices).
Terri Deutsch (410) 786-9462 (for issues related to hospice 
consultation services).
Karen Daily (410) 786-7176 (for issues related to clinical conditions 
for payment of covered items of durable medical equipment).

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Dorothy Shannon (410) 786-3396 (for issues related to outpatient 
therapy services performed ``incident to'' physicians' services).
Roberta Epps (410) 786-5919 (for issues related to low osmolar contrast 
media or supervision of diagnostic psychological testing services).
Gail Addis (410) 786-4522 (for issues related to care plan oversight).
Diane Milstead (410) 786-3355 or Gaysha Brooks (410) 786-9649 (for all 
other issues).

SUPPLEMENTARY INFORMATION:
    Submitting Comments: We welcome comments from the public on all 
issues set forth in this rule to assist us in fully considering issues 
and developing policies. You can assist us by referencing the file code 
CMS-1429-P and the specific ``issue identifier'' that precedes the 
section on which you choose to comment.
    Inspection of Public Comments: Comments received timely will be 
available for public inspection as they are processed, generally 
beginning approximately 3 weeks after publication of a document, at the 
headquarters of the Centers for Medicare & Medicaid Services, 7500 
Security Boulevard, Baltimore, Maryland 21244, Monday through Friday of 
each week from 8:30 a.m. to 4 p.m. To schedule an appointment to view 
public comments, phone (410) 786-7197.
    Copies: To order copies of the Federal Register containing this 
document, send your request to: New Orders, Superintendent of 
Documents, P.O. Box 371954, Pittsburgh, PA 15250-7954. Specify the date 
of the issue requested and enclose a check or money order payable to 
the Superintendent of Documents, or enclose your Visa or Master Card 
number and expiration date. Credit card orders can also be placed by 
calling the order desk at (202) 512-1800 (or toll-free at 1-888-293-
6498) or by faxing to (202) 512-2250. The cost for each copy is $10. As 
an alternative, you can view and photocopy the Federal Register 
document at most libraries designated as Federal Depository Libraries 
and at many other public and academic libraries throughout the country 
that receive the Federal Register.
    This Federal Register document is also available from the Federal 
Register online database through GPO Access, a service of the U.S. 
Government Printing Office. The web site address is: http://www.access.gpo.gov/nara/index.html.
    Information on the physician fee schedule can be found on the CMS 
homepage. You can access this data by using the following directions:
    1. Go to the CMS homepage (http://www.cms.hhs.gov).
    2. Place your cursor over the word ``Professionals'' in the blue 
area near the top of the page. Select ``physicians'' from the drop-down 
menu.
    3. Under ``Policies/Regulations'' select ``Physician Fee 
Schedule.''
    To assist readers in referencing sections contained in this 
preamble, we are providing the following table of contents. Some of the 
issues discussed in this preamble affect the payment policies but do 
not require changes to the regulations in the Code of Federal 
Regulations. Information on the regulation's impact appears throughout 
the preamble and is not exclusively in section VII.

Table of Contents

I. Background
    A. Legislative History
    B. Published Changes to the Fee Schedule
II. Provisions of the Proposed Regulation Related to the Physician 
Fee Schedule
    A. Resource-Based Practice Expense Relative Value Units (RVUs)
    B. Geographic Practice Cost Indices (GPCIs)
    C. Malpractice Work RVUs
    D. Coding Issues
III. Provisions Related to the Medicare Modernization Act of 2003
    A. Section 611--Preventive Physical Examination
    B. Section 613--Diabetes Screening
    C. Section 612--Cardiovascular Screening
    D. Section 413--Incentive Payment for Physician Scarcity
    E. Section 303--Payment for Covered Outpatient Drugs and 
Biologicals
    F. Section 952--Revision to Reassignment Provisions
    G. Section 642--Extension of Coverage of IVIG for the Treatment 
in the Home of Primary Immune Deficiency Diseases
    H. Section 623--Payment for Renal Dialysis Services
    I. Section 731--Coverage of Routine Costs for Category A 
Clinical Trials
    J. Section 629--Part B Deductible
    K. Section 512--Hospice Consultation Service
    L. Section 302--Clinical Conditions for Coverage of Durable 
Medical Equipment (DME)
    M. Section 614--Payment for Certain Mammography Services
    N. Section 305--Payment for Inhalation Drugs
IV. Other Issues
    A. Provisions Related to Therapy Services
    1. Outpatient Therapy Services Performed ``Incident to'' 
Physicians'' Services
    2. Supervision Requirements for Therapy Assistants in Private 
Practice
    3. Other Technical Revisions
    B. Low Osmolar Contrast Media
    C. Payments for Physicians and Practitioners Managing Dialysis 
Patients
    D. Technical Revision--Sec.  411.404
    E. Supervision of Clinical Psychological Testing
    F. Care Plan Oversight
    G. Assignment of Medicare Claims--Payment to the Supplier
V. Collection of Information Requirements
VI. Response to Comments
VII. Regulatory Impact Analysis
Addendum A--Explanation and Use of Addendum B.
Addendum B--2005 Relative Value Units and Related Information Used 
in Determining Medicare Payments for 2005.
Addendum C--Codes for Which We Received PEAC Recommendations on 
Practice Expense Direct Cost Inputs.
Addendum D--Proposed Changes to Practice Expense Equipment 
Description and Pricing.
Addendum E--Revised 2005 Office Rental Index Versus Current Office 
Rental Index by 2004 Fee Schedule Area
Addendum F--Current Geographic Practice Cost Indices by Medicare 
Carrier and Locality
Addendum G--Proposed 2005 Geographic Practice Cost Indices by 
Medicare Carrier and Locality
Addendum H--Proposed 2006 Geographic Practice Cost Indices by 
Medicare Carrier and Locality
Addendum I--Comparison of Current 2004 Geographic Adjustment Factors 
(GAFs) to Proposed 2005 GAFS
Addendum J--Comparison of Current 2004 GAFs to Proposed 2006 GAFs

    In addition, because of the many organizations and terms to which 
we refer by acronym in this proposed rule, we are listing these 
acronyms and their corresponding terms in alphabetical order below:

ACC American College of Cardiology
ACR American College of Radiology
AMA American Medical Association
APA American Psychological Association
ASP Average Sales Price
ATA American Telemedicine Association
BBA Balanced Budget Act of 1997
BBRA Balanced Budget Refinement Act of 1999
BIPA Benefits Improvement and Protection Act of 2000
BLS Bureau of Labor Statistics
CAH Critical Access Hospital
CF Conversion factor
CFR Code of Federal Regulations
CMS Centers for Medicare & Medicaid Services
CNS Clinical Nurse Specialist
CPT [Physicians'] Current Procedural Terminology [4th Edition, 2002, 
copyrighted by the American Medical Association]
CPEP Clinical Practice Expert Panel
CY Calendar Year
E/M Evaluation and management
ESRD End-Stage Renal Disease
FMR Fair market rental
FY Fiscal Year
GAF Geographic adjustment factor
GPCI Geographic practice cost index
HCPCS Healthcare Common Procedure Coding System
HHA Home health agency
HHS [Department of] Health and Human Services

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HOCM High osmolar contrast media
HPSA Health Professional Shortage Area
HRSA Health Resources and Services Administration
IDTFs Independent Diagnostic Testing Facilities
IPPS Inpatient prospective payment system
IOM Internet Only Manual
ISO Insurance Services Office
LOCM Low osmolar contrast media
MCM Medicare Carrier Manual
MCP Monthly Capitation Payment
MedPAC Medicare Payment Advisory Commission
MEI Medicare Economic Index
MGMA Medical Group Management Association
MMA Medicare Prescription Drug, Improvement, and Modernization Act 
of 2003
MPFS Medicare Physician Fee Schedule
MSA Metropolitan Statistical Area
NAMCS National Ambulatory Medical Care Survey
NP Nurse Practitioner
OBRA Omnibus Budget Reconciliation Act
OMB Office of Management and Budget
OPPS Outpatient prospective payment system
PA Physician Assistant
PC Professional component
PCF Patient compensation fund
PEAC Practice Expense Advisory Committee
PET Positron Emission Tomography
PHSA Public Health Services Act
PPS Prospective payment system
PSA Physician Scarcity Area
RN Registered Nurse
RUC [AMA's Specialty Society] Relative [Value] Update Committee
RUCA Rural-Urban Commuting Area
RVU Relative value unit
SCHIP State Child Health Insurance Program
SGR Sustainable growth rate
SLP Speech language pathology
SMS [AMA's] Socioeconomic Monitoring System
TC Technical component
USPSTF U.S. Preventive Services Task Force

I. Background

A. Legislative History

    Since January 1, 1992, Medicare has paid for physicians' services 
under section 1848 of the Social Security Act (the Act), ``Payment for 
Physicians' Services.'' The Act requires that payments under the fee 
schedule be based on national uniform relative value units (RVUs) based 
on the resources used in furnishing a service. Section 1848(c) of the 
Act requires that national RVUs be established for physician work, 
practice expense, and malpractice expense. Section 
1848(c)(2)(B)(ii)(II) of the Act provides that adjustments in RVUs may 
not cause total physician fee schedule payments to differ by more than 
$20 million from what they would have been had the adjustments not been 
made. If adjustments to RVUs cause expenditures to change by more than 
$20 million, we must make adjustments to ensure that they do not 
increase or decrease by more than $20 million.

B. Published Changes to the Fee Schedule

    The July 2000 and August 2003 proposed rules ((65 FR 44177) and (68 
FR 49030), respectively), include a summary of the final physician fee 
schedule rules published through February 2003.
    In the November 7, 2003 final rule, we refined the resource-based 
practice expense RVUs and made other changes to Medicare Part B payment 
policy. The specific policy changes concerned: The Medicare Economic 
Index; practice expense for professional component services; definition 
of diabetes for diabetes self-management training; supplemental survey 
data for practice expense; geographic practice cost indices; and 
several coding issues. In addition, this rule updated the codes subject 
to the physician self-referral prohibition. We also made revisions to 
the sustainable growth rate, the anesthesia conversion factor and 
finalized the CY 2003 interim RVUs and issued interim RVUs for new and 
revised procedure codes for CY 2004.
    As required by the statute, we announced that the physician fee 
schedule update for CY 2004 would be -4.5 percent; the initial estimate 
of the sustainable growth rate for CY 2004 was 7.4 percent; and the 
conversion factor for CY 2004 was $35.1339.
    Subsequent to the November 7, 2003 final rule, the Congress enacted 
the MMA (Pub. L. 108-17). On January 7, 2004, an interim final rule was 
published to implement provisions of the MMA applicable in 2004 to 
Medicare payment for covered drugs and physician fee schedule services. 
These provisions included--
     Revising the current payment methodology for Part B 
covered drugs and biologicals that are not paid on a cost or 
prospective payment basis;
     Making changes to Medicare payment for furnishing or 
administering drugs and biologicals;
     Revising the geographic practice cost indices;
     Changing the physician fee schedule conversion factor. The 
2004 physician fee schedule conversion factor is $37.3374; and
     Extending the ``opt-out'' provisions of section 
1802(b)(5)(3) of the Act to dentists, podiatrists, and optometrists.
    The information contained in the January 7, 2004 interim final rule 
concerning payment under the physician fee schedule superceded 
information contained in the November 7, 2003 final rule to the extent 
that the two are inconsistent.

II. Provisions of the Proposed Rule

    This proposed rule would affect the regulations set forth at Part 
405, Federal Health Insurance for the Aged and Disabled; Part 410, 
Supplementary Medical Insurance (SMI) Benefits; Part 411, Exclusions 
from Medicare and Limitations on Medicare Payment; Part 414, Payment 
for Part B Medical and Other Health Services; Part 418, Hospice Care; 
Part 424, Conditions for Medicare Payment; Part 484, Home Health 
Services; and Part 486, Conditions for Coverage of Specialized Services 
Furnished by Suppliers.

A. Resource-Based Practice Expense Relative Value Units

[If you choose to comment on issues in this section, please include the 
caption ``Practice Expense'' at the beginning of your comments.]
1. Resource-Based Practice Expense Legislation
    Section 121 of the Social Security Act Amendments of 1994 (Pub. L. 
103-432), enacted on October 31, 1994, amended section 
1848(c)(2)(C)(ii) of the Social Security Act and required us to develop 
a methodology for a resource-based system for determining practice 
expense RVUs for each physician's service beginning in 1998. Until that 
time, physicians' practice expenses were established based on 
historical allowed charges.
    In developing the methodology, we were to consider the staff, 
equipment, and supplies used in providing medical and surgical services 
in various settings. The legislation specifically required that, in 
implementing the new system of practice expense RVUs, we apply the same 
budget-neutrality provisions that we apply to other adjustments under 
the physician fee schedule.
    Section 4505(a) of the Balanced Budget Act of 1997 (BBA) (Pub. L. 
105-33), enacted on August 5, 1997, amended section 1848(c)(2)(C)(ii) 
of the Act and delayed the effective date of the resource-based 
practice expense RVU system until January 1, 1999. In addition, section 
4505(b) of the BBA provided for a 4-year transition period from charge-
based practice expense RVUs to resource-based RVUs.
    Further legislation affecting resource-based practice expense RVUs 
was included in the Medicare, Medicaid and State Child Health Insurance 
Program (SCHIP) Balanced Budget Refinement Act of 1999 (BBRA) (Pub. L. 
106-113)

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enacted on November 29, 1999. Section 212 of the BBRA amended section 
1848(c)(2)(C)(ii) of the Act by directing us to establish a process 
under which we accept and use, to the maximum extent practicable and 
consistent with sound data practices, data collected or developed by 
entities and organizations. These data would supplement the data we 
normally collect in determining the practice expense component of the 
physician fee schedule for payments in CY 2001 and CY 2002. (The 1999 
and 2003 final rules (64 FR 59380 and 68 FR 63196, respectively, 
extended the period during which we would accept supplemental data.)
2. Current Methodology for Computing the Practice Expense Relative 
Value Unit System
    In the November 2, 1998 final rule (63 FR 58910), effective with 
services furnished on or after January 1, 1999, we established at 42 
CFR 414.22(b)(5) a new methodology for computing resource-based 
practice expense RVUs that used the two significant sources of actual 
practice expense data we have available--the Clinical Practice Expert 
Panel (CPEP) data and the American Medical Association's (AMA) 
Socioeconomic Monitoring System (SMS) data. The CPEP data were 
collected from panels of physicians, practice administrators, and 
nonphysicians (for example registered nurses) nominated by physician 
specialty societies and other groups. The CPEP panels identified the 
direct inputs required for each physician service in both the office 
setting and out-of-office setting. The AMA's SMS data provided 
aggregate specialty-specific information on hours worked and practice 
expenses. The methodology was based on an assumption that current 
aggregate specialty practice costs are a reasonable way to establish 
initial estimates of relative resource costs for physicians' services 
across specialties. The methodology allocated these aggregate specialty 
practice costs to specific procedures and, thus, can be seen as a 
``top-down'' approach.
    Also in the November 2, 1998 final rule, in response to comments, 
we discussed the establishment of the Practice Expense Advisory 
Committee (PEAC) of the AMA's Specialty Society Relative Value Update 
Committee (RUC), which would review code-specific CPEP data during the 
refinement period. This committee would include representatives from 
all major specialty societies and would make recommendations to us on 
suggested changes to the CPEP data.
    As directed by the BBRA, we also established a process (see 65 FR 
65380) under which we would accept and use, to the maximum extent 
practicable and consistent with sound data practices, data collected by 
entities and organizations to supplement the data we normally collect 
in determining the practice expense component of the physician fee 
schedule.
a. Major Steps
    A brief discussion of the major steps involved in the determination 
of the practice expense RVUs follows.

(Please see the November 1, 2001 final rule (66 FR 55249) for a more 
detailed explanation of the top-down methodology.)
     Step 1--Determine the specialty specific practice expense 
per hour of physician direct patient care. We used the AMA's SMS survey 
of actual aggregate cost data by specialty to determine the practice 
expenses per hour for each specialty. We calculated the practice 
expenses per hour for the specialty by dividing the aggregate practice 
expenses for the specialty by the total number of hours spent in 
patient care activities.
     Step 2--Create a specialty-specific practice expense pool 
of practice expense costs for treating Medicare patients. To calculate 
the total number of hours spent treating Medicare patients for each 
specialty, we used the physician time assigned to each procedure code 
and the Medicare utilization data. The primary sources for the 
physician time data were surveys submitted to the AMA's RUC and surveys 
done by Harvard for the establishment of the work RVUs. We then 
multiplied the physician time assigned per procedure code by the number 
of times that code was billed by each specialty, and summed the 
products for each code, by specialty, to get the total physician hours 
spent treating Medicare patients for that specialty. We then calculated 
the specialty specific practice expense pools by multiplying the 
specialty practice expenses per hour (from step 1) by the total 
Medicare physician hours for the specialty.
     Step 3--Allocate the specialty specific practice expense 
pool to the specific services (procedure codes) performed by each 
specialty. For each specialty, we divided the practice expense pool 
into two groups based on whether direct or indirect costs were involved 
and used a different allocation basis for each group.
    (i) Direct costs--For direct costs (which include clinical labor, 
medical supplies, and medical equipment), we used the procedure-
specific CPEP data on the staff time, supplies, and equipment as the 
allocation basis. For the separate practice expense pool for services 
without physician work RVUs, we have used, on an interim basis, 1998 
practice expense RVUs to allocate the direct cost pools.
    (ii) Indirect costs--To allocate the cost pools for indirect costs, 
including administrative labor, office expenses, and all other 
expenses, we used the total direct costs, or the 1998 practice expense 
RVUs, in combination with the physician fee schedule work RVUs. We 
converted the work RVUs to dollars using the Medicare CF (expressed in 
1995 dollars for consistency with the SMS survey years).
     Step 4--The direct and indirect costs are then added 
together to attain the practice expense for each procedure, by 
specialty. For procedures performed by more than one specialty, the 
final practice expense allocation was a weighted average of practice 
expense allocations for the specialties that perform the procedure, 
based on the frequency with which each specialty performs the procedure 
on Medicare patients.
b. Other Methodological Issues
i. Nonphysician Work Pool
    As an interim measure, until we could further analyze the effect of 
the top-down methodology on the Medicare payment for services with 
physician work RVUs equal to zero (including the technical components 
of radiology services and other diagnostic tests), we created a 
separate practice expense pool. We first used the average clinical 
staff time from the CPEP data and the ``all physicians'' practice 
expense per hour to create the pool. In the December 2002 final rule, 
we changed this policy and now use the total clinical staff time and 
the weighted average specialty-specific practice expense per hour for 
specialties with services in this pool. In the next step, we used the 
adjusted 1998 practice expense RVUs to allocate this pool to each 
service. Also, for all radiology services that are assigned physician 
work RVUs, we used the adjusted 1998 practice expense RVUs for 
radiology services as an interim measure to allocate the direct 
practice expense cost pool for radiology.
    A specialty society may request that its services be removed from 
the nonphysician workpool. We have removed services from the 
nonphysician work pool if the requesting specialty predominates 
utilization of the service.

[[Page 47492]]

ii. Crosswalks for Specialties Without Practice Expense Survey Data
    Since many specialties identified in our claims data did not 
correspond exactly to the specialties included in the SMS survey data, 
it was necessary to crosswalk these specialties to the most appropriate 
SMS specialty.
iii. Physical Therapy Services
    Because we believe that most physical therapy services furnished in 
physicians' offices are performed by physical therapists, we 
crosswalked all utilization for therapy services in the CPT 97000 
series to the physical and occupational therapy practice expense pool.
3. Practice Expense Proposals for Calendar Year 2005
a. Supplemental Practice Expense Surveys
i. Survey Criteria and Submission Dates
    As required by the BBRA, we established criteria to evaluate survey 
data collected by organizations to supplement the SMS survey data 
normally used in the calculation of the practice expense component of 
the physician fee schedule. By regulation (see 68 FR 63200), we 
provided that, beginning this year, supplemental survey data must be 
submitted by March 1 to be considered for use in computing practice 
expense RVUs for the following year. This allows us to publish our 
decisions regarding survey data in the proposed rule and provides the 
opportunity for public comment on these results before implementation.
    To continue to ensure the maximum opportunity for specialties to 
submit supplemental practice expense data, we extended until 2005 the 
period that we would accept survey data that meet the criteria set 
forth in the November 2000 final rule. We will no longer accept 
supplemental practice expense data after that point. The deadline for 
submission of supplemental data to be considered in CY 2006 is March 1, 
2005.
ii. Survey by the College of American Pathologists (CAP)
    In the June 28, 2002 Federal Register (67 FR 43849), we proposed a 
technical change to the practice expense methodology that calculated 
the technical component as the difference between the global and 
professional component RVUs for services not included in the 
nonphysician work pool. In the December 31, 2002 final rule (67 FR 
79979), we established a 1-year moratorium on the technical change for 
pathology services to allow CAP to do a survey of independent 
laboratories. Consistent with last year's rules, CAP submitted its 
supplemental survey by August 1, 2003 for use in determining the 2004 
practice expense RVUs. Our contractor, The Lewin Group, evaluated the 
data and recommended that we accept the survey to supplement the data 
on PE. However, because we changed the survey deadline to March 1, CAP 
requested that we delay incorporation of the survey data until this 
year's proposed rule. CAP also requested that we extend the moratorium 
on calculating the technical component as the difference between the 
global and professional component RVUs for pathology services for one 
additional year to allow us to evaluate in a proposed rule the combined 
effects of the use of the new survey data along with other proposed 
technical changes. In the November 7, 2003 final rule, in response to 
the CAP comment, we agreed to extend the moratorium by an additional 
year. In this proposed rule, we propose to incorporate the CAP survey 
data into the practice expense methodology and to end the moratorium on 
calculating the technical component as the difference between the 
global and professional component RVUs for pathology services. We 
propose to use the following practice expense per hour figures for 
specialty 69--Independent Laboratory.

                                  Table 1.--Practice Expense Per Hour Figures for Specialty 69--Independent Laboratory
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                          Clinical                     Office        Medical       Medical
                       Specialty                            staff     Admin. staff     expense      supplies      equipment       Other         Total
--------------------------------------------------------------------------------------------------------------------------------------------------------
Independent Laboratory................................        $39.7         $37.5         $40.1         $19.3         $11.1         $16.1        $163.8
--------------------------------------------------------------------------------------------------------------------------------------------------------

iii. Submission of Supplemental Surveys
    We received surveys from the American College of Cardiology (ACC), 
the American College of Radiology (ACR), and the American Society for 
Therapeutic Radiation Oncology (ASTRO). Our contractor, The Lewin 
Group, evaluated the data and made recommendations to us regarding use 
of the data in a report on May 26, 2004. We have made The Lewin Group 
report available on the CMS Web site at http://www.cms.hhs.gov/physicians/pfs/ pfs/. The Lewin Group is recommending that we accept the 
data from ACC and ACR but indicated that the survey from ASTRO does not 
meet the precision criteria we have established for supplemental 
surveys. As a result, The Lewin Group is not recommending that we use 
the ASTRO survey results at this time. We agree with this 
recommendation and are proposing not using the ASTRO survey data at 
this time.
    Many of the procedures that are performed by radiology, cardiology, 
and radiation oncology are affected by the nonphysician work pool 
calculations. We created the nonphysician work pool as an interim 
measure because of a concern that the top-down methodology was having a 
large adverse impact on payment for services that do not have physician 
work RVUs. As we stated in the December 31, 2002 final rule (67 FR 
79979), we believe a relatively low practice expense per hour explains 
the adverse impact on diagnostic and other services that would occur 
from eliminating the nonphysician work pool. The ACR, ACC, and ASTRO 
began undertaking surveys in 2003 following our analysis of options for 
eliminating the nonphysician work pool in the December 31, 2002 final 
rule. CMS' interest is in using the supplemental survey data to 
eliminate the nonphysician work pool and use a single methodology to 
establish payments for all physician fee schedule services.
    We appreciate the efforts of these three specialties to undertake 
surveys and assist CMS in finding a permanent resolution of issues 
related to the nonphysician work pool. While the radiology survey data 
do meet the criteria we have established for use of supplemental 
surveys, the ACR has written to us asking that we not use the data 
until we have a stable and global solution that is workable for all 
specialties that are currently paid using the nonphysician work pool. 
The ACC also requested that we use the supplemental survey for services 
that are in the cardiology pool. However, ACC also indicated if CMS 
determines that it would only be appropriate to use the survey data if 
cardiology services are removed from the nonphysician work pool or if 
the nonphysician work pool

[[Page 47493]]

is eliminated, we should delay using the data until the issues involved 
can be discussed further.
    At this time, we are not proposing to eliminate the nonphysician 
work pool or to remove selected radiology and cardiology codes from it. 
Since our interest is in using supplemental data in conjunction with 
pricing all services under the top-down methodology, we agree with the 
request from ACR to delay use of its supplemental survey until issues 
related to the nonphysician work pool can be addressed. Furthermore, we 
believe the high practice expense per hour for cardiology from the 
supplemental survey results from the inclusion of practices that do 
very high cost office-based cardiology services. Because the RVUs for 
these office-based cardiology services are currently determined using 
the nonphysician work pool methodology, we believe the ACC supplemental 
survey data should only be used in conjunction with removing cardiology 
services from the nonphysician work pool. For this reason, we are also 
delaying use of the ACC survey data as we continue to analyze 
elimination of the nonphysician work pool in conjunction with using 
supplemental survey data. As we complete our analysis, we look forward 
to working with the medical community to find a permanent resolution of 
this issue.
b. Practice Expense Advisory Committee (PEAC) Recommendations on CPEP 
Inputs for 2005
    Since 1999, the PEAC, an advisory committee of the RUC, has been 
providing us with recommendations for refining the direct practice 
expense inputs (clinical staff, supplies, and equipment) for existing 
CPT codes. As we did last year, we are including our proposals 
regarding the PEAC recommendations in the proposed rule, to enable 
specialty groups to assess the impact of the proposed changes on their 
services and to make comments on them before the final rule.
    These PEAC recommendations are the result of meetings held in March 
and August 2003 and January and March 2004, and account for over 2,200 
codes from many specialties. (A list of these codes can be found in 
Addendum C.)
    The PEAC held its last meeting in March 2004, and these are the 
last recommendations we will be receiving from the committee. The AMA 
established the PEAC to assist the RUC in refining the direct input 
data used in calculating the practice expense RVUs for established 
codes. Since its inception, the PEAC has provided recommendations on 
over 7,600 codes, which leaves only a few hundred physician fee 
schedule codes that we believe are still unrefined. The PEAC has also 
recommended standard times for many clinical staff activities and has 
established several supply and equipment packages that can be applied 
across wide ranges of codes. This has helped us ensure that the CPEP 
inputs have been assigned equitably across procedures performed by 
different specialties. The work of the PEAC has, therefore, contributed 
greatly to the refinement of the practice expense inputs, and we 
appreciate the 5 years of hard work by the specialty societies and the 
AMA that helped make the PEAC so successful. Future practice expense 
issues, including the refinement of the remaining codes not addressed 
by the PEAC, will be handled by the RUC. We anticipate the RUC will 
formulate the specific process at a future meeting, possibly as soon as 
October 2004. If possible, additional information on this process will 
be included in the final fee schedule rule.
    We have reviewed the PEAC-submitted recommendations and propose to 
adopt nearly all of them. We have worked with the PEAC staff to correct 
any typographical errors and to make certain that the recommendations 
are in line with previously accepted standards. In addition, in order 
to prevent rank order anomalies, we reviewed those codes that are 
currently unrefined or that were refined early in the PEAC process to 
apply some of the major PEAC-agreed standards. For the unrefined 10-day 
global services, we are proposing to substitute for the original CPEP 
times the PEAC-agreed standard post-service office visit clinical staff 
times used for all 90-day and refined 10-day global services. We also 
are proposing to eliminate the discharge management clinical staff time 
from all but the 10 and 90-day global codes, substituting one post-
service phone call if not already in the earlier data. Lastly, we are 
proposing to delete any extra clinical staff time for post-visit phone 
calls because that time is already included in the time allotted for 
the visits.
    The complete PEAC recommendations and the revised practice expense 
database can be found on our web site. (See the ``Supplementary 
Information'' section of this proposed rule for directions on accessing 
our website.)
    We disagree with the PEAC recommendation for clinical labor time 
for CPT 99183, Hyperbaric oxygen (HBO) therapy. During last year's 
rulemaking, we assigned, on an interim basis, 135 minutes of total 
clinical labor. The PEAC however, recommended 42 minutes of total 
clinical labor time, which allows for 20 minutes for the HBO chamber 
treatment (intra) time. We believe that 90 minutes is a more 
appropriate estimation of the clinical staff time actually needed for 
the intra time because, according to our data, a typical HBO treatment 
session billed under the outpatient prospective payment system is 90 
minutes and the clinical staff is in constant attendance. Therefore, we 
are proposing a total clinical labor time of 112 minutes for this 
service.
    The PEAC recommendations for CPT codes 91011 and 91052 included a 
supply input for methacholine chloride as the injected stimulant for 
these two services. In discussions with representatives from the 
gastroenterology specialty subsequent to receipt of the PEAC 
recommendations, we learned this is incorrect, since an injected form 
of methacholine chloride is not currently available. For CPT 91011, 
esophageal motility study, we are proposing to include edrophonium, 1 
ml, as the drug typically used in this procedure. For CPT 91052, 
gastric analysis study, we were unable to identify the single drug that 
is most typically used with this procedure. We have added the 
edrophonium to the list of supplies where we need information from the 
specialty in order to price appropriately (see Table 3). We are also 
requesting that commenters, particularly the specialty organizations, 
provide us with information on the drug that is most typically used for 
CPT 91052, including drug dosage and price, so that it can be included 
in the practice expense database.
    In last year's final rule, we indicated that we would not go 
forward with the 2003 PEAC recommendations on eight E/M codes for 
nursing home services, CPT codes 99301 through 99316 and on two E/M 
codes for home visits, CPT codes 99348 and 99350, to allow the PEAC to 
reconsider the clinical staff time for these codes based on the 
specific input from the representatives of the nursing home and home 
visit specialties. This year's PEAC recommendations for the E/M nursing 
home services included the views of the long-term care physicians and 
represent an overall decrease in clinical labor inputs for these codes. 
However, the home care physicians subsequently withdrew these codes 
from further PEAC consideration, which leaves the 2003 PEAC 
recommendation for these services unchanged. Therefore, we are 
proposing to adopt the direct practice expense input recommendations 
from

[[Page 47494]]

the March 2003 PEAC meeting for CPT codes 99348 and 99350.
c. Repricing of Clinical Practice Expense Inputs--Equipment
    We use the practice expense inputs (the clinical staff, supplies, 
and equipment assigned to each procedure) to allocate the specialty-
specific practice expense cost pools to the procedures performed by 
each specialty. The costs of the original equipment inputs assigned by 
the CPEP panels were determined in 1997 by our contractor, Abt 
Associates, based primarily on list prices from equipment suppliers. 
Subsequent to the CPEP panels, equipment has also been added to the 
CPEP data, with the costs of the inputs provided by the relevant 
specialty society. We only include equipment with costs equal to or 
exceeding $500 in our practice expense database because the cost per 
use for equipment costing less than $500 would be negligible. We also 
considered the useful life of the equipment in establishing an 
equipment cost per minute of use. This was discussed in our proposed 
rule published June 18, 1997 (62 FR 33164). The primary source of this 
information was the ``Estimated Useful Lives of Depreciable Hospital 
Assets'' (1993 edition) from the American Hospital Association (AHA).
    We proposed updates and revisions to the clinical staff salary data 
and supply inputs and finalized these in the rules published November 
1, 2001 (66 FR 55255) and November 7, 2003 (68 FR 63196), respectively. 
We also indicated that, in future rulemaking, we would be proposing 
updates to the equipment inputs that are used in the CPEP database.
    We contracted with a consultant to assist us in obtaining the 
current price for each equipment item in our CPEP database. The 
consultant has been able to determine the current prices for most of 
the equipment inputs and, to ensure that accurate information was 
obtained, has submitted documentation from vendor catalogs or websites 
for nearly 600 equipment items.
    Our contractor also clarified the specific composition of each of 
the various packaged and standardized rooms or ophthalmology ``lanes'' 
currently identified in the equipment practice expense database (for 
example, ``mammography room'' or ``exam lane''). We are proposing to 
delete the current ``room'' designation for the radiopharmaceutical 
receiving area and, in its place, list separately the equipment 
necessary for each procedure as individual line items because there 
does not appear to be a standard configuration for such a room across 
the nuclear medicine codes.
    Although individual equipment items valued under $500 are not 
included in the equipment database, we do include instrument packs or 
surgical trays that are maintained, stored, and used as a unit, where 
the aggregate cost of individual items equals or exceeds $500. We have 
adopted the PEAC recommendation based on consensus among specialties to 
establish two generic instrument packages rather than list a myriad of 
different packages for each specialty. The basic instrument pack, 
assigned a value of $500, includes instrument aggregate costs ranging 
from $500 to $1,499. The medium pack was assigned $1,500, for 
instrument packages priced at or above $1,500. We are proposing to 
replace all surgical packs and trays in the practice expense database 
with the appropriate standardized packs described above.
    Our consultant worked closely with the specialty societies to 
obtain accurate information to identify equipment and applicable 
prices. The useful life for each equipment item has also been reviewed 
and updated as necessary. This update is primarily based on the AHA's 
``Estimated Useful Lives of Depreciable Hospital Assets'' (1998 
edition) by direct association with a listed item in the publication or 
by crosswalking from a reasonably similar item. We understand that AHA 
will publish updated guidelines this summer, and we plan to reflect any 
updates in our final rule.
    Addendum D lists the proposed new prices for equipment items, 
instrument packs, and rooms/lanes, as well as new descriptions when 
needed. A more detailed spreadsheet can be found on our website, http://www.cms.hhs.gov/physicians/pfs. This spreadsheet contains additional 
information regarding the sources used to price each equipment item.
    Additionally, there are specific equipment items for which a source 
has not yet been identified or for which pricing information has not 
yet been found and documented. These are included in Table 2 below. In 
this table, we have identified the equipment code (if assigned), the 
existing description for the equipment item and current price, the 
procedures or specialties associated with the item, as well as the 
proposed new description and standardized life for the equipment's use, 
where this could be identified. We have also identified equipment for 
deletion from the database, such as equipment items less than $500 and 
items that have become obsolete. We are requesting that commenters, 
particularly the relevant specialty groups, provide us with the needed 
pricing information, including appropriate documentation. Whenever 
possible, commenters should provide multiple sources of documentation 
so that a typical price can be determined. If we are not able to obtain 
any verified pricing information for an item, we may eliminate it from 
the database.

              Table 2.--Equipment Items Needing Specialty Input for Pricing and Proposed Deletions
----------------------------------------------------------------------------------------------------------------
                                                              Primary
                                                            specialties        *CPT code(s)
        Code          2005 description        Price       associated with    associated with     Status of item
                                                                item               item
----------------------------------------------------------------------------------------------------------------
                     Ambulatory blood          3,000.00  Cardiology.......  93784, 93786,      See Note A.
                      pressure monitor.                                      93788.
                     Biofeedback         ..............  Psychology.......  90875............  See Note A.
                      equipment.
                     CAD processor unit      210,000.00  Radiology........  76082, 76083,      See Note A (Need
                      (mammography).                                         76085.             system
                                                                                                components).
E53005.............  Camera system,          675,000.00  Anesthesia, IM,    78414............  See Note A.
                      cardiac, nuclear.                   cardiology.
E53026.............  Collimator,              29,990.00  Radiology........  78206, 78607,      See Note A.
                      cardiofocal set.                                       78647, 78803,
                                                                             78807.
E71013.............  Computer and VDT          9,000.00  Ophthalmology,     92060, 92065.....  See Notes A and
                      and software.                       optometry.                            C.
                     Computer software,       60,000.00  Radiation          77301............  See Note A.
                      MR/PET/CT fusion.                   oncology.
E51022.............  Computer system,         60,000.00  Radiation          77418............  See Note A.
                      record and verify.                  oncology.

[[Page 47495]]

 
E51050.............  Computer                221,500.00  Radiation          77300, 77305,      See Note A.
                      workstation, 3D                     oncology.          77310, 77315,
                      teletherapy                                            77321, 77331.
                      treatment
                      planning.
                     Computer            ..............  Radiology........  71555, 72159,      See Note A.
                      workstation, MRA                                       72198, 73225,
                      post processing.                                       73725, 74185.
                     Computer, server..  ..............  Radiation          77301............  See Note A. (Need
                                                          oncology.                             system
                                                                                                components).
                     Cortical bipolar-   ..............  Neurosurgery,      95961, 95962.....  See Note A.
                      biphasic                            neurology.
                      stimulating
                      equipment.
                     CPAP/BiPAP remote   ..............  Pulmonary          95811............  See Note A.
                      clinical unit.                      disease,
                                                          neurology.
                     Cryo-thermal unit.  ..............  Anesthesia.......  64620............  See Notes A and
                                                                                                C.
E53034.............  Densitometry unit,       65,000.00  Radiology........  78351............  See Notes A and
                      whole body, DPA.                                                          C.
E53032.............  Densitometry unit,       22,500.00  Radiology........  78350............  See Notes A and
                      whole body, SPA.                                                          C.
E53036.............  Detector (Probe)..       14,000.00  Radiology,         78455............  See Notes A and
                                                          cardiology.                           C.
                     Dialysis access          10,000.00  Nephrology.......  90940............  See Note A.
                      flow monitor.
                     Diathermy,          ..............  Anesthesia, GP,    97020............  See Notes A and
                      microwave.                          podiatry.                             C.
                     DNA image analyzer      200,000.00  Lab, pathology...  88358, 88361.....  See Note A.
                      (ACIS).
                     Drill,              ..............  Ophthalmology....  65125............  See Note A.
                      ophthalmology.
E55035.............  ECG signal                8,250.00  Cardiology, IM...  93278............  See Note A.
                      averaging system.
                     EEG monitor,        ..............  95953............  Neurology........  See Note A.
                      digital, portable.
E54008.............  EEG recorder,             6,940.00  Neurology........  95950............  See Note A.
                      ambulatory.
E54009.............  EEG review               44,950.00  Neurology........  95950............  See Note A.
                      station,
                      ambulatory.
                     Electroconvulsive   ..............  Psychiatry.......  90870............  See Note A.
                      therapy machine.
                     Electromagnetic          25,000.00  Physical therapy.  G0329............  See Note A.
                      therapy machine.
E54012.............  EMG botox.........        1,500.00  Critical care,     92265............  See Note A.
                                                          pulmonary,
                                                          ophthalmology.
E52002.............  Fetal monitor            35,000.00  Ob-gyn, radiology  76818, 76819.....  See Note A.
                      software.
                     Film alternator          27,500.00  Radiology........  329 codes........  See Note B.
                      (motorized film
                      viewbox).
                     Generator,                  950.00  Neurology, NP....  95923............  See Note A.
                      constant current.
E51072.............  HDR Afterload           375,000.00  Radiation          77781-84.........  See Note A.
                      System,                             oncology.
                      Nucletron--Oldelf
                      t.
                     Hyperbaric chamber      125,000.00  FP, IM, EM.......  99183............  See Note A.
                     Hyperthermia            360,000.00  Radiation          77600............  See Note A.
                      system,                             oncology.
                      ultrasound,
                      external.
                     Hyperthermia            250,000.00  Radiation          77620............  See Note A.
                      system,                             oncology.
                      ultrasound,
                      intracavitary.
                     Hysteroscopy             19,500.00  Ob-gyn...........  58563............  See Note A.
                      ablation system.
E13652.............  image analyzer           92,000.00  Pathology,         88355, 88356.....  See Note A.
                      (CAS system).                       neurology.
                     IMRT physics tools       55,485.00  Radiation          77301, 77418.....  See Note A.
                                                          oncology.
E91008.............  IVAC Injection            2,500.00  Radiology........  78206, 78607,      See Note A.
                      Automatic Pump.                                        78647, 78803,
                                                                             78807.
                     Mammography         ..............  Radiology........  76090, 76091,      See Note A.
                      reporting                                              76092.
                      software.
E12002.............  Neurobehavioral             717.00  Psychology, IM...  96115, 96117.....  See Note A.
                      status instrument-
                      average.
                     Orthovoltage            140,000.00  Radiation          77401............  See Note A.
                      radiotherapy                        oncology.
                      system.
                     OSHA ventilated           5,000.00  Radiation          77334............  See Note B.
                      hood.                               oncology.
E91011.............  Plasma pheresis          37,900.00  Radiology,         36481, 36510,      See Note A.
                      machine w/UV                        dermatology.       36522.
                      light source.
E55013.............  Programmer,              10,000.00  Cardiology,        33200-01, 33206-   See Note A.
                      pacemaker.                          cardiothoracic     08, 33212-18,
                                                          surgery, general   33220, 33222,
                                                          surgery.           33240, 33245-46,
                                                                             33249, 33282.

[[Page 47496]]

 
                     Pulse oxymetry            3,660.00  Pulmonary          94762............  See Note A.
                      recording                           disease, IM.
                      software
                      (prolonged
                      monitoring).
                     Radiation               550,670.00  Radiation          774XX............  See Note B.
                      treatment vault.                    oncology.
                     Radiation virtual   ..............  Radiation          77280, 77285,      See Note A.
                      simulation system.                  oncology.          77290, 77402-16.
                     Remote monitoring         9,500.00  Neurology........  95955............  See Note A.
                      service
                      (neurodiagnostics
                      ).
E54010.............  Review master.....       23,500.00  Pulmonary          95805, 95807-11,   See Note A.
                                                          disease,           95816, 95822,
                                                          neurology.         95955-56.
E51004.............  Room, basic             150,000.00  Radiology........  103 codes........  See Note A.
                      radiology.
E51016.............  Room, mammography.      130,000.00  Radiology........  19030, 19290-91,   See Note A.
                                                                             19295, 76086-92,
                                                                             76096.
E51005.............  Room, radiographic-     475,000.00  .................  123 codes........  See Note A.
                      fluoroscopic.
                     Source, 10 Ci Ir         22,000.00  Radiation          77781-84.........  See Note A.
                      192.                                oncology.
                     Strontium-90              8,599.00  Radiation          77789............  See Note A.
                      applicator.                         oncology.
                     Table, cystoscopy.  ..............  urology..........  52204-24, 52265-   See Note A.
                                                                             75 52310-17,
                                                                             52327-32.
E52001.............  Ultrasound color        155,000.00  Ob-gyn...........  59070, 59074,      See Note A.
                      doppler,                                               76818-19.
                      transducers and
                      vaginal probe.
E52007.............  Ultrasound,              29,900.00  Ob-gyn,            76825-28, 93303-   See Note A.
                      echocardiography                    cardiology,        12, 93314,
                      digital                             pediatrics.        93320, 93325,
                      acquisition (Novo                                      93350.
                      Microsonics,
                      TomTec).
                     Vacuum cart.......  ..............  Anesthesia.......  64620............  See Notes A and
                                                                                                C.
E13635.............  Video camera......        1,000.00  Radiation          77418............  See Note A.
                                                          oncology.
                     Water chiller            28,000.00  Radiation          77402-16.........  See Note B.
                      (radiation                          oncology.
                      treatment).
E51076.............  Well counter......  ..............  Radiology........  78160-72, 78282..  See Note A.
----------------------------------------------------------------------------------------------------------------
*CPT codes and descriptions only are copyright 2004 American Medical Association. All Rights Reserved.
  Applicable FARS/DFARS apply.
Notes:
A. Additional information required. Need detailed description (including system components as specified),
  source, and current pricing information.
B. Proposed deletion as indirect expense.
C. Item may no longer be available.

    In addition to reviewing and updating the cost information for 
equipment items in the database, our contractor also recommended the 
following revisions to provide uniformity and consistency in the CPEP 
equipment database. All of the following recommendations are noted in 
Addendum D:
    Assignment of equipment categories. In the original CPEP data, a 
number was assigned to each item of equipment. The contractor has 
recommended that each equipment item also be assigned a ``category'' to 
allow for easier identification and sorting of items. We agree and are 
proposing that equipment be assigned to one of the following six 
categories: documentation, laboratory, scopes, radiology, furniture, 
rooms-lanes, and other equipment.
    These categories could also be used to establish a new numbering 
system for equipment that would more clearly identify them for practice 
expense purposes. We would assign a letter to each category and use 
this in conjunction with a number (000 through 999) to identify each 
item of equipment. This would enable specialty groups to identify more 
easily whether an item of equipment has already been included in the 
practice expense database and would help avoid duplication of 
references to the same item of equipment under different descriptions. 
If we proceed in the final rule with this proposed method for 
categorizing equipment, we will assign new identifying numbers to each 
equipment input item and these will be available on our website.
    Consolidation/standardization of item descriptions.
    When items appear to be duplicative, we are proposing to combine 
the items. For example, for two cervical endoscopy procedures, our 
contractor identified that the price of the LEEP system includes a 
smoke evacuation system but that system is also listed separately. We 
propose to merge these two line items and reflect both prices in the 
price of the LEEP system. All proposed changes are specifically 
referenced in Addendum D.
    We welcome any comments on the proposed pricing and all other 
proposed revisions. To help us evaluate the information provided, 
comments should include documentation from more than one source, where 
available, such as information from a vendor catalog or website or from 
a current invoice.
d. Miscellaneous Practice Expense Issues
i. Pricing for Seldinger Needle
    We received comments from a specialty organization on our November 
7, 2003 rule stating that the $72.90 price assigned to the Seldinger 
needle, which is used in certain radiological procedures, is too high. 
The organization estimated that the cost is actually closer to $7.00; 
however, documentation was not provided to

[[Page 47497]]

support this price estimate. Our contractor was able to confirm pricing 
information from two sources, including a price of $3.50 from a 
hospital supplier and a price of $6.85 from a cardiology supplier. 
Based on this pricing variability, we are proposing to average the two 
prices of this supply item to reflect a cost of $5.175. If a commenter 
disagrees with this proposed change in price, the comment should 
provide documentation to support the recommended price, as well as the 
specific type of needle that is most commonly used.
ii. Hysteroscopic Endometrial Ablation
    We received requests from a manufacturer and physicians to price 
CPT code 56853, Hysteroscopy with endometrial ablation, in the office 
setting so that physicians providing this service in the nonfacility 
setting could receive an appropriate payment. (This service is 
currently valued only in the facility setting.) We have worked with the 
specialty society, the American College of Obstetricians and 
Gynecologists, to identify the required resources based on the typical 
practice. We propose to assign on an interim basis, the following 
direct practice expense inputs in the nonfacility setting for this 
service.
     Clinical Staff: RN/LPN/MTA--72 minutes (18 pre-service and 
54 service)
     Supplies: PEAC multispecialty visit supply package, Post-
op incision care kit, pelvic exam package, irrigation tubing, sterile 
impervious gown, surgical cap, shoe cover, surgical mask with face 
shield, 3x3 sterile gauze (20), cotton tip applicator, cotton balls 
(4), irrigation 0.9 percent sodium chloride 500-1000ml(3), maxi-pad, 
mini-pad, 3-pack betadine swab (4), Monsel's solution (10ml), lidocaine 
jelly (1000ml), disposable speculum, spinal needle, 18-24g needle, 20 
ml syringe, bupivicaine 0.25 percent (10ml), 1 percent xylocaine 
(20ml), cidex (10ml), Polaroid film-type 667 (2), endosheath, and 
hysteroscopic ablation device kit.
     Equipment: power table, fiberoptic exam light, endoscopic-
rigid hysteroscope, endoscopy video system, and hysteroscopic ablation 
system.
    We will request that the RUC review these inputs along with inputs 
of other codes still in need of refinement. iii. Photopheresis
    We received a request from a supplier to review the direct practice 
expense inputs currently in our database for the photopheresis service, 
CPT code 36522. These inputs are based on the original CPEP panel 
recommendations and the supplier does not believe they are reflective 
of the resources now being used. This service was not reviewed by the 
PEAC during the refinement process, and we agree that the direct inputs 
need to be revised for this service. We propose to assign, on an 
interim basis, the following nonfacility practice expense inputs, and 
we will request that the RUC review them as part of the practice 
expense refinement process.
     Clinical Staff: RN--223 minutes (treatment is for 
approximately 4 hours)
     Supplies: multispecialty visit supply package, 
photopheresis procedural kit, blood filter (filter iv set), IV blood 
administration set, 0.9 percent irrigation sodium chloride 500-1000 ml 
(2), heparin 1,000 units-ml (10), povidone solution-betadine, 
methoxsalen (UVADEX) sterile solution-10 ml vial, 1 percent-2 percent 
lidocaine-xylocaine, paper surgical tape (12), 2x3 underpad (chux), 
nonsterile drapesheet 40 inches x 60 inches, nonsterile Kling bandage, 
bandage strip, 3x3 sterile gauze, 4x4 sterile gauze, alcohol swab pad 
(3), impervious staff gown, 19-25 g butterfly needle, 14-24g 
angiocatheter, 18-27 g needle, 20 ml syringe, 10-12 ml syringe, 1 ml 
syringe, 22-26 g syringe needle-3 ml.
     Equipment: plasma pheresis machine with ultraviolet light 
source, medical recliner.
iv. Pricing of New Supply Items
    As part of last year's rulemaking process, we reviewed and updated 
the prices for supply items in our practice expense database. During 
subsequent meetings of both the PEAC and the RUC, supply items were 
added that were not included in the supply pricing update. The 
following table, Proposed Practice Expense Supply Item Additions for 
2005, lists these additional supply items and the proposed associated 
prices that we will use in the practice expense calculation.

                                           Table 3.--Proposed Practice Expense Supply Item Additions for 2004
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                         * CPT code(s)
         Supply description            Unit price *               Unit                associated with item                 Supply category
--------------------------------------------------------------------------------------------------------------------------------------------------------
Acrylic tray-base material..........           1.775  oz..........................  21421, 21452...........  Lab.
Adapter, luer lock..................           1.249  Item........................  36515..................  Hypodermic, IV.
Adapter, spike (for syringe)........           4.558  Item........................  36515..................  Hypodermic, IV.
Adhesive, conductive (silver,                  3.000  gm..........................  88349..................  Lab.
 liquid).
Adhesive, cyanoacrylate (2ml                  28.988  Item........................  65286..................  Pharmacy, Rx.
 uou).doc.
Airway adapter......................          12.500  Item........................  94770..................  Accessory, Procedure.
Albuterol inhal soln (3ml vial).....           0.436  Item........................  95070..................  Pharmacy, Rx.
Alcohol ethyl 100%..................           0.028  ml..........................  88348..................  Lab.
Applicator, cotton-tipped, sterile,            0.056  Item........................  127 codes..............  Wound Care, Dressings.
 6in.
Applicator, wood, 6.5in.............           0.008  Item........................  99348-49...............  Lab.
Bag system, 1000ml (for angiography            8.925  Item........................  93501, 93505-10........  Accessory, Procedure.
 waste fluids).
Balanced salt soln (BSS) (15ml uou).           1.600  Item........................  59 codes...............  Pharmacy, Rx.
Battery, AA.........................           0.450  Item........................  95250..................  Office Supply, Grocery.
Blade, surgical, super-sharp........           4.167  Item........................  14 codes...............  Cutters, Closures, Cautery.
Blade, urethrotome..................          85.030  Item........................  52270..................  Cutters, Closures, Cautery.
Blood collection tube holder........           0.163  Item........................  78110-11, 78120-22,      Hypodermic, IV.
                                                                                     78130, 78191, 78725.
Blood collection tube needle........           0.142  Item........................  36514-16, 78110-11,      Hypodermic, IV.
                                                                                     78120-22, 78130,
                                                                                     78191, 78725.
Blood pressure recording form,                 0.310  Item........................  93784, 93786, 93788....  Office Supply, Grocery.
 average.
Brush, protected airway specimen....          13.000  Item........................  31623, 31717...........  Accessory, Procedure.
Bur, surgical, sterile (drill)......           4.792  Item........................  28289..................  Accessory, Procedure.
Canned air (Dust-Off)...............           1.021  oz..........................  88348..................  Office Supply, Grocery.
Cannula, anterior chamber, 18-27g...           2.688  Item........................  65815, 66020, 66030,     Accessory, Procedure.
                                                                                     66250.

[[Page 47498]]

 
Catheter percutaneous fastener                12.745  Item........................  32201, 44901, 47525,     Accessory, Procedure.
 (Percu-Stay).                                                                       47530, 48511, 49021,
                                                                                     49041, 49061, 49423,
                                                                                     49424, 50021, 58823.
Catheter, (Glide)...................          62.000  Item........................  36218, 36248...........  Accessory, Procedure.
Catheter, (SIM2F1)..................          17.000  Item........................  36011-15, 36215-17,      Accessory, Procedure.
                                                                                     36245-47.
Catheter, angiographic..............          16.200  Item........................  93508, 93510, 93526....  Hypodermic, IV.
Catheter, balloon inflation device..          24.900  Item........................  35470-76...............  Accessory, Procedure.
Catheter, balloon ureteral (Dowd)...          65.000  Item........................  52330..................  Accessory, Procedure.
Catheter, balloon, low profile PTA..         431.500  Item........................  35470, 35471, 35474....  Accessory, Procedure.
Catheter, balloon, PTA..............         243.500  Item........................  35472-73, 35475-76.....  Accessory, Procedure.
Catheter, curved....................          17.775  Item........................  36218..................  Accessory, Produce.
Catheter, hyperthermia, closed-end..  ..............  Item........................  77600-20...............  Hypodermic, IV.
Catheter, hyperthermia, open-end....  ..............  Item........................  77600..................  Hypodermic, IV.
Catheter, microcatheter (selective           337.880  Item........................  36217, 36247...........  Accessory, Procedure.
 3rd order).
Catheter, Swan Ganz.................          65.000  Item........................  93501, 93526...........  Accessory, Procedure.
Catheter, ureteral, acorn tip.......           9.550  Item........................  52007, 52010, 52327,     Accessory, Procedure.
                                                                                     52330.
Clamp, circumcision.................           7.500  Item........................  54150..................  Cutters, Closures, Cautery.
Collagen, dermal implant (2.5ml uou)         317.000  Item........................  52327, 52330...........  Pharmacy, Rx.
 (Contigen).
Conformer, sterile, acrylic.........          20.000  Item........................  68340..................  Accessory, Procedure.
Contact lens (hard) care kit........           7.950  Item........................  92325-26...............  Pharmacy, NonRx.
Contact lens (hard) extra strength             0.158  ml..........................  92325-26...............  Pharmacy, NonRx.
 cleaning solution.
Contact lends (RGP) polishing soln             0.077  ml..........................  92325..................  Pharmacy, NonRx.
 (Silo2 Care).
Container, 2000ml, transfer pack....           7.120  Item........................  36515..................  Accessory, Procedure.
Container, 600ml, transfer pack.....           3.360  Item........................  36515..................  Accessory Procedure.
Cotton balls, sterile...............           0.022  Item........................  115 codes..............  Wound Care, Dressings.
Cup, sterile, 12-16 oz..............           0.760  Item........................  32201, 44901, 48511,     Lab.
                                                                                     49021, 49041, 49061,
                                                                                     50021, 58823, 93501,
                                                                                     93505, 93508, 93510,
                                                                                     93526.
Cup, sterile, 8 oz..................           0.542  Item........................  32201, 44901, 48511,     Lab.
                                                                                     49021, 49041, 49061,
                                                                                     50021, 58823.
Cuvette, whole blood oximeter.......         115.000  Item........................  93501, 93526...........  Hypodermic, IV.
Diamond knife cleaning rod..........           1.000  Item........................  99348..................  Lab.
Drainage catheter, all purpose......          88.430  Item........................  44901, 47525, 47530,     Accessory, Procedure.
                                                                                     48511, 49021, 49041,
                                                                                     49061, 49423, 50021,
                                                                                     50398, 58823.
Drainage catheter, chest............          88.890  Item........................  32201..................  Accessory, Procedure.
Drainage pouch, nephrostomy-biliary.          13.250  Item........................  32201, 44901, 47525,     Accessory, Procedure.
                                                                                     47530, 48511, 49021,
                                                                                     49041, 49061, 49423,
                                                                                     50021, 50398, 58823.
Drape, sterile, incise, ophthalmic..           4,900  ............................  67025, 67028, 67110,     Gown, Drape.
                                                                                     67120.
Drape, sterile, split-sheet.........          10,243  Item........................  212 codes..............  Gown, Drape.
Drape, sterile, table 44 in x 76 in.           5.250  Item........................  93501-10, 93526........  Gown, Drape.
Electrode, Bugbee...................         115.000  Item........................  52204, 52214, 52224,     Accessory, Procedure.
                                                                                     52265, 52275, 55200,
                                                                                     55250.
Electrode, EEG (single).............           1.638  Item........................  95961, 95816...........  Accessory, Procedure.
Electrode, EGG (single).............           2.917  Item........................  91132, 95925-27, 95930.  Accessory, Procedure.
Endoscopic deflecting brush.........          73.500  Item........................  52007..................  Accessory, Procedure.
Film, x-ray, laser print............           1.437  Item........................  146 codes..............  Office Supply, Grocery.
Floxin 0.3% otic soln...............           2.354  ml..........................  69145, 69620...........  Pharmacy, Rx.
Forceps, endomyocardial biopsy......         250.000  Item........................  93505..................  Accessory, Procedure.
Forceps, Kelly......................           2.335  Item........................  93501-10, 93526........  Accessory, Procedure.
Gas, nitrogen.......................           2.708  cu ft.......................  88348-49...............  Lab.
Glass knife boat....................           0.200  Item........................  88348..................  Lab.
Grid storage box (holds 50 grids)...           3.750  Item........................  88348..................  Lab.
Guidewire bowl w-lid, sterile.......           3.000  Item........................  93501-10, 93526........  Accessory, Procedure.
Guidewire, cerebral (Bentson).......          14.500  Item........................  36011-15, 36215-17,      Accessory, Procedure.
                                                                                     36245-47.
Guidewire, low profile (SpartaCore).         101.250  Item........................  35470-71, 35474........  Accessory, Procedure.
Guidewire, steerable (Hi-Torque)....          90.000  Item........................  35470-76, 37203........  Accessory, Procedure.
Guidewire, steerable (Transcend)....         180.000  Item........................  36217, 32647...........  Accessory, Procedure.
Guidewire, torque...................          41.000  Item........................  35470-76...............  Accessory, Procedure.
Heparin 5,000 units-mi inj..........           0.509  ml..........................  36514-15...............  Pharmacy, Rx.
Hyaluronic acid viscoelastic inj              61.000  Item........................  65286, 65815, 66250....  Pharmacy, Rx.
 (Amvisc, 0.5ml uou.
Hysteroscope ablation device........       1,146.000  Item........................  58563..................  Accessory, Procedure.
Jessner's soln......................           0.240  ml..........................  15788-89, 15792-93.....  Pharmacy, Rx.
Kenalog 40 inj......................           1.830  ml..........................  31830..................  Pharmacy, Rx.

[[Page 47499]]

 
Kit, AccuStick II Introducer system           82.620  Kit.........................  26 codes...............  Kit, Pack, Tray.
 with RO Marker.
Kit, apheresis treatment............         140.000  Kit.........................  36515..................  Kit, Pack, Tray.
Kit, barium enema...................           9.466  Kit.........................  75270, 74283...........  Kit, Pack, Tray.
Kit, BCR/ABL DNA probe..............          42.650  Kit.........................  88365..................  Kit, Pack, Tray.
Kit, slit catheter (for compartment           73.750  Kit.........................  20950..................  Kit, Pack, Tray.
 pressure monitor).
Kit, vasotomy.......................  ..............  Kit.........................  55200, 55250...........  Kit, Pack, Tray.
Lacrimal duct stent-tube set........          74.000  Item........................  68815..................  Accessory, Procedure.
Lead citrate........................           0.510  gm..........................  88348..................  Lab.
Manifold (for angiography)..........           6.682  Item........................  93501, 93508, 93510,     Accessory, procedure.
                                                                                     93526.
Marker, gold, for radiosurgery-               29.667  Item........................  77761-63...............  Accessory, Procedure.
 radiotherapy.
Mask, CPR (RespAide)................          16.950  Item........................  92950..................  Accessory, Procedure.
Methoxsalen, sterile solution                 49.500  ml..........................  36522..................  Pharmacy, Rx.
 (UVADEX), 10ml vial.
Microsponge, cellulose (10 pack uou)           3.620  Item........................  22 codes...............  Wound Care, Dressings.
Mount, carbon spectro-pure (for SEM)           0.500  Item........................  88349..................  Lab.
Nasal tip, olive....................           0.340  Item........................  92512..................  Accessory, Procedure.
Nebulizer medication cup............           0.140  Item........................  95070..................  Accessory, Procedure.
Needle, arterial, percutaneous......           3.150  Item........................  93501, 93505, 93508,     Hypodermic, IV.
                                                                                     93510, 93526.
Needle, bone biopsy.................          65.000  Item........................  20225..................  Hypodermic, IV.
Needle, flexi, hyperthermia.........          12.000  Item........................  77600-20...............  Hypodermic, IV.
Needle, micropigmentation (tattoo)..          12.000  Item........................  11920-21...............  Hypodermic, IV.
Needle, OSHA compliant (SafetyGlide)           0.454  Item........................  37 codes...............  Hypodermic, IV.
Needle, retrobulbar (Atkinson)......           1.825  Item........................  67120, 67141...........  Hypodermic, IV.
Omnipaque 350mg (125ml uou).........          29.530  Item........................  93508, 93510, 93526....  Pharmacy, Rx.
Omnipaque 350mg (50ml uou)..........          12.498  Item........................  42550, 70370...........  Pharmacy, Rx.
Osmometer sample tip and cleaner....           0.534  Item........................  88348..................  Lab.
Osmometer std, 50 mOsm-kg, 2ml amp..          17.000  ml..........................  88348..................  Lab.
Osmometer std, 850 mOsm-kg, 2ml amp.          17.000  ml..........................  88348..................  Lab.
Pack, drapes, ortho, large..........          40.646  Pack........................  102 codes..............  Kit, Pack, Tray.
Pack, drapes, ortho, small..........           1.128  Pack........................  37 codes...............  Kit, Pack, Tray.
Pack, ophthalmology visit (w-                  1.997  Pack........................  65272-73, 65280-85,      Kit, Pack, Tray.
 dilation).                                                                          65290, 65810-015,
                                                                                     65855-60, 66130, 66625-
                                                                                     35, 67031, 68130.
Pack, protective, ortho, large......           9.182  Pack........................  99 codes...............  Kit, Pack, Tray.
Pack, protective, ortho, small......           4.441  Pack........................  38 codes...............  Kit, Pack, Tray.
Paper, weighing (glassine)..........           0.021  Item........................  88348..................  Lab.
Phenol, liquified, USP..............           0.135  ml..........................  15788-93...............  Pharmacy, Rx.
Photo-Flo soln......................           0.021  ml..........................  88348..................  Office Supply, Grocery.
Pipette bulb........................           0.271  Item........................  88348-49...............  Lab.
Pipette 9inch.......................           0.054  Item........................  88348-89...............  Lab.
Plasma antibody adsorption column          1,150.000  Item........................  36515..................  Accessory, Procedure.
 (Prosorba).
Plasma LDL adsorption column               1,300.000  Item........................  36516..................  Accessory, Procedure.
 (Liposorber).
Plasma leukocyte filter.............          49.719  Item........................  36515..................  Accessory, Procedure.
Plasma separator (Liposorber).......         100.000  Item........................  36516..................  Accessory, Procedure.
Plate, surgical, mini-compression, 4         226.000  Item........................  21208..................  Accessory, Procedure.
 hole.
Plate, surgical, mini-i, 16mm.......         147.000  Item........................  21210..................  Accessory, Procedure.
Plate, surgical, reconstruction,             719.000  Item........................  21125-27, 21215........  Accessory, Procedure.
 left, 5 x 16 hole.
Plate, surgical, reconstruction,              50.000  Item........................  21125-27, 21215........  Accessory, Procedure.
 template, 5 x 16 hole.
Plate, surgical, rigid comminuted            389,000  item........................  21461, 21462...........  Accessory, Procedure.
 fracture.
Plate, surgical, rigid comminuted             29.000  Item........................  21461, 21462...........  Accessory, Procedure.
 fracture, template.
Pressure bag........................  ..............  Item........................  93501, 93508-10, 93526.  Hypodermic, IV.
Prosthesis, voice button (Blom-               48.000  Item........................  31611..................  Accessory, Procedure.
 Singer).
Scalpel, safety, surgical, with                2.143  Item........................  54150, 54160, 54162....  Cutters, Closures, Cautery.
 blade (10-20).
Screw, surgical, auto-drive, 2.0mm x          37.000  Item........................  2120...................  Accessory, Procedure.
 4mm.

[[Page 47500]]

 
Screw, surgical, Carroll-Girard, 9cm          92.000  Item........................  21401..................  Accessory, Procedure.
 x 3.75in.
Screw, surgical, lag, 2.4mm x 26mm..          66.000  Item........................  21461-62...............  Accessory, Procedure.
Screw, surgical, locking, 2.4mm x             74.000  Item........................  21127, 21208, 21215....  Accessory, Procedure.
 16mm.
Screw, surgical, self-tapping, 1.5-           27.000  Item........................  21100, 21452...........  Accessory, Procedure.
 2.0 mm.
Screw, surgical, standard, 2.4mm x            42.000  Item........................  21125..................  Accessory, Procedure.
 14mm.
Screw, surgical, standard, 2.7mm x            47.000  Item........................  21125-27, 21208, 21215,  Accessory, Procedure.
 12mm.                                                                               21461-62.
Sea salt............................           0.004  gm..........................  15810-11...............  Office Supply, Grocery.
Sensor, manometry...................          25.000  Item........................  91010-12, 91122........  Accessory, Procedure.
Sheath, peel away...................          68.990  Item........................  47530..................  Accessory, Procedure.
Skin refrigerant-anesthetic spray              5.000  oz..........................  15780-86, 15788-93.....  Pharmacy, Rx.
 (Frigiderm).
Sodium acetate......................           0.064  gm..........................  88348..................  Lab.
Sodium barbital.....................           0.315  gm..........................  88348..................  Lab.
Specimen block storage box..........           0.625  Item........................  88348..................  Lab.
Splint, finger (metal-foam).........           1.655  Item........................  26700-05, 26720-25,      Wound Care, Dressings.
                                                                                     26740-42, 26750-55,
                                                                                     26770-75.
Sucrose, reagent....................           0.037  gm..........................  88348..................  Lab.
Suture device for vessel closure             225.000  Item........................  35470-75...............  Accessory, Procedure.
 (Perclose A-T).
Suture, monocryl, 3-0 to 6-0, p, ps.           9.887  Item........................  15050, 15200, 15220,     Cutters, Closures, Cautery.
                                                                                     15240, 15260.
Suture, nylon, 8-0 to 9-0...........          15.320  Item........................  65270-72, 65275, 65420-  Cutters, Closures, Cautery.
                                                                                     26, 66130, 66250,
                                                                                     68115-30, 68320,
                                                                                     68330, 68340, 68360.
Suture, plain, gut, 2-0 to 6-0......           4.262  Item........................  41872..................  Cutters, Closures, Cautery.
Suture, polyester, 0 to 3-0                    3.895  Item........................  40840-45...............  Cutters, Closures, Cautery.
 (Mersilene).
Suture, vicryl, 7-0.................          21.773  Item........................  67120..................  Cutters, Closures, Cautery.
Syringe 12ml, coronary control......           7.000  Item........................  93508-10, 93526........  Hypodermic, IV.
Syringe filter......................           2.040  Item........................  88348..................  Hypodermic, IV.
Tape, foam, elastic, 2in (Microfoam)           0.003  Inch........................  21120-23, 21315, 21355-  Wound Care, Dressings.
                                                                                     56, 31820-25.
Toluidine Blue O (for microscopy)...           0.580  gm..........................  88348..................  Lab.
Towel clamp, plastic................           0.556  Item........................  93501-10, 93526........  Accessory, Procedure.
Tracheostomy collar-neckband........           3.235  Item........................  31580-84, 31588, 31610.  Wound Care, Dressings.
Tracheostomy dressing...............           3.240  Item........................  31580-84, 31588, 31610.  Wound Care, Dressings.
Tracheostomy tube...................          20.934  Item........................  31370-82, 31580-84,      Accessory, Procedure.
                                                                                     31588, 31610, 31613-
                                                                                     14, 31750, 41140,
                                                                                     41145.
Transducer, pressure monitoring (for           9.520  Item........................  93501, 93508, 93510,     Accessory, Procedure.
 angiography).                                                                       93526.
Tray, bronchogram...................  ..............  Tray........................  31708..................  Kit, Pack, Tray.
Tray, central line dressing change..           2.430  Tray........................  36514-16...............  Kit, Pack, Tray.
Tray, circumcision..................          25.173  Tray........................  54150, 54160-62........  Kit, Pack, Tray.
Tray, surgical skin prep, sterile...           6.765  Tray........................  134 codes..............  Kit, Pack, Tray.
Trichloroacetic acid 90% (sat soln).           0.855  ml..........................  46900..................  Pharmacy, Rx.
Tubing set (Liposorber).............          50.000  Item........................  36516..................  Hypodermic, IV.
Tubing set, blood warmer............           7.396  Item........................  36514-16...............  Hypodermic, IV.
Tubing set, plasma exchange.........         173.333  Item........................  36514..................  Hypodermic, IV.
Tubing set, plasma transfer.........           1.680  Item........................  36515..................  Hypodermic, IV.
Tubing set, Y-type blood recipient..           5.750  Item........................  36515..................  Hypodermic, IV.
Tubing, pressure injection line                3.170  Item........................  93508, 93510, 93526....  Accessory, Procedure.
 (angiography).
Tubing, sterile, connecting (fluid             1.950  Item........................  93510, 93526...........  Accessory, Procedure.
 administration).
Tubing, sterile, non-vented (fluid    ..............  Item........................  93501, 93508, 93510,     Accessory, Procedure.
 administration).                                                                    93526.
Tubing, suction, non-latex (2ft)               7.557  Item........................  99 codes...............  Accessory, Procedure.
 with Frazier tip (1).
Underpad 2ft x 2ft (lab bench)......           0.377  Item........................  88348-49...............  Lab.
Vial, specimen-sample, 4ml..........           0.550  Item........................  88348-49...............  Lab.
Wax sheet...........................           0.285  Item........................  88348..................  Lab.
--------------------------------------------------------------------------------------------------------------------------------------------------------
* CPT codes and descriptions only are copyright.
2004 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply.


[[Page 47501]]

    We have identified certain supply items for which we were unable to 
verify the pricing information (see Table 4, Supply Items Needing 
Specialty Input for Pricing). Therefore, we are requesting commenters, 
particularly specialty organizations, to provide pricing information on 
items in this table along with documentation to support the recommended 
price. In addition, we are seeking information on the specific contents 
of the listed kits, so that we do not duplicate any supply items.

                                               Table 4.--Supply Items Needing Specialty Input for Pricing
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                        Primary specialties      *CPT code(s)
         Code              2005 Description             Unit             Unit price    associated with item  associated with item     Status  of item
--------------------------------------------------------------------------------------------------------------------------------------------------------
SL008.................  Antibodies--detection  Slide.................           30.90  Lab, pathology......  88365...............  See Note A.
                        Blood pressure         Item..................            0.31  Cardiology..........  93784, 93786, 93788.  See Note A.
                         recording form,
                         average.
                        Catheter,              Item..................  ..............  Radiation oncology..  77600-20............  See Note A.
                         hyperthermia, closed-
                         end.
                        Catheter,              Item..................  ..............  Radiation oncology..  77600...............  See Note A.
                         hyperthermia, open-
                         end.
                        Edrophonium..........  ml....................            4.67  Gastroenterology....  91011...............  See Note A
                        Hysteroscope,          Item..................        1,146.00  Ob-gyn..............  58563...............  See Note A
                         ablation device.
                        Kit, BCR/ABL DNA       Kit...................           42.65  Pathology...........  88365...............  See Note A.
                         probe.
SA013.................  Kit, detection.......  Slide.................            8.50  Pathology, neurology  88355, 88356........  See Note A.
SA024.................  Kit, photopheresis     Kit...................          809.00  Dermatology, ob-gyn.  36522...............  See Note A.
                         procedure.
                        Kit, vasotomy........  Kit...................  ..............  Urology.............  55200, 55250........  See Note A.
                        Methoxsalen, sterile   ml....................           49.50  Dermatology,          36522...............  See Note A.
                         solution (UVADEX) 10                                           radiation oncology.
                         ml vial.
                        Pressure bag.........  Item..................  ..............  Cardiology..........  93501, 93508, 93510,  See Note A.
                                                                                                              93526.
SL114.................  Primary antibodies...  Slide.................            3.52  Pathology, neurology  88355, 88356, 88358.  See Note A.
                        Tray, bronchogram....  Tray..................  ..............  Pulmonary disease...  31708...............  See Note A.
                        Tubing, sterile, non-  Item..................  ..............  Cardiology..........  93501, 93508, 93510,  See Note A.
                         vented (fluid                                                                        93526.
                         administration).
--------------------------------------------------------------------------------------------------------------------------------------------------------
*CPT codes and descriptions only are copyright 2004 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply.
Note A. Additional information required. Need detailed description (including kit contents), source, and current pricing information.

v. Addition of Supply Item to CPT 88365, Tissue In Situ Hybridization
    We received a request from a pathology society to add a DNA probe 
to the CPEP database for CPT 88365, tissue in situ hybridization. The 
society specified that 1.5 DNA probes are typically used in this 
service and the cost of one probe is $42.65. Documentation supporting 
this price was also provided. We are proposing to add, on an interim 
basis, this supply to the practice expense database with the 
understanding that the inclusion of the item will be subject to 
forthcoming RUC review.
vi. Ophthalmology Equipment
    In the CPEP equipment data for many of the ophthalmology 
procedures, there is a duplication of time assigned to the screening 
lane and exam lane. In a majority of these identified procedures, the 
same timeframe was assigned to both the screening and exam lanes. While 
some of the procedures had not been refined by the PEAC, others were 
refined early on in the PEAC process before the PEAC agreed to assign 
only one equipment lane to each procedure because a patient can be in 
only one room at a time. In cases where both the screening and exam 
lanes are included, we are proposing to adjust the lane assignment by 
defaulting to the exam lane and, thus, we will delete the screening 
lane from these procedures. For all of the above services where a lane 
change was made, time values were assigned to the exam lane in 
accordance with our established standard procedure. We are asking 
commenters, in particular, organizations representing ophthalmology, to 
review these proposed changes and submit specific comments on the 
appropriateness of the exam lane default.
vii. Other Practice Expense Issues
Parathyroid Imaging, CPT 78070
    We received comments from the RUC and the specialty society 
representing nuclear medicine that the practice expenses for CPT 78070, 
parathyroid imaging, which is valued in the nonphysician work pool, are 
too low. Because this procedure involves multiple imaging sessions, the 
organizations have requested that a different crosswalk of charge-based 
RVUs be used to more appropriately value the practice expenses involved 
with CPT 78070. We agree and are proposing to crosswalk the charge-
based RVUs from CPT 78306, whole body imaging, to this procedure.

B. Geographic Practice Cost Indices (GPCIs)

[If you choose to comment on issues in this section, please include the 
caption ``GPCI'' at the beginning of your comments.]
1. Background
    The Social Security Act (the Act) requires that payments vary among 
physician fee schedule areas according to the extent that resource 
costs vary as measured by the Geographic Practice Cost Indices (GPCIs). 
In general, the fee schedule areas that existed under the prior 
reasonable charge system were retained under the physician fee schedule 
from calendar years 1992 to 1996. We implemented a comprehensive 
revision in the physician fee schedule payment areas (localities) in 
1997, reducing the number of localities from 210 to 89. A detailed 
discussion of physician fee schedule areas can be found in the July 2, 
1996 proposed rule (61 FR 34615) and the November 22, 1996 final rule 
(61 FR 59494).

[[Page 47502]]

    We are required by section 1848(e)(1)(A) of the Act to develop 
separate GPCIs to measure resource cost differences among localities 
compared to the national average for each of the three fee schedule 
components. While requiring that the practice expense and malpractice 
GPCIs reflect the full relative cost differences, section 
1848(e)(1)(A)(iii) of the Act requires that the physician work GPCIs 
reflect only one-quarter of the relative cost differences compared to 
the national average.
    Section 1848(e)(1)(C) of the Act requires us to review and, if 
necessary, to adjust the GPCIs at least every 3 years. This section of 
the Act also requires us to phase-in the adjustment over 2 years and 
implement only one-half of any adjustment if more than 1 year has 
elapsed since the last GPCI revision. The GPCIs were first implemented 
in 1992. The first review and revision was implemented in 1995, the 
second review was implemented in 1998, and the third review was 
implemented in 2001. This constitutes the fourth review of the work and 
practice expense GPCIs.
    The malpractice GPCIs were reviewed and revised as part of the 
November 7, 2003 (68 FR 63196) physician fee schedule final rule. At 
the time of the publication of the November 2003 final rule, the U.S. 
Census data upon which the work and practice expense GPCIs are based 
were not yet available.
    Section 412 of MMA amends section 1848(e)(1) of the Act and 
establishes a floor of 1.0 for the work GPCI for any locality where the 
GPCI would otherwise fall below 1.0. This 1.0 work GPCI floor will be 
used for purposes of payment for services furnished on or after January 
1, 2004 and before January 1, 2007. In addition, section 602 of MMA 
further amended section 1848(e)(1) of the Act for purposes of payment 
for services furnished in Alaska under the physician fee schedule on or 
after January 1, 2004 and before January 1, 2006, and sets the work, 
practice expense, and malpractice expense GPCIs at 1.67 if any GPCI 
would otherwise be less than 1.67.
    Based on these MMA provisions, we revised the addenda published in 
the November 7, 2003 final rule (68 FR 63196) that reflected both the 
transitional 2004 and 2005 malpractice GPCIs, as well as the work and 
practice expense GPCIs that were not updated (Addendum D and Addendum 
E, respectively) in an interim final rule with comment period entitled, 
``Changes to Medicare Payment for Drugs and Physician Fee Schedule 
Payments for Calendar Year 2004,'' published January 7, 2004 (69 FR 
1084). Due to the MMA provisions, no locality in these revised addenda 
has a work GPCI of less than 1.00. Additionally, the work, practice 
expense, and malpractice GPCIs for Alaska are set at 1.67.
    We are proposing to revise the work and practice expense GPCIs 
beginning in 2005 based on updated U.S. Census data and Department of 
Housing and Urban Development fair market rent data.
2. Development of the Geographic Practice Cost Indices
    The GPCIs were developed by a joint effort of the Urban Institute 
and the Center for Health Economics Research under contract to us. 
Indices were developed that measured the relative physician resource 
cost differences among areas compared to the national average in a 
``market basket'' of goods. The market basket consists of the resources 
involved with operating a private medical practice. The resource inputs 
are--
     Physician work or net income (used to construct the 
physician work GPCI);
     Employee wages, office rents, medical equipment, supplies, 
and other miscellaneous expenses used to comprise the practice expense 
GPCI; and
     Professional liability insurance premiums (used to 
construct the malpractice GPCI).
    The resource inputs and their respective weights for the resource 
costs associated with the work, practice expense, and malpractice 
expense associated with providing a physician service, were obtained 
from the 2003 AMA Physician Socioeconomic Characteristics publication 
(2003 Patient Care Physician Survey data) which measures physicians' 
earnings and overall practice expenses for 2000.
    The weights for the 2004 GPCIs, as well as the proposed 2005 
through 2007 GPCI revisions, are from the 2003 AMA survey and were used 
in the Medicare Economic Index (MEI) revision discussed in the November 
2003 physician fee schedule final rule (68 FR 63245). Table 5 below 
shows the weights of the resource inputs, as defined by the MEI, those 
used for the original GPCIs, as well as the weights for the first, 
second, and third GPCI revisions. The MEI weights associated with the 
first and second GPCI updates (1995-2000 GPCIs) were not revised. In 
addition, the MEI weights for the proposed fourth GPCI revision are 
also shown.

                                    Table 5.--Historical View of MEI Weights
----------------------------------------------------------------------------------------------------------------
                                                                      Percentage of practice cost indices
                                                             ---------------------------------------------------
                       Input component                         1992-1994    1995-2000    2001-2003    2004-2006
                                                                 GPCIs        GPCIs        GPCIs         GPCI
----------------------------------------------------------------------------------------------------------------
Physician Work..............................................         54.2         54.2         54.5         52.5
Practice Expense............................................         40.2         41.0         42.3         43.7
Employee Wages..............................................         15.7         16.3         16.8         18.7
Rent........................................................         11.1         10.3         11.6         12.2
Miscellaneous...............................................         13.4         14.4         13.9         12.8
Malpractice.................................................          5.6          4.8          3.2          3.9
    Total...................................................        100.0        100.0        100.0        100.0
----------------------------------------------------------------------------------------------------------------

a. Work Geographic Practice Cost Indices
    As in previous GPCI updates, the median hourly earnings component 
is based on a 20 percent sample of U.S. Census data from workers in 
seven professional occupations. The actual reported earnings of 
physicians were not used to establish the GPCIs because Medicare 
payments (which are based on the GPCIs) are in part determinants of the 
earnings. Including physician wages in the physician work GPCI could, 
in effect, make the index dependent upon Medicare payments. Based upon 
analysis performed by Health Economics Research, we believe that in the 
majority of instances, the earnings of physicians will vary among areas 
to the same degree that the earnings of other professionals vary.

[[Page 47503]]

    Data from the 2000 decennial U.S. Census by county of seven 
professional occupations (architecture and engineering; computer, 
mathematical, and natural sciences; social scientist, social workers, 
lawyers; education, library, training; registered nurses; pharmacists; 
writers, artists, editors) were utilized in the development of the 
proposed work GPCIs.

     Table 6.--Specific Occupation Categories Used in Development of
                           Physician Work GPCI
------------------------------------------------------------------------
                                                             Census 2000
                        Categories                           occupation
                                                                code
------------------------------------------------------------------------
Architecture and Engineering..............................       130-156
Computer, Mathematical, and Natural Sciences..............       100-124
                                                                 160-176
Social Scientists, Social Workers, Lawyers................       180-215
Education, Training, and Library..........................       220-255
Registered Nurses.........................................           313
Pharmacists...............................................           305
Writers, Artists, and Editors.............................       260-296
------------------------------------------------------------------------

    The Census Bureau has very specific criteria that tabulations must 
meet in order to be released to the public. To maximize the accuracy 
and availability of the data collection, the nonphysician professional 
wage data were aggregated into three geographic area categories:
    1. By Individual Counties--The tabulations were requested for each 
county in a Consolidated Metropolitan Statistical Area (CMSA).
    2. By Metropolitan Statistical Area (MSA)--The tabulations were 
requested by MSA for all counties that fall within an MSA.
    3. By Rest of State--The tabulations were requested by rest of 
State for counties that are not in a CMSA or MSA.
    The nonphysician professional wage data were subsequently assigned 
to each respective county within the MSA or Rest of State aggregations 
(or, in the case of CMSAs, the data were already at the county level), 
and a median wage by county was calculated for each occupational 
category. These median wages were then weighted by the total RVUs 
associated with a given county to ultimately arrive at locality-
specific work GPCIs. This geographic aggregation of Census data is the 
same methodology that was utilized in previous updates to the GPCIs.
    The work GPCIs reflect one-fourth of the relative cost differences, 
as required by statute, with the exception of those areas where MMA 
requires that the GPCI be set at no lower than 1.00 and that the Alaska 
GPCIs be set at 1.67.
b. Practice Expense GPCIs
    As in the past, we are proposing that the practice expense GPCI 
would be comprised of several factors that represent the major expenses 
incurred in operating a physician practice. The factors and the data 
sources we propose to use are detailed below. The impact of each 
individual factor on the calculation of the practice expense GPCI is 
based on the relative weight for that factor consistent with the 
calculation of the MEI.
    Employee Wage Indices--The employee wage index is based on special 
tabulations of 2000 census data, which are generated from the Long Form 
Questionnaire. These special tabulations provided by the Census Bureau 
are designed to capture the median wage by county of the professional 
labor force. The Employee Wage Index uses the median wages of four 
labor categories that are most commonly present in a physician's 
private practice (administrative support, registered nurses, licensed 
practical nurses, and health technicians). Median wages for these 
occupations were provided by the U.S. Census Bureau using the same set 
of geographic aggregation rules discussed previously in the physician 
work GPCI section.

   Table 7.--Specific Occupations Used in Creating Employee Wage Index
                                 Update
------------------------------------------------------------------------
               Categories                  Census 2000  occupation code
------------------------------------------------------------------------
Administrative Support.................  500-593
Registered Nurses......................  313
Licensed Practical Nurses..............  350
Health Technicians.....................  330, 332, 341, 351-354, 365
------------------------------------------------------------------------

    Office Rent Indices-- Since no national data are readily available 
for physician office rents, some proxy must be used for this portion of 
the practice expense index. To construct the practice expense GPCIs, we 
need data that are widely and consistently available across all fee 
schedule areas. Although we searched for alternative commercial rental 
data that were both widely and consistently available across all fee 
schedule areas, we were unable to identify any reliable sources of 
commercial rental data.
    As with the current practice expense GPCIs, the Department of 
Housing and Urban Development (HUD) Fair Market Rental (FMR) data for 
the residential rents were again used as the proxy for physician office 
rents. The proposed 2005 through 2007 practice expense GPCIs reflect 
the final fiscal year 2004 HUD FMR data. See Addendum E for a more 
detailed illustration of the actual office rent indices.
    We believe that the FMR data remain the best available source for 
constructing the office rent index. The FMR data are available for all 
areas, are updated annually, and retain consistency from area-to-area 
and from year-to-year. Additionally, physicians frequently locate their 
offices in areas that are residential, rather than commercial, in 
nature. Residential rates may, in fact, be a better measure of the 
differences among areas in the physician office market than a general 
commercial rental index. In developing FMRs for metropolitan areas, HUD 
assumes that all counties within an MSA have the same rent. However, we 
believe that the rents in the New York City MSA vary too widely and 
propose that the FMR for this metropolitan area should be adjusted to 
account for this variation. For the New York City MSA, we used median 
gross rent from the 2000 Census to adjust the individual rents within 
counties in this MSA.
    A reduction in an area's rent index does not necessarily mean that 
rents have gone down in that area since the last GPCI update. Since the 
GPCIs measure area costs compared to the national average, a decrease 
in an area's rent index means that that area's rental costs are lower 
relative to the national average rental costs. Addendum E illustrates 
the changes in the rental index based upon the new FMR data.
    Medical Equipment, Supplies, and other Miscellaneous Expenses--The 
GPCIs assume that items such as medical equipment and supplies have a 
national market and that input prices do not vary among geographic 
areas. We were again unable to find any data sources that demonstrated 
price differences by geographic areas. As mentioned in previous 
updates, some price differences might exist, but these differences are 
more likely to be based on volume discounts rather than on geographic 
areas. The medical equipment, supplies, and miscellaneous expense 
portion of the practice expense geographic index will continue to be 
1.000 for all areas in the proposed GPCIs, except for Alaska which will 
have an overall practice expense GPCI set at 1.67 for 2004 and 2005.
c. Malpractice Expense GPCIs
    The malpractice GPCIs were reviewed and revised as part of the 
November 7, 2003 (68 FR 63196) physician fee schedule final rule. 
Please refer to that

[[Page 47504]]

final rule for a detailed discussion of the update to the malpractice 
GPCIs.
4. Calculation and Effect of the Proposed 2005 Through 2007 Work and 
Practice Expense GPCIs
    All three of the indices for a specific fee schedule locality are 
based on the indices for the individual counties within the respective 
fee schedule localities. As has been done in the past, fee schedule 
RVUs would again be used to weight the county indices (to reflect 
volumes of services within counties) when mapping to fee schedule areas 
and in constructing the national average indices. However, we propose 
to use more recent data, 2002 versus 1998 RVUs, in the county, 
locality, and national mapping in the proposed GPCIs. The payment 
effect associated with the use of these revised RVUs would generally be 
negligible, in most cases resulting in changes at the third decimal 
point, if at all.
    Fee schedule payments are the product of the RVUs, the GPCIs, and 
the conversion factor. Updating the GPCIs changes the relative position 
of fee schedule areas compared to the national average. Since the 
changes represented by the proposed GPCIs could result in total 
payments either greater than or less than what would have been paid if 
the GPCIs were not updated, it would be necessary to apply scaling 
factors to the proposed GPCIs to ensure budget neutrality (prior to 
applying the provisions of MMA that change the work GPCIs to a minimum 
of 1.0 and increase the Alaska GPCIs to 1.67 because these provisions 
are exempted from budget neutrality). We determined that the proposed 
work and practice expense GPCIs would have resulted in slightly higher 
total national payments. Since the law requires that each individual 
component of the fee schedule--work, practice expense, and malpractice 
expense--is separately adjusted by its respective GPCI, we propose to 
scale each of the GPCIs separately. To ensure budget neutrality prior 
to applying the MMA provisions, it would be necessary to--
     Decrease the proposed work GPCI by 0.9965;
     Decrease the proposed practice expense GPCI by 0.9930; and
     Increase the malpractice GPCIs that were published in the 
November 7, 2003 final rule by 1.0021.
    As all geographic payment areas would receive the same percentage 
adjustments, the adjustments do not change the new relative positions 
among areas indicated by the proposed GPCIs. After the appropriate 
scaling factors are applied, the MMA provision setting a 1.0 floor 
would be applied to all work GPCIs falling below 1.0. Additionally, the 
GPCIs for Alaska would all be set to 1.67 in accordance with MMA.
    The locality specific effect of these proposed revisions to the 
work and practice expense GPCIs, as well as the revisions to the 
malpractice GPCIs published in the November 7, 2003 final rule, and the 
MMA provisions enacted December 8, 2003, are shown in Addendum F 
through Addendum H. Addendum F reflects the current GPCIs that were 
effective on January 1, 2004. Addendum F can be utilized as a baseline 
for purposes of comparison to the proposed GPCIs. Addendum H 
illustrates the proposed fully implemented 2006 GPCIs. Addendum G 
illustrates the proposed transitional 2005 GPCIs, which are one-half of 
the effect of the proposed fully implemented GPCI revisions as required 
by section 1848(e)(1)(C) of the Act.
    Because the three GPCIs have different weights, the overall effect 
of the proposed changes cannot be achieved by summing the individual 
effects of the revisions on the work, practice expense, and malpractice 
expense GPCIs. The overall effect of all three revised GPCI components 
on an area can be estimated by a comparison of the area's geographic 
adjustment factors (GAFs). The GAF for a specific payment area is the 
weighted composite of the three separate components. The GAF 
illustrates an estimate of the general effect on total payments across 
a specific fee schedule locality. The effects on individual physicians 
would vary depending on each physician's mix and volume of services.
    To illustrate a comparison of the overall effect of the current and 
proposed GPCIs, Addendum J contains a comparison of the current 2004 
GAFs to the proposed fully-implemented 2006 GAFs. Addendum I contains a 
comparison of the proposed transitional GAFs (2005) to the current 2004 
GAFs. Both Addenda I and J are sorted in descending order of change. As 
Addendum J shows, no fee schedule area would experience a total 
decrease in its respective GAF by more than 3.5 percent, or increase by 
more than 7 percent, if the proposed GPCI revisions are fully 
implemented in 2006. The majority of payment areas would change by 
considerably less than these amounts. Nearly 75 percent of payment 
areas would change by less than 2 percent with the majority of these 
payment areas changing by less than 1 percent. Consequently, as 
illustrated by Addendum I, no fee schedule area would experience a 
total decrease in its respective GAF of more than 1.6 percent, or an 
increase of more than 3.5 percent, in the transition year (2005).
    The GPCIs measure relative cost differences among payment areas 
compared to the national average. The national average cost is 
represented by a value of about 1.000. A proposed GPCI revision showing 
a decrease from the current value does not necessarily mean that 
absolute costs in a payment area have decreased, only that the average 
costs of a payment area have decreased as compared to the national 
average costs.
5. Payment Localities
    In the August 15, 2003 proposed rule, we requested comments on the 
composition of the current 89 Medicare physician payment localities to 
which the GPCIs are applied. In the November 7, 2003 final rule, we 
indicated that we received comments from various parties requesting 
that specific counties be removed from their current locality. We 
further indicated that we are continuing to examine alternatives for 
reconfiguring the current locality structure.
    While we have considered alternatives, we have not yet been able to 
come up with a policy and criteria that would satisfactorily apply to 
all situations. Any policy that we would propose would have to apply to 
all States and payment localities. For example, if we were to establish 
a policy that if adjacent county geographic indices exceeded a 
threshold amount, the lower county could be moved to the higher county 
or a separate locality could be created, that approach would cause 
redistributions within a State.
    Locality changes are budget-neutral with respect to the aggregate 
amount of Medicare money in a State. That is, reconfigurations of 
localities within a State do not result in any more Medicare money for 
the State in the aggregate, but only redistributions of money within a 
State. Since there will be both winners and losers in any locality 
reconfiguration, the State medical associations should be the impetus 
behind these changes. Since 1996, we have moved to Statewide areas in 
several States after receiving resolutions from State medical societies 
including support from physicians in losing areas, and after going 
through Notice and Comment rulemaking. The support of State medical 
associations has been the basis for previous changes to Statewide 
areas, and continues to be equally important in our consideration of 
other future locality changes.

[[Page 47505]]

C. Malpractice Relative Value Units (RVUs)

[If you choose to comment on issues in this section, please include the 
caption ``Malpractice RVUs'' at the beginning of your comments.]
1. History of Relative Value Unit System
    Section 1848(c)(2)(C) of the Act requires that each service paid 
under the physician fee schedule be comprised of three components: 
work, practice expense, and malpractice.
    From 1992 to 1999, malpractice RVUs were charge-based, using 
weighted specialty-specific malpractice expense percentages and 1991 
average allowed charges. Malpractice RVUs for new codes after 1991 were 
extrapolated from similar existing codes or as a percentage of the 
corresponding work RVU. Section 4505(f) of the BBA required us to 
implement resource-based malpractice RVUs for services furnished 
beginning in 2000. With the implementation of resource-based 
malpractice RVUs in 2000 and the full implementation of resource-based 
practice expense RVUs in 2002, all physician fee schedule RVUs were 
resource-based, eliminating the last vestiges of charged-based payment.
2. Proposed Methodology for the Revision of Resource-based Malpractice 
RVUs
    The methodology used in calculating the proposed resource-based 
malpractice RVUs is the same methodology that was used in the initial 
development of resource-based RVUs, the only difference being the use 
of more current data. The proposed resource-based malpractice expense 
RVUs are based upon:
     Actual 2001 and 2002 malpractice premium data;
     Projected 2003 premium data; and
     2002 Medicare payment data on allowed services and 
charges.
    As was done in the initial development of resource-based 
malpractice expense RVUs in the November 2, 1999 final rule, we are 
proposing to revise resource-based malpractice expense RVUs using 
specialty-specific malpractice premium data because they represent the 
actual malpractice expense to the physician. In addition, malpractice 
premium data are widely available. We propose to use actual 2001 and 
2002 malpractice premium data and projected 2003 malpractice premium 
data for three reasons:
     These are the most current data available.
     These data capture the highly publicized and most recent 
trends in the specialty-specific costs of professional liability 
insurance.
     These are the same malpractice premium data that were 
utilized in the development of revised malpractice GPCIs in the 
November 7, 2003 final rule.
    We were unable to obtain a nationally representative sample of 2003 
malpractice premium data for two reasons: (1) The premium data that we 
collected from the private insurance companies had to ``match'' the 
market share data that were provided by the respective State 
Departments of Insurance. Because none of the State Departments of 
Insurance had 2003 market share information at the time of this data 
collection, 2003 premium data were not usable; and (2) the majority of 
private insurers were not amicable to releasing premium data to us. In 
the majority of instances, the private insurance companies would 
release their premium data only to the State Departments of Insurance.
    Discussions with the industry lead us to conclude that the primary 
determinants of malpractice liability costs remain physician specialty, 
level of surgical involvement, and the physician's malpractice history. 
Malpractice premium data were collected for the top 20 Medicare 
physician specialties measured by total payments. Premiums were for a 
$1 million/$3 million mature claims-made policy (a policy covering 
claims made, rather than services provided during the policy term). We 
attempted to collect premium data from all 50 States, Washington, DC, 
and Puerto Rico. Data were collected from commercial and physician-
owned insurers and from joint underwriting associations (JUAs). A JUA 
is a State government-administered risk pooling insurance arrangement 
in areas where commercial insurers have left the market. Adjustments 
were made to reflect mandatory patient compensation funds (PCFs) (funds 
to pay for any claim beyond the statutory amount, thereby limiting an 
individual physician's liability in cases of a large suit) surcharges 
in States where PCF participation is mandatory. The premium data 
collected represent at least 50 percent of physician malpractice 
premiums paid in each State.
    For 2001, we were able to collect premium data from 48 States (for 
purposes of this discussion, State counts include Washington, DC and 
Puerto Rico). We were unable to obtain premium data from Kentucky, New 
Hampshire, New Mexico, and Washington DC. To calculate a proxy for the 
malpractice premium data for these four areas in 2001, we began with 
the most current malpractice premium data collected for these areas, 
1996 through 1998 (the last premium data collection that was 
undertaken). An average premium price was calculated (using 1996 
through 1998 data) for all States except Kentucky, New Hampshire, New 
Mexico, and Washington, DC. Similarly, an average premium price was 
calculated for the 1999 through 2001 period for all States except 
Kentucky, New Hampshire, New Mexico, and Washington, DC. The percentage 
change in these premium prices was calculated as the percent difference 
between the 1999 to 2001 calculated average premium price and the 1996 
to 1998 calculated average premium price. This percentage change was 
then applied to the weighted average 1996 to 1998 malpractice premium 
price for these four areas to arrive at a comparable 1999 to 2001 
average premium price.
    For 2002, we were able to obtain malpractice premium data from 33 
States. Many State Departments of Insurance had not yet obtained 
premium data from the primary insurers within their State at the time 
of this data collection. For those States for which we were unable to 
obtain malpractice premium data, we calculated a national average rate 
of growth for 2002 and applied this national rate of growth to the 
weighted average premium for 2001 to obtain an average premium for 2002 
for each county for which we were unable to obtain malpractice premium 
data for 2002.
    We projected premium values for 2003 based on the average of 
historical year-to-year changes for each locality (when locality level 
data were available) or by State (when only Statewide premium data 
projections were available). First, we calculated the percentage 
changes in the premiums from the 1999 through 2000, 2000 through 2001, 
and 2001 through 2002 periods for each payment locality. Next, we 
calculated the geometric mean of these three percentages and applied 
the mean to the 2002 premium to obtain the forecasted 2003 malpractice 
premium. We used the geometric mean to calculate the forecasted 2003 
premium data because the geometric mean is commonly used to derive the 
mean of a series of values that represent rates of change. Because the 
geometric mean is based on the logarithmic scale, it is less impacted 
by outlying data.
    Malpractice insurers generally use five-digit codes developed by 
the Insurance Services Office (ISO), an advisory body serving property 
and casualty insurers, to classify physician

[[Page 47506]]

specialties into different risk classes for premium rating purposes. 
ISO codes classify physicians not only by specialty, but in many cases 
also by whether or not the specialty performs surgical procedures. A 
given specialty could thus have two ISO codes, one for use in rating a 
member of that specialty who performs surgical procedures and another 
for rating a member who does not perform surgery. Medicare uses its own 
system of specialty classification for payment and data purposes. It 
was therefore necessary to map Medicare specialties to ISO codes and 
insurer risk classes. Different insurers, while using ISO codes, have 
their own risk class categories. To ensure consistency, we used the 
risk classes of St. Paul Companies, one of the oldest and largest 
malpractice insurers. Table 8 crosswalks Medicare specialties to ISO 
codes and to the St. Paul risk classes used.

         Table 8.--Crosswalk of Medicare Specialties to IOS Codes and to the St. Paul Risk Classes Used
----------------------------------------------------------------------------------------------------------------
                                                 ISO code                 Risk class
    Medicare code           Medicare      ----------------------------------------------------     St. Paul's
                           description      Surgery     Other       Surgery         Other         description
----------------------------------------------------------------------------------------------------------------
1....................  General practice..      80117      80420  4              1              Family/Gen.
                                                                                                Practitioners--N
                                                                                                o Obstetrical.
2....................  General surgery...      80143      80143  5              5              Surgery, General.
3....................   Allergy/               80254      80254  1A             1A             Allergy.
                        Immunology.
4....................  Otolaryngology....      80159      80265  3              1              Otarhinolaryngolo
                                                                                                gy.
5....................  Anesthesiology....      80151      80151  5A             5A             Anesthesiology.
6....................  Cardiology........      80281      80255  2              1              Cardiovascular
                                                                                                Disease.
7....................  Dermatology.......      80472      80256  5              1A             Dermatology.
8....................  Family practice...      80117      80420  4              1              Family/Gen.
                                                                                                Practitioners--N
                                                                                                o Obstetrical.
10...................  Gastroenterology..      80104      80241  3              1              Gastroenterology.
11...................  Internal medicine.      80284      80257  2              1              Internal
                                                                                                medicine.
13...................  Neurology.........      80288      80261  2              2              Neurology.
14...................  Neurosurgery......      80152      80152  8              8              Surgery,
                                                                                                Neurology.
16...................  Obstetrics/             80167      80244  4              1              Gynecology.
                        Gynecology.
18...................  Ophthalmology.....      80114      80263  2              1              Ophthalmology.
20...................  Orthopedic surgery      80501      80501  5              5              Surgery,
                                                                                                Orthopedic--excl
                                                                                                uding Spinal
                                                                                                Surgery.
20...................  Orthopedic surgery      80154      80154  6              6              Surgery,
                                                                                                Orthopedic--incl
                                                                                                uding Spinal
                                                                                                Surgery.
22...................  Pathology.........      80292      80266  2              1A             Pathology.
24...................  Plastic and             80156      80156  5              5              Surgery, Plastic.
                        reconstructive
                        surgery.
25...................  Physical medicine       80235      80235  1              1              Physical medicine
                        and rehab.                                                              and rehab.
26...................  Psychiatry*.......     80492,      80249  2              1A             Psychiatry.
                                               80431
28...................  Colorectal surgery      80115      80115  3              3              Surgery, Colon
                                                                                                and Rectal.
29...................  Pulmonary Disease.      80269      80269  1              1              Pulmonary
                                                                                                Disease.
30...................  Diagnostic              80280      80253  2              2              Radiology.
                        radiology **.
33...................  Thoracic surgery..      80144      80144  6              6              Surgery,
                                                                                                Thoracic.
34...................  Urology...........      80145      80145  2              2              Surgery,
                                                                                                Urological.
36...................  Nuclear medicine..      80262      80262  1              1              Nuclear medicine.
37...................  Pediatric medicine      80293      80267  2              1              Pediatrics.
38...................  Geriatric               80276      80243  2              1              Geriatrics.
                        medicine***.
39...................  Nephrology***.....      80287      80260  2              1              Nephrology.
40...................  Hand surgery......      80169      80169  5              5              Surgery, Hand.
44...................  Infectious disease      80279      80246  2              1              Infectious
                                                                                                disease.
46...................  Endocrinology***..      80272      80238  2              1              Endocrinology.
65...................  Physical therapist      80235      80235  1              1              Physical medicine
                        (independent).                                                          and rehab.
66...................  Rheumatology......      80252      80252  1              1              Rheumatology.
67...................  Occupational            80235      80235  1              1              Occupational
                        therapist                                                               Medicine.
                        (independent).
77...................  Vascular surgery..      80146      80146  6              6              Surgery,
                                                                                                Vascular.
78...................  Cardiac surgery...      80141      80141  6              6              Surgery, Cardiac.
82...................  Hematology........      80278      80245  2              1              Hematology.
83...................  Hematology/             80473      80473  1              1              Oncology.
                        oncology.
84...................  Preventive              80231      80231  1              1              General
                        medicine.                                                               Preventive
                                                                                                Medicine.
92...................  Radiation               80425      80425  2              2              Radiation
                        Oncology****.                                                           Therapy.
93...................  Emergency medicine      80157      80102  5              4              Emergency
                                                                                                Medicine.
98...................  Gynecologist/           80167      80244  4              1              Gynecology.
                        oncologist.
----------------------------------------------------------------------------------------------------------------
Note: For specialties with multiple risk classifications depending on the level of surgical involvement, the
  highest level of surgery for each specialty was selected for the ``surgery'' ISO and risk class; and the
  lowest level of surgery was selected for the ``nonsurgery'' ISO and risk class.
Note: If a specialty has only one risk classification, the same classification was used for both surgery and
  nonsurgery.
* The ISO codes for surgery for Psychiatry represents Psychiatry--shock therapy.
** St. Paul's is the only one of the five companies that has a ``major invasive'' procedures ISO Code for
  Radiology; therefore, the ``minor invasive procedures'' ISO Code is being used as the highest level of
  surgery.
*** St. Paul's is the only one of the five companies that has a ``major surgery'' ISO Code for Geriatrics,
  Nephrology, and Endocrinology; therefore, the minor surgery'' ISO Code is being used as the highest level of
  surgery.
**** Medical Protective's Description was used, as St. Paul's does not provide specific medical malpractice
  insurance for Radiation Therapy.


[[Page 47507]]

    Some physician specialties, nonphysician practitioners, and other 
entities (for example, independent diagnostic testing facilities) paid 
under the physician fee schedule could not be assigned an ISO code. We 
crosswalked these specialties to similar physician specialties assigned 
an ISO code and a risk class. The unassigned specialties and the 
specialty to which they were assigned are shown in Table 9.

    Table 9.--Crosswalk of Specialties to Similar Physician Specialties Assigned an ISO Code and a Risk Class
----------------------------------------------------------------------------------------------------------------
                                               Unassigned Medicare
                Medicare code                       specialty                    Crosswalk specialty
----------------------------------------------------------------------------------------------------------------
12..........................................  Osteopathic            Family Practice.
                                               Manipulative Therapy.
32..........................................  Anesthesiologist       Anesthesiology.
                                               Assistant.
35..........................................  Chiropractic.........  Physical medicine and rehab.
41..........................................  Optometry............  Ophthalmology.
43..........................................  Certified Registered   All Physicians.
                                               Nurse Assistant.
47..........................................  Physiological          All Physicians.
                                               Laboratory
                                               (independent).
48..........................................  Podiatry.............  All Physicians.
50..........................................  Nurse Practitioner...  All Physicians.
62..........................................  Psychologist.........  Psychiatry.
68..........................................  Clinical Psychologist  Psychiatry.
69..........................................  Clinical Laboratory..  All Physicians.
70..........................................  Multi-Specialty        All Physicians.
                                               Clinic or Group
                                               Practice.
74..........................................  Radiation Therapy      Radiation Oncology.
                                               Center.
76..........................................  Peripheral Vascular    Vascular Surgery.
                                               Disease.
79..........................................  Addiction Medicine...  Psychiatry.
80..........................................  Licensed Clinical      Psychiatry.
                                               Social Worker.
81..........................................  Critical Care          All Physicians.
                                               (Intensivists).
85..........................................  Maxillofacial Surgery  Plastic Surgery.
86..........................................  Neuropsychiatry......  Psychiatry.
89..........................................  Certified Clinical     All Physicians.
                                               Nurse Specialist.
90..........................................  Medical Oncology.....  Internal Medicine.
91..........................................  Surgical Oncology....  General Surgery.
94..........................................  Interventional         Radiology.
                                               Radiology.
96..........................................  Optician.............  Ophthalmology.
97..........................................  Physician Assistant..  All Physicians.
----------------------------------------------------------------------------------------------------------------

    In the development of the proposed resource-based malpractice RVU 
methodology, we considered two malpractice premium-based alternatives 
for resource-based malpractice RVUs, the dominant specialty approach 
and the specialty-weighted approach.

Dominant Specialty Approach

    The dominant specialty approach bases the malpractice RVUs upon the 
risk factor of only the dominant specialty performing a given service 
as long as the dominant specialty accounted for at least 51 percent of 
the total utilization for a given service. When 51 percent of the total 
utilization does not comprise the dominant specialty, this approach 
uses a modified specialty-weighted approach. In this modified 
specialty-weighted approach, two or more specialties are collectively 
defined as the dominant specialty. Starting with the specialty with the 
largest percentage of allowed services, the modified specialty-weighted 
approach successively adds the next highest specialty in terms of 
percentage of allowed services until a 50 percent threshold is 
achieved. The next step is to sum the risk factors of those specialties 
(weighted by utilization) in order to achieve at least 50 percent of 
the total utilization of a given service and then use the factors in 
the calculation of the final malpractice RVU.
    The dominant specialty approach produces modest increases for some 
specialties and modest decreases for other specialties. The largest 
increase for any given specialty, over the specialty-weighted approach, 
is less than 1.5 percent of total RVUs, while the largest decrease for 
any given specialty is less than 0.5 percent of total RVUs.

Specialty-Weighted Approach

    The approach that we adopted in the November 1999 final rule and 
are proposing to use in this proposed rule, bases the final malpractice 
RVUs upon a weighted average of the risk factors of all specialties 
performing a given service. The specialty-weighted approach ensures 
that all specialties performing a given service are accounted for in 
the calculation of the final malpractice RVU. Our proposed methodology 
is as follows:
    (1) Compute a national average premium for each specialty. 
Insurance rating area malpractice premiums for each specialty were 
mapped to the county level. The specialty premium for each county is 
then multiplied by the total county RVUs (as defined by Medicare claims 
data), which had been divided by the malpractice GPCI applicable to 
each county to standardize the relative values for geographic 
variations. If the malpractice RVUs were not normalized for geographic 
variation, the locality cost differences (as reflected by the GPCIs) 
would be counted twice. The product of the malpractice premiums and 
standardized RVUs is then summed across specialties for each county. 
This calculation is then divided by the total RVUs for all counties, 
for each specialty, to yield a national average premium for each 
specialty.
    Table 10 shows the national average premiums for the years 1999 
through 2003 for the 20 specialties for which we collected premium 
data. As stated previously, we used an average of the 3 most current 
years, 2001 to projected 2003 malpractice premiums, in our calculation 
of the proposed malpractice RVUs.

[[Page 47508]]



             Table 10.--National Average Premiums for the Years 1999 Through 2003 for the 20 Specialties for Which We Collected Premium Data
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                            Annual
                                                  2001       2002       2003     1996-1998    2001-2003   trend \2\   Specialty    Normalized     Risk
         ISO                  Specialty         average    average    average     average    average \1\              MGPCI \3\    2001-2003     factor
                                                                                                          (percent)               premium \4\     \5\
--------------------------------------------------------------------------------------------------------------------------------------------------------
80269................  Pulmonary disease.....     12,574     13,456     14,541        9,508       13,524       7.30        1.027       13,168       2.14
80280................  Diagnostic radiology..     15,807     16,783     17,997       12,372       16,862       6.39        0.997       16,913       2.75
80284................  Internal medicine.....     14,395     15,714     16,985       11,836       15,698       5.81        1.028       15,270       2.48
80274................  Gastroenterology......     14,347     15,398     16,643       11,745       15,463       5.65        1.017       15,204       2.47
80143................  General surgery.......     33,163     36,004     39,059       27,825       36,075       5.33        0.957       37,696       6.13
80423................  General practice......     13,325     14,479     15,731       11,234       14,512       5.25        0.943       15,389       2.50
80288................  Neurology.............     16,206     17,330     18,629       13,726       17,388       4.84        1.032       16,849       2.74
80114................  Ophthalmology.........     13,064     14,103     15,317       11,209       14,161       4.79        0.997       14,204       2.31
80152................  Neurosurgery..........     64,724     70,125     76,060       57,701       70,303       4.03        0.952       73,848      12.00
80281................  Cardiology............     14,798     15,836     17,085       13,204       15,906       3.79        1.021       15,579       2.53
80145................  Urology...............     18,701     20,253     21,931       16,958       20,295       3.66        0.999       20,315       3.30
80159................  Otolaryngology........     21,720     23,127     24,794       19,990       23,214       3.04        0.997       23,284       3.78
80154................  Orthopedic w/spinal...     40,384     43,758     47,321       38,584       43,821       2.58        0.955       45,886       7.46
80144................  Thoracic surgery......     39,538     43,200     47,249       38,812       43,329       2.23        1.020       42,479       6.91
80282................  Dermatology...........     11,046     11,549     12,375       10,650       11,657       1.82        1.020       11,428       1.86
80260................  Nephrology \6\........      8,408      9,290     10,142          n/a        9,280        n/a        0.999        9,289       1.51
80146................  Vascular surgery......     39,391     42,660     46,211          n/a       42,754        n/a        1.014       42,164       6.85
80141................  Cardiac surgery.......     37,802     40,498     43,722          n/a       40,674        n/a        0.921       44,163       7.18
80425................  Radiation oncology....     13,800     14,755     15,976          n/a       14,844        n/a        0.995       14,918       2.43
80102................  Emergency medicine....     20,671     22,672     24,733          n/a       22,692        n/a        0.974       23,298      3.79
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ A simple average of figures for 2001, 2002, and 2003.
\2\ Percent annualized average growth rate between 1996-1998 and 2001-2003.
\3\ An average of locality malpractice GPCIs using specialty-specific malpractice RVUs as weights.
\4\ 2001-2003 premium divided by specialty MGPCI.
\5\ (Normalized 2001-2003 Premium, .9289) x 1.51.
\6\ Nephrology is set to 1.51 to be consistent with the risk factor taken from the rating manuals. n/a signifies that the premium data were not
  available.

    (2) Calculate a risk factor for each specialty. Differences among 
specialties in malpractice premiums are a direct reflection of the 
malpractice risk associated with the services performed by a given 
specialty. The relative differences in national average premiums 
between various specialties can be expressed as a specialty risk 
factor. These risk factors are an index calculated by dividing the 
national average premium for each specialty by the national average 
premium for the specialty with the lowest average premium, nephrology. 
Table 11 shows the risk factors, surgical and nonsurgical, by 
specialty.

                         Table 11.--Risk Factors, Surgical and Nonsurgical, by Specialty
----------------------------------------------------------------------------------------------------------------
                                                                                    Nonsurgical   Surgical  risk
                 Medicare code                        Medicare description          risk factor       factor
----------------------------------------------------------------------------------------------------------------
01............................................  General practice................            1.79            4.26
02............................................  General surgery.................            6.13            6.13
03............................................  Allergy/Immunology..............            1.00            1.00
04............................................  Otolaryngology..................            1.45            3.78
05............................................  Anesthesiology..................            2.84            2.84
06............................................  Cardiology......................            1.45            2.53
07............................................  Dermatology.....................            1.00            3.90
08............................................  Family practice.................            1.79            4.26
10............................................  Gastroenterology................            2.05            3.49
11............................................  Internal medicine...............            2.05            2.48
12............................................  Osteopathic Manipulative Therapy            1.79            4.26
13............................................  Neurology.......................            2.52            2.74
14............................................  Neurosurgery....................           12.00           12.00
16............................................  Obstetrics/Gynecology...........            2.15            5.63
18............................................  Ophthalmology...................            1.24            2.31
20............................................  Orthopedic surgery w/o Spinal...            8.06            8.06
20............................................  Orthopedic surgery with Spinal..            7.46            7.46
22............................................  Pathology.......................            1.72            2.09
24............................................  Plastic Surgery.................            6.92            6.92
25............................................  Physical Med & Rehab............            1.26            1.26
26............................................  Psychiatry......................            1.11            3.08
28............................................  Colorectal surgery..............            4.08            4.08
29............................................  Pulmonary disease...............            2.14            2.14
30............................................  Diagnostic radiology............            2.07            2.75
32............................................  Anesthesiologist Assistant......            2.84            2.84
33............................................  Thoracic surgery................            6.91            6.91
34............................................  Urology.........................            3.30            3.30
35............................................  Chiropractic....................            1.26            1.26
36............................................  Nuclear medicine................            1.66            1.66
37............................................  Pediatric medicine..............            1.76            2.42
38............................................  Geriatric medicine..............            1.35            2.17
39............................................  Nephrology......................            1.51            1.96

[[Page 47509]]

 
40............................................  Hand surgery....................            4.71            4.71
41............................................  Optometry.......................            1.24            2.31
43............................................  Certified Registered Nurse                  3.04            3.71
                                                 Assistant.
44............................................  Infectious disease..............            1.55            2.09
46............................................  Endocrinology...................            2.03            2.09
47............................................  Physiological Laboratory                    3.04            3.71
                                                 (independent).
48............................................  Podiatry........................            3.04            3.71
50............................................  Nurse Practitioner..............            3.04            3.71
62............................................  Psychologist....................            1.11            3.08
65............................................  Physical therapist (independent)            1.26            1.26
66............................................  Rheumatology....................            2.11            2.11
67............................................  Occupational therapist..........            1.11            1.11
68............................................  Clinical Psychologist...........            1.11            3.08
69............................................  Clinical Laboratory.............            3.04            3.71
70............................................  Multi-Specialty Clinic or Group             3.04            3.71
                                                 Practice.
74............................................  Radiation Therapy Center........            2.43            2.43
76............................................  Peripheral Vascular Disease.....            6.85            6.85
77............................................  Vascular surgery................            6.85            6.85
78............................................  Cardiac surgery.................            7.18            7.18
79............................................  Addiction Medicine..............            1.11            3.08
80............................................  Licensed Clinical Social Worker.            1.11            3.08
81............................................  Critical Care (Intensivists)....            3.04            3.71
82............................................  Hematology......................            1.77            2.26
83............................................  Hematology/oncology.............            2.05            2.11
84............................................  Preventive medicine.............            1.26            1.26
85............................................  Maxillofacial Surgery...........            6.92            6.92
86............................................  Neuropsychiatry.................            1.11            3.08
89............................................  Certified Clinical Nurse                    3.04            3.71
                                                 Specialist.
90............................................  Medical Oncology................            2.05            2.48
91............................................  Surgical Oncology...............            6.13            6.13
92............................................  *Radiation oncology/therapy.....            2.43            2.43
93............................................  Emergency medicine..............            3.79            4.55
94............................................  Interventional Radiology........            2.07            2.75
96............................................  Optician........................            1.24            2.31
97............................................  Physician Assistant.............            3.04            3.71
98............................................  Gynecologist/oncologist.........            2.15           5.63
----------------------------------------------------------------------------------------------------------------
 Note: If a specialty has only one risk classification, the same classification was used for both surgery and
  nonsurgery.
 Note: For specialties with multiple risk classifications depending on the level of surgical involvement, the
  highest level of surgery was selected for surgery risk factor and the lowest level of surgery was selected for
  nonsurgery risk factor.

    (3) Calculate malpractice RVUs for each code. Resource-based 
malpractice RVUs were calculated for each procedure. The first step was 
to identify the percentage of services performed by each specialty for 
each respective procedure code. This percentage was then multiplied by 
each respective specialty's risk factor as calculated in Step 2. The 
products for all specialties for the procedure were then summed, 
yielding a specialty-weighted malpractice RVU reflecting the weighted 
malpractice costs across all specialties for that procedure. This 
number was then multiplied by the procedure's work RVUs to account for 
differences in risk-of-service. Since we were unable to find an 
acceptable source of data to be used in determining risk-of-service, 
work RVUs were used. We would welcome any suggestions for alternative 
data sources to be used in determining risk-of-service.
    As mentioned above, certain specialties may have more than one ISO 
rating class and risk factor. The surgical risk factor for a specialty 
was used for surgical services and the nonsurgical risk factor for 
evaluation and management services. Also, for obstetrics/gynecology, 
the lower gynecology risk factor was used for all codes except those 
obviously surgical services, in which case the higher, surgical risk 
factor was used.
    Certain codes have no physician work RVUs. The overwhelming 
majority of these codes are the technical components (TCs) of 
diagnostic tests, such as x-rays and cardiac catheterization, which 
have a distinctly separate technical component (the taking of an x-ray 
by a technician) and professional component (the interpretation of the 
x-ray by a physician). Examples of other codes with no work RVUs are 
audiology tests and injections. These services are usually furnished by 
nonphysicians, in this example, audiologists and nurses, respectively. 
In many cases, the nonphysician or entity furnishing the TC is distinct 
and separate from the physician ordering and interpreting the test. We 
believe it is appropriate for the malpractice RVUs assigned to TCs to 
be based on the malpractice costs of the nonphysician or entity, not 
the professional liability of the physician.
    Our proposed methodology, however, would result in zero malpractice 
RVUs for codes with no physician work, since we propose the use of 
physician work RVUs to adjust for risk-of-service. We believe that zero 
malpractice RVUs would be inappropriate because nonphysician health 
practitioners and entities such as independent diagnostic testing 
facilities (IDTFs) also have malpractice liability and carry 
malpractice insurance. Therefore, we are proposing to retain the 
current charge-based malpractice RVUs for all services with zero work 
RVUs. We are open to comments and suggestions for constructing 
resource-based malpractice RVUs for codes with no physician work.

[[Page 47510]]

    (4) Rescale for budget neutrality. The law requires that changes to 
fee schedule RVUs be budget neutral. The current resource-based 
malpractice RVUs and the proposed resource-based malpractice RVUs were 
constructed using entirely different malpractice premium data. Thus, 
the last step is to adjust for budget neutrality by rescaling the 
proposed malpractice RVUs so that the total proposed resource-based 
malpractice RVUs equal the total current resource-based malpractice 
RVUs. The proposed resource-based malpractice RVUs for each procedure 
were multiplied by the frequency count for that procedure to determine 
the total resource-based malpractice RVUs for each procedure. This was 
summed for all procedures to determine the total fee schedule proposed 
resource-based malpractice RVUs. This was compared to the total current 
resource-based malpractice RVUs, using the same calculation and cases. 
The total current and proposed malpractice RVUs were equal, and 
therefore budget neutral. Thus, no adjustments were needed to ensure 
that expenditures remained constant for the malpractice RVU portion of 
the physician fee schedule payment.
    The proposed resource-based malpractice RVUs are shown in Addendum 
B. These values have been adjusted for budget neutrality on the basis 
of the most recent available data. The values do not reflect the final 
budget-neutrality adjustment, which we will make in the final rule 
based upon the more current Medicare claims data. We do not believe, 
however, that the values will change significantly as a result of the 
final budget-neutrality adjustment.
    Because of the differences in the sizes of the three fee schedule 
components, implementation of the proposed resource-based malpractice 
RVUs will have a smaller payment effect than the previous 
implementation of resource-based practice expense RVUs. On average, 
work represents about 52.5 percent of the total payment for a 
procedure, practice expense about 43.6 percent of the total payment, 
and malpractice expense about 3.9 percent of the total payment. Thus, a 
20 percent change in practice expense or work RVUs would yield a change 
in payment of about 8 to 11 percent. In contrast, a corresponding 20 
percent change in malpractice values would yield a change in payment of 
only about 0.6 percent. Estimates of the effects on payment by 
specialty and selected high-volume procedures can be found in the 
impact section of this rule.
    We are requesting comments on our proposed methodology and 
resource-based malpractice RVUs.

D. Coding Issues

1. Change in Global Period for CPT Code 77427, Radiation Treatment 
Management, Five Treatments
[If you choose to comment on issues in this section, please include the 
caption ``CODING-GLOBAL PERIOD'' at the beginning of your comments.]
    This code was included in the November 2, 1999 physician fee 
schedule final rule and was effective for services beginning January 1, 
2000. In that rule, and subsequent rules, we have applied a global 
indicator of ``xxx'' to this code, meaning that the global concept does 
not apply. It has been brought to our attention that this global 
indicator is incorrect. The global indicator should be 090 since the 
RUC valuation of this service reflected a global period of 90 days and 
we accepted this valuation. Therefore, we would correct the global 
indicator for this service to reflect a global period of 90 days (090).
2. Requests for Adding Services to the List of Medicare Telehealth 
Services
[If you choose to comment on issues in this section, please include the 
caption ``CODING--TELEHEALTH'' at the beginning of your comments.]
a. Background
    Section 1834(m) of the Act defines telehealth services as 
professional consultations, office and other outpatient visits, and 
office psychiatry services identified as of July 1, 2000 by CPT codes 
99241 through 99275, 99201 through 99215, 90804 through 90809, and 
90862. In addition, the statute required us to establish a process for 
adding services to or deleting services from the list of telehealth 
services on an annual basis. In the CY 2003 final rule, we established 
a process for adding or deleting services to the list of Medicare 
telehealth services. This process provides the public an opportunity on 
an ongoing basis to submit requests for adding a service. For more 
information on submitting a request for addition to the list of 
Medicare telehealth services, visit our Web site at www.cms.hhs.gov/physicians/telehealth.
b. Submitted Requests for Addition to the List of Telehealth Services
    Requests for adding services to the list of Medicare telehealth 
services must be submitted and received no later than December 31st of 
each calendar year to be considered for the next proposed rule. For 
example, requests submitted in CY 2003 are considered for the CY 2005 
proposed rule.
    We received the following public requests for addition in CY 2003: 
Inpatient hospital care, emergency department visits, hospital 
observation services, inpatient psychotherapy, monthly management of 
patients with end-stage renal disease (ESRD), speech and audiologist 
services, case management, and care plan oversight.
    Requests for additions submitted in CY 2003 are discussed below.
    Inpatient hospital care, emergency department visits, hospital 
observation services, and inpatient psychotherapy
    The American Telemedicine Association (ATA) and an individual 
practitioner submitted a request to add initial and subsequent 
inpatient hospital care as represented by CPT codes 99221 through 99223 
and 99231 through 99233; hospital observation services (CPT codes 
99217, 99218 through 99220); and individual psychotherapy furnished in 
an inpatient, partial hospitalization, or residential care facility 
setting (as defined by CPT codes 90816 through 90822). The requestors 
argue that the addition of hospital observation services, inpatient 
hospital care, and inpatient psychotherapy will reduce transfers from 
remote facilities to tertiary care facilities, decrease length of stay, 
improve diagnostic accuracy, plan of care strategies and patient 
outcomes, and also stabilize local health care systems. The requestors 
emphasize that adding individual psychotherapy in the inpatient and 
partial hospitalization setting is crucial for providing access to 
mental health services for the rural population. Additionally, the 
requestors believe that no current Medicare telehealth service can be 
billed when a patient is in observation status or is admitted as an 
inpatient. They also noted that the current psychiatry services paid 
for as telehealth services are not appropriate for mental health 
patients in the hospital, partial hospital, or residential facility 
settings.
    The University of Kansas Medical Center requested that we add 
emergency department visits as defined by CPT codes 99281 through 99285 
as telehealth services. The requestor stated that, for many rural 
hospitals, the attending physician in emergency cases is a local 
primary care or family physician who may not have sufficient experience 
with the complexities of emergent care. The requestor believes that 
adding emergency department visits will provide quicker access to an 
expert trauma or emergency physician and that the time saved could be 
life-saving for the patient.

[[Page 47511]]

CMS Review
    As discussed in the June 28, 2002 Federal Register (67 FR 43862), 
we assign requests to one of two categories for review. Category 1 is 
comprised of services, which are similar in nature to an office or 
other outpatient visit, consultation, or office psychiatry. We review 
category 1 services to ensure that the roles of, and interaction among, 
the patient, physician, or practitioner at the distant site and 
telepresenter (if necessary) are similar to the current telehealth 
services.
    Category 2 services would include services that are not similar to 
an office or other outpatient visit, consultation, or office 
psychiatry. Because of the potential acuity of the patient in the 
hospital setting, we consider inpatient hospital care, emergency 
department visits, hospital observation services, and inpatient 
psychotherapy to fall into the second category of requests. As 
discussed on our website, for category 2 services, requestors must 
provide evidence indicating that the use of a telecommunications system 
produces similar diagnostic findings or therapeutic interventions as 
would face-to-face delivery of the same service.
    For inpatient hospital care, hospital observation services, and 
inpatient psychotherapy, the requestors did not submit evidence 
indicating that the use of a telecommunications system does not affect 
the diagnosis or treatment plan as compared to the face-to-face 
delivery of the service. The requestors instead submitted various 
studies and articles regarding: the psychiatric diagnostic interview 
examination; school-based pediatric acute care to children; child and 
adolescent psychotherapy in clinics and schools; the use of telehealth 
technology to simplify case management and prior authorization; 
consultation on neurology cases; and nursing care to reduce 
hospitalization for heart failure.
    These data are not directly relevant to the services that the 
requesters wanted to have added. They do not address whether the use of 
a telecommunications system produces similar diagnoses or therapeutic 
interventions by physicians or practitioners, as would the face-to-face 
delivery of inpatient hospital care, hospital observation services, and 
inpatient psychotherapy. With respect to emergency department visits, 
the requestor submitted a comparison study between emergency department 
telemedicine and face-to-face emergency department visits. However, 
this study did not take into account complex emergent care. Study 
participants were pre-selected based on cases with limited clinical 
intervention, for example, animal bites with no skin laceration or 
puncture wounds, insect bites without evidence of wheezing or airway 
compromise, sore throat, first degree burns--less than 5 percent, and 
nonurgent medical problems requiring a referral.
    In the absence of sufficient, well-designed comparison studies 
showing that the use of a telecommunications system produces similar 
diagnoses or therapeutic interventions as would the face-to-face 
delivery of the requested services, we are proposing not to add these 
services to the list of telehealth services.
    We believe that the current list of Medicare telehealth services is 
appropriate for hospital inpatients, emergency room cases, and patients 
designated as observation status. If guidance or advice is needed in 
these settings, a consultation could be requested from an appropriate 
source.
End Stage Renal Disease--Monthly Management of Patients on Dialysis
    The ATA and an individual practitioner submitted a request that we 
add the monthly management of patients on dialysis, as represented by 
HCPCS codes G0308 through G0319, to the list of Medicare telehealth 
services. Under these codes, Medicare pays an increased monthly 
capitated payment amount for additional visits during the month (up to 
four). The requestors noted the shortage of nephrologists and the 
difficulty they have in visiting face-to-face with all patients on 
dialysis. Additionally, the requestors stated that many States, 
including Alaska, Hawaii, Montana, and Wisconsin, have remote 
community-based dialysis centers with underserved populations located a 
considerable distance from a nephrologist. To address this issue, 
consultations and patient care conferences are currently being provided 
using a telecommunications system to manage patients on dialysis 
located in communities that do not have a nephrologist, including 
communities in Texas, where dialysis consultations and assessments 
using telecommunications are paid under the State's Medicaid program. 
Given the claims of a shortage of nephrologists and the new face-to-
face visit requirements for physicians managing patients on dialysis, 
the requestors believe that permitting the management of dialysis 
patients through telehealth services is crucial.
CMS Review
    The MCP G codes represent a range of services provided during a 
month, including a complete assessment of the patient and subsequent 
visits to monitor the patient's condition. We believe the types of 
services provided as part of the subsequent visits included in the 
codes are similar to the office and other outpatient visits currently 
on the list of Medicare telehealth services. Therefore, we believe 
these services would meet the criteria set forth in Category 1 of the 
process for adding services described above. However, we do not believe 
the complete assessment aspect of the MCP G codes is similar to 
existing telehealth services. For example, one aspect of a complete 
assessment would involve examination of the vascular access site. This 
is a specific clinical examination that is not similar to other 
services on the list.
    Therefore, we consider the request for addition of the complete 
assessment to the list of telehealth services to be a Category 2 
request, requiring comparative analyses. In submitting their requests 
for addition to the list of Medicare telehealth services, the 
requestors included summaries of many studies related to renal dialysis 
patient monitoring. However, we do not believe the requestor provided 
comparative analyses illustrating that the use of a telecommunications 
system is an adequate substitute for the clinical examination of the 
vascular access site. We do not believe that the use of a 
telecommunications system is an adequate method for conducting a 
complete assessment of the ESRD beneficiary. We believe that a clinical 
examination of the vascular access site can be adequately performed 
only with a face-to-face, ``hands on'' examination of the patient.
    However, we do believe the subsequent visits meet the criteria for 
approving a Category 1 request. That is, we believe the roles and 
interactions between the patient and the physician (or practitioner) 
are similar to those of office and other outpatient visits currently on 
the telehealth list. This presents a unique scenario, wherein a portion 
of the services represented by the MCP G codes are eligible to add to 
the list, but one service (the complete assessment) is not. To address 
this issue, we propose to add the ESRD-related services with 2 or 3 
visits per month and ESRD-related services with 4 or more visits per 
month as described by G0308, G0309, G0311, G0312, G0314, G0315, G0317, 
G0318 to the list of Medicare telehealth services. However, the 
complete assessment of the ESRD

[[Page 47512]]

beneficiary would not be permitted through the use of a 
telecommunications system. A comprehensive visit including a clinical 
examination of the vascular access site must be furnished face-to-face 
``hands on'' by a physician, clinical nurse specialist, nurse 
practitioner, or physician's assistant. An interactive 
telecommunications system may be used for providing additional visits 
required under the 2-to-3 visit MCP and the 4-or-more visit MCP.
    As noted previously, the MCP G codes are unique in that they 
reflect the ongoing care provided to ESRD patients by the physician or 
practitioner, on a monthly basis. These codes also reflect a range of 
services, from a monthly comprehensive assessment to monitoring the 
patient's overall condition and addressing individual issues and 
concerns as they arise during the month. We believe these codes are 
distinguishable from other codes by the scope of services and the 
ongoing nature of the services provided. Therefore, we believe that it 
would be appropriate to permit the use of a telecommunications system 
for providing some of the visits required under the ESRD MCP and to add 
these codes to the list of Medicare telehealth services.
    The MCP physician, for example, the physician or practitioner who 
provided the complete assessment, and other practitioners within the 
same group practice or employed by the same employer/entity, may 
furnish ESRD-related visits through a telecommunications system. 
However, the physician or practitioner who performs the complete 
assessment and establishes the plan of care should bill for the MCP in 
any given month.
    Clinical Criteria--The complete assessment visit must be conducted 
face-to-face. For subsequent visits, the physician or practitioner at 
the distant site is required, at a minimum, to use an interactive audio 
and video telecommunications system that allows the physician or 
practitioner to provide medical management services for a maintenance 
dialysis beneficiary. For example, an ESRD visit conducted via 
telecommunications system must permit the physician or practitioner at 
the distant site to perform an assessment of whether the dialysis is 
working effectively and whether the patient is tolerating the procedure 
well (physiologically and psychologically). During this assessment, the 
physician or practitioner at the distant site must be able to determine 
whether alteration in any aspect of the beneficiary's prescription is 
indicated, due to such changes as the estimate of the patient's dry 
weight.
    Clarification on originating sites--The statute currently defines a 
telehealth originating site as a physician's or practitioner's office, 
hospital, critical access hospital, rural health clinic, or Federally-
qualified health center. ESRD facilities are not originating sites 
(dialysis facilities are not defined in the statute as originating 
sites). Subsequent visits (other than the comprehensive assessment) in 
any of the statutorily-covered settings could be provided via 
telecommunications equipment, including a physician's satellite office 
within a dialysis center. Adding dialysis facilities to the list of 
Medicare telehealth originating sites would require a legislative 
change.
Speech and Audiologist Services
    The American Speech-Language Hearing Association (ASHA) requested 
that we add 36 audiology services (CPT code range 92541 through 92596) 
and 30 speech language pathology (SLP) services (CPT code range 31575 
through 97703) to the list of Medicare telehealth services. The ASHA 
believes the cognitive nature of these services makes them well-suited 
for telehealth and noted several telehealth programs that have been 
successful at providing SLP and audiology services. For example, 
existing telehealth networks were cited as successfully providing 
diagnosis, treatment, and management recommendations for patients with 
speech language and hearing disorders.
CMS Review
    Speech language pathologists and audiologists are not permitted 
under current law to provide and receive payment for Medicare 
telehealth services at the distant site. The statute permits only a 
physician, as defined by section 1861(r) of the Act or a practitioner 
as described in section 1842(b)(18)(C) of the Act (clinical nurse 
specialist, nurse practitioner, physician assistant, nurse midwife, 
clinical psychologist, and clinical social worker), to furnish Medicare 
telehealth services. We are exploring this issue as part of a report to 
Congress (required by section 223(d) of BIPA) on additional sites and 
settings, geographic areas, and practitioners that may be reimbursed 
for the provision of telehealth services. At this time, we are not 
adding speech and audiology services to the list of Medicare telehealth 
services.
Case Management and Care Plan Oversight (Team Conferences and Physician 
Supervision)
    Two requests were submitted asking that we add medical team 
conferences as identified by CPT codes 99361 and 99362 and physician 
supervision (CPT codes 99374 and 99375) as telehealth services. 
Requestors stated that for these services, the use of a 
telecommunications system provides interdisciplinary medical teams 
serving remote underserved populations better access to the clinical 
expertise and decision making of specialty physicians. The requestors 
note that the current list of Medicare telehealth services, for 
example, consultations or office visits, cannot be used for case 
management and care plan oversight services because the patient is not 
typically present.
CMS Review
    Medical team conferences and monthly physician supervision are 
already covered Medicare services and do not require a face-to-face 
encounter with the beneficiary. Under the Medicare program, the use of 
a telecommunications system in furnishing a telehealth service is a 
substitution for the face-to-face requirements of a service. Since 
medical team conferences and monthly physician supervision do not 
require a face-to-face encounter with the patient, we cannot add these 
services to the list of Medicare telehealth services.
Review Summary
    For the reasons stated above, we propose to add ESRD-related 
services as described by G0308, G0309, G0311, G0312, G0314, G0315, 
G0317 and G0318 to the list of Medicare telehealth services.
    Moreover, we would add the term ``ESRD-related visits'' to the 
definition of Medicare telehealth services at CFR 410.78 and 414.65 as 
appropriate.
    We do not propose to add any additional services discussed above to 
the list of Medicare telehealth services for CY 2005.
3. National Pricing of G0238 and G0239 Respiratory Therapy Service 
Codes
[If you choose to comment on issues in this section, please include the 
caption ``CODING--RESPIRATORY THERAPY'' at the beginning of your 
comments.]
    In the 2001 final rule, we created three G codes for respiratory 
therapy services: G0237 Therapeutic procedures to increase strength or 
endurance of respiratory muscles, face-to-face, one-on-one, each 15 
minutes (includes monitoring), G0238 Therapeutic procedures to improve

[[Page 47513]]

respiratory function, other than ones described by G0237, one-on-one, 
face-to-face, per 15 minutes (includes monitoring) and G0239 
Therapeutic procedures to improve respiratory function or increase 
strength or endurance of respiratory muscles, two or more individuals 
(includes monitoring).
    We assigned RVUs to one of the codes (G0237), and indicated that 
the other two codes (G0238 and G0239) would be carrier-priced. Since 
the services represented by these codes are frequently being performed 
in comprehensive outpatient rehabilitation facilities, and paid under 
the physician fee schedule through fiscal intermediaries, there has 
been some uncertainty surrounding the payment for the carrier-priced 
services. We believe assigning RVUs to G0238 and G0239 would alleviate 
some of this uncertainty. Since these services are typically performed 
by respiratory therapists, no physician work was assigned to G0237, and 
we are not proposing work RVUs for either G0238 or G0239.
    Therefore, we are proposing to value these services using the 
nonphysician workpool.
    We propose practice expense RVUS for G0238 equal to those for 
G0237. While these codes represent two different types of activities 
(G0237 involves therapeutic procedures specifically targeted at 
improving the strength and endurance of respiratory muscles such as 
pursed-lip breathing, diaphragmatic breathing, and paced breathing, and 
G0238 involves other activities such as teaching patients strategies 
for performing tasks with less respiratory effort and the performance 
of graded activity programs to increase endurance and strength of upper 
and lower extremities), we believe that the practice expense involved 
is substantially the same for both services and thus, propose to 
crosswalk the practice expense RVUs for G0237 to G0238.
    G0239 represents situations in which two or more individuals are 
receiving services simultaneously (such as those described above in 
G0237 or G0238) during the same time period. Although the practitioner 
must be in constant attendance, he or she need not be providing one-on-
one patient contact. For G0239, we believe a typical group session to 
be 30 minutes in length and to consist of 3 patients. Therefore, for 
the practice expense RVUs for G0239, we will use the practice expense 
RVUs of G0237 reduced by one-third to account for the fact that the 
service is being provided to more than one patient simultaneously and 
each patient in a group can be billed for the services of G0239.
    We also propose a malpractice RVU of 0.02, the malpractice RVU 
assigned to G0237, for these two G codes.
4. Bone Marrow Aspiration and Biopsy Through the Same Incision on the 
Same Date of Service
[If you choose to comment on issues in this section, please include the 
caption ``CODING--BONE MARROW ASPIRATION'' at the beginning of your 
comments.]
    In the physician fee schedule final rule published on June 28, 2002 
(67 FR 43864), we proposed creation of a new G-code that reflects a 
bone marrow biopsy and aspiration procedure performed on the same date, 
at the same encounter, through the same incision. While some commenters 
were supportive of this proposal, other commenters felt that creation 
of a G-code was unnecessary and that any concerns with respect to 
payment could be addressed through application of the multiple 
procedure payment rules. In a final rule published on December 31, 2002 
(67 FR 79992), we agreed that the code should go through the CPT 
process and did not make our proposal final.
    To date, CPT has not addressed the issue. Therefore, we are 
proposing to create a G-code for this service in 2005. We believe that 
there is minimal incremental work associated with performing the second 
procedure through the same incision during a single encounter and are 
proposing an add-on G-code to reflect the additional physician work and 
practice expense. As we had stated in our previous proposal, if the two 
procedures, aspiration and biopsy, are performed at different sites 
(for example, contralateral iliac crests, sternum/iliac crest or two 
separate incisions on the same iliac crest), the -59 modifier, which 
denotes a distinct procedural service, would be appropriate to use and 
Medicare's multiple procedure rules would apply. In this instance, the 
CPT codes for aspiration and biopsy would each be used.

G0XX1: Bone Marrow Aspiration Performed With Bone Marrow Biopsy Through 
Same Incision on Same Date of Service, Add-On

    The code would be used when a bone marrow aspiration and a bone 
marrow biopsy are performed on the same day through a single incision. 
The physician would use the CPT code for bone marrow biopsy (38221) and 
G0XX1 for the second procedure (bone marrow aspiration).
    Based on our estimation that the time associated with this G-code 
is approximately 5 minutes and based on a comparison to CPT code 38220 
which has 34 minutes of intraservice time and a work RVU of 1.08 work, 
we are proposing 0.16 work RVUs for this proposed G-code. The proposed 
malpractice RVUs are 0.04 which are the current malpractice RVUS 
assigned to CPT code 38220. We are proposing the following practice 
expense inputs:

--Clinical staff time: Registered nurse--5 minutes
    Lab technician--2 minutes
--Equipment: Exam table

    We are also proposing a ZZZ global period for this add-on code 
since this code is related to another service and is included in the 
global period of the other service.
5. Q Code for the Set-Up of Portable X-Ray Equipment
    The Q-code for the set-up of portable x-ray equipment, Q0092, is 
currently paid under the physician fee schedule and is assigned an RVU 
of 0.33. In 2004, this produces a national payment of $12.32. This set-
up code encompasses only a portion of the resources required to provide 
a portable x-ray service to patients. In 2003, portable x-ray suppliers 
received total Medicare payments of approximately $208 million. More 
than half of these payments (approximately $116 million) were for 
portable x-ray transportation (codes R0070 and R0075). The portable x-
ray set-up code (Q0092) generated approximately $19 million in 
payments. The remainder of the Medicare payments for portable x-ray 
services (approximately $73 million) were for the actual x-ray services 
themselves.
    Between 2002 and 2004, the Medicare carriers increased the average 
amount paid for portable x-ray transportation across the country from 
about $89 to $112, an increase of about 25 percent (transportation is 
carrier-priced). Nonetheless, the Conference Report accompanying the 
Consolidated Appropriations Bill, HR 2673 (Pub. L. 108-199, enacted 
January 23, 2004), urged the Secretary to review and update the RVUs 
for Q0092 utilizing existing data.
    In 2002, the National Association of Portable X-ray Providers had 
requested that we use their cost data to develop practice expense RVUs 
for the physician fee schedule services they provide. We asked the 
Lewin Group to evaluate the data using the same standards of review 
applied to other specialty survey data. The Lewin Group found that the 
data as presented were not adequately detailed

[[Page 47514]]

to calculate a practice expense per hour based on the current practice 
expense methodology. Therefore, we did not use the data. However, in 
response to ongoing requests from the portable x-ray industry that we 
reexamine payments for this code, we have reevaluated this code.
    This code is currently priced in the nonphysician work pool. 
Removing this code from the nonphysician work pool has an overall 
negative impact on payments to portable x-ray suppliers (as a result of 
decreases to radiology codes that remain in the nonphysician work pool) 
and has a negative impact on many of the codes remaining in the 
nonphysician workpool. An alternative to national pricing of portable 
x-ray set-up would be to require Medicare carriers to develop local 
pricing as they do currently for portable x-ray transportation. In 
2002, we received a comment from a supplier of portable x-rays stating 
that the practice costs associated with set-up of portable x-ray 
equipment are not included in the Socioeconomic Monitoring System (SMS) 
and that there are sufficient differences among geographic regions in 
the performance of this procedure that warrant reclassifying this 
service as carrier-priced. We are interested in public comments on 
whether we should pursue national pricing for portable x-ray set-up 
outside of the nonphysician work pool or local carrier pricing for 2005 
or whether we should continue to price the service in the nonphysician 
workpool.
6. Venous Mapping for Hemodialysis
    We are proposing to create a new G-code (G0XX3: Venous mapping for 
hemodialysis access placement (Service to be performed by operating 
surgeon for preoperative venous mapping prior to creation of a 
hemodialysis access conduit using an autogenous graft). Autogenous 
grafts have longer patency rates, a lower incidence of infection and 
greater durability than prosthetic grafts. Use of autogenous grafts can 
also result in a decrease in hospitalizations and morbidity related to 
vascular access complications. Creation of this G-code will enable us 
to distinguish between CPT code 93971 (Duplex scan of extremity veins 
including responses to compression and other maneuvers; unilateral or 
limited study) and G0XX3. This new code will allow us to track use of 
venous mapping for quality improvement purposes.
    This G code would only be billed by the operating surgeon in 
conjunction with the following CPT codes: 36819, 36821, 36825, and 
36832. Because CPT code 93971 and the new G-code would be used to 
describe a similar service, we would propose that we not permit payment 
for CPT code 93971 when this G-code is billed, unless code 93971 were 
being performed for a separately identifiable clinical indication in a 
different anatomic region.
    The physician work, practice expense and professional liability 
expense for this new G code would be the same as those for CPT code 
93971. Thus, we propose to crosswalk the RVUs for the new G-code from 
those of CPT code 93971. We would also assign this new G-code a global 
period of ``XXX'', which means that the global concept does not apply.

III. Provisions of the Medicare Modernization Act of 2003

A. Section 611--Initial Preventive Physical Examination

[If you choose to comment on issues in this section, please include the 
caption ``Section 611'' at the beginning of your comments.]
1. Coverage of Initial Preventive Physical Examinations
    Section 611 of the MMA provides for coverage under Part B of an 
initial preventive physical examination for new beneficiaries, 
effective for services furnished on or after January 1, 2005, subject 
to certain eligibility and other limitations.
    Previously, Medicare law had not allowed for payment for routine 
physical examinations or checkups. Section 1862(a)(7) of the Act states 
that routine physical checkups are excluded services. This exclusion is 
described in Sec.  411.15(a) (Particular services excluded from 
coverage). In addition, we have interpreted section 1862(a)(1)(A) of 
the Act to exclude coverage for preventive physical examinations. This 
section provides that items and services must be reasonable and 
necessary for the diagnosis or treatment of illness or injury or to 
improve the functioning of a malformed body member as stated in Sec.  
411.15(k). Since preventive services are not provided for diagnosis or 
treatment of illness, injury, or malformation, we determined that these 
services are not reasonable and necessary within the meaning of the 
statute.
    To conform the regulations to the MMA, we are specifying an 
exception to the list of examples of routine physical examinations 
excluded from coverage in Sec.  411.15(a)(1) and Sec.  411.15(k)(11) 
for initial preventive physical examinations that meet the eligibility 
limitation and the conditions for coverage that we are specifying under 
Sec.  410.16--Initial Preventive Physical Examinations.
    Coverage of initial preventive physical examinations is provided 
under Medicare Part B only. The MMA permits payment for one initial 
preventive physical examination within the first 6 months after the 
effective date of the beneficiary's first Part B coverage period, but 
only if that coverage period begins on or after January 1, 2005.
    We are proposing to add Sec.  410.16(b), Condition for Coverage of 
Initial Preventive Physical Examinations, and Sec.  410.16(c), 
Limitation on Coverage of Initial Preventive Physical Examinations, to 
provide for coverage of the various initial preventive physical 
examination services specified in the statute.
    We are proposing to define several terms, as described specifically 
in Sec.  410.16, that would be used in implementing the statutory 
provisions, including definitions of the following terms--
    (1) Eligible beneficiary;
    (2) An initial preventive physical examination;
    (3) Medical history;
    (4) Physician;
    (5) Qualified nonphysician practitioner.
    (6) Social history;
    (7) Review of the individual's functional ability and level of 
safety;
    Section 611 of the MMA defines an ``initial preventive physical 
examination'' to mean physicians' and certain qualified nonphysician 
practitioners' services consisting of--
    (1) A physical examination (including measurement of height, 
weight, blood pressure, and an electrocardiogram, but excluding 
clinical laboratory tests) with the goal of health promotion and 
disease detection; and
    (2) Education, counseling, and referral with respect to screening 
and other covered preventive benefits separately authorized under 
Medicare Part B.
    Specifically, section 611(b) of the MMA provides that the 
education, counseling, and referral of the individual by the physician 
or other qualified nonphysician practitioner should be with respect to 
the following statutory screening and other preventive services 
authorized under Medicare Part B:
    (1) Pneumococcal, influenza, and hepatitis B vaccine and their 
administration.
    (2) Screening mammography.
    (3) Screening pap smear and screening pelvic exam services.
    (4) Prostate cancer screening services.
    (5) Colorectal cancer screening tests.
    (6) Diabetes outpatient self-management training services;

[[Page 47515]]

    (7) Bone mass measurements.
    (8) Screening for glaucoma.
    (9) Medical nutrition therapy services for individuals with 
diabetes or renal disease.
    (10) Cardiovascular screening blood tests.
    (11) Diabetes screening tests.
    Based on the language of the statute, our review of the medical 
literature, current clinical practice guidelines, and United States 
Preventive Services Task Force recommendations, we are proposing to 
interpret the term, ``initial preventive physical examination,'' for 
purposes of this new benefit to include all of the following:
    (1) Review of the individual's comprehensive medical and social 
history, as those terms are defined in paragraph (a) of proposed Sec.  
410.16.
    (2) Review of the individual's potential (risk factors) for 
depression (including past experiences with depression or other mood 
disorders) based on the use of an appropriate screening instrument 
which the physician or other qualified nonphysician practitioner may 
select from various available standardized screening tests for this 
purpose, unless the appropriate screening instrument is defined through 
the national coverage determination (NCD) process.
    (3) Review of the individual's functional ability and level of 
safety, as described in paragraph (a) of proposed Sec.  410.16, (that 
is, at a minimum, a review of the following areas: hearing impairment, 
activities of daily living, falls risk, and home safety), based on the 
use of an appropriate screening instrument, which the physician or 
other qualified nonphysician practitioner may select from various 
available standardized screening tests for this purpose, unless the 
appropriate screening instrument is further defined through the NCD 
process.
    (4) An examination to include measurement of the individual's 
height, weight, blood pressure, a visual acuity screen, and other 
factors as deemed appropriate by the physician or qualified 
nonphysician practitioner, based on the individual's comprehensive 
medical and social history and current clinical standards.
    (5) Performance and interpretation of an electrocardiogram.
    (6) Education, counseling, and referral, as appropriate, based on 
the results of the previous five elements of the initial preventive 
physical examination.
    (7) Education, counseling, and referral, including a written plan 
provided to the individual for obtaining the appropriate screening and 
other preventive services, which are separately covered under Medicare 
Part B benefits; that is, pneumococcal, influenza, and hepatitis B 
vaccines and their administration, screening mammography, screening pap 
smear and screening pelvic exams, prostate cancer screening tests, 
diabetes outpatient self-management training services, bone mass 
measurements, screening for glaucoma, medical nutrition therapy 
services, cardiovascular screening blood tests, and diabetes screening 
tests.
    We are requesting public comments on the definition of the term 
``initial preventive physical examination.'' For example, we have 
chosen not to define the term, ``appropriate screening instrument,'' 
for screening individuals for depression, functional ability, and level 
of safety, as specified in the proposed rule, because we anticipate 
that the examining physician or qualified nonphysician practitioner 
will want to use the test of his or her choice, based on current 
clinical practice guidelines. We believe that any standardized 
screening test for depression, functional ability, and level of safety 
recognized by the American Academy of Family Physicians, the American 
College of Physicians-American Society of Internal Medicine, the 
American College of Preventive Medicine, the American Geriatrics 
Society, the American Psychiatric Association, or the United States 
Preventive Services Task Force, or other recognized medical 
professional group, would be acceptable for purposes of meeting the 
``appropriate screening instrument'' provision. We ask that commenters 
making specific recommendations on this or any related issue provide 
documentation from the medical literature, current clinical practice 
guidelines, or the United States Preventive Services Task Force 
recommendations.
    We recognize that the NCD process could be used to define more 
specifically the type or types of appropriate screening instruments for 
depression, functional ability, or level of safety and propose to 
include in Sec.  410.16(a) in elements (2) and (3) of the definition of 
an initial preventive physical examination a reference that would allow 
us to define these screening instruments more specifically through the 
national coverage determination (``NCD'') process. The NCD process 
would include an opportunity for public comment on the medical and 
scientific issues related to the coverage of the new tests that may be 
brought to our attention in the future. Use of an NCD to establish a 
change in the scope of benefits is authorized by section 1871(a)(2) of 
the Act.
2. Payment for Initial Preventive Physical Examination
    There is no current CPT code that contains the specific elements 
included in the initial preventive examination. Therefore, we are 
proposing to establish the following new HCPCS code, G0XX2, Initial 
preventive physical examination, to be used for billing for the initial 
preventive examination. As required by the statute, this code includes 
an electrocardiogram, but does not include the other previously 
mentioned preventive services that are currently separately covered and 
paid under the Medicare Part B screening benefits. When these other 
preventive services are performed, they should be identified using the 
existing appropriate codes.
a. Basis for Payment
    Payment for this new HCPCS code will be based on the following:
    1. Work RVUs--We are proposing a work value of 1.51 RVUs for G0XX2. 
This value is based on our determination that this new service has 
equivalent resources and work intensity to those contained in CPT E/M 
code 99203, new patient, office or other outpatient visit, and CPT code 
93000 electrocardiogram, complete. CPT code 99203 has a work RVU of 
1.34 and requires a detailed history, detailed examination, and medical 
decision making of low complexity, which we believe to be 
representative of the elements contained in the initial preventive 
health examination. CPT code 93000, which is for a routine ECG with the 
interpretation and report, has a work RVU of 0.17.
    2. Malpractice RVUs--For the malpractice component of G0XX2, we are 
proposing malpractice RVUs of 0.13 in the nonfacility setting based on 
the malpractice RVUs currently assigned to CPT code 99203 (0.10) and 
CPT code 93000 (0.03). In the facility setting, we are proposing 
malpractice RVUs of 0.11 based on the current malpractice RVUs assigned 
to CPT code 99203 (0.10) and 93010 (an EKG interpretation with a value 
of 0.01).
    3. Practice Expense RVUs--For the practice expense component of 
G0XX2, we are proposing practice expense RVUs of 1.65 in the 
nonfacility setting based on the practice RVUs assigned to CPT code 
99203 (1.14) and CPT code 93000 (0.51). In the facility setting, we are 
proposing practice expense RVUs of 0.54 based on the practice RVUs 
assigned to CPT code 99203 (0.48) and 93010 (0.06).

[[Page 47516]]

b. Evaluation and Management (E/M) Service
    Since some of the components for a medically necessary E/M visit 
are reflected in this new HCPCS code, we are also proposing, when it is 
appropriate, to allow a medically necessary E/M service no greater than 
a level 2 to be reported at the same visit as the initial preventive 
physical examination. That portion of the visit must be medically 
necessary to treat the patient's illness or injury or to improve the 
function of a malformed body member and should be reported with 
modifier -25. The physician or qualified nonphysician practitioner 
could also bill for the screening and other preventive services 
currently covered and paid by Medicare Part B under separate provisions 
of section 1861 of the Act, if provided during this initial preventive 
physical examination.
c. Coinsurance and Part B Deductible
    MMA did not make any provision for the waiver of the Medicare 
coinsurance and Part B deductible for the initial preventive physical 
examination. Payment for this service would be applied to the required 
deductible, which is $110 for CY 2005, if the deductible has not been 
met, and the usual coinsurance provisions would apply.

B. Section 613--Diabetes Screening Tests

[If you choose to comment on issues in this section, please include the 
caption ``Section 613'' at the beginning of your comments.]
    Section 613 of the MMA adds section 1861(yy) to the Act and 
mandates coverage of diabetes screening tests.
    The term ``diabetes screening tests'' is defined in section 613 as 
testing furnished to an individual at risk for diabetes including a 
fasting plasma glucose test and such other tests, and modifications to 
tests, as the Secretary determines appropriate, in consultation with 
appropriate organizations. In compliance with this directive, we 
consulted with the American Diabetes Association, the American 
Association of Clinical Endocrinologists, and the National Institute 
for Diabetes and Digestive and Kidney Diseases.
1. Coverage
    We are proposing in Sec.  410.18 that Medicare cover--
     A fasting plasma glucose test; and
     Post-glucose challenge tests; either an oral glucose 
tolerance test with a glucose challenge of 75 grams of glucose for 
nonpregnant adults, or a 2-hour post-glucose challenge test alone.
    We would not include a random serum or plasma glucose for persons 
with symptoms of uncontrolled diabetes such as excessive thirst or 
frequent urination in this benefit because it is already covered as a 
diagnostic service. This language is not intended to exclude other 
post-glucose challenge tests that may be developed in the future, 
including panels that may be created to include new diabetes and lipid 
screening tests. We also would include language that would allow 
Medicare to cover other diabetes screening tests, subject to a NCD 
process. We are requesting comments regarding the specific tests, 
definitions, and eligibility criteria. The comments that we receive 
will also be used to create the list of billing codes for covered tests 
and diagnosis codes that would be published in instructions for 
Medicare contractors.
    The statutory provision describes an ``individual at risk for 
diabetes'' as having any of the following risk factors:
    1. Hypertension.
    2. Dyslipidemia.
    3. Obesity, defined as a body mass index greater than or equal to 
30 kg/m2.
    4. Previous identification of an elevated impaired fasting glucose.
    5. Previous identification of impaired glucose tolerance.
    6. A risk factor consisting of at least two of the following 
characteristics:
    (a) Overweight, defined as a body mass index greater than 25 kg/m2, 
but less than 30.
    (b) A family history of diabetes.
    (c) A history of gestational diabetes mellitus or delivery of a 
baby weighing greater than 9 pounds.
    (d) 65 years of age or older.
    The statutory language directs the Secretary to establish standards 
regarding the frequency of diabetes screening tests that will be 
covered and limits the frequency to no more than twice within the 12-
month period following the date of the most recent diabetes screening 
test of that individual.
    We are proposing that Medicare beneficiaries diagnosed with ``pre-
diabetes'' be eligible for the maximum frequency allowed by the 
statute, that is, 2 screening tests per 12 month period. We propose to 
define ``pre-diabetes'' as a previous fasting glucose level of 100-125 
mg/dL, or a 2-hour post-glucose challenge of 140-199 mg/dL. This 
definition of ``pre-diabetes'' was developed with the assistance of the 
American Association of Clinical Endocrinologists and complements the 
definition of diabetes that we published November 7, 2003 (68 FR 
63195). We are specifically asking for comments regarding our new 
definition of ``pre-diabetes.'' We are also requesting suggestions for 
the definition of ``a family history of diabetes.''
    For individuals not meeting the ``pre-diabetes'' criteria, we are 
proposing that one diabetes screening test be covered per individual 
per year.
2. Payment
    We are proposing to pay for the screening diabetes tests at the 
same amounts paid for these tests when performed to diagnose an 
individual with signs and symptoms of diabetes. We would pay for these 
tests under the clinical laboratory fee schedule. We propose to pay for 
these tests under CPT code 82947 Glucose; quantitative, blood (except 
reagent strip) and CPT code 82951 Glucose; tolerance test (GTT), three 
specimens (includes glucose). To indicate that the purpose of the test 
is for diabetes screening, we would require that the laboratory include 
a screening diagnosis code in the diagnosis section of the claim. We 
propose V77.1 Special screening for diabetes mellitus as the applicable 
ICD-9--CM code for this purpose. Because laboratories are required and 
accustomed to submitting diagnosis codes when requesting payment for 
testing, we believe including a screening diagnosis code is appropriate 
for this benefit.

C. Section 612--Cardiovascular Screening Blood Tests

[If you choose to comment on issues in this section, please include the 
caption ``Section 612'' at the beginning of your comments.]
Section 612 of the MMA provides for Medicare coverage of cardiovascular 
screening blood tests for the early detection of cardiovascular disease 
or abnormalities associated with an elevated risk for that disease 
effective on or after January 1, 2005.
1. Coverage
    The Act requires coverage of tests for cholesterol and other lipid 
or trigylcerides levels for this purpose. It also authorizes the 
Secretary to approve coverage of other screening tests for other 
indications associated with cardiovascular disease or an elevated risk 
for that disease, including indications measured by noninvasive 
testing, if the United States Preventive Services Task Force (USPSTF) 
recommended a blood test for that indication.
    We invited comments about the types of tests from the American 
College of Physicians/ American Society of Internal Medicine, the 
American College of Cardiology, American Academy of

[[Page 47517]]

Family Physicians, American Heart Association, College of American 
Pathologists, American Society for Clinical Laboratory Science, 
American Society for Clinical Pathologists, American Association for 
Clinical Chemistry, and the American Clinical Laboratory Association. 
Comments were received from the American Heart Association, American 
Academy of Family Physicians, the American Association for Clinical 
Chemistry, American Society for Clinical Laboratory Science, the 
National Kidney Foundation, and the Vascular Disease Foundation, 
regarding the coverage of a number of cardiovascular screening tests in 
addition to the required blood lipid tests; for example, high 
sensitivity C-Reactive Protein (CRP), homocysteine, or Beta Naturetic 
Protein (BNP), electrocardiograms, Doppler and noninvasive vascular 
tests, and a skin reflectance test.
    We also reviewed the following 2001 recommendations of the USPSTF 
regarding screening for lipid disorders that are associated with 
cardiovascular disease:
    a. Clinicians should routinely screen men aged 35 years and older 
and women aged 45 years and older for lipid disorders and treat 
abnormal lipids in people who are at increased risk.
    b. Clinicians should routinely screen younger adults (men aged 20 
to 35 and women aged 20 to 45) for lipid disorders if they have other 
risk factors for coronary heart disease.
    c. No recommendation was made for or against routine screening for 
lipid disorders in younger adults (men aged 20 to 35 or women aged 20 
to 45) in the absence of known risk factors for coronary heart disease.
    d. Screening for lipid disorders should include measurement of 
total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-
C).
    e. Evidence is insufficient to recommend for or against 
trigylcerides measurement as a part of routine screening for lipid 
disorders.
    Based on the statutory language and our review of the scientific 
literature, expert opinion, and the USPSTF recommendations, we are 
proposing coverage of the following three screening blood tests for 
conditions associated with cardiovascular disease:
    (1) A total cholesterol test.
    (2) A cholesterol test for high density lipoproteins.
    (3) A triglycerides test.
    These tests should be performed as part of a panel and should be 
done after a 12-hour fast. We are also proposing coverage of each of 
these tests once every 5 years. The statute provides that the Secretary 
shall establish frequency standards for the coverage of cardiovascular 
screening blood tests, provided the frequency is no more often than 
once every 2 years. However, the scientific literature shows that 
cholesterol levels are fairly stable and do not fluctuate drastically 
for those older than age 65. The USPSTF clinical considerations 
indicate that, while screening may be appropriate in older people, 
repeated screening is less important because lipid levels are less 
likely to increase after age 65. Under the USPSTF recommendations, 
routine measurement of total cholesterol and HDL cholesterol every 5 
years is recommended by the National Cholesterol Education program 
Adult Treatment Panel II (ATP II), sponsored by the National Institutes 
of Health, and endorsed by the American Heart Association. In addition, 
the most recent Report of the Adult Treatment Panel (ATP III) includes 
similar recommendations. In all adults aged 20 years or older, a 
fasting lipoprotein profile (total cholesterol, LDL cholesterol, high 
density lipoprotein (HDL) cholesterol, and triglyceride) should be 
obtained once every 5 years. Since the LDL cholesterol can be 
calculated, the remaining tests, which are part of the lipid panel, are 
the tests we are proposing for coverage under this new benefit at a 5-
year screening interval. We do not believe the evidence justifies or 
the statute allows for coverage of other cardiovascular screening blood 
tests at this time.
    To facilitate our consideration of future coverage of other new 
types of cardiovascular screening blood tests, we have decided to add a 
provision to this proposed regulation that, in addition to the specific 
cardiovascular screening blood tests proposed for coverage in this 
proposed rule, would provide that other types of these tests may be 
covered under this new screening benefit, if we determine that this is 
appropriate through a National Coverage Determination (NCD). This 
provision would allow us to conduct a more timely assessment of other 
new types of cardiovascular screening blood tests that may have been 
approved for marketing by the Food and Drug Administration and 
recommended by the USPSTF than is possible under the standard 
rulemaking process. We intend to use the NCD process, which includes an 
opportunity for public comments, for evaluating the medical and 
scientific issues relating to the coverage of additional tests that may 
be brought to our attention in the future. Use of an NCD to establish a 
change in the scope of benefits is authorized by section 1871(a)(2) of 
the Act. These proposed coverage requirements are set forth in new 
section Sec.  410.17.
2. Payment
    Section 612 of the MMA provides for Medicare coverage of 
cardiovascular screening blood tests for the early detection of 
cardiovascular disease or abnormalities associated with an elevated 
risk for cardiovascular disease. The coverage is effective on or after 
January 1, 2005. We are proposing to pay for the screening 
cardiovascular disease tests at the same amounts paid for these tests 
when they are performed to diagnose an individual with signs and 
symptoms of cardiovascular disease. Medicare would pay for the tests 
under the clinical laboratory fee schedule. We propose to use the 
following CPT codes:
     82465 Cholesterol, serum or whole blood, total.
     83718 Lipoprotein, direct measurement; high density 
cholesterol (HDL cholesterol).
     84478 Triglycerides.
     80061 Lipid Panel.
    To indicate that the purpose of the test is for cardiovascular 
screening, we propose that the laboratory include in the diagnosis 
section of the claim the diagnosis code that provides the highest 
degree of accuracy and completeness in describing the diagnosis. We 
propose that the applicable ICD-9-CM codes for cardiovascular screening 
blood tests be selected from the following:
     V81.0 Special screening for ischemic heart disease.
     V81.1 Special screening for Hypertension.
     V81.2 Special screening for other and unspecified 
cardiovascular conditions.
    Because laboratories are required and accustomed to submitting 
diagnosis codes when requesting payment for testing, we believe 
including a screening diagnosis code for this purpose will not be 
unduly burdensome to them.

D. Section 413--Physician Scarcity Areas and Health Professional 
Shortage Areas Incentive Payments

[If you choose to comment on issues in this section, please include the 
caption ``Section 413'' at the beginning of your comments.]
1. Background
    Section 4043 of the Omnibus Budget Reconciliation Act (OBRA) of 
1987 added section 1833(m) to the Act to provide incentive payments to 
physicians who furnish services to

[[Page 47518]]

Medicare beneficiaries in Health Professional Shortage Areas (HPSAs). 
Under section 1833(m) of the Act, a 5 percent payment was added, 
beginning January 1, 1989, to the amounts otherwise payable under the 
physician fee schedule to doctors who furnish covered services to 
Medicare patients in designated HPSAs. Section 6102 of OBRA 1989 
further amended section 1833 of the Act to raise the amount of this 
incentive payment from 5 percent to 10 percent for services furnished 
after December 31, 1990. The OBRA 1989 amendment also increased 
eligible service areas to include both rural and urban HPSAs. The 
Congress established the HPSA incentive payments as incentives to 
attract new physicians to medically underserved communities and to 
encourage physicians in those areas to remain there.
    Eligibility for receiving the 10 percent incentive payment is based 
on whether the specific location at which the service is furnished is 
within an area that is designated (under section 332(a)(1)(A) of the 
Public Health Service Act (PHS)) as a HPSA. The Health Resources and 
Services Administration of the Department of Health and Human Services 
(HRSA) is responsible for designating shortage areas. HRSA designates 
several types of HPSAs. Some HPSAs are areas with shortages of primary 
care physicians, dentists, or psychiatrists. These shortage 
designations are referred to as geographic-based HPSAs. Also, there are 
HPSA designations based on underserved populations within an area, 
which are referred to as population-based HPSAs.
    Section 1833(m) of the Act provides incentive payments for 
physicians who furnish services in areas designated as HPSAs under 
section 332(a)(1)(A) of the PHS Act. These include all three types of 
geographic-based HPSAs (primary medical care, dental, and mental 
health). Consequently, physicians, including psychiatrists, furnishing 
services in a primary medical care HPSA are eligible to receive bonus 
payments. Medicare HPSA bonus payments apply to all physicians who 
perform covered services within a primary medical care HPSA, regardless 
of specialty. In addition, psychiatrists furnishing services in mental 
health HPSAs are eligible to receive incentive payments. We do not 
recognize dental HPSAs for the Medicare HPSA payment program because 
Medicare does not cover general dental services for its beneficiaries.
    Since the inception of the Medicare HPSA incentive payment program, 
physicians have been responsible for indicating their eligibility for 
the incentive payment on the Medicare billing form. To facilitate the 
verification of eligibility, physicians have been notified by their 
Medicare carriers when changes (withdrawals, revisions, or 
replacements) occur in HPSA designations. Using this information from 
carriers, physicians have been required to verify their eligibility and 
correctly code their Medicare claims using modifiers (QB for rural 
HPSAs and QU for urban HPSAs) to receive incentive payments.
2. New Legislation
a. Physician Scarcity Areas
    Section 413(a) of the MMA, provides a new 5 percent incentive 
payment to physicians furnishing services in physician scarcity areas. 
The MMA adds a new section 1833(u) of the Act which provides for paying 
primary care physicians furnishing services in a primary care scarcity 
county and specialty physicians furnishing services in a specialist 
care scarcity county, an additional amount equal to 5 percent of the 
amount paid for these services. Eligible physicians furnishing services 
in an area qualified as a physician scarcity area (PSA) and HPSA would 
be entitled to receive both incentive payments, that is, a 15 percent 
bonus payment. Eligibility for receiving both incentive payments is 
time limited (January 1, 2005 to January 1, 2008) because the 5 percent 
PSA bonus is scheduled to sunset on December 31, 2007.
    The Congress created the new 5 percent incentive payment program to 
make it easier to recruit and retain both primary and specialist care 
physicians for furnishing services to Medicare beneficiaries in PSAs.
    The two measures of physician scarcity are defined by the statute 
as follows:
    1. The primary care scarcity areas are determined by the ratio of 
primary care physicians to Medicare beneficiaries.
    2. The specialist care scarcity areas are determined by the ratio 
of specialty care physicians to Medicare beneficiaries.
i. Primary Care
    Consistent with section 1833(u) of the Act, we would identify 
eligible primary care scarcity counties by ranking each county by its 
ratio of primary care physicians to Medicare beneficiaries. From the 
list of primary care scarcity counties, only those counties with the 
lowest primary care ratios that represent 20 percent of the total 
number of Medicare beneficiaries residing in the counties will be 
considered eligible for the 5 percent incentive payment. For 
calculating the ratios, section 1833(u)(6) of the Act, as added by the 
MMA, defines a primary care physician as a general practitioner, family 
practice practitioner, general internist, obstetrician, or 
gynecologist. All other physicians will be considered specialists for 
purposes of the 5 percent incentive payment. Section 1833(u) of the 
Act, as added by the MMA, specifically defines ``physician'' as one 
described in section 1861(r)(1) of the Act. This statutory provision 
does not include dentists, podiatrists, optometrists, and 
chiropractors.
ii. Specialist Care
    To identify eligible specialist care scarcity areas, we would rank 
each county by its ratio of specialty physicians to Medicare 
beneficiaries. From the list of specialist care scarcity counties, only 
those counties with the lowest ratios that represent 20 percent of the 
total number of Medicare beneficiaries residing in the counties will be 
considered eligible for the 5 percent incentive payment.
iii. The Goldsmith Modification
    For purposes of counties identified as having a shortage of primary 
care or specialty care physicians, section 1833(u)(5) of the Act also 
requires that, to the extent feasible, we treat a rural census tract of 
a metropolitan statistical area (as determined under the most recent 
modification of the Goldsmith Modification) as an equivalent area. The 
Goldsmith modification evolved from an outreach grant program sponsored 
by the Office of Rural Health Policy of HRSA. This program was created 
to establish an operational definition of rural populations lacking 
easy access to health services in Large Area Metropolitan Counties 
(LAMCs). Dr. Harold F. Goldsmith and his associates created a 
methodology for identifying rural census tracts located within a large 
metropolitan county of at least 1,225 square miles. Using a combination 
of data on population density and commuting patterns, census tracts 
were identified as being so isolated by distance or physical features 
that they are more rural than urban in character.
iv. Rural-Urban Commuting Area
    The original Goldsmith Modification was developed using data from 
the 1980 census. In order to more accurately reflect current 
demographic and geographic characteristics of the nation, the Office of 
Rural Health Policy, in partnership with the Department of 
Agriculture's Economic Research

[[Page 47519]]

Service and the University of Washington, developed the Rural-Urban 
Commuting Area codes (RUCAs). Rather than being limited to LAMCs, RUCAs 
use urbanization, population density, and daily commuting data to 
categorize every census tract in the country. RUCAs are the updated 
version of the Goldsmith Modification and are used to identify rural 
census tracts in all metropolitan counties.
    Once all the full county PSAs are determined, we would identify, 
consistent with section 1833(u)(4)(C)of the Act, eligible PSAs by their 
5-digit zip code area for the purpose of automatically providing the 5 
percent incentive payment to eligible physicians. The zip code of the 
place of service is the only data element reported on the Medicare 
claim form that would allow automation. For zip codes that cross county 
boundaries, the statute specifically requires the use of the dominant 
county of the postal zip code (as determined by the U.S. Postal 
Service) if the Secretary uses the 5-digit postal zip code to identify 
areas eligible to receive the 5 percent payment. The statute also 
requires us to publish a list of eligible areas as part of the proposed 
and final physician fee schedule rules for the years for which PSAs are 
identified or revised and to post a list of PSAs on the CMS Website. 
Lastly, the statute provides no administrative or judicial review under 
sections 1869 or 1878 of the Act or otherwise, regarding the 
identification of a county or area, the assignment of a specialty of 
any physician, the assignment of a physician to a county, or the 
assignment of a postal ZIP Code to a county or other area.
b. Improvement to Medicare HPSA Incentive Payment Program
    In addition to the creation of the 5 percent PSA incentive payment, 
section 413 of MMA amended section 1833(m) of the Act to mandate that 
we automate payment of the 10 percent HPSA incentive payment to 
eligible physicians for full county HPSAs without a requirement for the 
physician to identify the HPSA involved. When automation is not 
feasible, consistent with section 1833(m) of the Act as amended by 
section 413(b) of MMA, we plan to post a list of HPSAs on our website. 
When automation is not feasible, the billing of modifiers would still 
be required.
    The statute provides for no administrative or judicial review of 
the identification of a county or area, the assignment of the 
individual physician's specialty, the assignment of a physician to a 
county or the assignment of a zip code to a county or area.
3. Provisions Related to Physician Scarcity Areas and HPSA Incentive 
Payment Program
a. Determination of Physician Scarcity Areas
    As the statute prescribes, PSAs for primary care would be 
determined by the ratio of primary care physicians to the Medicare 
beneficiaries residing in that county or area. A primary care physician 
is defined by statute as a general practitioner, family practice 
practitioner, general internist, obstetrician, or gynecologist. The 
physician definition for determining primary care PSAs will be based on 
HRSA's physician designations for primary medical care HPSAs, which 
include all of the above physicians. In other words, the PSA definition 
for primary care will be identical to HRSA's, except for pediatricians. 
Furthermore, the statute provides that the primary care ratio include 
only primary care doctors in the active practice of medicine. 
Physicians whose practice is exclusively for the Federal Government or 
who provide only administrative services would not be included in the 
physician tally. PSAs for specialty care would be determined by the 
ratio of physicians who are not primary care physicians to the Medicare 
beneficiaries residing in that county or area. The specialist care PSA 
ratio would include all physicians other than primary care physicians 
as defined in the statute. To the extent feasible, we also plan to 
include rural census tracts of metropolitan statistical areas (as 
determined under the most recent modification of the Goldsmith 
Modification), as identified at the zip code level, with sufficiently 
low physician-to-Medicare population ratios as equivalent to qualified 
full county scarcity areas. The calculation of physician scarcity 
ratios is being made by the North Carolina Rural Research and Policy 
Analysis Center using the most current Medicare beneficiary and 
physician data available. At this time, the North Carolina Rural 
Research and Policy Analysis Center can only determine physician 
scarcity for Goldsmith areas at the zip code level due to the fact that 
Medicare beneficiary data is currently unavailable at the census tract 
level.
    As previously discussed, section 1833(u) of the Act requires the 
automation of incentive payments for all PSAs, which we can only 
achieve by assigning zip codes to eligible areas. We propose the 
identification of qualified PSAs by zip code for automatic payment as 
follows:
     For zip codes that fall within a full county PSA, the 
bonus would be paid automatically.
     For full county PSAs, the dominant county of the 5-digit 
zip code, as determined by the U.S. Postal Service, would be used when 
the zip code area is not entirely located within the county. In some 
cases, a service may be provided in a county that is considered to be a 
PSA, but the zip code is not considered to be dominant for that area, 
which would not permit automation of the bonus payment. In order to 
receive the bonus for those areas, physicians would need to include a 
new physician scarcity modifier on the claim. We plan to establish and 
implement the new modifier through the Medicare Claims Processing 
Manual.
     For partial county PSAs (Goldsmith Modification), all zip 
code areas that are entirely located within the qualified Goldsmith 
area and all zip code areas that are partially located within a 
qualified Goldsmith area as long as the majority (51 percent) of the 
population located within the zip code area resides in the qualified 
Goldsmith area would be able to receive automatic payment.
    Due to the complex nature of processing available physician and 
Medicare beneficiary data into a usable format to identify counties and 
areas with the lowest ratios, we cannot make available a list of PSAs 
within this proposed rule. We are working closely with HRSA and its 
contractors to publish these lists in the physician fee schedule final 
rule.
b. Incentive Payments for Physician Scarcity Areas
    Similar to the Medicare HPSA bonus payment program, eligibility for 
receiving the 5 percent bonus payment would be based on whether the 
specific location at which the service is furnished is within an area 
that is designated as a PSA. Furthermore, the statute requires us to 
restrict eligibility for receiving the incentive payments for 
physicians' services furnished within primary care PSAs to general 
practitioners, family practice practitioners, general internists, 
obstetricians, or gynecologists. Also prescribed by statute, dentists, 
podiatrists, optometrists, and chiropractors are not eligible to 
receive incentive payments for PSAs. Section 1833(u) of the Act 
specifically defines a physician as one described in section 1861(r)(1) 
of the Act, which does not include dentists, podiatrists, optometrists, 
and chiropractors.

[[Page 47520]]

    To conform our regulations to the statute, we are proposing to add 
Sec.  414.66 to provide a 5 percent incentive payment to eligible 
physicians furnishing covered services in eligible PSAs. We propose to 
add Sec.  414.66(a)(1) to specify that primary care physicians 
furnishing services in primary care PSAs are entitled to an additional 
5 percent incentive payment above the amount paid under the physician 
fee schedule for their professional services furnished on or after 
January 1, 2005, and before January 1, 2008. The new incentive payment 
would apply to the professional services performed by physicians, 
including evaluation and management, surgery, consultation, and home, 
office and institutional visits. The technical component of physicians' 
services is not eligible because this component is not included in the 
definition of physicians' services at section 1861(q) of the Act as 
applied by the MMA. We are also proposing to add Sec.  414.66(b) to 
specify that physicians, other than primary care physicians, dentists, 
podiatrists, optometrists, and chiropractors, furnishing services in 
specialist care PSAs are entitled to an additional 5 percent payment 
above the amount paid under the physician fee schedule for their 
professional services furnished on or after January 1, 2005, and before 
January 1, 2008.
c. Improvement to Medicare HPSA Incentive Payment Program
    As of January 1, 2005, most physicians eligible for the 10 percent 
HPSA incentive payment would no longer be required to determine whether 
their service areas are eligible for incentive payments and to modify 
their claims to receive those payments. The MMA requires us to automate 
bonus payments for physicians' services furnished in full county HPSAs.
    Automation of full county HPSA incentive payments involves the same 
issues of automation as PSA incentive payments: the zip code of the 
place of service is the only data element reported on the claim form 
that would allow automation. Similarly, zip codes need to be cross-
walked to full county HPSAs. The statute allows use of the same method 
of automation of incentive payments for full county HPSAs as for full 
county PSAs. We are proposing the identification of HPSAs by zip code 
for automatic payment as follows:
     For zip codes that fall entirely within a full or partial 
county HPSA, the bonus would be paid automatically.
     When the zip code area is not entirely located within the 
full county HPSA, only the dominant county of the 5-digit zip code as 
determined by the U.S. Postal Service would be used for automatically 
paying the HPSA incentive payment.
     For all other zip code areas that are not entirely, but 
are to some extent, located within a designated HPSA (full county or 
partial), we would require physicians furnishing services in these 
areas to bill for the incentive payments by using the appropriate 
modifier on their Medicare claims. We propose to post on our website, 
prior to January 1, 2005, a list of zip codes that fully fall within a 
designated HPSA and a list of zip codes that partially fall within a 
designated HPSA, so that physicians can determine whether they would 
need to bill using a modifier.
    Determination of zip codes eligible for automatic HPSA bonus 
payment would be made on an annual basis, and there would not be any 
mid-year updates. We would effectuate mid-year revisions made to 
designations by HRSA the following year for automatic bonus payment 
purposes.
d. Medicare HPSA Incentive Payments
    The Medicare HPSA Incentive Payment program, which the Congress 
established under OBRA 1987, was implemented through the Medicare 
Claims Processing Manual. This proposed rule would create Sec.  414.67 
to conform the regulations to the law, as amended by OBRA 1987 and 
1989.
    We propose in Sec.  414.67 to provide a 10 percent incentive 
payment to eligible physicians furnishing covered services in eligible 
HPSAs. Section 414.67(a) would specify that physicians, regardless of 
specialty, furnishing services in a primary medical care HPSA are 
entitled to a 10 percent incentive payment above the amount paid for 
their professional services under the physician fee schedule. We would 
also create Sec.  414.67(c) to specify that psychiatrists furnishing 
services in a mental health HPSA are entitled to a 10 percent incentive 
payment above the amount paid for their professional services under the 
physician fee schedule. Psychiatrists furnishing services in mental 
health HPSAs that do not overlap with primary care HPSAs are the only 
physicians eligible to receive the 10 percent incentive payment in 
those areas. In other words, these stand-alone mental health HPSAs are 
eligible areas for psychiatrists only to receive incentive payments.

E. Section 303--Payment Reform for Covered Outpatient Drugs and 
Biologicals

[If you choose to comment on issues in this section, please include the 
caption ``Section 303'' at the beginning of your comments.]
1. Average Sales Price (ASP) Payment Methodology
a. Background
    Medicare Part B covers a limited number of prescription drugs and 
biologicals. For the purposes of this proposed rule, the term ``drugs'' 
will hereafter refer to both drugs and biologicals. Medicare Part B 
covered drugs generally fall into the following three categories:
     Drugs furnished incident to a physician's service.
     Durable medical equipment (DME) drugs.
     Drugs specifically covered by statute (for example, 
immunosuppressive drugs).
    Section 303(c) of the MMA revises the payment methodology for Part 
B covered drugs that are not paid on a cost or prospective payment 
basis. In particular, section 303(c) of the MMA amends Title XVIII of 
the Act by adding section 1847A. Beginning in 2005, section 1847A of 
the Act establishes a new ASP drug payment system. In 2005, almost all 
Medicare Part B drugs not paid on a cost or prospective payment basis 
will be paid under this system.
    The new ASP drug payment system is based on data submitted to us 
quarterly by manufacturers. For calendar quarters beginning on or after 
January 1, 2004, the statute requires manufacturers to report their ASP 
data to us for almost all Medicare Part B drugs not paid on a cost or 
prospective payment basis. Manufacturers' submissions are due to us not 
later than 30 days after the last day of each calendar quarter.
    For further information on the submission of manufacturers' ASP 
data, see the interim final rule titled ``Manufacturer Submission of 
Manufacturer's Average Sales Price (ASP) Data for Medicare Part B Drugs 
and Biologicals' published in the Federal Register on April 6, 2004 (69 
FR 17935). It is accessible on the CMS Web site at http://www.cms.hhs.gov/ providers/drugs/default.asp.
    The methodology for developing Medicare drug payment allowances 
based on the manufacturer's submitted ASP data is described in this 
proposed rule and reflected in proposed revisions to the regulations at 
Sec.  405.517 and new Subpart K in part 414.
b. Provisions of the Proposed Rule
i. The ASP Methodology
    Beginning in 2005, section 1847A of the Act establishes an ASP 
payment system for certain drugs and biologicals

[[Page 47521]]

not paid on a cost or prospective payment basis furnished on or after 
January 1, 2005. The most notable exceptions are described below in 
sections III.E.1.c through III.E.1.e.
ii. Calculation of ASP
    As described in section 1847A(b)(3)(A) of the Act for multiple 
source drugs and section 1847A(b)(4)(A) for single source drugs, the 
ASP for all drug products included within the same billing and payment 
code [or HCPCS code] is the volume-weighted average of the 
manufacturer's average sales prices reported to us across all the NDCs 
assigned to the HCPCS code. Specifically, section 1847A(b)(3)(A) of the 
Act and section 1847A(b)(4)(A) of the Act require that this amount be 
determined by--
     Computing the sum of the products (for each National Drug 
Code assigned to those drug products) of the manufacturer's average 
sales price and the total number of units sold; and
     Dividing that sum by the sum of the total number of units 
sold for all NDCs assigned to those drug products.
    Note that in the following discussions, the term ``manufacturer's 
ASP'' refers to the ASP data submitted to us by manufacturers at the 
NDC level and the term ``ASP'' used in isolation refers to the weighted 
average sales price for all drug products included within the HCPCS 
[billing and payment] code.
    Section 1847A(b)(5) of the Act requires that the ASP be determined 
without regard to any special packaging, labeling, or identifiers on 
the dosage form or product or package.
iii. Medicare Payment Allowances for Multiple Source Drugs
    Section 1847A(b)(1)(A) of the Act requires that the Medicare 
payment allowance for a multiple source drug included within the same 
HCPCS code be equal to 106 percent of the ASP for the HCPCS code. This 
payment allowance is subject to applicable deductible and coinsurance. 
The payment limit is also subject to the two limitations described 
below in section III.E.1.b.v of this preamble concerning widely 
available market prices and average manufacturer prices in the Medicaid 
drug rebate program. As described in section 1847A(e) of the Act, the 
payment limit may also be adjusted in response to a public health 
emergency under section 319 of the Public Health Service Act in which 
there is a documented inability to access drugs and a concomitant 
increase in the price of the drug which is not reflected in the 
manufacturer's average sales price.
iv. Medicare Payment Allowances for Single Source Drugs
    Section 1847A(b)(1)(B) of the Act requires that the Medicare 
payment allowance for a single source drug HCPCS code be equal to the 
lesser of 106 percent of the average sales price for the HCPCS code or 
106 percent of the wholesale acquisition cost of the HCPCS code. This 
payment allowance is subject to applicable deductible and coinsurance. 
The payment limit is also subject to the two limitations described 
below in section III.E.1.b.v concerning widely available market prices 
and average manufacturer prices in the Medicaid drug rebate program. As 
described in section 1847A(e) of the Act, the payment limit may also be 
adjusted in response to a public health emergency under section 319 of 
the Public Health Service Act.
    It has been brought to our attention that some physicians have 
concerns about their ability to purchase drugs at the Medicare payment 
amount of 106 percent of the ASP as these physicians believe that they 
are small purchasers of the Medicare Part B drugs subject to this 
proposed rule and do not have access to the average discounts. It is 
our understanding that many physicians are members of purchasing 
groups, which do obtain discounts on drugs. We encourage physicians to 
consider participating in such groups in order to achieve advantageous 
prices. We are interested in comments regarding the extent to which 
physicians can become members of such buying groups and the possible 
effects of doing so.
v. Limitations on ASP
    Section 1847A(d)(1) of the Act states that ``The Inspector General 
of the Department of Health and Human Services shall conduct studies, 
which may include surveys, to determine the widely available market 
prices of drugs and biologicals to which this section applies, as the 
Inspector General, in consultation with the Secretary, determines to be 
appropriate.'' Section 1847A(d)(2) of the Act states that ``Based upon 
such studies and other data for drugs and biologicals, the Inspector 
General shall compare the average sales price under this section for 
drugs and biologicals with--
     The widely available market price for such drugs and 
biologicals (if any); and
     The average manufacturer price (as determined under 
section 1927(k)(1)) for such drugs and biologicals.''
    Section 1847A(d)(3) of the Act states that ``The Secretary may 
disregard the average sales price for a drug or biological that exceeds 
the widely available market price or the average manufacturer price for 
such drug or biological by the applicable threshold percentage (as 
defined in subparagraph (B)).'' Section 1847A(d)(3)(B) states that 
``the term `applicable threshold percentage' means--
     In 2005, in the case of an average sales price for a drug 
or biological that exceeds widely available market price or the average 
manufacturer price, 5 percent; and
     In 2006 and subsequent years, the percentage applied under 
this subparagraph subject to such adjustment as the Secretary may 
specify for the widely available market price or the average 
manufacturer price, or both.''
    Section 1847A(d)(3)(C) of the Act states that ``If the Inspector 
General finds that the average sales price for a drug or biological 
exceeds such widely available market price or average manufacturer 
price for such drug or biological by the applicable threshold 
percentage, the Inspector General shall inform the Secretary (at such 
times as the Secretary may specify to carry out this subparagraph) and 
the Secretary shall, effective as of the next quarter, substitute for 
the amount of payment otherwise determined under this section for such 
drug or biological the lesser of--
     The widely available market price for the drug or 
biological (if any); or
     103 percent of the average manufacturer price (as 
determined under section 1927(k)(1)) for the drug or biological.''
vi. Payment Methodology in Cases Where the Average Sales Price During 
the First Quarter of Sales Is Unavailable
    Section 1847A(c)(4) of the Act states that ``In the case of a drug 
or biological during an initial period (not to exceed a full calendar 
quarter) in which data on the prices for sales for the drug or 
biological is not sufficiently available from the manufacturer to 
compute an average sales price for the drug or biological, the 
Secretary may determine the amount payable under this section for the 
drug or biological based on--
     The wholesale acquisition cost; or
     The methodologies in effect under this part on November 1, 
2003, to determine payment amounts for drugs or biologicals.''

[[Page 47522]]

c. Payment for Influenza, Pneumococcal, and Hepatitis B Vaccines
    Section 1841(o)(1)(A)(iv) of the Act requires that influenza, 
pneumococcal, and hepatitis B vaccines described in subparagraph (A) or 
(B) of section 1861(s)(10) of the Act be paid based on 95 percent of 
the average wholesale price (AWP) of the drug. These AWP payments, 
which will be updated quarterly, have not been revised by the ASP 
provisions.
d. Payment for Drugs Furnished During 2005 in Connection With the 
Furnishing of Renal Dialysis Services if Separately Billed by Renal 
Dialysis Facilities.
    Section 1881(b)(13)(A)(ii) of the Act indicates that payment for a 
drug furnished during 2005 in connection with the furnishing of renal 
dialysis services, if separately billed by renal dialysis facilities, 
will be based on the acquisition cost of the drug as determined by the 
Inspector General (IG) report to the Secretary required by section 
623(c) of the MMA or, insofar as the IG has not determined the 
acquisition cost with respect to a drug, the Secretary shall determine 
the payment amount for the drug. In the report, ``Medicare 
Reimbursement for Existing End-Stage Renal Disease Drugs,'' the IG 
found that, on average, in 2003 the four largest chains had drug 
acquisition costs that were 6 percent lower than the ASP of 10 of the 
top drugs, including erythropoietin. A sample of the remaining 
independent facilities had acquisition costs that were 4 percent above 
the ASP. Based on this information, the overall weighted average drug 
acquisition cost for renal dialysis facilities is 3 percent lower than 
the ASP. Therefore, payment for a drug or biological furnished during 
2005 in connection with renal dialysis services and separately billed 
by renal dialysis facilities will be based on the ASP of the drug minus 
3 percent. This will be updated quarterly based on the ASP reported to 
us by drug manufacturers.
e. Payment for Infusion Drugs Furnished Through an Item of DME
    In 2005, section 1841(o)(1)(D)(i) of the Act requires an infusion 
drug furnished through an item of DME covered under section 1861(n) of 
the Act be paid 95 percent of the average wholesale price for that drug 
in effect on October 1, 2003.
2. Provisions for Appropriate Reporting and Billing for Physicians' 
Services Associated With the Administration of Covered Outpatient Drugs
    Section 1848(c)(2)(J) of the Act (as added by section 303(a) of the 
MMA) requires the Secretary to promptly evaluate existing drug 
administration codes for physicians' services to ensure accurate 
reporting and billing for those services, taking into account levels of 
complexity of the administration and resource consumption. According to 
section 1848(c)(2)(B)(iv) of the Act (also as amended by section 303(a) 
of the MMA), any changes in expenditures in 2005 or 2006 resulting from 
this review are exempt from the budget neutrality requirement of 
section 1848(c)(2)(B)(ii) of the Act. The statute further indicates 
that the Secretary shall use existing processes for the consideration 
of coding changes and, to the extent changes are made, shall use those 
processes to establish relative values for those services. The 
Secretary is also required to consult with physician specialties 
affected by the provisions that change Medicare payments for drugs and 
drug administration.
    In the January 7, 2004 interim final rule with comment (69 FR 
1094), we indicated that the Physicians Regulatory Issues Team (PRIT) 
will review Medicare payment policy for drug administration and that we 
plan to consult with the AMA's CPT Editorial Panel and physician 
specialties affected by changes in payment for drugs and drug 
administration. We requested that the CPT Editorial Panel review all 
codes related to the administration of drugs and consider whether any 
revisions or additional codes are needed. At its February 2004 meeting, 
the CPT Editorial Panel established a workgroup, with representatives 
from affected specialties, to make recommendations on drug 
administration coding to the full Panel. In addition, the workgroup 
will be reviewing issues related to drug administration that were 
identified in the public comments on the January 7, 2004 Physician Fee 
Schedule rule. These comments raised the following two major issues:
    1. Can the current coding distinction between chemotherapy and 
nonchemotherapy infusions allow for recognition of the resources needed 
to administer drugs with high toxicity or potential for serious side 
effects for diagnoses other than cancer? If not, are code revisions or 
new codes needed?
    2. Does the current coding for chemotherapy administration capture 
all the support services provided by oncology practices for 
chemotherapy patients? If not, are code revisions or new codes such as 
a cancer management code needed?
    There were also a number of specific comments on individual codes 
raised by some specialties such as urology and ophthalmology. On June 
21, 2004, the workgroup held a public meeting to receive input and 
comments about drug administration code changes under consideration. 
The workgroup is expected to report to the full CPT Editorial Panel on 
all these issues at its August 2004 meeting. Once we review the CPT 
Editorial Panel's work on this issue, we will consider whether it is 
necessary for us to make coding changes effective January 1, 2005 
through the use of G codes, since the 2005 CPT book will already have 
been published. While the CPT Editorial Panel's work on this issue is 
important to us, we finally determine coding policy for Medicare; we 
also would welcome public comments on these issues. We would also 
welcome comments concerning any alternative methods of allocating 
practice expenses to the drug administration codes. (See section 
II.A.2. of this proposed rule for a discussion of allocation of 
practice expenses.) If coding changes are to be made for next year, we 
would announce them in the physician fee schedule final rule effective 
January 1, 2005.
    We also plan to analyze any shift or change in utilization patterns 
once the payment changes for drugs and drug administration required by 
MMA go into effect. While we do not believe the changes will result in 
access problems, we plan to continue studying this issue. We also note 
that the MMA requires the Medicare Payment Advisory Commission (MedPAC) 
to study items and services furnished by oncologists and drug 
administration services furnished by other specialties.
3. Blood Clotting Factor--Section 303(e)(1)--Items and Services 
Relating to Furnishing of Blood Clotting Factors
    For clotting factors furnished on or after January 1, 2005, we 
propose to establish a separate payment of $0.05 per unit to hemophilia 
treatment centers and homecare companies for the items and services 
associated with the furnishing of blood clotting factor.
    Section 303(e)(1) of the MMA requires the Secretary, after review 
of the January 2003 report to the Congress by the Comptroller General 
of the United States, to establish a separate payment to hemophilia 
treatment centers and homecare companies for the items and services 
associated with the furnishing of blood clotting factor. In the 
proposed rule, Payment Reform for Part B Drugs

[[Page 47523]]

(68 FR 50440), published in the Federal Register on August 20, 2003, we 
indicated that we are proposing to create a payment of $0.05 per unit 
of clotting factor provided to Medicare beneficiaries by hemophilia 
treatment centers and homecare companies to appropriately pay for the 
administrative costs associated with furnishing the clotting factor. We 
did not propose the creation of separate payment for furnishing the 
clotting factor for individuals or entities other than hemophilia 
treatment centers and homecare companies.
    We received comments from hemophilia organizations and specialty 
pharmacy providers of blood clotting factor. Most comments questioned 
our position to create a separate payment of $0.05 per unit, stating 
that this amount would jeopardize the ability of these facilities to 
adequately supply the clotting factor. Commenters were concerned that 
the $0.05 amount was too low and would cause many entities to 
discontinue providing the clotting factors and severely impact 
beneficiaries' access to clotting factor.
    Based on a review of the General Accounting Office (GAO) report and 
data received from various clotting factor providers, we believe a 
separate payment amount of $0.05 per unit would cover the 
administrative costs associated with supplying the clotting factor. As 
outlined in the MMA, any separate payment amount established may 
include the mixing and delivery of factors, including special inventory 
management and storage requirements, as well as ancillary supplies and 
patient training necessary for the self-administration of these 
factors. The MMA states that, in determining the separate payment, the 
total amount of payments and these separate payments shall not exceed 
the total amount of payments that would have been made for the factors 
if the amendments in section 303 of the MMA had not been enacted. As 
indicated in the GAO report, ``[w]hen Medicare's payment for clotting 
factor more closely reflects acquisition costs, we recommend that the 
Administrator establish a separate payment for providers based on the 
costs of delivering clotting factor to Medicare beneficiaries. 
Effective January 1, 2005, payment for blood clotting factors will more 
closely reflect acquisition costs as payment will be based on the 
average sales price as reported by drug manufacturers plus 6 percent.''
    Therefore, in the absence of additional data, we believe that a 
separate payment amount of $0.05 per unit for the cost of delivering 
clotting factor is an appropriate amount beginning CY 2005 and we are 
proposing revisions to Sec.  410.63 to reflect this amount. However, we 
are also seeking updated data and comments on the GAO report, as well 
as information on the fixed and variable costs of furnishing clotting 
factor. We recognize that there may be alternatives to a fee, which 
varies entirely based on the number of units of clotting factor 
furnished. We will closely examine all data and information submitted 
in order to make a final determination with respect to the 
appropriateness of the $0.05 per unit amount. That information will 
enable us to effectively determine the appropriateness of the $0.05 per 
unit amount.
4. Supplying Fee
    Section 1842(o)(6) of the Act, as added by section 303(e)(2) of the 
MMA, requires the Secretary to pay a supplying fee (less applicable 
deductible and coinsurance) to pharmacies for certain Medicare Part B 
drugs and biologicals, as determined appropriate by the Secretary. The 
types of Medicare Part B drugs and biologicals eligible for a supplying 
fee are immunosuppressive drugs described in section 1861(s)(2)(J) of 
the Act, oral anticancer chemotherapeutic drugs described in section 
1861(s)(2)(Q) of the Act, and oral anti-emetic drugs used as part of an 
anticancer chemotherapeutic regimen described in section 1861(s)(2)(T) 
of the Act. As discussed in the interim final rule published on January 
7, 2004 (69 FR 1084), we considered this fee to be bundled into the 
current payment for these drugs for 2004 where payment is based on the 
Average Wholesale Price (AWP).
    We propose to establish a separately billable supplying fee, 
effective January 1, 2005, when Medicare implements a different payment 
system for these drugs. We believe that a separately billable supplying 
fee of $10 per prescription is an appropriate level, beginning CY 2005. 
We received data suggesting various amounts for the supplying fee. 
Retail chain pharmacies suggested a supplying fee of $12 to $15 per 
prescription. These pharmacies stated that on average it cost between 
$10 to $12 to dispense a prescription to a Medicare beneficiary. 
However, when supplying immunosuppressive and oral anti-cancer drugs to 
Medicare beneficiaries, they argued that costs increase due to factors 
such as coordination of benefits activities. The specialty pharmacies 
that exclusively or largely furnish immunosuppressive drugs submitted 
data indicating that they believe a supplying fee of $44 (weighted 
average) to $56 (unweighted average) was appropriate. Pharmacies have 
pointed to the additional Medicare billing requirements as additional 
costs they had to incur, in the form of extra staff and time required 
to fulfill the billing requirements. We believe that a supplying fee of 
$10 per prescription is appropriate, especially when combined with the 
savings the pharmacy will experience with the clarification and 
elimination of the billing and shipping requirements, as described 
below.
    We point out that if we were to establish a supplying fee of $44, 
then we expect that Medicare would be spending more money in 2005 on 
the supplying fees and immunosuppressive drugs than Medicare would have 
paid for immunosuppressive drugs in 2005 under the former system at 95 
percent of AWP, when the supplying fee was bundled into payment for the 
drug.
    Our goal is to assure that each beneficiary who needs covered oral 
drugs has access to those medications. We seek comments about the 
appropriateness of our proposed supplying fee amount as well as the 
components of a supplying fee that would assure beneficiary access to 
oral drugs. We believe that a supplying fee is intended to cover a 
pharmacy's activities to get oral drugs to beneficiaries. We seek data 
and information on the additional services these pharmacies provide to 
Medicare beneficiaries, the extent to which oral drugs can be furnished 
without these additional services and the extent to which such services 
are covered under Medicare. We seek comment about whether the supplying 
fee should be somewhat higher during the initial month following a 
Medicare beneficiary's transplant to the extent that additional 
resources are required for example, due to more frequent changes in 
prescriptions for immunosuppressive drugs.
5. Billing Requirements
    We propose to clarify or eliminate the following billing 
requirements in an effort to reduce a pharmacy's costs of supplying 
covered immunosuppressive and oral drugs to Medicare beneficiaries:
     Original signed order. We wish to clarify Medicare's 
policy regarding the necessity of an original signed order prior to the 
filling of a prescription. According to the Medicare Program Integrity 
Manual (section 5.1 of Chapter 5), which addresses the ordering 
requirement for durable medical equipment, prosthetics, orthotics and 
supplies (DMEPOS), including drugs, most DMEPOS items can be dispensed

[[Page 47524]]

based on a verbal order from a physician. A written order must be 
obtained before submitting a claim, but that written order may be 
faxed, photocopied, electronic, or pen and ink. The order for the drug 
must specify the name of the drug, the concentration (if applicable), 
the dosage, and the frequency of administration. We hope that 
clarification of this requirement would reduce a pharmacy's costs of 
supplying covered immunosuppressive and oral drugs to Medicare 
beneficiaries to the extent that pharmacies are currently applying an 
original signed prescription requirement.
     Assignment of Benefits Form. Currently, pharmacies must 
obtain a completed Assignment of Benefits form in order to receive 
payment from Medicare. Other payors do not impose this requirement. 
This requirement increases a pharmacy's cost of supplying covered drugs 
to Medicare beneficiaries. Section 1842(o)(3) of the Act requires that 
payment for drugs under Part B of Medicare can only be made on an 
assignment related basis. However, Sec.  424.55(a) implies that if a 
beneficiary does not sign an assignment of benefits form, then Medicare 
will not make payment to the supplier. It has been pointed out that 
this requirement increases costs to suppliers that are not reimbursed 
by Medicare. We believe that it is not necessary for an assignment of 
benefit form to be filled out for drugs covered under Part B since 
payment for them can only be made on an assignment-related basis. We 
propose to eliminate use of the Assignment of Benefits form for Part B 
covered oral drugs as a means of reducing a pharmacy's costs of 
supplying such drugs to Medicare beneficiaries. (Additional discussion 
on assignment of Medicare claims is in section IV.G of this preamble.)
     DMERC Information Form (DIF). The DIF is a form created by 
the DMERC Medical Directors that contains information regarding the 
dates of the beneficiary's transplant and other diagnosis information. 
Pharmacies must have a completed DIF in order to receive payment. This 
requirement increases a pharmacy's cost of supplying covered drugs to 
Medicare beneficiaries. The DIF is a one-time requirement that was 
established to facilitate implementation of the immunosuppressive drug 
benefit when Medicare covered the drugs for different periods of time 
to distinguish between transplant and non-transplant uses for 
immunosuppressive drugs. Since section 1861(s)(2)(J) of the Act no 
longer imposes limits on the period of time for coverage of 
immunosuppressive drugs, we believe that the information on transplant 
diagnosis can be captured through other means (for example, diagnosis 
codes on the Part B claim form). In light of this statutory revision, 
we have had discussions with the DMERCs about their elimination of the 
use of this form when billing DMERC drugs. The DMERCs plan to eliminate 
the use of this form effective October 1, 2004. We believe that a 
pharmacy's costs of supplying Part B covered oral drugs to Medicare 
beneficiaries would be reduced with this change.
6. Shipping Time Frame
    It has been suggested that Medicare guidelines for refill 
prescriptions allowed too short of a window between shipping the next 
month's prescription and the end of the current month. It has been 
argued that, as a result, a pharmacy ``effectively'' had to ship the 
product to a beneficiary using an overnight delivery service.
    As indicated in section III.N of this preamble, on January 2, 2004, 
we revised the guidelines (effective February 2, 2004) regarding the 
time frame for subsequent deliveries of refills of DMEPOS products to 
occur no sooner than ``approximately 5 days prior to the end of the 
usage for the current product'' (see section 4.26.1 of Chapter 4--
Benefit Integrity of the Medicare Program Integrity Manual). This 
change allows shipping of refills on ``approximately'' the 25th day of 
the month in the case of a month's supply. We emphasize the word 
``approximately'; while we believe that normal ground service shipping 
would allow delivery in 5 days, if there were circumstances where 
ground service could not occur in 5 days, the guideline would still be 
met if the shipment occurs in 6 or 7 days. (``Days'' refers to business 
days or shipping days applicable to the shipper, that is, a 6-day week 
in the case of the U.S. Postal Service.) We believe that this change 
eliminates the need for suppliers to use overnight shipping methods and 
allows shipping of drugs by less expensive ground service.

F. Section 952--Revisions to Reassignment Provisions--Section 952 of 
the MMA

[If you choose to comment on issues in this section, please include the 
caption ``Section 952'' at the beginning of your comments.]
    Section 1842(b)(6) of the Act requires that payment may only be 
made to the physician or other person who furnished a service, or to 
the beneficiary for whom services were furnished, unless certain 
specified exceptions are met. Prior to the enactment of section 952 of 
the MMA, Medicare did not permit the reassignment of payments for 
services provided by an independent contractor physician or 
nonphysician practitioner unless the services were performed on the 
premises of the facility or health care delivery system that submitted 
the bill. Therefore, if the services were furnished offsite, 
reassignment was prohibited (see section 1842(b)(6)(A)(ii) of the Act).
    Section 1842(b)(6)(A)(ii) of the Act, as amended by section 952 of 
the MMA, allows a physician or nonphysician practitioner to reassign 
payment for Medicare-covered services, regardless of the site of 
service, as long as there is a contractual arrangement between the 
physician and nonphysician practitioner and the entity through which 
the entity submits the bill for those services. Thus, the services may 
be provided on or off the premises of the entity receiving the 
reassigned payments. The MMA Conference Agreement states that entities 
that retain independent contractors may enroll in the Medicare program. 
We note that the expanded exception created by section 952 applies to 
those situations when an entity seeks to obtain the medical services of 
a physician or nonphysician practitioner.
    Section 952 states that reassignment is permissible if the 
contractual arrangement between the entity that submits the bill for 
the service and the physician or nonphysician practitioner who performs 
the service ``meets such program integrity and other safeguards as the 
Secretary may determine to be appropriate.'' The Conference Agreement 
supports appropriate program integrity efforts for entities with 
independent contractors that bill the Medicare program, including joint 
and several liability (that is, both the entity accepting reassignment 
and the physician or nonphysician practitioner providing a service are 
both liable for any Medicare overpayments). The Conference Agreement 
also recommends that physician or nonphysician practitioners have 
unrestricted access to the billings submitted on their behalf by 
entities with which they contract. We incorporated these recommended 
safeguards in a change to the Medicare Manual, implementing section 952 
of the MMA that was published on February 27, 2004. We are proposing to 
revise Sec.  424.71 and Sec.  424.80 to reflect these safeguards, as 
well as the expanded exception established by section 952.
    Given the myriad relationships and financial arrangements 
potentially permitted by section 952, the purpose of

[[Page 47525]]

joint and several liability is to encourage both parties to the 
contractual arrangement to exercise oversight of billings submitted to 
the Medicare program by holding them each fully accountable. Since 
physician or nonphysician practitioners will be subject to liability 
for claims that are submitted to the Medicare program by entities to 
which they have reassigned payments, it follows that a physician or 
nonphysician practitioners should have access to the billings submitted 
on their behalf.
    We note that section 952 of the MMA revises only the statutory 
reassignment exceptions relevant to services provided in facilities and 
clinics (section 1842(b)(6)(A)(ii) of the Act). Arrangements involving 
reassignment must not violate any other applicable Medicare laws or 
regulations governing billing or claims submission, including, but not 
limited to, those regarding ``incident to'' services, payment for 
purchased diagnostic tests, and payment for purchased test 
interpretations.
    In addition, physician group practices should be mindful that 
compliance with the in-office ancillary services exception to the 
physician self-referral prohibition requires that a physician who is 
engaged by a group practice on an independent contractor basis must 
provide services to the group practice's patients in the group's 
facilities. As noted in the Phase I physician self-referral final rule 
(66 FR 887), ``[w]e consider an independent contractor physician to be 
``in the group practice'' if (1) he or she has a contractual 
arrangement to provide services to the group's patients in the group 
practice's facilities, (2) the contract contains compensation terms 
that are the same as those that apply to group members under section 
1877(h)(4)(iv) of the Act or the contract fits in the personal services 
exception, and (3) the contract complies with the reassignment rules * 
* * .'' See also 66 FR 886. This test is codified at Sec.  411.351 in 
the definition of ``physician in the group practice.''
    We are aware that the changes in the reassignment rules based on 
section 952 of the MMA may create new fraud and abuse vulnerabilities, 
which may not become apparent until the program has experience with the 
new contractual arrangements addressed in section 952 of the MMA. 
Parties should be mindful that contractual arrangements involving 
reassignment may not be used to camouflage inappropriate fee-splitting 
arrangements or payments for referrals. We are soliciting public 
comment on potential program vulnerabilities and on possible additional 
program integrity safeguards to guard against such vulnerabilities. We 
intend to monitor reassignment arrangements for potential program 
abuse.

G. Section 642--Extension of Coverage of IVIG for the Treatment of 
Primary Immune Deficiency Diseases in the Home

[If you choose to comment on issues in this section, please include the 
caption ``Section 642'' at the beginning of your comments.]

    Beginning for dates of service on or after January 1, 2004, 
Medicare pays for intravenous immune globulin administered in the home. 
This benefit is for the drug and not for the items or services related 
to the administration of the drug when administered in the home, if 
deemed medically appropriate. Manual instructions implementing this MMA 
provision have been issued and can be found at http://www.cms.hhs.gov/manuals/pm_trans/R6BP.pdf and http://www.cms.hhs.gov/manuals/pm_trans/R74CP.pdf. We are also proposing to revise Sec.  410.10 to 
address this statutory change.

H. Section 623--Payment for Renal Dialysis Services

[If you choose to comment on issues in this section, please include the 
caption ``Section 623'' at the beginning of your comments.]
1. Background
    We are proposing changes affecting payments to ESRD facilities that 
result from enactment of the MMA and would be effective January 1, 
2005. Section 1881(b) of the Act, as amended by section 623 of the MMA, 
directed the Secretary to revise the current composite rate payment 
system. The statute has several major provisions that require the 
development of revised composite payment rates, as follows:
     An update of 1.6 percent.
     An add-on to the composite rate for the difference between 
current payments for separately billable drugs and biologicals and 
payments based on the revised drug pricing methodology using 
acquisition costs.
     Case-mix adjustments for a limited number of patient 
characteristics.
     Application of a budget neutrality adjustment. The statute 
also allows the Secretary to adjust the payment rates by a geographic 
index as the Secretary determines to be appropriate which would be 
phased-in over a multiyear period.
    By January 1, 2005, we plan to implement the proposed revisions 
affecting the composite payment rate which would include the following:
     An increase of 1.6 percent to the basic composite payment 
rate.
     Proposed revisions to the pricing of separately billable 
drugs and biologicals.
     A drug add-on to the composite rate to reflect the 
difference between current payments for separately billable drugs and 
biologicals, and payment based on the revised drug pricing methodology 
using acquisition costs.
    We propose to implement the patient characteristics adjustments and 
the related budget neutrality adjustments by April 1, 2005. (See 
detailed discussion later in this section.)
2. Legislative History
    Section 2991 of the Social Security Amendments of 1972 (Pub. L. 92-
603), established Medicare's End Stage Renal Disease (ESRD) Program. 
This law extended Medicare coverage to individuals who have permanent 
kidney failure, require either dialysis or transplantation, and meet 
certain other eligibility requirements. The End Stage Renal Disease 
Program Amendments of 1978 (Pub. L. 95-292) added section 1881(b)(2)(B) 
to title XVIII of the Act.
    That legislation provided for the establishment of a prospective 
reimbursement methodology for the payment of dialysis treatments 
provided by renal dialysis facilities. Further changes to the ESRD 
payment system were made by section 2145 of Pub. L. 97-35, which 
amended section 1881 of the Act, requiring the development of a 
prospective reimbursement system for outpatient maintenance dialysis 
that promotes home dialysis. The payment system required either the 
reimbursement of home dialysis and in-facility dialysis under 
``composite'' rates, or the use of some other more efficient method 
determined to promote home dialysis more effectively.
    On February 12, 1982, we published a proposed rule on reimbursement 
for outpatient maintenance dialysis services (47 FR 6556) and we 
published the final rule on May 13, 1983 (48 FR 21254). This regulation 
implemented section 1881 of the Act, as amended by section 2145 of Pub. 
L. 97-35, and provided that each ESRD facility will receive a fixed 
composite payment rate per dialysis treatment, adjusted for geographic 
differences in area wage levels. Payment for in-facility and home 
dialysis treatments was established using a composite payment rate 
reflecting the costs of both modalities. Separate composite payment 
rates were established for hospital-based and independent dialysis 
facilities. The regulation also included a process under which 
facilities could obtain exceptions

[[Page 47526]]

to their composite payment rates under specified circumstances.
    The average composite payment rate per treatment, effective on 
August 1, 1983, was $123 for independent ESRD facilities and $127 for 
hospital-based facilities. The composite rate was designed to provide 
payment for a package of goods and services needed to furnish dialysis 
treatments that included certain routinely provided drugs, laboratory 
tests, supplies, and equipment. Unless specifically included in the 
composite payment rate, other injectable drugs and laboratory tests 
medically necessary for the care of the dialysis patient are separately 
billable.
    Prior to January 1, 2004, drugs not paid on a cost or prospective 
payment basis were paid based on the lower of the actual charge or 95 
percent of the AWP (section 1842(o)(1) of the Act, as added by section 
4556 of the BBA of 1997 (Pub. L. 105-33)). Sections 303 through 305 of 
the MMA make revisions to payment methodology for Part B covered drugs 
that are not paid on a cost or prospective payment basis. For CY 2004, 
the MMA provides that drugs not paid on a cost or prospective payment 
basis will be paid at 85 percent of the AWP determined as of April 1, 
2003. However, there are several exceptions to this general rule, 
including payment of ESRD drugs and biologicals. In CY 2004, drugs and 
biologicals furnished in connection with the furnishing of renal 
dialysis services if separately billed by renal dialysis facilities are 
paid at 95 percent of AWP. We note that hospital-based ESRD facilities 
are paid reasonable costs for separately billable drugs, except for 
Erythropoietin/Epoietin (EPO).
    EPO is an anti-anemia drug administered to certain patients with 
ESRD. Medicare Part B pays for EPO and its administration if it is 
furnished by an approved ESRD facility as part of an outpatient 
dialysis service or by a supplier of home dialysis equipment and 
supplies to ESRD patients in their homes as part of home dialysis 
services. Most dialysis is furnished to ESRD patients on an outpatient 
basis or is self-administered in the home.
    Section 1881(b)(11) of the Act expressly excludes payment for EPO 
furnished to ESRD patients from the composite rate for dialysis 
services. The costs of EPO are, therefore, billed separately by an ESRD 
facility or by a supplier of home dialysis equipment and supplies and 
are paid in addition to the facility's composite rate. Any EPO-related 
costs, such as the cost of its administration or overhead costs 
associated with its storage, however, are subsumed in the facility's 
composite rate.
    Section 413.174(f)(3) requires that we prospectively determine the 
EPO amount pursuant to section 1881(b)(11)(B)(ii) of the Act. Section 
4201(c) of the Omnibus Budget Reconciliation Act of 1990 (OBRA 90) 
(Pub. L. 101-508), however, amended section 1881(b)(11) of the Act to 
establish a new EPO payment methodology. OBRA 90 directed, effective 
January 1, 1991, that payment for EPO furnished to ESRD patients by 
Medicare-approved dialysis facilities or suppliers of home dialysis 
equipment and supplies for home use be made on a per-unit basis. OBRA 
90 also established a maximum payment amount of $11 per 1,000 unit 
doses rounded to the nearest 100 units. Subsequently, section 
13556(a)(2) of OBRA 93 was enacted, which further amended section 
1881(11)(b)(B)(ii) of the Act to reduce the maximum payment level to 
$10 per 1,000 units effective January 1, 1994. Although we have the 
authority to revise the rate, we continue to pay at the rate of $10 per 
1,000 units.
    Section 9335(a) of Pub. L. 99-509 required the Secretary to reduce 
the initially established composite payment rates by $2.00 per 
treatment effective October 1, 1986. This reduction was partially 
reversed as a result of the enactment of section 4201(a)(2) of Pub. L. 
101-508, which increased the composite payment rates in effect as of 
September 30, 1990 by $1.00 per treatment, but effectively froze the 
methodology for their calculation, including the data and definitions 
used, as of that date. Section 222 of Pub. L. 106-113, provided for a 
1.2 percent increase to the payment rates effective January 1, 2000, 
and also provided for another 1.2 percent increase effective January 1, 
2001. Section 422(a)(1) of Pub. L. 106-554, raised the amount of the 
January 1, 2001 payment increase by another 1.2 percent for a total 
increase of 2.4 percent effective January 1, 2001.
    Section 422 of Pub. L. 106-554 also directed the Secretary to 
develop a Prospective Payment System (PPS) that expanded the bundle of 
routine services reflected in the composite rate to include separately 
billable laboratory tests and drugs ``to the maximum extent feasible''. 
In addition, section 422(a) of Pub. L. 106-554 prohibited the granting 
of new composite rate payment exceptions for services furnished after 
December 31, 2000. Because a bundled ESRD payment system must be 
periodically updated, section 422(b) of Pub. L. 106-554 also required 
the development of an ESRD market basket to account for changes in 
price inflation, with discretionary consideration of other factors 
known to affect costs. Section 422(c) of Pub. L. 106-554 mandated the 
submission of a report to the Congress on the bundled payment system 
and ESRD market basket.
    On May 12, 2003, the Secretary submitted the required report to the 
Congress. The report explained the major issues that must be addressed 
before a bundled ESRD PPS can be implemented, presented an ESRD 
composite rate market basket, and discussed the results from the first 
phase of our sponsored research to develop a bundled payment system. 
The report presented the following three major findings that are 
relevant to our efforts to revise the composite rate payment system:
     Current data sources are adequate for proceeding to 
develop a bundled ESRD PPS.
     Case-mix may be an important variable for risk adjusting 
payments, based on preliminary analysis.
     Current data provide a sound basis for monitoring patient 
outcomes in a revised ESRD payment system.
3. Summary of Section 623 of MMA
    The following provisions in section 623 of the MMA, effective 
January 1, 2005, affect the composite payment rate methodology, as well 
as the pricing methodology for separately billable drugs and 
biologicals furnished by ESRD facilities:
    a. Section 623(a)--The last sentence of section 1881(b)(7) of the 
Act, as amended by MMA, provides for an increase in the current 
composite payment rate of 1.6 percent.
    b. Section 623(d)(1)--Section 1881(b)(13) of the Act, as added by 
MMA section 623(d)(1), provides for a revision to the current AWP 
pricing of separately billable drugs and biologicals; payment will be 
based on acquisition costs as determined by the OIG's study mandated 
under section 623(c) of the MMA. Insofar, as the OIG has not determined 
the acquisition costs, with respect to a drug or biological, the 
Secretary shall determine the payment amount for such drug or 
biological.
    c. Section 623(d)(1)--Section 1881(b)(12) of the Act, as added by 
MMA section 623(d)(1), also requires the establishment of a basic case-
mix adjusted composite payment rate that applies certain adjustments to 
the composite payment rate as follows:
     Adjustments for a limited number of patient 
characteristics.
     An adjustment that reflects the difference between current 
payments for

[[Page 47527]]

separately billed drugs and biologicals and the revised pricing based 
on acquisition costs or other method as determined by the Secretary.
     A geographic adjustment, if the Secretary determines such 
an adjustment is appropriate with the possibility of a phase-in.
     A budget neutrality adjustment, so that aggregate payments 
under the basic case-mix adjusted composite payment rates for 2005 
equal the aggregate payments that would have been made for the same 
period if section 1881(b)(12) of the Act did not apply.
4. Provisions of the Proposed Rule
a. Composite Rate Increase
    The current composite payment rates applicable to urban and rural 
hospital-based and independent ESRD facilities were effective January 
1, 2002. The current wage-adjusted rates for each urban and rural area 
were published in Tables III and IV of Program Memorandum A-01-19 
issued February 1, 2001 and are applicable through the end of 2004. 
Section 623(a)(3) of the MMA requires that the composite rates in 
effect on December 31, 2004 be increased by 1.6 percent. We are 
publishing revised wage-adjusted composite rates that reflect the 
statutorily required 1.6 percent increase. Those rates are set forth in 
Tables I and II at the end of this section. These tables reflect the 
updated hospital-based and independent facility composite rate of 
$132.40 and $128.35, respectively, adjusted by the current wage index. 
The rates will be effective January 1, 2005. The rates shown in the 
tables do not include any of the basic case-mix adjustments required 
under section 623 of the MMA.
b. Revised Pricing Methodology for Separately Billable Drugs and 
Biologicals Furnished by ESRD Facilities
    Section 623(d) of the MMA requires the Secretary to establish a 
basic case-mix adjusted PPS for dialysis services that are furnished 
beginning on January 1, 2005 by providers of services and renal 
dialysis facilities to individuals in a facility and to individuals at 
home. This system will include services comprising the composite rate 
as well as the difference between payment amounts for separately billed 
drugs and biologicals (including erythropoietin) furnished by ESRD 
facilities and acquisition costs of such drugs and biologicals as 
determined by the OIG reports from the studies mandated by section 
623(c) of the MMA.
    For 2004, the payment amounts for separately billed drugs and 
biologicals (other than erythropoietin) furnished by ESRD facilities 
are determined by 95 percent of AWP. For 2005, the payment amounts for 
separately billed drugs and biologicals (including erythropoietin) 
furnished by ESRD facilities are described in section III.E of the 
NRPM. Insofar as the acquisition cost has not been determined by the 
OIG, then the Secretary shall determine the payment amount of the drug 
and biological.
    For 2005 and subsequent years, the payment amounts for separately 
billed drugs and biologicals (including erythropoietin) furnished by 
ESRD facilities will be the acquisition cost or the amount that is 
derived from the ASP methodology in section 1847A of the Act, as the 
Secretary may specify.
    See section III.E.1.d. of this proposed rule for further 
explanation of payment for separately billable drugs and biologicals 
furnished by renal dialysis facilities.
c. Composite Rate Adjustment to Account for Changes in Pricing of 
Separately Billable Drugs and Biologicals
    Section 1881(b)(12) of the Act, as added by section 623(d) of the 
MMA, contains two provisions that specify how the drug add-on 
adjustment is to be handled in the revised ESRD payment system. First, 
subparagraph (B)(ii) of such section requires an adjustment to the 
composite payment rates to account for the difference between payment 
amounts for separately billed drugs (including erythropoietin) under 
the current payment system and acquisition costs as determined by the 
OIG. Second, subparagraph (E)(i) requires that the drug add-on 
adjustment be budget-neutral, that is, that it be designed to result in 
the same aggregate amount of expenditures as would have been made 
without the statutory policy change.
    We need to determine the composite rate adjustment for drug add-on 
amount that simultaneously deals with both statutory requirements. That 
is, the aggregate amount of the composite rate adjustment for drug add-
on amount needs to equal the aggregate amount of the drug spread (the 
difference between drug payments under the old system and acquisition 
costs).
    In order to ensure that we satisfy both constraints, it is 
necessary to consider the proposed drug pricing in developing the 
adjustment to the composite rates. As discussed in section III.E.1.d. 
of this proposed rule, we are proposing to pay for separately billable 
ESRD drugs using ASP minus 3 percent based on the average relationship 
of acquisition costs to average sales prices from the drug 
manufacturers as outlined in the OIG report. We have developed the 
proposed drug add-on adjustment using the ASP minus 3 percent drug 
prices. Section 2 below discusses the details of the calculation of the 
drug add-on adjustment. An alternative approach would be to use the 
2003 acquisition prices from the OIG report, calculate the aggregate 
difference between such prices and payments for drugs under the AWP 
system, update this difference to 2005 and then apply the budget 
neutrality adjustment. Because the same budget-neutrality adjustment 
would be used in both calculations, we believe that the drug add-on 
adjustment for the drug spread would be the same with both approaches. 
Therefore, we are proposing to use the ASP minus 3 percent prices as 
the basis for developing the drug add-on adjustment to the composite 
rate.
1. Options for Applying the Drug Add-On Adjustment to the Composite 
Payment Rate
    Currently, separately billable ESRD drugs are paid differently to 
hospital-based and independent ESRD facilities. EPO is currently the 
only drug for which payment is uniform across ESRD facilities; EPO is 
paid at the current rate of $10 per 1000 units. All other separately 
billed ESRD drugs provided by independent ESRD facilities are currently 
paid 95 percent of AWP prices. However, hospital based ESRD facilities 
are paid their reasonable cost for the other separately billed drugs 
they provide. Because they are paid on cost, hospital-based facilities 
have not made the profits from drug payment that independent facilities 
have enjoyed.
    The statutory language describing the add-on adjustment to the 
composite rate does not specifically differentiate between hospital-
based and independent facility composite rate adjustments. However, the 
drug add-on provision is included with the other provisions related to 
the basic case-mix adjusted composite rate system; thus, it could be 
argued that the drug add-on provision was intended to address ESRD 
industry concerns about the inadequacy of the composite payment rate. 
We believe these concerns apply equally to hospital-based facilities 
and independent facilities. Therefore, we are proposing a single 
adjustment to the composite payment rates for both hospital based and 
independent facilities.
    An alternative option would be to develop a separate adjustment for 
hospital-based facilities for EPO and one for independent facilities 
for all of their separately billed drugs. The IG's report provided the 
acquisition costs we are

[[Page 47528]]

using; it did not provide different acquisition costs for hospital-
based and independent facilities. We believe that it would not be 
appropriate for us to use these data to create two separate 
adjustments. The following discussion outlines the development of the 
drug add-on adjustment under both options--a single factor and separate 
factors.
2. Computation of Drug Add-On Adjustment to the ESRD Composite Payment 
Rate
i. Data
    To develop the drug add-on adjustment we used historical total 
aggregate payments for separately billed ESRD drugs for half of 2000 
and all of 2001 and 2002. For EPO, these payments were broken down 
according to type of ESRD facility (hospital-based versus independent). 
We also used the number of dialysis treatments performed by these two 
types of facilities over the same period.
ii. ASP Minus 3 Percent
    We updated the ASP minus 3 percent prices, for the first quarter of 
2004, to represent 2005 prices. We used the projected annual price 
growth factor for National Health Expenditure prescription drugs of 
3.39 percent.

                                TABLE 12
------------------------------------------------------------------------
                                           First quarter
                                           2004 average    Quarter 2005
                  Drugs                     sales price    average sales
                                           first minus 3   price minus 3
                                              percent         percent
------------------------------------------------------------------------
Epogen..................................           $8.74           $9.04
Calcitriol..............................            0.66            0.68
Doxercalciferol.........................            2.55            2.64
Iron--dextran...........................            9.22            9.54
Iron--sucrose...........................            0.34            0.35
Levocarnitine...........................            7.15            7.39
Paricalcitol............................            3.86            3.99
Sodium--ferric--glut....................            4.15            4.29
Alteplase, Recombinant..................           27.74           28.68
Vancomycin..............................            3.40            3.52
------------------------------------------------------------------------

iii. Current Medicare Reimbursement
    We updated the first quarter 2004 Medicare payment amounts (95 
percent of AWP), based on the January 2004 Single Drug Pricer, for 
drugs other than EPO, to estimate 2005 payment amounts by using an 
estimated AWP growth of 3 percent. These growth factors are based on 
historical trends of AWPs. We did not increase the price for Epogen 
since payment was maintained at $10.00 per thousand units prior to MMA.

                                TABLE 13
------------------------------------------------------------------------
                                                        Current medicare
                         Drugs                            reimbursement
                                                         prices for 2005
------------------------------------------------------------------------
Epogen................................................            $10.00
Calcitriol............................................              1.42
Doxercalciferol.......................................              5.67
Iron--dextran.........................................             18.45
Iron--sucrose.........................................              0.68
Levocarnitine.........................................             35.23
Paricalcitol..........................................              5.49
Sodium--ferric--glut..................................              8.42
Alteplase, Recombinant................................             37.80
Vancomycin............................................              7.24
------------------------------------------------------------------------

iv. Dialysis Treatments
    We updated the number of dialysis treatments by actuarial projected 
growth in the number of ESRD beneficiaries. Since Medicare covers a 
maximum of three treatments per week, utilization growth is limited, 
and therefore any increase in the number of treatments should be due to 
enrollment. In 2005, we project there will be a total of 36.5 million 
treatments performed (5.1 million treatments will be performed by 
hospital-based facilities and 31.4 million treatments by independent 
facilities).
v. Drug Payments
    We updated the total aggregate Epogen drug payments for each 
hospital-based and independent facilities using historical trend 
factors. For 2003 through 2005, the 2002 payment level was increased 
each year by trend factors of 2.8 percent for hospital-based facilities 
and by 9.4 percent for independent facilities.
    Using drug growth factors for drugs paid for by Medicare Part B 
carriers, which were calculated from historical data, we updated the 
aggregate spending for separately billable drugs, other than EPO, for 
independent facilities. We used 24.7 percent for 2003, 23.3 percent for 
2004, and 21.4 percent for 2005 as factors because historical growth of 
ESRD drugs is similar to that for drugs paid for by Part B carriers. 
These factors are projected to approach the level of National Health 
Expenditure prescription drug growth. For 2005, we estimate that 
spending will reach $185 million for Epogen provided in hospital-based 
facilities, and $2,664 million for drugs provided in independent 
facilities ($1,568 million for Epogen and $1,096 million for other 
drugs).
vi. Add-On Calculation and Budget Neutrality
    For each of the ten drugs, we calculated the percent by which ASP 
minus 3 percent prices are projected to be less than reimbursement 
amounts under the current system for 2005. For Epogen, this amount is 
10 percent. We applied this 10 percent figure to the total aggregate 
drug payments for Epogen in hospital-based facilities, resulting in a 
difference of $18 million. We then calculated a weighted average of the 
percentages by which ASP minus 3 percent would be below current 
Medicare reimbursement prices for the top 10 ESRD drugs. We weighted 
these percentages by using the 2002 Medicare reimbursement values 
contained in the OIG report for the ten drugs. This procedure resulted 
in a weighted average of 19 percent. Since these ten drugs represented 
98 percent of drugs payments, we applied the weighted average to 100 
percent or all of aggregate drug spending projections for independent 
facilities, producing a projected difference of $516 million.
    Combining the 2005 figures of $18 million and $516 million, for a 
total of $534 million and then distributing this over a total projected 
36.5 million treatments would result in a single add-on to the per 
treatment composite rate

[[Page 47529]]

of 11.3 percent. By making this adjustment to the composite rate, we 
estimate that the aggregate payments to ESRD facilities would be budget 
neutral with respect to drug payments.
    Alternatively, we could produce separate drug add-on adjustments 
for hospital-based and independent facilities using the same 
methodology. Under this option, we could distribute the $18 million 
difference in EPO payments to hospital-based facilities based on data 
projecting 5.1 million treatments resulting in a hospital-based 
facility drug add-on adjustment of 2.7 percent. We would distribute the 
$516 million difference in drug payments (including EPO) to independent 
facilities using projected treatments of 31.4 million, resulting in a 
drug add-on adjustment of 12.8 percent for independent facilities.
    Drug prices used in the computation of the proposed drug add-on 
adjustment to the ESRD composite payment rate, may be revised based on 
later data and will be reflected in the final rule.
3. Composite Rate Effect of Proposed Drug Add-On Adjustment
    We used a single drug add-on adjustment for both hospital-based and 
independent ESRD facilities, the proposed adjustment to the composite 
rate would be 1.113. Separate adjustments would provide a 1.128 
adjustment for independent facilities and 1.027 for hospital-based 
facilities. The following table illustrates the effect on the composite 
payment rates under the two potential drug add-on options. (Case-mix 
budget neutrality adjustments are not reflected in this table).

                                Table 14
------------------------------------------------------------------------
                                     CY 2005      Separate   Single add-
          Facility type             base rate      add-on         on
------------------------------------------------------------------------
Independent......................      $128.35      $144.78      $142.85
Hospital Based...................       132.41       135.99       147.37
------------------------------------------------------------------------

    Under the single add-on, the proportionately higher rate for 
hospital-based facilities would be consistent with section 1881(b)(7) 
which requires that our payment methods differentiate between hospital-
based facilities and others. Separate add-on adjustments would result 
in a significantly higher composite payment rate for independent 
facilities, than hospital-based facilities, that is, $8.79 higher per 
treatment.
d. Patient Characteristic Adjustments
1. Statutory Authority
    The current ESRD composite payment rates do not adjust for 
variation in patient characteristics or case mix. Section 
1881(b)(12)(A) of the Act, as added by section 623(d)(1) of the MMA, 
requires that the outpatient dialysis services included in the 
composite rate be case-mix adjusted. Specifically, the statute states 
that ``The Secretary shall establish a basic case-mix adjusted 
prospective payment system for dialysis services furnished by providers 
of services and renal dialysis facilities in a year to individuals in a 
facility and to individuals at home. The case-mix under the system 
would be for a limited number of patient characteristics.'' In the 
following sections, we describe the development of the methodology for 
the proposed patient characteristic case-mix adjusters required under 
the MMA.
2. Background
    Case-mix measures utilizing patient characteristics have been used 
in a number of prospective payment systems. Use of a case-mix measure 
permits targeting of greater payments to facilities that treat more 
costly resource-intensive patients. However, the legislative mandate to 
establish a case-mix adjustment for services included in the composite 
rate based on a limited number of patient characteristics presents a 
unique challenge.
    The composite rate represents payment for a fixed bundle of routine 
services provided to ESRD patients as part of a dialysis treatment. 
Generally, the items and services needed to provide a dialysis 
treatment do not vary significantly across patients. Moreover, the 
bills for composite payment rate services furnished to ESRD patients, 
which are generally submitted monthly, do not identify the specific 
items and services provided on a case-by-case basis. In addition, the 
Medicare cost reports identify only aggregate costs for composite rate 
services at the facility level. Therefore, any case-mix adjustment 
based on patient characteristics obtained from the bills for outpatient 
ESRD services and applied to the composite rate will reflect only 
variation in composite rate costs at the facility level.
    Earlier research by Hirth (1999) and Dor (1992) found that if case-
mix adjustments applied only to composite rate items and services the 
adjustments played a limited role in predicting variation in costs per 
treatment because case-mix and dialysis treatment patterns are very 
similar across facilities. However, more recent analyses conducted 
under our contract with the University of Michigan, Kidney, 
Epidemiology and Cost Center (KECC) found that patient level case-mix 
adjustment would be more relevant in a bundled payment system that 
includes both composite rate and separately billable items and 
services. KECC's research studies relied on an extensive set of 
variables to define patient case-mix. These variables included patient 
characteristics, a large number of specific comorbidities and clinical 
measures (including primary diagnosis) and other (non-Medicare) 
insurance coverage, as well as the duration of ESRD. We relied on 
linear regression analyses used in the studies to assess the 
relationship of patient characteristics and comorbidity measures to per 
session cost and Medicare payments to facilities. These studies relied 
on data from our administrative files.
    We are continuing and expanding the research project in support of 
the development of a fully bundled case-mix adjusted system. We are 
continuing to explore alternative models and options with more detailed 
analysis of patient characteristics as part of the legislatively 
mandated report to the Congress in the fall of 2005.
    Despite the difficulty in developing a patient characteristic case-
mix adjustment, we were able to develop case-mix adjustment factors for 
a limited number of patient characteristics, consistent with the 
legislative mandate. As expected, these adjusters are only modest 
predictors of variation in average costs for composite services. In 
developing the proposed patient characteristic adjustments, we used our 
available administrative data. Because facilities do not list 
individual composite rate items and services on the dialysis bill, 
billing data do not identify resources used by each patient. In

[[Page 47530]]

addition, facilities can underreport or not report comorbid conditions. 
Therefore, these bills are not useful for deriving average facility 
input costs. Since there are not any current requirements to list 
comorbid conditions on the dialysis bill, we used a combination of data 
sources to determine co-morbidities for ESRD patients on maintenance 
dialysis. These include the Medicare claims history file as well as the 
CMS Form 2728 (ESRD Medical Evidence Report) which provides information 
on the cause of ESRD and lists 20 possible co-morbidities present at 
the onset of a patient's ESRD. The Form 2728 is completed only at the 
initiation of dialysis treatment. It is not updated to reflect more 
recent medical conditions.
    Nonetheless, we found selected variables from the Form 2728 to be 
valid predictors of cost per treatment for the proposed case-mix 
adjustment, and the Form 2728 was also useful in developing our 
proposed case-mix adjustments. As discussed below, the Form 2728 
variables were supplemented by additional information we obtained from 
billing records.
3. Development of the Proposed Adjustments for Patient Characteristics
    We are proposing a methodology to establish a basic case-mix 
adjusted composite rate system using a limited number of patient 
characteristic variables developed from existing our administrative 
files. We analyzed a number of patient level variables including age, 
gender, alcohol and drug dependence, inability to ambulate/transfer, 
current smoker, number of years since ESRD onset, weight, height, mean 
BUN, and mean creatinine clearance, as well as a number of 
comorbidities.
    As a means to estimate how average cost variations among facilities 
are influenced by selected patient characteristics, extensive analyses 
were performed to develop a proposed ``basic case-mix adjusted PPS, for 
a limited number of patient characteristics,'' as specified in the 
statute. We analyzed the average cost per dialysis session (including 
both hemodialysis and Method I peritoneal dialysis converted to 
equivalent 3 times per week hemodialysis sessions) from national data 
gathered for the years 2000, 2001, and 2002.
    A stepwise regression was used to select a limited set of variables 
that were predictive of average facility cost per treatment. We used 
data pooled over a three-year period because we found the regression 
coefficients to reflect a consistent pattern over three years. We used 
data pooled over a three-year period to minimize the potential for 
volatility in the regressive coefficients. The analysis controlled for 
selected variables that influence facility costs, but are not case-mix 
related. These variables included wage index, the natural log of the 
number of dialysis sessions provided annually by the facility, type of 
facility, chain affiliation, and percentage of patients with urea 
reduction ratio (URR) as a measure of dialysis dose equal to or greater 
than 65 percent. The proposed model is based not only on the predictive 
power of these measures, but also upon objectivity (for example, 
discrete variables: age/gender), clinical plausibility, and 
practicality (that is, availability) of data collection. The variables 
used were assessed for their clinical plausibility by clinicians from 
the University of Michigan and CMS. Physicians assessed a proposed list 
to determine relationship of the proposed comorbidities to ESRD 
patients, and clinical practice/patterns.
    In addition to exploring a number of potential case-mix variables, 
we examined two methods, that is, linear and log linear models of the 
composite rate costs. We selected the log linear model in order to 
yield patient specific case-mix adjustments which can be multiplied by 
a dialysis facility's otherwise applicable composite rate payment. In 
this proposed rule, we provide a detailed example of the calculation of 
the proposed case-mix adjusted composite rate payments.
4. Proposed Patient Characteristic Adjustments
    As discussed in the background section above, the basic case-mix 
system is constrained by the composite rate and the data available for 
these adjustments. While we analyzed a number of variables, four 
patient characteristic variables were found to be modest predictors of 
cost variation among ESRD facilities. These patient characteristic 
variables include gender, age, and two comorbidities (AIDs and PVD) 
(See table 3 for specific ICD 9 codes for these comorbidities). Each of 
the gender categories was also divided into three age categories so 
that one adjustment factor could be developed to encompass both gender 
and age. The proposed patient characteristic adjustments are discussed 
below.
i. Gender and Age
    We are proposing adjustments for both gender and age. We found that 
gender and age were strong predictors of facility cost variations. In 
addition, data on gender and age are readily available, and are 
objective measures. After examining a number of options for age, we are 
proposing under 65, 65-79, and over 80 as the three categories for age. 
We attempted to develop a case-mix adjuster specific to the under 18 
age group. However, the population in that age group that was included 
in the data used to develop the case-mix adjustments was too small, and 
was generally concentrated in a very small number of facilities.
    While we recognize that pediatric patients are more costly to 
treat, those patients are generally treated in specialized pediatric 
facilities. As provided in MMA, those facilities can request 
adjustments to their composite payment rates through the exceptions 
process. This process will enable pediatric facilities to obtain 
payments that specifically recognize the higher cost associated with 
treating these patients. In developing the age adjustments, data for 
those patients were grouped into the under 65 age category. We note 
that adjustments for both gender and age are consistent with the MA 
risk adjustment models for ESRD patients.
ii. Proposed Comorbidity Adjustments
    As discussed above, the effect of the costs of dialysis for a 
number of conditions were analyzed. These included several 
comorbidities that did not have a statistically significant 
relationship to facility costs. In other cases, the lack of data 
precluded inclusion of a comorbid condition in the proposed patient 
characteristic adjustments. That is, we are unable to propose any 
adjustments based on data that cannot be routinely reported, (for 
example, some data elements that are reported only on the Form 2728). 
For the reasons discussed above, the Form 2728 is not an appropriate 
source of information since it is not updated after a patient enters 
the ESRD program. Two variables not currently available on the Medicare 
bill are weight and height. Weight and height are used to compute a 
patient's body mass index (BMI). Our analysis indicates that patients 
with extremely low or high BMI are costly to treat. Since BMI is 
directly related to a patient's dialysis prescription, we believe this 
factor could be an important measure of resource consumption related to 
the composite payment rate. We also believe that the length of time a 
patient is dialyzed could directly affect composite rate costs. We are 
currently exploring the feasibility of developing a mechanism to 
collect these data on the ESRD bill. In addition, we are soliciting 
comments on other data elements that could be added to the bill

[[Page 47531]]

that could be relevant predictors of composite rate costs.
    We also examined whether having cancer was predictive of higher 
resource used. We examined all cancers reported within the last 3 to 10 
years as reported on our claims history file or the Form 2728. While a 
patient's history of cancer was associated with higher costs, we found 
this measure to be too broad to be clinically meaningful. We will 
continue to evaluate this condition as a potential variable for 
refinement purposes. As ESRD facilities begin reporting patient 
comorbidities, we expect that we will be in a better position to 
identify the specific cancer diagnoses that may be related to increased 
composite rate costs.
    We also explored whether diabetes as a comorbidity is predictive of 
high resource use. We found that the predictive power of diabetes was 
dependent on whether PVD was part of the model. PVD was always 
statistically significant, when accounted for, while most measures of 
diabetes were not strongly associated with facility costs. Therefore, 
we are proposing a case-mix adjustment for PVD diagnoses. We believe 
this adjustment appropriately addresses the higher costs associated 
with sicker diabetic patients. We note that about 73 percent of 
diabetes patients included in our data also had PVD. Another comorbid 
condition that was found to be a significant predictor of facility cost 
is AIDs. This diagnosis is currently coded as part of the claims data.
    Another Form 2728 variable we examined was the presence of a 
substance (alcohol and drugs) dependence diagnosis. While the presence 
of substance abuse was found to be predictive of higher facility level 
costs, we are not proposing an adjustment for this comorbidity at this 
time since the substance abuse diagnosis is underreported on the 
claims. We are soliciting comments on the variables included in the 
proposed patient characteristic adjustment as well as recommendations 
for the inclusion of other potential variables that may affect the 
costs of dialysis.
    In summary, we are proposing to use a limited number of patient 
characteristics that do explain variation in reported costs for 
composite rate services consistent with the legislative requirement. 
The proposed adjustment factors are as follows:

                                Table 15
------------------------------------------------------------------------
 
------------------------------------------------------------------------
Female........................  age <65 years..................     1.11
                                age 65-79 years................     1.00
                                age >79 years..................     1.16
Male..........................  age <65 years..................     1.21
                                age 65-79 years................     1.17
                                age >79 years..................     1.23
AIDS..........................  ...............................     1.15
PVD...........................  ...............................     1.07
------------------------------------------------------------------------

    While the magnitude of some of the patient specific case-mix 
adjustments appears to be significant, facility variation in the case-
mix is limited. This is because of the overall similarity of the 
distribution of patients among the eight case-mix classification 
categories across facility classification groups. This is reflected by 
the average case-mix adjustment based on 2002 data for the various 
types of ESRD facilities shown in the table below.

                                Table 16
------------------------------------------------------------------------
                                                           Average case
                      Facility type                       mix adjustment
------------------------------------------------------------------------
All.....................................................          1.1919
Independent.............................................          1.1917
Hospital Based..........................................          1.1936
Urban...................................................          1.1931
Rural...................................................          1.1865
Small (<5k treatments/yr.)..............................          1.1911
Medium (5-10k treatments/yr.)...........................          1.1910
Large (>10k treatments/yr.).............................          1.1924
Non-profit..............................................          1.1924
For-profit..............................................          1.1918
------------------------------------------------------------------------

    As illustrated from this table, regardless of the type of provider, 
the average case-mix adjustments for patient characteristics do not 
vary significantly. We are continuing research to develop a more fully 
bundled proposed model that is not constrained by the existing 
composite rate. We will continue to study the predictive value of 
comorbidities and facility and patient level variables as part of the 
ongoing research. In addition, we are aware that by limiting the number 
of variables for the patient characteristics adjustment applicable to 
the composite payment rate, we are limiting the predictive power of the 
model. We are planning to consider additional variables to refine and 
update the proposed patient characteristics. Once we have implemented 
this basic case-mix system, we will continue to analyze comorbidities 
(on the reported claims file) and will consider expanding the list of 
variables used in the patient classification adjustment. In addition, 
we will be working with our fiscal intermediaries to improve the 
reporting of comorbidities on claims.
5. Technical Description of Model Used To Develop the Proposed Patient 
Characteristic Adjustments
    Both facility and patient level variables were used for the 
development of the proposed case-mix adjustment. Facility costs are 
based on Medicare allowable costs reported by facilities for dialysis 
and related services for which they are reimbursed through the 
composite rate. The sources of the cost data are the Medicare 
Independent Renal Dialysis Facility Cost Reports (Form CMS 265-94) and 
the Medicare Hospital Cost Reports (Form CMS 2552-96). We used the most 
current set of facility cost reports available (cost reports updated 
through December 2003 and made publicly available in March 2004).
    All cost reports spanning any part of calendar years 2000, 2001 or 
2002 were included in the development of the case mix adjusters. While 
for most facilities, especially independent facilities, a single cost 
report encompasses the entire calendar year; data for some facilities, 
most notably those whose reporting period spans two calendar years (for 
example, October through September rather than January through 
December) were pro-rated to calculate the average treatment cost during 
a calendar year. The resulting numbers of cost reports used in the 
analyses are shown in the table below by facility type and year. Note 
that currently there are fewer cost reports available for analysis in 
2002 because many facilities have not yet submitted cost reports for 
that year. The final version of this regulation will contain the most 
recent data available.

                                Table 17
------------------------------------------------------------------------
                                                 2000     2001     2002
------------------------------------------------------------------------
Independent facilities.......................    3,027    3,034    2,508
Hospital-based facilities....................      477      466      456
------------------------------------------------------------------------

    The average treatment cost per dialysis session for each facility 
was calculated by dividing the total reported cost for dialysis and 
related services by the total number of dialysis treatments. The source 
of the reported cost for independent facilities was Worksheet B from 
Form CMS 265-94 and, for hospital-based facilities, Worksheet I-2 (Form 
CMS 2552-96). The source for the total number of dialysis treatments 
for independent facilities was worksheet Form CMS265-94 and, for 
hospital-based facilities, worksheet I-4 (Form CMS 2552-96). Note that, 
for CMS Form 2552-96 and CMS Form 265-94, values

[[Page 47532]]

in the fields for renal dialysis and home program dialysis were used in 
the cost and treatment calculations. For the CMS Form 265-94 and the 
CMS Form 2552-96 (Worksheet C, and worksheet I-4, respectively) values 
in the field home program CAPD and home program CCPD were stated in 
terms of patient weeks, rather than the number of treatments. These 
cells were multiplied by three to make them comparable to the number of 
hemodialysis sessions per week. The method used was consistent with the 
research (Dor, Held, Pauley 1992, Hirth, et.al., 1999, Griffiths, 
et.al., 1994, and Ozgen and Ozcan, 2002).
    This method created an average Medicare allowable cost per dialysis 
treatment for each facility year of observation. Using the facility's 
Medicare billing number, cost report data were linked to claims data. 
For some facilities more than one billing number appears on claims and 
a list of correspondence among billing was used to link the claims to 
the cost report facility identifiers. This linkage was somewhat 
ambiguous for hospital facilities with satellite centers.
    Patient level data was obtained from the Medicare claims data, and 
the Medical Evidence Form (CMS 2728). ESRD patients were identified 
using the Renal Beneficiary and Utilization System (REBUS), Medical 
Evidence and Master Patient File Records. Dialysis-related services 
(for example, the number of dialysis sessions) were identified for ESRD 
patients by Billing source (72x: renal dialysis facility bills), 
revenue center codes and the Healthcare Common Procedure Coding System 
(HCPCS).
6. Study Sample
    Regression models for the average cost per session were used to 
estimate the typical cost per session. The average cost per session can 
be influenced by facilities with exceptional costs or with exceptional 
case-mix measures. To insure that the sample would characterize the 
patterns across the majority of facilities rather than being influenced 
by a few exceptional, non-representative facilities, the following 
facilities were excluded:
     Facilities with missing data from the cost reports or 
claims data. Twelve percent of the facilities lacked reported data.
     Facilities with high or low average costs.
     Facilities with exceptions.
     Facilities with extremely high or low proportions of 
patients with relevant medical cormorbidities.
     Small facilities.
    Facilities with high or low average costs were determined based 
upon their composite rate. Facilities, having values for the log of the 
ratio of average costs to the composite rate of less than minus 0.5 or 
greater than 1.0 were excluded. This excluded less than 1 percent of 
facilities. Some facilities, that is, those with extremely high or low 
values based on selected patient characteristics (for example, percent 
of patients having a specific comorbidities such as AIDs, HIV, or 
alcohol and drug dependence) and selected facility characteristics (for 
example, facility size or URR). As with average costs, facilities with 
extreme variables did not represent the normal distribution of patient 
characteristics across facilities. This excluded 1.6 percent of the 
facilities. In addition, we excluded small facilities with less than 20 
full patient years of dialysis during the year because it was difficult 
to assess the relationship between case-mix and facility costs based on 
the experience of a small number of patients. Facilities treating a 
small number of patients represented approximately 6.9 percent of the 
total facilities.
    The sample excluded facilities with exceptional reimbursement 
levels. These included facilities with exceptions, facilities with 
higher than average payments, for example, with $3.00 or greater than 
the predicted composite rate payments. We excluded facilities based on 
our list of exceptions granted from November 1993 to July 2001. Some 
facilities were not included within the sample because their average 
payments were greater than the calculated (predicted) composite rate 
for the individual facility. While for the majority of the facilities, 
average composite rate payments were exactly as predicted, for some 
facilities, the payments were $3.00 greater than the predicted rate. 
These facilities were excluded because they were likely to be 
facilities with errors in reporting or facilities with exceptions. Of 
all of the facilities in the sample, 7.5 of the facilities were 
excluded from the sample.
7. Developing Case-Mix Measures at Each Facility Based on Patient-
Specific Data
    Facility-level case-mix measures were defined using certain 
demographic and comorbidity indicators for the Medicare dialysis 
patients in each facility for CYs 2000 to 2002. In aggregating patient 
data by facility, case-mix measures for each patient were weighted by 
the number of hemodialysis-equivalent dialysis sessions received in 
each facility. This process gives approximately 12 times as much weight 
to the characteristics of patients receiving a full year of dialysis 
care at a particular facility as compared to a patient receiving only 
one month of care at that facility. The resulting facility-level case-
mix measures reflect how case-mix is distributed across individual 
treatments provided in the facility for Medicare dialysis patients. The 
number of dialysis sessions for each patient in each facility was 
obtained from Medicare outpatient institutional dialysis claims. The 
number of peritoneal dialysis patient days reported on each claim was 
multiplied by 3/7 to yield the number of hemodialysis-equivalent 
dialysis sessions provided during the time period covered by each 
claim. (For additional information see Phase I KECC Report, dated 
August 2002, p. 43).
8. Statistical Models
    We explored a number of statistical methods to model the 
relationship between composite rate costs and patient/facility 
characteristics. We explored both linear and log-linear ordinary least 
squares regression models for each year from 2000 to 2002 to predict 
the natural log of the ratio of each facility's composite rate costs 
divided by that facility's composite payment rate (without regard to 
exception payments).
i. Choice of Estimation Method
    We are proposing to use the log linear model in the methodology 
explained below in order to yield an easily administered case-mix 
adjuster which can be multiplied by the patient's otherwise applicable 
composite payment rate. This case-mix adjustment system also controls 
for selected variables.
    We used the cost to payment ratio (that is, the natural log of the 
ratio of reported costs compared to the composite rate calculated for 
each facility) as the dependent variable in the models. The analysis 
that supports our decision is described in detailed below. In order to 
determine how reimbursement levels could be adjusted to reflect the 
costs of treating different patients, estimates of how the cost of 
providing dialysis services (that is, the composite rate) varies 
according to the patient characteristics (for example, age gender and 
comorbidities) were completed. Because the reported cost per treatment 
for each facility, in part, reflects the level of reimbursement (for 
example, Medicare payments) that the facility received, the measure of 
facility costs used is defined as the ratio relative to the current 
standard reimbursement level for each facility. For the purposes

[[Page 47533]]

of these analyses, the standard Medicare reimbursement payments for 
composite rate services (excluding those facilities with payment 
exceptions) were used. These currently vary across facilities based on 
the application of the area wage index used to develop the patient 
characteristics adjustment. This wage index (that is, labor costs) was 
used to account for regional differences in labor costs, and includes 
an adjustment for hospital based versus independent facility status.
    As we have indicated, the costs of treatment varies from the 
composite rate payment for a number of reasons, including differences 
in the patient case-mix. The ratio of average reported costs at each 
facility were compared with the calculated composite rate payment in 
order to measure any variation in costs (that is, facility costs) from 
the composite rate. This cost to payment ratio measures the extent to 
which costs at a facility are higher or lower than the payment that 
would be expected based on their labor costs and facility type. 
Regression analysis was used to determine the extent to which the ratio 
varied with the average case-mix for each facility.
    The analysis indicated that a log transformation of this cost to 
payment ratio was less skewed and a better fit (that is, the predicted 
variables were closer to the actual values using the log 
transformation).
ii. Control Variables
    Apart from patient clinical and demographic characteristics, the 
proposed model also controls for selected other variables. These 
selected control variables include the wage index, the natural log of 
facility size (number of annual treatments), hospital-based/independent 
status, chain affiliation, and percent of patients with urea reduction 
ratios (URRs) greater than or equal to 65 percent. These control 
variables were included in the proposed model in order to account for 
the separate effect of facility variables and one readily available 
outcome variable on composite rate costs. These control variables were 
included in order to reduce potential distortion in the patient 
specific case-mix adjustors attributable to facility characteristics. 
We included the wage index to account for differences among facilities 
in area wage levels. We used facility size as a control factor because 
larger facilities, on average, have lower per treatment costs than 
smaller facilities. The hospital-based/independent classification was 
used because hospital based providers tend to have higher self-reported 
costs. Chain ownership is included in the model to account for 
differences among chains due to reporting conventions, as well as 
reflect similarities among facilities within chains. The URR was 
included as a control variable to account for a quality of care outcome 
measure at each facility, thereby mitigating any potential bias between 
composite rate costs and quality of care on the model's coefficients.
iii. The Log-Linear Model for Facility Costs
    We identified a limited number of comorbidities that are strong 
predictors of composite rate costs and developed an estimated 
adjustment factor for each of these comorbidities. In order to yield an 
adjustor that can be multiplied with the composite rate payment, the 
model was used to estimate the facility's reported composite rate costs 
per treatment, divided by the composite payment rate calculated for 
each facility. The resulting ratio was modeled using case-mix and 
control variables. Analysis indicated that a log transformation of this 
ratio was less skewed and was better fit by the model (that is, 
predicted values were closer to actual values using the log 
transformation, especially for high cost facilities).
    For facility j, the case-mix is measured by a vector of values, 
denoted by Xj. These values include both control variables 
and case-mix measures. The log of the ratio of cost per session 
(Cj) to composite rate (Rj) is denoted by 
Yj=log(Cj/Rj). The multiple 
observations for three years are not indicated explicitly. The model 
equation is Yj = Xj [beta] + [egr]j, 
where [beta] is the vector of coefficients for the predictor variables 
and [egr]j is an error term. This model is equivalent to the 
following model for cost for patient i, with a vector of individual 
characteristics Xij, at facility j: Cij = 
Rj eXij[beta].
9. Identifying Factors for Case-Mix Adjustment
    An evaluation of individual case-mix factors as potential risk 
adjusters was performed using several criteria to explain variation in 
facility costs. Consideration was also given to the validity of these 
potential case adjustors to costs based on clinical judgment, the 
stability of this relationship over time, the objectivity and accuracy 
of the data used to compute the factors, the reliability of information 
reported by different providers, and the feasibility of including them 
as risk adjusters.
    Case-mix factors that explained statistically significant variation 
in facility costs were identified based on a regression model that used 
a stepwise selection method. Unless otherwise specified, case-mix 
measures represent the fraction of dialysis sessions in each facility 
that were provided to patients having the relevant characteristic or 
comorbidity. Case-mix measures that were considered for selection in 
the model included age/gender groups (ages <65, 65-79 and 80+ years, 
separately for females and males), less than one year of treatment for 
ESRD, average weight among adult dialysis patients (ages>=20), low body 
mass index among adult dialysis patients (BMI<18.5 kg/m\2\) and the 
presence of individual comorbidities that were previously described 
that were developed from a combination of data from the Medicare claims 
history file and the CMS Form 2728.
10. Using the Model To Apply a Patient-Specific Case-Mix Adjustment to 
the Composite Rate
    The regression coefficients that are estimated using facility cost 
model we discuss above can be used to apply a patient-specific case mix 
adjustment to the composite rate. This is accomplished by re-
transforming the estimated coefficients to obtain relative factors for 
case mix adjustment. Based on a facility level cost model, where 
Xn is the proportion of patients in a facility having a 
specific characteristic (for example, a specific comorbidity), a one 
unit change in Xn can be used to characterize the difference 
between having and not having a specific patient characteristic. The 
coefficient for Xn,[beta]n, then estimates the 
change in the dependent variable (the natural log of the ratio of 
average composite rate costs to the composite rate) corresponding to 
whether or not a patient has that characteristic. The estimated 
coefficients can be re-transformed as e Xin[beta]tv to 
obtain relative factors for n=1 to N case-mix measures included in the 
model.
    The relative factors can then be applied multiplicatively to the 
composite rate in order to derive a case mix adjusted composite rate. 
Since these relative factors were all estimated to have values of 1.00 
or greater, an adjustment to the composite rate based on these factors 
would necessarily lead to higher payments by Medicare. However, the MMA 
provision requires that the modification to the composite rate payment 
system be budget neutral. For the purpose of this example only, a 
budget neutrality factor that is less than 1.00 must, therefore, also 
be applied, with the same factor being applied to all patients and all 
facilities.
    For patient i in facility j, a case-mix adjusted composite rate, 
ARij is

[[Page 47534]]

calculated as a function of the current composite rate, Rij, 
the estimated budget neutrality factor, N (to be determined), and an 
overall relative factor for case mix adjustment, Aij, where 
ARij = Rj * N * Aij, Rj = 
([rho]BjWj + (1-[rho])Bj, and 
Aij = eXij[beta].
    In the above equations, [rho] is the fraction of costs attributed 
to labor and therefore subject to an adjustment for geographic 
differences in wages, 1-[rho] is the fraction of costs attributed to 
non-labor inputs, Bj is the base rate for facility j, 
Wj is the CMS/BLS wage index for facility j (with 0.9 and 
1.3 representing the minimum and maximum values for Wj, 
respectively), Xij is a vector of case-mix measures for 
patient i at facility j, and B is the vector of coefficients estimated 
by the regression model. Parameters Pj and Bj 
vary according to whether facilities are independent or hospital-based 
and may also vary over time, while Wj is determined either 
by the MSA in which each facility is located or by the state location 
for facilities not in an MSA.
    As suggested by the equations above, the coefficients estimated by 
the cost model can be used to derive an aggregate relative adjustment 
factor for each patient (Aij) based on their individual 
characteristics (Xi). By applying this factor in a 
multiplicative fashion to the composite rate, it is also being applied 
multiplicatively to the wage index, so that the dollar effect of the 
case-mix adjustment also varies across facilities according to regional 
differences in labor costs. That is, the case-mix adjustment will be 
larger in magnitude for facilities that face relatively high labor 
costs. This is appropriate if we expect the higher level of care that 
may be necessary for certain types of patients, such as those with PVD, 
to require additional staff time or more highly trained staff in 
locales with differential wage levels. An overall relative case-mix 
adjustment factor for patient i, Ai, can be calculated based 
on the model as Ai = eXi[beta] = 
eX1i[beta]\1\ + X2i[beta]\2\ + + 
Xpi[beta]\p\.
    However, since this is equivalent to Ai = 
eXi[ballot] = 
eX1i[ballot]\1\*eX2i[ballot]
\2\* . . . *eXni[ballot]\n\, the overall relative 
case-mix adjustment factor, or patient multiplier, can be calculated by 
multiplying together the relative adjustment factors for each case-mix 
measure. For every n=1 to p, Xpi corresponds to a 1 if that 
characteristic is present and a 0 if that characteristic is not 
present. For any characteristic that is not present, Xpi=0 
and eXpi[ballot]\p\=1, such that the equation can 
be simplified by including only those terms that are relevant for each 
patient. For characteristics that are present, Xpi=1, and 
the equation can be further simplified by dropping Xpi.
    Where the individual factors for case-mix adjustment are age/
gender, PVD and AIDS, the equation used to calculate the relative 
factor for case mix adjustment can then be expressed as Ai 
=e[beta] = e[beta]\AS\*e[beta]\PVD\*e[beta]\AIDS\ where e[beta]\AS\ is 
the relative factor for the appropriate age and sex category (one of 
six age/sex groups), e[beta]\PVD\ is the relative factor for the 
relevant PVD category (whether PVD is present or absent) and 
e[beta]\AIDS\ is the relative factor for the appropriate AIDS category 
(whether AIDS is present or absent).
11. Example
    To illustrate, the proposed adjustment factors in section 4. above 
were used to derive a case-mix multiplier for a 7-year old male who has 
been diagnosed with PVD, but not AIDS. Using the proposed adjustment 
factors that correspond to males between the ages of 65 and 79 years 
and the presence of PVD, the overall case-mix multiplier for this 
patient is calculated as A = e\Xb\ = e[beta]\AS\*e[beta]\PVD\ = 1.17 x 
1.07 = 1.2519.
    A detailed example of the computation of the adjusted composite 
payment rate that includes the patient characteristics adjustments, as 
well as the applicable adjustments related to the ESRD drug payment 
revisions and budget neutrality, is provided later in this section I. 
below.
e. Geographic Index
    Section 623(d)(1) of the MMA provides that the Secretary shall 
adjust the payment rates under this section by a geographic index as 
the Secretary determines to be appropriate. This section also specifies 
that, if the Secretary revises the current geographic adjustments 
applied to the composite payment rate, the revised adjustments must be 
phased in over a period of time. The current geographic adjustment 
(wage index) is a blend of two wage indexes, one based on hospital wage 
data collected by us from fiscal year 1986 and the other developed from 
1980 hospital wage and employment data from the Bureau of Labor 
Statistics (BLS). The hospital and BLS proportions of the blended wage 
index are 40 percent and 60 percent. The actual wage index values and 
MSA/non-MSA designations currently used in connection with the 
composite rates were published in the August 15, 1986 Federal Register 
(51 FR 29412-29417). For the reasons discussed below, we have decided 
not to propose any changes to the current wage index adjustments at 
this time.
    On June 6, 2003, OMB issued Bulletin 03-04 that announced new MSAs 
and two new sets of statistical areas, Micropolitan Statistical Areas 
and Combined Statistical Areas (CSAs). We recognize that the new OMB 
definitions will have implications for the various payment systems we 
administer that reflect payment distinctions based on geographic 
location. Any changes adopted will not only result in payment 
redistributions among ESRD facilities, but will also affect hospitals, 
home health agencies, skilled nursing facilities, and rehabilitation 
providers.
    Therefore, it is essential that we evaluate any proposals to revise 
the area definitions and assess the impact of changes in geographical 
areas on those payment systems that incorporate adjusters for area wage 
levels among urban and rural locations.
    Although the MMA gives the Secretary discretion to revise the 
outdated wage indexes used in the composite rates, we believe that we 
should take no action to replace them with revised measures pending 
completion of our assessments.
    Therefore, we are proposing to take no action at this time to 
revise the current set of composite rate wage indexes and the urban and 
rural definitions used to develop them. Once revisions to the urban and 
rural definitions are adopted, we may be in a better position to 
propose revisions to the geographic adjustments applied to the case-mix 
adjusted composite payment rates.
    For purposes of applying the required geographic adjustments to the 
case-mix adjusted composite rate payment system, we are proposing to 
continue using the wage index values and urban and rural designations 
that are currently applied to the composite payment rates.
    Section 1881(b)(12)(E)(i) of the Act, as added by section 623(d)(1) 
of the MMA, requires that the basic case-mix adjusted composite rate 
system be designed to result in the same aggregate amount of 
expenditure for such services, as estimated by the Secretary, as would 
have been made for 2005 if that paragraph did not apply. Therefore, the 
drug add-on adjustment and the patient characteristics case-mix 
adjustment required by section 623(d)(1) of the MMA must result in the 
same aggregate expenditures for 2005 as if these adjustments were not 
made.
    With respect to the drug payment add-on adjustment the total 
estimated difference between the current drug payment based on 95 
percent of AWP and the payment amount generated from payment based on 
ASP minus 3 percent is reflected in the proposed adjustment which is 
designed so that aggregate

[[Page 47535]]

payments are budget neutral. (See section H.4.c.2. of this proposed 
rule for more detailed explanation of drug add-on adjustment).
    In order to account for the payment effect related to the case-mix 
adjustment, we standardized the composite rate by dividing the rate by 
the average case-mix modifier of 1.1919. (See section 4.ii Proposed 
Cormorbidity Adjustments). The resulting adjustment to the composite 
rate is .8390. However, we were not able to simulate the case-mix 
effects from the ESRD billing file because comorbidities are generally 
not included on the ESRD bill. (See section H.3. of this proposed rule 
for the discussion of the data issues.) We propose to refine our 
adjustments for case-mix once we have more complete data on the ESRD 
bill.

F. Payment Exceptions and the Revised Composite Payment Rates

    Before the enactment of BIPA, an ESRD facility could apply for and 
receive prospective adjustments or exceptions to its otherwise 
applicable composite payment rate under specified circumstances. 
Section 1881(b)(7) of the Act and Sec.  413.182 contain the statutory 
and regulatory authorities for the provision of exceptions to the 
composite payment rates. Section 422(a)(2) of BIPA prohibited the 
granting of new exceptions to the composite payment rates on or after 
December 31, 2000, except under very limited circumstances, which 
expired July 1, 2001. That prohibition remains in effect, with one 
exception. Section 623(b) of the MMA amended section 422(a)(2) of BIPA 
to afford pediatric facilities the opportunity to seek exceptions 
provided they did not have an exception rate in effect as of October 1, 
2002. The statute defines a pediatric facility as a renal facility, 50 
percent of whose patients are under age 18. On April 1, 2004, we opened 
an exception window for pediatric facilities. The exception window 
closes September 27, 2004.
    Section 422(a)(2)(C) of BIPA provided that any ESRD composite rate 
exception in effect on December 31, 2000 would continue as long as the 
exception rate exceeds the applicable composite payment rate. The MMA 
did not revise that provision. Comparisons of a provider's exception 
rate and the standard composite payment rate are straightforward, 
because each payment rate was applied on a facility specific basis, 
without any adjustments for case-mix. However, in this proposed rule, 
we are proposing revised composite payment rates that are case-mix 
adjusted. The wage adjusted composite payment rates listed for each 
urban and rural area noted in Tables I and II at the end of this 
section, although applied on a per treatment basis, are subject to case 
mix adjustments in accordance with section 623(d)(1) of the MMA. The 
proposed methodology for applying patient characteristic adjusters 
applicable to each treatment will determine the case-mix adjustment 
which will vary for each patient. Thus, an ESRD facility's average 
composite rate per treatment will depend on its unique case mix.
    Our policy was not to increase any ESRD facility's exception rate 
when there has been a congressionally mandated update to the ESRD 
composite payment rates. When computing an exception amount, we take 
into consideration the ESRD facility's patient population and the 
higher costs relating to the patient mix. Since ESRD facilities can 
maintain their current exception rates, we would expect them to compare 
the exception rate to the basic case-mix adjusted composite rate to 
determine the best payment rate for their facility. We are proposing to 
allow each dialysis facility the option of continuing to be paid at its 
exception rate or at the basic case-mix adjusted composite rate (which 
includes all the MMA 623 payment adjustments). If the facility retains 
its exception rate, it would not be subject to any of the adjustments 
specified in section 623 of the MMA. Whether a provider's exception 
rate in effect on December 31, 2000 will exceed its average case-mix 
adjusted composite payment rate is impossible for us to accurately 
determine. We believe that projections as to whether an ESRD facility's 
exception rate per treatment will exceed its average case-mix adjusted 
composite rate per treatment are best left to the entities affected. 
Therefore, we are proposing that each ESRD facility with composite rate 
exceptions currently in effect, and each pediatric ESRD facility 
granted an exception, must notify its fiscal intermediary in writing if 
it wishes to withdraw its exception and be subject to the basic case-
mix adjusted composite payment rate methodology set forth in this 
notice.
    We are proposing to allow an ESRD facility to notify its fiscal 
intermediary at any time if it wishes to give up its exception rate. 
Once a facility has notified its fiscal intermediary of its election to 
give up its exception rate, it would lose that exception rate, 
regardless of basis or amount, and be subject to the proposed case-mix 
adjusted composite payment rates beginning 30 days after the 
intermediary's receipt of the facility's notification letter. 
Facilities with exception rates will be required to notify their fiscal 
intermediaries only if they wish to forego their exceptions. ESRD 
facilities electing to retain their exceptions do not need to notify 
their intermediaries. ESRD facilities without exceptions, of course, 
will be subject to the composite payment rates determined using the 
basic case-mix methodology described in this notice beginning January 
1, 2005.

G. Summary of Composite Rate Revisions and Proposed Implementation

    As set forth in this proposed rule, we will increase the ESRD 
composite payment rates by 1.6 percent effective January 1, 2005 in 
accordance with section 623(a) of the MMA. Also, the composite payment 
rates will be increased to reflect revisions to the drug pricing 
methodology for separately billable drugs, as discussed in section 
H.4.b. of this proposed rule. That increase represents the spread or 
difference between the payment amounts for separately billable drugs 
and biologicals and their acquisition costs based on the OIG's May 2004 
report to the Secretary. The development and computation of the drug 
add-on adjustment are described in section H.4.c of this proposed rule. 
We have also proposed a basic case-mix methodology for adjusting the 
composite payment rates based on a limited number of patient 
characteristics, as prescribed in section 623(d) of the MMA. The 
development and application of the case-mix adjusters are explained in 
section H.4.d.4 of this proposed rule. The MMA requires that the basic 
case-mix adjusted composite payment rates be effective for services 
furnished beginning January 1, 2005. Despite the law's specificity with 
respect to effective date, the systems and operational changes 
necessary to apply the case-mix adjusters cannot be completed in time 
for a prospective January 1, 2005 effective date.
    The 1.6 percent statutory increase and 11.3 drug add-on for 
independent and hospital-based facilities for separately billable drugs 
will be applied to the composite rates for all ESRD facilities 
beginning January 1, 2005. However, the computation of the case mix 
adjusters depends on age, sex, and specific comorbidities which must be 
obtained from the bills for each ESRD facility. Therefore, the 
combination of case-mix adjusters used to increase a provider's 
otherwise applicable composite payment rate depends on a provider's 
unique patient profile and is facility-specific. The correct 
computation of these facility-specific case-mix adjusters will require 
numerous programming,

[[Page 47536]]

systems, billing, and instructional changes by us, fiscal 
intermediaries, and system maintainers. In addition, providers and 
their fiscal intermediaries will require education and training not 
only on the basic features of the new ESRD PPS, but also on the proper 
reporting of patient and clinical information on the bills, essential 
for an accurate case mix adjustment in connection with each patient's 
claims.
    Given these requirements, the lead time necessary for systems 
changes, and the anticipated time necessary for providers and their 
fiscal intermediaries to familiarize themselves with and correctly 
apply the basic case-mix adjustments, we are proposing an April 1, 2005 
effective date.
    As an alternative to an April 1, 2005 effective date for the 
patient characteristic case mix adjustments, we considered two options 
for an April 1, 2005 prospective implementation date that would 
effectively comply with the MMA's January 1, 2005 effective date. Under 
the first option, we would implement the patient characteristic 
adjustments on April 1, 2005 and reprocess bills and adjust payments to 
January 1, 2005. Under this option, the budget neutrality adjustment 
related to the patient characteristic factors would not be applied to 
the composite rate until bills are reprocessed.
    The second option that we considered was to make payment to 
facilities starting January 1, 2005, at the budget neutralized 
composite rate, until the systems changes for the case-mix adjustment 
can be implemented, April 1, 2005. Payment at this rate would avoid 
overpayments, and thus, the need to recoup moneys that may occur when 
we retroactively process the claims for case-mix adjustments on April 
1, 2005. Under this option, facilities would receive approximately 16 
percent less than they would otherwise be entitled to on January 1, 
2005.
    We rejected both of these alternatives. Both options require the 
reprocessing and adjustment of bills for the first quarter of 2005. In 
addition, because of the likelihood of payment error due to the 
complexity of the process and costly implementation and potential 
disruption of payment to ESRD facilities, we believe that these options 
are problematic. Given that the expected impact of the patient 
characteristic adjustments on ESRD facility payments will, for the most 
part, be minimal, we believe that applying the adjustments 
prospectively from April 1, 2005 provides a smoother transition to the 
new payment methodology.
    Finally, this notice provides for a budget neutrality reduction of 
.8390 percent to the case-mix adjusted composite payment rates. Our 
budget neutrality methodology is explained in section H.4.f. of this 
proposed rule. Because section 623(d) of the MMA requires that budget 
neutrality be applied in the context of implementing the case-mix 
adjusted composite rate payment system, we are proposing that the 
effective date of the budget neutrality adjustment should also be April 
1, 2005. If we applied the budget neutrality adjustment in January, 
rather than when the case-mix adjustment is applied in April, the 
result would be that all the composite rates would go down.
    We are specifically soliciting comments on these options of the 
proposed rule. However, the 1.6 percent statutory increase to the 
composite payment rates, and the drug add-on for separately billable 
drugs, will be effective January 1, 2005, as these adjustments are 
easily implemented prospectively.

IV. Example of Payment Calculation Under the Proposed Case-Mix Adjusted 
Composite Rate System

    The following example presents 2 patients dialyzing at Neighbor 
Dialysis, an independent facility in Baltimore, MD. Patient 1, 
John Smith, is a 71-year old male who has been diagnosed with PVD and 
AIDS. Patient 2, Jane Doe, is a 59-year old female who has 
been diagnosed with PVD.
Calculation of Basic Composite Rate for Neighbor Dialysis
Wage adjusted Composite Rate for independent facilities in Baltimore, 
Md. (Table I): $134.93
Wage adjusted Composite Rate increased by proposed drug add-on 
adjustment ($134.93 x 1.113): $150.18
Adjusted Facility Composite Rate after budget neutrality (150.18 x 
.8490): $126.00
Calculation of Case-mix Adjusted Payments
Patient 1--John Smith:
    Male age 65-79 years: 1.17
    AIDS: 1.15
    PVD: 1.07
Case-mix adjusted rate for John Smith ($126.00 x 1.17 x 1.15 x 1.07): 
$181.40
Patient 2--Jane Doe:
    Female age < 65 years: 1.11
    PVD: 1.07
Case-mix adjusted rate for Jane Doe ($126.00 x 1.11 x 1.07): $149.65

                          Table 18.--Composite Payment Rates Effective January 1, 2005
                                          [For urban renal facilities]
----------------------------------------------------------------------------------------------------------------
          MSA code                   Name of MSA                   State             Hospital       Independent
----------------------------------------------------------------------------------------------------------------
0040.......................  ABILENE....................  TX....................          127.58          123.18
0060.......................  AGUADILLA..................  PR....................          127.57          123.18
0080.......................  AKRON......................  OH....................          137.39          133.68
0120.......................  ALBANY.....................  GA....................          127.57          123.18
0160.......................  ALBANY-SCHENECTADY-TROY....  NY....................          129.93          125.70
0200.......................  ALBUQUERQUE................  NM....................          135.60          131.77
0220.......................  ALEXANDRIA.................  LA....................          129.70          125.46
0240.......................  ALLENTOWN-BETHLEHEM........  PA-NJ.................          134.75          130.87
0280.......................  ALTOONA....................  PA....................          133.79          129.84
0320.......................  AMARILLO...................  TX....................          130.03          125.80
0360.......................  ANAHEIM-SANTA ANA..........  CA....................          145.72          142.64
0380.......................  ANCHORAGE..................  AK....................          146.35          146.35
0400.......................  ANDERSON...................  IN....................          131.74          127.63
0405.......................  ANDERSON...................  SC....................          127.57          123.18
0440.......................  ANN ARBOR..................  MI....................          145.80          142.71
0450.......................  ANNISTON...................  AL....................          127.57          123.18
0460.......................  APPLETON-OSHKOSH-NEENAH....  WI....................          132.60          128.56
0470.......................  ARECIBO....................  PR....................          127.57          123.18
0480.......................  ASHEVILLE..................  NC....................          130.57          126.39
0500.......................  ATHENS.....................  GA....................          127.57          123.18

[[Page 47537]]

 
0520.......................  ATLANTA....................  GA....................          130.07          125.84
0560.......................  ATLANTIC CITY..............  NJ....................          134.72          130.82
0600.......................  AUGUSTA....................  GA-SC.................          130.08          125.85
0620.......................  AURORA-ELGIN...............  IL....................          140.21          136.70
0640.......................  AUSTIN.....................  TX....................          135.14          131.29
0680.......................  BAKERSFIELD................  CA....................          141.64          138.25
0720.......................  BALTIMORE..................  MD....................          138.55          134.93
0733.......................  BANGOR.....................  ME....................          129.34          125.09
0760.......................  BATON ROUGE................  LA....................          131.80          127.71
0780.......................  BATTLE CREEK...............  MI....................          134.05          130.11
0840.......................  BEAUMONT-PORT ARTHUR.......  TX....................          130.85          126.67
0845.......................  BEAVER COUNTY..............  PA....................          138.52          134.89
0860.......................  BELLINGHAM.................  WA....................          132.87          128.85
0870.......................  BENTON HARBOR..............  MI....................          127.57          123.18
0875.......................  BERGEN-PASSAIC.............  NJ....................          142.22          140.71
0880.......................  BILLINGS...................  MT....................          132.16          128.08
0920.......................  BILOXI-GULFPORT............  MS....................          127.57          123.18
0960.......................  BINGHAMTON.................  NY....................          130.00          125.77
1000.......................  BIRMINGHAM.................  AL....................          131.83          127.73
1010.......................  BISMARCK...................  ND....................          130.64          126.47
1020.......................  BLOOMINGTON................  IN....................          129.78          125.54
1040.......................  BLOOMINGTON-NORMAL.........  IL....................          129.69          125.45
1080.......................  BOISE CITY.................  ID....................          135.23          131.39
1123.......................  BOSTON-SALEM-BROCKTON......  MA....................          139.45          135.89
1125.......................  BOULDER-LONGMONT...........  CO....................          140.62          137.15
1140.......................  BRADENTON..................  FL....................          128.79          124.47
1145.......................  BRAZORIA...................  TX....................          134.02          130.08
1150.......................  BREMERTON..................  WA....................          129.14          124.87
1163.......................  BRIDGEPORT-NORWALK-DANBURY.  CT....................          141.49          138.08
1240.......................  BROWNSVILLE-HARLINGEN......  TX....................          129.79          125.56
1260.......................  BRYAN-COLLEGE STATION......  TX....................          128.68          124.37
1280.......................  BUFFALO....................  NY....................          133.55          129.59
1300.......................  BURLINGTON.................  NC....................          127.57          123.18
1303.......................  BURLINGTON.................  VT....................          131.37          127.24
1310.......................  CAGUAS.....................  PR....................          127.57          123.18
1320.......................  CANTON.....................  OH....................          131.51          127.40
1350.......................  CASPER.....................  WY....................          136.29          132.52
1360.......................  CEDAR RAPIDS...............  IA....................          131.05          126.92
1400.......................  CHAMPAIGN-URBANA-RANTOUL...  IL....................          133.39          129.39
1440.......................  CHARLESTON.................  SC....................          131.44          127.33
1480.......................  CHARLESTON.................  WVA...................          135.86          132.06
1520.......................  CHARLOTTE-ROCK HILL........  NC-SC.................          129.79          125.57
1540.......................  CHARLOTTESVILLE............  VA....................          133.15          129.15
1560.......................  CHATTANOOGA................  TN-GA.................          132.45          128.39
1580.......................  CHEYENNE...................  WY....................          131.21          127.06
1600.......................  CHICAGO....................  IL....................          142.79          139.48
1620.......................  CHICO......................  CA....................          139.53          135.98
1640.......................  CINCINNATI.................  OH-KY-IN..............          137.22          133.50
1660.......................  CLARKSVILLE-HOPKINSVILLE...  TN-KY.................          127.57          123.18
1680.......................  CLEVELAND..................  OH....................          141.66          138.27
11720......................  COLORADO SPRINGS...........  CO....................          135.83          132.03
1740.......................  COLUMBIA...................  MO....................          140.08          136.56
1760.......................  COLUMBIA...................  SC....................          130.43          126.24
1800.......................  COLUMBUS...................  GA-AL.................          128.15          123.79
1840.......................  COLUMBUS...................  OH....................          134.12          130.19
1880.......................  CORPUS CHRISTI.............  TX....................          131.52          127.41
1900.......................  CUMBERLAND.................  MD-WVA................          128.22          123.87
1920.......................  DALLAS.....................  TX....................          134.47          130.56
1950.......................  DANVILLE...................  VA....................          127.57          123.18
1960.......................  DAVENPORT-MOLINE...........  IA-IL.................          133.12          129.11
2000.......................  DAYTON-SPRINGFIELD.........  OH....................          137.82          134.14
2020.......................  DAYTONA BEACH..............  FL....................          127.85          123.47
2030.......................  DECATUR....................  AL....................          127.57          123.18
2040.......................  DECATUR....................  IL....................          131.69          127.57
2080.......................  DENVER.....................  CO....................          143.60          140.35
2120.......................  DES MOINES.................  IA....................          135.21          131.36
2160.......................  DETROIT....................  MI....................          143.03          139.73
2180.......................  DOTHAN.....................  AL....................          127.57          123.18
2200.......................  DUBUQUE....................  IA....................          132.63          128.61
2240.......................  DULUTH.....................  MN-WI.................          130.10          125.88
2290.......................  EAU CLAIRE.................  WI....................          128.84          124.53

[[Page 47538]]

 
2320.......................  EL PASO....................  TX....................          128.41          124.08
2330.......................  ELKHART-GOSHEN.............  IN....................          129.30          125.01
2335.......................  ELMIRA.....................  NY....................          132.63          128.60
2340.......................  ENID.......................  OK....................          129.51          125.24
2360.......................  ERIE.......................  PA....................          131.82          127.74
2400.......................  EUGENE-SPRINGFIELD.........  OR....................          133.37          129.37
2440.......................  EVANSVILLE.................  IN-KY.................          134.10          130.16
2520.......................  FARGO-MOORHEAD.............  ND-MN.................          133.83          129.88
2560.......................  FAYETTEVILLE...............  NC....................          127.57          123.18
2580.......................  FAYETTEVILLE-SPRINGDALE....  AR....................          127.57          123.18
2640.......................  FLINT......................  MI....................          141.83          138.45
2650.......................  FLORENCE...................  AL....................          127.57          123.18
2655.......................  FLORENCE...................  SC....................          127.57          123.18
2670.......................  FORT COLLINS-LOVELAND......  CO....................          131.49          127.38
2680.......................  FT LAUDERDALE-POMPANO BEACH  FL....................          137.23          133.51
2700.......................  FORT MYERS-CAPE CORAL......  FL....................          129.73          125.49
2710.......................  FORT PIERCE................  FL....................          130.09          125.87
2720.......................  FORT SMITH.................  AR-OK.................          128.97          124.67
2750.......................  FORT WALTON BEACH..........  FL....................          127.57          123.18
2760.......................  FORT WAYNE.................  IN....................          129.32          125.05
2800.......................  FORT WORTH-ARLINGTON.......  TX....................          133.06          129.04
2840.......................  FRESNO.....................  CA....................          142.09          138.72
2880.......................  GADSDEN....................  AL....................          128.48          124.17
2900.......................  GAINESVILLE................  FL....................          130.25          126.06
2920.......................  GALVESTON-TEXAS CITY.......  TX....................          137.86          134.20
2960.......................  GARY-HAMMOND...............  IN....................          138.47          134.85
2975.......................  GLENS FALLS................  NY....................          128.98          124.68
2985.......................  GRAND FORKS................  ND....................          129.26          124.98
3000.......................  GRAND RAPIDS...............  MI....................          133.41          129.44
3040.......................  GREAT FALLS................  MT....................          132.09          128.01
3060.......................  GREELEY....................  CO....................          134.34          130.43
3080.......................  GREEN BAY..................  WI....................          133.34          129.33
3120.......................  GREENSBORO-WINSTON SALEM-    NC....................          129.67          125.42
                              HIGH PT.
3160.......................  GREENVILLE-SPARTANBURG.....  SC....................          130.15          125.95
3180.......................  HAGERSTOWN.................  MD....................          132.79          128.78
3200.......................  HAMILTON-MIDDLETOWN........  OH....................          134.87          130.98
3240.......................  HARRISBURG-LEBANON-CARLISLE  PA....................          133.92          129.97
3283.......................  HARTFORD-NEW BRITAIN-        CT....................          140.38          136.90
                              BRISTOL.
3290.......................  HICKORY....................  NC....................          127.57          123.18
3320.......................  HONOLULU...................  HI....................          141.73          138.34
3350.......................  HOUMA-THIBODAUX............  LA....................          128.02          123.66
3360.......................  HOUSTON....................  TX....................          137.24          133.53
3400.......................  HUNTINGTON-ASHLAND.........  WVA-KY-OH.............          130.11          125.88
3440.......................  HUNTSVILLE.................  AL....................          127.57          123.18
3480.......................  INDIANAPOLIS...............  IN....................          135.16          131.30
3500.......................  IOWA CITY..................  IA....................          143.23          140.37
3520.......................  JACKSON....................  MI....................          134.43          130.53
3560.......................  JACKSON....................  MS....................          128.82          124.51
3580.......................  JACKSON....................  TN....................          127.57          123.18
3600.......................  JACKSONVILLE...............  FL....................          130.77          126.58
3605.......................  JACKSONVILLE...............  NC....................          127.75          123.37
3620.......................  JANESVILLE-BELOIT..........  WI....................          128.39          124.05
3640.......................  JERSEY CITY................  NJ....................          138.46          134.84
3660.......................  JOHNSON CITY-BRISTOL.......  TN-VA.................          127.57          123.18
3680.......................  JOHNSTOWN..................  PA....................          133.36          129.36
3690.......................  JOLIET.....................  IL....................          140.66          137.19
3710.......................  JOPLIN.....................  MO....................          127.97          123.61
3720.......................  KALAMAZOO..................  MI....................          143.25          139.98
3740.......................  KANKAKEE...................  IL....................          130.84          126.66
3760.......................  KANSAS CITY................  MO-KS.................          133.22          129.21
3800.......................  KENOSHA....................  WI....................          137.39          133.69
3810.......................  KILLEEN-TEMPLE.............  TX....................          128.12          123.75
3840.......................  KNOXVILLE..................  TN....................          127.83          123.45
3850.......................  KOKOMO.....................  IN....................          132.39          128.34
3870.......................  LA CROSSE..................  WI....................          131.00          126.87
3880.......................  LAFAYETTE..................  LA....................          132.84          128.83
3920.......................  LAFAYETTE..................  IN....................          128.65          124.33
3960.......................  LAKE CHARLES...............  LA....................          130.17          125.97
3965.......................  LAKE COUNTY................  IL....................          141.41          137.98
3980.......................  LAKELAND-WINTER HAVEN......  FL....................          127.57          123.18
4000.......................  LANCASTER..................  PA....................          135.38          131.54

[[Page 47539]]

 
4040.......................  LANSING-EAST LANSING.......  MI....................          135.98          132.18
4080.......................  LAREDO.....................  TX....................          127.57          123.18
4100.......................  LAS CRUCES.................  NM....................          127.57          123.18
4120.......................  LAS VEGAS..................  NV....................          141.01          137.58
4150.......................  LAWRENCE...................  KS....................          131.82          127.73
4200.......................  LAWTON.....................  OK....................          130.27          126.08
4243.......................  LEWISTON-AUBURN............  ME....................          128.39          124.06
4280.......................  LEXINGTON-FAYETTE..........  KY....................          130.21          126.01
4320.......................  LIMA.......................  OH....................          133.29          129.29
4360.......................  LINCOLN....................  NE....................          129.96          125.72
4400.......................  LITTLE ROCK-N LITTLE ROCK..  AR....................          135.96          132.17
4420.......................  LONGVIEW-MARSHALL..........  TX....................          127.57          123.18
4440.......................  LORAIN-ELYRIA..............  OH....................          134.22          130.30
4480.......................  LOS ANGELES-LONG BEACH.....  CA....................          146.35          145.02
4520.......................  LOUISVILLE.................  KY-IN.................          134.40          130.50
4600.......................  LUBBOCK....................  TX....................          129.87          125.63
4640.......................  LYNCHBURG..................  VA....................          128.00          123.63
4680.......................  MACON-WARNER ROBINS........  GA....................          129.46          125.19
4720.......................  MADISON....................  WI....................          135.45          131.63
4763.......................  MANCHESTER-NASHUA..........  NH....................          131.20          127.04
4800.......................  MANSFIELD..................  OH....................          130.40          126.20
4840.......................  MAYAGUEZ...................  PR....................          127.57          123.18
4880.......................  MCALLEN-EDINBURG-MISSION...  TX....................          127.57          123.18
4890.......................  MEDFORD....................  OR....................          133.00          128.99
4900.......................  MELBOURNE-TITUSVILLE.......  FL....................          130.19          125.99
4920.......................  MEMPHIS....................  TN-AR-MS..............          135.10          131.23
4940.......................  MERCED.....................  CA....................          138.45          134.83
5000.......................  MIAMI-HIALEAH..............  FL....................          138.47          134.85
5015.......................  MIDDLESEX-HUNTERDON........  NJ....................          134.87          130.99
5040.......................  MIDLAND....................  TX....................          135.10          131.24
5080.......................  MILWAUKEE..................  WI....................          136.75          133.02
5120.......................  MINNEAPOLIS-ST PAUL........  MN-WI.................          136.11          132.33
5160.......................  MOBILE.....................  AL....................          129.00          124.70
5170.......................  MODESTO....................  CA....................          138.05          134.41
5190.......................  MONMOUTH-OCEAN.............  NJ....................          133.08          129.06
5200.......................  MONROE.....................  LA....................          129.18          124.90
5240.......................  MONTGOMERY.................  AL....................          130.14          125.92
5280.......................  MUNCIE.....................  IN....................          131.36          127.22
5320.......................  MUSKEGON...................  MI....................          131.68          127.57
5345.......................  NAPLES.....................  FL....................          130.55          126.35
5360.......................  NASHVILLE..................  TN....................          132.71          128.70
5380.......................  NASSAU-SUFFOLK.............  NY....................          146.35          144.35
5403.......................  NEW BEDFORD-FALL RIVER-      MA....................          131.79          127.70
                              ATTELBORO.
5483.......................  NEW HAVEN-WATERBURY-MERIDEN  CT....................          137.50          133.80
5523.......................  NEW LONDON-NORWICH.........  CT....................          137.24          133.52
5560.......................  NEW ORLEANS................  LA....................          130.68          126.50
5600.......................  NEW YORK...................  NY....................          146.35          146.35
5640.......................  NEWARK.....................  NJ....................          141.09          137.67
5700.......................  NIAGARA FALLS..............  NY....................          130.31          126.11
5720.......................  NORFOLK-NEWPORT NEWS.......  VA....................          129.67          125.42
5775.......................  OAKLAND....................  CA....................          146.35          145.92
5790.......................  OCALA......................  FL....................          128.79          124.48
5800.......................  ODESSA.....................  TX....................          129.63          125.38
5880.......................  OKLAHOMA CITY..............  OK....................          134.67          130.78
5910.......................  OLYMPIA....................  WA....................          135.49          131.66
5920.......................  OMAHA......................  NE-IA.................          132.99          128.98
5950.......................  ORANGE COUNTY..............  NY....................          132.46          128.39
5960.......................  ORLANDO....................  FL....................          132.46          128.39
5990.......................  OWENSBORO..................  KY....................          127.57          123.18
6000.......................  OXNARD-VENTURA.............  CA....................          146.28          145.05
6015.......................  PANAMA CITY................  FL....................          127.57          123.18
6020.......................  PARKERSBURG-MARIETTA.......  WVA-OH................          130.89          126.73
6025.......................  PASCAGOULA.................  MS....................          135.50          131.67
6080.......................  PENSACOLA..................  FL....................          128.26          123.91
6120.......................  PEORIA.....................  IL....................          136.83          133.10
6160.......................  PHILADELPHIA...............  PA-NJ.................          141.48          138.07
6200.......................  PHOENIX....................  AZ....................          137.96          134.32
6240.......................  PINE BLUFF.................  AR....................          127.57          123.18
6280.......................  PITTSBURGH.................  PA....................          138.69          135.09
6323.......................  PITTSFIELD.................  MA....................          133.87          129.91
6360.......................  PONCE......................  PR....................          127.57          123.18

[[Page 47540]]

 
6403.......................  PORTLAND...................  ME....................          132.96          128.94
6440.......................  PORTLAND...................  OR....................          139.91          136.40
6453.......................  PORTSMOUTH-DOVER-ROCHESTER.  NH-ME.................          128.29          123.95
6460.......................  POUGHKEEPSIE...............  NY....................          135.84          132.03
6483.......................  PROVIDENCE-PAWTUCKET-        RI....................          134.58          130.69
                              WOONSOCKET.
6520.......................  PROVO-OREM.................  UT....................          130.42          126.22
6560.......................  PUEBLO.....................  CO....................          137.23          133.52
6600.......................  RACINE.....................  WI....................          129.52          125.26
6640.......................  RALEIGH-DURHAM.............  NC....................          132.93          128.90
6660.......................  RAPID CITY.................  SD....................          128.78          124.47
6680.......................  READING....................  PA....................          133.16          129.15
6690.......................  REDDING....................  CA....................          138.98          135.39
6720.......................  RENO.......................  NV....................          144.32          142.52
6740.......................  RICHLAND-KENNEWICK.........  WA....................          131.96          127.89
6760.......................  RICHMOND-PETERSBURG........  VA....................          129.76          125.53
6780.......................  RIVERSIDE-SAN BERNARDINO...  CA....................          143.65          140.40
6800.......................  ROANOKE....................  VA....................          130.33          126.13
6820.......................  ROCHESTER..................  MN....................          134.23          130.31
6840.......................  ROCHESTER..................  NY....................          134.50          130.60
6880.......................  ROCKFORD...................  IL....................          136.62          132.85
6920.......................  SACRAMENTO.................  CA....................          144.16          141.12
6960.......................  SAGINAW-BAY CITY-MIDLAND...  MI....................          138.22          134.57
6980.......................  ST CLOUD...................  MN....................          129.55          125.29
7000.......................  ST JOSEPH..................  MO....................          132.19          128.12
7040.......................  ST LOUIS...................  MO-IL.................          135.07          131.21
7080.......................  SALEM......................  OR....................          136.70          132.96
7120.......................  SALINAS-SEASIDE-MONTEREY...  CA....................          144.09          140.88
7160.......................  SALT LAKE CITY-OGDEN.......  UT....................          131.27          127.13
7200.......................  SAN ANGELO.................  TX....................          127.57          123.18
7240.......................  SAN ANTONIO................  TX....................          129.30          125.03
7320.......................  SAN DIEGO..................  CA....................          144.75          142.04
7360.......................  SAN FRANCISCO..............  CA....................          146.35          145.92
7400.......................  SAN JOSE...................  CA....................          146.35          145.68
7440.......................  SAN JUAN...................  PR....................          127.57          123.18
7480.......................  SANTA BARBARA-LOMPOC.......  CA....................          139.14          135.58
7485.......................  SANTA CRUZ.................  CA....................          140.64          137.18
7490.......................  SANTA FE...................  NM....................          129.81          125.59
7500.......................  SANTA ROSA-PETALUMA........  CA....................          146.35          145.59
7510.......................  SARASOTA...................  FL....................          131.98          127.90
7520.......................  SAVANNAH...................  GA....................          129.72          125.48
7560.......................  SCRANTON-WILKES BARRE......  PA....................          133.66          129.70
7600.......................  SEATTLE....................  WA....................          136.87          133.14
7610.......................  SHARON.....................  PA....................          132.08          128.00
7620.......................  SHEBOYGAN..................  WI....................          129.28          125.01
7640.......................  SHERMAN-DENISON............  TX....................          127.57          123.18
7680.......................  SHREVEPORT.................  LA....................          133.23          129.23
7720.......................  SIOUX CITY.................  IA-NE.................          132.47          128.40
7760.......................  SIOUX FALLS................  SD....................          130.62          126.44
7800.......................  SOUTH BEND-MISHAWAKA.......  IN....................          130.13          125.92
7840.......................  SPOKANE....................  WA....................          138.38          134.75
7880.......................  SPRINGFIELD................  IL....................          137.27          133.56
7920.......................  SPRINGFIELD................  MO....................          129.48          125.21
8003.......................  SPRINGFIELD................  MA....................          133.39          129.39
8050.......................  STATE COLLEGE..............  PA....................          137.91          134.25
8080.......................  STEUBENVILLE-WEIRTON.......  OH-WVA................          131.46          127.35
8120.......................  STOCKTON...................  CA....................          146.35          145.06
8160.......................  SYRACUSE...................  NY....................          141.36          139.77
8200.......................  TACOMA.....................  WA....................          136.53          132.76
8240.......................  TALLAHASSE.................  FL....................          129.91          125.67
8280.......................  TAMPA-ST PETERSBURG-         FL....................          132.27          128.21
                              CLEARWATER.
8320.......................  TERRE HAUTE................  IN....................          127.57          123.18
8360.......................  TEXARKANA..................  TX-AR.................          135.59          131.75
8400.......................  TOLEDO.....................  OH....................          140.91          137.45
8440.......................  TOPEKA.....................  KS....................          135.89          132.10
8480.......................  TRENTON....................  NJ....................          135.66          131.82
8520.......................  TUCSON.....................  AZ....................          134.02          130.07
8560.......................  TULSA......................  OK....................          133.31          129.30
8600.......................  TUSCALOOSA.................  AL....................          133.86          129.91
8640.......................  TYLER......................  TX....................          132.17          128.09
8680.......................  UTICA-ROME.................  NY....................          130.41          126.22
8720.......................  VALLEJO-FAIRFIELD-NAPA.....  CA....................          146.35          146.18

[[Page 47541]]

 
8725.......................  VANCOUVER..................  WA....................          139.12          135.53
8750.......................  VICTORIA...................  TX....................          127.57          123.18
8760.......................  VINELAND-MILLVILLE-          NJ....................          132.48          128.41
                              BRIDGETON.
8780.......................  VISALIA-PORTERVILLE........  CA....................          142.02          140.48
8800.......................  WACO.......................  TX....................          127.81          123.43
8840.......................  WASHINGTON.................  DC-MD-VA..............          141.74          138.35
8920.......................  WATERLOO-CEDAR FALLS.......  IA....................          129.50          125.24
8940.......................  WAUSAU.....................  WI....................          130.90          126.74
8960.......................  WEST PALM & DELRAY BEACH...  FL....................          131.84          127.75
9000.......................  WHEELING...................  WVA-OH................          131.83          127.74
9040.......................  WICHITA....................  KS....................          136.67          132.93
9080.......................  WICHITA FALLS..............  TX....................          127.57          123.18
9140.......................  WILLIAMSPORT...............  PA....................          130.24          126.04
9160.......................  WILMINGTON.................  DE-NJ-MD..............          136.71          132.97
9200.......................  WILMINGTON.................  NC....................          128.74          124.42
9243.......................  WORCESTER-LEOMINSTER.......  MA....................          132.43          128.37
9260.......................  YAKIMA.....................  WA....................          132.24          128.18
9280.......................  YORK.......................  PA....................          132.45          128.39
9320.......................  YOUNGSTOWN-WARREN..........  OH....................          137.25          133.54
9340.......................  YUBA CITY..................  CA....................          137.02          133.29
----------------------------------------------------------------------------------------------------------------


                          Table 19.--Composite Payment Rates Effective January 1, 2005
                                          [For rural renal facilities]
----------------------------------------------------------------------------------------------------------------
          MSA Code                   Name of MSA                   State             Hospital       Independent
----------------------------------------------------------------------------------------------------------------
AL.........................  ALABAMA....................  AL....................          127.57          123.18
AK.........................  ALASKA.....................  AK....................          146.35          146.35
AZ.........................  ARIZONA....................  AZ....................          128.68          124.35
AR.........................  ARKANSAS...................  AR....................          127.57          123.18
CA.........................  CALIFORNIA.................  CA....................          137.00          133.27
CO.........................  COLORADO...................  CO....................          128.21          123.86
CT.........................  CONNECTICUT................  CT....................          136.02          132.22
DE.........................  DELAWARE...................  DE....................          128.76          124.44
FL.........................  FLORIDA....................  FL....................          127.75          123.37
GA.........................  GEORGIA....................  GA....................          127.57          123.18
HI.........................  HAWAII.....................  HI....................          140.40          136.92
ID.........................  IDAHO......................  ID....................          127.83          123.45
IL.........................  ILLINOIS...................  IL....................          127.57          123.18
IN.........................  INDIANA....................  IN....................          127.57          123.18
IA.........................  IOWA.......................  IA....................          127.57          123.18
KS.........................  KANSAS.....................  KS....................          127.57          123.18
KY.........................  KENTUCKY...................  KY....................          127.57          123.18
LA.........................  LOUISIANA..................  LA....................          127.57          123.18
ME.........................  MAINE......................  ME....................          127.57          123.18
MD.........................  MARYLAND...................  MD....................          130.27          126.08
MA.........................  MASSACHUSETTS..............  MA....................          135.99          132.19
MI.........................  MICHIGAN...................  MI....................          132.98          128.97
MN.........................  MINNESOTA..................  MN....................          127.57          123.18
MS.........................  MISSISSIPPI................  MS....................          127.57          123.18
MO.........................  MISSOURI...................  MO....................          127.57          123.18
MT.........................  MONTANA....................  MT....................          127.87          123.50
NE.........................  NEBRASKA...................  NE....................          127.57          123.18
NV.........................  NEVADA.....................  NV....................          133.20          129.20
NH.........................  NEW HAMPSHIRE..............  NH....................          132.24          128.18
NM.........................  NEW MEXICO.................  NM....................          128.68          124.36
NY.........................  NEW YORK...................  NY....................          127.78          123.40
NC.........................  NORTH CAROLINA.............  NC....................          127.57          123.18
ND.........................  NORTH DAKOTA...............  ND....................          127.70          123.31
OH.........................  OHIO.......................  OH....................          128.66          124.34
OK.........................  OKLAHOMA...................  OK....................          127.57          123.18
OR.........................  OREGON.....................  OR....................          132.66          128.64
PA.........................  PENNSYLVANIA...............  PA....................          132.54          128.48
PR.........................  PUERTO RICO................  PR....................          127.57          123.18
RI.........................  RHODE ISLAND...............  RI....................          130.86          126.69
SC.........................  SOUTH CAROLINA.............  SC....................          127.57          123.18
SD.........................  SOUTH DAKOTA...............  SD....................          127.57          123.18
TN.........................  TENNESSEE..................  TN....................          127.57          123.18
TX.........................  TEXAS......................  TX....................          127.57          123.18

[[Page 47542]]

 
UT.........................  UTAH.......................  UT....................          128.56          124.24
VT.........................  VERMONT....................  VT....................          127.57          123.18
VA.........................  VIRGINIA...................  VA....................          127.57          123.18
WA.........................  WASHINGTON.................  WA....................          131.35          127.21
WV.........................  WEST VIRGINIA..............  WV....................          128.43          124.09
WI.........................  WISCONSIN..................  WI....................          127.57          123.18
WY.........................  WYOMING....................  WY....................          131.29          127.15
----------------------------------------------------------------------------------------------------------------


                         Table 20.--Comorbidities
------------------------------------------------------------------------
 
------------------------------------------------------------------------
AIDS
    042......................  Human immunodeficiency disease
Peripheral vascular disease
    0400.....................  Gas gangrene
    4151.....................  Pulmonary embolism and infarction
    41511....................  Pulmonary embolism and infarction,
                                iatrogenic pulmonary embolism and
                                infarction
    440......................  Atherosclerosis
    4400.....................  Atherosclerosis of aorta
    4401.....................  Atherosclerosis of renal artery
    4402.....................  Atherosclerosis of native arteries of the
                                extremities
    44020....................  Atherosclerosis of native arteries of the
                                extremities, unspecified
    44021....................  Atherosclerosis of native arteries of the
                                extremities, with intermittent
                                claudication
    44022....................  Atherosclerosis of native arteries of the
                                extremities, with rest pain
    44023....................  Atherosclerosis of the extremities with
                                ulceration
    44024....................  Atherosclerosis of the extremities with
                                gangrene
    44029....................  Atherosclerosis of native arteries of the
                                extremities, with ulceration
    4403.....................  Atherosclerosis of bypass graft of the
                                extremities
    44030....................  Atherosclerosis of bypass graft of the
                                extremities of unspecified graft
    44031....................  Atherosclerosis of bypass graft of the
                                extremities of autologous vein bypass
                                graft
    44032....................  Atherosclerosis of bypass graft of the
                                extremities of nonautologous biological
                                bypass graft
    441......................  Aortic aneurysm and dissection
    4410.....................  Aortic aneurysm and dissection,
                                dissection of aorta
    44100....................  Aortic aneurysm and dissection,
                                dissection of aorta, unspecified site
    44101....................  Aortic aneurysm and dissection,
                                dissection of aorta, thoracic
    44102....................  Aortic aneurysm and dissection,
                                dissection of aorta, abdominal
    44103....................  Aortic aneurysm and dissection,
                                dissection of aorta, thoracoabdominal
    4411.....................  Thoracic aneurysm, ruptured
    4412.....................  Thoracic aneurysm without mention of
                                rupture
    4413.....................  Abdominal aneurysm, ruptured
    4414.....................  Abdominal aneurysm without mention of
                                rupture
    4415.....................  Aortic aneurysm of unspecified site,
                                ruptured
    4416.....................  Thoracoabdominal aneurysm, ruptured
    4417.....................  Thoracoabdominal aneurysm without mention
                                of rupture
    4419.....................  Aortic aneurysm and dissection of
                                unspecified site without mention of
                                rupture
    442......................  Other aneurysm
    4420.....................  Other aneurysm of artery of upper
                                extremity
    4421.....................  Other aneurysm of renal artery
    4422.....................  Other aneurysm of iliac artery
    4423.....................  Other aneurysm of artery of lower
                                extremity
    4428.....................  Other aneurysm of other specified artery
    44281....................  Other aneurysm of other specified artery,
                                artery of neck
    44282....................  Other aneurysm of other specified artery,
                                subclavian artery
    44283....................  Other aneurysm of other specified artery,
                                splenic artery
    44284....................  Other aneurysm of other specified artery,
                                other visceral artery
    44289....................  Other aneurysm of other specified artery,
                                other
    4429.....................  Other aneurysm of unspecified site
    443......................  Other peripheral vascular disease
    4430.....................  Other peripheral vascular disease,
                                Raynaud's syndrome
    4431.....................  Other peripheral vascular disease,
                                thromboangiitis obliterans [Buerger's
                                disease]
    4432.....................  Other peripherovascular diseases, other
                                arterial dissection
    44321....................  Other peripherovascular diseases, other
                                arterial dissection, dissection of
                                carotid artery
    44322....................  Other peripherovascular diseases, other
                                arterial dissection, dissection of iliac
                                artery
    44323....................  Other peripherovascular diseases, other
                                arterial dissection, dissection of renal
                                artery
    44324....................  Other peripherovascular diseases, other
                                arterial dissection, dissection of
                                vertebral artery
    44329....................  Other peripherovascular diseases, other
                                arterial dissection, dissection of other
                                artery
    4438.....................  Other peripheral vascular disease, other
                                specified peripheral vascular disease
    44381....................  Other peripheral vascular disease, other
                                specified peripheral vascular disease,
                                peripheral angiopathy in diseases
                                classified elsewhere
    44389....................  Other peripheral vascular disease, other
                                specified peripheral vascular disease,
                                other
    4439.....................  Peripheral vascular disease, unspecified

[[Page 47543]]

 
    444......................  Arterial embolism and thrombosis
    4440.....................  Arterial embolism and thrombosis, of
                                abdominal aorta
    4441.....................  Arterial embolism and thrombosis, of
                                thoracic aorta
    4442.....................  Arterial embolism and thrombosis, of
                                arteries of the extremities
    44421....................  Arterial embolism and thrombosis, of
                                arteries of the extremities, upper
                                extremity
    44422....................  Arterial embolism and thrombosis, of
                                arteries of the extremities, lower
                                extremity
    4448.....................  Arterial embolism and thrombosis, of
                                other specified artery
    44481....................  Arterial embolism and thrombosis, of
                                other specified artery, upper extremity
    44489....................  Arterial embolism and thrombosis, of
                                other specified artery, lower extremity
    449......................  Arterial embolism and thrombosis, of
                                unspecified artery
    4450.....................  Atheroembolism, of extremities
    44501....................  Atheroembolism, of extremities, upper
                                extremity
    44502....................  Atheroembolism, of extremities, lower
                                extremity
    446......................  Polyarteritis nodosa and allied
                                conditions
    4460.....................  Polyarteritis nodosa and allied
                                conditions, polyarteritis nodosa
    451......................  Phlebitis and thrombophlebitis
    4510.....................  Phlebitis and thrombophlebitis of
                                superficial vessels of lower extremities
    4511.....................  Phlebitis and thrombophlebitis, of deep
                                vessels of lower extremities
    45111....................  Phlebitis and thrombophlebitis, of deep
                                vessels of lower extremities, femoral
                                vein
    45119....................  Phlebitis and thrombophlebitis, of deep
                                vessels of lower extremities, other
    4512.....................  Phlebitis and thrombophlebitis, of lower
                                extremities, unspecified
    45181....................  Phlebitis and thrombophlebitis, of other
                                sites, iliac vein
    45182....................  Phlebitis and thrombophlebitis, of other
                                sites, of superficial veins of upper
                                extremities
    45183....................  Phlebitis and thrombophlebitis, of other
                                sites, of deep veins of upper
                                extremities
    45184....................  Phlebitis and thrombophlebitis, of upper
                                extremities, unspecified
    45189....................  Phlebitis and thrombophlebitis, other
    4519.....................  Phlebitis and thrombophlebitis,
                                unspecified
    453......................  Other venous embolism and thrombosis
    4530.....................  Other venous embolism and thrombosis,
                                Budd-Chiari syndrome
    4531.....................  Other venous embolism and thrombosis,
                                Thrombophlebitis migrans
    4532.....................  Other venous embolism and thrombosis of
                                vena cava
    4533.....................  Other venous embolism and thrombosis of
                                renal vein
    4538.....................  Other venous embolism and thrombosis of
                                other specified sites
    4539.....................  Other venous embolism and thrombosis of
                                unspecified site
------------------------------------------------------------------------

I. Section 731(b)--Coverage for Routine Costs of Category A Clinical 
Trials

[If you choose to comment on issues in this section, please include the 
caption ``Section 731(b)'' at the beginning of your comments.]

    Section 1862(m) of the Act, as added by Section 731(b) of the MMA, 
prohibits the Secretary from excluding payment for the routine costs of 
care furnished to a Medicare beneficiary participating in a clinical 
trial of a Category A device based on a determination that such care is 
not ``reasonable and necessary'' under section 1862(a)(1). In effect, 
this section authorizes Medicare to cover the routine costs of clinical 
trials involving Category A devices. Category A (experimental/
investigational) devices are defined in Sec.  405.201 as innovative 
medical devices about which the Food and Drug Administration (FDA) has 
major questions about safety and effectiveness.
    For a trial to qualify for payment of routine costs, it must meet 
certain criteria established by the Secretary to ensure that the trial 
conforms to appropriate scientific and ethical standards. Current 
criteria are established in the National Coverage Determination Manual 
(CMS Pub. 100-3, Manual section 310.1).
    In addition, the MMA established additional criteria for trials 
initiated before January 1, 2010 to ensure that the devices involved in 
these trials be intended for use in the diagnosis, monitoring, or 
treatment of an immediately life-threatening disease or condition. 
Guidelines for determining if a device meets this requirement will be 
defined through the NCD process.
    Section 411.15(o) currently precludes Medicare payment for Category 
A devices. We would not revise this section because the MMA does not 
require Medicare to pay for the cost of the Category A device (as 
opposed to the cost of routine care associated with the trial of a 
Category A device).
    We are proposing changes to Sec.  405.207. As currently written, 
this section precludes coverage of services related to a noncovered 
device. Since the Category A device is noncovered, we would amend this 
section to allow coverage of routine care services related to a 
noncovered Category A device. In addition, we propose language to 
cross-reference Sec.  405.201 concerning coverage of Category B 
(nonexperimental/investigational) devices. We would not be changing 
coverage of Category B devices, but providing consistency by placing 
information on Category A and Category B devices in the same section.

J. Section 629--Part B Deductible

[If you choose to comment on issues in this section, please include the 
caption ``Section 629'' at the beginning of your comments.]

    Section 629 of the MMA provides for regular updates to the Medicare 
Part B deductible in consideration of inflationary changes in the 
nation's economy. Since 1991, the Medicare Part B deductible has been 
$100 per year. The MMA stipulates that the Medicare Part B deductible 
will be $110 for calendar year 2005, and, for a subsequent year, the 
deductible will be the previous year's deductible increased by the 
annual percentage increase in the monthly actuarial rate under section 
1839(a)(1) of the Act, ending with that subsequent year (rounded to the 
nearest dollar). Section 1839(a)(1) of the Act requires the Secretary 
of Health and Human Services to calculate the monthly actuarial rate 
for Medicare enrollees age 65 and over.
    We propose to update Sec.  410.160(f), ``Amount of the Part B 
annual deductible,'' to conform to the MMA and to reflect that the 
Medicare Part B deductible is $100 for calendar years

[[Page 47544]]

1991 through 2004. Finally, we plan to publish an annual notification 
in the Federal Register, announcing each upcoming year's Part B 
deductible. This notification for the Part B deductible will be 
included as part of the annual notice we currently publish announcing 
Medicare's Part B premiums and actuarial rates.

K. Section 512--Hospice Consultation

[If you choose to comment on issues in this section, please include the 
caption ``Section 512'' at the beginning of your comments.]
1. Coverage of Hospice Consultation Services
    Effective January 1, 2005, section 512 of the MMA provides for 
payment to be made to a hospice for specified services furnished by a 
physician who is either the medical director of or employee of a 
hospice agency. Payment will be made on behalf of a beneficiary who is 
terminally ill (which is defined as having a prognosis of 6 months or 
less if the disease or illness runs its normal course), has not made a 
hospice election, and has not previously received the pre-election 
hospice services specified in section 1812(a)(1)(5) of the Act as added 
by section 512 of the MMA. These services comprise an evaluation of an 
individual's need for pain and symptom management, counseling the 
individual regarding hospice and other care options, and may include 
advising the individual regarding advanced care planning.
    The decision to elect hospice services is a personal choice and is 
generally a decision made between the individual and his or her 
physician (probably the physician making the terminal diagnosis). 
Therefore, we believe that most individuals will seek this type of 
service from their own physician. Thus, we do not expect that the 
services of a hospice physician would be necessary for all individuals 
who elect hospice. However, a beneficiary, or his/her physician may 
seek the expertise of a hospice medical director or physician employee 
of a hospice to assure that a beneficiary's end-of-life options for 
care and pain management are discussed and evaluated.
    Currently, beneficiaries are able to receive this evaluation, pain 
management, counseling, and advice through other Medicare benefits. For 
example, physicians, typically those who determine the beneficiary's 
terminal diagnoses, can provide for these evaluation and management 
services as well as for pain and symptom management under the physician 
fee schedule. Beneficiaries may also obtain assistance with decisions 
pertaining to end-of life issues through discharge planning in 
hospitals and through services of social workers, case managers, and 
other health care professionals. To the extent that beneficiaries have 
already received Medicare-covered evaluation and counseling with 
respect to end-of-life care, the hospice evaluation and counseling 
would seem duplicative. We intend to monitor data regarding these 
services to assess whether Medicare is paying for duplicative services.
    We are proposing to cover the services described above for a 
terminally ill beneficiary, at the request of the beneficiary or the 
beneficiary's physician. The service would, in accordance with the 
statute, be available on a one-time basis to a beneficiary who has not 
elected or previously used the hospice benefit, but who might benefit 
from evaluation and counseling with a hospice physician regarding the 
beneficiary's decision-making process or to provide recommendations for 
pain and symptom management. Since the beneficiary or his/her physician 
decides to obtain this service from the hospice medical director or 
physician employee, the evaluation and counseling service may not be 
initiated by the hospice, that is, the entity receiving payment for the 
service.
    The statute specifies that payment will be made to the hospice when 
the physician providing the service is an employee physician or medical 
director of a hospice. Therefore, other hospice personnel, such as 
nurse practitioners, nurses, or social workers, cannot furnish the 
services. The statute requires the physicians to be employed by a 
hospice; therefore, the service cannot be furnished by a physician 
under contractual arrangements with the hospice or by the beneficiary's 
physician, if that physician is not an employee of the hospice. 
Moreover, if the beneficiary's physician is also the medical director 
or physician employee of a hospice, that physician already possesses 
the expertise necessary to furnish end-of-life evaluation, management, 
and counseling services and is providing these services to the 
beneficiary and is receiving payment for these services through the use 
of evaluation and management (E&M) codes.
    In the event that the individual's physician initiates the request 
for services of the hospice medical director or physician, we would 
expect that appropriate documentation guidelines would be followed. The 
request or referral would be in writing, and the hospice medical 
director or employee physician would be expected to provide a written 
note on the patient's medical chart. The hospice employee physician 
providing these services would be required to maintain a written record 
of this service. If the beneficiary initiates the services, we would 
expect that the hospice agency would maintain a written record of the 
service and that communication between the hospice medical director or 
physician and the beneficiary's physician would occur, with the 
beneficiary's permission, to the extent necessary to ensure continuity 
of care.
    We propose to add new Sec.  418.205 and Sec.  418.304(d) to 
implement section 512 of the MMA.
2. Payment for Hospice Consultation Services
    Section 512(b) of the MMA amends section 1414(i) of the Act and 
establishes payment for this service at an amount ``equal to an amount 
established for an office or other outpatient visit for evaluation and 
management associated with presenting problems of moderate severity and 
requiring medical decision-making of low complexity under the physician 
fee schedule, other than the portion of such amount attributable to the 
practice expense component.'' No existing CPT or HCPCS code 
specifically represents these services. We are proposing to establish a 
new HCPCS code, G0xx4 Hospice--evaluation and counseling services, pre-
election. The hospice would use this HCPCS code to submit claims to the 
Regional Home Health Intermediary (RHHI) for payment for these 
services. Utilization of this code would allow us to provide payment 
for this service as well as enable us to monitor the frequency with 
which the code is used and to assess whether the code is used 
appropriately. Payments by hospices to physicians or others in a 
position to refer patients for services furnished under this provision 
may implicate the Federal anti-kickback statute.
    In accordance with the statute, we are proposing that the payment 
amount for this service would be based on the work and malpractice 
expense RVUs for CPT code 99203 multiplied by the CF (1.34 Work RVU + 
0.10 Malpractice RVU)* (CF). This CPT code for an office or outpatient 
visit for the evaluation and management of a new patient represents a 
detailed history, detailed examination and medical decision making of 
low complexity, which, we believe, is quite similar to the components 
of this new service provided by a medical director or physician 
employed by the hospice

[[Page 47545]]

agency. Assuming that there are no changes in RVUs for CPT code 99203 
and that the CY 2005 update to the physician fee schedule is the 1.5 
percent specified in the MMA, the national payment amount for this 
service would be $54.57 for this service (1.44 * 37.8975).

L. Section 302--Clinical Conditions for Coverage of Durable Medical 
Equipment (DME)

[If you choose to comment on issues in this section, please include the 
caption ``Section 302'' at the beginning of your comments.]
1. Legislative Requirement
    Section 1832(a)(1)(E) of the Act, as added by section 302(a)(2) of 
the MMA, requires the Secretary to establish clinical conditions for 
payment of covered items of durable medical equipment (DME). The law 
requires the Secretary to establish types or classes of covered items 
that require a face-to-face examination of the individual by a 
physician or practitioner and also require a prescription for these 
items.
    Covered items of durable medical equipment, prosthetics, orthotics, 
and supplies (DMEPOS) have already been divided into classes of covered 
items, as established by the local medical review policies (LMRP) and 
local coverage determinations (LCD) issued by the durable medical 
equipment regional carriers (DMERCs). For example, the contractors have 
developed policies on long term home oxygen therapy, canes, crutches, 
wheelchairs, hospital beds, urological supplies, spinal orthoses, 
surgical dressing, and enteral and parenteral nutrition therapy. These 
and other policies for each of the four DMERCs are entered into the 
Medicare Coverage Database at http://www.cms.hhs.gov/coverage.
    These policies are developed based on clinical evidence and after 
discussion with clinical experts in the area. There are already a 
number of local coverage determinations and national coverage 
determinations that outline the clinical conditions for which these 
items are covered. These determinations outline the conditions for 
coverage, payment, and the documentation or testing necessary to 
establish medical necessity. We propose to continue developing these 
clinical conditions of coverage through the local and national coverage 
determination process.
    We are also proposing to expand the requirement for clinical 
conditions of coverage to medical supplies, appliances and devices 
defined in 42 CFR 410.36. These are commonly referred to as 
prosthetics, orthotics and supplies (POS). We believe items of POS 
require the same level of medical intervention and skill as DME. As 
with DME, there are already a number of local and national coverage 
determinations outlining appropriate clinical conditions for coverage 
and propose to continue this process.
    From a clinical perspective, we believe that it is appropriate for 
beneficiaries requiring DMEPOS to be under the care of a physician and 
for DMEPOS orders to occur in the context of routine clinical care. We 
believe it is good clinical practice for the beneficiary to be seen by 
the physician for their medical condition and the physician to decide 
whether or not an item of DMEPOS is appropriate during the face-to-face 
examination of the beneficiary. Since we expect a beneficiary to be 
seen by their physician for a specific medical condition, we do not 
believe that a requirement for a face-to-face examination for initial 
orders and at the time of the prescription renewals for items of 
continued need (those DMEPOS items where an order is good for only a 
certain period of time and requires a follow-up examination by the 
physician) would place a burden on the physician or beneficiary, as it 
would be part of a necessary examination. We believe this to be the 
current practice in most cases.
    Our goal is to encourage quality care, to mitigate any 
proliferation of use of these products and ensure that only patients 
that need items of DMEPOS receive them. To comply with the requirements 
of section 302(a)(2) of the MMA and to enhance quality and reduce 
fraud, we would establish basic requirements that apply to all items of 
durable medical equipment, prosthetics, orthotics, and supplies. We 
have identified a proliferation of use for some items of DMEPOS and we 
believe that engaging the physician or practitioner early in the 
process of ordering DMEPOS will assist us in mitigating any unnecessary 
proliferation of use.
    This regulation proposes to make a face-to-face exam by the 
physician to determine the medical necessity and ordering an item of 
DMEPOS an explicit requirement for all initial orders of DMEPOS and at 
the time of prescription renewal for all DMEPOS continued need items. 
However, we seek specific comments about whether specific items of 
DMEPOS should be exempt from the face-to-face examination requirement.
    In order for us to verify the medical necessity for an item, the 
prescribing physician's or practitioner's records must document the 
need at the time the physician or practitioner examines the 
beneficiary. For example, a letter to the supplier or to us dated 
months after the date the examination was conducted and the order was 
written would not be sufficient verification.
2. Provisions Related to DMEPOS
    To implement the provisions of the MMA, we would--
     Establish a requirement for a face-to-face examination by 
a physician, physician assistant (PA), clinical nurse specialist (CNS), 
or nurse practitioner (NP), as they are defined in the Act (the 
prescribing physician or practitioner) to determine the medical 
necessity of durable medical equipment, orthotics and prosthetics.
     Require that the prescribing physician or practitioner be 
independent from the DMEPOS supplier and may not be a contractor or an 
employee of the supplier.
     Establish a requirement that the face-to-face examination 
should be for the purpose of evaluating and treating the patient's 
medical condition and not for the sole purpose of obtaining the 
prescribing physician's or practitioner's order for the DMEPOS. We 
expect the prescribing physician or practitioner to conduct a 
sufficient examination of the patient's medical condition to ascertain 
the appropriate overall treatment plan and to order the DMEPOS as only 
one aspect of that treatment plan.
     Require an order prior to delivery for all items of 
durable medical equipment, prosthetics, or orthotics.
     Require that the order be dated and signed within 30 days 
after the face-to-face examination and include verification of the 
examination. We are soliciting comments on the appropriate verification 
process.
     Require the prescribing physician or practitioner to 
maintain appropriate and timely documentation in the medical records 
that support the need for all DMEPOS ordered.
     Provide that we would promulgate through contractor 
instructions other criteria required for payment, such as for 
prescription renewal requirements, repair, minor revisions and 
replacement. We are interested in comments on whether the Agency should 
establish national renewal requirements or permit contractor 
discretion.
     Provide that we would promulgate through the national 
coverage determination process or through the local coverage 
determination process additional clinical conditions for items of 
DMEPOS.
    We propose to revise language in Sec.  410.36 and Sec.  410.38 to 
implement section 302(a)(2) of the MMA.

[[Page 47546]]

M. Section 614--Payment for Certain Mammography Services

[If you choose to comment on issues in this section, please include the 
caption ``Section 614'' at the beginning of your comments.]

    Medicare covers an annual screening mammogram for all beneficiaries 
who are women age 40 and older, and one baseline mammogram for 
beneficiaries who are women age 35 through 39. Medicare also covers 
medically necessary diagnostic mammograms. Payment for screening 
mammography, regardless of setting, is paid under the physician fee 
schedule, but diagnostic mammography performed in the hospital 
outpatient department is currently paid under the hospital outpatient 
prospective payment system (OPPS).
    Section 614 of the MMA amended section 1833(t)(1)(B)(iv) of the Act 
to exclude payment for screening and diagnostic mammograms from the 
OPPS. In the OPPS proposed rule, we will discuss our proposal for 
payment for diagnostic mammograms using the payments established under 
the physician fee schedule. This proposal will parallel the current 
practice used for the payment of screening mammography services 
provided in the OPPS setting and will be effective January 1, 2005.

N. Section 305--Payment for Inhalation Drugs

[If you choose to comment on issues in this section, please include the 
caption ``Section 305'' at the beginning of your comments.]
1. Background
    Lung diseases such as chronic obstructive pulmonary disease (COPD) 
affect large numbers of Medicare beneficiaries. COPD is the fourth 
largest cause of death in America behind heart disease, certain 
cancers, and stroke. We hope to reduce the number of new COPD cases by 
educating Americans about the disease, its causes, and ways to prevent 
it. We hope to improve the lives of Medicare beneficiaries and improve 
beneficiary access to treatment for those who already suffer from these 
conditions.
    Depending on an individual's age and health, a number of steps can 
be taken to treat or prevent this. Because approximately 85 percent of 
those with COPD are smokers, the first step to avoid the disease is to 
stop smoking. Smoking has been linked to a large number of health 
problems and is a leading cause of cancer and pulmonary disease. The 
Department of Health and Human Services (HHS) has been actively 
encouraging Americans to quit smoking through its smoking cessation 
initiatives. Americans who quit smoking will enjoy longer, healthier 
lives and avoid diseases such as COPD.
    We have also recently approved services to address the needs of 
Americans suffering from COPD, including lung-volume reduction surgery, 
which, performed in more serious cases, removes the diseased lung 
tissue, allowing the rest of the lung to function better. Specifically, 
effective January 1, 2004, Medicare expanded coverage of lung volume 
reduction surgery to include patients, who are not high-risk surgical 
patients, who either have severe, upper-lobe emphysema, or have severe, 
non-upper-lobe emphysema with low exercise capacity.
    A number of drugs are available to treat the persons with asthma or 
who develop COPD. These include agents, often inhaled, that expand the 
bronchial tubes, allowing the patient to breathe more freely. Access to 
these drugs for Medicare beneficiaries has been expanded by the MMA.
    Nebulizers and metered dose inhalers (MDIs) are two different 
delivery methods to administer inhalation drugs to a beneficiary. A 
nebulizer works by aerosolizing liquefied inhalation drugs so that the 
medication can be more easily inhaled into the lungs. For about 10 to 
30 minutes, a beneficiary breathes the mist via compressor tubing 
hooked up to the nebulizer. An MDI consists of a canister of 
pressurized medication that is propelled directly into the airways of 
the lungs when a beneficiary presses on the inhaler and breathes in 
through the mouth, thereby allowing the medicine to take effect 
quickly.
    Medicare Part B currently pays for nebulizers and inhalation drugs. 
However, Medicare Part B does not cover MDIs and, therefore, does not 
pay for inhalation drugs delivered by an MDI. An MDI is considered to 
be an item of disposable medical equipment (for which there is no 
current Part B benefit category) while a nebulizer is considered to be 
an item of DME.
    The Part D drug benefit improves beneficiary access to inhalation 
therapy by covering MDIs (including the inhalation drugs they furnish) 
beginning January 1, 2006. In addition, the prescription drug discount 
card began offering discounts on MDIs effective June 1, 2004.
    Since Medicare currently covers inhalation drugs provided through 
nebulizers, but not alternative forms of inhalation therapy, there are 
strong financial incentives toward use of the former compared to 
alternatives. Our review of the literature over the past decade did not 
find that bronchodilators delivered via nebulizers were more effective 
than bronchodilators delivered via metered dose inhalers.
    Since one delivery method is not clinically superior to the other, 
when Medicare covers both methods of delivery of inhalation therapy, 
the decision to prescribe one over the other will be made by the 
physician and beneficiary based on beneficiary needs and preferences 
consistent with applicable standards of medical practice. It would not 
be unlikely for many beneficiaries to choose the convenience of MDIs 
over nebulizers once the Medicare coverage imbalance is removed in 
2006. Since MDIs are less expensive, very portable, and easier to use, 
it is likely there will be a substantial shift of Medicare 
beneficiaries from nebulizers to MDIs beginning in 2006, even absent 
the Medicare payment changes for nebulizers and inhalation drugs in 
2005.
2. What Medicare Part B Currently Covers
    Medicare Part B currently covers and pays for five separate items 
related to nebulizers. All of the items are subject to the standard 
Part B deductible and coinsurance.
a. Nebulizers
    Medicare Part B currently covers the rental of nebulizers. 
Nebulizers are in the ``capped rental'' category of DME for payment 
purposes. Payment is made on a monthly basis during the period of 
medical need. Medicare pays 10 percent of the payment amount during the 
first three months and 7.5 percent during the next 12 months. Section 
1834(a) of the Act specifies that the payment amount is equal to the 
amount paid for purchase of the nebulizer in 1986, indexed to current 
levels by the cumulative DME update factor specified in this 
subsection. Thus, Medicare will pay up to a cumulative total of 120 
percent of the payment amount for 15 months of renting a nebulizer.
    If the beneficiary needs a nebulizer for more than 15 months, and 
continues to rent it, Medicare makes no further payment for the 
equipment because the equipment has already been paid for. Medicare 
does continue to pay for maintenance and servicing of the nebulizer, as 
well as the inhalation drugs, but the supplier retains title to the 
equipment.
    During the 10th month of continuous rental of a nebulizer, the 
supplier is required to offer the beneficiary a purchase option, and if 
the beneficiary accepts the offer and exercises the

[[Page 47547]]

purchase option, the supplier transfers title to the nebulizer in the 
13th month. In this case, Medicare would make its final monthly rental 
payment in the 13th month, and the title then would transfer to the 
beneficiary. About 3 percent of beneficiaries exercise the purchase 
option.
    In 2003, the average Medicare monthly rental payment for nebulizers 
was $19.07 for the first three months and $14.30 for the fourth through 
fifteenth month. Thus, Medicare would pay $228.81 for a nebulizer if 
the beneficiary's period of medical need were 15 months. There are 
various types of nebulizers (compressor, ultrasonic, portable, 
disposable) and nebulizer accessories (breathing circuits, air filters, 
tubing extensions, mouthpieces, spare battery packs, DC adapters) 
available. Internet prices for compressor nebulizers range from $50 to 
$100, and prices for portable nebulizers range from $100 to $200, 
depending on the specific features of the nebulizer. The Medicare 
payment amount includes payment for delivery of the equipment. 
(Shipping costs for nebulizers available for purchase on the Internet 
range from free shipping up to $25).
b. Maintenance and Servicing of Nebulizers
    Medicare Part B makes an additional separate payment to the 
supplier for maintenance and servicing of the equipment (for parts and 
labor not covered by the supplier's or manufacturer's warranty). For 
nebulizers that are not purchased, but are used for more than 21 
months, the servicing fee covers six-month periods beginning after the 
21st month of use. As required by section 1834(a)(7) of the Act, 
Medicare's payment for maintenance and servicing is equal to the lesser 
of a reasonable and necessary maintenance and servicing fee, or 10 
percent of the total purchase price of the equipment. For nebulizers 
that are purchased, Medicare may make a payment to the supplier for any 
necessary maintenance and servicing that is performed.
    In 2003, the average service fee for nebulizers was $19.07 per six-
month period. Other than routine cleaning of the unit (that is, 
cleaning and changing filters, cleaning and disinfecting nebulizers, 
tubing, and mouthpieces), very little maintenance is required to 
maintain a nebulizer's peak performance. There is usually no scheduled 
maintenance for the nebulizer. Medicare pays for the usual frequency 
for replacement of accessories. Maintenance kits and replacement parts 
are available through online suppliers for approximately $5 to $15.
c. Inhalation Drugs
    Medicare Part B pays for drugs that the nebulizer furnishes to a 
beneficiary. Unlike nebulizers, inhalation drugs are not an explicit 
benefit covered by statute. However, there was an administrative 
decision made early in the program's history to cover inhalation drugs 
as a supply so that the nebulizer could work. Without the inhalation 
drugs, the nebulizer would not be effective for a beneficiary.
    The two most common inhalation drugs used by beneficiaries are 
albuterol sulfate (a beta-adrenergic bronchodilator) and ipratropium 
bromide (an anticholinergic bronchodilator). A beneficiary may use one 
or the other of these inhalation drugs, and they are frequently 
prescribed together. Both albuterol sulfate and ipratropium bromide are 
manufactured in powder form, but are generally liquefied and furnished 
to beneficiaries in liquid form for use in a nebulizer. The beneficiary 
may use a solution of one drug, or a combination of both drugs, in 
addition to saline if necessary, with the nebulizer. The beneficiary 
may mix the solution, or the supplier may furnish the drug in a pre-
mixed form (either commercially pre-mixed or pharmacy compounded). The 
shelf life of these drugs is at least 18 to 24 months, and they do not 
require any special storage arrangements such as refrigeration.
    Medicare also pays for other inhalation drugs, such as budesonide 
(an inhaled corticosteroid), which are used in conjunction with 
albuterol sulfate and ipratropium bromide. These drugs can also be 
administered using a nebulizer or an MDI.
d. Dispensing Fee
    Medicare has paid a monthly $5 dispensing fee for each covered 
inhalation drug or combination of drugs used in a nebulizer. The 
dispensing fee is paid for each drug dispensed, not the number of unit 
dose vials provided to the beneficiaries. Additionally, if two or more 
drugs are combined in single unit dose vials, only one dispensing fee 
will be paid per drug combination per month. A dispensing fee for 
saline is not separately billable or payable. Inhalation drugs are the 
only drugs for which Medicare Part B currently pays a separate 
dispensing fee.
e. Beneficiary Training.
    In 2003, CPT code 94664 was revised to include beneficiary training 
by a physician or physician's staff regarding use of a nebulizer, MDI, 
aerosol generator, or intermittent positive pressure breathing (IPPB) 
machine. The narrative terminology for the code currently is--
Demonstration and/or evaluation of patient utilization of an aerosol 
generator, nebulizer, metered dose inhaler or IPPB machine.'' The 2004 
Medicare physician fee schedule payment for this service is $13.44. 
This service has no physician work relative value units reflecting that 
the training is typically performed by physician office staff. In 2004, 
this service has 0.32 practice expense relative value units (RVUs) and 
0.04 malpractice RVUs. Additionally, the supplier of the nebulizer, 
under Sec.  424.57(c)(12), must ``document that it or another qualified 
party has at an appropriate time, provided beneficiaries with necessary 
information and instructions on how to use Medicare covered-items 
safely and effectively.'' Beneficiary training by a physician or 
physician's staff regarding use of a nebulizer would meet the 
definition of ``another qualified party'' for purposes of this supplier 
requirement.
3. Medicare Spending for Nebulizers and Inhalation Drugs
    In 2003, Medicare spent about $1.6 billion for nebulizers and 
inhalation drugs. This amount includes--
    (a) About $130 million for nebulizers (both rental and purchase) 
and nebulizer related accessories and supplies;
    (b) About $13 million for servicing/maintenance fees;
    (c) About $1.3 billion for albuterol sulfate and ipratropium 
bromide and another $120 million for other inhalation drugs for a total 
of approximately $1.4 billion. (This represents about 88 percent of 
Medicare spending for inhalation therapy.);
    (d) About $35.5 million for 7.1 million dispensing fees; and
    (e) About $4.5 million for beneficiary training under CPT code 
94664 (though this figure also includes training for other items as 
well as nebulizers).
    Medicare spending for inhalation drugs has grown rapidly. 
Preliminary data indicate that between 2001 and 2003, Medicare spending 
increased by 77 percent for albuterol sulfate and ipratropium bromide.
4. Inspector General and General Accounting Office Studies
    The HHS IG issued 10 reports between February 1996 and January 2004 
about Medicare payments for albuterol sulfate and ipratropium bromide 
in excess of acquisition costs. In a report issued in September 2001,

[[Page 47548]]

the General Accounting Office (GAO) also concluded that Medicare 
payment for these drugs was in excess of acquisition costs.
    Table 1 of the Interim Final Rule regarding Changes to Medicare 
Payment for Drugs and Physician Fee Schedule Payments for Calendar Year 
2004, published in the January 7, 2004 Federal Register (69 FR 1084), 
showed that the acquisition cost (averaging IG and GAO results) was 34 
percent of the Average Wholesale Price (AWP) for ipratropium bromide 
and 17 percent for albuterol sulfate. Prior to 2004, Medicare paid 95 
percent of the AWP for each of these drugs and beneficiary coinsurance 
was 20 percent of the Medicare payment amount. In the case of albuterol 
sulfate, the beneficiary coinsurance was more than the actual 
acquisition cost for the drug. During 2004, Medicare payment is 80 
percent of the AWP for each of these drugs. Beginning with 2005, 
Medicare payment will be 106 percent of the Average Sales Price (ASP).
    The IG report issued in January 2004 again concluded that Medicare 
payments were far in excess of acquisition costs for both albuterol 
sulfate and ipratropium bromide. The IG found that the Medicare 2004 
payment (and payment in prior years) was a multiple of the actual 
acquisition costs for both drugs based on a comparison to the median 
price that the drug was available through wholesalers/distributors and 
group purchasing organizations (GPOs) and comparison to the 
manufacturer-reported Wholesale Acquisition Cost (WAC).
5. Inhalation Drug Spread
    In 2003, ipratropium bromide and albuterol sulfate were the third 
and seventh largest drugs in terms of Medicare spending for carrier 
paid drugs. The differences between Medicare's payment amount and 
acquisition costs (that is, spread) for albuterol sulfate and 
ipratropium bromide are among the largest spreads for drugs studied by 
the IG and GAO. Based on the actual acquisition costs determined by IG 
and GAO studies, in 2003, Medicare paid an estimated nearly $900 
million in excess of acquisition costs for albuterol sulfate and 
ipratropium bromide.
    The IG and GAO findings of large differences between Medicare 
payment amounts and acquisition costs for inhalation drugs provided the 
foundation for Congressional enactment of section 305 of the MMA. This 
section of the MMA sets Medicare payment for inhalation drugs at 106 
percent of the ASP. (The Congressional Budget Office's November 20, 
2003 pricing of the MMA estimated section 305 as having savings of $4.2 
billion over 10 years.)
    Suppliers argue that inhalation drug spread has allowed them to 
fund activities related to care for beneficiaries with asthma or COPD 
that otherwise do not have a Medicare Part B benefit category. These 
other activities may include the following:
     Respiratory therapists on staff or in networks available 
on-call for home visits or telephone consultations.
     On-call pharmacists.
     Monthly calls to schedule medication refills.
     Continuous education on disease states, including monthly 
follow-ups.
     24-hour support lines.
     On-call and/or monthly home delivery of medication and 
supplies.
     Quality improvement programs.
6. Nebulizers vs. MDIs
    Medicare Part B currently covers only one type of inhalation 
therapy, nebulizers and inhalation drugs. Although Medicare Part B does 
not cover MDIs and the inhalation drugs they furnish, the new Part D 
benefit beginning in 2006 will cover these alternative hand-held 
inhalation therapy devices (MDIs). In addition, the discount card and 
$600 transitional assistance payment for low-income beneficiaries will 
help seniors buy inhalers in 2004 and 2005, helping to bridge the gap 
until 2006 when coverage begins.
    MDIs are the quickest and easiest way to take inhalation medication 
for most asthmatics and patients with COPD. The medication is propelled 
directly into the lungs, allowing it to take effect more quickly, and 
with fewer medication side effects. An MDI contains a specific number 
of ``metered inhalations,'' and is made to deliver the prescribed 
amount of medication for the labeled number of doses (typically 200 
doses, which is 8 doses per day for 25 days). Inhalation accessory 
devices, such as holding chambers and spacers, are used to improve the 
direction and deposition of medication delivered by MDIs, making it 
easier for beneficiaries to use an MDI and making the MDI more 
effective in delivering the medicine to the lungs.
    Since Medicare currently covers nebulizers and inhalation drugs, 
but not alternative forms of inhalation therapy, there are strong 
financial incentives toward use of the former compared to alternatives. 
Our review of the literature over the past decade, including two meta-
analyses and over two dozen individual studies applicable to adults, 
did not find that bronchodilators delivered via nebulizer were more 
effective than when delivered via metered dose inhaler.
    Since one delivery method is not clinically superior to the other, 
when Medicare covers both methods of delivery of inhalation therapy, 
the decision to prescribe one over the other will be made by the 
physician and beneficiary based on beneficiary needs and preferences 
consistent with applicable standards of medical practice. It would not 
be unlikely for many beneficiaries to choose the convenience of MDIs 
over nebulizers once the Medicare coverage imbalance is removed in 
2006. Since MDIs are less expensive, very portable, and easier to use, 
it is likely there will be a substantial shift of Medicare 
beneficiaries from nebulizers to MDIs beginning in 2006, even absent 
the Medicare payment changes for nebulizers and inhalation drugs in 
2005.
    Some claim that beneficiaries cannot use MDIs because they do not 
have the dexterity to use them. Use of an MDI requires proper 
inhalation techniques in order to receive the full benefit possible 
from the amount of medication included in each dose. Spacers and 
holding chambers extend the mouthpiece of the inhaler and increase the 
air volume into which the medication is atomized, allowing more time 
for the patient to breathe the medication and avoid misdirecting the 
medication onto the soft tissues inside the mouth where it will have 
little effect on lung function.
    A nebulizer may also require a certain level of dexterity (that is, 
operating, maintaining, and cleaning the nebulizer correctly). There 
may also be beneficiaries who do not have the dexterity to use either 
an MDI or nebulizer, which would require the availability of 
alternative therapies, such as an IPPB machine to aid in the delivery 
of aerosol medication by increasing the depth of breathing more than 
the patient alone can achieve.
7. Payments Beginning in 2005 Including Provisions of the Proposed Rule
    Our goal is to assure that each beneficiary who needs inhalation 
therapy has access to the most appropriate medication and delivery 
method. We expect that the combined changes to cover MDIs, adjust 
payments for inhalation drugs, and provide for an appropriate 
dispensing fee will improve beneficiary access and choice. We seek 
comments about an appropriate amount for a dispensing fee that would 
assure beneficiary access to inhalation medications provided through 
nebulizers.

[[Page 47549]]

    We believe that a dispensing fee is intended to cover a pharmacy's 
activities to get inhalation drugs to beneficiaries. We seek data and 
information on the additional services these pharmacies provide to 
Medicare beneficiaries, the extent to which inhalation drugs can be 
furnished without these additional services and the extent to which 
such services are covered under Medicare. We are concerned about 
significant shifts in beneficiary access to inhalation therapy prior to 
implementation of the Part D drug benefit in light of the reduction in 
Medicare payment for inhalation drugs beginning in 2005, and also seek 
comments about whether the dispensing fee should include a somewhat 
higher, transitional payment.
    Below we discuss, changes in payment for inhalation drugs and 
nebulizers beginning in 2005.
a. Nebulizers
    Section 1834(a)(21) of the Act, as amended by section 302(c)(2) of 
the MMA, requires a reduction in Medicare payment, beginning with 2005, 
for specified items of DME, including nebulizers paid under code E0570. 
The reduction is the difference in payment amounts under Medicare and 
the median Federal Employees Health Benefits (FEHB) plan, as identified 
in IG testimony before the Senate Committee of Appropriations on June 
12, 2002. Other codes for nebulizers and related equipment are not 
affected by the payment reduction.
b. Maintenance and Servicing of Nebulizers
    Since the maintenance and servicing fee is equal to the first 
month's rental payment, the maintenance and servicing fee for 
nebulizers will also be reduced in 2005.
c. Inhalation Drugs
    As discussed in the ASP payment section of this proposed rule, for 
the first quarter of 2005, the Medicare payment at ASP plus 6 percent 
is estimated to be $0.04 per milligram for albuterol sulfate and $0.30 
per milligram for ipratropium bromide. While these figures represent 
estimated reductions from 2004 payment levels of about 90 percent, they 
are not necessarily the actual payment amounts for the first quarter of 
2005. The actual payment amounts will be based on ASP's calculated from 
the manufacturer ASP to be submitted for the third quarter of 2004.
    Both albuterol sulfate and ipratropium bromide are generic drugs 
that have multiple manufacturers. Since these ASPs are average figures 
across all manufacturers, a pharmacy should be able to acquire 
albuterol sulfate and ipratropium bromide at these prices. Moreover, to 
the extent there is price variation among manufacturers, there will be 
some manufacturers with lower prices than others. In this case, a 
pharmacy might be able to obtain albuterol sulfate and ipratropium 
bromide at a price below the average.
    The Medicare payment amount includes a 6 percent add-on. Assuming 
that ASP remains constant between the first and third quarters of 2004, 
the 6 percent add-on would be about $1.00 for a typical month's supply 
of 450 milligrams of albuterol sulfate and about $3.00 for a 90-day 
supply. Similarly, the 6 percent add-on would be about $1.60 for a 
typical month's supply of 93 milligrams of ipratropium bromide and 
about $4.80 for a 90-day supply. Because albuterol sulfate and 
ipratropium bromide are often prescribed together, Medicare payment at 
106 percent of ASP would include, as additional payments above the 
acquisition cost of the drugs, a total payment to the supplier of about 
$2.60 for a 30-day supply and about $7.80 for a 90-day supply of both 
drugs.
d. Dispensing Fee
    Given the overall reduction in payment for inhalation drugs, we are 
concerned about beneficiary access to these drugs. Because shipping, 
handling, compounding, and other pharmacy activities would usually 
exceed the 6 percent payment above the drug acquisition cost, we 
believe that it is appropriate for Medicare to continue to pay a 
separate dispensing fee to pharmacies that furnish inhalation drugs to 
beneficiaries.
    We propose to establish a separate dispensing fee for inhalation 
drugs. This separate dispensing fee will be in addition to the 
difference between the supplier's acquisition cost and the Medicare 
payment for the drug. For example, if a supplier is acquiring albuterol 
and ipratropium bromide for the average sales price, the supplier would 
receive a separate dispensing fee amount plus their acquisition cost 
plus $7.80 for a 90-day supply. The $7.80 is the amount included in the 
payment for the drug itself since Medicare pays 6 percent above the 
average sales price.
    As noted above, Medicare has paid a $5 monthly dispensing fee for 
each covered inhalation drug or combination of drugs used in a 
nebulizer. Dispensing fees are paid by Medicaid and private insurers; 
we seek information about these dispensing fees for inhalation drugs 
and their applicability to Medicare. In addition, we seek comments 
about an appropriate dispensing fee amount to cover the shipping, 
handling, compounding, and other pharmacy activities required to get 
these inhalation medications to Medicare beneficiaries. We seek data 
and information that explains the direct labor and non-labor costs as 
well as indirect costs of overhead for these pharmacy activities as 
they relate to dispensing of inhalation drugs.
    Consideration of dispensing fees needs to be viewed in the context 
of several important changes and clarifications in Medicare policy and 
billing requirements.
    First, we are proposing to allow a prescription for inhalation 
drugs covering a 90-day period to be written by a physician and filled 
by a pharmacy. Current guidelines are that a pharmacy generally should 
not fill a prescription for inhalation drugs for more than a month's 
supply for a beneficiary. We believe that this requirement needs 
revision in the case of inhalation drugs for two key reasons. Most 
beneficiaries who use inhalation drugs use them for extended periods of 
time and often use them for the rest of their lives. In addition, we 
understand that many inhalation drugs are delivered to a beneficiary 
through the mail. We understand that a mail-order prescription drug 
model works well for a 90-day prescription. We believe that there will 
be significant savings in shipping for a 90-day prescription rather 
than a monthly prescription.
    We would expect that reasonableness would govern filling a monthly 
vs. a 90-day prescription with a physician writing and a pharmacy 
filling a monthly or a 90-day prescription depending on the 
circumstances of the beneficiary. For example, it would be reasonable 
to expect that the first time a beneficiary receives a prescription for 
a nebulizer and inhalation drugs that the prescription would be for a 
month. Similarly, it would be reasonable to expect that refill 
prescriptions for beneficiaries would be for a 90-day period. Carriers 
would continue to assess claims for dispensed quantities greater than 
what would be reasonable based on usual dosing guidelines. We would 
expect that the bulk of prescriptions would be for 90-day periods.
    Second, we recently revised the guidelines regarding the time frame 
for delivery of refills of DMEPOS products to occur no sooner than 
``approximately 5 days prior to the end of the usage for the current 
product''. As previously noted, inhalation drugs are often furnished to 
a beneficiary by mail. It has

[[Page 47550]]

been suggested that Medicare guidelines for refill prescriptions 
allowed too short of a window between shipping the next month's 
prescription and the end of the current month. It was argued that as a 
result, a pharmacy ``effectively'' had to ship the product to a 
beneficiary using an overnight delivery service.
    On January 2, 2004, we revised the guidelines (effective February 
2, 2004) regarding the time frame for subsequent deliveries of refills 
of DMEPOS products to occur no sooner than ``approximately 5 days prior 
to the end of the usage for the current product'' (see section 4.26.1 
of Chapter 4--Benefit Integrity of the Medicare Program Integrity 
Manual). This change allows shipping of inhalation drugs on 
``approximately'' the 25th day of the month in the case of a month's 
supply, and on ``approximately'' the 85th day in the case of a 90-day 
supply. We emphasize the word ``approximately''; while we believe that 
normal ground service shipping would allow delivery in 5 days, if there 
were circumstances where ground service could not occur in 5 days, the 
guideline would still be met if the shipment occurs in 6 or 7 days. 
(``Days'' refers to business days or shipping days applicable to the 
shipper, that is, a 6 day week in the case of the U.S. Postal 
Service.). We believe that this change eliminates the need for 
suppliers to use overnight shipping methods and allows shipping of 
inhalation drugs by less expensive ground service.
    Third, we understand that some pharmacies believe that Medicare has 
a requirement that a pharmacy must obtain an original signed 
prescription before each prescription is dispensed. The Program 
Integrity Manual (section 5.1 of Chapter 5) addresses the ordering 
requirement for DMEPOS items. The Manual indicates that most DMEPOS 
items, including drugs, can be dispensed based on a verbal order from a 
physician. The Manual further indicates that a written order must be 
obtained before submitting a claim, but that such written order may be 
faxed, photocopied, electronic or pen and ink. The order for inhalation 
drugs must specify the name of the drug, the concentration (if 
applicable), dosage, and frequency of administration. We hope that 
clarification of this requirement would reduce a pharmacy's costs of 
supplying covered inhalation drugs to Medicare beneficiaries to the 
extent that pharmacies are currently applying an original signed 
prescription requirement.
    Fourth, Medicare regulations (Sec.  424.57) specify the 
requirements a DMEPOS supplier must meet in order to receive payment 
for a Medicare covered item. Section 424.57(c)(12) contains the proof 
of delivery requirement and indicates that a ``supplier must be 
responsible for the delivery of Medicare covered items to beneficiaries 
and maintain proof of delivery.'' We recently revised the Program 
Integrity Manual (section 4.26 of Chapter 4) to address proof of 
delivery requirements for suppliers. As discussed in the Manual, the 
burden of proving delivery is left to the supplier. The Manual provides 
examples of the types of proof that are reasonable and acceptable, but 
it does not provide an all-inclusive list. Other acceptable proof-of-
delivery methods may exist and may be employed by suppliers. This 
documentation is normally only requested by the contractor when a 
complaint is received that the item was not provided or received. The 
documentation is necessary to investigate the allegation. We believe 
that the current provisions on proof of delivery are adequate and 
appropriate for inhalation drugs.
    Fifth, in section IV.H (Assignment of Medicare Claims--Payment to 
the Supplier) of this proposed rule, we propose to change current 
regulations at Sec.  424.55 to eliminate the requirement that 
beneficiaries assign claims to suppliers in situations where suppliers 
are required by section 1842(o)(3) of the Act to accept assignment. 
This change would eliminate the need for suppliers to have a signed 
Assignment of Benefits (AOB) form from a beneficiary in order for 
Medicare to make payment. Because such section of the Act requires 
Medicare to make payment for drugs only on an assigned basis, this 
change would eliminate a billing requirement for drugs, including 
inhalation drugs. We believe that this change would reduce a pharmacy's 
costs of supplying covered inhalation drugs to Medicare beneficiaries 
to the extent that pharmacies are requiring a signed AOB form before 
submitting a claim.
    We believe that the amount of dispensing fee needs to be considered 
in conjunction with--
    (1) Our proposal to allow 90-day prescriptions;
    (2) Our recent revision to allow the next month's refill 
prescription to be shipped approximately 5 business days prior to the 
end of usage for the product, that is, to allow shipping on the 25th of 
the month for a month's supply, and shipping or 85th day in the case of 
a 90-day period;
    (3) Our policy clarification regarding signed original orders 
before a prescription is filled;
    (4) Our proof of delivery requirement revisions; and
    (5) Our proposed change regarding the Assignment of Benefits form.
e. Beneficiary Training
    Medicare Part B will continue to pay for beneficiary training by a 
physician's staff regarding use of a nebulizer, MDI, aerosol generator, 
or IPPB machine. Section 424.57(c)(12) specifies that ``The supplier 
must document that it or another qualified party has at an appropriate 
time, provided beneficiaries with necessary information and 
instructions on how to use Medicare covered-items safely and 
effectively.'' Beneficiary training by a physician or physician's staff 
regarding use of a nebulizer would meet the definition of ``another 
qualified party'' for purposes of this supplier requirement.

IV. Other Issues

A. Proposals Related to Therapy Services

1. Outpatient Therapy Services Performed ``Incident To'' Physicians' 
Services
[If you choose to comment on issues in this section, please include the 
caption ``Therapy--Incident To'' at the beginning of your comments.]

    In last year's proposed rule, we requested comments on clarifying 
that the personnel qualifications of therapists in home health settings 
at Sec.  484.4 apply consistently to all therapy settings, including 
the offices of physical and occupational therapists, physicians, and 
nonphysician practitioners. We received comments from therapists, 
physicians, nontherapist health care providers and their representative 
organizations. After consideration of all comments, we now propose to 
revise 42 CFR 410.26, 410.59, 410.60 and 410.62 to reflect that 
physical therapy, occupational therapy, and speech-language pathology 
services provided incident to a physician's professional services are 
subject to certain limitations as described at section 1862(a)(20) of 
the Act.
    Regulations in 42 CFR 485.705 specify that, in almost all settings, 
outpatient rehabilitative therapy services, (physical therapy (PT), 
occupational therapy (OT), or speech-language pathology (SLP)) can be 
furnished only by the following individuals meeting the qualifications 
in Sec.  484.4: physical therapists, occupational therapists, 
appropriately supervised physical therapist assistants, appropriately 
supervised occupational therapy assistants, and speech-language 
pathologists. Some States permit licensed physicians, physician 
assistants, clinical nurse specialists, and nurse practitioners to 
furnish PT, OT,

[[Page 47551]]

and SLP services also. Therapy services, and those who provide therapy 
services, must also meet the standards and conditions as specified in 
Medicare manuals.
    Section 1862(a)(20) of the Act permits payment for therapy services 
furnished incident to a physician's professional services only if the 
practitioner meets the standards and conditions that would apply to 
such therapy services if they were furnished by a therapist, with the 
exception of the licensing requirement. We are proposing to amend the 
regulations to include the statutory requirement that only individuals 
meeting the existing qualification and training standards for 
therapists (with the exception of licensure) consistent with Sec.  
484.4 qualify to provide therapy services incident to physicians' 
services.
    Section 1862(a)(20) of the Act refers only to PT, OT, and SLP 
services and not to any other type of therapy or service. This section 
applies to services of the type described in section 1861(p), 1861(g) 
and 1861(ll) of the Act; it does not, for example, apply to therapy 
provided by qualified clinical psychologists. This section also does 
not apply to services that are not covered either as therapy or as 
evaluation and management services provided incident to a physician or 
nonphysician practitioner such as recreational therapy, relaxation 
therapy, athletic training, exercise physiology, kinesiology, or 
massage therapy services.
2. Qualification Standards and Supervision Requirements in Therapy 
Private Practice Settings
[If you choose to comment on issues in this section, please include the 
caption ``Therapy Standards and Requirements'' at the beginning of your 
comments.]

    Section 1861(p) includes services furnished to individuals by 
physical and occupational therapists meeting licensing and other 
standards prescribed by the Secretary if the services meet the 
necessary conditions for standards for health and safety. These 
services include those furnished in the therapist's office or the 
individual's home. By regulation, we have defined therapists under this 
provision as physical or occupational therapists in private practice 
(PTPPs and OTPPs).
    Under Medicare Part B, outpatient therapy services, including 
physical and occupational therapy services, are generally covered when 
reasonable and necessary and when provided by physical and occupational 
therapists meeting the qualifications set forth at Sec.  484.4. 
Services provided by qualified therapy assistants, including physical 
therapist assistants (PTAs) and occupational therapy assistants (OTAs), 
may also be covered by Medicare when furnished under the specified 
level of therapist supervision that is required for the setting in 
which the services are provided (institutions and private practice 
therapist offices). For PTPPs and OTPPs, the regulations specify that 
the PT or OT meets only State licensure or certification standards and 
do not currently refer to the professional qualification requirements 
at Sec.  484.4.
    Since 1999, when therapy services are provided by PTAs and OTAs in 
the PT or OT private practice setting, the services must be personally 
supervised by the PTPP or OTPP. In response to a requirement to report 
to Congress on State standards for supervision of PTAs, CMS contracted 
with the Urban Institute. The Urban Institute found that no State has 
the strict, full-time ``personal'' supervision requirement, for any 
setting, that Medicare places on PTAs in PTPPs (the report only 
examined PTAs, which are more heavily regulated than OTAs). The Urban 
Institute study found that only 7 States require any ``personal'' PTA 
supervision by the PT, and all 7 required this level of supervision 
only periodically, every 14, 30 or 60 days. The remaining States and 
Washington, DC all have less stringent PTA supervision requirements, 
including: 7 States and Washington, DC require full-time on-site 
supervision, which corresponds to Medicare's direct supervision level; 
16 States require the equivalent of Medicare's general supervision 
level, which does not require the PT to be on site, but requires the PT 
to be in contact via telecommunication; and another 16 States have 
rules for periodic on-site PT visits. Most States permit a supervision 
level similar to the Medicare ``general'' supervision requirement for 
physical therapy services delivered in institutional settings. To 
provide a consistent therapy assistant supervision policy, we are 
proposing to revise the regulations at 410.59 and 410.60 to require 
direct supervision of PTAs and OTAs when therapy services are provided 
by PTs or OTs in private practice. This proposed change would no longer 
require the personal presence of the PTPP or OTPP when their PTAs or 
OTAs provide services in the private practice setting. We are 
particularly interested in receiving comments regarding the proposed 
PTA supervision change, from personal to direct, for the private 
practice setting as whether or not it will have implications for the 
quality of services provided, or for Medicare spending, either through 
increased capacity to provide these services, or, alternatively, in the 
event that the Congress again extends the moratorium on the 
implementation of the limits on Medicare reimbursement for therapy 
services imposed by the Balanced Budget Act of 1997.
    Currently, the OTPP or PTPP regulations at Sec.  410.59(c) and 
Sec.  410.60(c) do not reference qualification requirements for therapy 
assistants, or other staff, working for PTs and OTs in private 
practices. These qualification requirements were removed during 1998 
rulemaking--when the coverage conditions requiring survey and 
certification, at Sec.  486 Subpart D, for independently practicing PTs 
and OTs were replaced with a simplified carrier enrollment process for 
PTPPs and OTPPs. In our 1998 rule, at 63 FR 58868, we deleted the 
references at Sec.  410.59 and Sec.  410.60 to the requirements at 
Sec.  484.4 for PTs and OTs in private practice. At that time, the 
qualifications for the staff of the PTPP and OTPP, including PTAs and 
OTAs, were inadvertently removed because the coverage conditions at 
Sec.  486 Subpart D were no longer applicable. In order to provide a 
consistent policy regarding requirements for therapists and therapy 
assistants, we are proposing to restore the qualifications by adding at 
Sec.  410.59 and Sec.  410.60 the cross-reference to the qualifications 
at Sec.  484.4 for privately practicing therapists and their therapy 
assistants.
3. Other Technical Revisions
[If you choose to comment on issues in this section, please include the 
caption ``Therapy Technical Revisions'' at the beginning of your 
comments.]

    We are making technical corrections to Sec.  410.62 to refer 
consistently to speech-language pathology in this section (currently 
the terms ``speech pathology'' and ``speech-language pathology'' are 
used interchangeably) and are revising Sec.  410.62(a)(2)(iii) to 
appropriately reference Sec.  410.61 (the current reference is to Sec.  
410.63).
    We are also removing subpart D, Conditions for Coverage: Outpatient 
Physical Therapy Services Furnished by Physical Therapists, from part 
486. Our November 1998 rule (63 FR 58868) discussed replacing this 
subpart with a simplified carrier enrollment process for physical or 
occupational therapists in private practice; however, the conforming 
regulatory change to remove Subpart D was never made.
    In addition, we are making a technical change at Sec.  484.4 to 
correct the title ``physical therapy assistant'' to ``physical 
therapist assistant.''

[[Page 47552]]

    We are also amending Sec.  410.59(e) and Sec.  410.60(e) to include 
a reference to the 2-year moratorium on the therapy caps established by 
section 624 of the MMA.

B. Low Osmolar Contrast Media

[If you choose to comment on issues in this section, please include the 
caption ``LOW OSMOLAR CONTRAST MEDIA'' at the beginning of your 
comments.]

    Contrast media are used to enhance the images produced by various 
types of diagnostic radiological procedures. High osmolar contrast 
media (HOCM), initially developed for use with these procedures, was 
relatively inexpensive and payment for HOCM is subsumed in the payment 
for the technical component of these procedures. When the more 
expensive low osmolar contrast media (LOCM) were developed, estimates 
showed that if all radiologic studies requiring contrast media were to 
use LOCM, the costs to the Medicare program would have been 
substantial. At that time, there were no definitive studies showing 
that the benefits of using LOCM justified the very high additional 
costs.
    When the Medicare physician fee schedule was established, findings 
of studies of patients receiving both types of contrast media had been 
published, and the American College of Radiology (ACR) had adopted 
criteria for the use of LOCM. We determined that the older, less 
expensive contrast media (HOCM) could be used safely in a large 
percentage of the Medicare population. However, we also decided that 
separate payment for LOCM should be made for patients with certain 
medical characteristics. We adopted the ACR criteria, with some 
modification, as the basis for a policy that separate payments be made 
for the use of LOCM in radiological procedures for patients meeting 
certain criteria. These criteria were established at Sec.  414.38. 
Specifically, separate payment is made for all intrathecal, 
intravenous, and intra-arterial injections of LOCM, when it is used for 
nonhospital patients who have one or more of the following five medical 
conditions--
     A history of previous adverse reactions to contrast media, 
with the exception of a sensation of heat, flushing, or a single 
episode of nausea or vomiting;
     A history of asthma or allergy;
     Significant cardiac dysfunction, including recent or 
imminent cardiac decompensation, severe arrhythmias, unstable angina 
pectoris, recent myocardial infarction, and pulmonary hypertension;
     Generalized debilitation;
     Sickle cell disease.

Under these conditions, we pay for LOCM, utilizing HCPCS codes A4644 
through A4646. The payment amount for LOCM is calculated according to 
the rules applicable to drugs provided incident to a physician's 
service. The amount is reduced by 8 percent to account for the 
allowance for contrast media already included in the technical 
component of the service.

    ACR has requested that we allow further separate payment for LOCM 
by either expanding or eliminating the conditions. According to ACR, 
use of LOCM has become the standard in most radiology practices and 
benefits both physicians and patients. The benefits of uniform use of 
LOCM would include--
     The reduction of patient discomfort arising when HOCM is 
used instead of LOCM; and
     A reduction in physician resources now required to screen 
for high-risk patients.

The price differential between HOCM and LOCM is also decreasing. 
Universal use of LOCM, along with declining prices, will result in an 
efficient, and safer alternative to HOCM.

    We are proposing to revise the regulations at Sec.  414.38 to 
eliminate the restrictive criteria for the payment of LOCM. This 
proposal would make Medicare payment for LOCM consistent across 
settings. Before January 1, 2003, the criteria in Sec.  414.38 were 
also used to determine payment in the hospital setting. However, as 
instructed in our Program Memorandum A-02-120, issued November 22, 
2002, hospitals that are subject to the outpatient prospective payment 
system (OPPS) no longer use these criteria. Instead, payment for both 
ionic and non-ionic contrast media (including LOCM) is packaged into 
the APC payment for the procedure. Under OPPS there is no longer a 
payment difference between LOCM and other contrast materials.
    Effective January 1, 2005, payment for LOCM would be made on the 
basis of the average sales price plus six percent in accordance with 
the standard methodology for drug pricing established by the MMA. 
However, because the technical portions of radiology services are 
currently valued in the nonphysician workpool and the CPEP inputs for 
these services are not used in calculating payment, we will continue to 
reduce payment for LOCM by eight percent to avoid any duplicate payment 
for contrast media.

C. Payments for Physicians and Practitioners Managing Patients on 
Dialysis

[If you choose to comment on issues in this section, please include the 
caption ``MANAGING PATIENTS ON DIALYSIS'' at the beginning of your 
comments.]
1. ESRD-Related Services Provided to Patients in Observation Settings
    In response to comments received on billing procedures when the 
patient is hospitalized during the month, we stated in the November 7, 
2003 Federal Register (68 FR 63220) that the physician may bill the 
code that reflects the number of visits during the month on days when 
the patient was not in the hospital (either admitted as an inpatient or 
in observation status). (We refer to Medicare's payment amount below as 
the monthly capitation payment or MCP and the patient's normal 
attending physician for ESRD-related services as the MCP physician).
    In comments on the August 15, 2003 proposed rule, the Renal 
Physicians Association (RPA) indicated that the observation area is not 
an uncommon setting for outpatient face-to-face encounters to occur and 
the observation area should be an approved site-of-service for 
physician-dialysis patient encounters that count toward the MCP visit 
total. We indicated in the final rule, however, that observation 
services would not be counted as a visit under the MCP, but would be 
paid separately. Prior to this, long-standing Medicare policy had 
subsumed ESRD-related observation visits within the MCP.
    Upon further review of this issue, we now agree with RPA's comment 
and propose that ESRD-related visits provided to patients by the MCP 
physician in an observation setting would be counted as visits for 
purposes of billing the MCP codes.
2. Payment for Outpatient ESRD-Related Services for Partial Month 
Scenarios
    Since changing our payments for managing patients on dialysis, we 
have received a number of comments from the nephrology community 
requesting guidance on billing for outpatient ESRD-related services 
provided to transient patients and in partial month scenarios where the 
comprehensive visit may not have been furnished: for example, when the 
patient is hospitalized during the month, or receives a kidney 
transplant before the monthly comprehensive visit is furnished. To 
address this issue, we propose to change the description of the G codes 
for ESRD-related home dialysis services, less than full month, as

[[Page 47553]]

identified by G0324 through G0327. The new descriptor would include 
other partial month scenarios, in addition to patients dialyzing at 
home. The proposed descriptors for G0324 through G0327 are as follows:
    ``G0324: End stage renal disease (ESRD) related services for 
dialysis less than a full month of service, per day; for patients under 
two years of age.''
    ``G0325: End stage renal disease (ESRD) related services for 
dialysis less than a full month of service, per day; for patients 
between two and eleven years of age.''
    ``G0326: End stage renal disease (ESRD) related services for 
dialysis less than a full month of service, per day; for patients 
between twelve and nineteen years of age.''
    ``G0327: End stage renal disease (ESRD) related services for 
dialysis less than a full month of service, per day; for patients 
twenty years of age and over.''

    The G codes G0324 through G0327 would be used to bill for 
outpatient ESRD-related services provided in the following scenarios:
     Transient patients--Patients traveling away from home 
(less than full month);
     Home Dialysis Patients (less than full month);
     Partial month where there was one or more face-to-face 
visits without the comprehensive visit and either the patient was 
hospitalized before a complete assessment was furnished, dialysis 
stopped due to death, or the patient had a transplant.
    We believe that modifying the definition of the per diem G codes 
(as identified by G0324 through G0327) would provide a consistent way 
to bill for these partial month scenarios. However, this proposed 
change to the descriptions of G0324 through G0327 is intended to 
accommodate unusual circumstances when the outpatient ESRD-related 
services would not be paid for under the MCP. Use of these per diem 
codes would be limited to the scenarios listed above. Physicians who 
have an on-going formal agreement with the MCP physician to provide 
cursory visits during the month (for example ``rounding physicians'') 
may not use the per diem codes.

Clarification on Billing for Transient Patients

    For transient patients who are away from their home dialysis site, 
and at another site for fewer than 30 consecutive days, the revised per 
diem G codes (G0324 through G0327) would be billed by the physician or 
practitioner responsible for the transient patient's ESRD-related care. 
Only the physician or practitioner responsible for the traveling ESRD 
patient's care would be permitted to bill for ESRD-related services 
using the per diem G codes (G0324 through G0327).
    If the transient patient is under the care of a physician or 
practitioner other than his or her regular MCP physician for a complete 
month, the physician or practitioner responsible for the transient 
patient's ESRD-related care cannot bill using the per diem codes. In 
this case the transient physician or practitioner treating the patient 
must furnish a complete assessment and bill for ESRD-related services 
under the MCP.
    We are currently evaluating the criteria for defining a transient 
patient and welcome comments on when a patient should be considered 
transient.

D. Technical Revision

[If you choose to comment on issues in this section, please include the 
caption ``TECHNICAL REVISION'' at the beginning of your comments.]
    In Sec.  411.404, Medicare noncoverage of all obesity-related 
services is used as an example. Since we are currently revising this 
coverage policy, we are proposing to omit this example.

E. Diagnostic Psychological Tests

[If you choose to comment on issues in this section, please include the 
caption ``DIAGNOSTIC PSYCHOLOGICAL TESTS'' at the beginning of your 
comments.]
    All diagnostic tests covered under section 1861(s)(3) of the Act 
and payable under the physician fee schedule must be furnished under 
the appropriate level of supervision by a physician as defined in 
section 1861(r) of the Act. Additionally, the physician or nonphysician 
practitioner who is treating the patient must order all diagnostic 
tests in order for these tests to be considered reasonable and 
necessary. These tests must be furnished under at least a general level 
of physician supervision, that is, the test is furnished under the 
physician's overall direction and control, but the physician's presence 
is not required during the performance of the procedure.
    However, certain diagnostic tests require either direct or personal 
supervision. Direct supervision in the office setting means the 
physician must be present in the office suite and immediately available 
to furnish assistance and direction throughout the performance of the 
procedure. It does not mean that the physician must be present in the 
room when the procedure is performed. Personal supervision means the 
physician must be in attendance in the room during the performance of 
the procedure. Physician supervision at the specified level is required 
throughout the performance of the test. Services furnished without the 
required level of supervision are not reasonable and necessary, and 
Medicare payment is precluded.
    Section 410.32(b)(2)(iii) does permit an exception to these 
physician supervision level requirements for clinical psychologists and 
independently practicing psychologists (who are not clinical 
psychologists) to personally perform diagnostic psychological testing 
services without physician supervision. However, diagnostic 
psychological tests performed by anyone other than a clinical 
psychologist or independently practicing psychologist must be provided 
under the general supervision of a physician as defined above. 
Accordingly, clinical psychologists and independently practicing 
psychologists have not been permitted to supervise others in the 
administration of diagnostic psychological tests.
    In Sec.  410.71(d), we require a clinical psychologist who 
furnishes diagnostic, assessment, preventive, and therapeutic services 
directly to individuals to hold a doctoral degree in psychology and to 
be licensed or certified, on the basis of the doctoral degree in 
psychology, by the State in which he or she practices. Program 
instructions define an independently practicing psychologist as an 
individual who is not a clinical psychologist and practices 
independently of an institution, agency, or physician's office. 
Examples include, but are not limited to, educational psychologists and 
counseling psychologists. Any psychologist who is licensed or certified 
to practice psychology in the State or jurisdiction where he or she is 
furnishing services may qualify as an independent psychologist. It is 
our understanding that all States, the District of Columbia, and Puerto 
Rico license psychologists, but that some trust territories do not. In 
the jurisdictions that do not issue licenses, an independently 
practicing psychologist may be any practicing psychologist.
    The American Psychological Association (APA) requested that we re-
evaluate our regulations regarding clinical psychologists' supervision 
of diagnostic psychological tests. The APA also provided additional 
information concerning provision of these services.
    According to the APA, clinical psychologists generally have seven 
years of graduate education in the study of human behavior and are 
highly trained in the selection, administration,

[[Page 47554]]

and interpretation of psychological tests. In addition, according to 
our payment data, the majority of health care practitioners, other than 
physicians, performing psychological and neuropsychological testing 
services under the central nervous system codes (CPT codes 96100 
through 96117) are psychologists. We agree that clinical psychologists 
possess core knowledge in test measurement and development, 
psychometric theory, specialized psychological assessment techniques, 
statistics, and the psychology of behavior that uniquely qualifies them 
to direct test selection and interpret test data.
    Therefore, we are proposing to change the supervision requirements 
regarding who can supervise diagnostic psychological testing services.
    Having ancillary staff supervised by clinical psychologists would 
enable these practitioners with a higher level of expertise to oversee 
psychological testing. It could also potentially relieve burdens on 
physicians and healthcare facilities.
    Additionally, in rural areas, we anticipate that permitting 
psychologists to supervise diagnostic psychological testing services 
would reduce delays in testing, diagnosis, and treatment that could 
result from the unavailability of physicians to supervise the tests.
    We propose that the appropriate level of supervision of diagnostic 
psychological tests by clinical psychologists be general supervision, 
the level required of physicians supervising the same services.
    We are proposing to revise the regulations at Sec.  
410.32(b)(2)(iii) to permit clinical psychologists to supervise the 
performance of diagnostic psychological and neuropsychological testing 
services. This proposal extends solely to clinical psychologists, and 
it does not include independently practicing psychologists.

F. Care Plan Oversight

[If you choose to comment on issues in this section, please include the 
caption ``CARE PLAN OVERSIGHT'' at the beginning of your comments.]
    Care Plan Oversight (CPO) refers to the supervision of patients 
under Medicare-covered home health or hospice care requiring complex 
multi-disciplinary care modalities, including regular development and 
review of plans of care. In the December 8, 1994 physician fee schedule 
final rule (59 FR 63423), we established separate payment for CPO when 
performed by physicians. The Balanced Budget Act (BBA) of 1997 extended 
to nonphysician practitioners (NPPs) the right to receive payment for 
Medicare physicians' services that fall within their scope of practice 
under State law. In the November 1, 2000 final rule (65 FR 65407), we 
created HCPCS codes G0181 and G0182 for reporting home health and 
hospice CPO, respectively. We also clarified in that rule that services 
of NPPs, practicing within the scope of State law applicable to their 
services, could be billed as CPO services.
    To certify a patient for home health services, a physician must 
review the patient records and sign the plan of care. Our policy has 
been that the physician who bills for CPO must be the same physician 
who signs the plan of care and that, according to the statute, 
(sections 1814(a)(2)(C) and 1835(a)(2)(A) of the Act), only a physician 
can sign the plan of care for home health services. The effect of these 
two provisions, both of which were in place prior to the BBA of 1997, 
created a problem with respect to an NPP billing for CPO in the home 
health setting.
    We propose to revise Sec.  414.39 to clarify that NPPs can perform 
home health CPO even though they cannot certify a patient for home 
health services and sign the plan of care. However, we are also 
proposing the conditions under which NPP services may be billed for 
CPO; we established these conditions in consultation with our 
contractor medical directors and CMS medical staff. In general, the 
proposed conditions are meant to ensure that the NPP has seen and 
examined the patient and that the appropriate and established 
relationship exists between the physician who certifies the patient for 
home health services and the NPP who will provide the home health CPO.

G. Assignment of Medicare Claims--Payment to the Supplier

[If you choose to comment on issues in this section, please include the 
caption ``Assignment'' at the beginning of your comments.]
    Current regulations require the beneficiary (or the person 
authorized to request payment on the beneficiary's behalf) to assign a 
claim to the supplier for an assignment to be effective. Over time, 
however, the Act has been amended in various sections to require 
suppliers, in some instances, to accept assignment for a Medicare 
covered service regardless of whether or not the beneficiary actually 
assigns the claim to the supplier. (This would include situations in 
which services are furnished by a participating physician or supplier.) 
In these instances, the requirement in our current regulations at Sec.  
424.55(a) that the beneficiary assign the claim to the supplier is now 
unnecessary. Therefore, we are proposing to create an exception to the 
general rule in Sec.  424.55(a). New Sec.  424.55(c) would eliminate 
the requirement that beneficiaries assign claims to suppliers in 
situations where suppliers are required by statute to accept 
assignment.
    We believe the creation of this exception to the requirement for 
beneficiaries to assign benefits in situations where benefits can by 
statute only be paid on an assigned basis will reduce the paperwork 
burden on beneficiaries and suppliers.

V. Collection of Information Requirements

    Under the Paperwork Reduction Act of 1995 (PRA), we are required to 
provide 60-day notice in the Federal Register and solicit public 
comment before a collection of information requirement is submitted to 
the Office of Management and Budget (OMB) for review and approval. In 
order to fairly evaluate whether OMB should approve an information 
collection, section 3506(c)(2)(A) of the PRA requires that we solicit 
comment on the following issues:
     The need for the information collection and its usefulness 
in carrying out the proper functions of our agency.
     The accuracy of our estimate of the information collection 
burden.
     The quality, utility, and clarity of the information to be 
collected.
     Recommendations to minimize the information collection 
burden on the affected public, including automated collection 
techniques.
    Section 410.16 requires the furnishing of education, counseling, 
and referral services as part of an initial preventive physical 
examination, a written plan for obtaining the appropriate screening and 
other preventive services which are also covered as separate Medicare B 
Part services.
    The burden associated with this requirement is the time required of 
the physician or practitioner to provide beneficiaries with education, 
counseling, and referral services and to develop and provide a written 
plan for obtaining screening and other preventive services.
    While these requirements are subject to the PRA, we believe the 
burden associated with these requirements to be reasonable and 
customary business practice; therefore, the burden for this collection 
requirement is exempt under 5 CFR 1320.3(b)(2)&(3).
    Section 411.404 requires that written notice must be given to a 
beneficiary, or someone acting on his or her behalf, that

[[Page 47555]]

the services were not covered because they did not meet Medicare 
coverage guidelines.
    Although this section is subject to the PRA, the burden associated 
with this requirement is currently captured and accounted for in two 
currently approved information collections under OMB numbers 0938-0566 
and 0938-0781.
    Sections 410.36 and 410.38 require that the physician must document 
in the medical records the need for the prosthetic, orthotic, durable 
medical equipment, and/or supplies being ordered.
    While these information collection requirements are subject to the 
PRA, the burden associated with them is exempt as defined in 5 CFR 
1320.3(b)(2).
    If you comment on these information collection and recordkeeping 
requirements, please mail copies directly to the following:
    Centers for Medicare & Medicaid Services, Office of Strategic 
Operations and Regulatory Affairs, Attn: Melissa Musotto (CMS-1429-P), 
Room C5-13-28, 7500 Security Boulevard, Baltimore, MD 21244-1850; and 
Office of Information and Regulatory Affairs, Office of Management and 
Budget, Room 10235, New Executive Office Building, Washington, DC 
20503, Attn: Christopher Martin, CMS Desk Officer (CMS-1429-P), 
[email protected]. FAX (202) 395-6974.

VI. Response to Comments

    Because of the large number of public comments we normally receive 
on Federal Register documents, we are not able to acknowledge or 
respond to them individually. We will consider all comments we receive 
by the date and time specified in the DATES section of this preamble, 
and, when we proceed with a subsequent document, we will respond to the 
comments in the preamble to that document.

VII. Regulatory Impact Analysis

    [If you choose to comment on issues in this section, please include 
the caption ``IMPACT'' at the beginning of your comments.]
    We have examined the impact of this rule as required by Executive 
Order 12866 (September 1993, Regulatory Planning and Review), the 
Regulatory Flexibility Act (RFA) (September 16, 1980 Pub. L. 96-354), 
section 1102(b) of the Social Security Act, the Unfunded Mandates 
Reform Act of 1995 (Pub.L. 104-4), and Executive Order 13132.
    Executive Order 12866 (as amended by Executive Order 13258, which 
merely reassigns responsibilities of duties) directs agencies to assess 
all costs and benefits of available regulatory alternatives and, when 
regulation is necessary, to select regulatory approaches that maximize 
net benefits (including potential economic, environmental, public 
health and safety effects, distributive impacts, and equity). A 
regulatory impact analysis must be prepared for proposed rules with 
economically significant effects (that is, a proposed rule that would 
have an annual effect on the economy of $100 million or more in any 1 
year, or would adversely affect in a material way the economy, a sector 
of the economy, productivity, competition, jobs, the environment, 
public health or safety, or State, local, or tribal governments or 
communities). As indicated in more detail below, we estimate that the 
physician fee schedule provisions included in this proposed rule will 
redistribute more than $100 million in 1 year. We are also estimating 
that the combined effect of several provisions of the MMA implemented 
in this proposed rule will increase spending by more than $100 million. 
Other MMA provisions implemented in this proposed rule are estimated to 
reduce spending by more than $100 million. We are considering this 
proposed rule to be economically significant because its provisions are 
estimated to result in an increase, decrease or aggregate 
redistribution of Medicare spending that will exceed $100 million. 
Therefore, this proposed rule is a major rule and we have prepared a 
regulatory impact analysis.
    The RFA requires that we analyze regulatory options for small 
businesses and other entities. We prepare a regulatory flexibility 
analysis unless we certify that a rule would not have a significant 
economic impact on a substantial number of small entities. The analysis 
must include a justification concerning the reason action is being 
taken, the kinds and number of small entities the rule affects, and an 
explanation of any meaningful options that achieve the objectives with 
less significant adverse economic impact on the small entities.
    Section 1102(b) of the Act requires us to prepare a regulatory 
impact analysis for any proposed rule that may have a significant 
impact on the operations of a substantial number of small rural 
hospitals. This analysis must conform to the provisions of section 603 
of the RFA. For purposes of section 1102(b) of the Act, we define a 
small rural hospital as a hospital that is located outside a 
Metropolitan Statistical Area and has fewer than 100 beds. We have 
determined that this proposed rule would have minimal impact on small 
hospitals located in rural areas. Of 431 hospital-based ESRD facilities 
located in rural areas, only 40 are affiliated with hospitals with 
fewer than 100 beds.
    For purposes of the RFA, physicians, nonphysician practitioners, 
and suppliers are considered small businesses if they generate revenues 
of $6 million or less. Approximately 95 percent of physicians are 
considered to be small entities. There are about 875,000 physicians, 
other practitioners and medical suppliers that receive Medicare payment 
under the physician fee schedule. There are in excess of 20,000 
physicians and other practitioners that receive Medicare payment for 
drugs. (As noted previously in this proposed rule and described further 
below, we are proposing significant changes to the payments for drugs.) 
These physicians are concentrated in the specialties of oncology, 
urology, and rheumatology. Of the physicians in these specialties, 
approximately 40 percent are in oncology and 45 percent in urology.
    For purposes of the RFA, approximately 98 percent of suppliers of 
durable medical equipment (DME) and prosthetic devices are considered 
small businesses according to the Small Business Administration's (SBA) 
size standards. We estimate that 106,000 entities bill Medicare for 
durable medical equipment, prosthetics, orthotics, and supplies 
(DMEPOS) each year. Total annual estimated Medicare revenues for DME 
suppliers exceed approximately $4.0 billion. Of this amount, 
approximately $1.6 billion are for DME drugs.
    In addition, most ESRD facilities are considered small entities, 
either based on nonprofit status, or by having revenues of $29 million 
or less in any year. We consider a substantial number of entities to be 
affected if the proposed rule is estimated to impact more than 5 
percent of the total number of small entities. Based on our analysis of 
the 697 nonprofit ESRD facilities considered small entities in 
accordance with the above definitions, we estimate that the combined 
impact of the proposed changes to payment for renal dialysis services 
included in this rule would have a 1.6 percent increase in payments 
relative to current composite rate payments.
    The analysis and discussion provided in this section, as well as 
elsewhere in this proposed rule, complies with the RFA requirements. 
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 expenditures in any year by State, local,

[[Page 47556]]

or tribal governments, in the aggregate, or by the private sector, of 
$110 million. Medicare beneficiaries are considered to be part of the 
private sector for this purpose. The net impact of the provisions of 
this rule, including those related to the MMA, are estimated to result 
in a savings to beneficiaries of nearly $270 million for FY 2005. The 
specific effects of the provisions being implemented in this proposed 
rule are explained in greater detail below.
    We have examined this proposed rule in accordance with Executive 
Order 13132 and have determined that this regulation would not have any 
significant impact on the rights, roles, or responsibilities of State, 
local, or tribal governments.
    We have prepared the following analysis, which, together with the 
information provided in the rest of this preamble, meets all assessment 
requirements. It explains the rationale for and purposes of the rule; 
details the costs and benefits of the rule; analyzes alternatives; and 
presents the measures we propose to use to minimize the burden on small 
entities. As indicated elsewhere in this proposed rule, we propose to 
refine resource-based practice expense RVUs and make a variety of other 
changes to our regulations, payments, or payment policy to ensure that 
our payment systems are updated to reflect changes in medical practice 
and the relative value of services. We are also proposing several 
changes resulting from the MMA, including changes to Medicare payment 
rates for outpatient drugs, changes to the payment for renal dialysis 
services, creating new preventive health care benefits and creating 
incentive payment program improvements for physician scarcity.
    We are providing information for each of the policy changes in the 
relevant sections of this proposed rule. We are unaware of any relevant 
Federal rules that duplicate, overlap or conflict with this proposed 
rule. The relevant sections of this proposed rule contain a description 
of significant alternatives if applicable.

A. Resource-Based Practice Expense and Malpractice Relative Value Units

    Under section 1848(c)(2) of the Act, adjustments to RVUs may not 
cause the amount of expenditures to differ by more than $20 million 
from the amount of expenditures that would have resulted without such 
adjustments. We are proposing several changes that would result in a 
change in expenditures that would exceed $20 million if we made no 
offsetting adjustments to either the conversion factor or RVUs.
    With respect to practice expense, our policy has been to meet the 
budget-neutrality requirements in the statute by incorporating a 
rescaling adjustment in the practice expense methodologies. That is, we 
estimate the aggregate number of practice expense RVUs that will be 
paid under current and proposed policy in CY 2005. We apply a uniform 
adjustment factor to make the aggregate number of proposed practice 
expense RVUs equal the number estimated that would be paid under 
current policy.
    Table 21 shows the specialty level impact on payment of changes 
being proposed for CY 2005. Our estimates of changes in Medicare 
revenues for physician fee schedule services compare payment rates for 
2005 with payment rates for 2004 using 2003 Medicare utilization for 
both years. We are using 2003 Medicare claims processed and paid 
through June 30, 2004 that we estimate are 96.7 complete and have 
adjusted the figures to reflect a full year of data. Thus, because we 
are using a single year of utilization, the estimated changes in 
revenues reflect payment changes only between 2004 and 2005. To the 
extent that there are year-to-year changes in the volume and mix of 
services provided by physicians, the actual impact on total Medicare 
revenues will be different than those shown here. The payment impacts 
reflect averages for each specialty based on Medicare utilization. The 
payment impact for an individual physician would be different from the 
average, based on the mix of services the physician provides. The 
average change in total revenues would be less than the impact 
displayed here because physicians furnish services to both Medicare and 
non-Medicare patients and specialties may receive substantial Medicare 
revenues for services that are not paid under the physician fee 
schedule. For instance, independent laboratories receive approximately 
80 percent of their Medicare revenues from clinical laboratory services 
that are not paid under the physician fee schedule. The table shows 
only the payment impact on physician fee schedule services.
    We modeled the impact of changes to the practice expense 
methodology and illustrated the effect in table 21 below. The column 
labeled ``Practice Expense RVU Refinements'' shows the effect of the 
refinements we are making to the practice expense methodology for 2005. 
For instance, we are incorporating refined practice expense inputs 
recommended by the PEAC into the methodology as well as updating the 
prices of medical equipment. We are also adding 2003 utilization data 
for codes that did not exist in the 1997 through 2002 period.
    In general, updating the methodology with 2003 utilization data has 
little or no impact on total payments to a specialty but the practice 
expense values for specific services may change. In general, the 
largest changes to a practice expense RVU will occur when a code was 
established after 2002 and we did not have any Medicare utilization 
data to determine the specialty that performs the service. In these 
cases, we either assigned the code to a specialty cost pool based on 
the specialty most likely to do the service or we used the ``all 
physician'' scaling factors to determine the code's practice expense 
RVUs. While we are trying to minimize instability in the practice 
expense RVUs for new services by assigning the specialty that is most 
likely to perform the service when we have no utilization data, the 
addition of utilization to the methodology may still result in some 
change to the practice expense RVUs during the first few years a code 
is in existence.
    The practice expense refinements will reduce payments to 
audiologists by approximately 4 percent. Virtually all of the reduction 
in payment is due to the refinement of procedure code 92547. We 
accepted the PEAC recommendation to reduce the clinical staff time of 
the audiologist involved in this add-on service from 71 minutes to 1 
minute. The refinement of clinical staff and equipment resulted in a 
reduction from 1.15 to 0.08 practice expense RVUs producing the nearly 
4 percent reduction in payments shown in table 21.
    Payments to vascular surgeons will increase approximately 3 percent 
as a result of the refinements. The increase in payment is attributed 
to the repricing of medical equipment used in performing noninvasive 
vascular diagnostic tests that will increase the practice expense RVUs 
for procedure codes 93880, 93923, 93925, 93970 and other codes in that 
family. The estimated 2 percent increase in payment from the practice 
expense refinements for interventional radiology is primarily due to 
the establishment of nonfacility pricing for procedure codes 35470 to 
35476. The 3 percent increase in payment to oral and maxillofacial 
surgeons is largely attributed to the refinement of medical supplies 
for procedure codes 21210 and 21215. The 1 percent decrease in payment 
to nurse practitioners and geriatricians is attributed to the 
refinement of the nonfacility practice expense RVUs for

[[Page 47557]]

nursing facility visits (procedure codes 99301 through 99316). As 
stated in the November 7, 2003 Federal Register (68 FR 63204), the 
changes to the nonfacility practice expense RVUs for these codes were 
delayed by 1 year to allow the PEAC to reconsider its earlier 
recommendation to us to reflect input from representatives of 
specialties that provide these services in nursing homes. The PEAC 
reconsidered its recommendations with input from these specialties. Our 
acceptance of the PEAC recommendations is resulting in a decrease in 
the nonfacility practice expense RVUs for the nursing facility visit 
codes.
    The column labeled ``Survey Data'' shows the impact on payment from 
using the supplemental practice expense survey from the College of 
American Pathologists (CAP). Using this survey together with making the 
technical component practice expense RVUs equal to the difference 
between the global and professional component practice expense RVUs and 
the other practice expense refinements will increase payments to 
pathologists by approximately 2 percent and independent laboratories by 
more than 6 percent. As we indicated above, independent laboratories 
receive approximately 20 percent of their total Medicare revenues from 
physician fee schedule services. The remaining 80 percent of their 
Medicare revenues are from clinical diagnostic laboratory services that 
will be unchanged by use of the CAP survey data. Thus, total Medicare 
revenues to independent laboratories as a result of using the CAP 
survey will increase by slightly more than 1 percent (or 20 percent of 
the 6 percent increase in physician fee schedule revenues). There will 
be little or no impact on all other specialties from use of the CAP 
survey.
    The column labeled ``Total'' in Table 21 below shows the payment 
impact by specialty of all the changes described above. If we change 
any of these proposals following our consideration of comments, these 
figures may change.

 Table 21.--Impact of Practice Expense RVU Changes on Total Medicare Allowed Charges by Physician, Practitioner
                                            and Supplier Subcategory
----------------------------------------------------------------------------------------------------------------
                                                     Medicare        Practice
                                                      allowed       expense RVU     Survey data        Total
                    Specialty                      charges ($ in    refinements      (percent)       (percent)
                                                     millions)       (percent)
----------------------------------------------------------------------------------------------------------------
Physicians:
    ALLERGY/IMMUNOLOGY..........................             161              -1               0              -1
    ANESTHESIOLOGY..............................           1,416               0               0               0
    CARDIAC SURGERY.............................             359               0               0               0
    CARDIOLOGY..................................           6,583               0               0               0
    COLON AND RECTAL SURGERY....................             111               0               0               0
    CRITICAL CARE...............................             130               0               0               0
    DERMATOLOGY.................................           1,870               0               0               0
    EMERGENCY MEDICINE..........................           1,672               0               0               0
    ENDOCRINOLOGY...............................             280               0               0               0
    FAMILY PRACTICE.............................           4,448               0               0               0
    GASTROENTEROLOGY............................           1,636               0               0               0
    GENERAL PRACTICE............................             998               0               0               0
    GENERAL SURGERY.............................           2,258               0               0               0
    GERIATRICS..................................             117              -1               0              -1
    HAND SURGERY................................              57               1               0               1
    HEMATOLOGY/ONCOLOGY.........................           1,753               0               0               0
    INFECTIOUS DISEASE..........................             401               0               0               0
    INTERNAL MEDICINE...........................           8,846               0               0               0
    INTERVENTIONAL RADIOLOGY....................             190               2               0               2
    NEPHROLOGY..................................           1,248               1               0               1
    NEUROLOGY...................................           1,200               0               0               0
    NEUROSURGERY................................             490               0               0               0
    NUCLEAR MEDICINE............................              85               0               0               0
    OBSTETRICS/GYNECOLOGY.......................             582               0               0               0
    OPHTHALMOLOGY...............................           4,583              -1               0              -1
    ORTHOPEDIC SURGERY..........................           2,902               0               0               0
    OTOLARNGOLOGY...............................             815               0               0               0
    PATHOLOGY...................................             869              -1               3               2
    PEDIATRICS..................................              59              -1               0              -1
    PHYSICAL MEDICINE...........................             677               0               0               0
    PLASTIC SURGERY.............................             281               0               0               0
    PSYCHIATRY..................................           1,093               0               0               0
    PULMONARY DISEASE...........................           1,446               0               0               0
    RADIATION ONCOLOGY..........................           1,164               0               0               0
    RADIOLOGY...................................           4,690               0               0               0
    RHEUMATOLOGY................................             413               0               0               0
    THORACIC SURGERY............................             463               0               0               0
    UROLOGY.....................................           1,699               0               0               0
    VASCULAR SURGERY............................             487               3               0               3
Practitioners:
    AUDIOLOGIST.................................              28              -4               0              -4
    CHIROPRACTOR................................             656               0               0               0
    CLINICAL PSYCHOLOGIST.......................             490               0               0               0
    CLINICAL SOCIAL WORKER......................             313               0               0               0
    NURSE ANESTHETIST...........................             481               0               0               0

[[Page 47558]]

 
    NURSE PRACTITIONER..........................             552              -1               0              -1
    OPTOMETRY...................................             664               0               0               0
    ORAL/MAXILLOFACIAL SURGERY..................              36               3               0               3
    PHYSICAL/OCCUPATIONAL THERAPY...............             990              -1               0              -1
    PHYSICIAN ASSISTANT.........................             410               0               0               0
    PODIATRY....................................           1,383               0               0               0
Suppliers:
    DIAGNOSTIC TESTING FACILITY.................             876               1               0               1
    INDEPENDENT LABORATORY......................             530               0               6               6
    PORTABLE X-RAY SUPPLIER.....................              91               0               0               0
Other:
    ALL OTHER...................................              93               0               2               2
    ALL PHYSICIAN FEE SCHEDULE..................          66,395               0               0               0
----------------------------------------------------------------------------------------------------------------

    As discussed in Section II.C of this rule, we are proposing changes 
to the malpractice RVUs based on more current malpractice premium data. 
As anticipated from past revisions to the malpractice RVUs, use of more 
current malpractice premium data results in minimal proposed impacts on 
the specialty level payments. See Table 22, ``Specialty Impact of 
Malpractice RVUs Revisions'', for a breakdown of the impacts of these 
revisions on individual specialties. Of the 54 specialties shown, 15 
specialties (representing a total of 40 percent of Medicare allowed 
charges) experience no estimated change. Total Medicare payments for an 
additional 32 specialties are estimated to increase or decrease between 
0.1 percent and 0.5 percent. We estimate that 7 specialties will 
experience a total payment increase or decrease of more than 0.5 
percent as a result of the malpractice RVU changes. If we change any of 
these proposals following our consideration of comments, these figures 
may change.

                            Table 22.--Specialty Impact of Malpractice RVU Revisions
----------------------------------------------------------------------------------------------------------------
                                                                Allowed charges     Percent of    Percent change
                          Specialty                                   \1\          total charges        \2\
----------------------------------------------------------------------------------------------------------------
DERMATOLOGY..................................................      1,870,318,730             2.8             0.7
PLASTIC SURGERY..............................................        280,508,065             0.4             0.6
ORAL/MAXILLOFACIAL SURGERY...................................         35,598,814             0.1             0.6
COLON AND RECTAL SURGERY.....................................        110,683,908             0.2             0.6
GASTROENTEROLOGY.............................................      1,635,616,057             2.5             0.5
GENERAL SURGERY..............................................      2,257,836,035             3.4             0.5
CRITICAL CARE................................................        130,256,300             0.2             0.5
INFECTIOUS DISEASE...........................................        395,195,230             0.6             0.4
GERIATRICS...................................................        116,547,182             0.2             0.3
PSYCHIATRY...................................................      1,092,801,668             1.7             0.3
PULMONARY DISEASE............................................      1,445,180,432             2.2             0.3
NURSE PRACTITIONER...........................................        549,723,060             0.8             0.2
PATHOLOGY....................................................        868,617,850             1.3             0.2
NEUROLOGY....................................................      1,199,069,489             1.8             0.2
PHYSICAL MEDICINE............................................        676,516,230             1.0             0.2
INDEPENDENT LABORATORY.......................................        529,571,661             0.8             0.2
OPTOMETRY....................................................        664,163,601             1.0             0.2
NEPHROLOGY...................................................      1,247,164,211             1.9             0.1
VASCULAR SURGERY.............................................        486,263,563             0.7             0.1
OBSTETRICS/GYNECOLOGY........................................        578,322,768             0.9             0.1
INTERNAL MEDICINE............................................      8,821,789,552            13.4             0.1
ENDOCRINOLOGY................................................        279,359,088             0.4             0.1
ANESTHESIOLOGY...............................................      1,415,251,017             2.1             0.0
HEMATOLOGY/ONCOLOGY..........................................      1,553,937,401             2.4             0.0
CARDIOLOGY...................................................      6,580,625,617            10.0             0.0
OPHTHALMOLOGY................................................      4,583,221,470             7.0             0.0
NURSE ANESTHETIST............................................        481,060,016             0.7             0.0
THORACIC SURGERY.............................................        463,428,857             0.7             0.0
RADIATION ONCOLOGY...........................................      1,162,754,357             1.8             0.0
ALL OTHER....................................................         92,826,859             0.1             0.0
CLINICAL SOCIAL WORKER.......................................        313,327,455             0.5             0.0
GENERAL PRACTICE.............................................        995,188,403             1.5             0.0
UROLOGY......................................................      1,689,047,785             2.6             0.0
INTERVENTIONAL RADIOLOGY.....................................        189,980,663             0.3             0.0
EMERGENCY MEDICINE...........................................      1,671,773,516             2.5             0.0
FAMILY PRACTICE..............................................      4,442,795,644             6.7             0.0
DIAGNOSTIC TESTING FACILITY..................................        876,242,174             1.3             0.0

[[Page 47559]]

 
PHYSICIANS ASSISTANT.........................................        409,700,298             0.6            -0.1
PEDIATRICS...................................................         58,880,964             0.1            -0.1
AUDIOLOGIST..................................................         27,930,180             0.0            -0.1
CLINICAL PSYCHOLOGIST........................................        490,006,176             0.7            -0.1
CARDIAC SURGERY..............................................        359,324,850             0.5            -0.1
PORTABLE X-RAY SUPPLIER......................................         91,026,934             0.1            -0.1
HAND SURGERY.................................................         56,595,222             0.1            -0.1
OTOLARNGOLOGY................................................        814,914,443             1.2            -0.1
RHEUMATOLOGY.................................................        405,622,764             0.6            -0.1
NUCLEAR MEDICINE.............................................         85,239,821             0.1            -0.1
CHIROPRACTOR.................................................        656,312,519             1.0            -0.2
RADIOLOGY....................................................      4,689,652,801             7.1            -0.3
PODIATRY.....................................................      1,382,552,109             2.1            -0.4
ORTHOPEDIC SURGERY...........................................      2,902,084,841             4.4            -0.4
NEUROSURGERY.................................................        489,366,546             0.7            -0.6
ALLERGY/IMMUNOLOGY...........................................        160,728,139             0.2            -0.9
PHYSICAL/OCCUPATIONAL THERAPY................................        990,284,755             1.5           -1.3
----------------------------------------------------------------------------------------------------------------
\1\ 2003 Allowed Charges
\2\ Percent change based upon percent change in total payment.

    Section 1848(d) and (f) of the Act requires the Secretary to set 
the physician fee schedule update under the sustainable growth rate 
(SGR) system. For 2004 and 2005, the statute requires the update to be 
no less than 1.5 percent. We believe it is highly likely that the 
statutory formula in section 1848(d)(4) will produce an update of less 
than 1.5 percent for 2005. Therefore, we estimate that the physician 
fee schedule update for 2005 will be 1.5 percent. We are currently 
forecasting payment reductions under the SGR system for 2006 and later 
years. As in the past, we will include a complete discussion of our 
methodology for calculating the SGR in the final rule.
    Table 23 below shows the estimated change in average payments by 
specialty resulting from changes to the practice expense and 
malpractice RVUs and the 2005 physician fee schedule update. (Please 
note that the table does not include the specialties of Hematology/
Oncology, Urology, Rheumatology and Obstetrics/Gynecology. There are 
unique issues related to drug administration that will further affect 
these specialties that are presented in detail below).

  Table 23.--Impact of Practice Expense and Malpractice RVU Changes and Physician Fee Schedule Update on Total
                  Medicare Allowed Charges by Physician, Practitioner and Supplier Subcategory
----------------------------------------------------------------------------------------------------------------
                                                                     Practice
                                                     Medicare       expenses &     Physician fee
                   Speciality                         allowed       malpractice      schedule          Total
                                                   charges ($ in    RVU changes       update         (percent)
                                                     Millions)       (percent)       (percent)
----------------------------------------------------------------------------------------------------------------
Physicians:
    ALLERGY/IMMUNOLOGY..........................             161              -2             1.5               0
    ANESTHESIOLOGY..............................           1,416               0             1.5               2
    CARDIAC SURGERY.............................             359               0             1.5               1
    CARDIOLOGY..................................           6,583               0             1.5               2
    COLON AND RECTAL SURGERY....................             111               1             1.5               2
    CRITICAL CARE...............................             130               0             1.5               2
    DERMATOLOGY.................................           1,870               1             1.5               3
    EMERGENCY MEDICINE..........................           1,672               0             1.5               2
    ENDOCRINOLOGY...............................             280               0             1.5               2
    FAMILY PRACTICE.............................           4,448               0             1.5               1
    GASTROENTEROLOGY............................           1,636               0             1.5               2
    GENERAL PRACTICE............................             998               0             1.5               1
    GENERAL SURGERY.............................           2,258               1             1.5               2
    GERIATRICS..................................             117              -1             1.5               1
    HAND SURGERY................................              57               0             1.5               2
    INFECTIOUS DISEASE..........................             401               0             1.5               2
    INTERNAL MEDICINE...........................           8,846               0             1.5               1
    INTERVENTIONAL RADIOLOGY....................             190               2             1.5               4
    NEPHROLOGY..................................           1,248               1             1.5               2
    NEUROLOGY...................................           1,200               0             1.5               2
    NEUROSURGERY................................             490              -1             1.5               1
    NUCLEAR MEDICINE............................              85               0             1.5               1
    OPHTHALMOLOGY...............................           4,583              -1             1.5               0
    ORTHOPEDIC SURGERY..........................           2,902               0             1.5               1
    OTOLARNGOLOGY...............................             815               0             1.5               2
    PATHOLOGY...................................             869               2             1.5               4

[[Page 47560]]

 
    PEDIATRICS..................................              59              -1             1.5               1
    PHYSICAL MEDICINE...........................             677               0             1.5               2
    PLASTIC SURGERY.............................             281               1             1.5               2
    PSYCHIATRY..................................           1,093               0             1.5               2
    PULMONARY DISEASE...........................           1,446               0             1.5               2
    RADIATION ONCOLOGY..........................           1,164               0             1.5               1
    RADIOLOGY...................................           4,690               0             1.5               1
    THORACIC SURGERY............................             463               0             1.5               2
    VASCULAR SURGERY............................             487               3             1.5               4
Practitioners:
    AUDIOLOGIST.................................              28              -4             1.5              -2
    CHIROPRACTOR................................             656              -1             1.5               1
    CLINICAL PSYCHOLOGIST.......................             490               0             1.5               1
    CLINICAL SOCIAL WORKER......................             313               0             1.5               1
    NURSE ANESTHETIST...........................             481               0             1.5               2
    NURSE PRACTITIONER..........................             552              -1             1.5               0
    OPTOMETRY...................................             664               0             1.5               1
    ORAL/MAXILLOFACIAL SURGERY..................              36               4             1.5               5
    PHYSICAL/OCCUPATIONAL THERAPY...............             990              -2             1.5              -1
    PHYSICIAN ASSISTANT.........................             410               0             1.5               1
    PODIATRY....................................           1,383              -1             1.5               1
Suppliers:
    DIAGNOSTIC TESTING FACILITY.................             876               1             1.5               3
    INDEPENDENT LABORATORY......................             530               6             1.5               8
    PORTABLE X-RAY SUPPLIER.....................              91               0             1.5               1
Other:
    ALL OTHER...................................              93               2             1.5               3
    ALL PHYSICIAN FEE SCHEDULE..................          66,395               0             1.5               2
----------------------------------------------------------------------------------------------------------------

    Table 24 shows the impact on payments for selected high-volume 
procedures of all of the changes previously discussed. We selected 
these procedures because they are the most commonly provided procedures 
by a broad spectrum of physician specialties, or they are of particular 
interest to the physician community (for example, the preventive office 
visit, G0XX2). This table shows the combined impact of the change in 
the practice expense and malpractice RVUs and the estimated physician 
fee schedule update on total payment for the procedure. There are 
separate columns that show the change in the facility rates and the 
nonfacility rates. For an explanation of facility and nonfacility 
practice expense refer to Sec.  414.22(b)(5)(i). The table shows the 
estimated change in payment rates based on provisions of this proposed 
rule and the estimated physician fee schedule update. If we change any 
of the provisions following the consideration of public comments, these 
figures may change.

                    Table 24.--Impact of Proposed Rule and Physician Fee Schedule Update on Medicare Payment for Selected Procedures
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                             Non-facility                          Facility
                                                                                 -----------------------------------------------------------------------
                CODE                    MOD               Description                                        Percent                             Percent
                                                                                      Old          New       change       Old          New       change
--------------------------------------------------------------------------------------------------------------------------------------------------------
11721..............................  ........  Debride nail, 6 or more..........      $ 38.08      $ 38.28         1      $ 29.87      $ 29.94         0
17000..............................  ........  Destroy benign/premlg lesion.....        60.49        61.39         1        35.84        45.48        27
27130..............................  ........  Total hip arthroplasty...........          N/A          N/A       N/A     1,370.28     1,382.50         1
27236..............................  ........  Treat thigh fracture.............          N/A          N/A       N/A     1,088.01     1,103.20         1
27244..............................  ........  Treat thigh fracture.............          N/A          N/A       N/A     1,115.27     1,133.51         2
27447..............................  ........  Total knee arthroplasty..........          N/A          N/A       N/A     1,475.95     1,492.02         1
33533..............................  ........  CABG, arterial, single...........          N/A          N/A       N/A     1,882.18     1,905.49         1
35301..............................  ........  Rechanneling of artery...........          N/A          N/A       N/A     1,114.89     1,122.90         1
43239..............................  ........  Upper GI endoscopy, biopsy.......       321.85       336.15         4       159.43       162.58         2
45385..............................  ........  Lesion removal colonoscopy.......       497.71       514.65         3       288.24       293.71         2
66821..............................  ........  After cataract laser surgery.....       240.83       237.62        -1       237.09       230.80        -3
66984..............................  ........  Cataract surg w/iol, 1 stage.....          N/A          N/A       N/A       684.39       683.67         0
67210..............................  ........  Treatment of retinal lesion......       577.98       599.92         4       560.81       573.01         2
71010..............................        26  Chest x-ray......................         9.33         9.47         2         9.33         9.47         2
71020..............................        26  Chest x-ray......................        11.20        11.37         2        11.20        11.37         2
76091..............................        26  Mammogram, both breasts..........        96.33        97.40         1          N/A          N/A       N/A
76091..............................  ........  Mammogram, both breasts..........        44.80        45.10         1        44.80        45.10         1

[[Page 47561]]

 
76092..............................        26  Mammogram, screening.............        84.76        85.27         1          N/A          N/A       N/A
76092..............................  ........  Mammogram, screening.............        36.22        36.38         0        36.22        36.38         0
77427..............................  ........  Radiation tx management, x5......       169.14       172.05         2       169.14       172.05         2
78465..............................        26  Heart image (3d), multiple.......        76.17        77.31         1        76.17        77.31         1
88305..............................        26  Tissue exam by pathologist.......        41.44        42.07         2        41.44        42.07         2
90801..............................  ........  Psy dx interview.................       150.84       153.48         2       142.26       144.39         1
90806..............................  ........  Psytx, off, 45-50 min............        97.45        98.91         1        93.72        95.12         1
90807..............................  ........  Psytx, off, 45-50 min w/e&m......       103.80       104.98         1       101.18       102.32         1
90862..............................  ........  Medication management............        51.15        52.30         2        48.17        49.27         2
90935..............................  ........  Hemodialysis, one evaluation.....          N/A          N/A       N/A        72.06        73.14         1
92004..............................  ........  Eye exam, new patient............       126.57       129.61         2        89.24        90.58         2
92012..............................  ........  Eye exam established pat.........        63.47        65.18         3        36.22        37.14         3
92014..............................  ........  Eye exam & treatment.............        93.34        96.26         3        58.99        60.64         3
92980..............................  ........  Insert intracoronary stent.......          N/A          N/A       N/A       812.09       829.58         2
92982..............................  ........  Coronary artery dilation.........          N/A          N/A       N/A       602.63       615.83         2
93000..............................  ........  Electrocardiogram, complete......        26.51        26.91         2          N/A          N/A       N/A
93010..............................  ........  Electrocardiogram report.........         8.96         9.10         2         8.96         9.10         2
93015..............................  ........  Cardiovascular stress test.......       106.78       108.01         1          N/A          N/A       N/A
93307..............................        26  Echo exam of heart...............        49.29        49.27         0        49.29        49.27         0
93510..............................        26  Left heart catheterization.......       252.77       257.32         2       252.77       257.32         2
98941..............................  ........  Chiropractic manipulation........        36.22        36.76         1        31.74        31.83         0
99203..............................  ........  Office/outpatient visit, new.....        95.96        97.40         2        71.69        72.38         1
99204..............................  ........  Office/outpatient visit, new.....       135.53       137.57         2       105.66       107.25         2
99205..............................  ........  Office/outpatient visit, new.....       172.13       174.71         1       140.39       142.49         1
99211..............................  ........  Office/outpatient visit, est.....        21.28        21.98         3         8.96         9.10         2
99212..............................  ........  Office/outpatient visit, est.....        37.71        38.66         3        23.52        24.25         3
99213..............................  ........  Office/outpatient visit, est.....        52.65        53.06         1        35.47        35.24        -1
99214..............................  ........  Office/outpatient visit, est.....        82.14        83.00         1        57.87        58.74         2
99215..............................  ........  Office/outpatient visit, est.....       119.11       121.27         2        93.34        95.12         2
99221..............................  ........  Initial hospital care............          N/A          N/A       N/A        66.83        68.22         2
99222..............................  ........  Initial hospital care............          N/A          N/A       N/A       111.27       112.93         1
99223..............................  ........  Initial hospital care............          N/A          N/A       N/A       154.95       157.27         1
99231..............................  ........  Subsequent hospital care.........          N/A          N/A       N/A        33.23        34.11         3
99232..............................  ........  Subsequent hospital care.........          N/A          N/A       N/A        54.89        56.09         2
99233..............................  ........  Subsequent hospital care.........          N/A          N/A       N/A        78.04        79.58         2
99236..............................  ........  Observ/hosp same date............          N/A          N/A       N/A       226.26       223.60        -1
99238..............................  ........  Hospital discharge day...........          N/A          N/A       N/A        69.82        70.87         2
99239..............................  ........  Hospital discharge day...........          N/A          N/A       N/A        95.21        91.71        -4
99241..............................  ........  Office consultation..............        50.03        50.40         1        33.98        34.49         2
99242..............................  ........  Office consultation..............        91.48        92.47         1        69.45        70.11         1
99243..............................  ........  Office consultation..............       120.60       122.79         2        92.22        93.99         2
99244..............................  ........  Office consultation..............       170.63       172.81         1       136.65       138.70         2
99245..............................  ........  Office consultation..............       220.29       224.35         2       181.09       184.56         2
99251..............................  ........  Initial inpatient consult........          N/A          N/A       N/A        35.84        36.00         0
99252..............................  ........  Initial inpatient consult........          N/A          N/A       N/A        71.69        72.76         1
99253..............................  ........  Initial inpatient consult........          N/A          N/A       N/A        97.45        98.91         1
99254..............................  ........  Initial inpatient consult........          N/A          N/A       N/A       140.39       142.12         1
99255..............................  ........  Initial inpatient consult........          N/A          N/A       N/A       193.03       195.55         1
99261..............................  ........  Follow-up inpatient consult......          N/A          N/A       N/A        22.40        22.36         0
99262..............................  ........  Follow-up inpatient consult......          N/A          N/A       N/A        44.80        45.48         2
99263..............................  ........  Follow-up inpatient consult......          N/A          N/A       N/A        66.09        67.46         2
99282..............................  ........  Emergency dept visit.............          N/A          N/A       N/A        27.63        27.67         0
99283..............................  ........  Emergency dept visit.............          N/A          N/A       N/A        61.61        62.15         1
99284..............................  ........  Emergency dept visit.............          N/A          N/A       N/A        95.58         7.02         2
99285..............................  ........  Emergency dept visit.............          N/A          N/A       N/A       149.72       151.97         2
99291..............................  ........  Critical care, first hour........       242.69       257.32         6       203.12       207.68         2
99292..............................  ........  Critical care, add'l 30 min......       107.91       114.45         6       101.56       103.84         2
99301..............................  ........  Nursing facility care............        71.69        66.32        -7        61.61        66.32         8
99302..............................  ........  Nursing facility care............        97.82        87.92       -10        82.52        87.92         7
99303..............................  ........  Nursing facility care............       120.97       108.39       -10       102.68       108.39         6
99311..............................  ........  Nursing fac care, subseq.........        40.70        34.49       -15        30.62        34.49        13
99312..............................  ........  Nursing fac care, subseq.........        63.10        56.85       -10        51.53        56.85        10
99313..............................  ........  Nursing fac care, subseq.........        86.25        79.96        -7        72.43        79.96        10
99348..............................  ........  Home visit, est patient..........        75.42        72.01        -5          N/A          N/A       N/A
99350..............................  ........  Home visit, est patient..........       169.89       165.23        -3          N/A          N/A       N/A
G0317..............................  ........  ESRDrelsvc 4+/mo;20+yr...........       303.18       307.73         2       303.18       307.73         2
G0318..............................  ........  ESRDrelsvc 2-3/mo;20+yr..........       252.40       256.19         2       252.40       256.19         2
G0319..............................  ........  ESRDrelsvc 1/mo;20+yr............       201.62       204.65         2       201.62       204.65         2

[[Page 47562]]

 
G0XX2..............................  ........  Preventive Office Visit..........          N/A       124.30       N/A          N/A        82.24       N/A
--------------------------------------------------------------------------------------------------------------------------------------------------------

    Section 303(a)(1) of the MMA amended section 1848(c)(2) of the Act 
to require increased work and practice expense RVUs for drug 
administration services. Section 303(a)(4) of the MMA required an 
additional temporary increase in payment to specific drug 
administration services (procedure codes 90780 through 90788, 96400, 
96408 through 96425, 96520, and 96530) of 32 percent for 2004 and 3 
percent for 2005. Table 25 shows the payment amounts for selected high-
volume drug administration CPT codes from 2002 to 2006 including the 
effect of the transition adjustment of 32 percent required for 2004 and 
3 percent for 2005 and 0 percent for 2006. The amounts shown in the 
table include the effect of the 1.5 percent update for 2004 and 2005. 
The 2006 payment amount shown in the table reflects the 2005 conversion 
factor because the 2006 physician fee schedule update is currently 
unknown.
    With the exception of procedure code 96412 declining by 17 percent 
(which occurred because resource-based pricing replaced the use of 
charge-based RVUs when the services were removed from the nonphysician 
work pool), the MMA permanently increases payment for all of these 
services from a low of 17 percent for procedure code 90781 to 321 
percent for procedure code 90782. The volume-weighted average permanent 
increase in payment among these drug administration services is 
approximately 105 percent (109 percent for oncologists and 94 percent 
for other physicians). Including the effect of the transition makes the 
volume-weighted increase in payment for these codes more than 170 
percent from 2003 to 2004 and 110 percent from 2003 to 2005. The 
payment amount for procedure code 96400 in 2002 was $5.07. Payment for 
this code increased substantially to $37.52 in 2003 when, at the 
request of the American Urological Association (see 67 FR 79981 
published on December 31, 2002), we removed this code from the 
nonphysician work pool. Including the effect of the additional changes 
required by MMA, we expect payment for this code to be $49.65 by 2006. 
Thus, the payment increase for procedure code 96400 between 2002 and 
2006 is 879 percent. As indicated earlier, we are continuing to 
consider coding and RVU changes for drug administration services for 
2005 based on the results of the CPT review and our consideration of 
public comments. If we change any of the RVUs for these codes as a 
result of CPT's review or the consideration of public comments, these 
figures may change.

           Table 25.--Impact of Proposed Rule and Physician Fee Schedule Update on Medicare Payment for Selected Drug Administration Services
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                  Non-facility payment
                                                              ------------------------------------------------------------------------------------------
                                                                                                          2005         2006
                       Code Description                            2002         2003         2004      Payment *    Payment *     Percent      Percent
                                                                 Payment      Payment      Payment     w/Current    w/Current   change 2003  change 2002
                                                                                                        PE RVUs      PE RVUs      to 2006      to 2006
--------------------------------------------------------------------------------------------------------------------------------------------------------
90780 IV infusion therapy, 1 hour............................       $40.54       $42.67      $117.79       $92.90       $90.20          111          122
90781 IV infusion, additional hour...........................        20.27        21.70        33.02        26.15        25.39           17           25
90782 Injection, sc/im.......................................         3.98         4.41        24.64        19.13        18.57          321          367
96400 Chemotherapy, sc/im....................................         5.07        37.52        64.07        51.14        49.65           32          879
96408 Chemotherapy, push technique...........................        35.11        37.52       154.76       122.96       119.38          218          240
96410 Chemotherapy,infusion method...........................        55.75        59.22       217.35       171.75       166.75          182          199
96412 Chemo, infuse method add-on............................        41.63        44.14        48.30        37.86        36.76          -17         -12
--------------------------------------------------------------------------------------------------------------------------------------------------------
* Payment amounts reflect the current practice expense RVUs and a 1.5 percent update for 2005. The 2006 update is currently unknown. The payment amounts
  for 2006 were calculated using the 2005 conversion factor. If we were to make further revisions to the practice expense RVUs following the
  consideration of public comments and/or the CPT coding process, the payment amounts will be different.

    Table 26 below shows the impact of the drug and physician fee 
schedule changes for selected specialties that receive a significant 
portion of their total Medicare revenues from drugs. Table 27 shows the 
combined payment impact of the drug and physician fee schedule payment 
changes on combined Medicare revenues. The first column (``Estimated 
Medicare Drug Revenues'') shows estimated 2004 Medicare Drug Revenues 
using 2003 utilization adjusted for drug payment changes required in 
2004 by the MMA. The next column (``% Change Medicare Drug Revenues'') 
shows the payment impact of the adoption of the average sales price 
plus 6 percent (ASP+6) drug payment methodology in 2005 relative to 
2004 on specialty drug payments. The payment impacts are based on ASP 
submissions from the 1st quarter of 2004. The ASP prices that will be 
used to determine payment in 2005 will begin with the 3rd quarter 2004 
ASP submission and will be updated quarterly. To model the impact 
illustrated, we assumed an average increase in ASP prices of 3.39 
percent (the national health expenditure prescription drug price growth 
factor) from the 1st quarter 2004 submission to the prices that will be 
used to determine 2005 payments. Table xxxxxxx follows table xxxxxx and 
shows the drug prices we used to determine the payment impact. The drug 
payment impacts are based on those high volume drugs where we have 
validated the ASP price submission that represent the following 
percentages of 2003 drug payments: 72 percent for Hematology/Oncology, 
94

[[Page 47563]]

percent for Urology, 97 percent for Rheumatology and 73 percent for 
Obstetrics/Gynecology. For drugs in which we did not complete our 
validation of the ASP submission before completing the proposed rule, 
we used the average payment change for other drugs provided by the 
specialty unless a special circumstance applied. (that is, for 
Hematology/Oncology and Obstetrics/Gynecology, we calculated the 
average reduction in payment for drugs excluding J9265, J2430, and 
J9390, three drugs having an unusually large reduction in payment as a 
result of coming off patent. We do not believe these reductions will be 
typical of other drugs furnished by oncologists and obstetrician/
gynecologists).
    Our estimates of changes in Medicare revenues for drugs and 
physician fee schedule services compare payment rates for 2005 with 
payment rates for 2004 using 2003 Medicare utilization for both years. 
We are using 2003 Medicare claims processed and paid through June 30, 
2004 that we estimate are 96.7 complete and have adjusted the figures 
to reflect a full year of data. Thus, because we are using a single 
year of utilization, the estimated changes in revenues reflect payment 
changes only between 2004 and 2005. To the extent that there are year-
to-year changes in the volume and mix of drugs and physician fee 
schedule services provided by physicians, the actual impact on total 
Medicare revenues will be different than those shown here.
    Assuming no change in utilization, we estimate that Medicare drug 
revenues for oncologists would decline by less than 8 percent as a 
result of policies adopted in this proposed rule. Oncologists 
administer a number of drugs that are changing in payments by different 
amounts. For instance, oncologists' highest Medicare revenue drug, 
Q0136 (EPOGEN; PROCRIT), would decline in payment by 7 percent while 
its second highest revenue drug, J9310 (RITUXAN), would increase in 
payment by 7 percent. Three drugs supplied by oncologists, J9265 (ONXOL 
TAXOL), J2430 (PAMIDRONATE DISODIUM), and J9390 (NAVELBINE), are coming 
off patent and their price would decline respectively by 81 percent, 71 
percent, and 12 percent. The 2004 Medicare payment amounts for these 
three drugs respectively were equal to 81, 85 and 81 percent of the 
April 1, 2003 average wholesale price levels that applied or did not 
decrease proportionally after the drugs came off patent. These three 
drugs are estimated to account for only 7 percent of oncologists 
adjusted 2004 Medicare drug revenues but contribute more than 5 percent 
of the approximate 8 percent total reduction in Medicare drug revenues 
that oncologists would experience as a result of adopting the ASP+6 
payment methodology. While Medicare revenues to oncologists would 
decline from the reductions in payment for these three drugs, the cost 
to acquire these drugs has already declined. Thus, Medicare's payment, 
as with all other drugs experiencing payment changes, will be much 
closer to the cost the physician pays to acquire the drug.
    Adoption of ASP+6 prices would reduce Medicare drug revenues for 
urologists by approximately 36 percent. This large reduction can be 
attributed to a 35 percent reduction in payment for two drugs: J9202 
(ZOLADEX) and J9217 (LUPRON DEPOT-PED). While we estimate an even 
larger reduction in the ASP+6 price for J9217, our payment impact 
assumes that nearly all Medicare carriers are using the ``least costly 
alternative'' pricing and paying code J9217 at the J9202 price.
    We estimate a 6 percent reduction in Medicare drug revenues for 
rheumatology. Nearly all of this reduction can be attributed to a 6 
percent reduction in Medicare payment for J1745 (REMICADE).
    We estimate less than an 18 percent decrease in Medicare drug 
revenues for obstetrics/gynecology. However, much of this revenue 
reduction can be attributed to an 81 percent reduction in payment for 
J9265 (ONXOL TAXOL) coming off patent. Even though this one drug is 
estimated to account for only 16 percent of obstetrics/gynecology 
adjusted 2004 Medicare drug revenues, it contributes 13 percent of the 
approximate 18 percent total reduction in Medicare drug revenues that 
obstetrics/gynecologists would experience as a result of adopting the 
ASP+6 payment methodology. As explained above, while Medicare revenues 
to obstetrics/gynecology would decline as a result of the price 
reduction for this code, Medicare's payment will be much closer to the 
price physicians pay to acquire the drug. We are estimating an average 
approximate reduction of 6 percent across other drugs supplied by 
obstetrics/gynecology.
    The remaining columns of Table 26 show the potential impact on 
physician fee schedule services of changes being contemplated for 2005 
for the specialties shown. The column labeled ``Practice Expense and 
Malpractice RVU Changes'' show the combined impact of the changes 
previously illustrated for these specialties in Tables 21 and 22. The 
column labeled ``Drug Administration Payment Changes'' shows a range of 
potential physician fee schedule impacts for 2005. The left side of 
this column shows the impact of the changes required in payment by 
section 303(a)(4) of the MMA (that is, the change in the transition 
payment from 2004 to 2005) if we were to make no further changes to the 
payments or codes for drug administration services. However, because we 
are considering further changes to the payments or codes for drug 
administration once the AMA's CPT Panel review of this issue is 
complete, the right hand side of the column labeled ``Drug 
Administration Payment Changes'' reflects the amount that physician fee 
schedule payments would have to increase to make the net reduction 
across all Medicare revenues for these specialties equal to 2 percent. 
The next column shows the physician fee schedule update of 1.5 percent 
and the final column labeled ``Total Physician Fee Schedule'' Changes'' 
shows the combined effect of all of the changes previously described. 
The left hand side of the column shows the combined effect of (1) the 
practice expense and malpractice RVU changes, (2) the maximum reduction 
in payment that could occur if we made no further changes to payments 
for drug administration and (3) the physician fee schedule update. The 
right hand side of the column shows the combined effect of (1) the 
practice expense and malpractice RVU changes, (2) the amount physician 
fee schedule revenues would have to increase to make the reduction in 
total revenues equal to 2 percent and (3) the physician fee schedule 
update.
    If we made no further changes to drug administration, physician fee 
schedule revenues would decline by 9 percent for oncology, be unchanged 
for urology and rheumatology, and increase by 1 percent for obstetrics/
gynecology. Physician fee schedule revenues would have to increase by 
12 percent for oncology, 19 percent for urology, 2 percent for 
rheumatology and 1 percent for obstetrics/gynecology for total revenues 
to these specialties to decline by 2 percent from adoption of the ASP+6 
percent drug payment methodology.
    Table 27 shows the combined impact of changes we are making to 
Medicare drug and physician fee schedule payments for the same 
specialties shown in table 26. The column labeled ``% of Total Medicare 
Revenues from Drugs'' shows the proportion of total Medicare revenues 
received from drugs, while the next column shows the payment impact 
from adoption of the ASP+6 drug payment methodology. The following 
columns show the proportion of total Medicare revenues received

[[Page 47564]]

from physician fee schedule services and the payment impact from 
physician fee schedule changes. All of the payment impacts are the same 
as those shown in Table 26. We note that these impacts and percentages 
represent averages for each specialty or supplier. The percentages and 
impacts for any individual physician are dependent on the mix of drugs 
and physician fee schedule services they provide to Medicare 
beneficiaries. These tables are intended to illustrate, assuming 
constant utilization, the combined impact of payment changes from 2004 
to 2005 across all of the services that these specialties perform using 
the most recent data available to us. Thus, the last 3 columns show 
combined Medicare revenues from all sources and the combined Medicare 
payment impact from the earlier described changes being proposed or 
considered for 2005.
    For example, as indicated in the Table 27, we estimate that 
approximately 70 percent of total 2004 Medicare revenues for 
oncologists are attributed to drugs. We estimate that Medicare revenues 
from drugs will decline by approximately 8 percent for oncology as a 
result of policies adopted in this proposed rule. Physician fee 
schedule services account for approximately 28 percent of oncology's 
2004 Medicare revenues. If we made no other changes to the RVUs or 
codes for drug administration services and if there is no change in the 
utilization of services, we estimate that physician fee schedule 
payments to oncology would decline by approximately 9 percent from 2004 
to 2005. In this scenario, combined Medicare payments to oncology would 
decline approximately 8 percent. However, if we were to make further 
changes to physician fee schedule payments so they increased by 12 
percent, we estimate the combined revenue reduction to oncology would 
be 2 percent.
    We estimate that urology receives approximately 37 percent of their 
2004 total revenues from drugs and 60 percent from physician fee 
schedule services. Because urology and other physician specialties 
receive a smaller share of their total Medicare revenues from drug 
administration services than oncology, they are less affected than 
oncology by the reduction in the drug administration transition payment 
percentage from 32 to 3 percent from 2004 to 2005. If we made no other 
changes to the RVUs or codes for drug administration services, we 
estimate that physician fee schedule revenues for urologists would 
increase by approximately 1 percent from 2004 to 2005. (While the 
reduction in payment for drug administration alone would slightly 
reduce urologists' physician fee schedule revenues, we estimate that 
any reduction would be offset by the physician fee schedule update). In 
this scenario, combined Medicare payments to urologists would decline 
approximately 13 percent. However, if we were to make further changes 
to physician fee schedule payments so that they increased by 19 
percent, we estimate the combined revenue reduction to urology would be 
2 percent.
    Rheumatology revenues from drugs are estimated to account for 
approximately 46 percent of their total revenues and would decline 
approximately 6 percent from adoption of the ASP+6 drug payment 
methodology. If we made no other changes to the RVUs or codes for drug 
administration services, we estimate that physician fee schedule 
revenues would be either unchanged or decline slightly in the aggregate 
and estimate a reduction in total Medicare revenues to rheumatology of 
approximately 3 percent. However, if we were to make further changes to 
physician fee schedule payments so they increased by 2 percent, we 
estimate the combined revenue reduction to rheumatologists would be 2 
percent.
    Medicare drug revenues represent 13 percent of total Medicare 
revenues for obstetrics/gynecology while physician fee schedule 
revenues account for 85 percent. We estimate that Medicare drug 
revenues for obstetrics/gynecology would decline by 18 percent and 
physician fee schedule revenues would increase 1 percent if we make no 
further changes to the RVUs or codes for drug administration services. 
In this scenario, obstetrics/gynecology's combined Medicare revenues 
would decline by 2 percent. Any change to the drug administration codes 
that increases their payments would make the net revenue reduction 
equal to or less than 2 percent for obstetrics/gynecology.

[[Page 47565]]



                                 Table 26.--Impact of Drug and Physician Fee Schedule Payment Changes on Total Medicare Allowed Charges for Selected Specialties
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                Drugs                                                                Physician fee schedule
                                      ----------------------------------------------------------------------------------------------------------------------------------------------------------
                                           Estimated                                             Practice expense
              Specialty                  medicare drug      Percent change    Medicare allowed  & malpractice RVU   Drug administration payment    Physician fee    Total physician fee schedule
                                         revenues ($ in     medicare drug      charges ($ in         changes                  changes             schedule update              changes
                                           millions)           revenues          millions)          (percent)                                        (percent)
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
HEMATOLOGY/ONCOLOGY..................             $4,363                 -8             $1,753                  0  -10 to 10...................                1.5  -9% to 12%
UROLOGY..............................              1,061                -36              1,699                  0  -1% to 17%..................                1.5  0% to 19%
RHEUMATOLOGY.........................                373                 -6                413                  0  -2% to 0%...................                1.5  0% to 2%
OBSTETRICS/GYNECOLOGY................                 88                -18                582                  0  -1% to -1%..................                1.5  1% to 1%
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
The amounts shown on the left-hand side of the column labeled ``Drug Administration Payment Changes'' offset a part of the increase these specialties received in 2004 as shown in the January
  7, 2004 Federal Register (69 FR 1100). We estimate the 2003-2005 increase in physician fee schedule payments to these specialties (before application of the physician fee schedule update) to
  be 28 percent for oncology, 2 percent for obstetrics/gynecology, 4 percent for rheumatology and 2 percent for urology. Urology received an additional 2 percent increase in total physician
  fee schedule payments (again, before application of the update) from 2002 to 2003 (see 67 FR 80035-80036 published on December 31, 2002) as a result of the large increase in payment for CPT
  code 96400 making the 2002-2005 payment increase exceed 4 percent.


[[Page 47566]]


                       Table 27.--Combined Payment Impact Drug and Physician Fee Schedule Payment Changes for Selected Specialties
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                Drugs                          Physician fee schedule                         All revenues
                               -------------------------------------------------------------------------------------------------------------------------
                                                                                                                Combined medicare
           Specialty             Percent of total    Percent change    Percent of total      Percent change        revenues all       Combined percent
                                medicare revenues    medicare drug    medicare revenues      physician fee        sources ($ in     change all medicare
                                    from drugs          revenues      from fee schedule    schedule revenues        millions)             revenues
--------------------------------------------------------------------------------------------------------------------------------------------------------
HEMATOLOGY/ONCOLOGY...........                 70                 -8                 28  -9% to 12%...........             $6,251  -8% to -2%
UROLOGY.......................                 37                -36                 60  0% to 19%............              2,842  -13% to -2%
RHEUMATOLOGY..................                 46                 -6                 51  0% to 2%.............                818  -3% to -2%
OBSTETRICS/GYNECOLOGY.........                 13                -18                 85  1% to 1%.............                684  -2% to -2%
--------------------------------------------------------------------------------------------------------------------------------------------------------

    The above tables show those specialties that receive significant 
revenues from drugs and physician fee schedule services that could be 
further affected by the review of drug administration coding currently 
undertaken by the CPT Editorial Panel and any changes we may make after 
further consideration of this effort and public comments.
    Although infectious disease physicians do receive significant 
revenues from drugs and drug administration, we are not showing them in 
this table because we have validated only drug payment data accounting 
for 27 percent of their allowed charges for drugs. Based on these data, 
we estimate an 11 percent reduction in their Medicare drug payments 
that account for approximately 6 percent of their total Medicare 
revenues. If total drug payment were to decline by 11 percent, we 
estimate that net revenues to infectious disease physicians will remain 
unchanged, absent any further changes in drug and drug administration 
coding. We are not showing DME and Other Medical Suppliers in the above 
table because they do not receive significant revenues for physician 
fee schedule services and will be unaffected by any further changes 
made to drug administration coding or RVUs because they do not bill for 
these services. However, they do receive a substantial portion of their 
total Medicare revenues from drugs that are affected by the change to 
ASP+6 pricing. For DME/Other Medical Suppliers, 40 and 60 percent of 
Medicare revenues respectively are received from drugs and DME fee 
schedule services. These suppliers would receive an approximate 
reduction of 70 percent in their Medicare drug revenues from the 
adoption of ASP+6 drug prices due to the large reduction in payment for 
two high volume inhalation drugs (J7619 and J7644). These impacts will 
be reduced somewhat by the dispensing fee we are proposing for 
inhalation drugs. We estimate the total reduction in payment across all 
of the services provided by DME suppliers as a result of provisions of 
this proposed rule would be approximately 28 percent.

                             Table 28.--Drug Pricing Table Used for Payment Impacts
----------------------------------------------------------------------------------------------------------------
                                                                                         Estimated
                                                                           CY 2004 Pay    CY 2005      Percent
          Code              Short description            Trade name         allowance    allowance      change
                                                                              limit      limit 6%)
----------------------------------------------------------------------------------------------------------------
J0152..................  Adenosine injection....  ADENOSCAN..............       $66.56       $69.78           5%
J0585..................  Botulinum toxin a per    BOTOX..................         4.43         4.69            6
                          unit.
J0880..................  Darbepoetin alfa         ARANESP................        21.20        18.10          -15
                          injection.
J1441..................  Filgrastim 480 mcg       NEUPOGEN...............       267.79       267.04            0
                          injection.
J1745..................  Infliximab injection...  REMICADE...............        58.79        53.32           -9
J2430..................  Pamidronate disodium/30  AREDIA, PAMIDRONATE           237.88        67.27          -72
                          MG.                      DISODIUM,.
J2505..................  Injection,               NEULASTA...............     2,507.50     2,260.77          -10
                          pegfilgrastim 6mg.
J2792..................  Rho(D) immune globulin   WINRHO.................        18.39        13.04          -29
                          h, sd.
J3395..................  Verteporfin injection..  VISUDYNE...............     1,404.26     1,368.79           -3
J3487..................  Zoledronic acid........  ZOMETA.................       194.54       202.50            4
J7192..................  Factor viii recombinant  KOGENATE, HELIXATE,             1.29         0.92          -29
                                                   RECOMBINATE, REFACTO,
                                                   BIOCLATE,.
J7317..................  Sodium hyaluronate       HYALGAN, SUPARTZ,             124.11       110.07          -11
                          injection.               ORTHOVISC.
J7320..................  Hylan G-F 20 injection.  SYNVISC................       204.03       188.88           -7
J7507..................  Tacrolimus oral per 1    PROGRAF................         3.13         3.19            2
                          MG.
J7517..................  Mycophenolate mofetil    CELLCEPT...............         2.55         2.54            0
                          oral.
J7619..................   Albuterol inh sol u d.  PROVENTIL, ALBUTEROL            0.39         0.04          -89
                                                   SULFATE, VENTOLIN.
J7626..................  Budesonide inhalation    PULMICORT..............         4.04         3.91           -3
                          sol.
J7644..................  Ipratropium brom inh     IPRATROPIUM BROMIDE....         2.82         0.30          -89
                          sol u d.
J9045..................  Carboplatin injection..  PARAPLATIN.............       137.54       131.77           -4
J9170..................  Docetaxel..............  TAXOTERE...............       301.40       287.59           -5
J9201..................  Gemcitabine HCl........  GEMZAR.................       111.33       107.46           -3
J9202..................  Goserelin acetate        ZOLADEX................       375.99       234.28          -38
                          implant.
J9206..................  Irinotecan injection...  CAMPTOSAR..............       130.24       123.86           -5
J9217*.................  Leuprolide acetate       LUPRON DEPOT, ELIGARD,        500.58       234.28          -53
                          suspnsion.               LUPRON DEPOT-PED.

[[Page 47567]]

 
J9219..................  Leuprolide acetate       VIADUR.................     4,831.40     2,190.71          -55
                          implant.
J9265..................  Paclitaxel injection...  TAXOL, ONXOL, NOV-ONXOL       138.28        25.84          -81
J9310..................  Rituximab cancer         RITUXAN................       427.28       438.38            3
                          treatment.
J9350..................  Topotecan..............  HYCAMTIN...............       706.17       731.46            4
J9355..................  Trastuzumab............  HERCEPTIN..............        52.01        50.84           -2
J9390..................  Vinorelbine tartrate/10  NAVELBINE..............        76.19        64.67          -15
                          mg.
Q0136..................  Non esrd epoetin alpha   PROCRIT................        11.62        10.37          -11
                          inj.
**Unlisted.............  .......................  ALOXI..................       307.80       202.51         -34
----------------------------------------------------------------------------------------------------------------
*The figures here for J9217 reflect the ASP prices submitted by the drug manufacturer. However, we assumed that
  Medicare carriers are applying ``least costly alternative'' pricing and are using the J9202 price for J9217.
**Aloxi is the brand name for an antiemetic that is paid in 2004 at 95% of AWP using an unlisted code because
  the drug was approved by the FDA in the fall of 2003. Even though we do not have a code or volume for this
  drug from 2003 like we do for the other drugs shown in the table, we are showing it here because it is the
  highest growth injectable antiemetic drug currently on the market.

B. Geographic Practice Cost Indices

    As discussed in section II.B, in this rule, we are proposing 
changes to the work and practice expense GPCIs based on new census 
data. The resulting geographic redistributions would not result in an 
overall increase in the current geographic adjustment indices by more 
than 3.5 percent or a decrease by more than 1.6 percent for any given 
locality in 2005. These geographic redistributions would not result in 
an overall increase in the current geographic adjustment indices by 
more than 7 percent or a decrease by more than 3.5 percent for any 
given locality in 2006. Addenda E and F illustrate the locality 
specific overall impact of this proposal. The GAF, as displayed in 
addenda E and F is a weighted composite index of the individual 
proposed revisions to the work, practice expense, and malpractice 
expense GPCIs, respectively. The malpractice GPCI was updated as part 
of the November 7, 2003 final rule, and the MMA provisions were 
addressed in the final rule published on January 7, 2004.

C. Coding Issues

1. Revisions to Global Period
    In section II.D.1, we are proposing a change in the global period 
for procedure code 77427, Radiation treatment management, five 
treatments from a global indicator of ``xxx'' (meaning that the global 
concept does not apply) to ``090'' (meaning that there is a 90-day 
global period). We are not changing any of the RVUs for procedure code 
77427 because this service was valued to reflect a global period of 90 
days. The implication of this change is that any visit services 
provided in the 90-day global period that are related to procedure code 
77427 will no longer be paid separately. We reviewed Medicare data and 
found that physicians rarely bill for services during the 90-day period 
following the date-of-service for procedure code 77427. Therefore, we 
believe this proposal will have little effect on Medicare program 
expenditures and our payments to physicians.
2. Additions to the List of Medicare Telehealth Services
    In section II.D.2, we are proposing to add end stage renal disease 
(ESRD) services, as represented by HCPCS codes G0308, G0309, G0311, 
G0312, G0314, G0315, G0317, G03178 to the list of telehealth services. 
We believe that this change will have little effect on Medicare 
expenditures.
3. National Pricing of G0238/G0239 (Respiratory Therapy Service Codes)
    As discussed earlier in the preamble, we are proposing to use the 
nonphysician workpool to value two respiratory therapy service codes 
(G0238 and G0239) that are currently carrier priced. We believe that 
this proposed change will eliminate the uncertainty surrounding payment 
of these codes when performed in comprehensive outpatient 
rehabilitation facilities that are paid under the physician fee 
schedule through fiscal intermediaries. We do not anticipate that 
nationally pricing these services would have a significant impact on 
Medicare expenditures.
4. New HCPCS Code for Bone Marrow Aspiration
    We are proposing a new HCPCS code for instances when a bone marrow 
aspiration and a bone marrow biopsy are performed on the same day 
through a single incision. Currently, we do not allow payment for both 
of these procedures on the same day. While this coding change will 
allow for a small additional payment for the second procedure performed 
through a single incision on the same day, we anticipate that the costs 
will be insignificant.
5. New HCPCS Code for Venous Mapping
    As stated earlier in the preamble, we are proposing a new HCPCS 
code for venous mapping for hemodialysis access placement. The primary 
reason for this new code is to enable us to track the use of venous 
mapping for quality improvement purposes. Since pricing for this 
service is not changing, there will be no impact on Medicare 
expenditures.

D. MMA Provisions

1. Section 611--Preventive Physical Examination
    As discussed earlier in this preamble, the MMA authorizes coverage 
of an initial preventive physical examination effective January 1, 
2005, subject to certain eligibility and other limitations. We estimate 
that this new benefit will result in an increase in Medicare 
expenditures. These new payments will be made to physicians and other 
practitioners who provide these examinations and for any medically 
necessary follow-up tests, counseling, or treatment that may be 
required as a result of the coverage of these examinations. The impact 
of this provision is shown in the following table.

[[Page 47568]]



                            TABLE 29.--Medicare Cost Estimates for MMA Provision 611
                                                  (in millions)
----------------------------------------------------------------------------------------------------------------
               MMA provision                   FY 2005       FY 2006       FY 2007       FY 2008       FY 2009
----------------------------------------------------------------------------------------------------------------
Sec. 611..................................           65            75            75            75            75
----------------------------------------------------------------------------------------------------------------

2. Section 613--Diabetes Screening
    Section 613 of the MMA adds subsection (yy) to section 1861 of the 
Social Security Act and mandates coverage of diabetes screening tests, 
effective on or after January 1, 2005. We estimate that this change in 
coverage for certain beneficiaries will result in an increase in 
Medicare payments. These payments will be made to physicians' office 
laboratories and other laboratory suppliers who perform these tests as 
a result of the increased frequency of coverage of these tests. The 
impact of this provision is shown in Table 30 that follows.
3. Section 612--Cardiovascular Screening
    Section 612 of the MMA provides for Medicare coverage for 
cholesterol and other lipid or triglyceride levels of cardiovascular 
screening blood tests for the early detection of abnormalities 
associated with an elevated risk for such diseases effective on or 
after January 1, 2005. We estimate that this change in coverage for 
certain beneficiaries will result in an increase in Medicare payments. 
These payments will be made to physician office laboratories and other 
laboratory suppliers who perform these tests as a result of the 
increased frequency of coverage of these tests. Increased Medicare 
program expenditures for this provision are shown in Table 30 below.

                        TABLE 30.--Medicare Cost Estimates for MMA Provisions 612 and 613
                                                  (in millions)
----------------------------------------------------------------------------------------------------------------
                 MMA provision                     FY 2005      FY 2006      FY 2007      FY 2008      FY 2009
----------------------------------------------------------------------------------------------------------------
Sec. 612 Cholesterol and Blood Lipid...........           50           80           90           90          100
Sec. 613 Diabetes Screening....................           20           40           50           60           80
----------------------------------------------------------------------------------------------------------------

4. Section 413--Incentive Payment for Physician Scarcity
a. Physician Scarcity Areas
    Section 413(a) of the MMA provides a new 5-percent incentive 
payment to physicians who furnish services in physician scarcity areas. 
The MMA provides for paying primary care physicians furnishing services 
in a primary care scarcity area, and specialty physicians furnishing 
services in a specialist care scarcity county, an additional amount 
equal to 5 percent of the amount paid for their professional services 
under the fee schedule from January 1, 2005 to December 31, 2007. We 
estimate that this new incentive payment for physician services will 
result in an increase in Medicare payments that are shown in Table 31.
b. Improvement to Medicare HPSA Incentive Payment Program
    Section 413(b) of the MMA amended section 1833(m) of the Act to 
mandate that we automate payment of the 10 percent HPSA incentive 
payment to eligible physicians. Since the inception of the HPSA 
incentive payment program, physicians have been required to determine 
their eligibility and correctly code their Medicare claims using 
modifiers. We estimate that this change to the HPSA incentive payment 
program to provide for automation of payment will result in an increase 
in Medicare payments because many eligible physicians are not applying 
for bonuses due to the burden of verifying eligibility. The impact of 
this provision is shown in Table 31.

                              TABLE 31.--Medicare Cost Estimates for MMA Provisions
                                                  (in millions)
----------------------------------------------------------------------------------------------------------------
                 MMA provision                     FY 2005      FY 2006      FY 2007      FY 2008      FY 2009
----------------------------------------------------------------------------------------------------------------
Sec. 413(a) Physician Scarcity Areas...........           30           50           50           20            0
Sec. 413(b) Improvement to HPSA................           20           30           30           30           30
----------------------------------------------------------------------------------------------------------------

5. Sections 303-304--Payment for Covered Outpatient Drugs and 
Biologicals and Section 305--Payment for Inhalation Drugs
    Sections 303 and 304 of the MMA make changes to Medicare payment 
for covered outpatient drugs and biologicals and changes to the 
administration of those drugs. Section 305 makes changes to payment for 
inhalation drugs. We implemented provisions of sections 303 through 305 
changing payments in 2004 for drugs and their administration in the 
January 7, 2004 Federal Register (69 FR 1084). In this proposed rule, 
we are making further changes to Medicare's payment for drugs and drug 
administration for 2005 required by sections 303 through 305 of the 
MMA. We estimate that adoption of the ASP+6 payment methodology will 
result in Medicare savings for FY 2005 of $180 million for section 303 
of the MMA, $140 million for section 304 of the MMA, and $210 million 
for section 305 of the MMA. If we were to make no further changes to 
the coding or payment for drug administration services, we estimate 
Medicare savings of $90 million for section 303 of the MMA and $40 
million for section 304 of the MMA. In addition, we are also proposing 
to pay a supplying fee of $10 per Medicare Part B oral drug 
prescription. We estimate this proposal will increase Medicare 
expenditures by $52 million from FY 2005 through FY 2009, assuming an 
average of two prescriptions per month. We are also

[[Page 47569]]

proposing to pay a furnishing fee of $0.05 per unit off clotting 
factor. This proposal is estimated to cost $13 million from FY 2005 
through FY 2009.
6. Section 952--Reassignment
    The reassignment provisions discussed in section III.F is currently 
estimated to have no significant impact on Medicare expenditures.
7. Section 623--Payment for Renal Dialysis Services
a. Effects on the Medicare Program (Budgetary Effect)
    Because the proposed basic case mix adjusted composite payment rate 
and the revised payment for ESRD drugs must be budget neutral in 
accordance with section 623(d)(1) of the MMA, except for the 
statutorily required 1.6 percent increase set forth in section 623(a), 
we estimate that there would be no budgetary impact for the Medicare 
program beyond this increase. The impact of this provision (net of 
beneficiary liability) is shown in the following table.

                            TABLE 32.--Medicare Cost Estimates for MMA Provision 623
                                                  (in millions)
----------------------------------------------------------------------------------------------------------------
               MMA provision                   FY 2005       FY 2006       FY 2007       FY 2008       FY 2009
----------------------------------------------------------------------------------------------------------------
Section 623...............................           40            50            50            60            60
----------------------------------------------------------------------------------------------------------------

b. Impact on ESRD Providers
    In order to understand the impact of the proposed changes affecting 
payments to ESRD facilities that result from enactment of the MMA on 
different categories of ESRD facilities, it is necessary to compare 
estimated payments under the current payment system (current payments) 
to estimated payments under the proposed revisions to the composite 
rate payment system as set forth in this proposed rule (proposed 
payments). To estimate the impact among various classes of ESRD 
facilities, it is imperative that the estimates of current payments and 
proposed payments contain similar inputs. Therefore, we simulated 
proposed payments only for those ESRD facilities for which we are able 
to calculate both current payment and proposed payment.
    Due to data limitations, we are unable estimate current and 
proposed payments for 592 facilities that bill for ESRD drugs. Of these 
592 facilities, 174 are hospital based and 418 are independent. 
Therefore, 29 percent of hospital-based facilities and 11 percent of 
independent facilities are not shown in the impact table. ESRD 
providers were grouped into the categories based on characteristics 
provided in the Online Survey and Certification and Reporting (OSCAR) 
file and the most recent cost report data from HCRIS. We also used the 
December 2003 update of CY 2003 Standard Analytical File (SAF) claims 
as a basis for Medicare dialysis treatments and separately billable 
drugs and biologicals. While the December 2003 update of the 2003 SAF 
file is not complete, we wanted to use the most recent data available, 
and plan to use an updated version of the 2003 SAF file for the final 
rule.

       Table 33.--Impact of MMA Section 623 Payments to Hospital Based and Independent ESRD Facilities (Includes Drug and Composite Rate Payments)
                                 [Percent change in total payments to ESRD facilities (both program and beneficiaries)]
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                          Effect of 1.6%
                                                                             Number of       Effect of       composite
                                                             Number of       dialysis       changes  in     rate update      Effect of    Overall effect
                                                            facilities      treatments    drug  payments     on total       case mix 3/         4/
                                                                           (in millions)        1/          payments 2/
--------------------------------------------------------------------------------------------------------------------------------------------------------
All.....................................................           3,671            29.2             0.0             1.0             0.0             1.0
Independent.............................................           3,240            26.1            -0.6             1.0            -0.0             0.4
Hospital Based..........................................             431             3.1             5.7             1.1             0.1             7.0
Size:                                                     ..............  ..............  ..............  ..............  ..............  ..............
    Small <5000 treatment per year......................           1,313             4.0            -0.6             1.0            -0.1             0.3
    Medium 5000-10000 treatments per yr.................           1,414            10.2            -0.7             1.0            -0.1             0.2
    Large > 10000 treatments per year...................             944            15.0             0.6             1.0             0.0             1.7
Type of Ownership:                                        ..............  ..............  ..............  ..............  ..............  ..............
    Not-for-profit......................................             697             5.2             2.9             1.1             0.0             4.1
    For-profit..........................................           2,710            21.9            -0.6             1.0            -0.0             0.4
    Other...............................................             264             2.1            -0.1             1.0             0.0             1.0
    Urban...............................................           2,701            23.6             0.1             1.0             0.1             1.2
    Rural...............................................             970             5.6            -0.5             1.0            -0.5            -0.0
Region:                                                   ..............  ..............  ..............  ..............  ..............  ..............
    New England.........................................             125             1.2             1.3             1.1             0.1             2.4
    Middle Atlantic.....................................             475             4.0             0.5             1.0             0.9             2.4
    East North Central..................................             540             4.5             0.4             1.0            -0.1             1.3
    West North Central..................................             255             1.7             1.4             1.1            -0.5             2.0
    South Atlantic......................................             886             6.9            -1.0             1.0             0.0             0.0
    East South Central..................................             309             2.2            -1.0             1.0            -0.7            -0.7
    West South Central..................................             522             4.1            -1.0             1.0            -0.2            -0.1
    Mountain............................................             194             1.3             0.6             1.1            -0.5             1.1
    Pacific.............................................             339             3.0             1.4             1.1            -0.2             2.3

[[Page 47570]]

 
    Puerto Rico.........................................              26             0.4             0.8             1.0             1.4            3.3
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ This column shows the effect of the changes in drug payments to ESRD providers. These include changes in payment for separately billable drugs and
  the 11.3% drug add-on.
\2\ This column shows the effect of the 1.6% update to the composite rate on total payments to ESRD providers. Note that ESRD providers receive an
  average of 36% of their total revenues from separately billable drugs which results in an average net increase of 1.0%.
\3\ This column shows impact of case-mix adjustments only.
\4\ This column shows percent change between the proposed and current payments to ESRD facilities. The proposed payments includes the 1.6% increase, the
  11.3% drug add-on, and the case-mix adjustments times treatments plus proposed payment for separately billable drugs. The current payment to ESRD
  facilities includes the current composite rate times treatments plus current drug payments for separately billable drugs.

    Table 33 shows the impact of MMA Section 623 on hospital based and 
independent facilities. We have included both composite rate payments 
as well as payments for separately billable drugs and biologicals 
because both are effected by Section 623. The first column of Table 33 
identifies the type of ESRD provider, the second column indicates the 
number of ESRD facilities for each type, and the third column indicates 
the number of dialysis treatments.
    The fourth column shows the effect of the changes in drug payments 
to ESRD providers. The overall effect of changes in drug payments is 
budget-neutral as required by MMA. The drug add-on adjustment is 
designed to result in the same aggregate amount of expenditures as 
would have been made without the statutory policy change.
    Current payments for drugs represent 2005 Medicare reimbursement 
using 95 percent of AWP prices for the top ten drugs. Medicare spending 
for drugs other than EPO is estimated using 2004 AWP prices updated by 
a 3 percent inflation factor times actual drug utilization from 2003 
claims. EPO is priced $10 per 1000 units (EPO units are estimated using 
payments because the units field on bills represents the number of EPO 
administrations rather than the number EPO units). Spending under the 
proposed change is 2004 ASP minus 3 percent for the top ten drugs plus 
3.39 percent inflation factor times actual drug utilization from 2003 
claims.
    Proposed payment for drugs under MMA also includes the 11.3 percent 
drug add-on to the composite rate. This amount is computed by 
multiplying the composite rate for each provider (with the 1.6 percent 
increase) times dialysis treatments from 2003 claims. Column 4 is 
computed by comparing spending under the proposed payment for drugs 
including the 11.3 percent drug add-on amount to spending under current 
payments for drugs. In order to make column 4 comparable with rest of 
Table 33, current composite rate payments to ESRD facilities were 
included in both current and proposed spending calculations.
    Column 5 shows the effect of the 1.6 percent increase to the 
composite rate on total payments to ESRD providers. While all ESRD 
providers will get a 1.6 percent increase to their composite rate, this 
table shows the net effect of this increase on ESRD providers total 
Medicare revenues (both drug and composite rate payments combined), and 
therefore does not show a 1.6 percent increase.
    On average, ESRD providers receive an average of 36 percent of 
their total revenues from separately billable drugs and 64 percent of 
their total revenues from composite rate payment. Since the 1.6 percent 
increase is applied to the 64 percent portion of their total Medicare 
revenues, the 1.6 percent composite rate increase is also 
arithmetically equal to a 1.0 percent increase in ESRD providers' total 
Medicare revenues. Column 5 is computed by combining proposed payment 
for drugs (including the 11.3 percent drug add-on amount) with: (1) 
Current composite rate times dialysis treatments from 2003 claims or 
(2) composite rate with 1.6 percent increase times dialysis treatments 
from 2003 claims. The difference between these two combinations is the 
net effect of the 1.6 percent increase on total payments to ESRD 
providers. In order to isolate the effect of the 1.6 percent increase, 
the computation in Column 5 assumes that drug payments to ESRD 
providers remain constant.
    Column 6 shows the impact of the case-mix adjustments as described 
in section H.4.d of this proposed rule. Because MMA requires this 
adjustment be budget-neutral in the aggregate, there is no overall 
impact to the ESRD providers as a whole. While the case-mix adjustment 
will have an impact within the various provider types, Column 6 shows 
that the effect between provider groupings is minimal. Column 6 is 
computed as the difference between proposed payments to ESRD providers 
with the case-mix adjustments compared to payments to providers without 
the case-mix adjustments. As described in section H.4.f, we 
standardized the composite rate to meet the MMA requirement that 
payment be budget-neutral with respect to aggregate payments. 
Therefore, there is no change for ESRD providers in aggregate. We note 
that when applying the case-mix adjustments, we did so at the summary 
level as shown in Table 33.
    Column 7 shows the overall effect of all changes in drug and 
composite rate payments to ESRD providers. The overall effect measured 
as the difference between proposed payment with all MMA changes as 
proposed in this rule and current payment. Proposed payment is computed 
by multiplying the composite rate for each provider (with both 1.6 
percent increase and the 11.3 percent add-on) times dialysis treatments 
from 2003 claims times the appropriate case-mix adjustment by provider 
category. In addition, proposed payment includes payments for 
separately billable drugs under the revised pricing methodology as 
described in section III-E-Section 303-Payment Reform for Outpatient 
Drugs and Biologicals, Subsection 1.d. Current payment is the current 
composite rate for each provider times dialysis treatments from 2003 
claims plus current drug payments for separately billable drugs.
    The overall impact to ESRD providers in aggregate is 1.0 percent. 
Among the three separately shown effects, the effect

[[Page 47571]]

of changes in drug payments has the most variation among provider type 
and contributes most to the overall effect. Separately billable ESRD 
drugs are paid differently to hospital-based and independent ESRD 
providers. As discussed in section H.4.c, we are proposing a single 
drug add-on to the composite rates for both hospital based and 
independent facilities. The 7.0 percent increase in payments to 
hospital-based providers is largely due to the proposed single drug 
add-on to the composite rate. Many hospital based providers are not-
for-profit, which may explain the larger than average increase in 
payments.
8. Section 731--Coverage of Routine Costs for Category A Clinical 
Trials
    The coverage of routine costs associated with certain Category A 
clinical trials as discussed in MMA section 731(b) has no significant 
impact on Medicare expenditures.
9. Section 629--Part B Deductible
    As explained earlier in the preamble, section 629 of the MMA 
provides for annual updates to the Medicare Part B deductible. The MMA 
stipulates that the Medicare Part B deductible will be $110 for 
calendar year 2005, and, for subsequent years, the deductible will be 
the previous year's deductible increased by the annual percentage 
increase in the monthly actuarial rate under section 1839(a)(1) of the 
Act, ending with that subsequent year (rounded to the nearest dollar). 
We note that while this MMA provision results in a savings to the 
Medicare program, it also increases beneficiary costs by an equal 
amount.

                           Table 34.--Estimated Medicare Savings for MMA Provision 629
                                                  [in millions]
----------------------------------------------------------------------------------------------------------------
               MMA provision                   FY 2005       FY 2006       FY 2007       FY 2008       FY 2009
----------------------------------------------------------------------------------------------------------------
Sec. 629..................................          110           290           440           590           770
----------------------------------------------------------------------------------------------------------------

10. Section 512--Hospice Consultation Service
    As explained in section III.K, effective January 1, 2005, section 
512 of the MMA provides for payment to be made to a hospice for 
specified services furnished by a physician who is either the medical 
director of, or an employee of, a hospice agency. We estimate that this 
MMA provision will increase Medicare expenditures by $10 million per 
year beginning in 2005.
11. Section 302--Clinical Conditions for Coverage of Durable Medical 
Equipment (DME)
    As explained earlier in the preamble, to comply with the 
requirements of section 302 of the MMA and to enhance quality and 
reduce fraud, we are proposing to establish basic requirements that 
apply to all items of durable medical equipment, prosthetics, 
orthotics, and supplies (DMEPOS). The impact to the Medicare program 
will be to improve quality of care because we are involving the 
physician early in the process when determining the medical necessity 
for items of DMEPOS. The physician community has stated that they are 
often asked to order an item of DMEPOS for their patient when they do 
not think the item is reasonable and necessary. We believe these 
requirements will result in no costs or savings to Medicare because if 
any additional spending from more physician visits occur it will be 
offset by savings from Medicare paying for less DMEPOS. However, we 
expect to continue evaluating this issue.

E. Other Issues

1. Outpatient Therapy Services Performed ``Incident to'' Physicians'' 
Services
    As discussed in section IV.A, we are proposing to amend the 
regulations to include the statutory requirement that only individuals 
meeting the existing qualification and training standards for 
therapists (with the exception of licensure) consistent with Sec.  
484.4 qualify to provide therapy services incident to physicians' 
services. We believe that while this will have little impact on 
Medicare expenditures, it will assist in ensuring the quality of 
services provided to beneficiaries.
2. Supervision Requirements for Therapy Assistants in Private Practice
    As discussed earlier in section IV.A.2, we are proposing to revise 
the regulations at Sec.  410.59 and Sec.  410.60 to replace a 
requirement to provide personal supervision and instead require direct 
supervision of physical therapist assistants and occupational therapy 
assistants when therapy services are provided by physical therapists or 
occupational therapists in private practice. This proposed policy 
change would provide beneficiaries access to medically necessary 
therapy services, under a physician-certified plan of care. We believe 
that this change would result in a 5 percent increase in therapy 
billing in therapy private practice settings with an estimated cost of 
$9 million for FY 2005. Projected costs for FY 2006 are $17 million 
while each subsequent year would only increase by $1 million each year, 
assuming the therapy caps are applied.
3. Low Osmolar Contrast Media
    As discussed earlier in the preamble, we are proposing to revise 
the regulations at Sec.  414.38 to eliminate the restrictive criteria 
for the payment of LOCM. This proposal will make payment for LOCM 
consistent across Medicare payment systems. By identifying contrast-
enhanced procedures that most commonly use LOCM, the typical ranges of 
LOCM amounts used by modality, and the cost ranges for LOCM in the 
marketplace, we estimate program costs as shown in the following table:

                                                    Table 35
----------------------------------------------------------------------------------------------------------------
            Regulatory Provision               FY 2005       FY 2006       FY 2007       FY 2008       FY 2009
----------------------------------------------------------------------------------------------------------------
LOCM......................................           20            30            30            30            30
----------------------------------------------------------------------------------------------------------------


[[Page 47572]]

4. Payments for Physicians and Practitioners Managing Patients on 
Dialysis
    We believe that the proposals with respect to ESRD-related services 
furnished to patients in observation settings and payment for 
outpatient ESRD-related services for partial month scenarios discussed 
earlier in section 1V. E. provide clarification of current policy 
surrounding these issues. We do not believe these proposals would have 
a significant impact on Medicare expenditures.
5. Supervision of Clinical Psychological Testing
    We are proposing to change the supervision requirements regarding 
who can supervise diagnostic psychological testing services. As 
previously discussed, having ancillary staff supervised by clinical 
psychologists would enable these practitioners with a higher level of 
expertise to oversee psychological testing and potentially relieve 
burdens on physicians and healthcare facilities.
    Additionally, in rural areas, we anticipate that permitting 
psychologists to supervise diagnostic psychological testing services 
would reduce delays in testing, diagnosis, and treatment that could 
result from the unavailability of physicians to supervise the tests. We 
believe that this proposal will have little impact on Medicare 
expenditures.
6. Care Plan Oversight
    As discussed in section IV.G, we are proposing to revise Sec.  
414.39 to clarify that NPPs can perform home health care plan oversight 
even though they cannot certify a patient for home health services and 
sign the plan of care. We do not expect that this proposal would have 
an impact on Medicare expenditures, since it is only clarifying that an 
NPP or a physician can provide care plan oversight for home health 
care.
7. Assignment of Medicare Claims
    The proposed changes with respect to assignment of Medicare claims 
are currently estimated to have no significant impact on Medicare 
expenditures. However, as stated earlier in this preamble at section 
IV.H, we believe the proposed changes will reduce the paperwork burden 
on beneficiaries and suppliers.

F. Alternatives Considered

    This proposed rule contains a range of policies, including 
proposals related to specific MMA provisions. The preamble provides 
descriptions of the statutory provisions that are addressed, identifies 
those policies when discretion has been exercised and presents 
rationale for our decisions and, when possible, alternatives that were 
considered.
    The following is a discussion of additional points on the proposed 
changes required by section 302 of the MMA involving ordering items of 
durable medical equipment, prosthetics, orthotics, and supplies 
(DMEPOS).
    In developing the proposed changes to implement section 302 of the 
MMA, we did consider establishing ``the face-to-face requirement,'' and 
``the order prior to delivery'' requirement only for specific items of 
DMEPOS for which there has been an identified proliferation of use. 
However, we believe it is important that the physician or nonphysician 
practitioner determine the medical need for all items of DME. It is 
good clinical practice for beneficiaries to be seen by the physician 
for their medical condition and at that time the physician will decide 
whether an item of DME is appropriate. It is our intent to make 
Medicare more consistent with private payers in that beneficiaries be 
seen by their physician for their medical condition, who then makes a 
diagnosis and orders any supplies needed to address their needs. Since 
we expect beneficiaries to be seen by their doctor for a specific 
medical condition, we do not believe that this would place a burden on 
the physician, as it would be part of a necessary examination.
    We also note that in establishing these proposed requirements we do 
make exceptions for items of continued need, such as, glucose test 
strips or support surfaces. Once the physician has initially 
established the need, we do not require additional visits or additional 
documentation.

G. Impact on Beneficiaries

    There are a number of changes made in this proposed rule that would 
have an effect on beneficiaries. In general, we believe these changes 
will improve beneficiary access to services that are currently covered 
or will expand the Medicare benefit package to include new services. As 
explained in more detail below, the MMA or regulatory provisions may 
increase beneficiary liability in some cases. Any changes in aggregate 
beneficiary liability from a particular provision will be a function of 
the coinsurance (20 percent if applicable for the particular provision 
after the beneficiary has met the deductible) and the effect of the 
aggregate cost (savings) of the provision on the calculation of the 
Medicare Part B premium rate (generally 25 percent of the provision's 
cost or savings). Taking into account the MMA and regulatory provisions 
of this proposed rule, we estimate beneficiary savings in FY 2005 of 
$270 million. This figure could be less if we make further changes to 
Medicare's drug administration payments.
    The MMA provisions that expand Medicare benefits include: section 
611, adding a preventive office visit for newly eligible Medicare 
beneficiaries; section 612 providing coverage of cardiovascular 
screening blood tests; and section 613, providing coverage for diabetes 
screening tests for Medicare beneficiaries at risk for diabetes. While 
the preventive office visit for newly eligible Medicare beneficiaries 
is subject to deductible and coinsurance, we believe Medicare 
beneficiaries will continue to benefit from expanded coverage for this 
service. We believe many beneficiaries have supplemental insurance 
coverage or Medicaid that pays the Medicare deductible on their behalf 
and there will be no immediate additional out-of-pocket cost. Further, 
even if a beneficiary pays nearly all of the costs of this new benefit, 
the preventive office visit will substitute for another service a 
beneficiary may need to meet the annual deductible and the beneficiary 
will receive more covered benefits at little additional cost. There are 
no out-of-pocket costs to the beneficiary for the cardiovascular 
screening blood tests and diabetes screening tests.
    Other proposals in this rule related to the MMA will also impact 
beneficiary liability, with the most significant related to indexing of 
the part B deductible (section 629 of the MMA) and the drug 
administration payment changes (sections 303 and 305 of the MMA). 
Indexing of the Part B deductible will result in an estimated cost to 
beneficiaries of $110 million in 2005. MMA provisions that improve 
administration of the 10 percent HPSA bonus and provide an additional 5 
percent bonus payment to physicians in Medicare scarcity areas will 
have no impact on beneficiary liability because the bonus payments are 
applied to the amount Medicare pays the physician net of beneficiary 
liability. These provisions will also improve access for Medicare 
beneficiaries by increasing payments to physicians in areas that 
traditionally have had a low ratio of physicians to population.
    The implementation of MMA provisions related to drugs and drug 
administration will reduce Medicare beneficiary liability for Medicare 
covered services. We estimate that implementation of sections 303 
through 305 of the MMA will reduce Medicare

[[Page 47573]]

beneficiary liability for drugs by $360 million in FY 2005. If we were 
to make no further changes to Medicare's payments for drug 
administration, we estimate additional savings to Medicare 
beneficiaries of $120 million in FY 2005. Provisions of this proposed 
rule that increase the supplying fee for immunosuppressive drugs and 
the furnishing fee for the clotting factor are estimated to increase 
beneficiary liability by $36 million and $10 million respectively, from 
FY 2005 through FY 2009.
    We do not believe that the drug and drug administration payment 
changes required by the MMA are intended to lessen beneficiary access 
to care. By reducing beneficiary liability, we believe it is likely 
that beneficiary access to care will be improved. As indicated earlier, 
without any further change in payment for drug administration, the MMA 
increased payment for drug administration by more than 105 percent from 
2003 to 2005 while making payment for drugs at 6 percent more than 
their average sales price. Nevertheless, we acknowledge that there is a 
concern among physicians and others that the large changes in 
Medicare's payments may affect their ability or willingness to continue 
making drugs and related services available.
    As indicated above, we are considering making further changes to 
Medicare payment for drug administration based on the results of CPT's 
review of this issue or in response to public comment. Further, we are 
gathering Medicare utilization for drugs and drug administration 
beginning in 2002 and plan to analyze shifts or changes in utilization 
patterns as the information becomes available to us once the payment 
changes required by the MMA go into effect. While we do not believe the 
payment changes for drugs and drug administration will result in access 
problems, we plan to continue studying this issue. We also note that 
the MMA requires the Medicare Payment Advisory Commission (MedPAC) to 
study related issues. Specifically, section 303(a)(5) of the MMA 
requires MedPAC to study items and services furnished by oncologists 
and drug administration services furnished by other specialists. 
Similarly, section 305(b) requires the General Accounting Office to 
study the adequacy of Medicare payments for inhalation therapy.
    We are also undertaking several changes using our administrative 
authority that will affect Medicare beneficiaries. Our proposal to 
remove restrictions that limit Medicare payment for use of low osmolar 
contrast material to specific indications would update Medicare's 
payment policy to be consistent with the standard practice of medicine 
and will improve the quality of care for beneficiaries.
    We believe early involvement of the physician in determining the 
medical necessity for items of DMEPOS will assist in improving the 
accuracy of Medicare program payments and the quality of care. In 
addition, it will also reduce out-of-pocket costs for unnecessary 
DMEPOS that may have otherwise been provided to Medicare beneficiaries.
    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 405

    Administrative practice and procedure, Health facilities, Health 
professions, Kidney diseases, Medical devices, Medicare, Reporting and 
recordkeeping requirements, Rural areas, X-rays

42 CFR Part 410

    Health facilities, Health professions, Kidney diseases, 
Laboratories, Medicare, Reporting and recordkeeping requirements, Rural 
areas, X-rays

42 CFR Part 411

    Kidney diseases, Medicare, Reporting and recordkeeping requirements

42 CFR Part 414

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

42 CFR Part 418

    Health facilities, Hospice care, Medicare, Reporting and 
recordkeeping requirements

42 CFR Part 424

    Emergency medical services, Health facilities, Health professions, 
Medicare, Reporting and recordkeeping requirements

42 CFR Part 484

    Health facilities, Health professions, Medicare, Reporting and 
recordkeeping requirements

42 CFR Part 486

    Grant programs-health, Health facilities, Medicare, Reporting and 
recordkeeping requirements, X-rays

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

PART 405--FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED

    1. The authority citation for part 405 continues to read as 
follows:

    Authority: Secs. 1102, 1861, 1862(a), 1871, 1874, 1881, and 
1886(k) of the Social Security Act (42 U.S.C. 1302, 1395x, 1395y(a), 
1395hh, 1395kk, 1395rr, and 1395ww(k)), and sec. 353 of the Public 
Health Service Act (42 U.S.C. 263a).

    2. Section 405.207 is amended by revising paragraph (b) to read as 
follows:


Sec.  405.207  Services related to a noncovered device.

* * * * *
    (b) When payment is made. Medicare payment may be made for--
    (1) Covered services to treat a condition or complication that 
arises due to the use of a noncovered device or a noncovered device-
related service; or
    (2) Routine care services related to experimental/investigational 
(Category A) devices as defined in Sec.  405.201(b); and furnished in 
conjunction with an FDA-approved clinical trial. The trial must meet 
criteria established through the national coverage determination 
process; and if the trial is initiated before January 1, 2010, the 
device must be determined as intended for use in the diagnosis, 
monitoring or treatment of an immediate life-threatening disease or 
condition.
    (3) Routine care services related to a non-experimental/
investigational (Category B) device defined in Sec.  405.201(b) that is 
furnished in conjunction with an FDA-approved clinical trial.
    3. Section 405.517 is amended by adding a new paragraph (a)(3) to 
read as follows:


Sec.  405.517  Payment for drugs and biologicals that are not paid on a 
cost or prospective payment basis.

    (a) Applicability. * * *
    (3) Payment for drugs and biologicals on or after January 1, 2005. 
Effective January 1, 2005, payment for drugs and biologicals that are 
not paid on a cost or prospective payment basis are paid in accordance 
with part 414, subpart K of this chapter.

PART 410--SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS

    4. The authority citation for part 410 continues to read as 
follows:


[[Page 47574]]


    Authority: Secs. 1102 and 1871 of the Social Security Act (42 
U.S.C. 1302 and 1395hh).
    5. Section 410.10 is amended by adding new paragraph (y) to read as 
follows:


Sec.  410.10  Medical and other health services: Included services.

* * * * *
    (y) Intravenous immune globulin administered in the home for the 
treatment of primary immune deficiency diseases.
    6. Section 410.16 is added to read as follows:


Sec.  410.16  Initial preventive physical examination: Conditions for 
and limitations on coverage.

    (a) Definitions. As used in this section, the following definitions 
apply--
    Eligible beneficiary means individuals who receive their initial 
preventive physical examinations within 6 months after the effective 
date of their first Medicare Part B coverage period, but only if their 
first Part B coverage period begins on or after January 1, 2005.
    Initial preventive physical examination means all of the following 
services furnished to an individual by a physician or other qualified 
nonphysician practitioner with the goal of health promotion and disease 
detection:
    (1) Review of the individual's comprehensive medical and social 
history.
    (2) Review of the individual's potential (risk factors) for 
depression, including past experiences with depression or other mood 
disorders, based on the use of an appropriate screening instrument, 
which the physician or other qualified nonphysician practitioner may 
select unless the appropriate screening instrument is further defined 
through a national coverage determination.
    (3) Review of the individual's functional ability, and level of 
safety, based on the use of an appropriate screening instrument, which 
the physician or other qualified nonphysician practitioner may select 
unless the appropriate screening instrument is defined through a 
national coverage determination.
    (4) An examination to include measurement of the individual's 
height, weight, blood pressure, a visual acuity screen, and other 
factors as deemed appropriate, based on the individual's medical and 
social history, and current clinical standards.
    (5) Performance and interpretation of an electrocardiogram.
    (6) Education, counseling, and referral, as deemed appropriate by 
the physician or qualified nonphysician practitioner, based on the 
results of the review and evaluation services described in this 
section.
    (7) Education, counseling, and referral, including a written plan 
provided to the individual for obtaining the appropriate screening and 
other preventive services for the individual that are covered as 
separate Medicare Part B benefits as described in section 1861(s)(10), 
section 1861(jj), section 1861(nn), section 1861(oo), section 1861(pp), 
section 1861(qq)(1), section 1861(rr), section 1861(uu), section 
1861(vv), section 1861(xx)(1), and section 1861(yy) of the Social 
Security Act (the Act).
    Medical history is defined to include, at a minimum, the following:
    (1) Past medical and surgical history, including experiences with 
illnesses, hospital stays, operations, allergies, injuries and 
treatments.
    (2) Current medications and supplements, including calcium and 
vitamins.
    (3) Family history, including a review of medical events in the 
patient's family, including diseases that may be hereditary or place 
the individual at risk.
    Physician for purposes of this provision means a doctor of medicine 
or osteopathy (as defined in section 1861(r)(1) of the Act).
    Qualified nonphysician practitioner for purposes of this provision 
means a physician assistant, nurse practitioner, or clinical nurse 
specialist (as authorized under section 1861(s)(2)(K)(i) and section 
1861(s)(2)(K)(ii) of the Act and defined in section 1861(aa)(5) of the 
Act, or in regulations at Sec.  410.74, Sec.  410.75, and Sec.  
410.76).
    Review of the individual's functional ability and level of safety. 
Review of the individual's functional ability and level of safety must 
include, at a minimum, a review of the following areas:
    (1) Hearing impairment.
    (2) Activities of daily living.
    (3) Falls risk.
    (4) Home safety.
    Social history is defined to include, at a minimum, the following:
    (1) History of alcohol, tobacco, and illicit drug use.
    (2) Work and travel history.
    (3) Diet.
    (4) Social activities.
    (5) Physical activities.
    (b) Condition for coverage of an initial preventive physical 
examination. Medicare Part B pays for an initial preventive physical 
examination provided to an eligible beneficiary, as described in 
paragraph (a) of this section, if it is furnished by a physician or 
other qualified nonphysician practitioner, as defined in paragraphs (a) 
of this section.
    (c) Limitations on coverage of initial preventive physical 
examinations. Payment may not be made for an initial preventive 
physical preventive examination that is performed for an individual who 
is not an eligible beneficiary as described in paragraph (a) of this 
section.
    7. A new Sec.  410.17 is added to read as follows:


Sec.  410.17  Cardiovascular disease screening tests.

    (a) Definition. For purposes of this subpart, the following 
definition applies:
    Cardiovascular screening blood test means:
    (1) A lipid panel consisting of a total cholesterol, HDL 
cholesterol, and triglyceride. The test is performed after a 12-hour 
fasting period.
    (2) Other blood tests, previously recommended by the U.S. 
Preventive Services Task Force (USPSTF), as determined by the Secretary 
through a national coverage determination process.
    (3) Other non-invasive tests, for indications that have a blood 
test recommended by the USPSTF, as determined by the Secretary through 
a national coverage determination process.
    (b) General conditions of coverage. Medicare Part B covers 
cardiovascular disease screening tests when ordered by the physician 
who is treating the beneficiary (see Sec.  410.32(a)) for the purpose 
of early detection of cardiovascular disease in individuals without 
apparent signs or symptoms of cardiovascular disease.
    (c) Limitation on coverage of cardiovascular screening tests. 
Payment may be made for cardiovascular screening tests performed for an 
asymptomatic individual only if the individual has not had the 
screening tests paid for by Medicare during the preceding 59 months 
following the month in which the last cardiovascular screening tests 
were performed.
    8. A new Sec.  410.18 is added to read as follows:


Sec.  410.18  Diabetes screening tests.

    (a) Definitions. For purposes of this section, the following 
definitions apply:
    Diabetes means diabetes mellitus, a condition of abnormal glucose 
metabolism diagnosed using the following criteria: a fasting blood 
sugar

[[Page 47575]]

greater than or equal to 126 mg/dL on two different occasions; a 2-hour 
post-glucose challenge greater than or equal to 200 mg/dL on two 
different occasions; or a random glucose test over 200 mg/dL for a 
person with symptoms of uncontrolled diabetes.
    Pre-diabetes means a condition of abnormal glucose metabolism 
diagnosed using the following criteria: a fasting glucose level of 100-
125 mg/dL, or a 2-hour post-glucose challenge of 140-199 mg/dL. The 
term pre-diabetes includes the following conditions:
    (1) Impaired fasting glucose.
    (2) Impaired glucose tolerance.
    (b) General conditions of coverage. Medicare Part B covers diabetes 
screening tests after a referral from a physician or qualified 
nonphysician practitioner to an individual at risk for diabetes for the 
purpose of early detection of diabetes.
    (c) Types of tests covered. The following tests are covered if all 
other conditions of this subpart are met:
    (1) Fasting plasma glucose test.
    (2) Post-glucose challenges including, but not limited to, an oral 
glucose tolerance test with a glucose challenge of 75 grams of glucose 
for non-pregnant adults, a 2-hour post glucose challenge test alone.
    (3) Other tests as determined by the Secretary through a national 
coverage determination.
    (d) Amount of testing covered. Medicare covers the following for 
individuals:
    (1) Diagnosed with pre-diabetes Medicare, two screening tests per 
calendar year.
    (2) Previously tested who were not diagnosed with pre-diabetes, or 
who have never been tested before, one screening test per year.
    (e) Eligible risk factors. Individuals with the following risk 
factors are eligible to receive the benefit:
    (1) Hypertension.
    (2) Dyslipidemia.
    (3) Obesity, defined as a body mass index greater than or equal to 
30 kg/m2.
    (4) Prior identification of impaired fasting glucose or glucose 
intolerance.
    (5) Any two of the following characteristics:
    (i) Overweight, defined as body mass index greater than 25, but 
less than 30, kg/m2.
    (ii) A family history of diabetes.
    (iii) 65 years of age or older.
    (iv) A history of birthing a baby weighing more than 9 pounds.
    (f) Individuals not covered. For individuals previously diagnosed 
as diabetic, no coverage.
    9. Section 410.26 is amended by revising paragraph (c) to read as 
follows:


Sec.  410.26  Services and supplies incident to a physician's 
professional services: Conditions.

* * * * *
    (c) Limitations. (1) Drugs and biologicals are also subject to the 
limitations specified in Sec.  410.29.
    (2) Physical therapy, occupational therapy and speech-language 
pathology services provided incident to a physician's professional 
services are subject to the provisions established in Sec.  
410.59(a)(3)(iii), Sec.  410.60(a)(3)(iii), and Sec.  410.62(a)(3)(ii).
    10. Section 410.32 is amended by revising paragraph (b)(2)(iii) to 
read as follows:


Sec.  410.32  Diagnostic x-ray tests, diagnostic laboratory tests, and 
other diagnostic tests: Conditions.

* * * * *
    (b) * * *
    (2) * * *
    (iii) Diagnostic psychological testing services when--
    (A) Personally furnished by a clinical psychologist or an 
independently practicing psychologist as defined in program 
instructions; or
    (B) Furnished under the general supervision of a physician or a 
clinical psychologist.
* * * * *
    11. Section 410.36 is amended by--
    A. Revising the section heading.
    B. Adding to paragraph (a), the paragraph heading ``Condition for 
coverage medical supplies, appliances, and devices.''
    C. Revising paragraph (b).
    D. Adding new paragraphs (c) and (d).
    The additions and revisions read as follows:


Sec.  410.36  Medical supplies, appliances, and devices: Conditions for 
and limitations on coverage.

    (a) Conditions for coverage of medical supplies, appliances, and 
medical devices. * * *
    (b) Conditions for coverage. Medicare Part B pays for the medical 
supplies, appliances, and devices listed in paragraph (a) of this 
section when:
    (1) The medical supplies, appliances, and devices are ordered by a 
physician, physician assistant, clinical nurse specialist, or nurse 
practitioner as defined in the Act.
    (2) The physician or prescribing practitioner--
    (i) Conducts a face-to-face examination to determine the medical 
necessity for medical supplies, appliances, and devices.
    (ii) Conducts the face-to-face examination only for the initial 
order and at the time of the prescription renewal for items of 
continued need, such as glucose testing supplies.
    (iii) Is independent from the DME supplier and may not be an 
employee or contractor of the supplier.
    (3) A written order is completed and signed before delivery of 
these medical supplies, appliances, and devices to the beneficiary.
    (4) The physician's or prescribing practitioner's order is dated 
and signed within 30 days after the face-to-face examination and the 
beneficiary's medical record includes verification of the face-to-face 
examination.
    (5) The physician or prescribing practitioner documents in the 
beneficiary's medical record the need for the medical supplies, 
appliances, and devices being ordered.
    (6) CMS may determine other criteria, such as prescription renewal 
requirements, repairs, minor revisions and replacement, through 
contractor instructions.
    (c) Limitation. Medicare does not pay for a face-to-face 
examination for the sole purpose of the beneficiary's obtaining the 
physician or prescribing practitioner's order for the medical supplies, 
appliances, and devices.
    (d) Clinical conditions for coverage. Clinical conditions for 
coverage, other than those set forth in paragraph (b) of this section, 
of medical supplies, appliances, and devices are determined through the 
national or local coverage determination process.
    12. Section 410.38 is amended by--
    A. Revising paragraph (g).
    B. Adding paragraphs (h) and (i).
    The revision and additions read as follows:


Sec.  410.38  Durable medical equipment: Scope and conditions.

* * * * *
    (g) Conditions for coverage. (1) Medicare Part B pays for durable 
medical equipment ordered by a physician, physician assistant, clinical 
nurse specialist, or nurse practitioner, as defined in the Act.
    (2) The physician or prescribing practitioner must--
    (i) Conduct a face-to-face examination to determine the medical 
necessity of each item of durable medical equipment.
    (ii) Conduct the face-to-face examination for the initial order and 
at the time of the prescription renewal for items of continued need, 
such as infusion pumps or hospital beds.
    (iii) Be independent from the DME supplier and cannot be an 
employee or contractor of the supplier.
    (3) A written order must be completed and signed before delivery of 
any

[[Page 47576]]

durable medical equipment to the beneficiary.
    (4) The physician's or prescribing practitioner's order must be 
dated and signed within 30 days after the face-to-face examination and 
the beneficiary's medical record must include verification of the face-
to-face examination.
    (5) The physician or prescribing practitioner must document in the 
beneficiary's medical record the need for the durable medical equipment 
being ordered.
    (6) CMS may determine other additional payment criteria, such as 
prescription renewal requirements, repairs, minor revisions and 
replacement, through contractor instructions.
    (h) Limitation. Medicare does not pay for a face-to-face 
examination for the sole purpose of the beneficiary's obtaining the 
physician's or prescribing practitioner's order for the durable medical 
equipment.
    (i) Clinical conditions for coverage. Clinical conditions for 
coverage, not defined in paragraph (g) of this section, of durable 
medical equipment are determined through the national or local coverage 
determination process.
    13. Section 410.59 is amended by--
    A. Revising paragraph (a) introductory text and paragraph 
(a)(3)(ii).
    B. Adding new paragraph (a)(3)(iii).
    C. Revising paragraph (b) heading.
    C. Revising paragraph (c)(2).
    D. Adding new paragraph (e)(1)(iii).
    The additions and revisions read as follows:


Sec.  410.59  Outpatient occupational therapy services: Conditions.

    (a) Basic rule. Except as specified in paragraph (a)(3)(iii) of 
this section, Medicare Part B pays for outpatient occupational therapy 
services only if they are furnished by an individual meeting the 
qualifications in Sec.  484.4 for an occupational therapist or by an 
appropriately supervised occupational therapy assistant who meets the 
following conditions: * * *
    (3) * * *
    (ii) By, or under the direct supervision of, an occupational 
therapist in private practice as described in paragraph (c) of this 
section; or
    (iii) By, or incident to the service of, a physician, physician 
assistant, clinical nurse specialist, or nurse practitioner when those 
professionals may perform occupational therapy services within the 
scope of their State practice. When an occupational therapy service is 
provided incident to the service of a physician, physician assistant, 
clinical nurse specialist, or nurse practitioner, the service and the 
person who furnishes the service must meet the standards and conditions 
that apply to occupational therapy and occupational therapists, except 
that a license to practice occupational therapy in the State is not 
required.
    (b) Conditions for coverage of outpatient therapy services 
furnished to certain inpatients of a hospital or a CAH or SNF. * * *
* * * * *
    (c) Special provisions for services furnished by occupational 
therapists in private practice. * * *
    (2) Supervision of occupational therapy services. Occupational 
therapy services are performed by, or under the direct supervision of, 
an occupational therapist in private practice. All services not 
performed personally by the therapist must be performed by employees of 
the practice, directly supervised by the therapist, and included in the 
fee for the therapist's services.
* * * * *
    (e) Annual limitation on incurred expenses.
    (1) * * *
    (iii) The limitation is not applied for services furnished from 
December 8, 2003 through December 31, 2005.
* * * * *
    14. Section 410.60 is amended by--
    A. Revising paragraph (a) introductory text.
    B. Revising paragraph (a)(3)(ii).
    C. Adding new paragraph (a)(3)(iii).
    D. Revising paragraph (b) heading.
    E. Revising paragraph (c)(2).
    F. Adding new paragraph (e)(1)(iii).
    The additions and revisions read as follows:


Sec.  410.60  Outpatient physical therapy services: Conditions.

    (a) Basic rule. Except as specified in paragraph (a)(3)(iii) of 
this section, Medicare Part B pays for outpatient physical therapy 
services only if they are furnished by an individual meeting the 
qualifications in Sec.  484.4 for a physical therapist or by an 
appropriately supervised physical therapist assistant who meets the 
following conditions:
* * * * *
    (3) * * *
    (ii) By or under the direct supervision of a physical therapist in 
private practice as described in paragraph (c) of this section; or
    (iii) By, or incident to, the service of a physician, physician 
assistant, clinical nurse specialist, or nurse practitioner when those 
professionals may perform physical therapy services within the scope of 
their State practice. When a physical therapy service is provided 
incident to the service of a physician, physician's assistant, clinical 
nurse specialist, or nurse practitioner, the service and person who 
furnishes the service must meet the standards and conditions that apply 
to physical therapy and physical therapists, except that a license to 
practice physical therapy in the State is not required.
    (b) Condition for coverage of outpatient physical therapy services 
furnished to certain inpatients of a hospital or a CAH or SNF. * * *
    (c) Special provisions for services furnished by physical 
therapists in private practice. * * *
    (2) Supervision of physical therapy services. Physical therapy 
services are performed by, or under the direct supervision of, a 
physical therapist in private practice. All services not performed 
personally by the therapist must be performed by employees of the 
practice, directly supervised by the therapist, and included in the fee 
for the therapist's services.
* * * * *
    (e) Annual limitation on incurred expenses.
    (1) * * *
    (iii) The limitation is not applied for services furnished from 
December 8, 2003 through December 31, 2005.
* * * * *
    15. Section 410.62 is amended by--
    A. Revising paragraph (a) introductory text and (a)(2)(i), 
(a)(2)(iii) and (a)(3).
    B. Revising paragraphs (b) and (c).
    The revisions read as follows:


Sec.  410.62  Outpatient speech-language pathology services: Conditions 
and exclusions.

    (a) Basic rule. Except as specified in paragraph (a)(3)(ii) of this 
section, Medicare Part B pays for outpatient speech-language pathology 
services only if they are furnished by an individual who meets the 
qualifications for a speech-language pathologist in Sec.  484.4 of this 
chapter if they meet the following conditions: * * *
    (2) * * *
    (i) Is established by a physician or, effective January 1, 1982, by 
either a physician or the speech-language pathologist who provides the 
services to the particular individual;
    (ii) * * *
    (iii) Meets the requirements of Sec.  410.61.
    (3) They are furnished--
    (i) By a provider as defined in Sec.  489.2 of this chapter, or by 
others under arrangements with, and under the supervision of, a 
provider; or
    (ii) By, or incident to, the service of a physician, physician 
assistant, clinical

[[Page 47577]]

nurse specialist, or nurse practitioner when those professionals may 
perform speech-language pathology services within the scope of their 
State practice. When a speech-language pathology service is provided 
incident to the services of a physician, physician's assistant, 
clinical nurse specialist, or nurse practitioner, the service and the 
person who furnishes the service must meet the standards and conditions 
that apply to speech-language pathology and speech-language 
pathologists, except that a license to practice speech-language 
pathology services in the State is not required.
    (b) Condition for coverage of outpatient speech-language pathology 
services to certain inpatients of a hospital, CAH, or SNF. Medicare 
Part B pays for outpatient speech-language pathology services furnished 
to an inpatient of a hospital, CAH, or SNF who requires the services 
but has exhausted or is otherwise ineligible for benefit days under 
Medicare Part A.
    (c) Excluded services. No service is included as an outpatient 
speech-language pathology service if it is not included as an inpatient 
hospital service if furnished to a hospital or CAH inpatient.
* * * * *
    16. Section 410.63 is amended by--
    A. Revising paragraph (b) section heading.
    B. Adding a new paragraph (c).
    The revision and addition reads as follows:


Sec.  410.63  Hepatitis vaccine and blood clotting factors: Conditions.

    (b) Blood clotting factors: Conditions. * * *
    (c) Blood clotting factors: Separate payment. Effective January 1, 
2005, Medicare pays hemophilia treatment centers and homecare companies 
that furnish blood clotting factor a separate payment of $0.05 per unit 
for the items and services associated with the furnishing of the blood 
clotting factor. These items and services include the mixing and 
delivery of factors, including special inventory management and storage 
requirements, as well as ancillary supplies and patient training 
necessary for the self-administration of these factors.
    17. Section 410.78 is amended by--
    A. Revising paragraph (a)(4).
    B. Revising paragraph (b) introductory text.
    The revisions read as follows:


Sec.  410.78  Telehealth services.

    (a) * * *
    (4) Originating site means the location of an eligible Medicare 
beneficiary at the time the service being furnished via a 
telecommunications system occurs. For asynchronous store and forward 
telecommunications technologies, the only originating sites are Federal 
telemedicine demonstration programs conducted in Alaska or Hawaii.
    (b) General rule. Medicare Part B pays for office and other 
outpatient visits, professional consultation, psychiatric diagnostic 
interview examination, individual psychotherapy, monthly end stage 
renal disease (ESRD) related evaluation and management services and 
pharmacologic management furnished by an interactive telecommunications 
system if the following conditions are met:
* * * * *
    18. Section 410.160 is amended by revising paragraph (f) to read as 
follows:


Sec.  410.160  Part B annual deductible.

* * * * *
    (f) Amount of the Part B annual deductible. (1) Beginning with 
expenses for services furnished during calendar year 2006, and for all 
succeeding years, the annual deductible is the previous year's 
deductible plus the annual percentage increase in the monthly actuarial 
rate for Medicare enrollees age 65 and over, rounded to the nearest 
dollar.
    (2) For 2005, the deductible is $110.
    (3) From 1991 through 2004, the deductible was $100.
    (4) From 1982 through 1990, the deductible was $75.
    (5) From 1973 through 1981, the deductible was $60.
    (6) From 1966 through 1972, the deductible was $50.
* * * * *

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

    19. The authority citation for part 411 continues to read as 
follows:

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

    20. Section 411.15 is amended by--
    A. Revising paragraph (a)(1).
    B. Adding paragraph (k)(11).
    The revision and addition read as follows:


Sec.  411.15  Particular services excluded from coverage.

* * * * *
    (a) * * *
    (1) Examinations performed for a purpose other than treatment or 
diagnosis of a specific illness, symptoms, complaint, or injury, except 
for screening mammography, colorectal cancer screening tests, screening 
pelvic exams, prostate cancer screening tests, glaucoma screening 
exams, or initial preventive physical examinations that meet the 
criteria specified in paragraphs (k)(6) through (k)(11) of this 
section.
* * * * *
    (k) * * *
    (11) In the case of initial preventive physical examinations, with 
the goal of health promotion and disease prevention, subject to the 
conditions and limitations specified in Sec.  410.16 of this chapter.
* * * * *
    21. Section 411.404 is amended by revising paragraph (b) to read as 
follows:


Sec.  411.404  Criteria for determining that a beneficiary knew that 
services were excluded from coverage as custodial care or as not 
reasonable and necessary.

* * * * *
    (b) Written notice. Written notice is given to the beneficiary, or 
to someone acting on his or her behalf, that the services were not 
covered because they did not meet Medicare coverage guidelines. A 
notice concerning similar or reasonably comparable services furnished 
on a previous occasion also meets this criterion. After a beneficiary 
is notified that there is no Medicare payment for a service that is not 
covered by Medicare, he or she is presumed to know that there is no 
Medicare payment for any form of subsequent treatment for the non-
covered condition.
* * * * *

PART 414--PAYMENT FOR PART B MEDICAL AND OTHER HEALTH SERVICES.

    22. The authority citation for part 414 continues to read as 
follows:

    Authority: Secs. 1102, 1871, and 1881(b)(1) of the Social 
Security Act (42 U.S.C. 1302, 1395hh, and 1395rr(b)(1)).


Sec.  414.38  [Removed]

    23. Section 414.38 is removed.
    24. Section 414.39 is amended by--
    A. Revising paragraph (a).
    B. Adding paragraph (c).
    The revision and addition read as follows:


Sec.  414.39  Special rules for payment of care plan oversight.

    (a) General. Except as specified in paragraphs (b) and (c) of this 
section, payment for care plan oversight is included in the payment for 
visits and other services under the physician fee schedule. For 
purposes of this section a nonphysician practitioner (NPP) is a nurse 
practitioner, clinical nurse specialist or physician assistant.
* * * * *

[[Page 47578]]

    (c) Special rules for payment of care plan oversight provided by 
nonphysician practitioners for beneficiaries who receive HHA services 
covered by Medicare. (1) An NPP can perform physician care plan 
oversight without certifying a patient for home health services (only a 
physician can certify a patient for home health care) if the 
relationship with the physician who signs the plan of care meets one of 
the following conditions:
    (i) The physician and NPP are part of the same group practice;
    (ii) If the NPP is a nurse practitioner or clinical nurse 
specialist, the physician signing the plan of care also has a 
collaborative agreement with the NPP;
    (iii) If the NPP is a physician assistant, the physician signing 
the plan of care is also the physician who provides general supervision 
of physician assistant services for the practice; or
    (iv) The physician signing the plan of care provides regular 
ongoing care under the same plan of care as does the NPP billing for 
care plan oversight.
    (2) Payment may be made for care plan oversight services furnished 
by an NPP when:
    (i) The NPP providing the care plan oversight has seen and examined 
the patient;
    (ii) The NPP providing care plan oversight is not functioning as a 
consultant whose participation is limited to a single medical condition 
rather than multi-disciplinary coordination of care; or
    (iii) The NPP providing care plan oversight integrates his or her 
care with that of the physician who signed the plan of care.
    25. Section 414.65 is amended by revising paragraph (a)(1) to read 
as follows:


Sec.  414.65  Payment for telehealth services.

    (a) * * *
    (1) The Medicare payment amount for office or other outpatient 
visits, consultation, individual psychotherapy, psychiatric diagnostic 
interview examination, monthly end stage renal disease (ESRD) related 
evaluation and management services and pharmacologic management 
furnished via an interactive telecommunications system is equal to the 
current fee schedule amount applicable for the service of the physician 
or practitioner.
* * * * *
    26. Section 414.66 is added to read as follows:


Sec.  414.66  Incentive payments for physicians scarcity areas.

    (a) Definition. As used in this section, the following definition 
applies--
    Primary care physician is defined as a general practitioner, family 
practice practitioner, general internist, obstetrician or gynecologist.
    (b) Physicians' services furnished to a beneficiary in a Physician 
Scarcity Area (PSA) for primary or specialist care are eligible for a 5 
percent incentive payment.
    (c) Primary care physicians furnishing services in primary care 
PSAs are entitled to an additional 5 percent incentive payment above 
the amount paid under the physician fee schedule for their professional 
services furnished on or after January 1, 2005 and before January 1, 
2008.
    (d) Physicians (other than dentists, podiatrists, optometrists, 
chiropractors, and those identified in paragraph (a) of this section) 
furnishing services in specialist care PSAs are entitled to an 
additional 5 percent payment above the amount paid under the physician 
fee schedule for their professional services furnished on or after 
January 1, 2005 and before January 1, 2008.
    27. Section 414.67 is added to read as follows:


Sec.  414.67  Incentive payments for Health Professional Shortage 
Areas.

    (a) Physicians' services furnished to a beneficiary in a 
geographic-based Health Professional Shortage Area (HPSA) are eligible 
for a 10 percent incentive payment.
    (b) Physicians furnishing services in a geographic-based primary 
medical care HPSA are entitled to a 10 percent incentive payment above 
the amount paid for their professional services under the physician fee 
schedule.
    (c) Psychiatrists furnishing services in a mental health HPSA are 
entitled to a 10 percent incentive payment above the amount paid for 
their professional services under the physician fee schedule. (The only 
physicians eligible to receive the 10 percent incentive payment in 
mental health HPSAs that do not overlap with primary care HPSAs are 
psychiatrists.)
    28. Part 414 is amended by adding a new subpart K to read as 
follows:
Subpart K--Payment for Drugs and Biologicals in 2005
Sec.
414.900 Basis.
414.902 Definitions.
414.904 Basis of Payment.

Subpart K--Payment for Drugs and Biologicals in 2005


Sec.  414.900  Basis.

    (a) This subpart implements section 1842(o) of the Social Security 
Act by specifying the methodology for determining the payment allowance 
limit for drugs and biologicals covered under Medicare Part B that are 
not paid on a cost or prospective payment system basis.
    (b) Examples of drugs that are subject to the requirements 
specified in this subpart are:
    (1) Drugs furnished incident to a physician's service; durable 
medical equipment (DME) drugs.
    (2) Separately billable drugs at independent dialysis facilities 
not under the ESRD composite rate.
    (3) Statutorily covered drugs, for example--
    (i) Influenza
    (ii) Pneumococcal and hepatitis vaccines.
    (iii) Antigens.
    (iv) Hemophilia blood clotting factor.
    (v) Immunosuppressive drugs.
    (vi) Certain oral anti-cancer drugs.


Sec.  414.902  Definitions.

    As used in this subpart, unless the context indicates otherwise--
    Drug means both drugs and biologicals.
    Manufacturer's average sales price means the price calculated and 
reported by a manufacturer under part 414, subpart J of this chapter.
    Multiple source drug means a drug described by section 
1847A(c)(6)(C) of the Act.
    Single source drug means a drug described by section 1847A(c)(6)(D) 
of the Act.
    Unit is defined as in part 414, subpart J of this chapter.
    Wholesale acquisition cost (WAC) means the price described by 
section 1847A(c)(6)(B) of the Act.


Sec.  414.904  Basis of payment.

    (a) Method of payment. Payment for a drug for calendar year 2005 is 
based on the lesser of--
    (1) The actual charge on the claim for program benefits; or
    (2) 106 percent of the average sales price, subject to the 
applicable limitations specified in paragraph (d) of this section or 
subject to the exceptions described in paragraph (e) of this section.
    (b) Multiple source drugs. (1) Average sales prices. The average 
sales price for all drug products included within the same multiple 
source drug billing and payment code is the volume-weighted

[[Page 47579]]

average of the manufacturers' average sales prices for those drug 
products.
    (2) Calculation of the average sales price. The average sales price 
is determined by--
    (i) Computing the sum of the products (for each National Drug Code 
assigned to the drug products) of the manufacturer's average sales 
price and the total number of units sold; and
    (ii) Dividing that sum by the sum of the total number of units sold 
for all NDCs assigned to the drug products.
    (c) Single source drugs. (1) Average sales price. The average sales 
price is the volume-weighted average of the manufacturers' average 
sales prices for all National Drug Codes assigned to the drug or 
biological product.
    (2) Calculation of the average sales price. The average sales price 
is determined by computing--
    (i) The sum of the products (for each National Drug Code assigned 
to the drug product) of the manufacturer's average sales price and the 
total number of units sold; and
    (ii) Dividing that sum by the sum of the total number of units sold 
for all NDCs assigned to the drug product.
    (d) Limitations on the average sales price. (1) Wholesale 
acquisition cost for a single source drug. The payment limit for a 
single source drug product is the lesser of 106 percent of the average 
sales price for the product or 106 percent of the wholesale acquisition 
cost for the product.
    (2) Payment limit for a drug furnished to an end-stage renal 
disease patient. The payment for a drug furnished to an end-stage renal 
disease patient that is separately billed by an end stage renal disease 
facility, including erythropoietin, cannot exceed 97 percent of the 
average sales price.
    (3) Widely available market price and average manufacturer price. 
If the Inspector General finds that the average sales price exceeds the 
widely available market price or the average manufacturer price by 5 
percent or more in calendar year 2005, the payment limit in the quarter 
following the transmittal of this information to the Secretary is the 
lesser of the widely available market price or 103 percent of the 
average manufacturer price.
    (e) Exceptions to the average sales price. (1) Vaccines. The 
payment limits for hepatitis B vaccine furnished to individuals at high 
or intermediate risk of contracting hepatitis B (as determined by the 
Secretary), pneumococcal vaccine, and influenza vaccine and are 
calculated using 95 percent of the average wholesale price.
    (2) Infusion drugs furnished through a covered item of durable 
medical equipment. The payment limit for an infusion drug furnished 
through a covered item of durable medical equipment is calculated using 
95 percent of the average wholesale price in effect on October 1, 2003 
and is not updated in 2005.
    (3) Blood and blood products. In the case of blood and blood 
products (other than blood clotting factors), the payment limits are 
determined in the same manner as the payment limits were determined on 
October 1, 2003.
    (4) Payment limit in a case where the average sales price during 
the first quarter of sales is unavailable. In the case of a drug during 
an initial period (not to exceed a full calendar quarter) in which data 
on the prices for sales of the drug are not sufficiently available from 
the manufacturer to compute an average sales price for the drug, the 
payment limit is based on the wholesale acquisition cost or the 
applicable Medicare Part B drug payment methodology in effect on 
November 1, 2003.
    (f) Except as otherwise specified (see paragraph (e)(2)of this 
section) for infusion drugs, the payment limits are updated quarterly.
    (g) The payment limit is computed without regard to any special 
packaging, labeling, or identifiers on the dosage form or product or 
package.
    (h) The payment amount is subject to applicable deductible and 
coinsurance.

PART 418--HOSPICE CARE

    29. The authority citation for part 418 continues to read as 
follows:

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

    30. Section 418.205 is added to read as follows:


Sec.  418.205  Special requirements for hospice pre-election evaluation 
and counseling services.

    (a) Definition. For purposes of this section, the following 
definition applies:
    Terminal illness is defined as having a prognosis of 6 months or 
less if the disease or illness runs its normal course.
    (b) Effective date for payment and requirements. Effective January 
1, 2005, payment for hospice pre-election evaluation and counseling 
services as specified in Sec.  418.304(d) may be made to a hospice 
agency on behalf of a Medicare beneficiary who is terminally ill if the 
requirements of this section are met.
    (1) The beneficiary: (i) Is certified as having a terminal illness.
    (ii) Has not made a hospice election.
    (iii) Has not previously received hospice pre-election evaluation 
and consultation services specified under this section.
    (2) Services provided. The hospice pre-election services include--
(i) An evaluation of an individual's need for pain and symptom 
management;
    (ii) Counseling regarding hospice and other care options; and
    (iii) May include advising the individual regarding advanced care 
planning.
    (3) Provider of pre-election hospice services. (i) The physician 
furnishing these services must be an employee or medical director of 
the hospice billing for this service.
    (ii) The services cannot be furnished by other hospice personnel, 
such as but not limited to nurse practitioners, nurses, or social 
workers, physicians under contractual arrangements with the hospice or 
by the beneficiary's physician, if that physician is not an employee of 
the hospice.
    (iii) If the beneficiary's physician is also the medical director 
or a physician employee of the hospice, the attending physician is not 
required to request or provide this service because that physician 
already possesses the expertise necessary to furnish end-of-life 
evaluation and management, and counseling services.
    (4) Documentation. (i) If the individual's physician initiates the 
request for services of the hospice medical director or physician, 
appropriate documentation is required.
    (ii) The request or referral must be in writing, and the hospice 
medical director or physician employee is expected to provide a written 
note on the patient's medical record.
    (iii) The hospice agency employing the physician providing these 
services is required to maintain a written record of the services 
rendered.
    (iv) If the services are initiated by the beneficiary, the hospice 
agency is required to maintain a record of the services and that 
communication between the hospice medical director or physician and the 
beneficiary's physician occurs, with the beneficiary's permission, to 
the extent necessary to ensure continuity of care.
    31. Section 418.304 is amended by adding paragraph (d) to read as 
follows.


Sec.  418.304  Payment for physician services.

* * * * *
    (d) Payment for hospice evaluation and counseling services--pre-
election. The intermediary makes payment for these services established 
in Sec.  418.205 to the hospice. As directed by the statute, payment 
for this service is set at an amount established for an office or other 
outpatient visit for evaluation and

[[Page 47580]]

management associated with presenting problems of moderate severity and 
requiring medical decision-making of low complexity under the physician 
fee schedule, other than the portion of such amount attributable to the 
practice expense component. Payment for this pre-election service is 
not calculated towards the hospice cap amount.

PART 424--CONDITIONS FOR MEDICARE PAYMENT

    32. The authority citation for part 424 continues to read as 
follows:

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

    33. Section 424.55 is amended by adding new paragraph (c) to read 
as follows:


Sec.  424.55  Payment to the supplier.

* * * * *
    (c) Exception. In situations when payment under the Act can only be 
made on an assignment-related basis or when payment is for services 
furnished by a participating physician or supplier, the beneficiary (or 
the person authorized to request payment on the beneficiary's behalf) 
is not required to assign the claim to the supplier in order for an 
assignment to be effective.
    34. Section 424.71 is amended as follows:
    A. The definition of ``Health care delivery system or system'' is 
removed.
    B. The definition of the term ``Entity'' is added in alphabetical 
order.
    The addition reads as follows:


Sec.  424.71  Definitions.

* * * * *
    Entity means a person, group, or facility that is enrolled in the 
Medicare program.
* * * * *
    35. Section 424.80 is amended by--
    A. Revising paragraph (b)(2).
    B. Removing paragraph (b)(3).
    C. Redesignating paragraphs (b)(4) through (6) as paragraphs (b) 
(3) through (5), respectively.
    D. Revising paragraph (c).
    E. Adding a new paragraph (d).
    The revisions and addition read as follows:


Sec.  424.80  Prohibition of reassignment of claims by suppliers.

* * * * *
    (b) * * *
    (1) * * *
    (2) Payment to an entity under a contractual arrangement. Medicare 
may pay an entity enrolled in the Medicare program if there is a 
contractual arrangement between the entity and the supplier under which 
the entity bills for the supplier's services, subject to the provisions 
of paragraph (d) of this section.
* * * * *
    (c) Rules applicable to an employer or entity. An employer or 
entity that may receive payment under paragraph (b)(1) or (b)(2) of 
this section is considered the supplier of those services for purposes 
of subparts C, D, and E of this part, subject to the provisions of 
paragraph (d) of this section.
    (d) Reassignment to an entity under a contractual arrangement: 
Conditions and limitations. (1) Liability of the parties. An entity 
enrolled in the Medicare program that receives payment under a 
contractual arrangement under paragraph (b)(2) of this section and the 
supplier that otherwise receives payment are jointly and severally 
responsible for any Medicare overpayment to that entity.
    (2) Access to records. The supplier furnishing the service has 
unrestricted access to claims submitted by an entity for services 
provided by that supplier.

PART 484-HOME HEALTH SERVICES

    36. The authority citation for part 484 continues to read as 
follows:

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


Sec.  484.4  [Amended]

    37. In Sec.  484.4 in the definition of physical therapy assistant 
the term ``physical therapy assistant'' is removed and the term 
``physical therapist assistant'' is added in its place wherever it 
appears.

PART 486--CONDITIONS FOR COVERAGE OF SPECIALIZED SERVICES FURNISHED 
BY SUPPLIERS

    38. The authority citation for part 486 continues to read as 
follows:

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

Subpart D [Removed and Reserved]

    39. Part 486 subpart D, consisting of Sec.  486.150 through Sec.  
486.163, is removed and reserved.

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

    Dated: July 13, 2004.
Mark B. McClellan,
Administrator, Centers for Medicare & Medicaid Services.
    Approved: July 23, 2004.
Tommy G. Thompson,
Secretary.

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

Addendum A--Explanation and Use of Addenda B

    The addenda on the following pages provide various data 
pertaining to the Medicare fee schedule for physicians' services 
furnished in 2005. Addendum B contains the RVUs for work, non-
facility practice expense, facility practice expense, and 
malpractice expense, and other information for all services included 
in the physician fee schedule.
    In previous years, we have listed many services in Addendum B 
that are not paid under the physician fee schedule. To avoid 
publishing as many pages of codes for these services, we are not 
including clinical laboratory codes and most alpha-numeric codes 
(Healthcare Common Procedure Coding System (HCPCS) codes not 
included in CPT) in Addendum B.

Addendum B--2005 Relative Value Units and Related Information Used in 
Determining Medicare Payments for 2005

    This addendum contains the following information for each CPT 
code and alphanumeric HCPCS code, except for alphanumeric codes 
beginning with B (enteral and parenteral therapy), E (durable 
medical equipment), K (temporary codes for nonphysicians' services 
or items), or L (orthotics), and codes for anesthesiology.
    1. CPT/HCPCS code. This is the CPT or alphanumeric HCPCS number 
for the service. Alphanumeric HCPCS codes are included at the end of 
this addendum.
    2. Modifier. A modifier is shown if there is a technical 
component (modifier TC) and a professional component (PC) (modifier 
-26) for the service. If there is a PC and a TC for the service, 
Addendum B contains three entries for the code: One for the global 
values (both professional and technical); one for modifier -26 (PC); 
and one for modifier TC. The global service is not designated by a 
modifier, and physicians must bill using the code without a modifier 
if the physician furnishes both the PC and the TC of the service.
    Modifier -53 is shown for a discontinued procedure. There will 
be RVUs for the code (CPT code 45378) with this modifier.
    3. Status indicator. This indicator shows whether the CPT/HCPCS 
code is in the physician fee schedule and whether it is separately 
payable if the service is covered.
    A = Active code. These codes are separately payable under the 
fee schedule if covered. There will be RVUs for codes with this 
status. The presence of an ``A'' indicator does not mean that 
Medicare has made a national decision regarding the coverage of the 
service. Carriers remain responsible for coverage decisions in the 
absence of a national Medicare policy.

[[Page 47581]]

    B = Bundled code. Payment for covered services is always bundled 
into payment for other services not specified. If RVUs are shown, 
they are not used for Medicare payment. If these services are 
covered, payment for them is subsumed by the payment for the 
services to which they are incident. (An example is a telephone call 
from a hospital nurse regarding care of a patient.)
    C = Carrier-priced code. Carriers will establish RVUs and 
payment amounts for these services, generally on a case-by-case 
basis following review of documentation, such as an operative 
report.
    D = Deleted code. These codes are deleted effective with the 
beginning of the calendar year.
    E = Excluded from physician fee schedule by regulation. These 
codes are for items or services that we chose to exclude from the 
physician fee schedule payment by regulation. No RVUs are shown, and 
no payment may be made under the physician fee schedule for these 
codes. Payment for them, if they are covered, continues under 
reasonable charge or other payment procedures.
    F = Deleted/discontinued codes. Code not subject to a 90-day 
grace period.
    G = Code not valid for Medicare purposes. Medicare does not 
recognize codes assigned this status. Medicare uses another code for 
reporting of, and payment for, these services.
    H = Deleted modifier. Either the TC or PC component shown for 
the code has been deleted, and the deleted component is shown in the 
data base with the H status indicator. (Code subject to a 90-day 
grace period.)
    I = Not valid for Medicare purposes. Medicare uses another code 
for the reporting of, and the payment for these services. (Code NOT 
subject to a 90-day grace period.)
    N = Noncovered service. These codes are noncovered services. 
Medicare payment may not be made for these codes. If RVUs are shown, 
they are not used for Medicare payment.
    P = Bundled or excluded code. There are no RVUs for these 
services. No separate payment should be made for them under the 
physician fee schedule.

--If the item or service is covered as incident to a physician's 
service and is furnished on the same day as a physician's service, 
payment for it is bundled into the payment for the physician's 
service to which it is incident (an example is an elastic bandage 
furnished by a physician incident to a physician's service).
--If the item or service is covered as other than incident to a 
physician's service, it is excluded from the physician fee schedule 
(for example, colostomy supplies) and is paid under the other 
payment provisions of the Act.

    R = Restricted coverage. Special coverage instructions apply. If 
the service is covered and no RVUs are shown, it is carrier-priced.
    T = Injections. There are RVUs for these services, but they are 
only paid if there are no other services payable under the physician 
fee schedule billed on the same date by the same provider. If any 
other services payable under the physician fee schedule are billed 
on the same date by the same provider, these services are bundled 
into the service(s) for which payment is made.
    X = Exclusion by law. These codes represent an item or service 
that is not within the definition of ``physicians' services'' for 
physician fee schedule payment purposes. No RVUs are shown for these 
codes, and no payment may be made under the physician fee schedule. 
(Examples are ambulance services and clinical diagnostic laboratory 
services.)
    4. Description of code. This is an abbreviated version of the 
narrative description of the code.
    5. Physician work RVUs. These are the RVUs for the physician 
work for this service in 2005. Codes that are not used for Medicare 
payment are identified with a ``+.''
    6. Facility practice expense RVUs. These are the fully 
implemented resource-based practice expense RVUs for facility 
settings.
    7. Non-facility practice expense RVUs. These are the fully 
implemented resource-based practice expense RVUs for non-facility 
settings.
    8. Malpractice expense RVUs. These are the RVUs for the 
malpractice expense for the service for 2005.
    9. Facility total. This is the sum of the work, fully 
implemented facility practice expense, and malpractice expense RVUs.
    10. Non-facility total. This is the sum of the work, fully 
implemented non-facility practice expense, and malpractice expense 
RVUs.
    11. Global period. This indicator shows the number of days in 
the global period for the code (0, 10, or 90 days). An explanation 
of the alpha codes follows:
    MMM = The code describes a service furnished in uncomplicated 
maternity cases including antepartum care, delivery, and postpartum 
care. The usual global surgical concept does not apply. See the 1999 
Physicians' Current Procedural Terminology for specific definitions.
    XXX = The global concept does not apply.
    YYY = The global period is to be set by the carrier (for 
example, unlisted surgery codes).
    ZZZ = Code related to another service that is always included in 
the global period of the other service. (Note: Physician work and 
practice expense are associated with intra service time and in some 
instances the post service time.)

    --------------------
\1\ CPT codes and descriptions only are copyright 2004 American Medical 
Association. All Rights Reserved. Applicable FARS/DFARS Apply.

\2\ Copyright 2004 American Dental Association. All rights reserved.

\3\ + Indicates RVUs are not used for Medicare Payments.

[[Page 47581]]



                                            Addendum B.--Relative Value Units (RVUS) and Related Information
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                             Physician     Non-                  Mal-       Non-
 CPT \1\/  HCPCS \2\        MOD           Status           Description          work     facility   Facility   practice   facility   Facility    Global
                                                                              RVUs \3\   PE RVUs    PE RVUs      RVUs      Total      total
--------------------------------------------------------------------------------------------------------------------------------------------------------
10021...............  ..............  A               Fna w/o image........       1.27       2.16       0.54       0.11       3.54       1.92        XXX
10022...............  ..............  A               Fna w/image..........       1.27       2.55       0.42       0.08       3.90       1.77        XXX
10040...............  ..............  A               Acne surgery.........       1.18       1.01       0.79       0.10       2.29       2.07        010
10060...............  ..............  A               Drainage of skin            1.17       1.21       0.94       0.10       2.48       2.21        010
                                                       abscess.
10061...............  ..............  A               Drainage of skin            2.40       1.82       1.50       0.21       4.43       4.11        010
                                                       abscess.
10080...............  ..............  A               Drainage of pilonidal       1.17       3.12       1.12       0.11       4.40       2.40        010
                                                       cyst.
10081...............  ..............  A               Drainage of pilonidal       2.45       4.10       1.51       0.26       6.81       4.22        010
                                                       cyst.
10120...............  ..............  A               Remove foreign body..       1.22       2.19       0.99       0.11       3.52       2.32        010
10121...............  ..............  A               Remove foreign body..       2.69       3.53       1.79       0.30       6.52       4.78        010
10140...............  ..............  A               Drainage of hematoma/       1.53       1.77       1.29       0.15       3.45       2.97        010
                                                       fluid.
10160...............  ..............  A               Puncture drainage of        1.20       1.61       1.09       0.12       2.93       2.41        010
                                                       lesion.
10180...............  ..............  A               Complex drainage,           2.25       3.00       1.98       0.32       5.57       4.55        010
                                                       wound.
11000...............  ..............  A               Debride infected skin       0.60       0.58       0.21       0.05       1.23       0.86        000
11001...............  ..............  A               Debride infected skin       0.30       0.23       0.11       0.02       0.55       0.43        ZZZ
                                                       add-on.
11010...............  ..............  A               Debride skin, fx.....       4.19       6.89       2.62       0.59      11.67       7.40        010
11011...............  ..............  A               Debride skin/muscle,        4.94       8.19       2.33       0.69      13.82       7.96        000
                                                       fx.
11012...............  ..............  A               Debride skin/muscle/        6.87      12.09       3.83       1.11      20.07      11.81        000
                                                       bone, fx.
11040...............  ..............  A               Debride skin, partial       0.50       0.52       0.21       0.04       1.06       0.75        000
11041...............  ..............  A               Debride skin, full...       0.82       0.66       0.33       0.07       1.55       1.22        000
11042...............  ..............  A               Debride skin/tissue..       1.12       0.97       0.44       0.11       2.20       1.67        000
11043...............  ..............  A               Debride tissue/muscle       2.38       3.40       2.59       0.27       6.05       5.24        010
11044...............  ..............  A               Debride tissue/muscle/      3.06       4.47       3.75       0.38       7.91       7.19        010
                                                       bone.
11055...............  ..............  R               Trim skin lesion.....       0.43       0.56       0.17       0.03       1.02       0.63        000
11056...............  ..............  R               Trim skin lesions, 2        0.61       0.63       0.23       0.05       1.29       0.89        000
                                                       to 4.

[[Page 47582]]

 
11057...............  ..............  R               Trim skin lesions,          0.79       0.74       0.30       0.06       1.59       1.15        000
                                                       over 4.
11100...............  ..............  A               Biopsy, skin lesion..       0.81       1.25       0.36       0.07       2.13       1.24        000
11101...............  ..............  A               Biopsy, skin add-on..       0.41       0.33       0.19       0.03       0.77       0.63        ZZZ
11200...............  ..............  A               Removal of skin tags.       0.77       1.05       0.76       0.07       1.89       1.60        010
11201...............  ..............  A               Remove skin tags add-       0.29       0.16       0.12       0.03       0.48       0.44        ZZZ
                                                       on.
11300...............  ..............  A               Shave skin lesion....       0.51       0.99       0.21       0.04       1.54       0.76        000
11301...............  ..............  A               Shave skin lesion....       0.85       1.11       0.38       0.07       2.03       1.30        000
11302...............  ..............  A               Shave skin lesion....       1.05       1.30       0.46       0.09       2.44       1.60        000
11303...............  ..............  A               Shave skin lesion....       1.24       1.58       0.52       0.11       2.93       1.87        000
11305...............  ..............  A               Shave skin lesion....       0.67       0.84       0.27       0.06       1.57       1.00        000
11306...............  ..............  A               Shave skin lesion....       0.99       1.10       0.42       0.08       2.17       1.49        000
11307...............  ..............  A               Shave skin lesion....       1.14       1.29       0.49       0.10       2.53       1.73        000
11308...............  ..............  A               Shave skin lesion....       1.41       1.45       0.59       0.12       2.98       2.12        000
11310...............  ..............  A               Shave skin lesion....       0.73       1.12       0.32       0.07       1.92       1.12        000
11311...............  ..............  A               Shave skin lesion....       1.05       1.23       0.49       0.09       2.37       1.63        000
11312...............  ..............  A               Shave skin lesion....       1.20       1.42       0.55       0.11       2.73       1.86        000
11313...............  ..............  A               Shave skin lesion....       1.62       1.79       0.72       0.15       3.56       2.49        000
11400...............  ..............  A               Exc tr-ext b9+marg          0.85       2.00       0.88       0.09       2.94       1.82        010
                                                       0.5 < cm.
11401...............  ..............  A               Exc tr-ext b9+marg          1.23       2.06       1.02       0.13       3.42       2.38        010
                                                       0.6-1 cm.
11402...............  ..............  A               Exc tr-ext b9+marg          1.51       2.23       1.08       0.17       3.91       2.76        010
                                                       1.1-2 cm.
11403...............  ..............  A               Exc tr-ext b9+marg          1.79       2.40       1.32       0.21       4.40       3.32        010
                                                       2.1-3 cm.
11404...............  ..............  A               Exc tr-ext b9+marg          2.06       2.71       1.40       0.25       5.02       3.71        010
                                                       3.1-4 cm.
11406...............  ..............  A               Exc tr-ext b9+marg >        2.76       3.07       1.66       0.33       6.16       4.75        010
                                                       4.0 cm.
11420...............  ..............  A               Exc h-f-nk-sp b9+marg       0.98       1.76       0.93       0.10       2.84       2.01        010
                                                       0.5 <.
11421...............  ..............  A               Exc h-f-nk-sp b9+marg       1.42       2.06       1.11       0.15       3.63       2.68        010
                                                       0.6-1.
11422...............  ..............  A               Exc h-f-nk-sp b9+marg       1.63       2.25       1.34       0.18       4.06       3.15        010
                                                       1.1-2.
11423...............  ..............  A               Exc h-f-nk-sp b9+marg       2.01       2.58       1.45       0.23       4.82       3.69        010
                                                       2.1-3.
11424...............  ..............  A               Exc h-f-nk-sp b9+marg       2.43       2.80       1.60       0.28       5.51       4.31        010
                                                       3.1-4.
11426...............  ..............  A               Exc h-f-nk-sp b9+marg       3.77       3.49       2.10       0.44       7.70       6.31        010
                                                       > 4 cm.
11440...............  ..............  A               Exc face-mm b9+marg         1.06       2.21       1.31       0.10       3.37       2.47        010
                                                       0.5 < cm.
11441...............  ..............  A               Exc face-mm b9+marg         1.48       2.34       1.49       0.16       3.98       3.13        010
                                                       0.6-1 cm.
11442...............  ..............  A               Exc face-mm b9+marg         1.72       2.54       1.57       0.20       4.46       3.49        010
                                                       1.1-2 cm.
11443...............  ..............  A               Exc face-mm b9+marg         2.29       2.92       1.81       0.26       5.47       4.36        010
                                                       2.1-3 cm.
11444...............  ..............  A               Exc face-mm b9+marg         3.14       3.47       2.17       0.35       6.96       5.66        010
                                                       3.1-4 cm.
11446...............  ..............  A               Exc face-mm b9+marg >       4.48       4.04       2.76       0.47       8.99       7.71        010
                                                       4 cm.
11450...............  ..............  A               Removal, sweat gland        2.73       5.06       2.02       0.35       8.14       5.10        090
                                                       lesion.
11451...............  ..............  A               Removal, sweat gland        3.94       6.64       2.54       0.52      11.10       7.00        090
                                                       lesion.
11462...............  ..............  A               Removal, sweat gland        2.51       5.14       2.01       0.31       7.96       4.83        090
                                                       lesion.
11463...............  ..............  A               Removal, sweat gland        3.94       6.85       2.68       0.51      11.30       7.13        090
                                                       lesion.
11470...............  ..............  A               Removal, sweat gland        3.25       5.09       2.26       0.38       8.72       5.89        090
                                                       lesion.
11471...............  ..............  A               Removal, sweat gland        4.40       6.74       2.76       0.54      11.68       7.70        090
                                                       lesion.
11600...............  ..............  A               Exc tr-ext mlg+marg         1.31       2.64       0.97       0.13       4.08       2.41        010
                                                       0.5 < cm.
11601...............  ..............  A               Exc tr-ext mlg+marg         1.80       2.70       1.22       0.18       4.68       3.20        010
                                                       0.6-1 cm.
11602...............  ..............  A               Exc tr-ext mlg+marg         1.95       2.83       1.26       0.20       4.98       3.41        010
                                                       1.1-2 cm.
11603...............  ..............  A               Exc tr-ext mlg+marg         2.19       3.07       1.33       0.24       5.50       3.76        010
                                                       2.1-3 cm.
11604...............  ..............  A               Exc tr-ext mlg+marg         2.40       3.38       1.39       0.28       6.06       4.07        010
                                                       3.1-4 cm.
11606...............  ..............  A               Exc tr-ext mlg+marg >       3.42       4.06       1.73       0.40       7.88       5.55        010
                                                       4 cm.
11620...............  ..............  A               Exc h-f-nk-sp               1.19       2.60       0.95       0.13       3.92       2.27        010
                                                       mlg+marg 0.5 <.
11621...............  ..............  A               Exc h-f-nk-sp               1.76       2.70       1.24       0.19       4.65       3.19        010
                                                       mlg+marg 0.6-1.
11622...............  ..............  A               Exc h-f-nk-sp               2.09       2.97       1.38       0.23       5.29       3.70        010
                                                       mlg+marg 1.1-2.
11623...............  ..............  A               Exc h-f-nk-sp               2.61       3.33       1.58       0.31       6.25       4.50        010
                                                       mlg+marg 2.1-3.
11624...............  ..............  A               Exc h-f-nk-sp               3.06       3.74       1.77       0.38       7.18       5.21        010
                                                       mlg+marg 3.1-4.
11626...............  ..............  A               Exc h-f-nk-sp mlg+mar       4.29       4.64       2.38       0.50       9.43       7.17        010
                                                       > 4 cm.
11640...............  ..............  A               Exc face-mm                 1.35       2.66       1.11       0.15       4.16       2.61        010
                                                       malig+marg 0.5 <.
11641...............  ..............  A               Exc face-mm                 2.16       3.02       1.52       0.24       5.42       3.92        010
                                                       malig+marg 0.6-1.
11642...............  ..............  A               Exc face-mm                 2.59       3.40       1.71       0.30       6.29       4.60        010
                                                       malig+marg 1.1-2.
11643...............  ..............  A               Exc face-mm                 3.10       3.80       1.95       0.37       7.27       5.42        010
                                                       malig+marg 2.1-3.
11644...............  ..............  A               Exc face-mm                 4.02       4.67       2.44       0.49       9.18       6.95        010
                                                       malig+marg 3.1-4.
11646...............  ..............  A               Exc face-mm mlg+marg        5.94       5.74       3.46       0.67      12.35      10.07        010
                                                       > 4 cm.
11719...............  ..............  R               Trim nail(s).........       0.17       0.25       0.07       0.01       0.43       0.25        000
11720...............  ..............  A               Debride nail, 1-5....       0.32       0.34       0.12       0.03       0.69       0.47        000
11721...............  ..............  A               Debride nail, 6 or          0.54       0.43       0.21       0.04       1.01       0.79        000
                                                       more.
11730...............  ..............  A               Removal of nail plate       1.13       1.03       0.43       0.09       2.25       1.65        000
11732...............  ..............  A               Remove nail plate,          0.57       0.44       0.22       0.05       1.06       0.84        ZZZ
                                                       add-on.
11740...............  ..............  A               Drain blood from            0.37       0.56       0.36       0.03       0.96       0.76        000
                                                       under nail.
11750...............  ..............  A               Removal of nail bed..       1.86       2.16       1.75       0.15       4.17       3.76        010
11752...............  ..............  A               Remove nail bed/            2.67       2.99       2.99       0.28       5.94       5.94        010
                                                       finger tip.
11755...............  ..............  A               Biopsy, nail unit....       1.31       1.57       0.77       0.11       2.99       2.19        000
11760...............  ..............  A               Repair of nail bed...       1.58       2.63       1.79       0.18       4.39       3.55        010
11762...............  ..............  A               Reconstruction of           2.89       2.88       2.34       0.27       6.04       5.50        010
                                                       nail bed.
11765...............  ..............  A               Excision of nail            0.69       1.78       0.76       0.06       2.53       1.51        010
                                                       fold, toe.
11770...............  ..............  A               Removal of pilonidal        2.61       3.50       1.50       0.32       6.43       4.43        010
                                                       lesion.
11771...............  ..............  A               Removal of pilonidal        5.73       5.66       3.31       0.72      12.11       9.76        090
                                                       lesion.
11772...............  ..............  A               Removal of pilonidal        6.97       7.54       5.08       0.88      15.39      12.93        090
                                                       lesion.
11900...............  ..............  A               Injection into skin         0.52       0.65       0.21       0.04       1.21       0.77        000
                                                       lesions.

[[Page 47583]]

 
11901...............  ..............  A               Added skin lesions          0.80       0.66       0.35       0.07       1.53       1.22        000
                                                       injection.
11920...............  ..............  R               Correct skin color          1.61       3.69       1.09       0.22       5.52       2.92        000
                                                       defects.
11921...............  ..............  R               Correct skin color          1.93       3.95       1.27       0.28       6.16       3.48        000
                                                       defects.
11922...............  ..............  R               Correct skin color          0.49       1.13       0.25       0.07       1.69       0.81        ZZZ
                                                       defects.
11950...............  ..............  R               Therapy for contour         0.84       1.14       0.39       0.09       2.07       1.32        000
                                                       defects.
11951...............  ..............  R               Therapy for contour         1.19       1.49       0.51       0.15       2.83       1.85        000
                                                       defects.
11952...............  ..............  R               Therapy for contour         1.69       1.85       0.68       0.24       3.78       2.61        000
                                                       defects.
11954...............  ..............  R               Therapy for contour         1.85       2.43       0.90       0.17       4.45       2.92        000
                                                       defects.
11960...............  ..............  A               Insert tissue               9.07         NA      10.37       1.23         NA      20.67        090
                                                       expander(s).
11970...............  ..............  A               Replace tissue              7.05         NA       6.12       1.04         NA      14.21        090
                                                       expander.
11971...............  ..............  A               Remove tissue               2.13       9.13       3.78       0.30      11.56       6.21        090
                                                       expander(s).
11976...............  ..............  R               Removal of                  1.78       1.73       0.68       0.20       3.71       2.66        000
                                                       contraceptive cap.
11980...............  ..............  A               Implant hormone             1.48       1.08       0.54       0.13       2.69       2.15        000
                                                       pellet(s).
11981...............  ..............  A               Insert drug implant         1.48       1.70       0.68       0.11       3.29       2.27        XXX
                                                       device.
11982...............  ..............  A               Remove drug implant         1.78       1.94       0.83       0.18       3.90       2.79        XXX
                                                       device.
11983...............  ..............  A               Remove/insert drug          3.30       2.28       1.46       0.24       5.82       5.00        XXX
                                                       implant.
12001...............  ..............  A               Repair superficial          1.70       2.00       0.78       0.15       3.85       2.63        010
                                                       wound(s).
12002...............  ..............  A               Repair superficial          1.86       2.06       0.91       0.17       4.09       2.94        010
                                                       wound(s).
12004...............  ..............  A               Repair superficial          2.24       2.35       1.02       0.21       4.80       3.47        010
                                                       wound(s).
12005...............  ..............  A               Repair superficial          2.86       2.85       1.21       0.27       5.98       4.34        010
                                                       wound(s).
12006...............  ..............  A               Repair superficial          3.66       3.42       1.52       0.37       7.45       5.55        010
                                                       wound(s).
12007...............  ..............  A               Repair superficial          4.11       3.86       1.82       0.44       8.41       6.37        010
                                                       wound(s).
12011...............  ..............  A               Repair superficial          1.76       2.15       0.79       0.16       4.07       2.71        010
                                                       wound(s).
12013...............  ..............  A               Repair superficial          1.99       2.30       0.95       0.18       4.47       3.12        010
                                                       wound(s).
12014...............  ..............  A               Repair superficial          2.46       2.59       1.07       0.22       5.27       3.75        010
                                                       wound(s).
12015...............  ..............  A               Repair superficial          3.19       3.16       1.26       0.29       6.64       4.74        010
                                                       wound(s).
12016...............  ..............  A               Repair superficial          3.92       3.59       1.53       0.37       7.88       5.82        010
                                                       wound(s).
12017...............  ..............  A               Repair superficial          4.70         NA       1.89       0.48         NA       7.07        010
                                                       wound(s).
12018...............  ..............  A               Repair superficial          5.52         NA       2.25       0.58         NA       8.35        010
                                                       wound(s).
12020...............  ..............  A               Closure of split            2.62       3.84       1.92       0.30       6.76       4.84        010
                                                       wound.
12021...............  ..............  A               Closure of split            1.84       1.83       1.42       0.23       3.90       3.49        010
                                                       wound.
12031...............  ..............  A               Layer closure of            2.15       2.28       0.96       0.22       4.65       3.33        010
                                                       wound(s).
12032...............  ..............  A               Layer closure of            2.47       3.85       1.81       0.24       6.56       4.52        010
                                                       wound(s).
12034...............  ..............  A               Layer closure of            2.92       3.20       1.46       0.31       6.43       4.69        010
                                                       wound(s).
12035...............  ..............  A               Layer closure of            3.42       5.22       2.16       0.39       9.03       5.97        010
                                                       wound(s).
12036...............  ..............  A               Layer closure of            4.04       5.59       2.55       0.52      10.15       7.11        010
                                                       wound(s).
12037...............  ..............  A               Layer closure of            4.66       6.13       2.96       0.61      11.40       8.23        010
                                                       wound(s).
12041...............  ..............  A               Layer closure of            2.37       2.54       1.13       0.24       5.15       3.74        010
                                                       wound(s).
12042...............  ..............  A               Layer closure of            2.74       3.27       1.47       0.26       6.27       4.47        010
                                                       wound(s).
12044...............  ..............  A               Layer closure of            3.14       3.23       1.61       0.32       6.69       5.07        010
                                                       wound(s).
12045...............  ..............  A               Layer closure of            3.63       5.30       2.28       0.41       9.34       6.32        010
                                                       wound(s).
12046...............  ..............  A               Layer closure of            4.24       6.55       2.75       0.49      11.28       7.48        010
                                                       wound(s).
12047...............  ..............  A               Layer closure of            4.64       6.39       3.08       0.57      11.60       8.29        010
                                                       wound(s).
12051...............  ..............  A               Layer closure of            2.47       3.27       1.45       0.25       5.99       4.17        010
                                                       wound(s).
12052...............  ..............  A               Layer closure of            2.77       3.22       1.44       0.26       6.25       4.47        010
                                                       wound(s).
12053...............  ..............  A               Layer closure of            3.12       3.24       1.54       0.30       6.66       4.96        010
                                                       wound(s).
12054...............  ..............  A               Layer closure of            3.45       3.56       1.64       0.34       7.35       5.43        010
                                                       wound(s).
12055...............  ..............  A               Layer closure of            4.42       4.49       2.12       0.46       9.37       7.00        010
                                                       wound(s).
12056...............  ..............  A               Layer closure of            5.23       6.76       3.05       0.53      12.52       8.81        010
                                                       wound(s).
12057...............  ..............  A               Layer closure of            5.95       6.16       3.75       0.64      12.75      10.34        010
                                                       wound(s).
13100...............  ..............  A               Repair of wound or          3.12       4.05       2.30       0.33       7.50       5.75        010
                                                       lesion.
13101...............  ..............  A               Repair of wound or          3.91       4.66       2.68       0.40       8.97       6.99        010
                                                       lesion.
13102...............  ..............  A               Repair wound/lesion         1.24       1.17       0.57       0.15       2.56       1.96        ZZZ
                                                       add-on.
13120...............  ..............  A               Repair of wound or          3.30       4.14       2.35       0.35       7.79       6.00        010
                                                       lesion.
13121...............  ..............  A               Repair of wound or          4.32       4.85       2.79       0.43       9.60       7.54        010
                                                       lesion.
13122...............  ..............  A               Repair wound/lesion         1.44       1.51       0.63       0.18       3.13       2.25        ZZZ
                                                       add-on.
13131...............  ..............  A               Repair of wound or          3.78       4.36       2.68       0.39       8.53       6.85        010
                                                       lesion.
13132...............  ..............  A               Repair of wound or          5.94       5.58       3.80       0.56      12.08      10.30        010
                                                       lesion.
13133...............  ..............  A               Repair wound/lesion         2.19       1.66       1.03       0.24       4.09       3.46        ZZZ
                                                       add-on.
13150...............  ..............  A               Repair of wound or          3.80       4.87       2.76       0.41       9.08       6.97        010
                                                       lesion.
13151...............  ..............  A               Repair of wound or          4.44       4.80       3.14       0.45       9.69       8.03        010
                                                       lesion.
13152...............  ..............  A               Repair of wound or          6.32       6.03       4.03       0.62      12.97      10.97        010
                                                       lesion.
13153...............  ..............  A               Repair wound/lesion         2.38       1.93       1.14       0.28       4.59       3.80        ZZZ
                                                       add-on.
13160...............  ..............  A               Late closure of wound      10.46         NA       7.15       1.48         NA      19.09        090
14000...............  ..............  A               Skin tissue                 5.88       7.82       5.43       0.70      14.40      12.01        090
                                                       rearrangement.
14001...............  ..............  A               Skin tissue                 8.46       9.39       7.03       1.00      18.85      16.49        090
                                                       rearrangement.
14020...............  ..............  A               Skin tissue                 6.58       8.58       6.48       0.77      15.93      13.83        090
                                                       rearrangement.
14021...............  ..............  A               Skin tissue                10.04       9.96       8.23       1.10      21.10      19.37        090
                                                       rearrangement.
14040...............  ..............  A               Skin tissue                 7.86       8.78       7.16       0.83      17.47      15.85        090
                                                       rearrangement.
14041...............  ..............  A               Skin tissue                11.47      10.58       8.64       1.13      23.18      21.24        090
                                                       rearrangement.
14060...............  ..............  A               Skin tissue                 8.49       8.78       7.41       0.88      18.15      16.78        090
                                                       rearrangement.
14061...............  ..............  A               Skin tissue                12.27      11.59       9.46       1.20      25.06      22.93        090
                                                       rearrangement.
14300...............  ..............  A               Skin tissue                11.74      11.11       9.13       1.40      24.25      22.27        090
                                                       rearrangement.
14350...............  ..............  A               Skin tissue                 9.60         NA       7.14       1.22         NA      17.96        090
                                                       rearrangement.
15000...............  ..............  A               Skin graft...........       3.99       3.79       2.18       0.47       8.25       6.64        000

[[Page 47584]]

 
15001...............  ..............  A               Skin graft add-on....       1.00       1.35       0.41       0.13       2.48       1.54        ZZZ
15050...............  ..............  A               Skin pinch graft.....       4.29       6.92       5.11       0.55      11.76       9.95        090
15100...............  ..............  A               Skin split graft.....       9.04      12.55       7.82       1.24      22.83      18.10        090
15101...............  ..............  A               Skin split graft add-       1.72       3.72       1.17       0.24       5.68       3.13        ZZZ
                                                       on.
15120...............  ..............  A               Skin split graft.....       9.82      10.72       7.79       1.19      21.73      18.80        090
15121...............  ..............  A               Skin split graft add-       2.67       4.49       1.84       0.36       7.52       4.87        ZZZ
                                                       on.
15200...............  ..............  A               Skin full graft......       8.02       9.41       6.19       1.02      18.45      15.23        090
15201...............  ..............  A               Skin full graft add-        1.32       2.56       0.62       0.18       4.06       2.12        ZZZ
                                                       on.
15220...............  ..............  A               Skin full graft......       7.86       9.18       6.67       0.97      18.01      15.50        090
15221...............  ..............  A               Skin full graft add-        1.19       2.31       0.56       0.17       3.67       1.92        ZZZ
                                                       on.
15240...............  ..............  A               Skin full graft......       9.03      10.20       7.94       1.08      20.31      18.05        090
15241...............  ..............  A               Skin full graft add-        1.86       2.44       0.91       0.24       4.54       3.01        ZZZ
                                                       on.
15260...............  ..............  A               Skin full graft......      10.04      10.21       8.57       0.97      21.22      19.58        090
15261...............  ..............  A               Skin full graft add-        2.23       2.68       1.40       0.26       5.17       3.89        ZZZ
                                                       on.
15342...............  ..............  A               Cultured skin graft,        1.00       1.86       0.55       0.10       2.96       1.65        010
                                                       25 cm.
15343...............  ..............  A               Culture skn graft           0.25       0.09       0.09       0.03       0.37       0.37        ZZZ
                                                       addl 25 cm.
15350...............  ..............  A               Skin homograft.......       3.99       6.44       3.84       0.48      10.91       8.31        090
15351...............  ..............  A               Skin homograft add-on       1.00       0.36       0.36       0.14       1.50       1.50        ZZZ
15400...............  ..............  A               Skin heterograft.....       3.99       4.01       4.01       0.39       8.39       8.39        090
15401...............  ..............  A               Skin heterograft add-       1.00       1.89       0.44       0.12       3.01       1.56        ZZZ
                                                       on.
15570...............  ..............  A               Form skin pedicle           9.20      11.30       6.75       1.30      21.80      17.25        090
                                                       flap.
15572...............  ..............  A               Form skin pedicle           9.26       9.49       6.44       1.29      20.04      16.99        090
                                                       flap.
15574...............  ..............  A               Form skin pedicle           9.87      10.67       7.77       1.22      21.76      18.86        090
                                                       flap.
15576...............  ..............  A               Form skin pedicle           8.68       9.75       6.87       0.95      19.38      16.50        090
                                                       flap.
15600...............  ..............  A               Skin graft...........       1.91       7.61       3.06       0.27       9.79       5.24        090
15610...............  ..............  A               Skin graft...........       2.42       4.74       3.42       0.33       7.49       6.17        090
15620...............  ..............  A               Skin graft...........       2.94       7.76       3.87       0.36      11.06       7.17        090
15630...............  ..............  A               Skin graft...........       3.27       7.03       4.14       0.38      10.68       7.79        090
15650...............  ..............  A               Transfer skin pedicle       3.96       7.14       4.20       0.49      11.59       8.65        090
                                                       flap.
15732...............  ..............  A               Muscle-skin graft,         17.81      18.03      12.20       1.98      37.82      31.99        090
                                                       head/neck.
15734...............  ..............  A               Muscle-skin graft,         17.76      18.12      12.36       2.52      38.40      32.64        090
                                                       trunk.
15736...............  ..............  A               Muscle-skin graft,         16.25      18.14      11.20       2.38      36.77      29.83        090
                                                       arm.
15738...............  ..............  A               Muscle-skin graft,         17.89      17.91      11.70       2.58      38.38      32.17        090
                                                       leg.
15740...............  ..............  A               Island pedicle flap        10.23      10.14       8.25       1.01      21.38      19.49        090
                                                       graft.
15750...............  ..............  A               Neurovascular pedicle      11.39         NA       9.02       1.51         NA      21.92        090
                                                       graft.
15756...............  ..............  A               Free myo/skin flap         35.18         NA      20.52       4.51         NA      60.21        090
                                                       microvasc.
15757...............  ..............  A               Free skin flap,            35.18         NA      21.55       4.05         NA      60.78        090
                                                       microvasc.
15758...............  ..............  A               Free fascial flap,         35.05         NA      21.53       3.91         NA      60.49        090
                                                       microvasc.
15760...............  ..............  A               Composite skin graft.       8.73      10.02       7.25       0.94      19.69      16.92        090
15770...............  ..............  A               Derma-fat-fascia            7.51         NA       6.67       1.01         NA      15.19        090
                                                       graft.
15775...............  ..............  R               Hair transplant punch       3.95       2.97       1.30       0.52       7.44       5.77        000
                                                       grafts.
15776...............  ..............  R               Hair transplant punch       5.53       5.33       2.80       0.72      11.58       9.05        000
                                                       grafts.
15780...............  ..............  A               Abrasion treatment of       7.28      11.57       8.24       0.75      19.60      16.27        090
                                                       skin.
15781...............  ..............  A               Abrasion treatment of       4.84       6.91       5.36       0.47      12.22      10.67        090
                                                       skin.
15782...............  ..............  A               Abrasion treatment of       4.31       9.92       6.56       0.35      14.58      11.22        090
                                                       skin.
15783...............  ..............  A               Abrasion treatment of       4.28       6.87       4.18       0.42      11.57       8.88        090
                                                       skin.
15786...............  ..............  A               Abrasion, lesion,           2.03       3.35       1.32       0.18       5.56       3.53        010
                                                       single.
15787...............  ..............  A               Abrasion, lesions,          0.33       1.10       0.16       0.03       1.46       0.52        ZZZ
                                                       add-on.
15788...............  ..............  R               Chemical peel, face,        2.09       6.72       3.08       0.19       9.00       5.36        090
                                                       epiderm.
15789...............  ..............  R               Chemical peel, face,        4.91       8.09       4.82       0.43      13.43      10.16        090
                                                       dermal.
15792...............  ..............  R               Chemical peel,              1.86       7.11       4.45       0.17       9.14       6.48        090
                                                       nonfacial.
15793...............  ..............  A               Chemical peel,              3.73       6.29       4.39       0.32      10.34       8.44        090
                                                       nonfacial.
15810...............  ..............  A               Salabrasion..........       4.73         NA       3.90       0.34         NA       8.97        090
15811...............  ..............  A               Salabrasion..........       5.38       5.47       4.76       0.80      11.65      10.94        090
15819...............  ..............  A               Plastic surgery, neck       9.37         NA       7.17       0.91         NA      17.45        090
15820...............  ..............  A               Revision of lower           5.14       6.93       5.52       0.48      12.55      11.14        090
                                                       eyelid.
15821...............  ..............  A               Revision of lower           5.71       7.32       5.68       0.46      13.49      11.85        090
                                                       eyelid.
15822...............  ..............  A               Revision of upper           4.44       5.82       4.47       0.39      10.65       9.30        090
                                                       eyelid.
15823...............  ..............  A               Revision of upper           7.04       7.84       6.40       0.50      15.38      13.94        090
                                                       eyelid.
15831...............  ..............  A               Excise excessive skin      12.38         NA       8.15       1.69         NA      22.22        090
                                                       tissue.
15832...............  ..............  A               Excise excessive skin      11.57         NA       8.33       1.63         NA      21.53        090
                                                       tissue.
15833...............  ..............  A               Excise excessive skin      10.62         NA       8.20       1.48         NA      20.30        090
                                                       tissue.
15834...............  ..............  A               Excise excessive skin      10.83         NA       7.68       1.60         NA      20.11        090
                                                       tissue.
15835...............  ..............  A               Excise excessive skin      11.65         NA       7.53       1.63         NA      20.81        090
                                                       tissue.
15836...............  ..............  A               Excise excessive skin       9.33         NA       6.77       1.31         NA      17.41        090
                                                       tissue.
15837...............  ..............  A               Excise excessive skin       8.42       8.63       7.36       1.19      18.24      16.97        090
                                                       tissue.
15838...............  ..............  A               Excise excessive skin       7.12         NA       6.05       0.63         NA      13.80        090
                                                       tissue.
15839...............  ..............  A               Excise excessive skin       9.37       8.87       6.39       1.15      19.39      16.91        090
                                                       tissue.
15840...............  ..............  A               Graft for face nerve       13.24         NA       9.96       1.39         NA      24.59        090
                                                       palsy.
15841...............  ..............  A               Graft for face nerve       23.23         NA      14.98       2.79         NA      41.00        090
                                                       palsy.
15842...............  ..............  A               Flap for face nerve        37.90         NA      22.88       2.91         NA      63.69        090
                                                       palsy.
15845...............  ..............  A               Skin and muscle            12.55         NA       9.29       0.86         NA      22.70        090
                                                       repair, face.
15850...............  ..............  B               Removal of sutures...       0.78       1.57       0.29       0.05       2.40       1.12        XXX
15851...............  ..............  A               Removal of sutures...       0.86       1.70       0.31       0.06       2.62       1.23        000
15852...............  ..............  A               Dressing change not         0.86       1.87       0.33       0.09       2.82       1.28        000
                                                       for burn.

[[Page 47585]]

 
15860...............  ..............  A               Test for blood flow         1.95       0.83       0.78       0.25       3.03       2.98        000
                                                       in graft.
15920...............  ..............  A               Removal of tail bone        7.94         NA       5.55       0.97         NA      14.46        090
                                                       ulcer.
15922...............  ..............  A               Removal of tail bone        9.89         NA       7.20       1.41         NA      18.50        090
                                                       ulcer.
15931...............  ..............  A               Remove sacrum               9.23         NA       5.68       1.23         NA      16.14        090
                                                       pressure sore.
15933...............  ..............  A               Remove sacrum              10.83         NA       7.84       1.48         NA      20.15        090
                                                       pressure sore.
15934...............  ..............  A               Remove sacrum              12.67         NA       8.03       1.76         NA      22.46        090
                                                       pressure sore.
15935...............  ..............  A               Remove sacrum              14.55         NA      10.31       2.06         NA      26.92        090
                                                       pressure sore.
15936...............  ..............  A               Remove sacrum              12.36         NA       8.21       1.74         NA      22.31        090
                                                       pressure sore.
15937...............  ..............  A               Remove sacrum              14.19         NA       9.80       2.01         NA      26.00        090
                                                       pressure sore.
15940...............  ..............  A               Remove hip pressure         9.33         NA       6.17       1.30         NA      16.80        090
                                                       sore.
15941...............  ..............  A               Remove hip pressure        11.41         NA       9.43       1.63         NA      22.47        090
                                                       sore.
15944...............  ..............  A               Remove hip pressure        11.44         NA       8.59       1.63         NA      21.66        090
                                                       sore.
15945...............  ..............  A               Remove hip pressure        12.67         NA       9.63       1.80         NA      24.10        090
                                                       sore.
15946...............  ..............  A               Remove hip pressure        21.54         NA      14.34       3.09         NA      38.97        090
                                                       sore.
15950...............  ..............  A               Remove thigh pressure       7.53         NA       5.41       1.02         NA      13.96        090
                                                       sore.
15951...............  ..............  A               Remove thigh pressure      10.70         NA       7.85       1.48         NA      20.03        090
                                                       sore.
15952...............  ..............  A               Remove thigh pressure      11.37         NA       7.74       1.58         NA      20.69        090
                                                       sore.
15953...............  ..............  A               Remove thigh pressure      12.61         NA       8.97       1.83         NA      23.41        090
                                                       sore.
15956...............  ..............  A               Remove thigh pressure      15.50         NA      10.75       2.18         NA      28.43        090
                                                       sore.
15958...............  ..............  A               Remove thigh pressure      15.46         NA      11.02       2.17         NA      28.65        090
                                                       sore.
16000...............  ..............  A               Initial treatment of        0.89       0.87       0.26       0.08       1.84       1.23        000
                                                       burn(s).
16010...............  ..............  A               Treatment of burn(s).       0.87       0.66       0.63       0.08       1.61       1.58        000
16015...............  ..............  A               Treatment of burn(s).       2.35         NA       1.15       0.30         NA       3.80        000
16020...............  ..............  A               Treatment of burn(s).       0.80       1.31       0.59       0.08       2.19       1.47        000
16025...............  ..............  A               Treatment of burn(s).       1.85       1.77       0.96       0.19       3.81       3.00        000
16030...............  ..............  A               Treatment of burn(s).       2.08       2.18       1.12       0.22       4.48       3.42        000
16035...............  ..............  A               Incision of burn            3.74         NA       1.58       0.42         NA       5.74        090
                                                       scab, initi.
16036...............  ..............  A               Escharotomy; add-l          1.50         NA       0.60       0.20         NA       2.30        ZZZ
                                                       incision.
17000...............  ..............  A               Destroy benign/premlg       0.60       0.97       0.55       0.05       1.62       1.20        010
                                                       lesion.
17003...............  ..............  A               Destroy lesions, 2-14       0.15       0.11       0.07       0.01       0.27       0.23        ZZZ
17004...............  ..............  A               Destroy lesions, 15         2.79       2.30       1.59       0.23       5.32       4.61        010
                                                       or more.
17106...............  ..............  A               Destruction of skin         4.58       4.58       3.33       0.44       9.60       8.35        090
                                                       lesions.
17107...............  ..............  A               Destruction of skin         9.15       7.17       5.43       0.87      17.19      15.45        090
                                                       lesions.
17108...............  ..............  A               Destruction of skin        13.18       9.25       7.64       1.33      23.76      22.15        090
                                                       lesions.
17110...............  ..............  A               Destruct lesion, 1-14       0.65       1.63       0.71       0.05       2.33       1.41        010
17111...............  ..............  A               Destruct lesion, 15         0.92       1.68       0.81       0.08       2.68       1.81        010
                                                       or more.
17250...............  ..............  A               Chemical cautery,           0.50       1.22       0.34       0.05       1.77       0.89        000
                                                       tissue.
17260...............  ..............  A               Destruction of skin         0.91       1.28       0.68       0.08       2.27       1.67        010
                                                       lesions.
17261...............  ..............  A               Destruction of skin         1.17       1.61       0.83       0.10       2.88       2.10        010
                                                       lesions.
17262...............  ..............  A               Destruction of skin         1.58       1.88       1.02       0.13       3.59       2.73        010
                                                       lesions.
17263...............  ..............  A               Destruction of skin         1.79       2.05       1.09       0.15       3.99       3.03        010
                                                       lesions.
17264...............  ..............  A               Destruction of skin         1.94       2.22       1.12       0.16       4.32       3.22        010
                                                       lesions.
17266...............  ..............  A               Destruction of skin         2.34       2.50       1.22       0.20       5.04       3.76        010
                                                       lesions.
17270...............  ..............  A               Destruction of skin         1.32       1.70       0.87       0.11       3.13       2.30        010
                                                       lesions.
17271...............  ..............  A               Destruction of skin         1.49       1.77       0.98       0.13       3.39       2.60        010
                                                       lesions.
17272...............  ..............  A               Destruction of skin         1.77       1.99       1.11       0.15       3.91       3.03        010
                                                       lesions.
17273...............  ..............  A               Destruction of skin         2.05       2.20       1.21       0.17       4.42       3.43        010
                                                       lesions.
17274...............  ..............  A               Destruction of skin         2.59       2.56       1.44       0.22       5.37       4.25        010
                                                       lesions.
17276...............  ..............  A               Destruction of skin         3.20       2.94       1.68       0.29       6.43       5.17        010
                                                       lesions.
17280...............  ..............  A               Destruction of skin         1.17       1.61       0.81       0.10       2.88       2.08        010
                                                       lesions.
17281...............  ..............  A               Destruction of skin         1.72       1.90       1.09       0.15       3.77       2.96        010
                                                       lesions.
17282...............  ..............  A               Destruction of skin         2.04       2.15       1.24       0.17       4.36       3.45        010
                                                       lesions.
17283...............  ..............  A               Destruction of skin         2.64       2.54       1.49       0.22       5.40       4.35        010
                                                       lesions.
17284...............  ..............  A               Destruction of skin         3.21       2.92       1.74       0.28       6.41       5.23        010
                                                       lesions.
17286...............  ..............  A               Destruction of skin         4.43       3.67       2.43       0.41       8.51       7.27        010
                                                       lesions.
17304...............  ..............  A               1 stage mohs, up to 5       7.59       8.22       3.55       0.64      16.45      11.78        000
                                                       spec.
17305...............  ..............  A               2 stage mohs, up to 5       2.85       3.88       1.34       0.24       6.97       4.43        000
                                                       spec.
17306...............  ..............  A               3 stage mohs, up to 5       2.85       3.90       1.35       0.24       6.99       4.44        000
                                                       spec.
17307...............  ..............  A               Mohs addl stage up to       2.85       2.63       1.36       0.24       5.72       4.45        000
                                                       5 spec.
17310...............  ..............  A               Mohs any stage > 5          0.95       1.62       0.46       0.09       2.66       1.50        ZZZ
                                                       spec each.
17340...............  ..............  A               Cryotherapy of skin..       0.76       0.37       0.36       0.06       1.19       1.18        010
17360...............  ..............  A               Skin peel therapy....       1.43       1.44       0.87       0.12       2.99       2.42        010
19000...............  ..............  A               Drainage of breast          0.84       1.98       0.31       0.08       2.90       1.23        000
                                                       lesion.
19001...............  ..............  A               Drain breast lesion         0.42       0.25       0.14       0.04       0.71       0.60        ZZZ
                                                       add-on.
19020...............  ..............  A               Incision of breast          3.56       6.36       2.68       0.45      10.37       6.69        090
                                                       lesion.
19030...............  ..............  A               Injection for breast        1.53       2.88       0.50       0.09       4.50       2.12        000
                                                       x-ray.
19100...............  ..............  A               Bx breast percut w/o        1.27       2.08       0.42       0.15       3.50       1.84        000
                                                       image.
19101...............  ..............  A               Biopsy of breast,           3.18       4.51       1.91       0.36       8.05       5.45        010
                                                       open.
19102...............  ..............  A               Bx breast percut w/         2.00       3.83       0.66       0.15       5.98       2.81        000
                                                       image.
19103...............  ..............  A               Bx breast percut w/         3.69      11.53       1.23       0.30      15.52       5.22        000
                                                       device.
19110...............  ..............  A               Nipple exploration...       4.29       5.82       2.87       0.56      10.67       7.72        090
19112...............  ..............  A               Excise breast duct          3.66       6.11       2.69       0.48      10.25       6.83        090
                                                       fistula.
19120...............  ..............  A               Removal of breast           5.55       4.55       3.06       0.72      10.82       9.33        090
                                                       lesion.
19125...............  ..............  A               Excision, breast            6.05       4.79       3.28       0.79      11.63      10.12        090
                                                       lesion.
19126...............  ..............  A               Excision, addl breast       2.93         NA       1.00       0.38         NA       4.31        ZZZ
                                                       lesion.

[[Page 47586]]

 
19140...............  ..............  A               Removal of breast           5.13       7.18       3.41       0.69      13.00       9.23        090
                                                       tissue.
19160...............  ..............  A               Removal of breast           5.98         NA       3.43       0.78         NA      10.19        090
                                                       tissue.
19162...............  ..............  A               Remove breast tissue,      13.51         NA       6.34       1.74         NA      21.59        090
                                                       nodes.
19180...............  ..............  A               Removal of breast....       8.79         NA       5.03       1.14         NA      14.96        090
19182...............  ..............  A               Removal of breast....       7.72         NA       4.77       1.03         NA      13.52        090
19200...............  ..............  A               Removal of breast....      15.47         NA       7.98       1.82         NA      25.27        090
19220...............  ..............  A               Removal of breast....      15.70         NA       8.25       1.97         NA      25.92        090
19240...............  ..............  A               Removal of breast....      15.98         NA       8.23       2.06         NA      26.27        090
19260...............  ..............  A               Removal of chest wall      15.42         NA      11.17       2.01         NA      28.60        090
                                                       lesion.
19271...............  ..............  A               Revision of chest          18.87         NA      17.99       2.51         NA      39.37        090
                                                       wall.
19272...............  ..............  A               Extensive chest wall       21.52         NA      18.97       3.01         NA      43.50        090
                                                       surgery.
19290...............  ..............  A               Place needle wire,          1.27       2.89       0.42       0.08       4.24       1.77        000
                                                       breast.
19291...............  ..............  A               Place needle wire,          0.63       1.22       0.21       0.04       1.89       0.88        ZZZ
                                                       breast.
19295...............  ..............  A               Place breast clip,          0.00       2.70         NA       0.01       2.71         NA        ZZZ
                                                       percut.
19316...............  ..............  A               Suspension of breast.      10.67         NA       7.52       1.60         NA      19.79        090
19318...............  ..............  A               Reduction of large         15.60         NA      11.12       2.79         NA      29.51        090
                                                       breast.
19324...............  ..............  A               Enlarge breast.......       5.84         NA       4.87       0.84         NA      11.55        090
19325...............  ..............  A               Enlarge breast with         8.44         NA       6.53       1.28         NA      16.25        090
                                                       implant.
19328...............  ..............  A               Removal of breast           5.67         NA       5.02       0.89         NA      11.58        090
                                                       implant.
19330...............  ..............  A               Removal of implant          7.58         NA       6.02       1.24         NA      14.84        090
                                                       material.
19340...............  ..............  A               Immediate breast            6.32         NA       3.10       1.03         NA      10.45        ZZZ
                                                       prosthesis.
19342...............  ..............  A               Delayed breast             11.18         NA       8.89       1.77         NA      21.84        090
                                                       prosthesis.
19350...............  ..............  A               Breast reconstruction       8.91      13.79       7.15       1.38      24.08      17.44        090
19355...............  ..............  A               Correct inverted            7.56      10.25       4.70       1.07      18.88      13.33        090
                                                       nipple(s).
19357...............  ..............  A               Breast reconstruction      18.13         NA      13.76       2.79         NA      34.68        090
19361...............  ..............  A               Breast reconstruction      19.23         NA      11.71       2.84         NA      33.78        090
19364...............  ..............  A               Breast reconstruction      40.94         NA      23.49       5.85         NA      70.28        090
19366...............  ..............  A               Breast reconstruction      21.25         NA      11.16       3.07         NA      35.48        090
19367...............  ..............  A               Breast reconstruction      25.69         NA      16.45       3.84         NA      45.98        090
19368...............  ..............  A               Breast reconstruction      32.37         NA      20.12       4.63         NA      57.12        090
19369...............  ..............  A               Breast reconstruction      29.78         NA      19.66       4.29         NA      53.73        090
19370...............  ..............  A               Surgery of breast           8.04         NA       6.87       1.27         NA      16.18        090
                                                       capsule.
19371...............  ..............  A               Removal of breast           9.34         NA       7.79       1.65         NA      18.78        090
                                                       capsule.
19380...............  ..............  A               Revise breast               9.13         NA       7.67       1.42         NA      18.22        090
                                                       reconstruction.
19396...............  ..............  A               Design custom breast        2.17       1.08       0.99       0.26       3.51       3.42        000
                                                       implant.
20000...............  ..............  A               Incision of abscess..       2.12       2.70       1.73       0.19       5.01       4.04        010
20005...............  ..............  A               Incision of deep            3.41       3.50       2.25       0.41       7.32       6.07        010
                                                       abscess.
20100...............  ..............  A               Explore wound, neck..      10.06         NA       4.46       1.19         NA      15.71        010
20101...............  ..............  A               Explore wound, chest.       3.22       5.94       1.62       0.41       9.57       5.25        010
20102...............  ..............  A               Explore wound,              3.93       7.50       1.91       0.50      11.93       6.34        010
                                                       abdomen.
20103...............  ..............  A               Explore wound,              5.29       8.60       3.39       0.70      14.59       9.38        010
                                                       extremity.
20150...............  ..............  A               Excise epiphyseal bar      13.67         NA       7.04       1.43         NA      22.14        090
20200...............  ..............  A               Muscle biopsy........       1.46       3.05       0.75       0.22       4.73       2.43        000
20205...............  ..............  A               Deep muscle biopsy...       2.35       4.07       1.19       0.31       6.73       3.85        000
20206...............  ..............  A               Needle biopsy, muscle       0.99       6.63       0.63       0.07       7.69       1.69        000
20220...............  ..............  A               Bone biopsy, trocar/        1.27       4.89       0.80       0.09       6.25       2.16        000
                                                       needle.
20225...............  ..............  A               Bone biopsy, trocar/        1.87      26.72       1.13       0.18      28.77       3.18        000
                                                       needle.
20240...............  ..............  A               Bone biopsy,                3.23         NA       2.56       0.41         NA       6.20        010
                                                       excisional.
20245...............  ..............  A               Bone biopsy,                7.77         NA       6.59       1.19         NA      15.55        010
                                                       excisional.
20250...............  ..............  A               Open bone biopsy.....       5.02         NA       3.50       0.91         NA       9.43        010
20251...............  ..............  A               Open bone biopsy.....       5.55         NA       4.15       1.05         NA      10.75        010
20500...............  ..............  A               Injection of sinus          1.23       2.27       1.53       0.10       3.60       2.86        010
                                                       tract.
20501...............  ..............  A               Inject sinus tract          0.76       2.98       0.25       0.05       3.79       1.06        000
                                                       for x-ray.
20520...............  ..............  A               Removal of foreign          1.85       2.93       1.77       0.20       4.98       3.82        010
                                                       body.
20525...............  ..............  A               Removal of foreign          3.49       9.14       2.62       0.47      13.10       6.58        010
                                                       body.
20526...............  ..............  A               Ther injection, carp        0.94       0.97       0.51       0.10       2.01       1.55        000
                                                       tunnel.
20550...............  ..............  A               Inj tendon sheath/          0.75       0.71       0.23       0.08       1.54       1.06        000
                                                       ligament.
20551...............  ..............  A               Inj tendon origin/          0.75       0.69       0.33       0.08       1.52       1.16        000
                                                       insertion.
20552...............  ..............  A               Inj trigger point, 1/       0.66       0.72       0.20       0.07       1.45       0.93        000
                                                       2 muscl.
20553...............  ..............  A               Inject trigger              0.75       0.82       0.22       0.05       1.62       1.02        000
                                                       points, =/> 3.
20600...............  ..............  A               Drain/inject, joint/        0.66       0.65       0.35       0.06       1.37       1.07        000
                                                       bursa.
20605...............  ..............  A               Drain/inject, joint/        0.68       0.76       0.36       0.07       1.51       1.11        000
                                                       bursa.
20610...............  ..............  A               Drain/inject, joint/        0.79       0.95       0.42       0.10       1.84       1.31        000
                                                       bursa.
20612...............  ..............  A               Aspirate/inj ganglion       0.70       0.71       0.36       0.07       1.48       1.13        000
                                                       cyst.
20615...............  ..............  A               Treatment of bone           2.28       3.53       1.84       0.19       6.00       4.31        010
                                                       cyst.
20650...............  ..............  A               Insert and remove           2.23       2.36       1.55       0.25       4.84       4.03        010
                                                       bone pin.
20660...............  ..............  A               Apply, rem fixation         2.51       3.05       1.61       0.54       6.10       4.66        000
                                                       device.
20661...............  ..............  A               Application of head         4.88         NA       5.06       1.11         NA      11.05        090
                                                       brace.
20662...............  ..............  A               Application of pelvis       6.06         NA       5.58       0.53         NA      12.17        090
                                                       brace.
20663...............  ..............  A               Application of thigh        5.42         NA       4.89       0.33         NA      10.64        090
                                                       brace.
20664...............  ..............  A               Halo brace                  8.05         NA       7.15       1.68         NA      16.88        090
                                                       application.
20665...............  ..............  A               Removal of fixation         1.31       2.21       1.35       0.19       3.71       2.85        010
                                                       device.
20670...............  ..............  A               Removal of support          1.74      11.52       2.09       0.26      13.52       4.09        010
                                                       implant.
20680...............  ..............  A               Removal of support          3.34       8.77       3.71       0.52      12.63       7.57        090
                                                       implant.
20690...............  ..............  A               Apply bone fixation         3.51         NA       2.54       0.58         NA       6.63        090
                                                       device.

[[Page 47587]]

 
20692...............  ..............  A               Apply bone fixation         6.40         NA       3.77       0.99         NA      11.16        090
                                                       device.
20693...............  ..............  A               Adjust bone fixation        5.85         NA       5.73       0.98         NA      12.56        090
                                                       device.
20694...............  ..............  A               Remove bone fixation        4.15       7.13       4.04       0.69      11.97       8.88        090
                                                       device.
20802...............  ..............  A               Replantation, arm,         41.09         NA      21.49       4.51         NA      67.09        090
                                                       complete.
20805...............  ..............  A               Replant forearm,           49.93         NA      35.25       4.64         NA      89.82        090
                                                       complete.
20808...............  ..............  A               Replantation hand,         61.56         NA      43.10       5.37         NA     110.03        090
                                                       complete.
20816...............  ..............  A               Replantation digit,        30.89         NA      38.46       4.37         NA      73.72        090
                                                       complete.
20822...............  ..............  A               Replantation digit,        25.55         NA      35.14       3.46         NA      64.15        090
                                                       complete.
20824...............  ..............  A               Replantation thumb,        30.89         NA      37.30       4.15         NA      72.34        090
                                                       complete.
20827...............  ..............  A               Replantation thumb,        26.37         NA      37.15       3.73         NA      67.25        090
                                                       complete.
20838...............  ..............  A               Replantation foot,         41.35         NA      22.78      10.71         NA      74.84        090
                                                       complete.
20900...............  ..............  A               Removal of bone for         5.57       8.44       5.66       0.85      14.86      12.08        090
                                                       graft.
20902...............  ..............  A               Removal of bone for         7.54         NA       7.06       1.21         NA      15.81        090
                                                       graft.
20910...............  ..............  A               Remove cartilage for        5.33         NA       5.26       0.66         NA      11.25        090
                                                       graft.
20912...............  ..............  A               Remove cartilage for        6.34         NA       6.15       0.70         NA      13.19        090
                                                       graft.
20920...............  ..............  A               Removal of fascia for       5.30         NA       4.40       0.58         NA      10.28        090
                                                       graft.
20922...............  ..............  A               Removal of fascia for       6.60       7.54       4.87       0.68      14.82      12.15        090
                                                       graft.
20924...............  ..............  A               Removal of tendon for       6.47         NA       6.06       0.97         NA      13.50        090
                                                       graft.
20926...............  ..............  A               Removal of tissue for       5.52         NA       4.99       0.81         NA      11.32        090
                                                       graft.
20931...............  ..............  A               Spinal bone allograft       1.81         NA       0.93       0.42         NA       3.16        ZZZ
20937...............  ..............  A               Spinal bone autograft       2.79         NA       1.45       0.49         NA       4.73        ZZZ
20938...............  ..............  A               Spinal bone autograft       3.02         NA       1.55       0.57         NA       5.14        ZZZ
20950...............  ..............  A               Fluid pressure,             1.26       6.83       0.99       0.19       8.28       2.44        000
                                                       muscle.
20955...............  ..............  A               Fibula bone graft,         39.15         NA      25.19       4.72         NA      69.06        090
                                                       microvasc.
20956...............  ..............  A               Iliac bone graft,          39.21         NA      25.05       7.16         NA      71.42        090
                                                       microvasc.
20957...............  ..............  A               Mt bone graft,             40.59         NA      19.21       4.32         NA      64.12        090
                                                       microvasc.
20962...............  ..............  A               Other bone graft,          39.21         NA      26.71       6.19         NA      72.11        090
                                                       microvasc.
20969...............  ..............  A               Bone/skin graft,           43.85         NA      27.63       4.68         NA      76.16        090
                                                       microvasc.
20970...............  ..............  A               Bone/skin graft,           43.00         NA      25.97       6.77         NA      75.74        090
                                                       iliac crest.
20972...............  ..............  A               Bone/skin graft,           42.93         NA      20.56       3.44         NA      66.93        090
                                                       metatarsal.
20973...............  ..............  A               Bone/skin graft,           45.69         NA      25.46       5.61         NA      76.76        090
                                                       great toe.
20974...............  ..............  A               Electrical bone             0.62       0.69       0.54       0.10       1.41       1.26        000
                                                       stimulation.
20975...............  ..............  A               Electrical bone             2.60         NA       1.71       0.46         NA       4.77        000
                                                       stimulation.
20979...............  ..............  A               Us bone stimulation..       0.62       0.80       0.33       0.09       1.51       1.04        000
20982...............  ..............  A               Ablate, bone tumor(s)       7.27     109.89       2.97       0.69     117.85      10.93        000
                                                       perq.
21010...............  ..............  A               Incision of jaw joint      10.12         NA       7.14       1.02         NA      18.28        090
21015...............  ..............  A               Resection of facial         5.28         NA       5.43       0.70         NA      11.41        090
                                                       tumor.
21025...............  ..............  A               Excision of bone,          10.04      12.22       9.35       1.30      23.56      20.69        090
                                                       lower jaw.
21026...............  ..............  A               Excision of facial          4.84       7.85       6.31       0.63      13.32      11.78        090
                                                       bone(s).
21029...............  ..............  A               Contour of face bone        7.70       9.34       6.99       0.90      17.94      15.59        090
                                                       lesion.
21030...............  ..............  A               Excise max/zygoma b9        4.49       6.32       5.03       0.86      11.67      10.38        090
                                                       tumor.
21031...............  ..............  A               Remove exostosis,           3.24       5.16       3.62       0.47       8.87       7.33        090
                                                       mandible.
21032...............  ..............  A               Remove exostosis,           3.24       5.34       3.51       0.46       9.04       7.21        090
                                                       maxilla.
21034...............  ..............  A               Excise max/zygoma mlg      16.15      15.88      12.63       1.74      33.77      30.52        090
                                                       tumor.
21040...............  ..............  A               Excise mandible             4.49       6.38       4.72       0.57      11.44       9.78        090
                                                       lesion.
21044...............  ..............  A               Removal of jaw bone        11.84         NA       9.37       1.10         NA      22.31        090
                                                       lesion.
21045...............  ..............  A               Extensive jaw surgery      16.15         NA      12.34       1.57         NA      30.06        090
21046...............  ..............  A               Remove mandible cyst       12.98         NA      11.86       0.88         NA      25.72        090
                                                       complex.
21047...............  ..............  A               Excise lwr jaw cyst w/     18.72         NA      13.42       0.88         NA      33.02        090
                                                       repair.
21048...............  ..............  A               Remove maxilla cyst        13.48         NA      12.08       0.88         NA      26.44        090
                                                       complex.
21049...............  ..............  A               Excis uppr jaw cyst w/     17.97         NA      13.00       0.88         NA      31.85        090
                                                       repair.
21050...............  ..............  A               Removal of jaw joint.      10.75         NA       9.43       1.36         NA      21.54        090
21060...............  ..............  A               Remove jaw joint           10.21         NA       8.60       1.51         NA      20.32        090
                                                       cartilage.
21070...............  ..............  A               Remove coronoid             8.19         NA       7.10       1.16         NA      16.45        090
                                                       process.
21076...............  ..............  A               Prepare face/oral          13.40      12.34       9.99       1.91      27.65      25.30        010
                                                       prosthesis.
21077...............  ..............  A               Prepare face/oral          33.70      31.27      25.96       5.03      70.00      64.69        090
                                                       prosthesis.
21079...............  ..............  A               Prepare face/oral          22.31      21.46      17.12       3.09      46.86      42.52        090
                                                       prosthesis.
21080...............  ..............  A               Prepare face/oral          25.06      24.45      19.33       3.68      53.19      48.07        090
                                                       prosthesis.
21081...............  ..............  A               Prepare face/oral          22.85      22.26      17.45       3.10      48.21      43.40        090
                                                       prosthesis.
21082...............  ..............  A               Prepare face/oral          20.84      19.30      15.69       2.95      43.09      39.48        090
                                                       prosthesis.
21083...............  ..............  A               Prepare face/oral          19.27      18.76      14.41       2.55      40.58      36.23        090
                                                       prosthesis.
21084...............  ..............  A               Prepare face/oral          22.48      22.40      17.67       2.28      47.16      42.43        090
                                                       prosthesis.
21085...............  ..............  A               Prepare face/oral           8.99       8.27       6.77       1.17      18.43      16.93        010
                                                       prosthesis.
21086...............  ..............  A               Prepare face/oral          24.88      23.73      19.39       3.19      51.80      47.46        090
                                                       prosthesis.
21087...............  ..............  A               Prepare face/oral          24.88      23.23      19.14       3.58      51.69      47.60        090
                                                       prosthesis.
21100...............  ..............  A               Maxillofacial               4.21      11.59       4.76       0.35      16.15       9.32        090
                                                       fixation.
21110...............  ..............  A               Interdental fixation.       5.20       9.57       8.35       0.62      15.39      14.17        090
21116...............  ..............  A               Injection, jaw joint        0.81       4.36       0.33       0.06       5.23       1.20        000
                                                       x-ray.
21120...............  ..............  A               Reconstruction of           4.92      10.62       7.48       0.49      16.03      12.89        090
                                                       chin.
21121...............  ..............  A               Reconstruction of           7.63       9.73       7.81       0.93      18.29      16.37        090
                                                       chin.
21122...............  ..............  A               Reconstruction of           8.51         NA       8.62       0.98         NA      18.11        090
                                                       chin.
21123...............  ..............  A               Reconstruction of          11.14         NA      10.78       0.91         NA      22.83        090
                                                       chin.
21125...............  ..............  A               Augmentation, lower        10.60      55.70       8.31       0.76      67.06      19.67        090
                                                       jaw bone.
21127...............  ..............  A               Augmentation, lower        11.10      42.76       9.44       1.66      55.52      22.20        090
                                                       jaw bone.
21137...............  ..............  A               Reduction of forehead       9.81         NA       7.71       1.13         NA      18.65        090

[[Page 47588]]

 
21138...............  ..............  A               Reduction of forehead      12.17         NA       9.50       0.61         NA      22.28        090
21139...............  ..............  A               Reduction of forehead      14.59         NA      11.04       1.68         NA      27.31        090
21141...............  ..............  A               Reconstruct midface,       18.07         NA      13.75       2.41         NA      34.23        090
                                                       lefort.
21142...............  ..............  A               Reconstruct midface,       18.78         NA      12.94       2.26         NA      33.98        090
                                                       lefort.
21143...............  ..............  A               Reconstruct midface,       19.55         NA      14.30       1.09         NA      34.94        090
                                                       lefort.
21145...............  ..............  A               Reconstruct midface,       19.91         NA      14.02       2.58         NA      36.51        090
                                                       lefort.
21146...............  ..............  A               Reconstruct midface,       20.68         NA      15.44       3.09         NA      39.21        090
                                                       lefort.
21147...............  ..............  A               Reconstruct midface,       21.74         NA      15.13       1.83         NA      38.70        090
                                                       lefort.
21150...............  ..............  A               Reconstruct midface,       25.20         NA      16.75       3.04         NA      44.99        090
                                                       lefort.
21151...............  ..............  A               Reconstruct midface,       28.26         NA      22.88       4.22         NA      55.36        090
                                                       lefort.
21154...............  ..............  A               Reconstruct midface,       30.47         NA      23.07       4.55         NA      58.09        090
                                                       lefort.
21155...............  ..............  A               Reconstruct midface,       34.40         NA      23.85       6.61         NA      64.86        090
                                                       lefort.
21159...............  ..............  A               Reconstruct midface,       42.32         NA      29.02       6.31         NA      77.65        090
                                                       lefort.
21160...............  ..............  A               Reconstruct midface,       46.37         NA      27.46       4.91         NA      78.74        090
                                                       lefort.
21172...............  ..............  A               Reconstruct orbit/         27.76         NA      14.01       2.83         NA      44.60        090
                                                       forehead.
21175...............  ..............  A               Reconstruct orbit/         33.12         NA      18.18       3.43         NA      54.73        090
                                                       forehead.
21179...............  ..............  A               Reconstruct entire         22.22         NA      14.72       3.24         NA      40.18        090
                                                       forehead.
21180...............  ..............  A               Reconstruct entire         25.15         NA      15.92       3.08         NA      44.15        090
                                                       forehead.
21181...............  ..............  A               Contour cranial bone        9.89         NA       7.78       1.37         NA      19.04        090
                                                       lesion.
21182...............  ..............  A               Reconstruct cranial        32.14         NA      19.47       3.42         NA      55.03        090
                                                       bone.
21183...............  ..............  A               Reconstruct cranial        35.26         NA      21.18       3.51         NA      59.95        090
                                                       bone.
21184...............  ..............  A               Reconstruct cranial        38.18         NA      22.37       6.84         NA      67.39        090
                                                       bone.
21188...............  ..............  A               Reconstruction of          22.43         NA      18.83       2.97         NA      44.23        090
                                                       midface.
21193...............  ..............  A               Reconst lwr jaw w/o        17.12         NA      12.84       2.10         NA      32.06        090
                                                       graft.
21194...............  ..............  A               Reconst lwr jaw w/         19.81         NA      13.91       2.11         NA      35.83        090
                                                       graft.
21195...............  ..............  A               Reconst lwr jaw w/o        17.21         NA      14.79       1.22         NA      33.22        090
                                                       fixation.
21196...............  ..............  A               Reconst lwr jaw w/         18.88         NA      15.66       2.03         NA      36.57        090
                                                       fixation.
21198...............  ..............  A               Reconstr lwr jaw           14.14         NA      12.69       1.41         NA      28.24        090
                                                       segment.
21199...............  ..............  A               Reconstr lwr jaw w/        15.98         NA       9.15       1.39         NA      26.52        090
                                                       advance.
21206...............  ..............  A               Reconstruct upper jaw      14.08         NA      12.62       1.78         NA      28.48        090
                                                       bone.
21208...............  ..............  A               Augmentation of            10.21      22.32       9.56       1.11      33.64      20.88        090
                                                       facial bones.
21209...............  ..............  A               Reduction of facial         6.71      10.78       8.06       0.90      18.39      15.67        090
                                                       bones.
21210...............  ..............  A               Face bone graft......      10.21      24.84       9.33       1.37      36.42      20.91        090
21215...............  ..............  A               Lower jaw bone graft.      10.75      41.85       9.35       1.51      54.11      21.61        090
21230...............  ..............  A               Rib cartilage graft..      10.75         NA       8.46       1.20         NA      20.41        090
21235...............  ..............  A               Ear cartilage graft..       6.71       9.83       6.40       0.68      17.22      13.79        090
21240...............  ..............  A               Reconstruction of jaw      14.03         NA      12.17       2.28         NA      28.48        090
                                                       joint.
21242...............  ..............  A               Reconstruction of jaw      12.93         NA      11.66       2.29         NA      26.88        090
                                                       joint.
21243...............  ..............  A               Reconstruction of jaw      20.76         NA      17.37       3.05         NA      41.18        090
                                                       joint.
21244...............  ..............  A               Reconstruction of          11.84         NA      12.07       1.24         NA      25.15        090
                                                       lower jaw.
21245...............  ..............  A               Reconstruction of jaw      11.84      14.35       9.83       1.12      27.31      22.79        090
21246...............  ..............  A               Reconstruction of jaw      12.45         NA       9.03       1.24         NA      22.72        090
21247...............  ..............  A               Reconstruct lower jaw      22.60         NA      17.43       3.23         NA      43.26        090
                                                       bone.
21248...............  ..............  A               Reconstruction of jaw      11.46      12.11       9.38       1.67      25.24      22.51        090
21249...............  ..............  A               Reconstruction of jaw      17.49      16.70      12.67       2.02      36.21      32.18        090
21255...............  ..............  A               Reconstruct lower jaw      16.69         NA      16.15       2.57         NA      35.41        090
                                                       bone.
21256...............  ..............  A               Reconstruction of          16.17         NA      12.03       1.36         NA      29.56        090
                                                       orbit.
21260...............  ..............  A               Revise eye sockets...      16.50         NA      12.75       0.98         NA      30.23        090
21261...............  ..............  A               Revise eye sockets...      31.44         NA      24.21       3.09         NA      58.74        090
21263...............  ..............  A               Revise eye sockets...      28.38         NA      19.17       2.61         NA      50.16        090
21267...............  ..............  A               Revise eye sockets...      18.87         NA      19.72       1.64         NA      40.23        090
21268...............  ..............  A               Revise eye sockets...      24.44         NA      20.22       2.43         NA      47.09        090
21270...............  ..............  A               Augmentation, cheek        10.21      11.66       7.24       1.04      22.91      18.49        090
                                                       bone.
21275...............  ..............  A               Revision,                  11.22         NA       8.63       1.29         NA      21.14        090
                                                       orbitofacial bones.
21280...............  ..............  A               Revision of eyelid...       6.02         NA       5.95       0.46         NA      12.43        090
21282...............  ..............  A               Revision of eyelid...       3.48         NA       4.58       0.27         NA       8.33        090
21295...............  ..............  A               Revision of jaw             1.53         NA       2.54       0.15         NA       4.22        090
                                                       muscle/bone.
21296...............  ..............  A               Revision of jaw             4.24         NA       4.90       0.35         NA       9.49        090
                                                       muscle/bone.
21300...............  ..............  A               Treatment of skull          0.72       2.39       0.26       0.11       3.22       1.09        000
                                                       fracture.
21310...............  ..............  A               Treatment of nose           0.58       2.30       0.15       0.05       2.93       0.78        000
                                                       fracture.
21315...............  ..............  A               Treatment of nose           1.51       4.23       1.88       0.14       5.88       3.53        010
                                                       fracture.
21320...............  ..............  A               Treatment of nose           1.85       3.91       1.62       0.18       5.94       3.65        010
                                                       fracture.
21325...............  ..............  A               Treatment of nose           3.76         NA       8.61       0.34         NA      12.71        090
                                                       fracture.
21330...............  ..............  A               Treatment of nose           5.37         NA       9.64       0.61         NA      15.62        090
                                                       fracture.
21335...............  ..............  A               Treatment of nose           8.60         NA       9.60       0.75         NA      18.95        090
                                                       fracture.
21336...............  ..............  A               Treat nasal septal          5.71         NA       9.57       0.56         NA      15.84        090
                                                       fracture.
21337...............  ..............  A               Treat nasal septal          2.70       6.49       3.56       0.27       9.46       6.53        090
                                                       fracture.
21338...............  ..............  A               Treat nasoethmoid           6.45         NA      13.90       0.75         NA      21.10        090
                                                       fracture.
21339...............  ..............  A               Treat nasoethmoid           8.08         NA      13.77       0.92         NA      22.77        090
                                                       fracture.
21340...............  ..............  A               Treatment of nose          10.75         NA       8.59       0.97         NA      20.31        090
                                                       fracture.
21343...............  ..............  A               Treatment of sinus         12.93         NA      15.39       1.67         NA      29.99        090
                                                       fracture.
21344...............  ..............  A               Treatment of sinus         19.69         NA      16.42       2.45         NA      38.56        090
                                                       fracture.
21345...............  ..............  A               Treat nose/jaw              8.15       9.84       7.16       1.11      19.10      16.42        090
                                                       fracture.
21346...............  ..............  A               Treat nose/jaw             10.59         NA      12.18       1.22         NA      23.99        090
                                                       fracture.
21347...............  ..............  A               Treat nose/jaw             12.67         NA      16.03       1.57         NA      30.27        090
                                                       fracture.

[[Page 47589]]

 
21348...............  ..............  A               Treat nose/jaw             16.66         NA      11.21       1.62         NA      29.49        090
                                                       fracture.
21355...............  ..............  A               Treat cheek bone            3.76       6.24       3.49       0.28      10.28       7.53        010
                                                       fracture.
21356...............  ..............  A               Treat cheek bone            4.14       7.10       4.53       0.47      11.71       9.14        010
                                                       fracture.
21360...............  ..............  A               Treat cheek bone            6.45         NA       5.92       0.71         NA      13.08        090
                                                       fracture.
21365...............  ..............  A               Treat cheek bone           14.93         NA      10.79       1.72         NA      27.44        090
                                                       fracture.
21366...............  ..............  A               Treat cheek bone           17.74         NA      11.52       1.90         NA      31.16        090
                                                       fracture.
21385...............  ..............  A               Treat eye socket            9.15         NA       8.27       0.83         NA      18.25        090
                                                       fracture.
21386...............  ..............  A               Treat eye socket            9.15         NA       7.06       1.04         NA      17.25        090
                                                       fracture.
21387...............  ..............  A               Treat eye socket            9.69         NA       8.93       0.96         NA      19.58        090
                                                       fracture.
21390...............  ..............  A               Treat eye socket           10.11         NA       7.91       0.92         NA      18.94        090
                                                       fracture.
21395...............  ..............  A               Treat eye socket           12.66         NA       9.21       1.60         NA      23.47        090
                                                       fracture.
21400...............  ..............  A               Treat eye socket            1.40       2.64       1.90       0.14       4.18       3.44        090
                                                       fracture.
21401...............  ..............  A               Treat eye socket            3.26       8.05       3.49       0.27      11.58       7.02        090
                                                       fracture.
21406...............  ..............  A               Treat eye socket            7.00         NA       6.26       0.82         NA      14.08        090
                                                       fracture.
21407...............  ..............  A               Treat eye socket            8.60         NA       7.05       0.94         NA      16.59        090
                                                       fracture.
21408...............  ..............  A               Treat eye socket           12.36         NA       9.10       1.39         NA      22.85        090
                                                       fracture.
21421...............  ..............  A               Treat mouth roof            5.13       9.33       8.31       0.61      15.07      14.05        090
                                                       fracture.
21422...............  ..............  A               Treat mouth roof            8.31         NA       8.06       0.97         NA      17.34        090
                                                       fracture.
21423...............  ..............  A               Treat mouth roof           10.38         NA       9.30       1.20         NA      20.88        090
                                                       fracture.
21431...............  ..............  A               Treat craniofacial          7.04         NA       9.51       1.05         NA      17.60        090
                                                       fracture.
21432...............  ..............  A               Treat craniofacial          8.60         NA       8.05       0.87         NA      17.52        090
                                                       fracture.
21433...............  ..............  A               Treat craniofacial         25.31         NA      16.66       3.07         NA      45.04        090
                                                       fracture.
21435...............  ..............  A               Treat craniofacial         17.22         NA      12.82       2.81         NA      32.85        090
                                                       fracture.
21436...............  ..............  A               Treat craniofacial         28.00         NA      18.25       3.23         NA      49.48        090
                                                       fracture.
21440...............  ..............  A               Treat dental ridge          2.70       7.10       6.16       0.35      10.15       9.21        090
                                                       fracture.
21445...............  ..............  A               Treat dental ridge          5.37       9.73       8.36       0.68      15.78      14.41        090
                                                       fracture.
21450...............  ..............  A               Treat lower jaw             2.97       7.38       6.92       0.37      10.72      10.26        090
                                                       fracture.
21451...............  ..............  A               Treat lower jaw             4.86       9.34       8.40       0.65      14.85      13.91        090
                                                       fracture.
21452...............  ..............  A               Treat lower jaw             1.98      13.11       4.61       0.20      15.29       6.79        090
                                                       fracture.
21453...............  ..............  A               Treat lower jaw             5.53      10.73      10.71       0.71      16.97      16.95        090
                                                       fracture.
21454...............  ..............  A               Treat lower jaw             6.45         NA       6.50       0.76         NA      13.71        090
                                                       fracture.
21461...............  ..............  A               Treat lower jaw             8.08      24.43      12.64       0.95      33.46      21.67        090
                                                       fracture.
21462...............  ..............  A               Treat lower jaw             9.78      27.59      12.69       0.94      38.31      23.41        090
                                                       fracture.
21465...............  ..............  A               Treat lower jaw            11.89         NA       9.99       1.63         NA      23.51        090
                                                       fracture.
21470...............  ..............  A               Treat lower jaw            15.32         NA      12.18       1.97         NA      29.47        090
                                                       fracture.
21480...............  ..............  A               Reset dislocated jaw.       0.61       1.77       0.19       0.06       2.44       0.86        000
21485...............  ..............  A               Reset dislocated jaw.       3.98       8.22       7.67       0.49      12.69      12.14        090
21490...............  ..............  A               Repair dislocated jaw      11.84         NA       9.84       1.79         NA      23.47        090
21493...............  ..............  A               Treat hyoid bone            1.27         NA       0.55       0.07         NA       1.89        090
                                                       fracture.
21494...............  ..............  A               Treat hyoid bone            6.27         NA       3.53       0.53         NA      10.33        090
                                                       fracture.
21495...............  ..............  A               Treat hyoid bone            5.68         NA       8.41       0.46         NA      14.55        090
                                                       fracture.
21497...............  ..............  A               Interdental wiring...       3.85       8.44       7.63       0.44      12.73      11.92        090
21501...............  ..............  A               Drain neck/chest            3.80       6.47       3.83       0.45      10.72       8.08        090
                                                       lesion.
21502...............  ..............  A               Drain chest lesion...       7.11         NA       5.67       0.93         NA      13.71        090
21510...............  ..............  A               Drainage of bone            5.73         NA       5.70       0.79         NA      12.22        090
                                                       lesion.
21550...............  ..............  A               Biopsy of neck/chest.       2.06       3.59       1.72       0.19       5.84       3.97        010
21555...............  ..............  A               Remove lesion, neck/        4.34       5.53       3.20       0.54      10.41       8.08        090
                                                       chest.
21556...............  ..............  A               Remove lesion, neck/        5.56         NA       4.08       0.66         NA      10.30        090
                                                       chest.
21557...............  ..............  A               Remove tumor, neck/         8.87         NA       5.41       1.09         NA      15.37        090
                                                       chest.
21600...............  ..............  A               Partial removal of          6.88         NA       5.77       0.95         NA      13.60        090
                                                       rib.
21610...............  ..............  A               Partial removal of         14.59         NA       9.11       2.49         NA      26.19        090
                                                       rib.
21615...............  ..............  A               Removal of rib.......       9.86         NA       6.70       1.39         NA      17.95        090
21616...............  ..............  A               Removal of rib and         12.02         NA       8.04       1.72         NA      21.78        090
                                                       nerves.
21620...............  ..............  A               Partial removal of          6.78         NA       6.03       0.93         NA      13.74        090
                                                       sternum.
21627...............  ..............  A               Sternal debridement..       6.80         NA       6.43       0.95         NA      14.18        090
21630...............  ..............  A               Extensive sternum          17.35         NA      11.89       2.45         NA      31.69        090
                                                       surgery.
21632...............  ..............  A               Extensive sternum          18.11         NA      11.13       2.45         NA      31.69        090
                                                       surgery.
21685...............  ..............  A               Hyoid myotomy &            12.98         NA       9.96       1.05         NA      23.99        090
                                                       suspension.
21700...............  ..............  A               Revision of neck            6.18         NA       4.44       0.72         NA      11.34        090
                                                       muscle.
21705...............  ..............  A               Revision of neck            9.59         NA       5.60       1.21         NA      16.40        090
                                                       muscle/rib.
21720...............  ..............  A               Revision of neck            5.67       2.45       2.45       0.86       8.98       8.98        090
                                                       muscle.
21725...............  ..............  A               Revision of neck            6.98         NA       5.63       0.78         NA      13.39        090
                                                       muscle.
21740...............  ..............  A               Reconstruction of          16.48         NA       8.56       2.06         NA      27.10        090
                                                       sternum.
21750...............  ..............  A               Repair of sternum          10.75         NA       6.11       1.44         NA      18.30        090
                                                       separation.
21800...............  ..............  A               Treatment of rib            0.96         NA       1.37       0.09         NA       2.42        090
                                                       fracture.
21805...............  ..............  A               Treatment of rib            2.75         NA       3.38       0.35         NA       6.48        090
                                                       fracture.
21810...............  ..............  A               Treatment of rib            6.85         NA       5.01       0.93         NA      12.79        090
                                                       fracture(s).
21820...............  ..............  A               Treat sternum               1.28       1.84       1.79       0.15       3.27       3.22        090
                                                       fracture.
21825...............  ..............  A               Treat sternum               7.40         NA       6.68       0.99         NA      15.07        090
                                                       fracture.
21920...............  ..............  A               Biopsy soft tissue of       2.06       3.29       1.48       0.20       5.55       3.74        010
                                                       back.
21925...............  ..............  A               Biopsy soft tissue of       4.48       5.20       3.24       0.59      10.27       8.31        090
                                                       back.
21930...............  ..............  A               Remove lesion, back         4.99       5.73       3.40       0.63      11.35       9.02        090
                                                       or flank.
21935...............  ..............  A               Remove tumor, back...      17.93         NA      10.24       2.46         NA      30.63        090
22100...............  ..............  A               Remove part of neck         9.72         NA       7.73       1.68         NA      19.13        090
                                                       vertebra.
22101...............  ..............  A               Remove part, thorax         9.80         NA       7.99       1.80         NA      19.59        090
                                                       vertebra.

[[Page 47590]]

 
22102...............  ..............  A               Remove part, lumbar         9.80         NA       8.25       1.57         NA      19.62        090
                                                       vertebra.
22103...............  ..............  A               Remove extra spine          2.34         NA       1.21       0.39         NA       3.94        ZZZ
                                                       segment.
22110...............  ..............  A               Remove part of neck        12.72         NA       9.38       2.24         NA      24.34        090
                                                       vertebra.
22112...............  ..............  A               Remove part, thorax        12.79         NA       9.46       1.92         NA      24.17        090
                                                       vertebra.
22114...............  ..............  A               Remove part, lumbar        12.79         NA       9.45       2.13         NA      24.37        090
                                                       vertebra.
22116...............  ..............  A               Remove extra spine          2.32         NA       1.16       0.41         NA       3.89        ZZZ
                                                       segment.
22210...............  ..............  A               Revision of neck           23.78         NA      15.63       4.60         NA      44.01        090
                                                       spine.
22212...............  ..............  A               Revision of thorax         19.39         NA      13.45       3.12         NA      35.96        090
                                                       spine.
22214...............  ..............  A               Revision of lumbar         19.42         NA      13.98       3.10         NA      36.50        090
                                                       spine.
22216...............  ..............  A               Revise, extra spine         6.03         NA       3.12       1.05         NA      10.20        ZZZ
                                                       segment.
22220...............  ..............  A               Revision of neck           21.34         NA      13.87       3.43         NA      38.64        090
                                                       spine.
22222...............  ..............  A               Revision of thorax         21.49         NA      11.74       3.46         NA      36.69        090
                                                       spine.
22224...............  ..............  A               Revision of lumbar         21.49         NA      14.40       3.63         NA      39.52        090
                                                       spine.
22226...............  ..............  A               Revise, extra spine         6.03         NA       3.08       1.05         NA      10.16        ZZZ
                                                       segment.
22305...............  ..............  A               Treat spine process         2.05       2.31       1.92       0.33       4.69       4.30        090
                                                       fracture.
22310...............  ..............  A               Treat spine fracture.       2.61       2.79       2.34       0.42       5.82       5.37        090
22315...............  ..............  A               Treat spine fracture.       8.83       9.68       7.32       1.60      20.11      17.75        090
22318...............  ..............  A               Treat odontoid fx w/o      21.47         NA      13.56       4.70         NA      39.73        090
                                                       graft.
22319...............  ..............  A               Treat odontoid fx w/       23.96         NA      14.97       5.38         NA      44.31        090
                                                       graft.
22325...............  ..............  A               Treat spine fracture.      18.27         NA      12.26       3.18         NA      33.71        090
22326...............  ..............  A               Treat neck spine           19.56         NA      12.93       3.85         NA      36.34        090
                                                       fracture.
22327...............  ..............  A               Treat thorax spine         19.17         NA      12.55       3.21         NA      34.93        090
                                                       fracture.
22328...............  ..............  A               Treat each add spine        4.60         NA       2.26       0.78         NA       7.64        ZZZ
                                                       fx.
22505...............  ..............  A               Manipulation of spine       1.87         NA       0.94       0.30         NA       3.11        010
22520...............  ..............  A               Percut vertebroplasty       8.90      99.93       5.09       1.43     110.26      15.42        010
                                                       thor.
22521...............  ..............  A               Percut vertebroplasty       8.33      90.95       4.94       1.34     100.62      14.61        010
                                                       lumb.
22522...............  ..............  A               Percut vertebroplasty       4.30         NA       1.67       0.69         NA       6.66        ZZZ
                                                       add-l.
22532...............  ..............  A               Lat thorax spine           23.96         NA      14.84       3.78         NA      42.58        090
                                                       fusion.
22533...............  ..............  A               Lat lumbar spine           23.09         NA      13.60       2.80         NA      39.49        090
                                                       fusion.
22534...............  ..............  A               Lat thor/lumb, add-l        5.99         NA       3.03       1.04         NA      10.06        ZZZ
                                                       seg.
22548...............  ..............  A               Neck spine fusion....      25.78         NA      15.79       5.15         NA      46.72        090
22554...............  ..............  A               Neck spine fusion....      18.59         NA      12.33       3.73         NA      34.65        090
22556...............  ..............  A               Thorax spine fusion..      23.42         NA      14.72       3.78         NA      41.92        090
22558...............  ..............  A               Lumbar spine fusion..      22.25         NA      13.28       2.80         NA      38.33        090
22585...............  ..............  A               Additional spinal           5.52         NA       2.79       1.04         NA       9.35        ZZZ
                                                       fusion.
22590...............  ..............  A               Spine & skull spinal       20.48         NA      13.31       4.31         NA      38.10        090
                                                       fusion.
22595...............  ..............  A               Neck spinal fusion...      19.36         NA      12.82       3.88         NA      36.06        090
22600...............  ..............  A               Neck spine fusion....      16.12         NA      11.18       3.24         NA      30.54        090
22610...............  ..............  A               Thorax spine fusion..      16.00         NA      11.40       2.95         NA      30.35        090
22612...............  ..............  A               Lumbar spine fusion..      20.97         NA      14.18       3.55         NA      38.70        090
22614...............  ..............  A               Spine fusion, extra         6.43         NA       3.35       1.14         NA      10.92        ZZZ
                                                       segment.
22630...............  ..............  A               Lumbar spine fusion..      20.81         NA      13.59       3.86         NA      38.26        090
22632...............  ..............  A               Spine fusion, extra         5.22         NA       2.66       0.98         NA       8.86        ZZZ
                                                       segment.
22800...............  ..............  A               Fusion of spine......      18.22         NA      12.74       3.04         NA      34.00        090
22802...............  ..............  A               Fusion of spine......      30.83         NA      19.55       5.01         NA      55.39        090
22804...............  ..............  A               Fusion of spine......      36.22         NA      22.65       5.68         NA      64.55        090
22808...............  ..............  A               Fusion of spine......      26.23         NA      16.28       4.55         NA      47.06        090
22810...............  ..............  A               Fusion of spine......      30.22         NA      18.33       4.43         NA      52.98        090
22812...............  ..............  A               Fusion of spine......      32.65         NA      20.03       4.55         NA      57.23        090
22818...............  ..............  A               Kyphectomy, 1-2            31.78         NA      18.85       6.00         NA      56.63        090
                                                       segments.
22819...............  ..............  A               Kyphectomy, 3 or more      36.39         NA      20.03       5.64         NA      62.06        090
22830...............  ..............  A               Exploration of spinal      10.83         NA       7.95       1.89         NA      20.67        090
                                                       fusion.
22840...............  ..............  A               Insert spine fixation      12.52         NA       6.48       2.19         NA      21.19        ZZZ
                                                       device.
22842...............  ..............  A               Insert spine fixation      12.56         NA       6.49       2.21         NA      21.26        ZZZ
                                                       device.
22843...............  ..............  A               Insert spine fixation      13.44         NA       6.59       2.37         NA      22.40        ZZZ
                                                       device.
22844...............  ..............  A               Insert spine fixation      16.42         NA       8.73       2.63         NA      27.78        ZZZ
                                                       device.
22845...............  ..............  A               Insert spine fixation      11.94         NA       6.06       2.39         NA      20.39        ZZZ
                                                       device.
22846...............  ..............  A               Insert spine fixation      12.40         NA       6.32       2.47         NA      21.19        ZZZ
                                                       device.
22847...............  ..............  A               Insert spine fixation      13.78         NA       7.01       2.37         NA      23.16        ZZZ
                                                       device.
22848...............  ..............  A               Insert pelv fixation        5.99         NA       3.18       0.96         NA      10.13        ZZZ
                                                       device.
22849...............  ..............  A               Reinsert spinal            18.48         NA      11.86       3.14         NA      33.48        090
                                                       fixation.
22850...............  ..............  A               Remove spine fixation       9.51         NA       7.11       1.61         NA      18.23        090
                                                       device.
22851...............  ..............  A               Apply spine prosth          6.70         NA       3.35       1.23         NA      11.28        ZZZ
                                                       device.
22852...............  ..............  A               Remove spine fixation       9.00         NA       6.90       1.52         NA      17.42        090
                                                       device.
22855...............  ..............  A               Remove spine fixation      15.11         NA       9.79       2.90         NA      27.80        090
                                                       device.
22900...............  ..............  A               Remove abdominal wall       5.79         NA       3.25       0.74         NA       9.78        090
                                                       lesion.
23000...............  ..............  A               Removal of calcium          4.35       8.62       4.42       0.59      13.56       9.36        090
                                                       deposits.
23020...............  ..............  A               Release shoulder            8.92         NA       7.79       1.43         NA      18.14        090
                                                       joint.
23030...............  ..............  A               Drain shoulder lesion       3.42       7.42       2.90       0.53      11.37       6.85        010
23031...............  ..............  A               Drain shoulder bursa.       2.74       7.91       2.72       0.44      11.09       5.90        010
23035...............  ..............  A               Drain shoulder bone         8.60         NA       8.72       1.38         NA      18.70        090
                                                       lesion.
23040...............  ..............  A               Exploratory shoulder        9.19         NA       8.09       1.50         NA      18.78        090
                                                       surgery.
23044...............  ..............  A               Exploratory shoulder        7.11         NA       6.71       1.19         NA      15.01        090
                                                       surgery.
23065...............  ..............  A               Biopsy shoulder             2.27       2.48       1.62       0.24       4.99       4.13        010
                                                       tissues.
23066...............  ..............  A               Biopsy shoulder             4.15       7.70       3.98       0.62      12.47       8.75        090
                                                       tissues.

[[Page 47591]]

 
23075...............  ..............  A               Removal of shoulder         2.39       3.68       1.78       0.33       6.40       4.50        010
                                                       lesion.
23076...............  ..............  A               Removal of shoulder         7.62         NA       5.86       1.11         NA      14.59        090
                                                       lesion.
23077...............  ..............  A               Remove tumor of            16.07         NA      10.90       2.27         NA      29.24        090
                                                       shoulder.
23100...............  ..............  A               Biopsy of shoulder          6.02         NA       5.89       0.96         NA      12.87        090
                                                       joint.
23101...............  ..............  A               Shoulder joint              5.57         NA       5.58       0.91         NA      12.06        090
                                                       surgery.
23105...............  ..............  A               Remove shoulder joint       8.22         NA       7.39       1.32         NA      16.93        090
                                                       lining.
23106...............  ..............  A               Incision of                 5.95         NA       5.94       0.83         NA      12.72        090
                                                       collarbone joint.
23107...............  ..............  A               Explore treat               8.61         NA       7.60       1.40         NA      17.61        090
                                                       shoulder joint.
23120...............  ..............  A               Partial removal,            7.10         NA       6.69       1.13         NA      14.92        090
                                                       collar bone.
23125...............  ..............  A               Removal of collar           9.38         NA       7.81       1.45         NA      18.64        090
                                                       bone.
23130...............  ..............  A               Remove shoulder bone,       7.54         NA       7.33       1.27         NA      16.14        090
                                                       part.
23140...............  ..............  A               Removal of bone             6.88         NA       5.50       0.99         NA      13.37        090
                                                       lesion.
23145...............  ..............  A               Removal of bone             9.08         NA       7.79       1.42         NA      18.29        090
                                                       lesion.
23146...............  ..............  A               Removal of bone             7.82         NA       7.38       1.13         NA      16.33        090
                                                       lesion.
23150...............  ..............  A               Removal of humerus          8.47         NA       7.15       1.24         NA      16.86        090
                                                       lesion.
23155...............  ..............  A               Removal of humerus         10.33         NA       8.68       1.48         NA      20.49        090
                                                       lesion.
23156...............  ..............  A               Removal of humerus          8.67         NA       7.60       1.36         NA      17.63        090
                                                       lesion.
23170...............  ..............  A               Remove collar bone          6.85         NA       6.54       1.10         NA      14.49        090
                                                       lesion.
23172...............  ..............  A               Remove shoulder blade       6.89         NA       6.63       0.95         NA      14.47        090
                                                       lesion.
23174...............  ..............  A               Remove humerus lesion       9.50         NA       8.63       1.56         NA      19.69        090
23180...............  ..............  A               Remove collar bone          8.52         NA       9.43       1.47         NA      19.42        090
                                                       lesion.
23182...............  ..............  A               Remove shoulder blade       8.14         NA       9.09       1.26         NA      18.49        090
                                                       lesion.
23184...............  ..............  A               Remove humerus lesion       9.37         NA       9.78       1.50         NA      20.65        090
23190...............  ..............  A               Partial removal of          7.23         NA       6.38       1.18         NA      14.79        090
                                                       scapula.
23195...............  ..............  A               Removal of head of          9.80         NA       7.95       1.18         NA      18.93        090
                                                       humerus.
23200...............  ..............  A               Removal of collar          12.06         NA       9.14       1.69         NA      22.89        090
                                                       bone.
23210...............  ..............  A               Removal of shoulder        12.47         NA       9.49       2.01         NA      23.97        090
                                                       blade.
23220...............  ..............  A               Partial removal of         14.54         NA      11.12       2.50         NA      28.16        090
                                                       humerus.
23221...............  ..............  A               Partial removal of         17.71         NA      12.01       2.33         NA      32.05        090
                                                       humerus.
23222...............  ..............  A               Partial removal of         23.88         NA      16.10       3.90         NA      43.88        090
                                                       humerus.
23330...............  ..............  A               Remove shoulder             1.85       3.75       1.88       0.24       5.84       3.97        010
                                                       foreign body.
23331...............  ..............  A               Remove shoulder             7.37         NA       7.01       1.14         NA      15.52        090
                                                       foreign body.
23332...............  ..............  A               Remove shoulder            11.60         NA       9.53       1.85         NA      22.98        090
                                                       foreign body.
23350...............  ..............  A               Injection for               1.00       3.52       0.33       0.06       4.58       1.39        000
                                                       shoulder x-ray.
23395...............  ..............  A               Muscle                     16.82         NA      12.97       2.56         NA      32.35        090
                                                       transfer,shoulder/
                                                       arm.
23397...............  ..............  A               Muscle transfers.....      16.11         NA      11.57       2.62         NA      30.30        090
23400...............  ..............  A               Fixation of shoulder       13.52         NA      10.38       2.07         NA      25.97        090
                                                       blade.
23405...............  ..............  A               Incision of tendon &        8.36         NA       7.15       1.29         NA      16.80        090
                                                       muscle.
23406...............  ..............  A               Incise tendon(s) &         10.77         NA       8.60       1.72         NA      21.09        090
                                                       muscle(s).
23410...............  ..............  A               Repair rotator cuff,       12.43         NA       9.61       1.95         NA      23.99        090
                                                       acute.
23412...............  ..............  A               Repair rotator cuff,       13.29         NA      10.10       2.08         NA      25.47        090
                                                       chronic.
23415...............  ..............  A               Release of shoulder         9.96         NA       8.15       1.70         NA      19.81        090
                                                       ligament.
23420...............  ..............  A               Repair of shoulder...      13.28         NA      11.06       2.10         NA      26.44        090
23430...............  ..............  A               Repair biceps tendon.       9.97         NA       8.32       1.57         NA      19.86        090
23440...............  ..............  A               Remove/transplant          10.46         NA       8.49       1.63         NA      20.58        090
                                                       tendon.
23450...............  ..............  A               Repair shoulder            13.38         NA      10.06       2.12         NA      25.56        090
                                                       capsule.
23455...............  ..............  A               Repair shoulder            14.35         NA      10.65       2.26         NA      27.26        090
                                                       capsule.
23460...............  ..............  A               Repair shoulder            15.35         NA      11.58       2.43         NA      29.36        090
                                                       capsule.
23462...............  ..............  A               Repair shoulder            15.28         NA      10.97       2.42         NA      28.67        090
                                                       capsule.
23465...............  ..............  A               Repair shoulder            15.83         NA      11.52       2.51         NA      29.86        090
                                                       capsule.
23466...............  ..............  A               Repair shoulder            14.20         NA      11.53       2.25         NA      27.98        090
                                                       capsule.
23470...............  ..............  A               Reconstruct shoulder       17.12         NA      12.23       2.70         NA      32.05        090
                                                       joint.
23472...............  ..............  A               Reconstruct shoulder       21.07         NA      14.38       3.29         NA      38.74        090
                                                       joint.
23480...............  ..............  A               Revision of collar         11.16         NA       8.98       1.89         NA      22.03        090
                                                       bone.
23485...............  ..............  A               Revision of collar         13.41         NA      10.10       2.12         NA      25.63        090
                                                       bone.
23490...............  ..............  A               Reinforce clavicle...      11.84         NA       9.04       1.44         NA      22.32        090
23491...............  ..............  A               Reinforce shoulder         14.19         NA      10.91       2.29         NA      27.39        090
                                                       bones.
23500...............  ..............  A               Treat clavicle              2.08       2.87       2.54       0.29       5.24       4.91        090
                                                       fracture.
23505...............  ..............  A               Treat clavicle              3.68       4.41       3.85       0.58       8.67       8.11        090
                                                       fracture.
23515...............  ..............  A               Treat clavicle              7.40         NA       6.70       1.16         NA      15.26        090
                                                       fracture.
23520...............  ..............  A               Treat clavicle              2.16       2.86       2.75       0.32       5.34       5.23        090
                                                       dislocation.
23525...............  ..............  A               Treat clavicle              3.59       4.57       3.96       0.42       8.58       7.97        090
                                                       dislocation.
23530...............  ..............  A               Treat clavicle              7.30         NA       6.12       1.21         NA      14.63        090
                                                       dislocation.
23532...............  ..............  A               Treat clavicle              8.00         NA       7.11       1.17         NA      16.28        090
                                                       dislocation.
23540...............  ..............  A               Treat clavicle              2.23       2.87       2.41       0.27       5.37       4.91        090
                                                       dislocation.
23545...............  ..............  A               Treat clavicle              3.25       4.20       3.39       0.42       7.87       7.06        090
                                                       dislocation.
23550...............  ..............  A               Treat clavicle              7.23         NA       6.55       1.14         NA      14.92        090
                                                       dislocation.
23552...............  ..............  A               Treat clavicle              8.44         NA       7.46       1.27         NA      17.17        090
                                                       dislocation.
23570...............  ..............  A               Treat shoulder blade        2.23       3.01       2.90       0.35       5.59       5.48        090
                                                       fx.
23575...............  ..............  A               Treat shoulder blade        4.05       4.88       4.32       0.66       9.59       9.03        090
                                                       fx.
23585...............  ..............  A               Treat scapula               8.95         NA       7.80       1.44         NA      18.19        090
                                                       fracture.
23600...............  ..............  A               Treat humerus               2.93       4.54       3.57       0.46       7.93       6.96        090
                                                       fracture.
23605...............  ..............  A               Treat humerus               4.86       6.14       5.11       0.81      11.81      10.78        090
                                                       fracture.
23615...............  ..............  A               Treat humerus               9.34         NA       8.97       1.51         NA      19.82        090
                                                       fracture.
23616...............  ..............  A               Treat humerus              21.24         NA      14.28       3.37         NA      38.89        090
                                                       fracture.

[[Page 47592]]

 
23620...............  ..............  A               Treat humerus               2.40       3.61       3.00       0.38       6.39       5.78        090
                                                       fracture.
23625...............  ..............  A               Treat humerus               3.92       4.93       4.28       0.64       9.49       8.84        090
                                                       fracture.
23630...............  ..............  A               Treat humerus               7.34         NA       6.77       1.18         NA      15.29        090
                                                       fracture.
23650...............  ..............  A               Treat shoulder              3.38       3.80       2.81       0.30       7.48       6.49        090
                                                       dislocation.
23655...............  ..............  A               Treat shoulder              4.56         NA       4.24       0.62         NA       9.42        090
                                                       dislocation.
23660...............  ..............  A               Treat shoulder              7.48         NA       6.53       1.22         NA      15.23        090
                                                       dislocation.
23665...............  ..............  A               Treat dislocation/          4.46       5.33       4.72       0.70      10.49       9.88        090
                                                       fracture.
23670...............  ..............  A               Treat dislocation/          7.89         NA       7.00       1.25         NA      16.14        090
                                                       fracture.
23675...............  ..............  A               Treat dislocation/          6.04       6.83       5.82       0.97      13.84      12.83        090
                                                       fracture.
23680...............  ..............  A               Treat dislocation/         10.04         NA       8.27       1.61         NA      19.92        090
                                                       fracture.
23700...............  ..............  A               Fixation of shoulder.       2.52         NA       2.17       0.43         NA       5.12        010
23800...............  ..............  A               Fusion of shoulder         14.14         NA      10.68       2.34         NA      27.16        090
                                                       joint.
23802...............  ..............  A               Fusion of shoulder         16.58         NA      10.41       2.45         NA      29.44        090
                                                       joint.
23900...............  ..............  A               Amputation of arm &        19.69         NA      12.03       3.04         NA      34.76        090
                                                       girdle.
23920...............  ..............  A               Amputation at              14.59         NA      10.26       2.21         NA      27.06        090
                                                       shoulder joint.
23921...............  ..............  A               Amputation follow-up        5.48         NA       5.09       0.90         NA      11.47        090
                                                       surgery.
23930...............  ..............  A               Drainage of arm             2.94       6.36       2.31       0.41       9.71       5.66        010
                                                       lesion.
23931...............  ..............  A               Drainage of arm bursa       1.79       5.93       2.17       0.26       7.98       4.22        010
23935...............  ..............  A               Drain arm/elbow bone        6.08         NA       6.43       0.98         NA      13.49        090
                                                       lesion.
24000...............  ..............  A               Exploratory elbow           5.81         NA       5.50       0.93         NA      12.24        090
                                                       surgery.
24006...............  ..............  A               Release elbow joint..       9.30         NA       7.85       1.48         NA      18.63        090
24065...............  ..............  A               Biopsy arm/elbow soft       2.08       3.22       1.75       0.22       5.52       4.05        010
                                                       tissue.
24066...............  ..............  A               Biopsy arm/elbow soft       5.20       8.95       4.14       0.77      14.92      10.11        090
                                                       tissue.
24075...............  ..............  A               Remove arm/elbow            3.91       7.37       3.41       0.54      11.82       7.86        090
                                                       lesion.
24076...............  ..............  A               Remove arm/elbow            6.29         NA       5.17       0.91         NA      12.37        090
                                                       lesion.
24077...............  ..............  A               Remove tumor of arm/       11.74         NA       8.85       1.67         NA      22.26        090
                                                       elbow.
24100...............  ..............  A               Biopsy elbow joint          4.92         NA       4.64       0.78         NA      10.34        090
                                                       lining.
24101...............  ..............  A               Explore/treat elbow         6.12         NA       6.02       1.01         NA      13.15        090
                                                       joint.
24102...............  ..............  A               Remove elbow joint          8.02         NA       6.97       1.27         NA      16.26        090
                                                       lining.
24105...............  ..............  A               Removal of elbow            3.60         NA       4.50       0.60         NA       8.70        090
                                                       bursa.
24110...............  ..............  A               Remove humerus lesion       7.38         NA       6.93       1.21         NA      15.52        090
24115...............  ..............  A               Remove/graft bone           9.62         NA       7.54       1.36         NA      18.52        090
                                                       lesion.
24116...............  ..............  A               Remove/graft bone          11.79         NA       9.31       2.05         NA      23.15        090
                                                       lesion.
24120...............  ..............  A               Remove elbow lesion..       6.64         NA       6.02       1.07         NA      13.73        090
24125...............  ..............  A               Remove/graft bone           7.88         NA       6.27       0.73         NA      14.88        090
                                                       lesion.
24126...............  ..............  A               Remove/graft bone           8.30         NA       7.10       1.13         NA      16.53        090
                                                       lesion.
24130...............  ..............  A               Removal of head of          6.24         NA       6.11       1.03         NA      13.38        090
                                                       radius.
24134...............  ..............  A               Removal of arm bone         9.72         NA       9.38       1.52         NA      20.62        090
                                                       lesion.
24136...............  ..............  A               Remove radius bone          7.98         NA       7.41       1.29         NA      16.68        090
                                                       lesion.
24138...............  ..............  A               Remove elbow bone           8.04         NA       7.86       1.29         NA      17.19        090
                                                       lesion.
24140...............  ..............  A               Partial removal of          9.17         NA       9.76       1.45         NA      20.38        090
                                                       arm bone.
24145...............  ..............  A               Partial removal of          7.57         NA       8.27       1.22         NA      17.06        090
                                                       radius.
24147...............  ..............  A               Partial removal of          7.53         NA       8.80       1.26         NA      17.59        090
                                                       elbow.
24149...............  ..............  A               Radical resection of       14.18         NA      11.65       2.23         NA      28.06        090
                                                       elbow.
24150...............  ..............  A               Extensive humerus          13.25         NA      10.35       2.15         NA      25.75        090
                                                       surgery.
24151...............  ..............  A               Extensive humerus          15.56         NA      11.94       1.27         NA      28.77        090
                                                       surgery.
24152...............  ..............  A               Extensive radius           10.04         NA       7.99       1.01         NA      19.04        090
                                                       surgery.
24153...............  ..............  A               Extensive radius           11.52         NA       5.74       0.70         NA      17.96        090
                                                       surgery.
24155...............  ..............  A               Removal of elbow           11.71         NA       8.51       1.82         NA      22.04        090
                                                       joint.
24160...............  ..............  A               Remove elbow joint          7.82         NA       6.88       1.26         NA      15.96        090
                                                       implant.
24164...............  ..............  A               Remove radius head          6.22         NA       5.76       1.01         NA      12.99        090
                                                       implant.
24200...............  ..............  A               Removal of arm              1.76       3.45       1.63       0.19       5.40       3.58        010
                                                       foreign body.
24201...............  ..............  A               Removal of arm              4.55       9.85       4.23       0.68      15.08       9.46        090
                                                       foreign body.
24220...............  ..............  A               Injection for elbow x-      1.31       3.71       0.44       0.08       5.10       1.83        000
                                                       ray.
24300...............  ..............  A               Manipulate elbow w/         3.74         NA       5.62       0.63         NA       9.99        090
                                                       anesth.
24301...............  ..............  A               Muscle/tendon              10.18         NA       8.32       1.64         NA      20.14        090
                                                       transfer.
24305...............  ..............  A               Arm tendon                  7.44         NA       6.83       1.13         NA      15.40        090
                                                       lengthening.
24310...............  ..............  A               Revision of arm             5.97         NA       5.91       0.91         NA      12.79        090
                                                       tendon.
24320...............  ..............  A               Repair of arm tendon.      10.54         NA       7.93       1.72         NA      20.19        090
24330...............  ..............  A               Revision of arm             9.59         NA       8.02       1.51         NA      19.12        090
                                                       muscles.
24331...............  ..............  A               Revision of arm            10.63         NA       8.75       1.33         NA      20.71        090
                                                       muscles.
24332...............  ..............  A               Tenolysis, triceps...       7.44         NA       6.70       1.19         NA      15.33        090
24340...............  ..............  A               Repair of biceps            7.88         NA       7.07       1.27         NA      16.22        090
                                                       tendon.
24341...............  ..............  A               Repair arm tendon/          7.89         NA       7.97       1.26         NA      17.12        090
                                                       muscle.
24342...............  ..............  A               Repair of ruptured         10.60         NA       8.61       1.69         NA      20.90        090
                                                       tendon.
24343...............  ..............  A               Repr elbow lat ligmnt       8.64         NA       8.07       1.39         NA      18.10        090
                                                       w/tiss.
24344...............  ..............  A               Reconstruct elbow lat      13.98         NA      11.43       2.25         NA      27.66        090
                                                       ligmnt.
24345...............  ..............  A               Repr elbw med ligmnt        8.64         NA       7.95       1.40         NA      17.99        090
                                                       w/tissu.
24346...............  ..............  A               Reconstruct elbow med      13.98         NA      11.25       2.04         NA      27.27        090
                                                       ligmnt.
24350...............  ..............  A               Repair of tennis            5.24         NA       5.68       0.86         NA      11.78        090
                                                       elbow.
24351...............  ..............  A               Repair of tennis            5.90         NA       6.02       0.98         NA      12.90        090
                                                       elbow.
24352...............  ..............  A               Repair of tennis            6.42         NA       6.28       1.09         NA      13.79        090
                                                       elbow.
24354...............  ..............  A               Repair of tennis            6.47         NA       6.24       1.11         NA      13.82        090
                                                       elbow.
24356...............  ..............  A               Revision of tennis          6.67         NA       6.42       1.08         NA      14.17        090
                                                       elbow.
24360...............  ..............  A               Reconstruct elbow          12.32         NA       9.46       1.92         NA      23.70        090
                                                       joint.

[[Page 47593]]

 
24361...............  ..............  A               Reconstruct elbow          14.06         NA      10.56       2.10         NA      26.72        090
                                                       joint.
24362...............  ..............  A               Reconstruct elbow          14.97         NA      10.04       2.30         NA      27.31        090
                                                       joint.
24363...............  ..............  A               Replace elbow joint..      18.46         NA      13.69       2.84         NA      34.99        090
24365...............  ..............  A               Reconstruct head of         8.38         NA       7.19       1.39         NA      16.96        090
                                                       radius.
24366...............  ..............  A               Reconstruct head of         9.12         NA       7.53       1.47         NA      18.12        090
                                                       radius.
24400...............  ..............  A               Revision of humerus..      11.04         NA       9.14       1.82         NA      22.00        090
24410...............  ..............  A               Revision of humerus..      14.80         NA      10.60       2.57         NA      27.97        090
24420...............  ..............  A               Revision of humerus..      13.42         NA      10.90       2.07         NA      26.39        090
24430...............  ..............  A               Repair of humerus....      12.79         NA       9.97       2.04         NA      24.80        090
24435...............  ..............  A               Repair humerus with        13.15         NA      11.12       2.10         NA      26.37        090
                                                       graft.
24470...............  ..............  A               Revision of elbow           8.73         NA       7.80       0.77         NA      17.30        090
                                                       joint.
24495...............  ..............  A               Decompression of            8.11         NA       8.94       1.18         NA      18.23        090
                                                       forearm.
24498...............  ..............  A               Reinforce humerus....      11.90         NA       9.50       1.93         NA      23.33        090
24500...............  ..............  A               Treat humerus               3.21       4.86       3.71       0.48       8.55       7.40        090
                                                       fracture.
24505...............  ..............  A               Treat humerus               5.16       6.59       5.39       0.86      12.61      11.41        090
                                                       fracture.
24515...............  ..............  A               Treat humerus              11.63         NA       9.55       1.88         NA      23.06        090
                                                       fracture.
24516...............  ..............  A               Treat humerus              11.63         NA       9.31       1.88         NA      22.82        090
                                                       fracture.
24530...............  ..............  A               Treat humerus               3.49       5.20       4.05       0.55       9.24       8.09        090
                                                       fracture.
24535...............  ..............  A               Treat humerus               6.86       7.83       6.62       1.16      15.85      14.64        090
                                                       fracture.
24538...............  ..............  A               Treat humerus               9.42         NA       8.89       1.51         NA      19.82        090
                                                       fracture.
24545...............  ..............  A               Treat humerus              10.44         NA       8.60       1.70         NA      20.74        090
                                                       fracture.
24546...............  ..............  A               Treat humerus              15.67         NA      11.50       2.52         NA      29.69        090
                                                       fracture.
24560...............  ..............  A               Treat humerus               2.80       4.49       3.22       0.39       7.68       6.41        090
                                                       fracture.
24565...............  ..............  A               Treat humerus               5.55       6.62       5.52       0.94      13.11      12.01        090
                                                       fracture.
24566...............  ..............  A               Treat humerus               7.78         NA       8.34       1.33         NA      17.45        090
                                                       fracture.
24575...............  ..............  A               Treat humerus              10.64         NA       8.44       1.70         NA      20.78        090
                                                       fracture.
24576...............  ..............  A               Treat humerus               2.86       4.77       3.73       0.42       8.05       7.01        090
                                                       fracture.
24577...............  ..............  A               Treat humerus               5.78       6.92       5.83       0.97      13.67      12.58        090
                                                       fracture.
24579...............  ..............  A               Treat humerus              11.58         NA       9.02       1.89         NA      22.49        090
                                                       fracture.
24582...............  ..............  A               Treat humerus               8.54         NA       9.26       1.48         NA      19.28        090
                                                       fracture.
24586...............  ..............  A               Treat elbow fracture.      15.19         NA      11.26       2.45         NA      28.90        090
24587...............  ..............  A               Treat elbow fracture.      15.14         NA      11.05       2.23         NA      28.42        090
24600...............  ..............  A               Treat elbow                 4.22       4.86       3.53       0.47       9.55       8.22        090
                                                       dislocation.
24605...............  ..............  A               Treat elbow                 5.41         NA       5.41       0.87         NA      11.69        090
                                                       dislocation.
24615...............  ..............  A               Treat elbow                 9.41         NA       7.87       1.53         NA      18.81        090
                                                       dislocation.
24620...............  ..............  A               Treat elbow fracture.       6.97         NA       6.27       1.07         NA      14.31        090
24635...............  ..............  A               Treat elbow fracture.      13.17         NA      14.21       2.17         NA      29.55        090
24640...............  ..............  A               Treat elbow                 1.20       1.85       0.81       0.13       3.18       2.14        010
                                                       dislocation.
24650...............  ..............  A               Treat radius fracture       2.16       3.79       2.78       0.33       6.28       5.27        090
24655...............  ..............  A               Treat radius fracture       4.39       5.95       4.80       0.70      11.04       9.89        090
24665...............  ..............  A               Treat radius fracture       8.13         NA       7.69       1.35         NA      17.17        090
24666...............  ..............  A               Treat radius fracture       9.48         NA       8.25       1.55         NA      19.28        090
24670...............  ..............  A               Treat ulnar fracture.       2.54       4.11       3.09       0.38       7.03       6.01        090
24675...............  ..............  A               Treat ulnar fracture.       4.71       6.00       4.97       0.77      11.48      10.45        090
24685...............  ..............  A               Treat ulnar fracture.       8.79         NA       7.72       1.43         NA      17.94        090
24800...............  ..............  A               Fusion of elbow joint      11.18         NA       8.87       1.63         NA      21.68        090
24802...............  ..............  A               Fusion/graft of elbow      13.67         NA      10.49       2.16         NA      26.32        090
                                                       joint.
24900...............  ..............  A               Amputation of upper         9.59         NA       7.49       1.44         NA      18.52        090
                                                       arm.
24920...............  ..............  A               Amputation of upper         9.53         NA       7.71       1.48         NA      18.72        090
                                                       arm.
24925...............  ..............  A               Amputation follow-up        7.06         NA       6.44       1.12         NA      14.62        090
                                                       surgery.
24930...............  ..............  A               Amputation follow-up       10.23         NA       7.66       1.53         NA      19.42        090
                                                       surgery.
24931...............  ..............  A               Amputate upper arm &       12.70         NA       6.10       1.88         NA      20.68        090
                                                       implant.
24935...............  ..............  A               Revision of                15.54         NA       8.40       2.05         NA      25.99        090
                                                       amputation.
25000...............  ..............  A               Incision of tendon          3.37         NA       6.96       0.53         NA      10.86        090
                                                       sheath.
25001...............  ..............  A               Incise flexor carpi         3.37         NA       4.16       0.52         NA       8.05        090
                                                       radialis.
25020...............  ..............  A               Decompress forearm 1        5.91         NA       9.84       0.95         NA      16.70        090
                                                       space.
25023...............  ..............  A               Decompress forearm 1       12.94         NA      15.33       1.91         NA      30.18        090
                                                       space.
25024...............  ..............  A               Decompress forearm 2        9.49         NA       7.51       1.10         NA      18.10        090
                                                       spaces.
25025...............  ..............  A               Decompress forearm 2       16.52         NA       9.99       1.79         NA      28.30        090
                                                       spaces.
25028...............  ..............  A               Drainage of forearm         5.24         NA       8.40       0.78         NA      14.42        090
                                                       lesion.
25031...............  ..............  A               Drainage of forearm         4.13         NA       8.21       0.63         NA      12.97        090
                                                       bursa.
25035...............  ..............  A               Treat forearm bone          7.35         NA      13.88       1.21         NA      22.44        090
                                                       lesion.
25040...............  ..............  A               Explore/treat wrist         7.17         NA       7.40       1.15         NA      15.72        090
                                                       joint.
25065...............  ..............  A               Biopsy forearm soft         1.99       3.23       1.90       0.20       5.42       4.09        010
                                                       tissues.
25066...............  ..............  A               Biopsy forearm soft         4.12         NA       7.18       0.62         NA      11.92        090
                                                       tissues.
25075...............  ..............  A               Removel forearm             3.73         NA       6.06       0.52         NA      10.31        090
                                                       lesion subcu.
25076...............  ..............  A               Removel forearm             4.91         NA       9.83       0.74         NA      15.48        090
                                                       lesion deep.
25077...............  ..............  A               Remove tumor, forearm/      9.75         NA      12.53       1.38         NA      23.66        090
                                                       wrist.
25085...............  ..............  A               Incision of wrist           5.49         NA       7.40       0.84         NA      13.73        090
                                                       capsule.
25100...............  ..............  A               Biopsy of wrist joint       3.89         NA       5.49       0.58         NA       9.96        090
25101...............  ..............  A               Explore/treat wrist         4.68         NA       6.06       0.51         NA      11.25        090
                                                       joint.
25105...............  ..............  A               Remove wrist joint          5.84         NA       7.58       0.91         NA      14.33        090
                                                       lining.
25107...............  ..............  A               Remove wrist joint          6.42         NA       8.54       0.97         NA      15.93        090
                                                       cartilage.
25110...............  ..............  A               Remove wrist tendon         3.91         NA       7.20       0.60         NA      11.71        090
                                                       lesion.
25111...............  ..............  A               Remove wrist tendon         3.38         NA       4.89       0.52         NA       8.79        090
                                                       lesion.

[[Page 47594]]

 
25112...............  ..............  A               Reremove wrist tendon       4.52         NA       5.49       0.70         NA      10.71        090
                                                       lesion.
25115...............  ..............  A               Remove wrist/forearm        8.81         NA      14.32       1.31         NA      24.44        090
                                                       lesion.
25116...............  ..............  A               Remove wrist/forearm        7.10         NA      13.40       1.08         NA      21.58        090
                                                       lesion.
25118...............  ..............  A               Excise wrist tendon         4.36         NA       5.97       0.68         NA      11.01        090
                                                       sheath.
25119...............  ..............  A               Partial removal of          6.03         NA       7.86       0.90         NA      14.79        090
                                                       ulna.
25120...............  ..............  A               Removal of forearm          6.09         NA      12.28       0.99         NA      19.36        090
                                                       lesion.
25125...............  ..............  A               Remove/graft forearm        7.47         NA      13.08       1.14         NA      21.69        090
                                                       lesion.
25126...............  ..............  A               Remove/graft forearm        7.54         NA      13.15       1.16         NA      21.85        090
                                                       lesion.
25130...............  ..............  A               Removal of wrist            5.25         NA       6.61       0.81         NA      12.67        090
                                                       lesion.
25135...............  ..............  A               Remove & graft wrist        6.88         NA       7.64       0.93         NA      15.45        090
                                                       lesion.
25136...............  ..............  A               Remove & graft wrist        5.96         NA       6.77       0.89         NA      13.62        090
                                                       lesion.
25145...............  ..............  A               Remove forearm bone         6.36         NA      12.33       0.91         NA      19.60        090
                                                       lesion.
25150...............  ..............  A               Partial removal of          7.08         NA       8.50       1.11         NA      16.69        090
                                                       ulna.
25151...............  ..............  A               Partial removal of          7.38         NA      12.93       1.12         NA      21.43        090
                                                       radius.
25170...............  ..............  A               Extensive forearm          11.07         NA      15.29       1.69         NA      28.05        090
                                                       surgery.
25210...............  ..............  A               Removal of wrist bone       5.94         NA       7.00       0.87         NA      13.81        090
25215...............  ..............  A               Removal of wrist            7.88         NA       9.00       1.20         NA      18.08        090
                                                       bones.
25230...............  ..............  A               Partial removal of          5.22         NA       6.31       0.78         NA      12.31        090
                                                       radius.
25240...............  ..............  A               Partial removal of          5.16         NA       7.18       0.80         NA      13.14        090
                                                       ulna.
25246...............  ..............  A               Injection for wrist x-      1.45       3.48       0.48       0.09       5.02       2.02        000
                                                       ray.
25248...............  ..............  A               Remove forearm              5.13         NA       8.64       0.70         NA      14.47        090
                                                       foreign body.
25250...............  ..............  A               Removal of wrist            6.59         NA       6.09       0.95         NA      13.63        090
                                                       prosthesis.
25251...............  ..............  A               Removal of wrist            9.56         NA       7.91       1.27         NA      18.74        090
                                                       prosthesis.
25259...............  ..............  A               Manipulate wrist w/         3.74         NA       5.62       0.62         NA       9.98        090
                                                       anesthes.
25260...............  ..............  A               Repair forearm tendon/      7.79         NA      13.77       1.17         NA      22.73        090
                                                       muscle.
25263...............  ..............  A               Repair forearm tendon/      7.81         NA      13.67       1.11         NA      22.59        090
                                                       muscle.
25265...............  ..............  A               Repair forearm tendon/      9.87         NA      14.56       1.36         NA      25.79        090
                                                       muscle.
25270...............  ..............  A               Repair forearm tendon/      5.99         NA      12.45       0.92         NA      19.36        090
                                                       muscle.
25272...............  ..............  A               Repair forearm tendon/      7.03         NA      13.15       1.10         NA      21.28        090
                                                       muscle.
25274...............  ..............  A               Repair forearm tendon/      8.74         NA      13.88       1.28         NA      23.90        090
                                                       muscle.
25275...............  ..............  A               Repair forearm tendon       8.49         NA       7.49       1.19         NA      17.17        090
                                                       sheath.
25280...............  ..............  A               Revise wrist/forearm        7.21         NA      12.88       1.07         NA      21.16        090
                                                       tendon.
25290...............  ..............  A               Incise wrist/forearm        5.28         NA      15.12       0.81         NA      21.21        090
                                                       tendon.
25295...............  ..............  A               Release wrist/forearm       6.54         NA      12.45       0.95         NA      19.94        090
                                                       tendon.
25300...............  ..............  A               Fusion of tendons at        8.79         NA       8.61       1.15         NA      18.55        090
                                                       wrist.
25301...............  ..............  A               Fusion of tendons at        8.39         NA       8.26       1.24         NA      17.89        090
                                                       wrist.
25310...............  ..............  A               Transplant forearm          8.13         NA      13.29       1.17         NA      22.59        090
                                                       tendon.
25312...............  ..............  A               Transplant forearm          9.56         NA      14.17       1.37         NA      25.10        090
                                                       tendon.
25315...............  ..............  A               Revise palsy hand          10.18         NA      14.74       1.52         NA      26.44        090
                                                       tendon(s).
25316...............  ..............  A               Revise palsy hand          12.31         NA      16.51       2.07         NA      30.89        090
                                                       tendon(s).
25320...............  ..............  A               Repair/revise wrist        10.75         NA      11.40       1.58         NA      23.73        090
                                                       joint.
25332...............  ..............  A               Revise wrist joint...      11.39         NA       9.15       1.72         NA      22.26        090
25335...............  ..............  A               Realignment of hand..      12.86         NA      11.80       2.00         NA      26.66        090
25337...............  ..............  A               Reconstruct ulna/          10.15         NA      11.24       1.57         NA      22.96        090
                                                       radioulnar.
25350...............  ..............  A               Revision of radius...       8.77         NA      14.12       1.36         NA      24.25        090
25355...............  ..............  A               Revision of radius...      10.15         NA      14.74       1.39         NA      26.28        090
25360...............  ..............  A               Revision of ulna.....       8.42         NA      14.01       1.36         NA      23.79        090
25365...............  ..............  A               Revise radius & ulna.      12.38         NA      15.77       2.03         NA      30.18        090
25370...............  ..............  A               Revise radius or ulna      13.34         NA      16.19       2.27         NA      31.80        090
25375...............  ..............  A               Revise radius & ulna.      13.02         NA      16.55       2.22         NA      31.79        090
25390...............  ..............  A               Shorten radius or          10.38         NA      14.74       1.55         NA      26.67        090
                                                       ulna.
25391...............  ..............  A               Lengthen radius or         13.63         NA      16.70       2.17         NA      32.50        090
                                                       ulna.
25392...............  ..............  A               Shorten radius & ulna      13.93         NA      16.09       2.15         NA      32.17        090
25393...............  ..............  A               Lengthen radius &          15.85         NA      17.71       2.76         NA      36.32        090
                                                       ulna.
25394...............  ..............  A               Repair carpal bone,        10.38         NA       8.05       1.31         NA      19.74        090
                                                       shorten.
25400...............  ..............  A               Repair radius or ulna      10.90         NA      15.32       1.73         NA      27.95        090
25405...............  ..............  A               Repair/graft radius        14.36         NA      17.42       2.27         NA      34.05        090
                                                       or ulna.
25415...............  ..............  A               Repair radius & ulna.      13.33         NA      16.64       2.07         NA      32.04        090
25420...............  ..............  A               Repair/graft radius &      16.31         NA      18.41       2.58         NA      37.30        090
                                                       ulna.
25425...............  ..............  A               Repair/graft radius        13.19         NA      21.64       1.91         NA      36.74        090
                                                       or ulna.
25426...............  ..............  A               Repair/graft radius &      15.80         NA      16.70       1.39         NA      33.89        090
                                                       ulna.
25430...............  ..............  A               Vasc graft into             9.24         NA       7.21       1.25         NA      17.70        090
                                                       carpal bone.
25431...............  ..............  A               Repair nonunion            10.42         NA       8.33       1.69         NA      20.44        090
                                                       carpal bone.
25440...............  ..............  A               Repair/graft wrist         10.42         NA       9.51       1.50         NA      21.43        090
                                                       bone.
25441...............  ..............  A               Reconstruct wrist          12.88         NA       9.98       2.06         NA      24.92        090
                                                       joint.
25442...............  ..............  A               Reconstruct wrist          10.83         NA       8.86       1.51         NA      21.20        090
                                                       joint.
25443...............  ..............  A               Reconstruct wrist          10.37         NA       8.75       1.66         NA      20.78        090
                                                       joint.
25444...............  ..............  A               Reconstruct wrist          11.13         NA       9.01       1.53         NA      21.67        090
                                                       joint.
25445...............  ..............  A               Reconstruct wrist           9.68         NA       7.97       1.52         NA      19.17        090
                                                       joint.
25446...............  ..............  A               Wrist replacement....      16.53         NA      11.90       2.43         NA      30.86        090
25447...............  ..............  A               Repair wrist joint(s)      10.35         NA       8.63       1.53         NA      20.51        090
25449...............  ..............  A               Remove wrist joint         14.47         NA      10.64       2.08         NA      27.19        090
                                                       implant.
25450...............  ..............  A               Revision of wrist           7.86         NA      10.31       1.22         NA      19.39        090
                                                       joint.
25455...............  ..............  A               Revision of wrist           9.48         NA      11.25       1.21         NA      21.94        090
                                                       joint.
25490...............  ..............  A               Reinforce radius.....       9.53         NA      13.89       1.38         NA      24.80        090

[[Page 47595]]

 
25491...............  ..............  A               Reinforce ulna.......       9.95         NA      14.66       1.52         NA      26.13        090
25492...............  ..............  A               Reinforce radius and       12.31         NA      15.43       2.14         NA      29.88        090
                                                       ulna.
25500...............  ..............  A               Treat fracture of           2.45       3.59       2.74       0.33       6.37       5.52        090
                                                       radius.
25505...............  ..............  A               Treat fracture of           5.20       6.54       5.43       0.82      12.56      11.45        090
                                                       radius.
25515...............  ..............  A               Treat fracture of           9.17         NA       7.65       1.47         NA      18.29        090
                                                       radius.
25520...............  ..............  A               Treat fracture of           6.25       6.86       6.06       1.02      14.13      13.33        090
                                                       radius.
25525...............  ..............  A               Treat fracture of          12.22         NA      10.16       1.97         NA      24.35        090
                                                       radius.
25526...............  ..............  A               Treat fracture of          12.96         NA      13.63       2.04         NA      28.63        090
                                                       radius.
25530...............  ..............  A               Treat fracture of           2.09       3.77       2.88       0.32       6.18       5.29        090
                                                       ulna.
25535...............  ..............  A               Treat fracture of           5.13       6.02       5.29       0.83      11.98      11.25        090
                                                       ulna.
25545...............  ..............  A               Treat fracture of           8.89         NA       7.85       1.43         NA      18.17        090
                                                       ulna.
25560...............  ..............  A               Treat fracture radius       2.44       3.71       2.64       0.33       6.48       5.41        090
                                                       & ulna.
25565...............  ..............  A               Treat fracture radius       5.62       6.70       5.43       0.90      13.22      11.95        090
                                                       & ulna.
25574...............  ..............  A               Treat fracture radius       7.00         NA       7.37       1.14         NA      15.51        090
                                                       & ulna.
25575...............  ..............  A               Treat fracture radius/     10.43         NA       9.66       1.67         NA      21.76        090
                                                       ulna.
25600...............  ..............  A               Treat fracture radius/      2.63       4.09       2.99       0.39       7.11       6.01        090
                                                       ulna.
25605...............  ..............  A               Treat fracture radius/      5.80       7.22       6.21       0.96      13.98      12.97        090
                                                       ulna.
25611...............  ..............  A               Treat fracture radius/      7.76         NA       9.11       1.32         NA      18.19        090
                                                       ulna.
25620...............  ..............  A               Treat fracture radius/      8.54         NA       7.47       1.35         NA      17.36        090
                                                       ulna.
25622...............  ..............  A               Treat wrist bone            2.61       4.27       3.13       0.39       7.27       6.13        090
                                                       fracture.
25624...............  ..............  A               Treat wrist bone            4.52       6.30       5.08       0.72      11.54      10.32        090
                                                       fracture.
25628...............  ..............  A               Treat wrist bone            8.42         NA       8.04       1.30         NA      17.76        090
                                                       fracture.
25630...............  ..............  A               Treat wrist bone            2.88       4.19       2.97       0.43       7.50       6.28        090
                                                       fracture.
25635...............  ..............  A               Treat wrist bone            4.38       5.94       3.93       0.65      10.97       8.96        090
                                                       fracture.
25645...............  ..............  A               Treat wrist bone            7.24         NA       6.99       1.12         NA      15.35        090
                                                       fracture.
25650...............  ..............  A               Treat wrist bone            3.05       4.31       3.21       0.41       7.77       6.67        090
                                                       fracture.
25651...............  ..............  A               Pin ulnar styloid           5.35         NA       5.42       0.73         NA      11.50        090
                                                       fracture.
25652...............  ..............  A               Treat fracture ulnar        7.59         NA       6.94       1.19         NA      15.72        090
                                                       styloid.
25660...............  ..............  A               Treat wrist                 4.75         NA       4.76       0.64         NA      10.15        090
                                                       dislocation.
25670...............  ..............  A               Treat wrist                 7.91         NA       7.27       1.23         NA      16.41        090
                                                       dislocation.
25671...............  ..............  A               Pin radioulnar              5.99         NA       6.07       0.93         NA      12.99        090
                                                       dislocation.
25675...............  ..............  A               Treat wrist                 4.66       5.67       4.67       0.61      10.94       9.94        090
                                                       dislocation.
25676...............  ..............  A               Treat wrist                 8.03         NA       7.53       1.34         NA      16.90        090
                                                       dislocation.
25680...............  ..............  A               Treat wrist fracture.       5.98         NA       4.85       0.73         NA      11.56        090
25685...............  ..............  A               Treat wrist fracture.       9.77         NA       8.05       1.53         NA      19.35        090
25690...............  ..............  A               Treat wrist                 5.49         NA       5.57       0.89         NA      11.95        090
                                                       dislocation.
25695...............  ..............  A               Treat wrist                 8.33         NA       7.38       1.32         NA      17.03        090
                                                       dislocation.
25800...............  ..............  A               Fusion of wrist joint       9.75         NA       9.20       1.31         NA      20.26        090
25805...............  ..............  A               Fusion/graft of wrist      11.26         NA      10.35       1.79         NA      23.40        090
                                                       joint.
25810...............  ..............  A               Fusion/graft of wrist      10.55         NA      10.01       1.60         NA      22.16        090
                                                       joint.
25820...............  ..............  A               Fusion of hand bones.       7.44         NA       7.99       1.11         NA      16.54        090
25825...............  ..............  A               Fuse hand bones with        9.26         NA       9.34       1.34         NA      19.94        090
                                                       graft.
25830...............  ..............  A               Fusion, radioulnar         10.04         NA      14.57       1.39         NA      26.00        090
                                                       jnt/ulna.
25900...............  ..............  A               Amputation of forearm       9.00         NA      12.73       1.36         NA      23.09        090
25905...............  ..............  A               Amputation of forearm       9.11         NA      12.65       1.28         NA      23.04        090
25907...............  ..............  A               Amputation follow-up        7.79         NA      12.07       1.20         NA      21.06        090
                                                       surgery.
25909...............  ..............  A               Amputation follow-up        8.95         NA      12.60       1.21         NA      22.76        090
                                                       surgery.
25915...............  ..............  A               Amputation of forearm      17.05         NA      19.33       1.13         NA      37.51        090
25920...............  ..............  A               Amputate hand at            8.67         NA       8.07       1.33         NA      18.07        090
                                                       wrist.
25922...............  ..............  A               Amputate hand at            7.41         NA       7.30       1.29         NA      16.00        090
                                                       wrist.
25924...............  ..............  A               Amputation follow-up        8.45         NA       8.31       1.47         NA      18.23        090
                                                       surgery.
25927...............  ..............  A               Amputation of hand...       8.79         NA      12.00       1.34         NA      22.13        090
25929...............  ..............  A               Amputation follow-up        7.58         NA       6.15       1.27         NA      15.00        090
                                                       surgery.
25931...............  ..............  A               Amputation follow-up        7.80         NA      11.93       1.04         NA      20.77        090
                                                       surgery.
26010...............  ..............  A               Drainage of finger          1.54       5.60       1.64       0.17       7.31       3.35        010
                                                       abscess.
26011...............  ..............  A               Drainage of finger          2.19       8.81       2.32       0.32      11.32       4.83        010
                                                       abscess.
26020...............  ..............  A               Drain hand tendon           4.66         NA       5.73       0.72         NA      11.11        090
                                                       sheath.
26025...............  ..............  A               Drainage of palm            4.81         NA       5.52       0.74         NA      11.07        090
                                                       bursa.
26030...............  ..............  A               Drainage of palm            5.92         NA       6.16       0.92         NA      13.00        090
                                                       bursa(s).
26034...............  ..............  A               Treat hand bone             6.22         NA       6.34       0.97         NA      13.53        090
                                                       lesion.
26035...............  ..............  A               Decompress fingers/         9.50         NA       8.28       1.40         NA      19.18        090
                                                       hand.
26037...............  ..............  A               Decompress fingers/         7.24         NA       6.74       1.09         NA      15.07        090
                                                       hand.
26040...............  ..............  A               Release palm                3.33         NA       4.04       0.54         NA       7.91        090
                                                       contracture.
26045...............  ..............  A               Release palm                5.55         NA       5.63       0.93         NA      12.11        090
                                                       contracture.
26055...............  ..............  A               Incise finger tendon        2.69      14.17       3.93       0.43      17.29       7.05        090
                                                       sheath.
26060...............  ..............  A               Incision of finger          2.81         NA       3.50       0.44         NA       6.75        090
                                                       tendon.
26070...............  ..............  A               Explore/treat hand          3.68         NA       3.38       0.47         NA       7.53        090
                                                       joint.
26075...............  ..............  A               Explore/treat finger        3.78         NA       3.79       0.52         NA       8.09        090
                                                       joint.
26080...............  ..............  A               Explore/treat finger        4.23         NA       4.85       0.65         NA       9.73        090
                                                       joint.
26100...............  ..............  A               Biopsy hand joint           3.66         NA       4.13       0.54         NA       8.33        090
                                                       lining.
26105...............  ..............  A               Biopsy finger joint         3.70         NA       4.22       0.58         NA       8.50        090
                                                       lining.
26110...............  ..............  A               Biopsy finger joint         3.52         NA       4.03       0.53         NA       8.08        090
                                                       lining.
26115...............  ..............  A               Removel hand lesion         3.85      13.01       4.76       0.59      17.45       9.20        090
                                                       subcut.
26116...............  ..............  A               Removel hand lesion,        5.52         NA       5.99       0.82         NA      12.33        090
                                                       deep.
26117...............  ..............  A               Remove tumor, hand/         8.54         NA       7.05       1.24         NA      16.83        090
                                                       finger.

[[Page 47596]]

 
26121...............  ..............  A               Release palm                7.53         NA       6.95       1.17         NA      15.65        090
                                                       contracture.
26123...............  ..............  A               Release palm                9.28         NA       8.85       1.42         NA      19.55        090
                                                       contracture.
26125...............  ..............  A               Release palm                4.60         NA       2.44       0.70         NA       7.74        ZZZ
                                                       contracture.
26130...............  ..............  A               Remove wrist joint          5.41         NA       5.33       0.97         NA      11.71        090
                                                       lining.
26135...............  ..............  A               Revise finger joint,        6.95         NA       6.45       1.01         NA      14.41        090
                                                       each.
26140...............  ..............  A               Revise finger joint,        6.16         NA       6.03       0.92         NA      13.11        090
                                                       each.
26145...............  ..............  A               Tendon excision, palm/      6.31         NA       6.04       0.98         NA      13.33        090
                                                       finger.
26160...............  ..............  A               Remove tendon sheath        3.15      12.36       4.12       0.48      15.99       7.75        090
                                                       lesion.
26170...............  ..............  A               Removal of palm             4.76         NA       4.93       0.71         NA      10.40        090
                                                       tendon, each.
26180...............  ..............  A               Removal of finger           5.17         NA       5.40       0.81         NA      11.38        090
                                                       tendon.
26185...............  ..............  A               Remove finger bone...       5.24         NA       6.02       0.72         NA      11.98        090
26200...............  ..............  A               Remove hand bone            5.50         NA       5.35       0.87         NA      11.72        090
                                                       lesion.
26205...............  ..............  A               Remove/graft bone           7.69         NA       6.88       1.20         NA      15.77        090
                                                       lesion.
26210...............  ..............  A               Removal of finger           5.14         NA       5.41       0.79         NA      11.34        090
                                                       lesion.
26215...............  ..............  A               Remove/graft finger         7.09         NA       6.30       1.10         NA      14.49        090
                                                       lesion.
26230...............  ..............  A               Partial removal of          6.32         NA       5.90       0.95         NA      13.17        090
                                                       hand bone.
26235...............  ..............  A               Partial removal,            6.18         NA       5.80       0.93         NA      12.91        090
                                                       finger bone.
26236...............  ..............  A               Partial removal,            5.31         NA       5.32       0.80         NA      11.43        090
                                                       finger bone.
26250...............  ..............  A               Extensive hand              7.54         NA       6.42       1.21         NA      15.17        090
                                                       surgery.
26255...............  ..............  A               Extensive hand             12.41         NA       9.38       1.47         NA      23.26        090
                                                       surgery.
26260...............  ..............  A               Extensive finger            7.02         NA       6.17       1.05         NA      14.24        090
                                                       surgery.
26261...............  ..............  A               Extensive finger            9.08         NA       6.20       1.29         NA      16.57        090
                                                       surgery.
26262...............  ..............  A               Partial removal of          5.66         NA       5.32       0.85         NA      11.83        090
                                                       finger.
26320...............  ..............  A               Removal of implant          3.97         NA       4.31       0.59         NA       8.87        090
                                                       from hand.
26340...............  ..............  A               Manipulate finger w/        2.50         NA       4.87       0.39         NA       7.76        090
                                                       anesth.
26350...............  ..............  A               Repair finger/hand          5.98         NA      15.28       0.85         NA      22.11        090
                                                       tendon.
26352...............  ..............  A               Repair/graft hand           7.67         NA      15.84       1.19         NA      24.70        090
                                                       tendon.
26356...............  ..............  A               Repair finger/hand          8.06         NA      18.75       1.22         NA      28.03        090
                                                       tendon.
26357...............  ..............  A               Repair finger/hand          8.57         NA      16.30       1.33         NA      26.20        090
                                                       tendon.
26358...............  ..............  A               Repair/graft hand           9.13         NA      17.19       1.34         NA      27.66        090
                                                       tendon.
26370...............  ..............  A               Repair finger/hand          7.10         NA      15.70       1.09         NA      23.89        090
                                                       tendon.
26372...............  ..............  A               Repair/graft hand           8.75         NA      17.07       1.27         NA      27.09        090
                                                       tendon.
26373...............  ..............  A               Repair finger/hand          8.15         NA      16.64       1.30         NA      26.09        090
                                                       tendon.
26390...............  ..............  A               Revise hand/finger          9.18         NA      13.77       1.35         NA      24.30        090
                                                       tendon.
26392...............  ..............  A               Repair/graft hand          10.24         NA      17.43       1.49         NA      29.16        090
                                                       tendon.
26410...............  ..............  A               Repair hand tendon...       4.62         NA      12.40       0.72         NA      17.74        090
26412...............  ..............  A               Repair/graft hand           6.30         NA      13.72       0.98         NA      21.00        090
                                                       tendon.
26415...............  ..............  A               Excision, hand/finger       8.33         NA      12.22       1.06         NA      21.61        090
                                                       tendon.
26416...............  ..............  A               Graft hand or finger        9.36         NA      15.03       1.18         NA      25.57        090
                                                       tendon.
26418...............  ..............  A               Repair finger tendon.       4.24         NA      12.78       0.65         NA      17.67        090
26420...............  ..............  A               Repair/graft finger         6.76         NA      14.05       1.05         NA      21.86        090
                                                       tendon.
26426...............  ..............  A               Repair finger/hand          6.14         NA      13.57       0.96         NA      20.67        090
                                                       tendon.
26428...............  ..............  A               Repair/graft finger         7.20         NA      14.32       1.10         NA      22.62        090
                                                       tendon.
26432...............  ..............  A               Repair finger tendon.       4.01         NA      10.55       0.62         NA      15.18        090
26433...............  ..............  A               Repair finger tendon.       4.55         NA      11.22       0.70         NA      16.47        090
26434...............  ..............  A               Repair/graft finger         6.08         NA      11.92       0.88         NA      18.88        090
                                                       tendon.
26437...............  ..............  A               Realignment of              5.81         NA      11.84       0.89         NA      18.54        090
                                                       tendons.
26440...............  ..............  A               Release palm/finger         5.01         NA      13.94       0.76         NA      19.71        090
                                                       tendon.
26442...............  ..............  A               Release palm & finger       8.15         NA      16.43       1.16         NA      25.74        090
                                                       tendon.
26445...............  ..............  A               Release hand/finger         4.30         NA      13.70       0.66         NA      18.66        090
                                                       tendon.
26449...............  ..............  A               Release forearm/hand        6.99         NA      16.21       1.03         NA      24.23        090
                                                       tendon.
26450...............  ..............  A               Incision of palm            3.66         NA       7.53       0.58         NA      11.77        090
                                                       tendon.
26455...............  ..............  A               Incision of finger          3.63         NA       7.46       0.55         NA      11.64        090
                                                       tendon.
26460...............  ..............  A               Incise hand/finger          3.45         NA       7.28       0.51         NA      11.24        090
                                                       tendon.
26471...............  ..............  A               Fusion of finger            5.72         NA      11.52       0.88         NA      18.12        090
                                                       tendons.
26474...............  ..............  A               Fusion of finger            5.31         NA      11.69       0.74         NA      17.74        090
                                                       tendons.
26476...............  ..............  A               Tendon lengthening...       5.17         NA      11.23       0.79         NA      17.19        090
26477...............  ..............  A               Tendon shortening....       5.14         NA      11.40       0.77         NA      17.31        090
26478...............  ..............  A               Lengthening of hand         5.79         NA      12.09       0.94         NA      18.82        090
                                                       tendon.
26479...............  ..............  A               Shortening of hand          5.73         NA      11.94       0.90         NA      18.57        090
                                                       tendon.
26480...............  ..............  A               Transplant hand             6.68         NA      15.43       1.00         NA      23.11        090
                                                       tendon.
26483...............  ..............  A               Transplant/graft hand       8.28         NA      15.89       1.22         NA      25.39        090
                                                       tendon.
26485...............  ..............  A               Transplant palm             7.69         NA      15.77       1.09         NA      24.55        090
                                                       tendon.
26489...............  ..............  A               Transplant/graft palm       9.54         NA      12.39       1.18         NA      23.11        090
                                                       tendon.
26490...............  ..............  A               Revise thumb tendon..       8.40         NA      13.04       1.17         NA      22.61        090
26492...............  ..............  A               Tendon transfer with        9.61         NA      13.84       1.39         NA      24.84        090
                                                       graft.
26494...............  ..............  A               Hand tendon/muscle          8.46         NA      13.47       1.21         NA      23.14        090
                                                       transfer.
26496...............  ..............  A               Revise thumb tendon..       9.58         NA      13.47       1.38         NA      24.43        090
26497...............  ..............  A               Finger tendon               9.56         NA      13.82       1.46         NA      24.84        090
                                                       transfer.
26498...............  ..............  A               Finger tendon              13.98         NA      16.40       1.95         NA      32.33        090
                                                       transfer.
26499...............  ..............  A               Revision of finger...       8.97         NA      13.40       1.30         NA      23.67        090
26500...............  ..............  A               Hand tendon                 5.95         NA      11.98       0.89         NA      18.82        090
                                                       reconstruction.
26502...............  ..............  A               Hand tendon                 7.13         NA      12.45       1.03         NA      20.61        090
                                                       reconstruction.
26504...............  ..............  A               Hand tendon                 7.46         NA      12.85       1.18         NA      21.49        090
                                                       reconstruction.
26508...............  ..............  A               Release thumb               6.00         NA      11.97       0.94         NA      18.91        090
                                                       contracture.

[[Page 47597]]

 
26510...............  ..............  A               Thumb tendon transfer       5.42         NA      11.65       0.77         NA      17.84        090
26516...............  ..............  A               Fusion of knuckle           7.14         NA      12.50       1.04         NA      20.68        090
                                                       joint.
26517...............  ..............  A               Fusion of knuckle           8.82         NA      13.82       1.49         NA      24.13        090
                                                       joints.
26518...............  ..............  A               Fusion of knuckle           9.01         NA      13.63       1.52         NA      24.16        090
                                                       joints.
26520...............  ..............  A               Release knuckle             5.29         NA      14.38       0.80         NA      20.47        090
                                                       contracture.
26525...............  ..............  A               Release finger              5.32         NA      14.49       0.81         NA      20.62        090
                                                       contracture.
26530...............  ..............  A               Revise knuckle joint.       6.68         NA       6.13       1.03         NA      13.84        090
26531...............  ..............  A               Revise knuckle with         7.90         NA       7.10       1.15         NA      16.15        090
                                                       implant.
26535...............  ..............  A               Revise finger joint..       5.23         NA       3.74       0.58         NA       9.55        090
26536...............  ..............  A               Revise/implant finger       6.36         NA       9.63       0.89         NA      16.88        090
                                                       joint.
26540...............  ..............  A               Repair hand joint....       6.42         NA      12.22       0.97         NA      19.61        090
26541...............  ..............  A               Repair hand joint           8.61         NA      13.69       1.23         NA      23.53        090
                                                       with graft.
26542...............  ..............  A               Repair hand joint           6.77         NA      12.25       0.98         NA      20.00        090
                                                       with graft.
26545...............  ..............  A               Reconstruct finger          6.91         NA      12.66       1.01         NA      20.58        090
                                                       joint.
26546...............  ..............  A               Repair nonunion hand.       8.91         NA      15.14       1.33         NA      25.38        090
26548...............  ..............  A               Reconstruct finger          8.02         NA      13.25       1.16         NA      22.43        090
                                                       joint.
26550...............  ..............  A               Construct thumb            21.21         NA      18.11       2.98         NA      42.30        090
                                                       replacement.
26551...............  ..............  A               Great toe-hand             46.51         NA      33.36       5.65         NA      85.52        090
                                                       transfer.
26553...............  ..............  A               Single transfer, toe-      46.20         NA      22.83       3.49         NA      72.52        090
                                                       hand.
26554...............  ..............  A               Double transfer, toe-      54.87         NA      37.75       9.36         NA     101.98        090
                                                       hand.
26555...............  ..............  A               Positional change of       16.61         NA      18.47       2.26         NA      37.34        090
                                                       finger.
26556...............  ..............  A               Toe joint transfer...      47.19         NA      33.81       8.04         NA      89.04        090
26560...............  ..............  A               Repair of web finger.       5.37         NA      10.18       0.76         NA      16.31        090
26561...............  ..............  A               Repair of web finger.      10.90         NA      12.81       1.53         NA      25.24        090
26562...............  ..............  A               Repair of web finger.      14.98         NA      17.46       1.18         NA      33.62        090
26565...............  ..............  A               Correct metacarpal          6.73         NA      12.32       0.96         NA      20.01        090
                                                       flaw.
26567...............  ..............  A               Correct finger              6.81         NA      12.25       1.02         NA      20.08        090
                                                       deformity.
26568...............  ..............  A               Lengthen metacarpal/        9.07         NA      15.87       1.34         NA      26.28        090
                                                       finger.
26580...............  ..............  A               Repair hand deformity      18.15         NA      14.01       1.88         NA      34.04        090
26587...............  ..............  A               Reconstruct extra          14.03         NA       9.06       1.46         NA      24.55        090
                                                       finger.
26590...............  ..............  A               Repair finger              17.93         NA      14.31       1.62         NA      33.86        090
                                                       deformity.
26591...............  ..............  A               Repair muscles of           3.25         NA      10.31       0.49         NA      14.05        090
                                                       hand.
26593...............  ..............  A               Release muscles of          5.30         NA      11.38       0.77         NA      17.45        090
                                                       hand.
26596...............  ..............  A               Excision constricting       8.94         NA       9.00       1.38         NA      19.32        090
                                                       tissue.
26600...............  ..............  A               Treat metacarpal            1.96       3.61       2.68       0.29       5.86       4.93        090
                                                       fracture.
26605...............  ..............  A               Treat metacarpal            2.85       4.56       3.65       0.45       7.86       6.95        090
                                                       fracture.
26607...............  ..............  A               Treat metacarpal            5.35         NA       6.38       0.84         NA      12.57        090
                                                       fracture.
26608...............  ..............  A               Treat metacarpal            5.35         NA       6.54       0.88         NA      12.77        090
                                                       fracture.
26615...............  ..............  A               Treat metacarpal            5.32         NA       5.73       0.85         NA      11.90        090
                                                       fracture.
26641...............  ..............  A               Treat thumb                 3.93       4.60       3.58       0.43       8.96       7.94        090
                                                       dislocation.
26645...............  ..............  A               Treat thumb fracture.       4.40       5.18       4.20       0.62      10.20       9.22        090
26650...............  ..............  A               Treat thumb fracture.       5.71         NA       6.95       0.94         NA      13.60        090
26665...............  ..............  A               Treat thumb fracture.       7.59         NA       6.99       1.19         NA      15.77        090
26670...............  ..............  A               Treat hand                  3.68       4.29       2.99       0.39       8.36       7.06        090
                                                       dislocation.
26675...............  ..............  A               Treat hand                  4.63       5.48       4.48       0.72      10.83       9.83        090
                                                       dislocation.
26676...............  ..............  A               Pin hand dislocation.       5.51         NA       6.99       0.88         NA      13.38        090
26685...............  ..............  A               Treat hand                  6.97         NA       6.44       1.05         NA      14.46        090
                                                       dislocation.
26686...............  ..............  A               Treat hand                  7.93         NA       7.21       1.21         NA      16.35        090
                                                       dislocation.
26700...............  ..............  A               Treat knuckle               3.68       3.79       2.91       0.34       7.81       6.93        090
                                                       dislocation.
26705...............  ..............  A               Treat knuckle               4.18       5.35       4.31       0.61      10.14       9.10        090
                                                       dislocation.
26706...............  ..............  A               Pin knuckle                 5.11         NA       5.27       0.77         NA      11.15        090
                                                       dislocation.
26715...............  ..............  A               Treat knuckle               5.73         NA       5.91       0.89         NA      12.53        090
                                                       dislocation.
26720...............  ..............  A               Treat finger                1.66       2.79       2.09       0.22       4.67       3.97        090
                                                       fracture, each.
26725...............  ..............  A               Treat finger                3.33       4.77       3.51       0.50       8.60       7.34        090
                                                       fracture, each.
26727...............  ..............  A               Treat finger                5.22         NA       6.60       0.84         NA      12.66        090
                                                       fracture, each.
26735...............  ..............  A               Treat finger                5.97         NA       6.06       0.94         NA      12.97        090
                                                       fracture, each.
26740...............  ..............  A               Treat finger                1.94       3.14       2.71       0.30       5.38       4.95        090
                                                       fracture, each.
26742...............  ..............  A               Treat finger                3.84       4.99       3.89       0.56       9.39       8.29        090
                                                       fracture, each.
26746...............  ..............  A               Treat finger                5.80         NA       6.12       0.91         NA      12.83        090
                                                       fracture, each.
26750...............  ..............  A               Treat finger                1.70       2.49       2.05       0.20       4.39       3.95        090
                                                       fracture, each.
26755...............  ..............  A               Treat finger                3.10       4.43       3.02       0.41       7.94       6.53        090
                                                       fracture, each.
26756...............  ..............  A               Pin finger fracture,        4.38         NA       6.23       0.69         NA      11.30        090
                                                       each.
26765...............  ..............  A               Treat finger                4.16         NA       4.96       0.62         NA       9.74        090
                                                       fracture, each.
26770...............  ..............  A               Treat finger                3.02       3.46       2.46       0.27       6.75       5.75        090
                                                       dislocation.
26775...............  ..............  A               Treat finger                3.70       5.20       3.84       0.49       9.39       8.03        090
                                                       dislocation.
26776...............  ..............  A               Pin finger                  4.79         NA       6.40       0.73         NA      11.92        090
                                                       dislocation.
26785...............  ..............  A               Treat finger                4.20         NA       4.99       0.67         NA       9.86        090
                                                       dislocation.
26820...............  ..............  A               Thumb fusion with           8.25         NA      13.49       1.36         NA      23.10        090
                                                       graft.
26841...............  ..............  A               Fusion of thumb......       7.12         NA      13.39       1.17         NA      21.68        090
26842...............  ..............  A               Thumb fusion with           8.23         NA      13.57       1.24         NA      23.04        090
                                                       graft.
26843...............  ..............  A               Fusion of hand joint.       7.60         NA      12.53       1.21         NA      21.34        090
26844...............  ..............  A               Fusion/graft of hand        8.72         NA      13.55       1.29         NA      23.56        090
                                                       joint.
26850...............  ..............  A               Fusion of knuckle....       6.96         NA      12.41       1.05         NA      20.42        090
26852...............  ..............  A               Fusion of knuckle           8.45         NA      13.14       1.23         NA      22.82        090
                                                       with graft.
26860...............  ..............  A               Fusion of finger            4.68         NA      11.42       0.73         NA      16.83        090
                                                       joint.

[[Page 47598]]

 
26861...............  ..............  A               Fusion of finger jnt,       1.74         NA       0.93       0.24         NA       2.91        ZZZ
                                                       add-on.
26862...............  ..............  A               Fusion/graft of             7.36         NA      12.63       1.05         NA      21.04        090
                                                       finger joint.
26863...............  ..............  A               Fuse/graft added            3.89         NA       2.10       0.56         NA       6.55        ZZZ
                                                       joint.
26910...............  ..............  A               Amputate metacarpal         7.59         NA      11.57       1.13         NA      20.29        090
                                                       bone.
26951...............  ..............  A               Amputation of finger/       4.58         NA      10.48       0.70         NA      15.76        090
                                                       thumb.
26952...............  ..............  A               Amputation of finger/       6.30         NA      12.05       0.94         NA      19.29        090
                                                       thumb.
26990...............  ..............  A               Drainage of pelvis          7.47         NA       7.75       1.18         NA      16.40        090
                                                       lesion.
26991...............  ..............  A               Drainage of pelvis          6.67      11.17       5.43       1.07      18.91      13.17        090
                                                       bursa.
26992...............  ..............  A               Drainage of bone           13.00         NA      11.06       2.06         NA      26.12        090
                                                       lesion.
27000...............  ..............  A               Incision of hip             5.61         NA       5.46       0.96         NA      12.03        090
                                                       tendon.
27001...............  ..............  A               Incision of hip             6.93         NA       6.33       1.16         NA      14.42        090
                                                       tendon.
27003...............  ..............  A               Incision of hip             7.33         NA       6.74       1.18         NA      15.25        090
                                                       tendon.
27005...............  ..............  A               Incision of hip             9.65         NA       8.04       1.58         NA      19.27        090
                                                       tendon.
27006...............  ..............  A               Incision of hip             9.67         NA       8.21       1.56         NA      19.44        090
                                                       tendons.
27025...............  ..............  A               Incision of hip/thigh      11.14         NA       8.75       1.75         NA      21.64        090
                                                       fascia.
27030...............  ..............  A               Drainage of hip joint      12.99         NA       9.85       2.10         NA      24.94        090
27033...............  ..............  A               Exploration of hip         13.37         NA      10.12       2.20         NA      25.69        090
                                                       joint.
27035...............  ..............  A               Denervation of hip         16.66         NA      12.61       2.43         NA      31.70        090
                                                       joint.
27036...............  ..............  A               Excision of hip joint/     12.86         NA      10.28       2.11         NA      25.25        090
                                                       muscle.
27040...............  ..............  A               Biopsy of soft              2.87       5.25       2.01       0.30       8.42       5.18        010
                                                       tissues.
27041...............  ..............  A               Biopsy of soft              9.88         NA       6.79       1.30         NA      17.97        090
                                                       tissues.
27047...............  ..............  A               Remove hip/pelvis           7.44       7.14       4.78       1.00      15.58      13.22        090
                                                       lesion.
27048...............  ..............  A               Remove hip/pelvis           6.24         NA       5.12       0.89         NA      12.25        090
                                                       lesion.
27049...............  ..............  A               Remove tumor, hip/         13.64         NA       8.93       1.95         NA      24.52        090
                                                       pelvis.
27050...............  ..............  A               Biopsy of sacroiliac        4.35         NA       4.64       0.66         NA       9.65        090
                                                       joint.
27052...............  ..............  A               Biopsy of hip joint..       6.22         NA       6.09       0.98         NA      13.29        090
27054...............  ..............  A               Removal of hip joint        8.53         NA       7.59       1.35         NA      17.47        090
                                                       lining.
27060...............  ..............  A               Removal of ischial          5.42         NA       4.94       0.78         NA      11.14        090
                                                       bursa.
27062...............  ..............  A               Remove femur lesion/        5.36         NA       5.40       0.91         NA      11.67        090
                                                       bursa.
27065...............  ..............  A               Removal of hip bone         5.89         NA       5.71       0.90         NA      12.50        090
                                                       lesion.
27066...............  ..............  A               Removal of hip bone        10.31         NA       8.73       1.60         NA      20.64        090
                                                       lesion.
27067...............  ..............  A               Remove/graft hip bone      13.81         NA      10.92       2.25         NA      26.98        090
                                                       lesion.
27070...............  ..............  A               Partial removal of         10.70         NA       9.98       1.67         NA      22.35        090
                                                       hip bone.
27071...............  ..............  A               Partial removal of         11.44         NA      10.98       1.82         NA      24.24        090
                                                       hip bone.
27075...............  ..............  A               Extensive hip surgery      34.95         NA      19.82       5.16         NA      59.93        090
27076...............  ..............  A               Extensive hip surgery      22.09         NA      15.05       3.43         NA      40.57        090
27077...............  ..............  A               Extensive hip surgery      39.94         NA      23.29       5.61         NA      68.84        090
27078...............  ..............  A               Extensive hip surgery      13.42         NA      10.70       2.12         NA      26.24        090
27079...............  ..............  A               Extensive hip surgery      13.73         NA      10.31       2.00         NA      26.04        090
27080...............  ..............  A               Removal of tail bone.       6.38         NA       5.17       0.92         NA      12.47        090
27086...............  ..............  A               Remove hip foreign          1.87       4.57       1.82       0.22       6.66       3.91        010
                                                       body.
27087...............  ..............  A               Remove hip foreign          8.53         NA       6.85       1.29         NA      16.67        090
                                                       body.
27090...............  ..............  A               Removal of hip             11.13         NA       8.76       1.81         NA      21.70        090
                                                       prosthesis.
27091...............  ..............  A               Removal of hip             22.11         NA      13.97       3.49         NA      39.57        090
                                                       prosthesis.
27093...............  ..............  A               Injection for hip x-        1.30       4.50       0.48       0.12       5.92       1.90        000
                                                       ray.
27095...............  ..............  A               Injection for hip x-        1.50       5.81       0.52       0.13       7.44       2.15        000
                                                       ray.
27096...............  ..............  A               Inject sacroiliac           1.40       3.95       0.33       0.10       5.45       1.83        000
                                                       joint.
27097...............  ..............  A               Revision of hip             8.79         NA       6.63       1.49         NA      16.91        090
                                                       tendon.
27098...............  ..............  A               Transfer tendon to          8.82         NA       7.26       0.91         NA      16.99        090
                                                       pelvis.
27100...............  ..............  A               Transfer of abdominal      11.06         NA       8.97       1.76         NA      21.79        090
                                                       muscle.
27105...............  ..............  A               Transfer of spinal         11.75         NA       9.41       1.32         NA      22.48        090
                                                       muscle.
27110...............  ..............  A               Transfer of iliopsoas      13.24         NA       9.48       1.82         NA      24.54        090
                                                       muscle.
27111...............  ..............  A               Transfer of iliopsoas      12.13         NA       9.36       2.11         NA      23.60        090
                                                       muscle.
27120...............  ..............  A               Reconstruction of hip      17.98         NA      11.83       2.73         NA      32.54        090
                                                       socket.
27122...............  ..............  A               Reconstruction of hip      14.96         NA      11.02       2.42         NA      28.40        090
                                                       socket.
27125...............  ..............  A               Partial hip                14.67         NA      10.60       2.32         NA      27.59        090
                                                       replacement.
27130...............  ..............  A               Total hip                  20.09         NA      13.28       3.11         NA      36.48        090
                                                       arthroplasty.
27132...............  ..............  A               Total hip                  23.27         NA      15.60       3.64         NA      42.51        090
                                                       arthroplasty.
27134...............  ..............  A               Revise hip joint           28.48         NA      17.76       4.44         NA      50.68        090
                                                       replacement.
27137...............  ..............  A               Revise hip joint           21.14         NA      13.90       3.35         NA      38.39        090
                                                       replacement.
27138...............  ..............  A               Revise hip joint           22.14         NA      14.37       3.51         NA      40.02        090
                                                       replacement.
27140...............  ..............  A               Transplant femur           12.22         NA       9.61       1.97         NA      23.80        090
                                                       ridge.
27146...............  ..............  A               Incision of hip bone.      17.40         NA      12.49       2.61         NA      32.50        090
27147...............  ..............  A               Revision of hip bone.      20.55         NA      13.51       2.80         NA      36.86        090
27151...............  ..............  A               Incision of hip bones      22.48         NA       8.26       3.57         NA      34.31        090
27156...............  ..............  A               Revision of hip bones      24.59         NA      16.32       3.52         NA      44.43        090
27158...............  ..............  A               Revision of pelvis...      19.71         NA      11.30       3.14         NA      34.15        090
27161...............  ..............  A               Incision of neck of        16.68         NA      12.29       2.77         NA      31.74        090
                                                       femur.
27165...............  ..............  A               Incision/fixation of       17.88         NA      13.07       2.82         NA      33.77        090
                                                       femur.
27170...............  ..............  A               Repair/graft femur         16.05         NA      11.49       2.56         NA      30.10        090
                                                       head/neck.
27175...............  ..............  A               Treat slipped               8.45         NA       6.75       1.47         NA      16.67        090
                                                       epiphysis.
27176...............  ..............  A               Treat slipped              12.03         NA       9.14       2.00         NA      23.17        090
                                                       epiphysis.
27177...............  ..............  A               Treat slipped              15.06         NA      10.99       2.49         NA      28.54        090
                                                       epiphysis.
27178...............  ..............  A               Treat slipped              11.97         NA       8.53       2.08         NA      22.58        090
                                                       epiphysis.
27179...............  ..............  A               Revise head/neck of        12.96         NA      10.09       2.25         NA      25.30        090
                                                       femur.

[[Page 47599]]

 
27181...............  ..............  A               Treat slipped              14.66         NA      10.31       2.28         NA      27.25        090
                                                       epiphysis.
27185...............  ..............  A               Revision of femur           9.17         NA       7.78       1.59         NA      18.54        090
                                                       epiphysis.
27187...............  ..............  A               Reinforce hip bones..      13.52         NA      10.55       2.16         NA      26.23        090
27193...............  ..............  A               Treat pelvic ring           5.55       5.32       5.17       0.93      11.80      11.65        090
                                                       fracture.
27194...............  ..............  A               Treat pelvic ring           9.64         NA       7.64       1.62         NA      18.90        090
                                                       fracture.
27200...............  ..............  A               Treat tail bone             1.84       2.23       2.17       0.26       4.33       4.27        090
                                                       fracture.
27202...............  ..............  A               Treat tail bone             7.03         NA      17.13       0.93         NA      25.09        090
                                                       fracture.
27215...............  ..............  A               Treat pelvic               10.03         NA       7.30       1.78         NA      19.11        090
                                                       fracture(s).
27216...............  ..............  A               Treat pelvic ring          15.17         NA       9.91       2.49         NA      27.57        090
                                                       fracture.
27217...............  ..............  A               Treat pelvic ring          14.09         NA      10.34       2.23         NA      26.66        090
                                                       fracture.
27218...............  ..............  A               Treat pelvic ring          20.12         NA      11.62       3.23         NA      34.97        090
                                                       fracture.
27220...............  ..............  A               Treat hip socket            6.17       5.71       5.62       1.05      12.93      12.84        090
                                                       fracture.
27222...............  ..............  A               Treat hip socket           12.68         NA      10.04       2.17         NA      24.89        090
                                                       fracture.
27226...............  ..............  A               Treat hip wall             14.89         NA       8.03       2.46         NA      25.38        090
                                                       fracture.
27227...............  ..............  A               Treat hip fracture(s)      23.41         NA      15.53       3.73         NA      42.67        090
27228...............  ..............  A               Treat hip fracture(s)      27.12         NA      17.75       4.44         NA      49.31        090
27230...............  ..............  A               Treat thigh fracture.       5.49       5.51       5.11       0.90      11.90      11.50        090
27232...............  ..............  A               Treat thigh fracture.      10.66         NA       7.34       1.78         NA      19.78        090
27235...............  ..............  A               Treat thigh fracture.      12.14         NA       9.57       2.08         NA      23.79        090
27236...............  ..............  A               Treat thigh fracture.      15.58         NA      11.04       2.49         NA      29.11        090
27238...............  ..............  A               Treat thigh fracture.       5.51         NA       5.27       0.86         NA      11.64        090
27240...............  ..............  A               Treat thigh fracture.      12.48         NA       9.58       2.06         NA      24.12        090
27244...............  ..............  A               Treat thigh fracture.      15.92         NA      11.42       2.57         NA      29.91        090
27245...............  ..............  A               Treat thigh fracture.      20.28         NA      13.85       3.24         NA      37.37        090
27246...............  ..............  A               Treat thigh fracture.       4.70       4.45       4.42       0.80       9.95       9.92        090
27248...............  ..............  A               Treat thigh fracture.      10.43         NA       8.35       1.68         NA      20.46        090
27250...............  ..............  A               Treat hip dislocation       6.94         NA       4.75       0.61         NA      12.30        090
27252...............  ..............  A               Treat hip dislocation      10.37         NA       7.53       1.58         NA      19.48        090
27253...............  ..............  A               Treat hip dislocation      12.90         NA       9.89       1.91         NA      24.70        090
27254...............  ..............  A               Treat hip dislocation      18.23         NA      12.17       2.97         NA      33.37        090
27256...............  ..............  A               Treat hip dislocation       4.11       3.52       2.09       0.43       8.06       6.63        010
27257...............  ..............  A               Treat hip dislocation       5.21         NA       2.82       0.67         NA       8.70        010
27258...............  ..............  A               Treat hip dislocation      15.41         NA      11.10       2.51         NA      29.02        090
27259...............  ..............  A               Treat hip dislocation      21.52         NA      14.33       3.35         NA      39.20        090
27265...............  ..............  A               Treat hip dislocation       5.04         NA       4.91       0.64         NA      10.59        090
27266...............  ..............  A               Treat hip dislocation       7.48         NA       6.46       1.26         NA      15.20        090
27275...............  ..............  A               Manipulation of hip         2.27         NA       2.10       0.38         NA       4.75        010
                                                       joint.
27280...............  ..............  A               Fusion of sacroiliac       13.37         NA      10.55       2.21         NA      26.13        090
                                                       joint.
27282...............  ..............  A               Fusion of pubic bones      11.32         NA       8.34       1.26         NA      20.92        090
27284...............  ..............  A               Fusion of hip joint..      23.41         NA      15.00       3.26         NA      41.67        090
27286...............  ..............  A               Fusion of hip joint..      23.41         NA      16.02       3.54         NA      42.97        090
27290...............  ..............  A               Amputation of leg at       23.25         NA      14.33       3.33         NA      40.91        090
                                                       hip.
27295...............  ..............  A               Amputation of leg at       18.62         NA      11.64       2.77         NA      33.03        090
                                                       hip.
27301...............  ..............  A               Drain thigh/knee            6.48      10.12       5.14       1.00      17.60      12.62        090
                                                       lesion.
27303...............  ..............  A               Drainage of bone            8.27         NA       7.54       1.35         NA      17.16        090
                                                       lesion.
27305...............  ..............  A               Incise thigh tendon &       5.91         NA       5.50       0.92         NA      12.33        090
                                                       fascia.
27306...............  ..............  A               Incision of thigh           4.61         NA       4.97       0.79         NA      10.37        090
                                                       tendon.
27307...............  ..............  A               Incision of thigh           5.79         NA       5.69       1.01         NA      12.49        090
                                                       tendons.
27310...............  ..............  A               Exploration of knee         9.26         NA       7.75       1.51         NA      18.52        090
                                                       joint.
27315...............  ..............  A               Partial removal,            6.96         NA       4.91       1.21         NA      13.08        090
                                                       thigh nerve.
27320...............  ..............  A               Partial removal,            6.29         NA       5.19       0.94         NA      12.42        090
                                                       thigh nerve.
27323...............  ..............  A               Biopsy, thigh soft          2.28       3.52       1.88       0.27       6.07       4.43        010
                                                       tissues.
27324...............  ..............  A               Biopsy, thigh soft          4.89         NA       4.45       0.73         NA      10.07        090
                                                       tissues.
27327...............  ..............  A               Removal of thigh            4.46       6.01       3.73       0.63      11.10       8.82        090
                                                       lesion.
27328...............  ..............  A               Removal of thigh            5.56         NA       4.65       0.83         NA      11.04        090
                                                       lesion.
27329...............  ..............  A               Remove tumor, thigh/       14.12         NA       9.68       2.05         NA      25.85        090
                                                       knee.
27330...............  ..............  A               Biopsy, knee joint          4.96         NA       4.72       0.85         NA      10.53        090
                                                       lining.
27331...............  ..............  A               Explore/treat knee          5.87         NA       5.68       0.95         NA      12.50        090
                                                       joint.
27332...............  ..............  A               Removal of knee             8.26         NA       7.26       1.38         NA      16.90        090
                                                       cartilage.
27333...............  ..............  A               Removal of knee             7.29         NA       6.81       1.17         NA      15.27        090
                                                       cartilage.
27334...............  ..............  A               Remove knee joint           8.69         NA       7.58       1.41         NA      17.68        090
                                                       lining.
27335...............  ..............  A               Remove knee joint           9.99         NA       8.39       1.61         NA      19.99        090
                                                       lining.
27340...............  ..............  A               Removal of kneecap          4.17         NA       4.69       0.71         NA       9.57        090
                                                       bursa.
27345...............  ..............  A               Removal of knee cyst.       5.91         NA       5.77       0.95         NA      12.63        090
27347...............  ..............  A               Remove knee cyst.....       5.77         NA       5.58       0.94         NA      12.29        090
27350...............  ..............  A               Removal of kneecap...       8.16         NA       7.38       1.31         NA      16.85        090
27355...............  ..............  A               Remove femur lesion..       7.64         NA       7.03       1.20         NA      15.87        090
27356...............  ..............  A               Remove femur lesion/        9.47         NA       8.11       1.58         NA      19.16        090
                                                       graft.
27357...............  ..............  A               Remove femur lesion/       10.51         NA       8.94       1.81         NA      21.26        090
                                                       graft.
27358...............  ..............  A               Remove femur lesion/        4.73         NA       2.52       0.76         NA       8.01        ZZZ
                                                       fixation.
27360...............  ..............  A               Partial removal, leg       10.48         NA      10.15       1.68         NA      22.31        090
                                                       bone(s).
27365...............  ..............  A               Extensive leg surgery      16.25         NA      11.89       2.70         NA      30.84        090
27370...............  ..............  A               Injection for knee x-       0.96       3.76       0.32       0.07       4.79       1.35        000
                                                       ray.
27372...............  ..............  A               Removal of foreign          5.06      10.10       4.69       0.77      15.93      10.52        090
                                                       body.
27380...............  ..............  A               Repair of kneecap           7.15         NA       7.37       1.16         NA      15.68        090
                                                       tendon.

[[Page 47600]]

 
27381...............  ..............  A               Repair/graft kneecap       10.32         NA       9.17       1.63         NA      21.12        090
                                                       tendon.
27385...............  ..............  A               Repair of thigh             7.75         NA       7.71       1.27         NA      16.73        090
                                                       muscle.
27386...............  ..............  A               Repair/graft of thigh      10.54         NA       9.61       1.69         NA      21.84        090
                                                       muscle.
27390...............  ..............  A               Incision of thigh           5.32         NA       5.43       0.84         NA      11.59        090
                                                       tendon.
27391...............  ..............  A               Incision of thigh           7.19         NA       6.83       1.19         NA      15.21        090
                                                       tendons.
27392...............  ..............  A               Incision of thigh           9.19         NA       7.94       1.52         NA      18.65        090
                                                       tendons.
27393...............  ..............  A               Lengthening of thigh        6.38         NA       6.04       0.98         NA      13.40        090
                                                       tendon.
27394...............  ..............  A               Lengthening of thigh        8.49         NA       7.49       1.37         NA      17.35        090
                                                       tendons.
27395...............  ..............  A               Lengthening of thigh       11.71         NA       9.63       1.80         NA      23.14        090
                                                       tendons.
27396...............  ..............  A               Transplant of thigh         7.85         NA       7.29       1.13         NA      16.27        090
                                                       tendon.
27397...............  ..............  A               Transplants of thigh       11.26         NA       9.27       1.50         NA      22.03        090
                                                       tendons.
27400...............  ..............  A               Revise thigh muscles/       9.01         NA       7.52       1.47         NA      18.00        090
                                                       tendons.
27403...............  ..............  A               Repair of knee              8.32         NA       7.33       1.34         NA      16.99        090
                                                       cartilage.
27405...............  ..............  A               Repair of knee              8.64         NA       7.66       1.41         NA      17.71        090
                                                       ligament.
27407...............  ..............  A               Repair of knee             10.26         NA       8.48       1.65         NA      20.39        090
                                                       ligament.
27409...............  ..............  A               Repair of knee             12.88         NA      10.10       2.18         NA      25.16        090
                                                       ligaments.
27418...............  ..............  A               Repair degenerated         10.83         NA       9.05       1.70         NA      21.58        090
                                                       kneecap.
27420...............  ..............  A               Revision of unstable        9.82         NA       8.25       1.55         NA      19.62        090
                                                       kneecap.
27422...............  ..............  A               Revision of unstable        9.77         NA       8.25       1.55         NA      19.57        090
                                                       kneecap.
27424...............  ..............  A               Revision/removal of         9.80         NA       8.22       1.54         NA      19.56        090
                                                       kneecap.
27425...............  ..............  A               Lat retinacular             5.21         NA       5.67       0.89         NA      11.77        090
                                                       release open.
27427...............  ..............  A               Reconstruction, knee.       9.35         NA       7.95       1.47         NA      18.77        090
27428...............  ..............  A               Reconstruction, knee.      13.98         NA      11.37       2.30         NA      27.65        090
27429...............  ..............  A               Reconstruction, knee.      15.50         NA      12.61       2.61         NA      30.72        090
27430...............  ..............  A               Revision of thigh           9.66         NA       8.15       1.53         NA      19.34        090
                                                       muscles.
27435...............  ..............  A               Incision of knee            9.48         NA       8.59       1.45         NA      19.52        090
                                                       joint.
27437...............  ..............  A               Revise kneecap.......       8.45         NA       7.23       1.51         NA      17.19        090
27438...............  ..............  A               Revise kneecap with        11.21         NA       8.52       1.80         NA      21.53        090
                                                       implant.
27440...............  ..............  A               Revision of knee           10.41         NA       6.01       1.56         NA      17.98        090
                                                       joint.
27441...............  ..............  A               Revision of knee           10.80         NA       6.71       1.66         NA      19.17        090
                                                       joint.
27442...............  ..............  A               Revision of knee           11.87         NA       8.90       1.86         NA      22.63        090
                                                       joint.
27443...............  ..............  A               Revision of knee           10.91         NA       8.70       1.67         NA      21.28        090
                                                       joint.
27445...............  ..............  A               Revision of knee           17.65         NA      12.32       2.80         NA      32.77        090
                                                       joint.
27446...............  ..............  A               Revision of knee           15.82         NA      11.25       2.44         NA      29.51        090
                                                       joint.
27447...............  ..............  A               Total knee                 21.45         NA      14.57       3.35         NA      39.37        090
                                                       arthroplasty.
27448...............  ..............  A               Incision of thigh....      11.04         NA       8.86       1.67         NA      21.57        090
27450...............  ..............  A               Incision of thigh....      13.96         NA      10.81       2.26         NA      27.03        090
27454...............  ..............  A               Realignment of thigh       17.53         NA      12.73       2.84         NA      33.10        090
                                                       bone.
27455...............  ..............  A               Realignment of knee..      12.80         NA      10.02       2.06         NA      24.88        090
27457...............  ..............  A               Realignment of knee..      13.43         NA      10.06       2.21         NA      25.70        090
27465...............  ..............  A               Shortening of thigh        13.85         NA      10.55       2.31         NA      26.71        090
                                                       bone.
27466...............  ..............  A               Lengthening of thigh       16.31         NA      12.12       2.57         NA      31.00        090
                                                       bone.
27468...............  ..............  A               Shorten/lengthen           18.94         NA      12.62       2.90         NA      34.46        090
                                                       thighs.
27470...............  ..............  A               Repair of thigh......      16.05         NA      12.08       2.57         NA      30.70        090
27472...............  ..............  A               Repair/graft of thigh      17.69         NA      12.96       2.85         NA      33.50        090
27475...............  ..............  A               Surgery to stop leg         8.63         NA       7.40       1.50         NA      17.53        090
                                                       growth.
27477...............  ..............  A               Surgery to stop leg         9.84         NA       7.90       1.72         NA      19.46        090
                                                       growth.
27479...............  ..............  A               Surgery to stop leg        12.78         NA      10.03       2.22         NA      25.03        090
                                                       growth.
27485...............  ..............  A               Surgery to stop leg         8.83         NA       7.56       1.71         NA      18.10        090
                                                       growth.
27486...............  ..............  A               Revise/replace knee        19.24         NA      13.46       2.99         NA      35.69        090
                                                       joint.
27487...............  ..............  A               Revise/replace knee        25.23         NA      16.52       3.90         NA      45.65        090
                                                       joint.
27488...............  ..............  A               Removal of knee            15.72         NA      11.68       2.49         NA      29.89        090
                                                       prosthesis.
27495...............  ..............  A               Reinforce thigh......      15.53         NA      11.71       2.52         NA      29.76        090
27496...............  ..............  A               Decompression of            6.10         NA       5.85       0.96         NA      12.91        090
                                                       thigh/knee.
27497...............  ..............  A               Decompression of            7.16         NA       5.77       1.00         NA      13.93        090
                                                       thigh/knee.
27498...............  ..............  A               Decompression of            7.98         NA       6.16       1.27         NA      15.41        090
                                                       thigh/knee.
27499...............  ..............  A               Decompression of            8.99         NA       7.12       1.32         NA      17.43        090
                                                       thigh/knee.
27500...............  ..............  A               Treatment of thigh          5.91       6.11       4.99       0.95      12.97      11.85        090
                                                       fracture.
27501...............  ..............  A               Treatment of thigh          5.91       6.02       5.38       1.01      12.94      12.30        090
                                                       fracture.
27502...............  ..............  A               Treatment of thigh         10.56         NA       8.35       1.73         NA      20.64        090
                                                       fracture.
27503...............  ..............  A               Treatment of thigh         10.56         NA       8.52       1.80         NA      20.88        090
                                                       fracture.
27506...............  ..............  A               Treatment of thigh         17.42         NA      12.93       2.83         NA      33.18        090
                                                       fracture.
27507...............  ..............  A               Treatment of thigh         13.97         NA      10.04       2.24         NA      26.25        090
                                                       fracture.
27508...............  ..............  A               Treatment of thigh          5.82       6.45       5.48       0.95      13.22      12.25        090
                                                       fracture.
27509...............  ..............  A               Treatment of thigh          7.70         NA       8.03       1.30         NA      17.03        090
                                                       fracture.
27510...............  ..............  A               Treatment of thigh          9.12         NA       7.34       1.54         NA      18.00        090
                                                       fracture.
27511...............  ..............  A               Treatment of thigh         13.62         NA      11.29       2.20         NA      27.11        090
                                                       fracture.
27513...............  ..............  A               Treatment of thigh         17.89         NA      13.95       2.91         NA      34.75        090
                                                       fracture.
27514...............  ..............  A               Treatment of thigh         17.27         NA      13.42       2.76         NA      33.45        090
                                                       fracture.
27516...............  ..............  A               Treat thigh fx growth       5.36       6.35       5.51       0.89      12.60      11.76        090
                                                       plate.
27517...............  ..............  A               Treat thigh fx growth       8.77         NA       7.44       1.28         NA      17.49        090
                                                       plate.
27519...............  ..............  A               Treat thigh fx growth      15.00         NA      11.71       2.42         NA      29.13        090
                                                       plate.
27520...............  ..............  A               Treat kneecap               2.86       4.54       3.46       0.44       7.84       6.76        090
                                                       fracture.
27524...............  ..............  A               Treat kneecap               9.99         NA       8.31       1.62         NA      19.92        090
                                                       fracture.
27530...............  ..............  A               Treat knee fracture..       3.77       5.31       4.43       0.62       9.70       8.82        090

[[Page 47601]]

 
27532...............  ..............  A               Treat knee fracture..       7.29       7.35       6.45       1.25      15.89      14.99        090
27535...............  ..............  A               Treat knee fracture..      11.48         NA      10.20       1.78         NA      23.46        090
27536...............  ..............  A               Treat knee fracture..      15.63         NA      11.67       2.56         NA      29.86        090
27538...............  ..............  A               Treat knee                  4.86       6.13       5.20       0.81      11.80      10.87        090
                                                       fracture(s).
27540...............  ..............  A               Treat knee fracture..      13.08         NA       9.60       2.11         NA      24.79        090
27550...............  ..............  A               Treat knee                  5.75       6.02       4.96       0.73      12.50      11.44        090
                                                       dislocation.
27552...............  ..............  A               Treat knee                  7.89         NA       7.08       1.34         NA      16.31        090
                                                       dislocation.
27556...............  ..............  A               Treat knee                 14.39         NA      11.79       2.32         NA      28.50        090
                                                       dislocation.
27557...............  ..............  A               Treat knee                 16.74         NA      13.25       2.83         NA      32.82        090
                                                       dislocation.
27558...............  ..............  A               Treat knee                 17.69         NA      13.18       2.82         NA      33.69        090
                                                       dislocation.
27560...............  ..............  A               Treat kneecap               3.81       4.84       3.24       0.39       9.04       7.44        090
                                                       dislocation.
27562...............  ..............  A               Treat kneecap               5.78         NA       4.88       0.75         NA      11.41        090
                                                       dislocation.
27566...............  ..............  A               Treat kneecap              12.21         NA       9.41       2.03         NA      23.65        090
                                                       dislocation.
27570...............  ..............  A               Fixation of knee            1.74         NA       1.77       0.30         NA       3.81        010
                                                       joint.
27580...............  ..............  A               Fusion of knee.......      19.34         NA      14.85       3.09         NA      37.28        090
27590...............  ..............  A               Amputate leg at thigh      12.01         NA       7.08       1.68         NA      20.77        090
27591...............  ..............  A               Amputate leg at thigh      12.66         NA       9.04       1.95         NA      23.65        090
27592...............  ..............  A               Amputate leg at thigh      10.00         NA       6.61       1.41         NA      18.02        090
27594...............  ..............  A               Amputation follow-up        6.91         NA       5.49       1.02         NA      13.42        090
                                                       surgery.
27596...............  ..............  A               Amputation follow-up       10.58         NA       7.27       1.55         NA      19.40        090
                                                       surgery.
27598...............  ..............  A               Amputate lower leg at      10.51         NA       7.40       1.48         NA      19.39        090
                                                       knee.
27600...............  ..............  A               Decompression of            5.64         NA       4.76       0.84         NA      11.24        090
                                                       lower leg.
27601...............  ..............  A               Decompression of            5.63         NA       5.09       0.86         NA      11.58        090
                                                       lower leg.
27602...............  ..............  A               Decompression of            7.34         NA       5.32       1.06         NA      13.72        090
                                                       lower leg.
27603...............  ..............  A               Drain lower leg             4.93       7.53       4.17       0.71      13.17       9.81        090
                                                       lesion.
27604...............  ..............  A               Drain lower leg bursa       4.46       6.10       3.96       0.67      11.23       9.09        090
27605...............  ..............  A               Incision of achilles        2.87       7.67       2.32       0.36      10.90       5.55        010
                                                       tendon.
27606...............  ..............  A               Incision of achilles        4.13         NA       3.36       0.66         NA       8.15        010
                                                       tendon.
27607...............  ..............  A               Treat lower leg bone        7.96         NA       6.89       1.25         NA      16.10        090
                                                       lesion.
27610...............  ..............  A               Explore/treat ankle         8.33         NA       7.28       1.34         NA      16.95        090
                                                       joint.
27612...............  ..............  A               Exploration of ankle        7.32         NA       6.31       0.97         NA      14.60        090
                                                       joint.
27613...............  ..............  A               Biopsy lower leg soft       2.17       3.24       1.80       0.22       5.63       4.19        010
                                                       tissue.
27614...............  ..............  A               Biopsy lower leg soft       5.65       7.15       4.44       0.75      13.55      10.84        090
                                                       tissue.
27615...............  ..............  A               Remove tumor, lower        12.54         NA      10.73       1.75         NA      25.02        090
                                                       leg.
27618...............  ..............  A               Remove lower leg            5.08       6.03       4.00       0.68      11.79       9.76        090
                                                       lesion.
27619...............  ..............  A               Remove lower leg            8.39       9.53       5.95       1.16      19.08      15.50        090
                                                       lesion.
27620...............  ..............  A               Explore/treat ankle         5.97         NA       5.68       0.87         NA      12.52        090
                                                       joint.
27625...............  ..............  A               Remove ankle joint          8.29         NA       6.75       1.14         NA      16.18        090
                                                       lining.
27626...............  ..............  A               Remove ankle joint          8.90         NA       7.21       1.33         NA      17.44        090
                                                       lining.
27630...............  ..............  A               Removal of tendon           4.79       7.60       4.38       0.67      13.06       9.84        090
                                                       lesion.
27635...............  ..............  A               Remove lower leg bone       7.77         NA       7.09       1.25         NA      16.11        090
                                                       lesion.
27637...............  ..............  A               Remove/graft leg bone       9.84         NA       8.61       1.61         NA      20.06        090
                                                       lesion.
27638...............  ..............  A               Remove/graft leg bone      10.55         NA       8.63       1.70         NA      20.88        090
                                                       lesion.
27640...............  ..............  A               Partial removal of         11.35         NA      11.05       1.78         NA      24.18        090
                                                       tibia.
27641...............  ..............  A               Partial removal of          9.23         NA       9.03       1.39         NA      19.65        090
                                                       fibula.
27645...............  ..............  A               Extensive lower leg        14.15         NA      12.52       2.12         NA      28.79        090
                                                       surgery.
27646...............  ..............  A               Extensive lower leg        12.64         NA      11.52       1.83         NA      25.99        090
                                                       surgery.
27647...............  ..............  A               Extensive ankle/heel       12.22         NA       8.03       1.23         NA      21.48        090
                                                       surgery.
27648...............  ..............  A               Injection for ankle x-      0.96       3.57       0.33       0.07       4.60       1.36        000
                                                       ray.
27650...............  ..............  A               Repair achilles             9.68         NA       7.69       1.44         NA      18.81        090
                                                       tendon.
27652...............  ..............  A               Repair/graft achilles      10.31         NA       8.20       1.51         NA      20.02        090
                                                       tendon.
27654...............  ..............  A               Repair of achilles         10.00         NA       7.43       1.32         NA      18.75        090
                                                       tendon.
27656...............  ..............  A               Repair leg fascia           4.56       8.58       3.78       0.62      13.76       8.96        090
                                                       defect.
27658...............  ..............  A               Repair of leg tendon,       4.97         NA       4.56       0.70         NA      10.23        090
                                                       each.
27659...............  ..............  A               Repair of leg tendon,       6.80         NA       5.64       0.97         NA      13.41        090
                                                       each.
27664...............  ..............  A               Repair of leg tendon,       4.58         NA       4.55       0.68         NA       9.81        090
                                                       each.
27665...............  ..............  A               Repair of leg tendon,       5.39         NA       4.97       0.82         NA      11.18        090
                                                       each.
27675...............  ..............  A               Repair lower leg            7.17         NA       5.97       0.94         NA      14.08        090
                                                       tendons.
27676...............  ..............  A               Repair lower leg            8.41         NA       6.96       0.91         NA      16.28        090
                                                       tendons.
27680...............  ..............  A               Release of lower leg        5.73         NA       5.37       0.87         NA      11.97        090
                                                       tendon.
27681...............  ..............  A               Release of lower leg        6.81         NA       6.15       1.06         NA      14.02        090
                                                       tendons.
27685...............  ..............  A               Revision of lower leg       6.49       7.29       5.46       0.82      14.60      12.77        090
                                                       tendon.
27686...............  ..............  A               Revise lower leg            7.45         NA       6.48       1.21         NA      15.14        090
                                                       tendons.
27687...............  ..............  A               Revision of calf            6.23         NA       5.62       0.89         NA      12.74        090
                                                       tendon.
27690...............  ..............  A               Revise lower leg            8.70         NA       6.65       1.16         NA      16.51        090
                                                       tendon.
27691...............  ..............  A               Revise lower leg            9.95         NA       8.02       1.46         NA      19.43        090
                                                       tendon.
27692...............  ..............  A               Revise additional leg       1.87         NA       0.92       0.28         NA       3.07        ZZZ
                                                       tendon.
27695...............  ..............  A               Repair of ankle             6.50         NA       6.14       1.01         NA      13.65        090
                                                       ligament.
27696...............  ..............  A               Repair of ankle             8.26         NA       6.71       1.10         NA      16.07        090
                                                       ligaments.
27698...............  ..............  A               Repair of ankle             9.35         NA       7.16       1.29         NA      17.80        090
                                                       ligament.
27700...............  ..............  A               Revision of ankle           9.28         NA       5.67       1.03         NA      15.98        090
                                                       joint.
27702...............  ..............  A               Reconstruct ankle          13.65         NA      10.44       2.15         NA      26.24        090
                                                       joint.
27703...............  ..............  A               Reconstruction, ankle      15.85         NA      11.21       2.48         NA      29.54        090
                                                       joint.
27704...............  ..............  A               Removal of ankle            7.61         NA       5.59       1.22         NA      14.42        090
                                                       implant.
27705...............  ..............  A               Incision of tibia....      10.36         NA       8.45       1.60         NA      20.41        090

[[Page 47602]]

 
27707...............  ..............  A               Incision of fibula...       4.36         NA       5.24       0.74         NA      10.34        090
27709...............  ..............  A               Incision of tibia &         9.94         NA       8.39       1.54         NA      19.87        090
                                                       fibula.
27712...............  ..............  A               Realignment of lower       14.23         NA      10.97       2.22         NA      27.42        090
                                                       leg.
27715...............  ..............  A               Revision of lower leg      14.37         NA      11.09       2.38         NA      27.84        090
27720...............  ..............  A               Repair of tibia......      11.77         NA       9.71       1.90         NA      23.38        090
27722...............  ..............  A               Repair/graft of tibia      11.80         NA       9.46       1.94         NA      23.20        090
27724...............  ..............  A               Repair/graft of tibia      18.17         NA      12.68       2.93         NA      33.78        090
27725...............  ..............  A               Repair of lower leg..      15.57         NA      12.18       2.53         NA      30.28        090
27727...............  ..............  A               Repair of lower leg..      13.99         NA      10.68       2.22         NA      26.89        090
27730...............  ..............  A               Repair of tibia             7.40         NA       6.42       1.29         NA      15.11        090
                                                       epiphysis.
27732...............  ..............  A               Repair of fibula            5.31         NA       4.93       0.57         NA      10.81        090
                                                       epiphysis.
27734...............  ..............  A               Repair lower leg            8.47         NA       6.61       0.68         NA      15.76        090
                                                       epiphyses.
27740...............  ..............  A               Repair of leg               9.29         NA       7.98       1.58         NA      18.85        090
                                                       epiphyses.
27742...............  ..............  A               Repair of leg              10.28       3.88       3.88       0.68      14.84      14.84        090
                                                       epiphyses.
27745...............  ..............  A               Reinforce tibia......      10.05         NA       8.44       1.70         NA      20.19        090
27750...............  ..............  A               Treatment of tibia          3.19       4.76       3.86       0.51       8.46       7.56        090
                                                       fracture.
27752...............  ..............  A               Treatment of tibia          5.83       6.64       5.66       0.99      13.46      12.48        090
                                                       fracture.
27756...............  ..............  A               Treatment of tibia          6.77         NA       6.79       1.09         NA      14.65        090
                                                       fracture.
27758...............  ..............  A               Treatment of tibia         11.65         NA       9.41       1.82         NA      22.88        090
                                                       fracture.
27759...............  ..............  A               Treatment of tibia         13.74         NA      10.54       2.23         NA      26.51        090
                                                       fracture.
27760...............  ..............  A               Treatment of ankle          3.01       4.68       3.62       0.44       8.13       7.07        090
                                                       fracture.
27762...............  ..............  A               Treatment of ankle          5.24       6.33       5.27       0.80      12.37      11.31        090
                                                       fracture.
27766...............  ..............  A               Treatment of ankle          8.35         NA       7.36       1.41         NA      17.12        090
                                                       fracture.
27780...............  ..............  A               Treatment of fibula         2.65       4.19       3.24       0.39       7.23       6.28        090
                                                       fracture.
27781...............  ..............  A               Treatment of fibula         4.39       5.49       4.64       0.71      10.59       9.74        090
                                                       fracture.
27784...............  ..............  A               Treatment of fibula         7.10         NA       6.65       1.18         NA      14.93        090
                                                       fracture.
27786...............  ..............  A               Treatment of ankle          2.84       4.46       3.36       0.43       7.73       6.63        090
                                                       fracture.
27788...............  ..............  A               Treatment of ankle          4.44       5.63       4.65       0.71      10.78       9.80        090
                                                       fracture.
27792...............  ..............  A               Treatment of ankle          7.65         NA       7.10       1.28         NA      16.03        090
                                                       fracture.
27808...............  ..............  A               Treatment of ankle          2.83       4.80       3.71       0.44       8.07       6.98        090
                                                       fracture.
27810...............  ..............  A               Treatment of ankle          5.12       6.23       5.15       0.81      12.16      11.08        090
                                                       fracture.
27814...............  ..............  A               Treatment of ankle         10.66         NA       8.75       1.71         NA      21.12        090
                                                       fracture.
27816...............  ..............  A               Treatment of ankle          2.89       4.39       3.43       0.41       7.69       6.73        090
                                                       fracture.
27818...............  ..............  A               Treatment of ankle          5.49       6.37       5.17       0.80      12.66      11.46        090
                                                       fracture.
27822...............  ..............  A               Treatment of ankle         10.98         NA      10.80       1.79         NA      23.57        090
                                                       fracture.
27823...............  ..............  A               Treatment of ankle         12.98         NA      11.64       2.11         NA      26.73        090
                                                       fracture.
27824...............  ..............  A               Treat lower leg             2.89       4.59       3.57       0.44       7.92       6.90        090
                                                       fracture.
27825...............  ..............  A               Treat lower leg             6.18       6.59       5.37       1.00      13.77      12.55        090
                                                       fracture.
27826...............  ..............  A               Treat lower leg             8.53         NA       9.01       1.36         NA      18.90        090
                                                       fracture.
27827...............  ..............  A               Treat lower leg            14.04         NA      12.90       2.31         NA      29.25        090
                                                       fracture.
27828...............  ..............  A               Treat lower leg            16.21         NA      14.06       2.65         NA      32.92        090
                                                       fracture.
27829...............  ..............  A               Treat lower leg joint       5.48         NA       6.92       0.89         NA      13.29        090
27830...............  ..............  A               Treat lower leg             3.78       4.41       3.87       0.49       8.68       8.14        090
                                                       dislocation.
27831...............  ..............  A               Treat lower leg             4.55         NA       4.58       0.75         NA       9.88        090
                                                       dislocation.
27832...............  ..............  A               Treat lower leg             6.48         NA       6.36       1.07         NA      13.91        090
                                                       dislocation.
27840...............  ..............  A               Treat ankle                 4.57         NA       3.91       0.45         NA       8.93        090
                                                       dislocation.
27842...............  ..............  A               Treat ankle                 6.20         NA       5.18       0.92         NA      12.30        090
                                                       dislocation.
27846...............  ..............  A               Treat ankle                 9.78         NA       8.12       1.61         NA      19.51        090
                                                       dislocation.
27848...............  ..............  A               Treat ankle                11.18         NA       9.84       1.74         NA      22.76        090
                                                       dislocation.
27860...............  ..............  A               Fixation of ankle           2.34         NA       1.98       0.37         NA       4.69        010
                                                       joint.
27870...............  ..............  A               Fusion of ankle            13.89         NA      10.75       2.04         NA      26.68        090
                                                       joint, open.
27871...............  ..............  A               Fusion of                   9.16         NA       7.85       1.47         NA      18.48        090
                                                       tibiofibular joint.
27880...............  ..............  A               Amputation of lower        11.83         NA       7.48       1.67         NA      20.98        090
                                                       leg.
27881...............  ..............  A               Amputation of lower        12.32         NA       9.16       1.89         NA      23.37        090
                                                       leg.
27882...............  ..............  A               Amputation of lower         8.93         NA       6.90       1.26         NA      17.09        090
                                                       leg.
27884...............  ..............  A               Amputation follow-up        8.20         NA       6.15       1.21         NA      15.56        090
                                                       surgery.
27886...............  ..............  A               Amputation follow-up        9.31         NA       6.89       1.38         NA      17.58        090
                                                       surgery.
27888...............  ..............  A               Amputation of foot at       9.66         NA       7.76       1.43         NA      18.85        090
                                                       ankle.
27889...............  ..............  A               Amputation of foot at       9.97         NA       6.76       1.40         NA      18.13        090
                                                       ankle.
27892...............  ..............  A               Decompression of leg.       7.38         NA       5.92       1.01         NA      14.31        090
27893...............  ..............  A               Decompression of leg.       7.34         NA       5.83       1.08         NA      14.25        090
27894...............  ..............  A               Decompression of leg.      10.47         NA       8.01       1.58         NA      20.06        090
28001...............  ..............  A               Drainage of bursa of        2.73       2.98       1.95       0.23       5.94       4.91        010
                                                       foot.
28002...............  ..............  A               Treatment of foot           4.61       4.99       3.76       0.51      10.11       8.88        010
                                                       infection.
28003...............  ..............  A               Treatment of foot           8.40       6.24       5.22       0.93      15.57      14.55        090
                                                       infection.
28005...............  ..............  A               Treat foot bone             8.67         NA       6.57       0.95         NA      16.19        090
                                                       lesion.
28008...............  ..............  A               Incision of foot            4.44       4.56       3.21       0.43       9.43       8.08        090
                                                       fascia.
28010...............  ..............  A               Incision of toe             2.84       2.38       2.38       0.27       5.49       5.49        090
                                                       tendon.
28011...............  ..............  A               Incision of toe             4.13         NA       3.30       0.47         NA       7.90        090
                                                       tendons.
28020...............  ..............  A               Exploration of foot         5.00       6.03       4.13       0.64      11.67       9.77        090
                                                       joint.
28022...............  ..............  A               Exploration of foot         4.66       5.20       3.85       0.49      10.35       9.00        090
                                                       joint.
28024...............  ..............  A               Exploration of toe          4.37       5.22       3.92       0.43      10.02       8.72        090
                                                       joint.
28030...............  ..............  A               Removal of foot nerve       6.14         NA       3.61       0.55         NA      10.30        090
28035...............  ..............  A               Decompression of            5.08       5.85       4.09       0.57      11.50       9.74        090
                                                       tibia nerve.
28043...............  ..............  A               Excision of foot            3.53       3.82       3.17       0.37       7.72       7.07        090
                                                       lesion.

[[Page 47603]]

 
28045...............  ..............  A               Excision of foot            4.71       5.38       3.60       0.49      10.58       8.80        090
                                                       lesion.
28046...............  ..............  A               Resection of tumor,        10.16       8.76       6.47       1.17      20.09      17.80        090
                                                       foot.
28050...............  ..............  A               Biopsy of foot joint        4.24       4.89       3.59       0.55       9.68       8.38        090
                                                       lining.
28052...............  ..............  A               Biopsy of foot joint        3.93       4.92       3.43       0.42       9.27       7.78        090
                                                       lining.
28054...............  ..............  A               Biopsy of toe joint         3.44       4.73       3.22       0.34       8.51       7.00        090
                                                       lining.
28060...............  ..............  A               Partial removal, foot       5.22       5.47       3.87       0.53      11.22       9.62        090
                                                       fascia.
28062...............  ..............  A               Removal of foot             6.51       6.53       4.01       0.61      13.65      11.13        090
                                                       fascia.
28070...............  ..............  A               Removal of foot joint       5.09       5.22       3.81       0.56      10.87       9.46        090
                                                       lining.
28072...............  ..............  A               Removal of foot joint       4.57       5.53       4.29       0.63      10.73       9.49        090
                                                       lining.
28080...............  ..............  A               Removal of foot             3.57       5.12       3.68       0.35       9.04       7.60        090
                                                       lesion.
28086...............  ..............  A               Excise foot tendon          4.77       7.98       4.68       0.69      13.44      10.14        090
                                                       sheath.
28088...............  ..............  A               Excise foot tendon          3.85       5.76       3.89       0.51      10.12       8.25        090
                                                       sheath.
28090...............  ..............  A               Removal of foot             4.40       5.15       3.44       0.46      10.01       8.30        090
                                                       lesion.
28092...............  ..............  A               Removal of toe              3.63       5.22       3.52       0.40       9.25       7.55        090
                                                       lesions.
28100...............  ..............  A               Removal of ankle/heel       5.65       7.98       4.69       0.70      14.33      11.04        090
                                                       lesion.
28102...............  ..............  A               Remove/graft foot           7.72         NA       6.24       0.88         NA      14.84        090
                                                       lesion.
28103...............  ..............  A               Remove/graft foot           6.49         NA       4.61       0.70         NA      11.80        090
                                                       lesion.
28104...............  ..............  A               Removal of foot             5.11       5.49       3.92       0.56      11.16       9.59        090
                                                       lesion.
28106...............  ..............  A               Remove/graft foot           7.15         NA       4.75       0.64         NA      12.54        090
                                                       lesion.
28107...............  ..............  A               Remove/graft foot           5.55       6.54       4.20       0.54      12.63      10.29        090
                                                       lesion.
28108...............  ..............  A               Removal of toe              4.15       4.59       3.25       0.37       9.11       7.77        090
                                                       lesions.
28110...............  ..............  A               Part removal of             4.07       5.22       3.22       0.41       9.70       7.70        090
                                                       metatarsal.
28111...............  ..............  A               Part removal of             5.00       6.28       3.65       0.55      11.83       9.20        090
                                                       metatarsal.
28112...............  ..............  A               Part removal of             4.48       5.80       3.56       0.51      10.79       8.55        090
                                                       metatarsal.
28113...............  ..............  A               Part removal of             4.78       6.07       4.32       0.49      11.34       9.59        090
                                                       metatarsal.
28114...............  ..............  A               Removal of metatarsal       9.78      11.63       8.37       1.23      22.64      19.38        090
                                                       heads.
28116...............  ..............  A               Revision of foot.....       7.74       6.80       5.17       0.83      15.37      13.74        090
28118...............  ..............  A               Removal of heel bone.       5.95       6.25       4.34       0.69      12.89      10.98        090
28119...............  ..............  A               Removal of heel spur.       5.38       5.43       3.72       0.52      11.33       9.62        090
28120...............  ..............  A               Part removal of ankle/      5.39       7.30       4.41       0.66      13.35      10.46        090
                                                       heel.
28122...............  ..............  A               Partial removal of          7.28       6.84       5.26       0.76      14.88      13.30        090
                                                       foot bone.
28124...............  ..............  A               Partial removal of          4.80       5.00       3.65       0.42      10.22       8.87        090
                                                       toe.
28126...............  ..............  A               Partial removal of          3.51       4.21       2.99       0.32       8.04       6.82        090
                                                       toe.
28130...............  ..............  A               Removal of ankle bone       8.10         NA       6.92       1.12         NA      16.14        090
28140...............  ..............  A               Removal of metatarsal       6.90       7.22       4.76       0.79      14.91      12.45        090
28150...............  ..............  A               Removal of toe.......       4.08       4.84       3.28       0.41       9.33       7.77        090
28153...............  ..............  A               Partial removal of          3.65       4.31       2.68       0.34       8.30       6.67        090
                                                       toe.
28160...............  ..............  A               Partial removal of          3.73       4.57       3.33       0.37       8.67       7.43        090
                                                       toe.
28171...............  ..............  A               Extensive foot              9.59         NA       5.86       0.83         NA      16.28        090
                                                       surgery.
28173...............  ..............  A               Extensive foot              8.79       7.59       5.19       0.85      17.23      14.83        090
                                                       surgery.
28175...............  ..............  A               Extensive foot              6.04       5.70       3.70       0.53      12.27      10.27        090
                                                       surgery.
28190...............  ..............  A               Removal of foot             1.96       3.40       1.49       0.17       5.53       3.62        010
                                                       foreign body.
28192...............  ..............  A               Removal of foot             4.63       5.49       3.64       0.46      10.58       8.73        090
                                                       foreign body.
28193...............  ..............  A               Removal of foot             5.72       5.61       3.93       0.56      11.89      10.21        090
                                                       foreign body.
28200...............  ..............  A               Repair of foot tendon       4.59       5.10       3.55       0.48      10.17       8.62        090
28202...............  ..............  A               Repair/graft of foot        6.83       7.40       4.49       0.64      14.87      11.96        090
                                                       tendon.
28208...............  ..............  A               Repair of foot tendon       4.36       4.82       3.30       0.42       9.60       8.08        090
28210...............  ..............  A               Repair/graft of foot        6.34       6.22       4.02       0.64      13.20      11.00        090
                                                       tendon.
28220...............  ..............  A               Release of foot             4.52       4.67       3.42       0.40       9.59       8.34        090
                                                       tendon.
28222...............  ..............  A               Release of foot             5.61       5.24       4.12       0.49      11.34      10.22        090
                                                       tendons.
28225...............  ..............  A               Release of foot             3.65       4.28       2.90       0.33       8.26       6.88        090
                                                       tendon.
28226...............  ..............  A               Release of foot             4.52       4.80       3.74       0.45       9.77       8.71        090
                                                       tendons.
28230...............  ..............  A               Incision of foot            4.23       4.67       3.66       0.42       9.32       8.31        090
                                                       tendon(s).
28232...............  ..............  A               Incision of toe             3.38       4.53       3.31       0.34       8.25       7.03        090
                                                       tendon.
28234...............  ..............  A               Incision of foot            3.36       4.68       3.35       0.34       8.38       7.05        090
                                                       tendon.
28238...............  ..............  A               Revision of foot            7.72       7.25       4.93       0.81      15.78      13.46        090
                                                       tendon.
28240...............  ..............  A               Release of big toe...       4.35       4.64       3.48       0.45       9.44       8.28        090
28250...............  ..............  A               Revision of foot            5.91       5.63       4.13       0.68      12.22      10.72        090
                                                       fascia.
28260...............  ..............  A               Release of midfoot          7.95       6.34       4.99       0.92      15.21      13.86        090
                                                       joint.
28261...............  ..............  A               Revision of foot           11.71       8.62       7.29       1.12      21.45      20.12        090
                                                       tendon.
28262...............  ..............  A               Revision of foot and       15.81      13.56      10.90       2.43      31.80      29.14        090
                                                       ankle.
28264...............  ..............  A               Release of midfoot         10.33       7.74       7.28       1.28      19.35      18.89        090
                                                       joint.
28270...............  ..............  A               Release of foot             4.75       4.89       3.73       0.46      10.10       8.94        090
                                                       contracture.
28272...............  ..............  A               Release of toe joint,       3.79       4.18       2.85       0.31       8.28       6.95        090
                                                       each.
28280...............  ..............  A               Fusion of toes.......       5.18       6.25       4.48       0.63      12.06      10.29        090
28285...............  ..............  A               Repair of hammertoe..       4.58       4.87       3.42       0.44       9.89       8.44        090
28286...............  ..............  A               Repair of hammertoe..       4.55       4.79       3.25       0.41       9.75       8.21        090
28288...............  ..............  A               Partial removal of          4.73       5.94       4.88       0.53      11.20      10.14        090
                                                       foot bone.
28289...............  ..............  A               Repair hallux rigidus       7.03       7.98       5.75       0.87      15.88      13.65        090
28290...............  ..............  A               Correction of bunion.       5.65       6.26       4.72       0.69      12.60      11.06        090
28292...............  ..............  A               Correction of bunion.       7.03       7.48       5.54       0.67      15.18      13.24        090
28293...............  ..............  A               Correction of bunion.       9.14      10.63       6.10       0.79      20.56      16.03        090
28294...............  ..............  A               Correction of bunion.       8.55       7.45       4.72       0.81      16.81      14.08        090
28296...............  ..............  A               Correction of bunion.       9.17       8.16       5.41       0.88      18.21      15.46        090
28297...............  ..............  A               Correction of bunion.       9.17       8.95       6.25       1.08      19.20      16.50        090

[[Page 47604]]

 
28298...............  ..............  A               Correction of bunion.       7.93       7.23       5.00       0.80      15.96      13.73        090
28299...............  ..............  A               Correction of bunion.      10.56       8.77       6.06       1.01      20.34      17.63        090
28300...............  ..............  A               Incision of heel bone       9.53         NA       7.02       1.36         NA      17.91        090
28302...............  ..............  A               Incision of ankle           9.54         NA       6.88       1.59         NA      18.01        090
                                                       bone.
28304...............  ..............  A               Incision of midfoot         9.15       8.37       5.93       1.05      18.57      16.13        090
                                                       bones.
28305...............  ..............  A               Incise/graft midfoot       10.48       4.63       4.63       0.87      15.98      15.98        090
                                                       bones.
28306...............  ..............  A               Incision of                 5.85       7.37       4.41       0.69      13.91      10.95        090
                                                       metatarsal.
28307...............  ..............  A               Incision of                 6.32      11.75       5.49       0.82      18.89      12.63        090
                                                       metatarsal.
28308...............  ..............  A               Incision of                 5.28       6.27       3.90       0.53      12.08       9.71        090
                                                       metatarsal.
28309...............  ..............  A               Incision of                12.76         NA       8.22       1.70         NA      22.68        090
                                                       metatarsals.
28310...............  ..............  A               Revision of big toe..       5.42       6.48       4.13       0.53      12.43      10.08        090
28312...............  ..............  A               Revision of toe......       4.54       6.21       4.28       0.51      11.26       9.33        090
28313...............  ..............  A               Repair deformity of         5.00       6.67       5.64       0.63      12.30      11.27        090
                                                       toe.
28315...............  ..............  A               Removal of sesamoid         4.85       6.03       3.80       0.46      11.34       9.11        090
                                                       bone.
28320...............  ..............  A               Repair of foot bones.       9.17         NA       6.93       1.27         NA      17.37        090
28322...............  ..............  A               Repair of metatarsals       8.33      10.27       6.50       1.16      19.76      15.99        090
28340...............  ..............  A               Resect enlarged toe         6.97       7.26       4.56       0.58      14.81      12.11        090
                                                       tissue.
28341...............  ..............  A               Resect enlarged toe..       8.40       7.45       5.10       0.72      16.57      14.22        090
28344...............  ..............  A               Repair extra toe(s)..       4.25       6.93       3.86       0.51      11.69       8.62        090
28345...............  ..............  A               Repair webbed toe(s).       5.91       7.19       4.97       0.54      13.64      11.42        090
28360...............  ..............  A               Reconstruct cleft          13.32         NA      10.75       1.90         NA      25.97        090
                                                       foot.
28400...............  ..............  A               Treatment of heel           2.16       3.63       3.06       0.32       6.11       5.54        090
                                                       fracture.
28405...............  ..............  A               Treatment of heel           4.56       4.83       4.61       0.71      10.10       9.88        090
                                                       fracture.
28406...............  ..............  A               Treatment of heel           6.30         NA       6.98       1.03         NA      14.31        090
                                                       fracture.
28415...............  ..............  A               Treat heel fracture..      15.95         NA      13.42       2.44         NA      31.81        090
28420...............  ..............  A               Treat/graft heel           16.62         NA      13.08       2.65         NA      32.35        090
                                                       fracture.
28430...............  ..............  A               Treatment of ankle          2.09       3.39       2.58       0.29       5.77       4.96        090
                                                       fracture.
28435...............  ..............  A               Treatment of ankle          3.39       3.90       3.74       0.48       7.77       7.61        090
                                                       fracture.
28436...............  ..............  A               Treatment of ankle          4.70         NA       6.10       0.76         NA      11.56        090
                                                       fracture.
28445...............  ..............  A               Treat ankle fracture.      15.60         NA      11.26       2.40         NA      29.26        090
28450...............  ..............  A               Treat midfoot               1.90       3.11       2.50       0.25       5.26       4.65        090
                                                       fracture, each.
28455...............  ..............  A               Treat midfoot               3.09       3.43       3.43       0.41       6.93       6.93        090
                                                       fracture, each.
28456...............  ..............  A               Treat midfoot               2.68         NA       4.38       0.43         NA       7.49        090
                                                       fracture.
28465...............  ..............  A               Treat midfoot               7.00         NA       6.48       0.97         NA      14.45        090
                                                       fracture, each.
28470...............  ..............  A               Treat metatarsal            1.99       3.12       2.46       0.27       5.38       4.72        090
                                                       fracture.
28475...............  ..............  A               Treat metatarsal            2.97       3.33       3.21       0.38       6.68       6.56        090
                                                       fracture.
28476...............  ..............  A               Treat metatarsal            3.37         NA       5.18       0.51         NA       9.06        090
                                                       fracture.
28485...............  ..............  A               Treat metatarsal            5.70         NA       5.67       0.72         NA      12.09        090
                                                       fracture.
28490...............  ..............  A               Treat big toe               1.09       2.01       1.67       0.12       3.22       2.88        090
                                                       fracture.
28495...............  ..............  A               Treat big toe               1.58       2.18       2.08       0.16       3.92       3.82        090
                                                       fracture.
28496...............  ..............  A               Treat big toe               2.33       9.78       3.77       0.31      12.42       6.41        090
                                                       fracture.
28505...............  ..............  A               Treat big toe               3.80       9.77       4.81       0.49      14.06       9.10        090
                                                       fracture.
28510...............  ..............  A               Treatment of toe            1.09       1.53       1.53       0.11       2.73       2.73        090
                                                       fracture.
28515...............  ..............  A               Treatment of toe            1.46       1.89       1.89       0.14       3.49       3.49        090
                                                       fracture.
28525...............  ..............  A               Treat toe fracture...       3.32       9.36       4.36       0.41      13.09       8.09        090
28530...............  ..............  A               Treat sesamoid bone         1.06       1.45       1.45       0.10       2.61       2.61        090
                                                       fracture.
28531...............  ..............  A               Treat sesamoid bone         2.35       8.98       2.61       0.23      11.56       5.19        090
                                                       fracture.
28540...............  ..............  A               Treat foot                  2.04       2.41       2.41       0.19       4.64       4.64        090
                                                       dislocation.
28545...............  ..............  A               Treat foot                  2.45       2.35       2.35       0.36       5.16       5.16        090
                                                       dislocation.
28546...............  ..............  A               Treat foot                  3.20       8.03       5.00       0.41      11.64       8.61        090
                                                       dislocation.
28555...............  ..............  A               Repair foot                 6.29      11.58       6.67       0.90      18.77      13.86        090
                                                       dislocation.
28570...............  ..............  A               Treat foot                  1.66       2.42       2.34       0.20       4.28       4.20        090
                                                       dislocation.
28575...............  ..............  A               Treat foot                  3.31       3.74       3.74       0.56       7.61       7.61        090
                                                       dislocation.
28576...............  ..............  A               Treat foot                  4.16      10.32       5.68       0.59      15.07      10.43        090
                                                       dislocation.
28585...............  ..............  A               Repair foot                 7.98       8.27       6.65       1.01      17.26      15.64        090
                                                       dislocation.
28600...............  ..............  A               Treat foot                  1.89       2.82       2.69       0.24       4.95       4.82        090
                                                       dislocation.
28605...............  ..............  A               Treat foot                  2.71       3.14       3.14       0.39       6.24       6.24        090
                                                       dislocation.
28606...............  ..............  A               Treat foot                  4.89      15.93       6.18       0.78      21.60      11.85        090
                                                       dislocation.
28615...............  ..............  A               Repair foot                 7.76         NA       8.16       1.21         NA      17.13        090
                                                       dislocation.
28630...............  ..............  A               Treat toe dislocation       1.70       1.57       1.01       0.17       3.44       2.88        010
28635...............  ..............  A               Treat toe dislocation       1.91       2.02       1.53       0.19       4.12       3.63        010
28636...............  ..............  A               Treat toe dislocation       2.77       3.87       2.62       0.38       7.02       5.77        010
28645...............  ..............  A               Repair toe                  4.21       5.81       3.59       0.44      10.46       8.24        090
                                                       dislocation.
28660...............  ..............  A               Treat toe dislocation       1.23       1.26       0.81       0.12       2.61       2.16        010
28665...............  ..............  A               Treat toe dislocation       1.92         NA       1.43       0.22         NA       3.57        010
28666...............  ..............  A               Treat toe dislocation       2.66       5.90       2.57       0.38       8.94       5.61        010
28675...............  ..............  A               Repair of toe               2.92       8.85       3.88       0.40      12.17       7.20        090
                                                       dislocation.
28705...............  ..............  A               Fusion of foot bones.      18.77         NA      12.65       2.77         NA      34.19        090
28715...............  ..............  A               Fusion of foot bones.      13.08         NA       9.98       1.93         NA      24.99        090
28725...............  ..............  A               Fusion of foot bones.      11.59         NA       8.50       1.66         NA      21.75        090
28730...............  ..............  A               Fusion of foot bones.      10.74         NA       8.71       1.44         NA      20.89        090
28735...............  ..............  A               Fusion of foot bones.      10.83         NA       8.08       1.44         NA      20.35        090
28737...............  ..............  A               Revision of foot            9.63         NA       7.07       1.12         NA      17.82        090
                                                       bones.
28740...............  ..............  A               Fusion of foot bones.       8.01      11.72       6.66       1.03      20.76      15.70        090
28750...............  ..............  A               Fusion of big toe           7.29      13.06       6.84       1.04      21.39      15.17        090
                                                       joint.

[[Page 47605]]

 
28755...............  ..............  A               Fusion of big toe           4.73       7.02       4.04       0.52      12.27       9.29        090
                                                       joint.
28760...............  ..............  A               Fusion of big toe           7.74       8.24       5.81       0.81      16.79      14.36        090
                                                       joint.
28800...............  ..............  A               Amputation of midfoot       8.20         NA       6.12       1.04         NA      15.36        090
28805...............  ..............  A               Amputation thru             8.38         NA       5.93       1.10         NA      15.41        090
                                                       metatarsal.
28810...............  ..............  A               Amputation toe &            6.20         NA       4.78       0.81         NA      11.79        090
                                                       metatarsal.
28820...............  ..............  A               Amputation of toe....       4.40       8.56       4.15       0.55      13.51       9.10        090
28825...............  ..............  A               Partial amputation of       3.58       8.01       3.87       0.44      12.03       7.89        090
                                                       toe.
29000...............  ..............  A               Application of body         2.25       3.00       1.73       0.47       5.72       4.45        000
                                                       cast.
29010...............  ..............  A               Application of body         2.06       3.29       1.77       0.36       5.71       4.19        000
                                                       cast.
29015...............  ..............  A               Application of body         2.41       2.97       1.60       0.26       5.64       4.27        000
                                                       cast.
29020...............  ..............  A               Application of body         2.11       3.19       1.42       0.21       5.51       3.74        000
                                                       cast.
29025...............  ..............  A               Application of body         2.40       3.19       1.84       0.44       6.03       4.68        000
                                                       cast.
29035...............  ..............  A               Application of body         1.77       3.61       1.58       0.29       5.67       3.64        000
                                                       cast.
29040...............  ..............  A               Application of body         2.22       2.49       1.52       0.18       4.89       3.92        000
                                                       cast.
29044...............  ..............  A               Application of body         2.12       3.97       1.90       0.37       6.46       4.39        000
                                                       cast.
29046...............  ..............  A               Application of body         2.41       3.27       2.08       0.40       6.08       4.89        000
                                                       cast.
29049...............  ..............  A               Application of figure       0.89       1.30       0.53       0.11       2.30       1.53        000
                                                       eight.
29055...............  ..............  A               Application of              1.78       2.98       1.47       0.28       5.04       3.53        000
                                                       shoulder cast.
29058...............  ..............  A               Application of              1.31       1.56       0.73       0.16       3.03       2.20        000
                                                       shoulder cast.
29065...............  ..............  A               Application of long         0.87       1.32       0.75       0.14       2.33       1.76        000
                                                       arm cast.
29075...............  ..............  A               Application of              0.77       1.26       0.68       0.12       2.15       1.57        000
                                                       forearm cast.
29085...............  ..............  A               Apply hand/wrist cast       0.87       1.28       0.63       0.13       2.28       1.63        000
29086...............  ..............  A               Apply finger cast....       0.62       0.96       0.50       0.08       1.66       1.20        000
29105...............  ..............  A               Apply long arm splint       0.87       1.23       0.51       0.12       2.22       1.50        000
29125...............  ..............  A               Apply forearm splint.       0.59       1.02       0.39       0.07       1.68       1.05        000
29126...............  ..............  A               Apply forearm splint.       0.77       1.21       0.46       0.06       2.04       1.29        000
29130...............  ..............  A               Application of finger       0.50       0.47       0.17       0.06       1.03       0.73        000
                                                       splint.
29131...............  ..............  A               Application of finger       0.55       0.74       0.24       0.03       1.32       0.82        000
                                                       splint.
29200...............  ..............  A               Strapping of chest...       0.65       0.73       0.35       0.05       1.43       1.05        000
29220...............  ..............  A               Strapping of low back       0.64       0.73       0.39       0.05       1.42       1.08        000
29240...............  ..............  A               Strapping of shoulder       0.71       0.86       0.37       0.06       1.63       1.14        000
29260...............  ..............  A               Strapping of elbow or       0.55       0.75       0.33       0.05       1.35       0.93        000
                                                       wrist.
29280...............  ..............  A               Strapping of hand or        0.51       0.81       0.33       0.03       1.35       0.87        000
                                                       finger.
29305...............  ..............  A               Application of hip          2.03       3.34       1.76       0.33       5.70       4.12        000
                                                       cast.
29325...............  ..............  A               Application of hip          2.32       3.52       1.95       0.39       6.23       4.66        000
                                                       casts.
29345...............  ..............  A               Application of long         1.40       1.76       1.06       0.23       3.39       2.69        000
                                                       leg cast.
29355...............  ..............  A               Application of long         1.53       1.71       1.12       0.24       3.48       2.89        000
                                                       leg cast.
29358...............  ..............  A               Apply long leg cast         1.43       2.06       1.09       0.23       3.72       2.75        000
                                                       brace.
29365...............  ..............  A               Application of long         1.18       1.65       0.95       0.20       3.03       2.33        000
                                                       leg cast.
29405...............  ..............  A               Apply short leg cast.       0.86       1.22       0.71       0.13       2.21       1.70        000
29425...............  ..............  A               Apply short leg cast.       1.01       1.23       0.74       0.13       2.37       1.88        000
29435...............  ..............  A               Apply short leg cast.       1.18       1.55       0.92       0.19       2.92       2.29        000
29440...............  ..............  A               Addition of walker to       0.57       0.69       0.27       0.08       1.34       0.92        000
                                                       cast.
29445...............  ..............  A               Apply rigid leg cast.       1.78       1.80       0.96       0.24       3.82       2.98        000
29450...............  ..............  A               Application of leg          2.08       1.47       1.10       0.19       3.74       3.37        000
                                                       cast.
29505...............  ..............  A               Application, long leg       0.69       1.18       0.46       0.07       1.94       1.22        000
                                                       splint.
29515...............  ..............  A               Application lower leg       0.73       0.87       0.47       0.08       1.68       1.28        000
                                                       splint.
29520...............  ..............  A               Strapping of hip.....       0.54       0.87       0.47       0.02       1.43       1.03        000
29530...............  ..............  A               Strapping of knee....       0.57       0.79       0.33       0.05       1.41       0.95        000
29540...............  ..............  A               Strapping of ankle          0.51       0.42       0.31       0.04       0.97       0.86        000
                                                       and/or ft.
29550...............  ..............  A               Strapping of toes....       0.47       0.42       0.28       0.04       0.93       0.79        000
29580...............  ..............  A               Application of paste        0.57       0.65       0.36       0.06       1.28       0.99        000
                                                       boot.
29590...............  ..............  A               Application of foot         0.76       0.51       0.29       0.06       1.33       1.11        000
                                                       splint.
29700...............  ..............  A               Removal/revision of         0.57       0.89       0.28       0.07       1.53       0.92        000
                                                       cast.
29705...............  ..............  A               Removal/revision of         0.76       0.82       0.38       0.11       1.69       1.25        000
                                                       cast.
29710...............  ..............  A               Removal/revision of         1.34       1.53       0.70       0.20       3.07       2.24        000
                                                       cast.
29715...............  ..............  A               Removal/revision of         0.94       1.17       0.40       0.13       2.24       1.47        000
                                                       cast.
29720...............  ..............  A               Repair of body cast..       0.68       1.16       0.39       0.11       1.95       1.18        000
29730...............  ..............  A               Windowing of cast....       0.75       0.81       0.35       0.11       1.67       1.21        000
29740...............  ..............  A               Wedging of cast......       1.12       1.15       0.49       0.16       2.43       1.77        000
29750...............  ..............  A               Wedging of clubfoot         1.26       1.06       0.58       0.19       2.51       2.03        000
                                                       cast.
29800...............  ..............  A               Jaw arthroscopy/            6.42         NA       7.06       0.99         NA      14.47        090
                                                       surgery.
29804...............  ..............  A               Jaw arthroscopy/            8.13         NA       7.84       1.30         NA      17.27        090
                                                       surgery.
29805...............  ..............  A               Shoulder arthroscopy,       5.88         NA       5.84       1.01         NA      12.73        090
                                                       dx.
29806...............  ..............  A               Shoulder arthroscopy/      14.35         NA      11.08       2.42         NA      27.85        090
                                                       surgery.
29807...............  ..............  A               Shoulder arthroscopy/      13.88         NA      10.91       2.35         NA      27.14        090
                                                       surgery.
29819...............  ..............  A               Shoulder arthroscopy/       7.61         NA       6.77       1.26         NA      15.64        090
                                                       surgery.
29820...............  ..............  A               Shoulder arthroscopy/       7.06         NA       6.21       1.17         NA      14.44        090
                                                       surgery.
29821...............  ..............  A               Shoulder arthroscopy/       7.71         NA       6.79       1.24         NA      15.74        090
                                                       surgery.
29822...............  ..............  A               Shoulder arthroscopy/       7.42         NA       6.67       1.20         NA      15.29        090
                                                       surgery.
29823...............  ..............  A               Shoulder arthroscopy/       8.16         NA       7.21       1.30         NA      16.67        090
                                                       surgery.
29824...............  ..............  A               Shoulder arthroscopy/       8.24         NA       7.47       1.30         NA      17.01        090
                                                       surgery.
29825...............  ..............  A               Shoulder arthroscopy/       7.61         NA       6.75       1.12         NA      15.48        090
                                                       surgery.
29826...............  ..............  A               Shoulder arthroscopy/       8.98         NA       7.52       1.42         NA      17.92        090
                                                       surgery.
29827...............  ..............  A               Arthroscop rotator         15.34         NA      11.52       2.08         NA      28.94        090
                                                       cuff repr.

[[Page 47606]]

 
29830...............  ..............  A               Elbow arthroscopy....       5.75         NA       5.33       0.87         NA      11.95        090
29834...............  ..............  A               Elbow arthroscopy/          6.27         NA       5.82       1.02         NA      13.11        090
                                                       surgery.
29835...............  ..............  A               Elbow arthroscopy/          6.47         NA       5.87       1.12         NA      13.46        090
                                                       surgery.
29836...............  ..............  A               Elbow arthroscopy/          7.54         NA       6.77       1.08         NA      15.39        090
                                                       surgery.
29837...............  ..............  A               Elbow arthroscopy/          6.86         NA       6.12       1.11         NA      14.09        090
                                                       surgery.
29838...............  ..............  A               Elbow arthroscopy/          7.70         NA       6.87       1.23         NA      15.80        090
                                                       surgery.
29840...............  ..............  A               Wrist arthroscopy....       5.53         NA       5.31       0.82         NA      11.66        090
29843...............  ..............  A               Wrist arthroscopy/          6.00         NA       5.62       0.90         NA      12.52        090
                                                       surgery.
29844...............  ..............  A               Wrist arthroscopy/          6.36         NA       5.81       0.99         NA      13.16        090
                                                       surgery.
29845...............  ..............  A               Wrist arthroscopy/          7.51         NA       6.47       0.99         NA      14.97        090
                                                       surgery.
29846...............  ..............  A               Wrist arthroscopy/          6.74         NA       6.04       1.04         NA      13.82        090
                                                       surgery.
29847...............  ..............  A               Wrist arthroscopy/          7.07         NA       6.18       1.07         NA      14.32        090
                                                       surgery.
29848...............  ..............  A               Wrist endoscopy/            5.43         NA       5.59       0.87         NA      11.89        090
                                                       surgery.
29850...............  ..............  A               Knee arthroscopy/           8.18         NA       5.06       0.84         NA      14.08        090
                                                       surgery.
29851...............  ..............  A               Knee arthroscopy/          13.08         NA       9.78       2.04         NA      24.90        090
                                                       surgery.
29855...............  ..............  A               Tibial arthroscopy/        10.60         NA       8.75       1.71         NA      21.06        090
                                                       surgery.
29856...............  ..............  A               Tibial arthroscopy/        14.12         NA      10.65       2.46         NA      27.23        090
                                                       surgery.
29860...............  ..............  A               Hip arthroscopy, dx..       8.04         NA       6.94       1.23         NA      16.21        090
29861...............  ..............  A               Hip arthroscopy/            9.14         NA       7.34       1.45         NA      17.93        090
                                                       surgery.
29862...............  ..............  A               Hip arthroscopy/            9.89         NA       8.55       1.62         NA      20.06        090
                                                       surgery.
29863...............  ..............  A               Hip arthroscopy/            9.89         NA       8.49       1.56         NA      19.94        090
                                                       surgery.
29870...............  ..............  A               Knee arthroscopy, dx.       5.06         NA       4.88       0.85         NA      10.79        090
29871...............  ..............  A               Knee arthroscopy/           6.54         NA       5.86       1.12         NA      13.52        090
                                                       drainage.
29873...............  ..............  A               Knee arthroscopy/           5.99         NA       6.57       0.89         NA      13.45        090
                                                       surgery.
29874...............  ..............  A               Knee arthroscopy/           7.04         NA       6.06       1.10         NA      14.20        090
                                                       surgery.
29875...............  ..............  A               Knee arthroscopy/           6.30         NA       5.84       1.05         NA      13.19        090
                                                       surgery.
29876...............  ..............  A               Knee arthroscopy/           7.91         NA       7.01       1.36         NA      16.28        090
                                                       surgery.
29877...............  ..............  A               Knee arthroscopy/           7.34         NA       6.73       1.25         NA      15.32        090
                                                       surgery.
29879...............  ..............  A               Knee arthroscopy/           8.03         NA       7.10       1.36         NA      16.49        090
                                                       surgery.
29880...............  ..............  A               Knee arthroscopy/           8.49         NA       7.35       1.43         NA      17.27        090
                                                       surgery.
29881...............  ..............  A               Knee arthroscopy/           7.75         NA       6.95       1.31         NA      16.01        090
                                                       surgery.
29882...............  ..............  A               Knee arthroscopy/           8.64         NA       7.23       1.48         NA      17.35        090
                                                       surgery.
29883...............  ..............  A               Knee arthroscopy/          11.03         NA       9.04       1.88         NA      21.95        090
                                                       surgery.
29884...............  ..............  A               Knee arthroscopy/           7.32         NA       6.68       1.21         NA      15.21        090
                                                       surgery.
29885...............  ..............  A               Knee arthroscopy/           9.08         NA       7.95       1.48         NA      18.51        090
                                                       surgery.
29886...............  ..............  A               Knee arthroscopy/           7.53         NA       6.83       1.29         NA      15.65        090
                                                       surgery.
29887...............  ..............  A               Knee arthroscopy/           9.03         NA       7.92       1.51         NA      18.46        090
                                                       surgery.
29888...............  ..............  A               Knee arthroscopy/          13.88         NA      10.18       2.22         NA      26.28        090
                                                       surgery.
29889...............  ..............  A               Knee arthroscopy/          15.98         NA      12.41       2.67         NA      31.06        090
                                                       surgery.
29891...............  ..............  A               Ankle arthroscopy/          8.39         NA       7.50       1.28         NA      17.17        090
                                                       surgery.
29892...............  ..............  A               Ankle arthroscopy/          8.99         NA       7.72       1.16         NA      17.87        090
                                                       surgery.
29893...............  ..............  A               Scope, plantar              5.21       6.27       3.98       0.45      11.93       9.64        090
                                                       fasciotomy.
29894...............  ..............  A               Ankle arthroscopy/          7.20         NA       5.46       0.99         NA      13.65        090
                                                       surgery.
29895...............  ..............  A               Ankle arthroscopy/          6.98         NA       5.46       0.96         NA      13.40        090
                                                       surgery.
29897...............  ..............  A               Ankle arthroscopy/          7.17         NA       5.87       1.10         NA      14.14        090
                                                       surgery.
29898...............  ..............  A               Ankle arthroscopy/          8.31         NA       6.18       1.11         NA      15.60        090
                                                       surgery.
29899...............  ..............  A               Ankle arthroscopy/         13.89         NA      10.55       2.04         NA      26.48        090
                                                       surgery.
29900...............  ..............  A               Mcp joint                   5.41         NA       5.81       0.87         NA      12.09        090
                                                       arthroscopy, dx.
29901...............  ..............  A               Mcp joint                   6.12         NA       6.20       0.97         NA      13.29        090
                                                       arthroscopy, surg.
29902...............  ..............  A               Mcp joint                   6.69         NA       6.46       0.84         NA      13.99        090
                                                       arthroscopy, surg.
30000...............  ..............  A               Drainage of nose            1.43       4.09       1.40       0.12       5.64       2.95        010
                                                       lesion.
30020...............  ..............  A               Drainage of nose            1.43       3.28       1.47       0.12       4.83       3.02        010
                                                       lesion.
30100...............  ..............  A               Intranasal biopsy....       0.94       1.97       0.82       0.08       2.99       1.84        000
30110...............  ..............  A               Removal of nose             1.63       3.24       1.57       0.14       5.01       3.34        010
                                                       polyp(s).
30115...............  ..............  A               Removal of nose             4.34         NA       5.76       0.42         NA      10.52        090
                                                       polyp(s).
30117...............  ..............  A               Removal of intranasal       3.16      13.13       4.62       0.26      16.55       8.04        090
                                                       lesion.
30118...............  ..............  A               Removal of intranasal       9.68         NA       9.19       0.82         NA      19.69        090
                                                       lesion.
30120...............  ..............  A               Revision of nose.....       5.26       6.48       5.99       0.56      12.30      11.81        090
30124...............  ..............  A               Removal of nose             3.10         NA       3.62       0.30         NA       7.02        090
                                                       lesion.
30125...............  ..............  A               Removal of nose             7.15         NA       8.32       0.58         NA      16.05        090
                                                       lesion.
30130...............  ..............  A               Removal of turbinate        3.37         NA       5.58       0.32         NA       9.27        090
                                                       bones.
30140...............  ..............  A               Removal of turbinate        3.42         NA       6.19       0.36         NA       9.97        090
                                                       bones.
30150...............  ..............  A               Partial removal of          9.13         NA      10.99       0.91         NA      21.03        090
                                                       nose.
30160...............  ..............  A               Removal of nose......       9.57         NA      10.19       0.87         NA      20.63        090
30200...............  ..............  A               Injection treatment         0.78       1.62       0.74       0.06       2.46       1.58        000
                                                       of nose.
30210...............  ..............  A               Nasal sinus therapy..       1.08       2.10       1.31       0.09       3.27       2.48        010
30220...............  ..............  A               Insert nasal septal         1.54       4.23       1.53       0.12       5.89       3.19        010
                                                       button.
30300...............  ..............  A               Remove nasal foreign        1.04       4.64       1.93       0.08       5.76       3.05        010
                                                       body.
30310...............  ..............  A               Remove nasal foreign        1.96         NA       3.09       0.17         NA       5.22        010
                                                       body.
30320...............  ..............  A               Remove nasal foreign        4.51         NA       7.03       0.37         NA      11.91        090
                                                       body.
30400...............  ..............  R               Reconstruction of           9.82         NA      15.46       1.02         NA      26.30        090
                                                       nose.
30410...............  ..............  R               Reconstruction of          12.96         NA      18.32       1.47         NA      32.75        090
                                                       nose.
30420...............  ..............  R               Reconstruction of          15.86         NA      17.87       1.48         NA      35.21        090
                                                       nose.
30430...............  ..............  R               Revision of nose.....       7.20         NA      15.95       0.79         NA      23.94        090
30435...............  ..............  R               Revision of nose.....      11.69         NA      19.28       1.33         NA      32.30        090

[[Page 47607]]

 
30450...............  ..............  R               Revision of nose.....      18.62         NA      21.82       1.89         NA      42.33        090
30460...............  ..............  A               Revision of nose.....       9.95         NA       9.94       0.91         NA      20.80        090
30462...............  ..............  A               Revision of nose.....      19.54         NA      20.20       1.90         NA      41.64        090
30465...............  ..............  A               Repair nasal stenosis      11.62         NA      11.99       1.10         NA      24.71        090
30520...............  ..............  A               Repair of nasal             5.69         NA       6.65       0.47         NA      12.81        090
                                                       septum.
30540...............  ..............  A               Repair nasal defect..       7.74         NA       9.29       0.64         NA      17.67        090
30545...............  ..............  A               Repair nasal defect..      11.36         NA      11.87       0.81         NA      24.04        090
30560...............  ..............  A               Release of nasal            1.26       4.78       2.13       0.10       6.14       3.49        010
                                                       adhesions.
30580...............  ..............  A               Repair upper jaw            6.68       7.76       5.78       0.87      15.31      13.33        090
                                                       fistula.
30600...............  ..............  A               Repair mouth/nose           6.01       7.53       5.02       0.61      14.15      11.64        090
                                                       fistula.
30620...............  ..............  A               Intranasal                  5.96         NA       8.81       0.56         NA      15.33        090
                                                       reconstruction.
30630...............  ..............  A               Repair nasal septum         7.11         NA       7.94       0.61         NA      15.66        090
                                                       defect.
30801...............  ..............  A               Cauterization, inner        1.09       4.14       1.93       0.09       5.32       3.11        010
                                                       nose.
30802...............  ..............  A               Cauterization, inner        2.03       4.61       2.35       0.17       6.81       4.55        010
                                                       nose.
30901...............  ..............  A               Control of nosebleed.       1.21       1.36       0.32       0.11       2.68       1.64        000
30903...............  ..............  A               Control of nosebleed.       1.54       2.71       0.50       0.13       4.38       2.17        000
30905...............  ..............  A               Control of nosebleed.       1.97       3.51       0.76       0.17       5.65       2.90        000
30906...............  ..............  A               Repeat control of           2.45       3.89       1.20       0.20       6.54       3.85        000
                                                       nosebleed.
30915...............  ..............  A               Ligation, nasal sinus       7.19         NA       6.69       0.60         NA      14.48        090
                                                       artery.
30920...............  ..............  A               Ligation, upper jaw         9.82         NA       8.96       0.80         NA      19.58        090
                                                       artery.
30930...............  ..............  A               Therapy, fracture of        1.26         NA       1.62       0.12         NA       3.00        010
                                                       nose.
31000...............  ..............  A               Irrigation, maxillary       1.15       2.85       1.40       0.10       4.10       2.65        010
                                                       sinus.
31002...............  ..............  A               Irrigation, sphenoid        1.91         NA       3.26       0.16         NA       5.33        010
                                                       sinus.
31020...............  ..............  A               Exploration,                2.94       8.54       5.18       0.28      11.76       8.40        090
                                                       maxillary sinus.
31030...............  ..............  A               Exploration,                5.91      11.51       6.66       0.58      18.00      13.15        090
                                                       maxillary sinus.
31032...............  ..............  A               Explore sinus, remove       6.56         NA       7.22       0.61         NA      14.39        090
                                                       polyps.
31040...............  ..............  A               Exploration behind          9.41         NA       9.85       0.90         NA      20.16        090
                                                       upper jaw.
31050...............  ..............  A               Exploration, sphenoid       5.27         NA       6.35       0.57         NA      12.19        090
                                                       sinus.
31051...............  ..............  A               Sphenoid sinus              7.10         NA       8.24       0.69         NA      16.03        090
                                                       surgery.
31070...............  ..............  A               Exploration of              4.27         NA       5.93       0.39         NA      10.59        090
                                                       frontal sinus.
31075...............  ..............  A               Exploration of              9.15         NA       9.72       0.80         NA      19.67        090
                                                       frontal sinus.
31080...............  ..............  A               Removal of frontal         11.40         NA      13.54       1.36         NA      26.30        090
                                                       sinus.
31081...............  ..............  A               Removal of frontal         12.73         NA      13.99       2.47         NA      29.19        090
                                                       sinus.
31084...............  ..............  A               Removal of frontal         13.49         NA      13.50       1.23         NA      28.22        090
                                                       sinus.
31085...............  ..............  A               Removal of frontal         14.18         NA      13.94       1.74         NA      29.86        090
                                                       sinus.
31086...............  ..............  A               Removal of frontal         12.84         NA      13.26       1.11         NA      27.21        090
                                                       sinus.
31087...............  ..............  A               Removal of frontal         13.08         NA      12.51       1.28         NA      26.87        090
                                                       sinus.
31090...............  ..............  A               Exploration of              9.52         NA      12.54       0.94         NA      23.00        090
                                                       sinuses.
31200...............  ..............  A               Removal of ethmoid          4.96         NA       9.24       0.31         NA      14.51        090
                                                       sinus.
31201...............  ..............  A               Removal of ethmoid          8.36         NA       9.16       0.82         NA      18.34        090
                                                       sinus.
31205...............  ..............  A               Removal of ethmoid         10.22         NA      11.89       0.73         NA      22.84        090
                                                       sinus.
31225...............  ..............  A               Removal of upper jaw.      19.20         NA      17.81       1.69         NA      38.70        090
31230...............  ..............  A               Removal of upper jaw.      21.91         NA      19.35       1.89         NA      43.15        090
31231...............  ..............  A               Nasal endoscopy, dx..       1.10       3.38       0.88       0.09       4.57       2.07        000
31233...............  ..............  A               Nasal/sinus                 2.18       4.31       1.47       0.19       6.68       3.84        000
                                                       endoscopy, dx.
31235...............  ..............  A               Nasal/sinus                 2.64       4.91       1.72       0.27       7.82       4.63        000
                                                       endoscopy, dx.
31237...............  ..............  A               Nasal/sinus                 2.98       5.19       1.88       0.28       8.45       5.14        000
                                                       endoscopy, surg.
31238...............  ..............  A               Nasal/sinus                 3.26       5.23       2.08       0.27       8.76       5.61        000
                                                       endoscopy, surg.
31239...............  ..............  A               Nasal/sinus                 8.69         NA       8.01       0.62         NA      17.32        010
                                                       endoscopy, surg.
31240...............  ..............  A               Nasal/sinus                 2.61         NA       1.73       0.25         NA       4.59        000
                                                       endoscopy, surg.
31254...............  ..............  A               Revision of ethmoid         4.64         NA       2.84       0.46         NA       7.94        000
                                                       sinus.
31255...............  ..............  A               Removal of ethmoid          6.95         NA       4.10       0.74         NA      11.79        000
                                                       sinus.
31256...............  ..............  A               Exploration maxillary       3.29         NA       2.11       0.34         NA       5.74        000
                                                       sinus.
31267...............  ..............  A               Endoscopy, maxillary        5.45         NA       3.29       0.56         NA       9.30        000
                                                       sinus.
31276...............  ..............  A               Sinus endoscopy,            8.84         NA       5.11       0.92         NA      14.87        000
                                                       surgical.
31287...............  ..............  A               Nasal/sinus                 3.91         NA       2.45       0.40         NA       6.76        000
                                                       endoscopy, surg.
31288...............  ..............  A               Nasal/sinus                 4.57         NA       2.80       0.47         NA       7.84        000
                                                       endoscopy, surg.
31290...............  ..............  A               Nasal/sinus                17.21         NA      12.04       1.41         NA      30.66        010
                                                       endoscopy, surg.
31291...............  ..............  A               Nasal/sinus                18.16         NA      12.46       1.74         NA      32.36        010
                                                       endoscopy, surg.
31292...............  ..............  A               Nasal/sinus                14.74         NA      10.60       1.27         NA      26.61        010
                                                       endoscopy, surg.
31293...............  ..............  A               Nasal/sinus                16.19         NA      11.37       1.17         NA      28.73        010
                                                       endoscopy, surg.
31294...............  ..............  A               Nasal/sinus                19.03         NA      12.86       1.42         NA      33.31        010
                                                       endoscopy, surg.
31300...............  ..............  A               Removal of larynx          14.27         NA      14.99       1.21         NA      30.47        090
                                                       lesion.
31320...............  ..............  A               Diagnostic incision,        5.25         NA      10.34       0.46         NA      16.05        090
                                                       larynx.
31360...............  ..............  A               Removal of larynx....      17.05         NA      16.72       1.44         NA      35.21        090
31365...............  ..............  A               Removal of larynx....      24.12         NA      20.35       2.03         NA      46.50        090
31367...............  ..............  A               Partial removal of         21.83         NA      21.88       1.81         NA      45.52        090
                                                       larynx.
31368...............  ..............  A               Partial removal of         27.05         NA      25.47       2.26         NA      54.78        090
                                                       larynx.
31370...............  ..............  A               Partial removal of         21.35         NA      22.26       1.77         NA      45.38        090
                                                       larynx.
31375...............  ..............  A               Partial removal of         20.18         NA      20.41       1.65         NA      42.24        090
                                                       larynx.
31380...............  ..............  A               Partial removal of         20.18         NA      20.60       1.64         NA      42.42        090
                                                       larynx.
31382...............  ..............  A               Partial removal of         20.49         NA      21.61       1.72         NA      43.82        090
                                                       larynx.
31390...............  ..............  A               Removal of larynx &        27.49         NA      24.37       2.32         NA      54.18        090
                                                       pharynx.
31395...............  ..............  A               Reconstruct larynx &       31.04         NA      28.28       2.61         NA      61.93        090
                                                       pharynx.
31400...............  ..............  A               Revision of larynx...      10.29         NA      13.80       0.84         NA      24.93        090

[[Page 47608]]

 
31420...............  ..............  A               Removal of epiglottis      10.20         NA       9.54       0.83         NA      20.57        090
31500...............  ..............  A               Insert emergency            2.33         NA       0.55       0.18         NA       3.06        000
                                                       airway.
31502...............  ..............  A               Change of windpipe          0.65       0.31       0.28       0.05       1.01       0.98        000
                                                       airway.
31505...............  ..............  A               Diagnostic                  0.61       1.45       0.62       0.05       2.11       1.28        000
                                                       laryngoscopy.
31510...............  ..............  A               Laryngoscopy with           1.92       3.32       1.25       0.17       5.41       3.34        000
                                                       biopsy.
31511...............  ..............  A               Remove foreign body,        2.16       3.12       1.06       0.19       5.47       3.41        000
                                                       larynx.
31512...............  ..............  A               Removal of larynx           2.07       3.20       1.36       0.17       5.44       3.60        000
                                                       lesion.
31513...............  ..............  A               Injection into vocal        2.10         NA       1.46       0.17         NA       3.73        000
                                                       cord.
31515...............  ..............  A               Laryngoscopy for            1.80       3.63       1.07       0.14       5.57       3.01        000
                                                       aspiration.
31520...............  ..............  A               Diagnostic                  2.56         NA       1.56       0.20         NA       4.32        000
                                                       laryngoscopy.
31525...............  ..............  A               Diagnostic                  2.63       3.65       1.66       0.22       6.50       4.51        000
                                                       laryngoscopy.
31526...............  ..............  A               Diagnostic                  2.57         NA       1.71       0.21         NA       4.49        000
                                                       laryngoscopy.
31527...............  ..............  A               Laryngoscopy for            3.27         NA       1.87       0.27         NA       5.41        000
                                                       treatment.
31528...............  ..............  A               Laryngoscopy and            2.37         NA       1.46       0.20         NA       4.03        000
                                                       dilation.
31529...............  ..............  A               Laryngoscopy and            2.68         NA       1.71       0.22         NA       4.61        000
                                                       dilation.
31530...............  ..............  A               Operative                   3.38         NA       1.95       0.29         NA       5.62        000
                                                       laryngoscopy.
31531...............  ..............  A               Operative                   3.58         NA       2.27       0.29         NA       6.14        000
                                                       laryngoscopy.
31535...............  ..............  A               Operative                   3.16         NA       1.99       0.26         NA       5.41        000
                                                       laryngoscopy.
31536...............  ..............  A               Operative                   3.55         NA       2.24       0.29         NA       6.08        000
                                                       laryngoscopy.
31540...............  ..............  A               Operative                   4.12         NA       2.54       0.34         NA       7.00        000
                                                       laryngoscopy.
31541...............  ..............  A               Operative                   4.52         NA       2.77       0.37         NA       7.66        000
                                                       laryngoscopy.
31560...............  ..............  A               Operative                   5.45         NA       3.15       0.44         NA       9.04        000
                                                       laryngoscopy.
31561...............  ..............  A               Operative                   5.99         NA       3.36       0.40         NA       9.75        000
                                                       laryngoscopy.
31570...............  ..............  A               Laryngoscopy with           3.86       5.67       2.38       0.31       9.84       6.55        000
                                                       injection.
31571...............  ..............  A               Laryngoscopy with           4.26         NA       2.59       0.35         NA       7.20        000
                                                       injection.
31575...............  ..............  A               Diagnostic                  1.10       1.90       0.89       0.09       3.09       2.08        000
                                                       laryngoscopy.
31576...............  ..............  A               Laryngoscopy with           1.97       3.66       1.29       0.15       5.78       3.41        000
                                                       biopsy.
31577...............  ..............  A               Remove foreign body,        2.47       3.76       1.53       0.20       6.43       4.20        000
                                                       larynx.
31578...............  ..............  A               Removal of larynx           2.84       4.28       1.52       0.23       7.35       4.59        000
                                                       lesion.
31579...............  ..............  A               Diagnostic                  2.26       3.78       1.48       0.19       6.23       3.93        000
                                                       laryngoscopy.
31580...............  ..............  A               Revision of larynx...      12.36         NA      15.92       1.00         NA      29.28        090
31582...............  ..............  A               Revision of larynx...      21.59         NA      25.84       1.76         NA      49.19        090
31584...............  ..............  A               Treat larynx fracture      19.61         NA      18.15       1.57         NA      39.33        090
31585...............  ..............  A               Treat larynx fracture       4.63         NA       6.70       0.49         NA      11.82        090
31586...............  ..............  A               Treat larynx fracture       8.02         NA      10.86       0.65         NA      19.53        090
31587...............  ..............  A               Revision of larynx...      11.97         NA       9.26       0.99         NA      22.22        090
31588...............  ..............  A               Revision of larynx...      13.09         NA      13.60       1.05         NA      27.74        090
31590...............  ..............  A               Reinnervate larynx...       6.96         NA      15.54       0.85         NA      23.35        090
31595...............  ..............  A               Larynx nerve surgery.       8.33         NA      10.58       0.79         NA      19.70        090
31600...............  ..............  A               Incision of windpipe.       7.17         NA       3.18       0.80         NA      11.15        000
31601...............  ..............  A               Incision of windpipe.       4.44         NA       2.39       0.47         NA       7.30        000
31603...............  ..............  A               Incision of windpipe.       4.14         NA       1.71       0.45         NA       6.30        000
31605...............  ..............  A               Incision of windpipe.       3.57         NA       1.18       0.39         NA       5.14        000
31610...............  ..............  A               Incision of windpipe.       8.75         NA       8.27       0.80         NA      17.82        090
31611...............  ..............  A               Surgery/speech              5.63         NA       6.11       0.47         NA      12.21        090
                                                       prosthesis.
31612...............  ..............  A               Puncture/clear              0.91       1.10       0.35       0.08       2.09       1.34        000
                                                       windpipe.
31613...............  ..............  A               Repair windpipe             4.58         NA       5.99       0.45         NA      11.02        090
                                                       opening.
31614...............  ..............  A               Repair windpipe             7.11         NA       8.71       0.62         NA      16.44        090
                                                       opening.
31615...............  ..............  A               Visualization of            2.09       2.59       1.20       0.16       4.84       3.45        000
                                                       windpipe.
31622...............  ..............  A               Dx bronchoscope/wash.       2.78       5.71       1.06       0.19       8.68       4.03        000
31623...............  ..............  A               Dx bronchoscope/brush       2.88       6.51       1.05       0.16       9.55       4.09        000
31624...............  ..............  A               Dx bronchoscope/            2.88       5.85       1.05       0.16       8.89       4.09        000
                                                       lavage.
31625...............  ..............  A               Bronchoscopy w/             3.36       5.91       1.21       0.20       9.47       4.77        000
                                                       biopsy(s).
31628...............  ..............  A               Bronchoscopy/lung bx,       3.80       6.13       1.30       0.19      10.12       5.29        000
                                                       each.
31629...............  ..............  A               Bronchoscopy/needle         4.09      13.50       1.40       0.17      17.76       5.66        000
                                                       bx, each.
31630...............  ..............  A               Bronchoscopy dilate/        3.81         NA       1.70       0.35         NA       5.86        000
                                                       fx repr.
31631...............  ..............  A               Bronchoscopy, dilate        4.36         NA       1.74       0.37         NA       6.47        000
                                                       w/stent.
31632...............  ..............  A               Bronchoscopy/lung bx,       1.03       0.83       0.31       0.19       2.05       1.53        ZZZ
                                                       add-l.
31633...............  ..............  A               Bronchoscopy/needle         1.32       0.93       0.40       0.17       2.42       1.89        ZZZ
                                                       bx add-l.
31635...............  ..............  A               Bronchoscopy w/fb           3.67       6.17       1.43       0.27      10.11       5.37        000
                                                       removal.
31640...............  ..............  A               Bronchoscopy w/tumor        4.93         NA       2.07       0.44         NA       7.44        000
                                                       excise.
31641...............  ..............  A               Bronchoscopy, treat         5.02         NA       1.88       0.37         NA       7.27        000
                                                       blockage.
31643...............  ..............  A               Diag bronchoscope/          3.49         NA       1.23       0.20         NA       4.92        000
                                                       catheter.
31645...............  ..............  A               Bronchoscopy, clear         3.16       5.21       1.13       0.18       8.55       4.47        000
                                                       airways.
31646...............  ..............  A               Bronchoscopy, reclear       2.72       4.93       1.00       0.16       7.81       3.88        000
                                                       airway.
31656...............  ..............  A               Bronchoscopy, inj for       2.17       6.44       0.83       0.13       8.74       3.13        000
                                                       x-ray.
31700...............  ..............  A               Insertion of airway         1.34       2.17       0.69       0.08       3.59       2.11        000
                                                       catheter.
31708...............  ..............  A               Instill airway              1.41       2.12       0.46       0.07       3.60       1.94        000
                                                       contrast dye.
31710...............  ..............  A               Insertion of airway         1.30         NA       0.41       0.09         NA       1.80        000
                                                       catheter.
31715...............  ..............  A               Injection for               1.11         NA       0.34       0.07         NA       1.52        000
                                                       bronchus x-ray.
31717...............  ..............  A               Bronchial brush             2.12       8.66       0.79       0.10      10.88       3.01        000
                                                       biopsy.
31720...............  ..............  A               Clearance of airways.       1.06       0.33       0.33       0.08       1.47       1.47        000
31725...............  ..............  A               Clearance of airways.       1.96       0.65       0.58       0.13       2.74       2.67        000
31730...............  ..............  A               Intro, windpipe wire/       2.85       2.20       0.99       0.22       5.27       4.06        000
                                                       tube.
31750...............  ..............  A               Repair of windpipe...      13.00         NA      17.58       1.14         NA      31.72        090

[[Page 47609]]

 
31755...............  ..............  A               Repair of windpipe...      15.91         NA      24.51       1.41         NA      41.83        090
31760...............  ..............  A               Repair of windpipe...      22.32         NA      10.76       3.08         NA      36.16        090
31766...............  ..............  A               Reconstruction of          30.38         NA      13.67       4.53         NA      48.58        090
                                                       windpipe.
31770...............  ..............  A               Repair/graft of            22.48         NA      10.28       2.76         NA      35.52        090
                                                       bronchus.
31775...............  ..............  A               Reconstruct bronchus.      23.50         NA      11.82       3.06         NA      38.38        090
31780...............  ..............  A               Reconstruct windpipe.      17.69         NA      11.07       1.72         NA      30.48        090
31781...............  ..............  A               Reconstruct windpipe.      23.49         NA      12.15       2.51         NA      38.15        090
31785...............  ..............  A               Remove windpipe            17.20         NA      10.20       1.54         NA      28.94        090
                                                       lesion.
31786...............  ..............  A               Remove windpipe            23.94         NA      13.12       3.33         NA      40.39        090
                                                       lesion.
31800...............  ..............  A               Repair of windpipe          7.42         NA       9.29       0.76         NA      17.47        090
                                                       injury.
31805...............  ..............  A               Repair of windpipe         13.11         NA       7.25       1.78         NA      22.14        090
                                                       injury.
31820...............  ..............  A               Closure of windpipe         4.48       5.66       3.65       0.40      10.54       8.53        090
                                                       lesion.
31825...............  ..............  A               Repair of windpipe          6.80       7.66       5.37       0.58      15.04      12.75        090
                                                       defect.
31830...............  ..............  A               Revise windpipe scar.       4.49       5.76       3.98       0.43      10.68       8.90        090
32000...............  ..............  A               Drainage of chest....       1.54       3.10       0.48       0.09       4.73       2.11        000
32002...............  ..............  A               Treatment of                2.19       3.24       1.06       0.13       5.56       3.38        000
                                                       collapsed lung.
32005...............  ..............  A               Treat lung lining           2.19       6.50       0.70       0.22       8.91       3.11        000
                                                       chemically.
32020...............  ..............  A               Insertion of chest          3.97         NA       1.35       0.42         NA       5.74        000
                                                       tube.
32035...............  ..............  A               Exploration of chest.       8.66         NA       5.88       1.18         NA      15.72        090
32036...............  ..............  A               Exploration of chest.       9.67         NA       6.46       1.32         NA      17.45        090
32095...............  ..............  A               Biopsy through chest        8.35         NA       5.38       1.10         NA      14.83        090
                                                       wall.
32100...............  ..............  A               Exploration/biopsy of      15.22         NA       7.84       2.03         NA      25.09        090
                                                       chest.
32110...............  ..............  A               Explore/repair chest.      22.97         NA      10.74       3.01         NA      36.72        090
32120...............  ..............  A               Re-exploration of          11.52         NA       7.10       1.54         NA      20.16        090
                                                       chest.
32124...............  ..............  A               Explore chest free         12.70         NA       7.23       1.77         NA      21.70        090
                                                       adhesions.
32140...............  ..............  A               Removal of lung            13.91         NA       7.70       1.88         NA      23.49        090
                                                       lesion(s).
32141...............  ..............  A               Remove/treat lung          13.98         NA       7.57       1.86         NA      23.41        090
                                                       lesions.
32150...............  ..............  A               Removal of lung            14.13         NA       7.63       1.88         NA      23.64        090
                                                       lesion(s).
32151...............  ..............  A               Remove lung foreign        14.19         NA       8.03       1.61         NA      23.83        090
                                                       body.
32160...............  ..............  A               Open chest heart            9.29         NA       5.28       1.20         NA      15.77        090
                                                       massage.
32200...............  ..............  A               Drain, open, lung          15.27         NA       8.62       1.25         NA      25.14        090
                                                       lesion.
32201...............  ..............  A               Drain, percut, lung         3.99      21.04       1.30       0.24      25.27       5.53        000
                                                       lesion.
32215...............  ..............  A               Treat chest lining...      11.31         NA       6.92       1.50         NA      19.73        090
32220...............  ..............  A               Release of lung......      23.96         NA      12.96       3.20         NA      40.12        090
32225...............  ..............  A               Partial release of         13.94         NA       7.68       1.86         NA      23.48        090
                                                       lung.
32310...............  ..............  A               Removal of chest           13.42         NA       7.41       1.77         NA      22.60        090
                                                       lining.
32320...............  ..............  A               Free/remove chest          23.96         NA      12.16       3.23         NA      39.35        090
                                                       lining.
32400...............  ..............  A               Needle biopsy chest         1.76       2.14       0.55       0.10       4.00       2.41        000
                                                       lining.
32402...............  ..............  A               Open biopsy chest           7.55         NA       5.14       1.00         NA      13.69        090
                                                       lining.
32405...............  ..............  A               Biopsy, lung or             1.93       0.67       0.63       0.12       2.72       2.68        000
                                                       mediastinum.
32420...............  ..............  A               Puncture/clear lung..       2.18         NA       0.68       0.14         NA       3.00        000
32440...............  ..............  A               Removal of lung......      24.96         NA      12.89       3.33         NA      41.18        090
32442...............  ..............  A               Sleeve pneumonectomy.      26.20         NA      14.75       3.14         NA      44.09        090
32445...............  ..............  A               Removal of lung......      25.05         NA      14.06       3.55         NA      42.66        090
32480...............  ..............  A               Partial removal of         23.71         NA      12.05       3.16         NA      38.92        090
                                                       lung.
32482...............  ..............  A               Bilobectomy..........      24.96         NA      12.90       3.30         NA      41.16        090
32484...............  ..............  A               Segmentectomy........      20.66         NA      11.38       2.82         NA      34.86        090
32486...............  ..............  A               Sleeve lobectomy.....      23.88         NA      13.24       3.36         NA      40.48        090
32488...............  ..............  A               Completion                 25.67         NA      13.78       3.55         NA      43.00        090
                                                       pneumonectomy.
32491...............  ..............  R               Lung volume reduction      21.22         NA      12.62       3.11         NA      36.95        090
32500...............  ..............  A               Partial removal of         21.97         NA      12.35       2.92         NA      37.24        090
                                                       lung.
32501...............  ..............  A               Repair bronchus add-        4.68         NA       1.53       0.64         NA       6.85        ZZZ
                                                       on.
32520...............  ..............  A               Remove lung & revise       21.65         NA      11.31       2.91         NA      35.87        090
                                                       chest.
32522...............  ..............  A               Remove lung & revise       24.16         NA      12.11       3.29         NA      39.56        090
                                                       chest.
32525...............  ..............  A               Remove lung & revise       26.46         NA      12.79       3.49         NA      42.74        090
                                                       chest.
32540...............  ..............  A               Removal of lung            14.62         NA       9.63       1.96         NA      26.21        090
                                                       lesion.
32601...............  ..............  A               Thoracoscopy,               5.45         NA       2.35       0.73         NA       8.53        000
                                                       diagnostic.
32602...............  ..............  A               Thoracoscopy,               5.95         NA       2.51       0.80         NA       9.26        000
                                                       diagnostic.
32603...............  ..............  A               Thoracoscopy,               7.80         NA       3.03       1.09         NA      11.92        000
                                                       diagnostic.
32604...............  ..............  A               Thoracoscopy,               8.77         NA       3.44       1.12         NA      13.33        000
                                                       diagnostic.
32605...............  ..............  A               Thoracoscopy,               6.92         NA       2.90       0.91         NA      10.73        000
                                                       diagnostic.
32606...............  ..............  A               Thoracoscopy,               8.39         NA       3.33       0.85         NA      12.57        000
                                                       diagnostic.
32650...............  ..............  A               Thoracoscopy,              10.73         NA       6.76       1.44         NA      18.93        090
                                                       surgical.
32651...............  ..............  A               Thoracoscopy,              12.89         NA       7.23       1.75         NA      21.87        090
                                                       surgical.
32652...............  ..............  A               Thoracoscopy,              18.63         NA      10.14       2.53         NA      31.30        090
                                                       surgical.
32653...............  ..............  A               Thoracoscopy,              12.85         NA       6.97       1.76         NA      21.58        090
                                                       surgical.
32654...............  ..............  A               Thoracoscopy,              12.42         NA       7.53       1.64         NA      21.59        090
                                                       surgical.
32655...............  ..............  A               Thoracoscopy,              13.08         NA       7.24       1.75         NA      22.07        090
                                                       surgical.
32656...............  ..............  A               Thoracoscopy,              12.89         NA       7.93       1.80         NA      22.62        090
                                                       surgical.
32657...............  ..............  A               Thoracoscopy,              13.63         NA       7.68       1.86         NA      23.17        090
                                                       surgical.
32658...............  ..............  A               Thoracoscopy,              11.61         NA       7.35       1.62         NA      20.58        090
                                                       surgical.
32659...............  ..............  A               Thoracoscopy,              11.57         NA       7.45       1.55         NA      20.57        090
                                                       surgical.
32660...............  ..............  A               Thoracoscopy,              17.40         NA       9.47       1.87         NA      28.74        090
                                                       surgical.
32661...............  ..............  A               Thoracoscopy,              13.23         NA       7.79       1.77         NA      22.79        090
                                                       surgical.
32662...............  ..............  A               Thoracoscopy,              16.42         NA       8.81       2.26         NA      27.49        090
                                                       surgical.

[[Page 47610]]

 
32663...............  ..............  A               Thoracoscopy,              18.44         NA      10.75       2.56         NA      31.75        090
                                                       surgical.
32664...............  ..............  A               Thoracoscopy,              14.18         NA       7.63       2.06         NA      23.87        090
                                                       surgical.
32665...............  ..............  A               Thoracoscopy,              15.52         NA       8.13       2.03         NA      25.68        090
                                                       surgical.
32800...............  ..............  A               Repair lung hernia...      13.67         NA       7.45       1.91         NA      23.03        090
32810...............  ..............  A               Close chest after          13.03         NA       7.55       1.83         NA      22.41        090
                                                       drainage.
32815...............  ..............  A               Close bronchial            23.12         NA      10.99       3.11         NA      37.22        090
                                                       fistula.
32820...............  ..............  A               Reconstruct injured        21.45         NA      12.22       3.02         NA      36.69        090
                                                       chest.
32851...............  ..............  A               Lung transplant,           38.57         NA      27.68       5.44         NA      71.69        090
                                                       single.
32852...............  ..............  A               Lung transplant with       41.74         NA      33.18       5.79         NA      80.71        090
                                                       bypass.
32853...............  ..............  A               Lung transplant,           47.74         NA      31.75       6.35         NA      85.84        090
                                                       double.
32854...............  ..............  A               Lung transplant with       50.90         NA      34.78       7.07         NA      92.75        090
                                                       bypass.
32900...............  ..............  A               Removal of rib(s)....      20.24         NA       9.90       2.79         NA      32.93        090
32905...............  ..............  A               Revise & repair chest      20.72         NA      10.14       2.87         NA      33.73        090
                                                       wall.
32906...............  ..............  A               Revise & repair chest      26.73         NA      12.08       3.74         NA      42.55        090
                                                       wall.
32940...............  ..............  A               Revision of lung.....      19.40         NA       9.49       2.66         NA      31.55        090
32960...............  ..............  A               Therapeutic                 1.84       1.76       0.57       0.19       3.79       2.60        000
                                                       pneumothorax.
32997...............  ..............  A               Total lung lavage....       5.99         NA       1.90       0.42         NA       8.31        000
33010...............  ..............  A               Drainage of heart sac       2.24         NA       0.78       0.15         NA       3.17        000
33011...............  ..............  A               Repeat drainage of          2.24         NA       0.81       0.17         NA       3.22        000
                                                       heart sac.
33015...............  ..............  A               Incision of heart sac       6.79         NA       4.95       0.64         NA      12.38        090
33020...............  ..............  A               Incision of heart sac      12.59         NA       6.80       1.62         NA      21.01        090
33025...............  ..............  A               Incision of heart sac      12.07         NA       6.36       1.60         NA      20.03        090
33030...............  ..............  A               Partial removal of         18.68         NA       9.54       2.53         NA      30.75        090
                                                       heart sac.
33031...............  ..............  A               Partial removal of         21.76         NA      10.05       2.89         NA      34.70        090
                                                       heart sac.
33050...............  ..............  A               Removal of heart sac       14.34         NA       7.86       1.83         NA      24.03        090
                                                       lesion.
33120...............  ..............  A               Removal of heart           24.52         NA      11.62       3.25         NA      39.39        090
                                                       lesion.
33130...............  ..............  A               Removal of heart           21.36         NA      10.14       2.80         NA      34.30        090
                                                       lesion.
33140...............  ..............  A               Heart revascularize        19.97         NA      10.89       2.66         NA      33.52        090
                                                       (tmr).
33141...............  ..............  A               Heart tmr w/other           4.83         NA       1.57       0.62         NA       7.02        ZZZ
                                                       procedure.
33200...............  ..............  A               Insertion of heart         12.46         NA       6.94       1.52         NA      20.92        090
                                                       pacemaker.
33201...............  ..............  A               Insertion of heart         10.16         NA       6.69       1.18         NA      18.03        090
                                                       pacemaker.
33206...............  ..............  A               Insertion of heart          6.66         NA       4.54       0.54         NA      11.74        090
                                                       pacemaker.
33207...............  ..............  A               Insertion of heart          8.03         NA       4.73       0.63         NA      13.39        090
                                                       pacemaker.
33208...............  ..............  A               Insertion of heart          8.12         NA       4.84       0.60         NA      13.56        090
                                                       pacemaker.
33210...............  ..............  A               Insertion of heart          3.30         NA       1.25       0.20         NA       4.75        000
                                                       electrode.
33211...............  ..............  A               Insertion of heart          3.39         NA       1.31       0.23         NA       4.93        000
                                                       electrode.
33212...............  ..............  A               Insertion of pulse          5.51         NA       3.40       0.47         NA       9.38        090
                                                       generator.
33213...............  ..............  A               Insertion of pulse          6.36         NA       3.76       0.50         NA      10.62        090
                                                       generator.
33214...............  ..............  A               Upgrade of pacemaker        7.74         NA       4.97       0.58         NA      13.29        090
                                                       system.
33215...............  ..............  A               Reposition pacing-          4.75         NA       3.18       0.39         NA       8.32        090
                                                       defib lead.
33216...............  ..............  A               Insert lead pace-           5.77         NA       4.28       0.39         NA      10.44        090
                                                       defib, one.
33217...............  ..............  A               Insert lead pace-           5.74         NA       4.31       0.43         NA      10.48        090
                                                       defib, dual.
33218...............  ..............  A               Repair lead pace-           5.43         NA       4.34       0.43         NA      10.20        090
                                                       defib, one.
33220...............  ..............  A               Repair lead pace-           5.51         NA       4.31       0.43         NA      10.25        090
                                                       defib, dual.
33222...............  ..............  A               Revise pocket,              4.95         NA       4.34       0.42         NA       9.71        090
                                                       pacemaker.
33223...............  ..............  A               Revise pocket, pacing-      6.45         NA       4.61       0.47         NA      11.53        090
                                                       defib.
33224...............  ..............  A               Insert pacing lead &        9.04         NA       3.99       0.43         NA      13.46        000
                                                       connect.
33225...............  ..............  A               L ventric pacing lead       8.33         NA       3.25       0.43         NA      12.01        ZZZ
                                                       add-on.
33226...............  ..............  A               Reposition l ventric        8.68         NA       3.81       0.43         NA      12.92        000
                                                       lead.
33233...............  ..............  A               Removal of pacemaker        3.29         NA       3.28       0.24         NA       6.81        090
                                                       system.
33234...............  ..............  A               Removal of pacemaker        7.81         NA       4.92       0.60         NA      13.33        090
                                                       system.
33235...............  ..............  A               Removal pacemaker           9.39         NA       6.82       0.76         NA      16.97        090
                                                       electrode.
33236...............  ..............  A               Remove electrode/          12.58         NA       7.45       1.72         NA      21.75        090
                                                       thoracotomy.
33237...............  ..............  A               Remove electrode/          13.69         NA       7.79       1.63         NA      23.11        090
                                                       thoracotomy.
33238...............  ..............  A               Remove electrode/          15.20         NA       8.22       1.94         NA      25.36        090
                                                       thoracotomy.
33240...............  ..............  A               Insert pulse                7.59         NA       4.63       0.50         NA      12.72        090
                                                       generator.
33241...............  ..............  A               Remove pulse                3.24         NA       2.97       0.22         NA       6.43        090
                                                       generator.
33243...............  ..............  A               Remove eltrd/              22.61         NA      11.45       2.80         NA      36.86        090
                                                       thoracotomy.
33244...............  ..............  A               Remove eltrd,              13.74         NA       8.90       1.02         NA      23.66        090
                                                       transven.
33245...............  ..............  A               Insert epic eltrd          14.28         NA       7.99       1.85         NA      24.12        090
                                                       pace-defib.
33246...............  ..............  A               Insert epic eltrd/         20.68         NA      10.35       2.46         NA      33.49        090
                                                       generator.
33249...............  ..............  A               Eltrd/insert pace-         14.21         NA       8.44       0.86         NA      23.51        090
                                                       defib.
33250...............  ..............  A               Ablate heart               21.82         NA      11.05       2.79         NA      35.66        090
                                                       dysrhythm focus.
33251...............  ..............  A               Ablate heart               24.84         NA      11.68       2.87         NA      39.39        090
                                                       dysrhythm focus.
33253...............  ..............  A               Reconstruct atria....      31.01         NA      13.84       4.04         NA      48.89        090
33261...............  ..............  A               Ablate heart               24.84         NA      11.79       2.82         NA      39.45        090
                                                       dysrhythm focus.
33282...............  ..............  A               Implant pat-active ht       4.16         NA       4.07       0.25         NA       8.48        090
                                                       record.
33284...............  ..............  A               Remove pat-active ht        2.50         NA       3.55       0.16         NA       6.21        090
                                                       record.
33300...............  ..............  A               Repair of heart wound      17.89         NA       9.25       2.33         NA      29.47        090
33305...............  ..............  A               Repair of heart wound      21.41         NA      10.64       2.79         NA      34.84        090
33310...............  ..............  A               Exploratory heart          18.48         NA       9.60       2.58         NA      30.66        090
                                                       surgery.
33315...............  ..............  A               Exploratory heart          22.34         NA      10.90       2.87         NA      36.11        090
                                                       surgery.
33320...............  ..............  A               Repair major blood         16.76         NA       8.25       1.83         NA      26.84        090
                                                       vessel(s).
33321...............  ..............  A               Repair major vessel..      20.17         NA       9.81       2.69         NA      32.67        090
33322...............  ..............  A               Repair major blood         20.59         NA      10.38       2.65         NA      33.62        090
                                                       vessel(s).

[[Page 47611]]

 
33330...............  ..............  A               Insert major vessel        21.40         NA      10.28       2.65         NA      34.33        090
                                                       graft.
33332...............  ..............  A               Insert major vessel        23.92         NA      10.53       3.11         NA      37.56        090
                                                       graft.
33335...............  ..............  A               Insert major vessel        29.96         NA      13.35       3.86         NA      47.17        090
                                                       graft.
33400...............  ..............  A               Repair of aortic           28.46         NA      15.65       3.69         NA      47.80        090
                                                       valve.
33401...............  ..............  A               Valvuloplasty, open..      23.87         NA      13.50       1.30         NA      38.67        090
33403...............  ..............  A               Valvuloplasty, w/cp        24.85         NA      14.30       3.53         NA      42.68        090
                                                       bypass.
33404...............  ..............  A               Prepare heart-aorta        28.50         NA      14.53       4.02         NA      47.05        090
                                                       conduit.
33405...............  ..............  A               Replacement of aortic      34.95         NA      18.28       4.55         NA      57.78        090
                                                       valve.
33406...............  ..............  A               Replacement of aortic      37.44         NA      19.11       4.93         NA      61.48        090
                                                       valve.
33410...............  ..............  A               Replacement of aortic      32.41         NA      16.58       4.05         NA      53.04        090
                                                       valve.
33411...............  ..............  A               Replacement of aortic      36.20         NA      18.74       4.86         NA      59.80        090
                                                       valve.
33412...............  ..............  A               Replacement of aortic      41.94         NA      20.40       5.61         NA      67.95        090
                                                       valve.
33413...............  ..............  A               Replacement of aortic      43.43         NA      20.80       5.94         NA      70.17        090
                                                       valve.
33414...............  ..............  A               Repair of aortic           30.30         NA      14.15       4.00         NA      48.45        090
                                                       valve.
33415...............  ..............  A               Revision, subvalvular      27.11         NA      12.05       3.56         NA      42.72        090
                                                       tissue.
33416...............  ..............  A               Revise ventricle           30.30         NA      13.52       4.14         NA      47.96        090
                                                       muscle.
33417...............  ..............  A               Repair of aortic           28.49         NA      13.63       3.96         NA      46.08        090
                                                       valve.
33420...............  ..............  A               Revision of mitral         22.67         NA       9.61       1.89         NA      34.17        090
                                                       valve.
33422...............  ..............  A               Revision of mitral         25.90         NA      13.64       3.39         NA      42.93        090
                                                       valve.
33425...............  ..............  A               Repair of mitral           26.96         NA      13.05       3.59         NA      43.60        090
                                                       valve.
33426...............  ..............  A               Repair of mitral           32.95         NA      17.13       4.25         NA      54.33        090
                                                       valve.
33427...............  ..............  A               Repair of mitral           39.94         NA      19.35       5.27         NA      64.56        090
                                                       valve.
33430...............  ..............  A               Replacement of mitral      33.45         NA      17.29       4.36         NA      55.10        090
                                                       valve.
33460...............  ..............  A               Revision of tricuspid      23.56         NA      11.32       3.23         NA      38.11        090
                                                       valve.
33463...............  ..............  A               Valvuloplasty,             25.58         NA      12.92       3.36         NA      41.86        090
                                                       tricuspid.
33464...............  ..............  A               Valvuloplasty,             27.29         NA      13.53       3.52         NA      44.34        090
                                                       tricuspid.
33465...............  ..............  A               Replace tricuspid          28.75         NA      12.98       3.88         NA      45.61        090
                                                       valve.
33468...............  ..............  A               Revision of tricuspid      30.07         NA      13.68       4.35         NA      48.10        090
                                                       valve.
33470...............  ..............  A               Revision of pulmonary      20.78         NA      10.71       2.01         NA      33.50        090
                                                       valve.
33471...............  ..............  A               Valvotomy, pulmonary       22.22         NA       9.77       3.31         NA      35.30        090
                                                       valve.
33472...............  ..............  A               Revision of pulmonary      22.22         NA      11.89       3.11         NA      37.22        090
                                                       valve.
33474...............  ..............  A               Revision of pulmonary      23.01         NA      10.89       2.70         NA      36.60        090
                                                       valve.
33475...............  ..............  A               Replacement,               32.95         NA      15.41       4.30         NA      52.66        090
                                                       pulmonary valve.
33476...............  ..............  A               Revision of heart          25.73         NA      11.97       2.97         NA      40.67        090
                                                       chamber.
33478...............  ..............  A               Revision of heart          26.70         NA      13.06       3.85         NA      43.61        090
                                                       chamber.
33496...............  ..............  A               Repair, prosth valve       27.21         NA      12.76       3.60         NA      43.57        090
                                                       clot.
33500...............  ..............  A               Repair heart vessel        25.51         NA      11.47       3.33         NA      40.31        090
                                                       fistula.
33501...............  ..............  A               Repair heart vessel        17.75         NA       8.29       2.04         NA      28.08        090
                                                       fistula.
33502...............  ..............  A               Coronary artery            21.01         NA      11.10       2.11         NA      34.22        090
                                                       correction.
33503...............  ..............  A               Coronary artery graft      21.75         NA       9.78       1.84         NA      33.37        090
33504...............  ..............  A               Coronary artery graft      24.62         NA      11.84       3.32         NA      39.78        090
33505...............  ..............  A               Repair artery w/           26.80         NA      12.93       2.67         NA      42.40        090
                                                       tunnel.
33506...............  ..............  A               Repair artery,             35.45         NA      14.59       3.85         NA      53.89        090
                                                       translocation.
33508...............  ..............  A               Endoscopic vein             0.31         NA       0.10       0.88         NA       1.29        ZZZ
                                                       harvest.
33510...............  ..............  A               CABG, vein, single...      28.96         NA      16.33       3.75         NA      49.04        090
33511...............  ..............  A               CABG, vein, two......      29.96         NA      17.07       3.83         NA      50.86        090
33512...............  ..............  A               CABG, vein, three....      31.75         NA      17.60       4.13         NA      53.48        090
33513...............  ..............  A               CABG, vein, four.....      31.95         NA      17.78       4.16         NA      53.89        090
33514...............  ..............  A               CABG, vein, five.....      32.70         NA      18.05       4.00         NA      54.75        090
33516...............  ..............  A               Cabg, vein, six or         34.95         NA      18.79       4.51         NA      58.25        090
                                                       more.
33517...............  ..............  A               CABG, artery-vein,          2.57         NA       0.84       0.33         NA       3.74        ZZZ
                                                       single.
33518...............  ..............  A               CABG, artery-vein,          4.84         NA       1.58       0.63         NA       7.05        ZZZ
                                                       two.
33519...............  ..............  A               CABG, artery-vein,          7.11         NA       2.32       0.92         NA      10.35        ZZZ
                                                       three.
33521...............  ..............  A               CABG, artery-vein,          9.39         NA       3.07       1.20         NA      13.66        ZZZ
                                                       four.
33522...............  ..............  A               CABG, artery-vein,         11.65         NA       3.80       1.49         NA      16.94        ZZZ
                                                       five.
33523...............  ..............  A               Cabg, art-vein, six        13.93         NA       4.52       1.81         NA      20.26        ZZZ
                                                       or more.
33530...............  ..............  A               Coronary artery,            5.85         NA       1.90       0.77         NA       8.52        ZZZ
                                                       bypass/reop.
33533...............  ..............  A               CABG, arterial,            29.96         NA      16.46       3.86         NA      50.28        090
                                                       single.
33534...............  ..............  A               CABG, arterial, two..      32.15         NA      17.70       4.13         NA      53.98        090
33535...............  ..............  A               CABG, arterial, three      34.45         NA      18.13       4.43         NA      57.01        090
33536...............  ..............  A               Cabg, arterial, four       37.44         NA      18.28       4.60         NA      60.32        090
                                                       or more.
33542...............  ..............  A               Removal of heart           28.81         NA      13.01       3.79         NA      45.61        090
                                                       lesion.
33545...............  ..............  A               Repair of heart            36.72         NA      15.64       4.81         NA      57.17        090
                                                       damage.
33572...............  ..............  A               Open coronary               4.44         NA       1.45       0.58         NA       6.47        ZZZ
                                                       endarterectomy.
33600...............  ..............  A               Closure of valve.....      29.47         NA      12.55       4.13         NA      46.15        090
33602...............  ..............  A               Closure of valve.....      28.50         NA      12.46       3.25         NA      44.21        090
33606...............  ..............  A               Anastomosis/artery-        30.69         NA      13.69       4.33         NA      48.71        090
                                                       aorta.
33608...............  ..............  A               Repair anomaly w/          31.04         NA      14.11       4.41         NA      49.56        090
                                                       conduit.
33610...............  ..............  A               Repair by enlargement      30.56         NA      13.66       4.56         NA      48.78        090
33611...............  ..............  A               Repair double              33.95         NA      14.15       4.11         NA      52.21        090
                                                       ventricle.
33612...............  ..............  A               Repair double              34.95         NA      15.17       5.18         NA      55.30        090
                                                       ventricle.
33615...............  ..............  A               Repair, modified           33.95         NA      13.27       2.90         NA      50.12        090
                                                       fontan.
33617...............  ..............  A               Repair single              36.94         NA      16.02       4.88         NA      57.84        090
                                                       ventricle.
33619...............  ..............  A               Repair single              44.93         NA      20.82       3.60         NA      69.35        090
                                                       ventricle.
33641...............  ..............  A               Repair heart septum        21.36         NA       9.59       2.73         NA      33.68        090
                                                       defect.

[[Page 47612]]

 
33645...............  ..............  A               Revision of heart          24.78         NA      11.78       3.26         NA      39.82        090
                                                       veins.
33647...............  ..............  A               Repair heart septum        28.69         NA      13.79       3.12         NA      45.60        090
                                                       defects.
33660...............  ..............  A               Repair of heart            29.96         NA      13.50       3.88         NA      47.34        090
                                                       defects.
33665...............  ..............  A               Repair of heart            28.56         NA      13.85       4.21         NA      46.62        090
                                                       defects.
33670...............  ..............  A               Repair of heart            34.95         NA      13.20       3.47         NA      51.62        090
                                                       chambers.
33681...............  ..............  A               Repair heart septum        30.56         NA      14.69       4.03         NA      49.28        090
                                                       defect.
33684...............  ..............  A               Repair heart septum        29.61         NA      13.63       4.08         NA      47.32        090
                                                       defect.
33688...............  ..............  A               Repair heart septum        30.57         NA      10.52       4.39         NA      45.48        090
                                                       defect.
33690...............  ..............  A               Reinforce pulmonary        19.52         NA      10.19       2.66         NA      32.37        090
                                                       artery.
33692...............  ..............  A               Repair of heart            30.70         NA      13.94       4.58         NA      49.22        090
                                                       defects.
33694...............  ..............  A               Repair of heart            33.95         NA      14.23       3.71         NA      51.89        090
                                                       defects.
33697...............  ..............  A               Repair of heart            35.95         NA      14.87       4.32         NA      55.14        090
                                                       defects.
33702...............  ..............  A               Repair of heart            26.50         NA      12.58       4.00         NA      43.08        090
                                                       defects.
33710...............  ..............  A               Repair of heart            29.67         NA      14.00       3.01         NA      46.68        090
                                                       defects.
33720...............  ..............  A               Repair of heart            26.52         NA      12.29       3.60         NA      42.41        090
                                                       defect.
33722...............  ..............  A               Repair of heart            28.37         NA      13.88       4.33         NA      46.58        090
                                                       defect.
33730...............  ..............  A               Repair heart-vein          34.20         NA      14.13       4.32         NA      52.65        090
                                                       defect(s).
33732...............  ..............  A               Repair heart-vein          28.12         NA      13.41       2.88         NA      44.41        090
                                                       defect.
33735...............  ..............  A               Revision of heart          21.36         NA       9.06       1.56         NA      31.98        090
                                                       chamber.
33736...............  ..............  A               Revision of heart          23.48         NA      11.87       2.50         NA      37.85        090
                                                       chamber.
33737...............  ..............  A               Revision of heart          21.73         NA      10.95       3.30         NA      35.98        090
                                                       chamber.
33750...............  ..............  A               Major vessel shunt...      21.38         NA      10.24       2.56         NA      34.18        090
33755...............  ..............  A               Major vessel shunt...      21.76         NA       8.82       3.24         NA      33.82        090
33762...............  ..............  A               Major vessel shunt...      21.76         NA      10.17       3.18         NA      35.11        090
33764...............  ..............  A               Major vessel shunt &       21.76         NA      10.25       2.15         NA      34.16        090
                                                       graft.
33766...............  ..............  A               Major vessel shunt...      22.73         NA      11.68       3.39         NA      37.80        090
33767...............  ..............  A               Major vessel shunt...      24.46         NA      11.75       2.74         NA      38.95        090
33770...............  ..............  A               Repair great vessels       36.94         NA      14.69       5.42         NA      57.05        090
                                                       defect.
33771...............  ..............  A               Repair great vessels       34.60         NA      12.42       5.63         NA      52.65        090
                                                       defect.
33774...............  ..............  A               Repair great vessels       30.93         NA      14.75       4.70         NA      50.38        090
                                                       defect.
33775...............  ..............  A               Repair great vessels       32.15         NA      15.02       5.23         NA      52.40        090
                                                       defect.
33776...............  ..............  A               Repair great vessels       33.99         NA      15.80       5.52         NA      55.31        090
                                                       defect.
33777...............  ..............  A               Repair great vessels       33.41         NA      14.87       5.44         NA      53.72        090
                                                       defect.
33778...............  ..............  A               Repair great vessels       39.94         NA      16.89       5.83         NA      62.66        090
                                                       defect.
33779...............  ..............  A               Repair great vessels       36.16         NA      15.39       1.74         NA      53.29        090
                                                       defect.
33780...............  ..............  A               Repair great vessels       41.69         NA      19.06       5.15         NA      65.90        090
                                                       defect.
33781...............  ..............  A               Repair great vessels       36.40         NA      13.48       5.92         NA      55.80        090
                                                       defect.
33786...............  ..............  A               Repair arterial trunk      38.94         NA      16.70       2.03         NA      57.67        090
33788...............  ..............  A               Revision of pulmonary      26.58         NA      11.95       4.02         NA      42.55        090
                                                       artery.
33800...............  ..............  A               Aortic suspension....      16.22         NA       8.16       2.28         NA      26.66        090
33802...............  ..............  A               Repair vessel defect.      17.63         NA       9.24       1.66         NA      28.53        090
33803...............  ..............  A               Repair vessel defect.      19.57         NA       9.78       3.17         NA      32.52        090
33813...............  ..............  A               Repair septal defect.      20.62         NA      10.93       1.13         NA      32.68        090
33814...............  ..............  A               Repair septal defect.      25.73         NA      12.66       3.56         NA      41.95        090
33820...............  ..............  A               Revise major vessel..      16.27         NA       8.39       2.19         NA      26.85        090
33822...............  ..............  A               Revise major vessel..      17.29         NA       8.98       1.92         NA      28.19        090
33824...............  ..............  A               Revise major vessel..      19.49         NA      10.01       2.91         NA      32.41        090
33840...............  ..............  A               Remove aorta               20.60         NA      10.31       2.45         NA      33.36        090
                                                       constriction.
33845...............  ..............  A               Remove aorta               22.09         NA      11.36       3.13         NA      36.58        090
                                                       constriction.
33851...............  ..............  A               Remove aorta               21.24         NA      10.71       2.81         NA      34.76        090
                                                       constriction.
33852...............  ..............  A               Repair septal defect.      23.67         NA      11.38       2.55         NA      37.60        090
33853...............  ..............  A               Repair septal defect.      31.67         NA      14.84       4.13         NA      50.64        090
33860...............  ..............  A               Ascending aortic           37.94         NA      16.46       5.05         NA      59.45        090
                                                       graft.
33861...............  ..............  A               Ascending aortic           41.94         NA      17.72       5.45         NA      65.11        090
                                                       graft.
33863...............  ..............  A               Ascending aortic           44.93         NA      18.70       5.46         NA      69.09        090
                                                       graft.
33870...............  ..............  A               Transverse aortic          43.93         NA      18.39       5.96         NA      68.28        090
                                                       arch graft.
33875...............  ..............  A               Thoracic aortic graft      33.01         NA      14.11       4.43         NA      51.55        090
33877...............  ..............  A               Thoracoabdominal           42.54         NA      16.33       5.46         NA      64.33        090
                                                       graft.
33910...............  ..............  A               Remove lung artery         24.55         NA      11.45       3.32         NA      39.32        090
                                                       emboli.
33915...............  ..............  A               Remove lung artery         20.99         NA       9.64       1.73         NA      32.36        090
                                                       emboli.
33916...............  ..............  A               Surgery of great           25.79         NA      11.37       3.47         NA      40.63        090
                                                       vessel.
33917...............  ..............  A               Repair pulmonary           24.46         NA      12.21       3.25         NA      39.92        090
                                                       artery.
33918...............  ..............  A               Repair pulmonary           26.41         NA      12.13       4.12         NA      42.66        090
                                                       atresia.
33919...............  ..............  A               Repair pulmonary           39.94         NA      17.52       4.45         NA      61.91        090
                                                       atresia.
33920...............  ..............  A               Repair pulmonary           31.90         NA      13.85       3.50         NA      49.25        090
                                                       atresia.
33922...............  ..............  A               Transect pulmonary         23.48         NA      10.92       3.25         NA      37.65        090
                                                       artery.
33924...............  ..............  A               Remove pulmonary            5.49         NA       1.83       0.70         NA       8.02        ZZZ
                                                       shunt.
33935...............  ..............  R               Transplantation,           60.87         NA      28.77       9.19         NA      98.83        090
                                                       heart/lung.
33945...............  ..............  R               Transplantation of         42.04         NA      21.38       5.91         NA      69.33        090
                                                       heart.
33960...............  ..............  A               External circulation       19.33         NA       4.90       2.46         NA      26.69        000
                                                       assist.
33961...............  ..............  A               External circulation       10.91         NA       3.61       1.08         NA      15.60        ZZZ
                                                       assist.
33967...............  ..............  A               Insert ia percut            4.84         NA       1.83       0.35         NA       7.02        000
                                                       device.
33968...............  ..............  A               Remove aortic assist        0.64         NA       0.23       0.06         NA       0.93        000
                                                       device.
33970...............  ..............  A               Aortic circulation          6.74         NA       2.28       0.81         NA       9.83        000
                                                       assist.
33971...............  ..............  A               Aortic circulation          9.68         NA       6.03       1.21         NA      16.92        090
                                                       assist.

[[Page 47613]]

 
33973...............  ..............  A               Insert balloon device       9.75         NA       3.30       1.18         NA      14.23        000
33974...............  ..............  A               Remove intra-aortic        14.39         NA       7.91       1.71         NA      24.01        090
                                                       balloon.
33975...............  ..............  A               Implant ventricular        20.97         NA       6.27       2.95         NA      30.19        XXX
                                                       device.
33976...............  ..............  A               Implant ventricular        22.97         NA       7.53       2.73         NA      33.23        XXX
                                                       device.
33977...............  ..............  A               Remove ventricular         19.26         NA      11.08       2.68         NA      33.02        090
                                                       device.
33978...............  ..............  A               Remove ventricular         21.70         NA      11.75       3.03         NA      36.48        090
                                                       device.
33979...............  ..............  A               Insert intracorporeal      45.93         NA      14.89       4.80         NA      65.62        XXX
                                                       device.
33980...............  ..............  A               Remove intracorporeal      56.17         NA      25.22       5.55         NA      86.94        090
                                                       device.
34001...............  ..............  A               Removal of artery          12.89         NA       6.71       1.76         NA      21.36        090
                                                       clot.
34051...............  ..............  A               Removal of artery          15.19         NA       7.77       2.20         NA      25.16        090
                                                       clot.
34101...............  ..............  A               Removal of artery           9.99         NA       5.35       1.36         NA      16.70        090
                                                       clot.
34111...............  ..............  A               Removal of arm artery       9.99         NA       5.35       1.36         NA      16.70        090
                                                       clot.
34151...............  ..............  A               Removal of artery          24.96         NA      10.39       3.34         NA      38.69        090
                                                       clot.
34201...............  ..............  A               Removal of artery          10.01         NA       5.41       1.38         NA      16.80        090
                                                       clot.
34203...............  ..............  A               Removal of leg artery      16.48         NA       8.05       2.25         NA      26.78        090
                                                       clot.
34401...............  ..............  A               Removal of vein clot.      24.96         NA      10.65       3.00         NA      38.61        090
34421...............  ..............  A               Removal of vein clot.      11.98         NA       6.28       1.48         NA      19.74        090
34451...............  ..............  A               Removal of vein clot.      26.96         NA      11.42       3.65         NA      42.03        090
34471...............  ..............  A               Removal of vein clot.      10.16         NA       5.31       0.88         NA      16.35        090
34490...............  ..............  A               Removal of vein clot.       9.85         NA       5.43       1.34         NA      16.62        090
34501...............  ..............  A               Repair valve, femoral      15.98         NA       8.50       2.31         NA      26.79        090
                                                       vein.
34502...............  ..............  A               Reconstruct vena cava      26.91         NA      12.28       3.41         NA      42.60        090
34510...............  ..............  A               Transposition of vein      18.92         NA       9.43       2.39         NA      30.74        090
                                                       valve.
34520...............  ..............  A               Cross-over vein graft      17.92         NA       8.48       1.63         NA      28.03        090
34530...............  ..............  A               Leg vein fusion......      16.62         NA       8.61       2.16         NA      27.39        090
34800...............  ..............  A               Endovasc abdo repair       20.72         NA       9.15       2.35         NA      32.22        090
                                                       w/tube.
34802...............  ..............  A               Endovasc abdo repr w/      22.97         NA       9.77       2.34         NA      35.08        090
                                                       device.
34804...............  ..............  A               Endovasc abdo repr w/      22.97         NA       9.79       2.35         NA      35.11        090
                                                       device.
34805...............  ..............  A               Endovasc abdo repair       21.85         NA       9.66       1.99         NA      33.50        090
                                                       w/pros.
34808...............  ..............  A               Endovasc abdo occlud        4.12         NA       1.37       0.50         NA       5.99        ZZZ
                                                       device.
34812...............  ..............  A               Xpose for endoprosth,       6.74         NA       2.23       1.09         NA      10.06        000
                                                       femorl.
34813...............  ..............  A               Femoral endovas graft       4.79         NA       1.57       0.65         NA       7.01        ZZZ
                                                       add-on.
34820...............  ..............  A               Xpose for endoprosth,       9.74         NA       3.23       1.35         NA      14.32        000
                                                       iliac.
34825...............  ..............  A               Endovasc extend            11.98         NA       6.13       1.29         NA      19.40        090
                                                       prosth, init.
34826...............  ..............  A               Endovasc exten              4.12         NA       1.37       0.45         NA       5.94        ZZZ
                                                       prosth, add-l.
34830...............  ..............  A               Open aortic tube           32.54         NA      13.68       3.75         NA      49.97        090
                                                       prosth repr.
34831...............  ..............  A               Open aortoiliac            35.29         NA      11.73       3.95         NA      50.97        090
                                                       prosth repr.
34832...............  ..............  A               Open aortofemor            35.29         NA      14.60       4.05         NA      53.94        090
                                                       prosth repr.
34833...............  ..............  A               Xpose for endoprosth,      11.98         NA       4.42       0.84         NA      17.24        000
                                                       iliac.
34834...............  ..............  A               Xpose, endoprosth,          5.34         NA       2.19       0.59         NA       8.12        000
                                                       brachial.
34900...............  ..............  A               Endovasc iliac repr w/     16.36         NA       7.59       1.80         NA      25.75        090
                                                       graft.
35001...............  ..............  A               Repair defect of           19.61         NA       9.54       2.64         NA      31.79        090
                                                       artery.
35002...............  ..............  A               Repair artery              20.97         NA       9.68       2.38         NA      33.03        090
                                                       rupture, neck.
35005...............  ..............  A               Repair defect of           18.09         NA       8.83       2.29         NA      29.21        090
                                                       artery.
35011...............  ..............  A               Repair defect of           17.97         NA       7.97       2.42         NA      28.36        090
                                                       artery.
35013...............  ..............  A               Repair artery              21.97         NA       9.66       2.98         NA      34.61        090
                                                       rupture, arm.
35021...............  ..............  A               Repair defect of           19.62         NA       9.41       2.43         NA      31.46        090
                                                       artery.
35022...............  ..............  A               Repair artery              23.15         NA       9.86       2.32         NA      35.33        090
                                                       rupture, chest.
35045...............  ..............  A               Repair defect of arm       17.54         NA       7.53       2.38         NA      27.45        090
                                                       artery.
35081...............  ..............  A               Repair defect of           27.97         NA      11.44       3.66         NA      43.07        090
                                                       artery.
35082...............  ..............  A               Repair artery              38.44         NA      15.27       5.10         NA      58.81        090
                                                       rupture, aorta.
35091...............  ..............  A               Repair defect of           35.35         NA      13.55       4.76         NA      53.66        090
                                                       artery.
35092...............  ..............  A               Repair artery              44.93         NA      17.61       5.97         NA      68.51        090
                                                       rupture, aorta.
35102...............  ..............  A               Repair defect of           30.71         NA      12.34       4.09         NA      47.14        090
                                                       artery.
35103...............  ..............  A               Repair artery              40.44         NA      15.82       5.49         NA      61.75        090
                                                       rupture, groin.
35111...............  ..............  A               Repair defect of           24.96         NA      10.45       3.35         NA      38.76        090
                                                       artery.
35112...............  ..............  A               Repair artery              29.96         NA      11.95       3.89         NA      45.80        090
                                                       rupture,spleen.
35121...............  ..............  A               Repair defect of           29.96         NA      12.35       4.05         NA      46.36        090
                                                       artery.
35122...............  ..............  A               Repair artery              34.95         NA      13.78       4.48         NA      53.21        090
                                                       rupture, belly.
35131...............  ..............  A               Repair defect of           24.96         NA      10.73       3.49         NA      39.18        090
                                                       artery.
35132...............  ..............  A               Repair artery              29.96         NA      12.36       4.07         NA      46.39        090
                                                       rupture, groin.
35141...............  ..............  A               Repair defect of           19.97         NA       8.90       2.72         NA      31.59        090
                                                       artery.
35142...............  ..............  A               Repair artery              23.27         NA      10.35       3.11         NA      36.73        090
                                                       rupture, thigh.
35151...............  ..............  A               Repair defect of           22.61         NA       9.98       3.04         NA      35.63        090
                                                       artery.
35152...............  ..............  A               Repair artery              25.58         NA      11.36       3.35         NA      40.29        090
                                                       rupture, knee.
35161...............  ..............  A               Repair defect of           18.73         NA       9.13       2.48         NA      30.34        090
                                                       artery.
35162...............  ..............  A               Repair artery rupture      19.75         NA       9.56       2.75         NA      32.06        090
35180...............  ..............  A               Repair blood vessel        13.60         NA       6.94       1.97         NA      22.51        090
                                                       lesion.
35182...............  ..............  A               Repair blood vessel        29.96         NA      12.78       4.09         NA      46.83        090
                                                       lesion.
35184...............  ..............  A               Repair blood vessel        17.97         NA       8.29       2.45         NA      28.71        090
                                                       lesion.
35188...............  ..............  A               Repair blood vessel        14.26         NA       7.62       1.98         NA      23.86        090
                                                       lesion.
35189...............  ..............  A               Repair blood vessel        27.96         NA      11.94       3.68         NA      43.58        090
                                                       lesion.
35190...............  ..............  A               Repair blood vessel        12.73         NA       6.47       1.71         NA      20.91        090
                                                       lesion.
35201...............  ..............  A               Repair blood vessel        16.12         NA       7.98       2.13         NA      26.23        090
                                                       lesion.
35206...............  ..............  A               Repair blood vessel        13.23         NA       6.57       1.83         NA      21.63        090
                                                       lesion.

[[Page 47614]]

 
35207...............  ..............  A               Repair blood vessel        10.13         NA       7.53       1.46         NA      19.12        090
                                                       lesion.
35211...............  ..............  A               Repair blood vessel        22.09         NA      10.64       2.89         NA      35.62        090
                                                       lesion.
35216...............  ..............  A               Repair blood vessel        18.72         NA       8.99       2.49         NA      30.20        090
                                                       lesion.
35221...............  ..............  A               Repair blood vessel        24.35         NA       9.92       3.20         NA      37.47        090
                                                       lesion.
35226...............  ..............  A               Repair blood vessel        14.48         NA       7.46       1.89         NA      23.83        090
                                                       lesion.
35231...............  ..............  A               Repair blood vessel        19.97         NA       9.75       2.74         NA      32.46        090
                                                       lesion.
35236...............  ..............  A               Repair blood vessel        17.08         NA       7.90       2.35         NA      27.33        090
                                                       lesion.
35241...............  ..............  A               Repair blood vessel        23.09         NA      11.14       3.00         NA      37.23        090
                                                       lesion.
35246...............  ..............  A               Repair blood vessel        26.41         NA      11.43       3.21         NA      41.05        090
                                                       lesion.
35251...............  ..............  A               Repair blood vessel        30.15         NA      11.77       3.99         NA      45.91        090
                                                       lesion.
35256...............  ..............  A               Repair blood vessel        18.33         NA       8.37       2.51         NA      29.21        090
                                                       lesion.
35261...............  ..............  A               Repair blood vessel        17.77         NA       8.00       2.41         NA      28.18        090
                                                       lesion.
35266...............  ..............  A               Repair blood vessel        14.89         NA       7.01       1.98         NA      23.88        090
                                                       lesion.
35271...............  ..............  A               Repair blood vessel        22.09         NA      10.53       2.99         NA      35.61        090
                                                       lesion.
35276...............  ..............  A               Repair blood vessel        24.21         NA      11.22       3.24         NA      38.67        090
                                                       lesion.
35281...............  ..............  A               Repair blood vessel        27.96         NA      11.69       3.73         NA      43.38        090
                                                       lesion.
35286...............  ..............  A               Repair blood vessel        16.14         NA       8.07       2.22         NA      26.43        090
                                                       lesion.
35301...............  ..............  A               Rechanneling of            18.67         NA       8.44       2.52         NA      29.63        090
                                                       artery.
35311...............  ..............  A               Rechanneling of            26.96         NA      11.73       3.47         NA      42.16        090
                                                       artery.
35321...............  ..............  A               Rechanneling of            15.98         NA       7.37       2.18         NA      25.53        090
                                                       artery.
35331...............  ..............  A               Rechanneling of            26.16         NA      11.22       3.56         NA      40.94        090
                                                       artery.
35341...............  ..............  A               Rechanneling of            25.07         NA      10.85       3.44         NA      39.36        090
                                                       artery.
35351...............  ..............  A               Rechanneling of            22.97         NA       9.58       3.16         NA      35.71        090
                                                       artery.
35355...............  ..............  A               Rechanneling of            18.47         NA       8.08       2.51         NA      29.06        090
                                                       artery.
35361...............  ..............  A               Rechanneling of            28.16         NA      11.69       3.84         NA      43.69        090
                                                       artery.
35363...............  ..............  A               Rechanneling of            30.15         NA      12.56       4.16         NA      46.87        090
                                                       artery.
35371...............  ..............  A               Rechanneling of            14.70         NA       6.94       2.01         NA      23.65        090
                                                       artery.
35372...............  ..............  A               Rechanneling of            17.97         NA       8.04       2.47         NA      28.48        090
                                                       artery.
35381...............  ..............  A               Rechanneling of            15.79         NA       7.81       2.14         NA      25.74        090
                                                       artery.
35390...............  ..............  A               Reoperation, carotid        3.19         NA       1.06       0.43         NA       4.68        ZZZ
                                                       add-on.
35400...............  ..............  A               Angioscopy...........       3.00         NA       1.11       0.42         NA       4.53        ZZZ
35450...............  ..............  A               Repair arterial            10.05         NA       3.55       1.24         NA      14.84        000
                                                       blockage.
35452...............  ..............  A               Repair arterial             6.90         NA       2.60       0.82         NA      10.32        000
                                                       blockage.
35454...............  ..............  A               Repair arterial             6.03         NA       2.31       0.82         NA       9.16        000
                                                       blockage.
35456...............  ..............  A               Repair arterial             7.34         NA       2.76       0.99         NA      11.09        000
                                                       blockage.
35458...............  ..............  A               Repair arterial             9.48         NA       3.46       1.21         NA      14.15        000
                                                       blockage.
35459...............  ..............  A               Repair arterial             8.62         NA       3.16       1.16         NA      12.94        000
                                                       blockage.
35460...............  ..............  A               Repair venous               6.03         NA       2.26       0.82         NA       9.11        000
                                                       blockage.
35470...............  ..............  A               Repair arterial             8.62      90.69       3.34       0.70     100.01      12.66        000
                                                       blockage.
35471...............  ..............  A               Repair arterial            10.05     102.73       3.94       0.69     113.47      14.68        000
                                                       blockage.
35472...............  ..............  A               Repair arterial             6.90      65.72       2.74       0.59      73.21      10.23        000
                                                       blockage.
35473...............  ..............  A               Repair arterial             6.03      61.03       2.42       0.51      67.57       8.96        000
                                                       blockage.
35474...............  ..............  A               Repair arterial             7.35      89.50       2.89       0.56      97.41      10.80        000
                                                       blockage.
35475...............  ..............  R               Repair arterial             9.48      56.75       3.55       0.63      66.86      13.66        000
                                                       blockage.
35476...............  ..............  A               Repair venous               6.03      45.31       2.35       0.39      51.73       8.77        000
                                                       blockage.
35480...............  ..............  A               Atherectomy, open....      11.06         NA       4.03       1.27         NA      16.36        000
35481...............  ..............  A               Atherectomy, open....       7.60         NA       2.87       0.99         NA      11.46        000
35482...............  ..............  A               Atherectomy, open....       6.64         NA       2.56       0.85         NA      10.05        000
35483...............  ..............  A               Atherectomy, open....       8.09         NA       3.02       1.05         NA      12.16        000
35484...............  ..............  A               Atherectomy, open....      10.42         NA       3.76       1.28         NA      15.46        000
35485...............  ..............  A               Atherectomy, open....       9.48         NA       3.53       1.30         NA      14.31        000
35490...............  ..............  A               Atherectomy,               11.06         NA       4.69       0.63         NA      16.38        000
                                                       percutaneous.
35491...............  ..............  A               Atherectomy,                7.60         NA       3.28       0.51         NA      11.39        000
                                                       percutaneous.
35492...............  ..............  A               Atherectomy,                6.64         NA       3.19       0.42         NA      10.25        000
                                                       percutaneous.
35493...............  ..............  A               Atherectomy,                8.09         NA       3.80       0.57         NA      12.46        000
                                                       percutaneous.
35494...............  ..............  A               Atherectomy,               10.42         NA       4.45       0.79         NA      15.66        000
                                                       percutaneous.
35495...............  ..............  A               Atherectomy,                9.48         NA       4.38       0.69         NA      14.55        000
                                                       percutaneous.
35500...............  ..............  A               Harvest vein for            6.44         NA       2.02       0.88         NA       9.34        ZZZ
                                                       bypass.
35501...............  ..............  A               Artery bypass graft..      19.16         NA       8.46       2.67         NA      30.29        090
35506...............  ..............  A               Artery bypass graft..      19.64         NA       9.45       2.69         NA      31.78        090
35507...............  ..............  A               Artery bypass graft..      19.64         NA       9.41       2.66         NA      31.71        090
35508...............  ..............  A               Artery bypass graft..      18.62         NA       9.43       2.43         NA      30.48        090
35509...............  ..............  A               Artery bypass graft..      18.04         NA       8.75       2.47         NA      29.26        090
35510...............  ..............  A               Artery bypass graft..      22.97         NA      10.16       2.10         NA      35.23        090
35511...............  ..............  A               Artery bypass graft..      21.17         NA       9.34       2.38         NA      32.89        090
35512...............  ..............  A               Artery bypass graft..      22.47         NA       9.99       2.10         NA      34.56        090
35515...............  ..............  A               Artery bypass graft..      18.62         NA       9.27       2.50         NA      30.39        090
35516...............  ..............  A               Artery bypass graft..      16.30         NA       6.80       2.19         NA      25.29        090
35518...............  ..............  A               Artery bypass graft..      21.17         NA       8.96       2.84         NA      32.97        090
35521...............  ..............  A               Artery bypass graft..      22.17         NA       9.82       2.98         NA      34.97        090
35522...............  ..............  A               Artery bypass graft..      21.73         NA       9.74       2.10         NA      33.57        090
35525...............  ..............  A               Artery bypass graft..      20.60         NA       9.36       2.10         NA      32.06        090
35526...............  ..............  A               Artery bypass graft..      29.91         NA      12.49       2.43         NA      44.83        090
35531...............  ..............  A               Artery bypass graft..      36.15         NA      14.46       5.00         NA      55.61        090
35533...............  ..............  A               Artery bypass graft..      27.96         NA      11.71       3.59         NA      43.26        090

[[Page 47615]]

 
35536...............  ..............  A               Artery bypass graft..      31.65         NA      12.92       4.36         NA      48.93        090
35541...............  ..............  A               Artery bypass graft..      25.76         NA      11.19       3.49         NA      40.44        090
35546...............  ..............  A               Artery bypass graft..      25.50         NA      10.85       2.66         NA      39.01        090
35548...............  ..............  A               Artery bypass graft..      21.54         NA       9.41       2.84         NA      33.79        090
35549...............  ..............  A               Artery bypass graft..      23.31         NA      10.37       3.18         NA      36.86        090
35551...............  ..............  A               Artery bypass graft..      26.63         NA      11.48       3.71         NA      41.82        090
35556...............  ..............  A               Artery bypass graft..      21.73         NA       9.71       2.86         NA      34.30        090
35558...............  ..............  A               Artery bypass graft..      21.17         NA       9.53       2.83         NA      33.53        090
35560...............  ..............  A               Artery bypass graft..      31.95         NA      13.29       4.40         NA      49.64        090
35563...............  ..............  A               Artery bypass graft..      24.16         NA      10.50       3.39         NA      38.05        090
35565...............  ..............  A               Artery bypass graft..      23.17         NA      10.12       3.14         NA      36.43        090
35566...............  ..............  A               Artery bypass graft..      26.88         NA      11.37       3.63         NA      41.88        090
35571...............  ..............  A               Artery bypass graft..      24.02         NA      10.84       3.26         NA      38.12        090
35572...............  ..............  A               Harvest                     6.81         NA       2.23       0.76         NA       9.80        ZZZ
                                                       femoropopliteal vein.
35582...............  ..............  A               Vein bypass graft....      27.09         NA      11.55       3.32         NA      41.96        090
35583...............  ..............  A               Vein bypass graft....      22.34         NA      10.15       2.97         NA      35.46        090
35585...............  ..............  A               Vein bypass graft....      28.35         NA      12.23       3.81         NA      44.39        090
35587...............  ..............  A               Vein bypass graft....      24.71         NA      11.44       3.34         NA      39.49        090
35600...............  ..............  A               Harvest artery for          4.94         NA       1.62       0.64         NA       7.20        ZZZ
                                                       cabg.
35601...............  ..............  A               Artery bypass graft..      17.47         NA       8.61       2.36         NA      28.44        090
35606...............  ..............  A               Artery bypass graft..      18.68         NA       9.00       2.52         NA      30.20        090
35612...............  ..............  A               Artery bypass graft..      15.74         NA       7.88       2.10         NA      25.72        090
35616...............  ..............  A               Artery bypass graft..      15.68         NA       8.10       2.18         NA      25.96        090
35621...............  ..............  A               Artery bypass graft..      19.97         NA       8.67       2.76         NA      31.40        090
35623...............  ..............  A               Bypass graft, not          23.96         NA      10.48       3.30         NA      37.74        090
                                                       vein.
35626...............  ..............  A               Artery bypass graft..      27.71         NA      11.96       3.80         NA      43.47        090
35631...............  ..............  A               Artery bypass graft..      33.95         NA      13.81       4.64         NA      52.40        090
35636...............  ..............  A               Artery bypass graft..      29.46         NA      12.28       3.84         NA      45.58        090
35641...............  ..............  A               Artery bypass graft..      24.53         NA      11.05       3.28         NA      38.86        090
35642...............  ..............  A               Artery bypass graft..      17.95         NA       8.67       1.88         NA      28.50        090
35645...............  ..............  A               Artery bypass graft..      17.44         NA       8.27       2.21         NA      27.92        090
35646...............  ..............  A               Artery bypass graft..      30.95         NA      13.08       4.20         NA      48.23        090
35647...............  ..............  A               Artery bypass graft..      27.96         NA      11.76       3.78         NA      43.50        090
35650...............  ..............  A               Artery bypass graft..      18.97         NA       8.35       2.55         NA      29.87        090
35651...............  ..............  A               Artery bypass graft..      25.00         NA      10.73       3.08         NA      38.81        090
35654...............  ..............  A               Artery bypass graft..      24.96         NA      10.63       3.40         NA      38.99        090
35656...............  ..............  A               Artery bypass graft..      19.50         NA       8.60       2.61         NA      30.71        090
35661...............  ..............  A               Artery bypass graft..      18.97         NA       8.91       2.56         NA      30.44        090
35663...............  ..............  A               Artery bypass graft..      21.97         NA       9.96       2.99         NA      34.92        090
35665...............  ..............  A               Artery bypass graft..      20.97         NA       9.43       2.84         NA      33.24        090
35666...............  ..............  A               Artery bypass graft..      22.16         NA      10.64       3.00         NA      35.80        090
35671...............  ..............  A               Artery bypass graft..      19.30         NA       9.36       2.62         NA      31.28        090
35681...............  ..............  A               Composite bypass            1.60         NA       0.53       0.20         NA       2.33        ZZZ
                                                       graft.
35682...............  ..............  A               Composite bypass            7.19         NA       2.38       0.95         NA      10.52        ZZZ
                                                       graft.
35683...............  ..............  A               Composite bypass            8.49         NA       2.81       1.10         NA      12.40        ZZZ
                                                       graft.
35685...............  ..............  A               Bypass graft patency/       4.04         NA       1.35       0.56         NA       5.95        ZZZ
                                                       patch.
35686...............  ..............  A               Bypass graft/av fist        3.34         NA       1.12       0.47         NA       4.93        ZZZ
                                                       patency.
35691...............  ..............  A               Arterial                   18.02         NA       8.39       2.46         NA      28.87        090
                                                       transposition.
35693...............  ..............  A               Arterial                   15.34         NA       7.71       2.07         NA      25.12        090
                                                       transposition.
35694...............  ..............  A               Arterial                   19.13         NA       8.59       2.63         NA      30.35        090
                                                       transposition.
35695...............  ..............  A               Arterial                   19.13         NA       8.54       2.70         NA      30.37        090
                                                       transposition.
35697...............  ..............  A               Reimplant artery each       3.00         NA       1.02       0.41         NA       4.43        ZZZ
35700...............  ..............  A               Reoperation, bypass         3.08         NA       1.02       0.42         NA       4.52        ZZZ
                                                       graft.
35701...............  ..............  A               Exploration, carotid        8.49         NA       5.15       1.16         NA      14.80        090
                                                       artery.
35721...............  ..............  A               Exploration, femoral        7.17         NA       4.45       0.99         NA      12.61        090
                                                       artery.
35741...............  ..............  A               Exploration popliteal       7.99         NA       4.68       1.08         NA      13.75        090
                                                       artery.
35761...............  ..............  A               Exploration of artery/      5.36         NA       4.04       0.73         NA      10.13        090
                                                       vein.
35800...............  ..............  A               Explore neck vessels.       7.01         NA       4.65       0.93         NA      12.59        090
35820...............  ..............  A               Explore chest vessels      12.86         NA       7.18       1.72         NA      21.76        090
35840...............  ..............  A               Explore abdominal           9.76         NA       5.28       1.27         NA      16.31        090
                                                       vessels.
35860...............  ..............  A               Explore limb vessels.       5.54         NA       4.03       0.75         NA      10.32        090
35870...............  ..............  A               Repair vessel graft        22.14         NA       9.75       2.89         NA      34.78        090
                                                       defect.
35875...............  ..............  A               Removal of clot in         10.11         NA       5.20       1.36         NA      16.67        090
                                                       graft.
35876...............  ..............  A               Removal of clot in         16.97         NA       7.54       2.28         NA      26.79        090
                                                       graft.
35879...............  ..............  A               Revise graft w/vein..      15.98         NA       7.71       2.16         NA      25.85        090
35881...............  ..............  A               Revise graft w/vein..      17.97         NA       8.68       2.42         NA      29.07        090
35901...............  ..............  A               Excision, graft, neck       8.18         NA       5.32       1.09         NA      14.59        090
35903...............  ..............  A               Excision, graft,            9.38         NA       6.18       1.27         NA      16.83        090
                                                       extremity.
35905...............  ..............  A               Excision, graft,           31.20         NA      13.18       4.40         NA      48.78        090
                                                       thorax.
35907...............  ..............  A               Excision, graft,           34.95         NA      14.15       4.76         NA      53.86        090
                                                       abdomen.
36000...............  ..............  A               Place needle in vein.       0.18       0.60       0.05       0.01       0.79       0.24        XXX
36002...............  ..............  A               Pseudoaneurysm              1.96       2.87       0.97       0.18       5.01       3.11        000
                                                       injection trt.
36005...............  ..............  A               Injection ext               0.95       7.89       0.31       0.06       8.90       1.32        000
                                                       venography.
36010...............  ..............  A               Place catheter in           2.43      20.07       0.79       0.20      22.70       3.42        XXX
                                                       vein.
36011...............  ..............  A               Place catheter in           3.14      28.80       1.06       0.24      32.18       4.44        XXX
                                                       vein.

[[Page 47616]]

 
36012...............  ..............  A               Place catheter in           3.51      19.13       1.19       0.23      22.87       4.93        XXX
                                                       vein.
36013...............  ..............  A               Place catheter in           2.52      22.22       0.69       0.25      24.99       3.46        XXX
                                                       artery.
36014...............  ..............  A               Place catheter in           3.02      20.50       1.03       0.20      23.72       4.25        XXX
                                                       artery.
36015...............  ..............  A               Place catheter in           3.51      24.30       1.19       0.22      28.03       4.92        XXX
                                                       artery.
36100...............  ..............  A               Establish access to         3.02      12.32       1.11       0.28      15.62       4.41        XXX
                                                       artery.
36120...............  ..............  A               Establish access to         2.01      10.85       0.64       0.15      13.01       2.80        XXX
                                                       artery.
36140...............  ..............  A               Establish access to         2.01      13.05       0.64       0.16      15.22       2.81        XXX
                                                       artery.
36145...............  ..............  A               Artery to vein shunt.       2.01      12.75       0.66       0.13      14.89       2.80        XXX
36160...............  ..............  A               Establish access to         2.52      13.81       0.84       0.25      16.58       3.61        XXX
                                                       aorta.
36200...............  ..............  A               Place catheter in           3.02      16.90       1.01       0.23      20.15       4.26        XXX
                                                       aorta.
36215...............  ..............  A               Place catheter in           4.67      27.75       1.60       0.31      32.73       6.58        XXX
                                                       artery.
36216...............  ..............  A               Place catheter in           5.27      29.86       1.79       0.36      35.49       7.42        XXX
                                                       artery.
36217...............  ..............  A               Place catheter in           6.29      56.62       2.17       0.44      63.35       8.90        XXX
                                                       artery.
36218...............  ..............  A               Place catheter in           1.01       5.18       0.34       0.07       6.26       1.42        ZZZ
                                                       artery.
36245...............  ..............  A               Place catheter in           4.67      33.09       1.68       0.33      38.09       6.68        XXX
                                                       artery.
36246...............  ..............  A               Place catheter in           5.27      30.97       1.81       0.38      36.62       7.46        XXX
                                                       artery.
36247...............  ..............  A               Place catheter in           6.29      50.83       2.14       0.47      57.59       8.90        XXX
                                                       artery.
36248...............  ..............  A               Place catheter in           1.01       4.12       0.34       0.07       5.20       1.42        ZZZ
                                                       artery.
36260...............  ..............  A               Insertion of infusion       9.70         NA       4.91       1.26         NA      15.87        090
                                                       pump.
36261...............  ..............  A               Revision of infusion        5.44         NA       3.68       0.62         NA       9.74        090
                                                       pump.
36262...............  ..............  A               Removal of infusion         4.01         NA       2.75       0.52         NA       7.28        090
                                                       pump.
36400...............  ..............  A               Bl draw < 3 yrs fem/        0.38       0.28       0.09       0.03       0.69       0.50        XXX
                                                       jugular.
36405...............  ..............  A               Bl draw < 3 yrs scalp       0.31       0.26       0.08       0.02       0.59       0.41        XXX
                                                       vein.
36406...............  ..............  A               Bl draw < 3 yrs other       0.18       0.29       0.05       0.01       0.48       0.24        XXX
                                                       vein.
36410...............  ..............  A               Non-routine bl draw >       0.18       0.30       0.05       0.01       0.49       0.24        XXX
                                                       3 yrs.
36420...............  ..............  A               Vein access cutdown <       1.01       0.34       0.27       0.06       1.41       1.34        XXX
                                                       1 yr.
36425...............  ..............  A               Vein access cutdown >       0.76         NA       0.22       0.06         NA       1.04        XXX
                                                       1 yr.
36430...............  ..............  A               Blood transfusion           0.00       1.00         NA       0.06       1.06         NA        XXX
                                                       service.
36440...............  ..............  A               Bl push transfuse, 2        1.03         NA       0.29       0.07         NA       1.39        XXX
                                                       yr or <.
36450...............  ..............  A               Bl exchange/                2.23         NA       0.70       0.10         NA       3.03        XXX
                                                       transfuse, nb.
36455...............  ..............  A               Bl exchange/transfuse       2.43         NA       1.01       0.14         NA       3.58        XXX
                                                       non-nb.
36460...............  ..............  A               Transfusion service,        6.58         NA       2.24       0.88         NA       9.70        XXX
                                                       fetal.
36470...............  ..............  A               Injection therapy of        1.09       2.69       0.73       0.13       3.91       1.95        010
                                                       vein.
36471...............  ..............  A               Injection therapy of        1.57       3.08       0.96       0.19       4.84       2.72        010
                                                       veins.
36481...............  ..............  A               Insertion of                6.98       6.04       2.58       0.48      13.50      10.04        000
                                                       catheter, vein.
36500...............  ..............  A               Insertion of                3.51         NA       1.36       0.24         NA       5.11        000
                                                       catheter, vein.
36510...............  ..............  A               Insertion of                1.09       3.95       0.61       0.08       5.12       1.78        000
                                                       catheter, vein.
36511...............  ..............  A               Apheresis wbc........       1.74         NA       0.73       0.08         NA       2.55        000
36512...............  ..............  A               Apheresis rbc........       1.74         NA       0.74       0.08         NA       2.56        000
36513...............  ..............  A               Apheresis platelets..       1.74         NA       0.73       0.08         NA       2.55        000
36514...............  ..............  A               Apheresis plasma.....       1.74      17.69       0.71       0.08      19.51       2.53        000
36515...............  ..............  A               Apheresis, adsorp/          1.74      65.03       0.65       0.08      66.85       2.47        000
                                                       reinfuse.
36516...............  ..............  A               Apheresis, selective.       1.22      84.13       0.48       0.08      85.43       1.78        000
36522...............  ..............  A               Photopheresis........       1.67      30.87       1.13       0.14      32.68       2.94        000
36550...............  ..............  A               Declot vascular             0.00       0.40         NA       0.37       0.77         NA        XXX
                                                       device.
36555...............  ..............  A               Insert non-tunnel cv        2.68       5.80       0.80       0.12       8.60       3.60        000
                                                       cath.
36556...............  ..............  A               Insert non-tunnel cv        2.50       5.75       0.74       0.19       8.44       3.43        000
                                                       cath.
36557...............  ..............  A               Insert tunneled cv          5.09      21.23       2.64       0.58      26.90       8.31        010
                                                       cath.
36558...............  ..............  A               Insert tunneled cv          4.79      21.12       2.54       0.58      26.49       7.91        010
                                                       cath.
36560...............  ..............  A               Insert tunneled cv          6.24      29.79       3.03       0.58      36.61       9.85        010
                                                       cath.
36561...............  ..............  A               Insert tunneled cv          5.99      29.70       2.94       0.58      36.27       9.51        010
                                                       cath.
36563...............  ..............  A               Insert tunneled cv          6.19      26.76       2.98       0.83      33.78      10.00        010
                                                       cath.
36565...............  ..............  A               Insert tunneled cv          5.99      24.81       2.94       0.58      31.38       9.51        010
                                                       cath.
36566...............  ..............  A               Insert tunneled cv          6.49      25.60       3.11       0.58      32.67      10.18        010
                                                       cath.
36568...............  ..............  A               Insert tunneled cv          1.92       7.60       0.58       0.12       9.64       2.62        000
                                                       cath.
36569...............  ..............  A               Insert tunneled cv          1.82       7.42       0.57       0.19       9.43       2.58        000
                                                       cath.
36570...............  ..............  A               Insert tunneled cv          5.31      33.30       2.72       0.58      39.19       8.61        010
                                                       cath.
36571...............  ..............  A               Insert tunneled cv          5.29      33.38       2.71       0.58      39.25       8.58        010
                                                       cath.
36575...............  ..............  A               Repair tunneled cv          0.67       4.07       0.26       0.22       4.96       1.15        000
                                                       cath.
36576...............  ..............  A               Repair tunneled cv          3.19       6.98       1.83       0.21      10.38       5.23        010
                                                       cath.
36578...............  ..............  A               Replace tunneled cv         3.49      11.20       2.30       0.21      14.90       6.00        010
                                                       cath.
36580...............  ..............  A               Replace tunneled cv         1.31       7.08       0.41       0.19       8.58       1.91        000
                                                       cath.
36581...............  ..............  A               Replace tunneled cv         3.43      19.63       1.91       0.21      23.27       5.55        010
                                                       cath.
36582...............  ..............  A               Replace tunneled cv         5.19      26.19       2.85       0.21      31.59       8.25        010
                                                       cath.
36583...............  ..............  A               Replace tunneled cv         5.24      26.21       2.87       0.20      31.65       8.31        010
                                                       cath.
36584...............  ..............  A               Replace tunneled cv         1.20       7.11       0.55       0.19       8.50       1.94        000
                                                       cath.
36585...............  ..............  A               Replace tunneled cv         4.79      28.01       2.72       0.21      33.01       7.72        010
                                                       cath.
36589...............  ..............  A               Removal tunneled cv         2.27       2.24       1.39       0.25       4.76       3.91        010
                                                       cath.
36590...............  ..............  A               Removal tunneled cv         3.30       3.38       1.72       0.43       7.11       5.45        010
                                                       cath.
36595...............  ..............  A               Mech remov tunneled         3.59      17.42       1.45       0.33      21.34       5.37        000
                                                       cv cath.
36596...............  ..............  A               Mech remov tunneled         0.75       3.71       0.50       0.39       4.85       1.64        000
                                                       cv cath.
36597...............  ..............  A               Reposition venous           1.21       2.41       0.44       0.08       3.70       1.73        000
                                                       catheter.
36600...............  ..............  A               Withdrawal of               0.32       0.49       0.09       0.02       0.83       0.43        XXX
                                                       arterial blood.
36620...............  ..............  A               Insertion catheter,         1.15         NA       0.23       0.07         NA       1.45        000
                                                       artery.
36625...............  ..............  A               Insertion catheter,         2.11         NA       0.53       0.21         NA       2.85        000
                                                       artery.

[[Page 47617]]

 
36640...............  ..............  A               Insertion catheter,         2.10         NA       1.05       0.22         NA       3.37        000
                                                       artery.
36660...............  ..............  A               Insertion catheter,         1.40         NA       0.44       0.09         NA       1.93        000
                                                       artery.
36680...............  ..............  A               Insert needle, bone         1.20         NA       0.49       0.13         NA       1.82        000
                                                       cavity.
36800...............  ..............  A               Insertion of cannula.       2.43         NA       1.80       0.23         NA       4.46        000
36810...............  ..............  A               Insertion of cannula.       3.96         NA       1.68       0.47         NA       6.11        000
36815...............  ..............  A               Insertion of cannula.       2.62         NA       1.17       0.33         NA       4.12        000
36819...............  ..............  A               Av fusion/uppr arm         13.98         NA       6.36       1.87         NA      22.21        090
                                                       vein.
36820...............  ..............  A               Av fusion/forearm          13.98         NA       6.37       1.88         NA      22.23        090
                                                       vein.
36821...............  ..............  A               Av fusion direct any        8.92         NA       4.67       1.18         NA      14.77        090
                                                       site.
36822...............  ..............  A               Insertion of                5.41         NA       4.41       0.73         NA      10.55        090
                                                       cannula(s).
36823...............  ..............  A               Insertion of               20.97         NA       9.38       2.64         NA      32.99        090
                                                       cannula(s).
36825...............  ..............  A               Artery-vein autograft       9.83         NA       5.07       1.29         NA      16.19        090
36830...............  ..............  A               Artery-vein                11.98         NA       5.25       1.60         NA      18.83        090
                                                       nonautograft.
36831...............  ..............  A               Open thrombect av           7.99         NA       3.94       1.07         NA      13.00        090
                                                       fistula.
36832...............  ..............  A               Av fistula revision,       10.48         NA       4.74       1.39         NA      16.61        090
                                                       open.
36833...............  ..............  A               Av fistula revision..      11.93         NA       5.21       1.60         NA      18.74        090
36834...............  ..............  A               Repair A-V aneurysm..       9.92         NA       4.79       1.34         NA      16.05        090
36835...............  ..............  A               Artery to vein shunt.       7.14         NA       4.34       0.99         NA      12.47        090
36838...............  ..............  A               Dist revas ligation,       20.60         NA       9.37       2.99         NA      32.96        090
                                                       hemo.
36860...............  ..............  A               External cannula            2.01       1.77       0.67       0.13       3.91       2.81        000
                                                       declotting.
36861...............  ..............  A               Cannula declotting...       2.52         NA       1.49       0.25         NA       4.26        000
36870...............  ..............  A               Percut thrombect av         5.15      32.39       3.14       0.33      37.87       8.62        090
                                                       fistula.
37140...............  ..............  A               Revision of                23.56         NA      10.46       1.71         NA      35.73        090
                                                       circulation.
37145...............  ..............  A               Revision of                24.57         NA      10.87       2.99         NA      38.43        090
                                                       circulation.
37160...............  ..............  A               Revision of                21.57         NA       9.25       2.79         NA      33.61        090
                                                       circulation.
37180...............  ..............  A               Revision of                24.57         NA      10.29       3.12         NA      37.98        090
                                                       circulation.
37181...............  ..............  A               Splice spleen/kidney       26.64         NA      10.99       3.37         NA      41.00        090
                                                       veins.
37182...............  ..............  A               Insert hepatic shunt       16.97         NA       6.04       0.59         NA      23.60        000
                                                       (tips).
37183...............  ..............  A               Remove hepatic shunt        7.99         NA       3.01       0.59         NA      11.59        000
                                                       (tips).
37195...............  ..............  A               Thrombolytic therapy,       0.00       8.04         NA       0.46       8.50         NA        XXX
                                                       stroke.
37200...............  ..............  A               Transcatheter biopsy.       4.55         NA       1.49       0.27         NA       6.31        000
37201...............  ..............  A               Transcatheter therapy       4.99         NA       2.54       0.35         NA       7.88        000
                                                       infuse.
37202...............  ..............  A               Transcatheter therapy       5.67         NA       3.02       0.53         NA       9.22        000
                                                       infuse.
37203...............  ..............  A               Transcatheter               5.02      33.39       2.03       0.33      38.74       7.38        000
                                                       retrieval.
37204...............  ..............  A               Transcatheter              18.11         NA       5.89       1.37         NA      25.37        000
                                                       occlusion.
37205...............  ..............  A               Transcatheter stent..       8.27         NA       3.75       0.59         NA      12.61        000
37206...............  ..............  A               Transcatheter stent         4.12         NA       1.43       0.31         NA       5.86        ZZZ
                                                       add-on.
37207...............  ..............  A               Transcatheter stent..       8.27         NA       3.15       1.10         NA      12.52        000
37208...............  ..............  A               Transcatheter stent         4.12         NA       1.38       0.55         NA       6.05        ZZZ
                                                       add-on.
37209...............  ..............  A               Exchange arterial           2.27         NA       0.74       0.16         NA       3.17        000
                                                       catheter.
37250...............  ..............  A               Iv us first vessel          2.10         NA       0.75       0.20         NA       3.05        ZZZ
                                                       add-on.
37251...............  ..............  A               Iv us each add vessel       1.60         NA       0.55       0.19         NA       2.34        ZZZ
                                                       add-on.
37500...............  ..............  A               Endoscopy ligate perf      10.98         NA       6.88       0.48         NA      18.34        090
                                                       veins.
37565...............  ..............  A               Ligation of neck vein      10.86         NA       5.61       1.31         NA      17.78        090
37600...............  ..............  A               Ligation of neck           11.23         NA       6.62       1.30         NA      19.15        090
                                                       artery.
37605...............  ..............  A               Ligation of neck           13.09         NA       6.90       1.93         NA      21.92        090
                                                       artery.
37606...............  ..............  A               Ligation of neck            6.27         NA       4.56       0.94         NA      11.77        090
                                                       artery.
37607...............  ..............  A               Ligation of a-v             6.15         NA       3.57       0.83         NA      10.55        090
                                                       fistula.
37609...............  ..............  A               Temporal artery             3.00       4.51       1.96       0.36       7.87       5.32        010
                                                       procedure.
37615...............  ..............  A               Ligation of neck            5.72         NA       4.10       0.69         NA      10.51        090
                                                       artery.
37616...............  ..............  A               Ligation of chest          16.47         NA       8.10       2.19         NA      26.76        090
                                                       artery.
37617...............  ..............  A               Ligation of abdomen        22.03         NA       9.17       2.85         NA      34.05        090
                                                       artery.
37618...............  ..............  A               Ligation of extremity       4.83         NA       3.62       0.65         NA       9.10        090
                                                       artery.
37620...............  ..............  A               Revision of major          10.54         NA       5.70       0.94         NA      17.18        090
                                                       vein.
37650...............  ..............  A               Revision of major           7.79         NA       4.69       1.05         NA      13.53        090
                                                       vein.
37660...............  ..............  A               Revision of major          20.97         NA       9.05       2.60         NA      32.62        090
                                                       vein.
37700...............  ..............  A               Revise leg vein......       3.72         NA       2.80       0.52         NA       7.04        090
37720...............  ..............  A               Removal of leg vein..       5.65         NA       3.71       0.79         NA      10.15        090
37730...............  ..............  A               Removal of leg veins.       7.32         NA       4.26       0.97         NA      12.55        090
37735...............  ..............  A               Removal of leg veins/      10.51         NA       5.50       1.48         NA      17.49        090
                                                       lesion.
37760...............  ..............  A               Ligation, leg veins,       10.45         NA       5.35       1.38         NA      17.18        090
                                                       open.
37765...............  ..............  A               Phleb veins - extrem -      7.34         NA       4.61       0.48         NA      12.43        090
                                                        to 20.
37766...............  ..............  A               Phleb veins - extrem        9.29         NA       5.31       0.48         NA      15.08        090
                                                       20+.
37780...............  ..............  A               Revision of leg vein.       3.83         NA       2.86       0.54         NA       7.23        090
37785...............  ..............  A               Ligate/divide/excise        3.83       5.22       2.73       0.53       9.58       7.09        090
                                                       vein.
37788...............  ..............  A               Revascularization,         21.98         NA       9.18       1.56         NA      32.72        090
                                                       penis.
37790...............  ..............  A               Penile venous               8.33         NA       4.47       0.62         NA      13.42        090
                                                       occlusion.
38100...............  ..............  A               Removal of spleen,         14.48         NA       6.19       1.85         NA      22.52        090
                                                       total.
38101...............  ..............  A               Removal of spleen,         15.29         NA       6.54       2.01         NA      23.84        090
                                                       partial.
38102...............  ..............  A               Removal of spleen,          4.79         NA       1.63       0.61         NA       7.03        ZZZ
                                                       total.
38115...............  ..............  A               Repair of ruptured         15.80         NA       6.65       1.97         NA      24.42        090
                                                       spleen.
38120...............  ..............  A               Laparoscopy,               16.97         NA       7.38       2.18         NA      26.53        090
                                                       splenectomy.
38200...............  ..............  A               Injection for spleen        2.64         NA       0.89       0.17         NA       3.70        000
                                                       x-ray.
38205...............  ..............  R               Harvest allogenic           1.50         NA       0.68       0.06         NA       2.24        000
                                                       stem cells.
38206...............  ..............  R               Harvest auto stem           1.50         NA       0.67       0.06         NA       2.23        000
                                                       cells.

[[Page 47618]]

 
38220...............  ..............  A               Bone marrow                 1.08       3.97       0.52       0.06       5.11       1.66        XXX
                                                       aspiration.
38221...............  ..............  A               Bone marrow biopsy...       1.37       4.19       0.65       0.07       5.63       2.09        XXX
38230...............  ..............  R               Bone marrow                 4.53         NA       3.27       0.33         NA       8.13        010
                                                       collection.
38240...............  ..............  R               Bone marrow/stem            2.24         NA       1.03       0.11         NA       3.38        XXX
                                                       transplant.
38241...............  ..............  R               Bone marrow/stem            2.24         NA       1.04       0.11         NA       3.39        XXX
                                                       transplant.
38242...............  ..............  A               Lymphocyte infuse           1.71         NA       0.78       0.07         NA       2.56        000
                                                       transplant.
38300...............  ..............  A               Drainage, lymph node        1.99       4.36       2.06       0.22       6.57       4.27        010
                                                       lesion.
38305...............  ..............  A               Drainage, lymph node        5.99         NA       4.47       0.60         NA      11.06        090
                                                       lesion.
38308...............  ..............  A               Incision of lymph           6.44         NA       3.76       0.85         NA      11.05        090
                                                       channels.
38380...............  ..............  A               Thoracic duct               7.45         NA       5.68       0.80         NA      13.93        090
                                                       procedure.
38381...............  ..............  A               Thoracic duct              12.86         NA       6.90       1.81         NA      21.57        090
                                                       procedure.
38382...............  ..............  A               Thoracic duct              10.06         NA       5.79       1.40         NA      17.25        090
                                                       procedure.
38500...............  ..............  A               Biopsy/removal, lymph       3.74       3.71       2.08       0.48       7.93       6.30        010
                                                       nodes.
38505...............  ..............  A               Needle biopsy, lymph        1.14       2.06       0.79       0.10       3.30       2.03        000
                                                       nodes.
38510...............  ..............  A               Biopsy/removal, lymph       6.42       5.54       3.48       0.74      12.70      10.64        010
                                                       nodes.
38520...............  ..............  A               Biopsy/removal, lymph       6.66         NA       4.06       0.84         NA      11.56        090
                                                       nodes.
38525...............  ..............  A               Biopsy/removal, lymph       6.06         NA       3.33       0.79         NA      10.18        090
                                                       nodes.
38530...............  ..............  A               Biopsy/removal, lymph       7.97         NA       4.43       1.06         NA      13.46        090
                                                       nodes.
38542...............  ..............  A               Explore deep node(s),       5.90         NA       4.48       0.63         NA      11.01        090
                                                       neck.
38550...............  ..............  A               Removal, neck/armpit        6.91         NA       3.96       0.87         NA      11.74        090
                                                       lesion.
38555...............  ..............  A               Removal, neck/armpit       14.12         NA       8.57       1.67         NA      24.36        090
                                                       lesion.
38562...............  ..............  A               Removal, pelvic lymph      10.47         NA       5.79       1.21         NA      17.47        090
                                                       nodes.
38564...............  ..............  A               Removal, abdomen           10.81         NA       5.27       1.31         NA      17.39        090
                                                       lymph nodes.
38570...............  ..............  A               Laparoscopy, lymph          9.24         NA       3.97       1.12         NA      14.33        010
                                                       node biop.
38571...............  ..............  A               Laparoscopy,               14.66         NA       5.64       1.20         NA      21.50        010
                                                       lymphadenectomy.
38572...............  ..............  A               Laparoscopy,               16.57         NA       7.07       1.89         NA      25.53        010
                                                       lymphadenectomy.
38700...............  ..............  A               Removal of lymph            8.23         NA       6.22       0.76         NA      15.21        090
                                                       nodes, neck.
38720...............  ..............  A               Removal of lymph           13.59         NA       9.35       1.24         NA      24.18        090
                                                       nodes, neck.
38724...............  ..............  A               Removal of lymph           14.52         NA       9.82       1.32         NA      25.66        090
                                                       nodes, neck.
38740...............  ..............  A               Remove armpit lymph        10.01         NA       4.98       1.30         NA      16.29        090
                                                       nodes.
38745...............  ..............  A               Remove armpit lymph        13.08         NA       6.14       1.68         NA      20.90        090
                                                       nodes.
38746...............  ..............  A               Remove thoracic lymph       4.88         NA       1.61       0.67         NA       7.16        ZZZ
                                                       nodes.
38747...............  ..............  A               Remove abdominal            4.88         NA       1.66       0.62         NA       7.16        ZZZ
                                                       lymph nodes.
38760...............  ..............  A               Remove groin lymph         12.93         NA       6.16       1.65         NA      20.74        090
                                                       nodes.
38765...............  ..............  A               Remove groin lymph         19.95         NA       8.85       2.44         NA      31.24        090
                                                       nodes.
38770...............  ..............  A               Remove pelvis lymph        13.21         NA       5.76       1.37         NA      20.34        090
                                                       nodes.
38780...............  ..............  A               Remove abdomen lymph       16.57         NA       8.22       1.88         NA      26.67        090
                                                       nodes.
38790...............  ..............  A               Inject for lymphatic        1.29       7.42       0.76       0.13       8.84       2.18        000
                                                       x-ray.
38792...............  ..............  A               Identify sentinel           0.52         NA       0.44       0.06         NA       1.02        000
                                                       node.
38794...............  ..............  A               Access thoracic lymph       4.44         NA       3.43       0.21         NA       8.08        090
                                                       duct.
39000...............  ..............  A               Exploration of chest.       6.09         NA       4.68       0.83         NA      11.60        090
39010...............  ..............  A               Exploration of chest.      11.77         NA       6.64       1.59         NA      20.00        090
39200...............  ..............  A               Removal chest lesion.      13.60         NA       6.78       1.82         NA      22.20        090
39220...............  ..............  A               Removal chest lesion.      17.39         NA       8.50       2.23         NA      28.12        090
39400...............  ..............  A               Visualization of            5.60         NA       4.85       0.79         NA      11.24        010
                                                       chest.
39501...............  ..............  A               Repair diaphragm           13.17         NA       6.48       1.68         NA      21.33        090
                                                       laceration.
39502...............  ..............  A               Repair paraesophageal      16.31         NA       7.16       2.10         NA      25.57        090
                                                       hernia.
39503...............  ..............  A               Repair of diaphragm        94.86         NA      33.37      11.59         NA     139.82        090
                                                       hernia.
39520...............  ..............  A               Repair of diaphragm        16.08         NA       8.06       2.10         NA      26.24        090
                                                       hernia.
39530...............  ..............  A               Repair of diaphragm        15.39         NA       7.15       1.97         NA      24.51        090
                                                       hernia.
39531...............  ..............  A               Repair of diaphragm        16.40         NA       7.40       2.10         NA      25.90        090
                                                       hernia.
39540...............  ..............  A               Repair of diaphragm        13.30         NA       6.25       1.67         NA      21.22        090
                                                       hernia.
39541...............  ..............  A               Repair of diaphragm        14.39         NA       6.60       1.86         NA      22.85        090
                                                       hernia.
39545...............  ..............  A               Revision of diaphragm      13.35         NA       7.57       1.81         NA      22.73        090
39560...............  ..............  A               Resect diaphragm,          11.98         NA       6.31       1.55         NA      19.84        090
                                                       simple.
39561...............  ..............  A               Resect diaphragm,          17.47         NA       9.35       2.27         NA      29.09        090
                                                       complex.
40490...............  ..............  A               Biopsy of lip........       1.22       1.63       0.61       0.11       2.96       1.94        000
40500...............  ..............  A               Partial excision of         4.27       6.90       4.33       0.45      11.62       9.05        090
                                                       lip.
40510...............  ..............  A               Partial excision of         4.69       6.61       4.01       0.51      11.81       9.21        090
                                                       lip.
40520...............  ..............  A               Partial excision of         4.66       7.53       4.10       0.55      12.74       9.31        090
                                                       lip.
40525...............  ..............  A               Reconstruct lip with        7.54         NA       6.29       0.88         NA      14.71        090
                                                       flap.
40527...............  ..............  A               Reconstruct lip with        9.12         NA       7.33       1.01         NA      17.46        090
                                                       flap.
40530...............  ..............  A               Partial removal of          5.39       7.81       4.57       0.60      13.80      10.56        090
                                                       lip.
40650...............  ..............  A               Repair lip...........       3.63       6.79       3.32       0.39      10.81       7.34        090
40652...............  ..............  A               Repair lip...........       4.25       7.74       4.27       0.53      12.52       9.05        090
40654...............  ..............  A               Repair lip...........       5.30       8.59       4.93       0.67      14.56      10.90        090
40700...............  ..............  A               Repair cleft lip/          12.77         NA       9.06       1.08         NA      22.91        090
                                                       nasal.
40701...............  ..............  A               Repair cleft lip/          15.83         NA      11.30       2.36         NA      29.49        090
                                                       nasal.
40702...............  ..............  A               Repair cleft lip/          13.02         NA       8.27       0.92         NA      22.21        090
                                                       nasal.
40720...............  ..............  A               Repair cleft lip/          13.53         NA       9.86       1.74         NA      25.13        090
                                                       nasal.
40761...............  ..............  A               Repair cleft lip/          14.70         NA      10.24       1.70         NA      26.64        090
                                                       nasal.
40800...............  ..............  A               Drainage of mouth           1.17       2.97       1.77       0.12       4.26       3.06        010
                                                       lesion.
40801...............  ..............  A               Drainage of mouth           2.53       4.01       2.74       0.32       6.86       5.59        010
                                                       lesion.
40804...............  ..............  A               Removal, foreign            1.24       3.41       1.87       0.12       4.77       3.23        010
                                                       body, mouth.
40805...............  ..............  A               Removal, foreign            2.69       4.48       2.81       0.29       7.46       5.79        010
                                                       body, mouth.

[[Page 47619]]

 
40806...............  ..............  A               Incision of lip fold.       0.31       1.83       0.50       0.03       2.17       0.84        000
40808...............  ..............  A               Biopsy of mouth             0.96       2.65       1.48       0.10       3.71       2.54        010
                                                       lesion.
40810...............  ..............  A               Excision of mouth           1.31       2.88       1.66       0.13       4.32       3.10        010
                                                       lesion.
40812...............  ..............  A               Excise/repair mouth         2.31       3.71       2.40       0.28       6.30       4.99        010
                                                       lesion.
40814...............  ..............  A               Excise/repair mouth         3.41       4.94       3.89       0.40       8.75       7.70        090
                                                       lesion.
40816...............  ..............  A               Excision of mouth           3.66       5.17       3.99       0.39       9.22       8.04        090
                                                       lesion.
40818...............  ..............  A               Excise oral mucosa          2.41       5.17       3.97       0.21       7.79       6.59        090
                                                       for graft.
40819...............  ..............  A               Excise lip or cheek         2.41       4.08       3.09       0.27       6.76       5.77        090
                                                       fold.
40820...............  ..............  A               Treatment of mouth          1.28       3.93       2.44       0.12       5.33       3.84        010
                                                       lesion.
40830...............  ..............  A               Repair mouth                1.76       3.73       2.11       0.17       5.66       4.04        010
                                                       laceration.
40831...............  ..............  A               Repair mouth                2.46       4.65       3.05       0.28       7.39       5.79        010
                                                       laceration.
40840...............  ..............  R               Reconstruction of           8.72       9.77       6.96       0.98      19.47      16.66        090
                                                       mouth.
40842...............  ..............  R               Reconstruction of           8.72      10.04       6.78       0.94      19.70      16.44        090
                                                       mouth.
40843...............  ..............  R               Reconstruction of          12.08      11.93       7.80       1.39      25.40      21.27        090
                                                       mouth.
40844...............  ..............  R               Reconstruction of          15.99      15.74      11.55       2.12      33.85      29.66        090
                                                       mouth.
40845...............  ..............  R               Reconstruction of          18.55      17.03      13.19       2.02      37.60      33.76        090
                                                       mouth.
41000...............  ..............  A               Drainage of mouth           1.30       2.32       1.41       0.12       3.74       2.83        010
                                                       lesion.
41005...............  ..............  A               Drainage of mouth           1.26       3.33       1.73       0.15       4.74       3.14        010
                                                       lesion.
41006...............  ..............  A               Drainage of mouth           3.24       4.79       3.16       0.34       8.37       6.74        090
                                                       lesion.
41007...............  ..............  A               Drainage of mouth           3.10       5.11       3.02       0.34       8.55       6.46        090
                                                       lesion.
41008...............  ..............  A               Drainage of mouth           3.36       4.67       3.20       0.44       8.47       7.00        090
                                                       lesion.
41009...............  ..............  A               Drainage of mouth           3.58       4.96       3.56       0.45       8.99       7.59        090
                                                       lesion.
41010...............  ..............  A               Incision of tongue          1.06       3.44       1.60       0.09       4.59       2.75        010
                                                       fold.
41015...............  ..............  A               Drainage of mouth           3.95       5.39       4.14       0.49       9.83       8.58        090
                                                       lesion.
41016...............  ..............  A               Drainage of mouth           4.06       5.60       4.22       0.51      10.17       8.79        090
                                                       lesion.
41017...............  ..............  A               Drainage of mouth           4.06       5.62       4.30       0.53      10.21       8.89        090
                                                       lesion.
41018...............  ..............  A               Drainage of mouth           5.09       6.13       4.58       0.65      11.87      10.32        090
                                                       lesion.
41100...............  ..............  A               Biopsy of tongue.....       1.63       2.42       1.42       0.15       4.20       3.20        010
41105...............  ..............  A               Biopsy of tongue.....       1.42       2.30       1.32       0.13       3.85       2.87        010
41108...............  ..............  A               Biopsy of floor of          1.05       2.07       1.13       0.10       3.22       2.28        010
                                                       mouth.
41110...............  ..............  A               Excision of tongue          1.51       2.99       1.64       0.13       4.63       3.28        010
                                                       lesion.
41112...............  ..............  A               Excision of tongue          2.73       4.46       3.22       0.28       7.47       6.23        090
                                                       lesion.
41113...............  ..............  A               Excision of tongue          3.19       4.73       3.46       0.35       8.27       7.00        090
                                                       lesion.
41114...............  ..............  A               Excision of tongue          8.46         NA       7.18       0.84         NA      16.48        090
                                                       lesion.
41115...............  ..............  A               Excision of tongue          1.74       3.28       1.85       0.19       5.21       3.78        010
                                                       fold.
41116...............  ..............  A               Excision of mouth           2.44       4.35       2.80       0.23       7.02       5.47        090
                                                       lesion.
41120...............  ..............  A               Partial removal of          9.76         NA      15.31       0.84         NA      25.91        090
                                                       tongue.
41130...............  ..............  A               Partial removal of         11.13         NA      16.19       0.96         NA      28.28        090
                                                       tongue.
41135...............  ..............  A               Tongue and neck            23.06         NA      23.23       2.01         NA      48.30        090
                                                       surgery.
41140...............  ..............  A               Removal of tongue....      25.46         NA      26.66       2.50         NA      54.62        090
41145...............  ..............  A               Tongue removal, neck       30.01         NA      30.53       2.59         NA      63.13        090
                                                       surgery.
41150...............  ..............  A               Tongue, mouth, jaw         23.01         NA      24.70       2.05         NA      49.76        090
                                                       surgery.
41153...............  ..............  A               Tongue, mouth, neck        23.73         NA      25.01       2.10         NA      50.84        090
                                                       surgery.
41155...............  ..............  A               Tongue, jaw, & neck        27.68         NA      26.79       2.44         NA      56.91        090
                                                       surgery.
41250...............  ..............  A               Repair tongue               1.91       2.76       1.19       0.18       4.85       3.28        010
                                                       laceration.
41251...............  ..............  A               Repair tongue               2.27       3.27       1.56       0.22       5.76       4.05        010
                                                       laceration.
41252...............  ..............  A               Repair tongue               2.97       3.89       2.26       0.31       7.17       5.54        010
                                                       laceration.
41500...............  ..............  A               Fixation of tongue...       3.70         NA       7.45       0.32         NA      11.47        090
41510...............  ..............  A               Tongue to lip surgery       3.41         NA       7.99       0.38         NA      11.78        090
41520...............  ..............  A               Reconstruction,             2.73       4.62       3.61       0.27       7.62       6.61        090
                                                       tongue fold.
41800...............  ..............  A               Drainage of gum             1.17       2.59       1.29       0.12       3.88       2.58        010
                                                       lesion.
41805...............  ..............  A               Removal foreign body,       1.24       2.67       2.22       0.15       4.06       3.61        010
                                                       gum.
41806...............  ..............  A               Removal foreign             2.69       3.58       3.03       0.35       6.62       6.07        010
                                                       body,jawbone.
41822...............  ..............  R               Excision of gum             2.31       3.88       1.86       0.34       6.53       4.51        010
                                                       lesion.
41823...............  ..............  R               Excision of gum             3.30       5.56       4.00       0.44       9.30       7.74        090
                                                       lesion.
41825...............  ..............  A               Excision of gum             1.31       3.06       2.24       0.15       4.52       3.70        010
                                                       lesion.
41826...............  ..............  A               Excision of gum             2.31       2.43       2.10       0.30       5.04       4.71        010
                                                       lesion.
41827...............  ..............  A               Excision of gum             3.41       5.51       3.66       0.37       9.29       7.44        090
                                                       lesion.
41828...............  ..............  R               Excision of gum             3.09       3.80       2.96       0.44       7.33       6.49        010
                                                       lesion.
41830...............  ..............  R               Removal of gum tissue       3.34       4.95       3.62       0.45       8.74       7.41        010
41872...............  ..............  R               Repair gum...........       2.59       5.01       3.45       0.22       7.82       6.26        090
41874...............  ..............  R               Repair tooth socket..       3.09       4.83       3.17       0.45       8.37       6.71        090
42000...............  ..............  A               Drainage mouth roof         1.23       2.57       1.26       0.11       3.91       2.60        010
                                                       lesion.
42100...............  ..............  A               Biopsy roof of mouth.       1.31       2.08       1.36       0.13       3.52       2.80        010
42104...............  ..............  A               Excision lesion,            1.64       2.53       1.55       0.16       4.33       3.35        010
                                                       mouth roof.
42106...............  ..............  A               Excision lesion,            2.10       3.22       2.44       0.25       5.57       4.79        010
                                                       mouth roof.
42107...............  ..............  A               Excision lesion,            4.43       5.70       3.94       0.46      10.59       8.83        090
                                                       mouth roof.
42120...............  ..............  A               Remove palate/lesion.       6.16         NA      11.77       0.53         NA      18.46        090
42140...............  ..............  A               Excision of uvula....       1.62       3.72       2.09       0.13       5.47       3.84        090
42145...............  ..............  A               Repair palate,              8.04         NA       7.49       0.66         NA      16.19        090
                                                       pharynx/uvula.
42160...............  ..............  A               Treatment mouth roof        1.80       4.25       2.29       0.16       6.21       4.25        010
                                                       lesion.
42180...............  ..............  A               Repair palate........       2.50       3.07       2.10       0.21       5.78       4.81        010
42182...............  ..............  A               Repair palate........       3.82       3.87       3.02       0.40       8.09       7.24        010
42200...............  ..............  A               Reconstruct cleft          11.98         NA      10.20       1.22         NA      23.40        090
                                                       palate.
42205...............  ..............  A               Reconstruct cleft          13.27         NA      10.06       1.44         NA      24.77        090
                                                       palate.

[[Page 47620]]

 
42210...............  ..............  A               Reconstruct cleft          14.48         NA      11.44       2.00         NA      27.92        090
                                                       palate.
42215...............  ..............  A               Reconstruct cleft           8.81         NA       9.05       1.31         NA      19.17        090
                                                       palate.
42220...............  ..............  A               Reconstruct cleft           7.01         NA       6.77       0.49         NA      14.27        090
                                                       palate.
42225...............  ..............  A               Reconstruct cleft           9.53         NA      16.94       0.97         NA      27.44        090
                                                       palate.
42226...............  ..............  A               Lengthening of palate       9.99         NA      14.63       0.89         NA      25.51        090
42227...............  ..............  A               Lengthening of palate       9.51         NA      15.40       1.02         NA      25.93        090
42235...............  ..............  A               Repair palate........       7.86         NA      11.86       0.82         NA      20.54        090
42260...............  ..............  A               Repair nose to lip          9.79      10.17       7.06       0.98      20.94      17.83        090
                                                       fistula.
42280...............  ..............  A               Preparation, palate         1.54       1.95       1.14       0.21       3.70       2.89        010
                                                       mold.
42281...............  ..............  A               Insertion, palate           1.93       2.62       1.87       0.16       4.71       3.96        010
                                                       prosthesis.
42300...............  ..............  A               Drainage of salivary        1.93       2.82       1.81       0.17       4.92       3.91        010
                                                       gland.
42305...............  ..............  A               Drainage of salivary        6.06         NA       4.72       0.53         NA      11.31        090
                                                       gland.
42310...............  ..............  A               Drainage of salivary        1.56       2.26       1.54       0.15       3.97       3.25        010
                                                       gland.
42320...............  ..............  A               Drainage of salivary        2.35       3.26       2.09       0.23       5.84       4.67        010
                                                       gland.
42325...............  ..............  A               Create salivary cyst        2.75       4.61       2.31       0.22       7.58       5.28        090
                                                       drain.
42326...............  ..............  A               Create salivary cyst        3.77       5.89       3.16       0.23       9.89       7.16        090
                                                       drain.
42330...............  ..............  A               Removal of salivary         2.21       3.14       1.84       0.19       5.54       4.24        010
                                                       stone.
42335...............  ..............  A               Removal of salivary         3.31       4.90       3.14       0.30       8.51       6.75        090
                                                       stone.
42340...............  ..............  A               Removal of salivary         4.59       6.04       3.93       0.41      11.04       8.93        090
                                                       stone.
42400...............  ..............  A               Biopsy of salivary          0.78       1.65       0.72       0.06       2.49       1.56        000
                                                       gland.
42405...............  ..............  A               Biopsy of salivary          3.29       4.02       2.45       0.29       7.60       6.03        010
                                                       gland.
42408...............  ..............  A               Excision of salivary        4.53       5.90       3.61       0.42      10.85       8.56        090
                                                       cyst.
42409...............  ..............  A               Drainage of salivary        2.81       4.52       2.76       0.23       7.56       5.80        090
                                                       cyst.
42410...............  ..............  A               Excise parotid gland/       9.33         NA       6.21       0.93         NA      16.47        090
                                                       lesion.
42415...............  ..............  A               Excise parotid gland/      16.86         NA      10.84       1.49         NA      29.19        090
                                                       lesion.
42420...............  ..............  A               Excise parotid gland/      19.56         NA      12.35       1.72         NA      33.63        090
                                                       lesion.
42425...............  ..............  A               Excise parotid gland/      13.00         NA       8.60       1.14         NA      22.74        090
                                                       lesion.
42426...............  ..............  A               Excise parotid gland/      21.23         NA      12.99       1.86         NA      36.08        090
                                                       lesion.
42440...............  ..............  A               Excise submaxillary         6.96         NA       4.79       0.61         NA      12.36        090
                                                       gland.
42450...............  ..............  A               Excise sublingual           4.61       5.89       4.24       0.42      10.92       9.27        090
                                                       gland.
42500...............  ..............  A               Repair salivary duct.       4.29       5.67       4.18       0.41      10.37       8.88        090
42505...............  ..............  A               Repair salivary duct.       6.17       7.12       5.35       0.56      13.85      12.08        090
42507...............  ..............  A               Parotid duct                6.10         NA       6.53       0.49         NA      13.12        090
                                                       diversion.
42508...............  ..............  A               Parotid duct                9.09         NA       8.34       0.74         NA      18.17        090
                                                       diversion.
42509...............  ..............  A               Parotid duct               11.52         NA      10.17       1.50         NA      23.19        090
                                                       diversion.
42510...............  ..............  A               Parotid duct                8.14         NA       7.78       0.66         NA      16.58        090
                                                       diversion.
42550...............  ..............  A               Injection for               1.25       3.25       0.41       0.08       4.58       1.74        000
                                                       salivary x-ray.
42600...............  ..............  A               Closure of salivary         4.81       6.57       4.12       0.40      11.78       9.33        090
                                                       fistula.
42650...............  ..............  A               Dilation of salivary        0.77       1.10       0.71       0.07       1.94       1.55        000
                                                       duct.
42660...............  ..............  A               Dilation of salivary        1.13       1.35       0.85       0.09       2.57       2.07        000
                                                       duct.
42665...............  ..............  A               Ligation of salivary        2.53       4.16       2.59       0.21       6.90       5.33        090
                                                       duct.
42700...............  ..............  A               Drainage of tonsil          1.62       2.65       1.71       0.13       4.40       3.46        010
                                                       abscess.
42720...............  ..............  A               Drainage of throat          5.41       4.82       3.78       0.48      10.71       9.67        010
                                                       abscess.
42725...............  ..............  A               Drainage of throat         10.70         NA       8.21       0.96         NA      19.87        090
                                                       abscess.
42800...............  ..............  A               Biopsy of throat.....       1.39       2.18       1.40       0.12       3.69       2.91        010
42802...............  ..............  A               Biopsy of throat.....       1.54       4.77       2.06       0.13       6.44       3.73        010
42804...............  ..............  A               Biopsy of upper nose/       1.24       3.74       1.73       0.10       5.08       3.07        010
                                                       throat.
42806...............  ..............  A               Biopsy of upper nose/       1.58       4.08       1.93       0.13       5.79       3.64        010
                                                       throat.
42808...............  ..............  A               Excise pharynx lesion       2.30       3.09       1.93       0.19       5.58       4.42        010
42809...............  ..............  A               Remove pharynx              1.81       2.33       1.35       0.16       4.30       3.32        010
                                                       foreign body.
42810...............  ..............  A               Excision of neck cyst       3.25       5.71       3.54       0.31       9.27       7.10        090
42815...............  ..............  A               Excision of neck cyst       7.06         NA       6.40       0.63         NA      14.09        090
42820...............  ..............  A               Remove tonsils and          3.90         NA       3.29       0.33         NA       7.52        090
                                                       adenoids.
42821...............  ..............  A               Remove tonsils and          4.28         NA       3.50       0.35         NA       8.13        090
                                                       adenoids.
42825...............  ..............  A               Removal of tonsils...       3.41         NA       3.17       0.28         NA       6.86        090
42826...............  ..............  A               Removal of tonsils...       3.37         NA       3.03       0.28         NA       6.68        090
42830...............  ..............  A               Removal of adenoids..       2.57         NA       2.56       0.21         NA       5.34        090
42831...............  ..............  A               Removal of adenoids..       2.71         NA       2.84       0.22         NA       5.77        090
42835...............  ..............  A               Removal of adenoids..       2.30         NA       2.46       0.21         NA       4.97        090
42836...............  ..............  A               Removal of adenoids..       3.18         NA       2.95       0.26         NA       6.39        090
42842...............  ..............  A               Extensive surgery of        8.75         NA      10.99       0.72         NA      20.46        090
                                                       throat.
42844...............  ..............  A               Extensive surgery of       14.29         NA      16.23       1.24         NA      31.76        090
                                                       throat.
42845...............  ..............  A               Extensive surgery of       24.25         NA      23.17       2.07         NA      49.49        090
                                                       throat.
42860...............  ..............  A               Excision of tonsil          2.22         NA       2.40       0.19         NA       4.81        090
                                                       tags.
42870...............  ..............  A               Excision of lingual         5.39         NA       8.57       0.45         NA      14.41        090
                                                       tonsil.
42890...............  ..............  A               Partial removal of         12.92         NA      14.15       1.10         NA      28.17        090
                                                       pharynx.
42892...............  ..............  A               Revision of                15.81         NA      17.17       1.33         NA      34.31        090
                                                       pharyngeal walls.
42894...............  ..............  A               Revision of                22.85         NA      22.01       1.91         NA      46.77        090
                                                       pharyngeal walls.
42900...............  ..............  A               Repair throat wound..       5.24         NA       3.66       0.55         NA       9.45        010
42950...............  ..............  A               Reconstruction of           8.09         NA      11.85       0.72         NA      20.66        090
                                                       throat.
42953...............  ..............  A               Repair throat,              8.95         NA      17.22       0.88         NA      27.05        090
                                                       esophagus.
42955...............  ..............  A               Surgical opening of         7.38         NA      10.69       0.70         NA      18.77        090
                                                       throat.
42960...............  ..............  A               Control throat              2.33         NA       1.95       0.18         NA       4.46        010
                                                       bleeding.
42961...............  ..............  A               Control throat              5.58         NA       4.96       0.46         NA      11.00        090
                                                       bleeding.
42962...............  ..............  A               Control throat              7.13         NA       5.91       0.62         NA      13.66        090
                                                       bleeding.

[[Page 47621]]

 
42970...............  ..............  A               Control nose/throat         5.42         NA       4.22       0.40         NA      10.04        090
                                                       bleeding.
42971...............  ..............  A               Control nose/throat         6.20         NA       5.12       0.54         NA      11.86        090
                                                       bleeding.
42972...............  ..............  A               Control nose/throat         7.19         NA       5.69       0.59         NA      13.47        090
                                                       bleeding.
43020...............  ..............  A               Incision of esophagus       8.08         NA       5.41       0.92         NA      14.41        090
43030...............  ..............  A               Throat muscle surgery       7.68         NA       5.48       0.70         NA      13.86        090
43045...............  ..............  A               Incision of esophagus      20.09         NA      10.71       2.22         NA      33.02        090
43100...............  ..............  A               Excision of esophagus       9.18         NA       6.23       0.98         NA      16.39        090
                                                       lesion.
43101...............  ..............  A               Excision of esophagus      16.22         NA       7.89       2.09         NA      26.20        090
                                                       lesion.
43107...............  ..............  A               Removal of esophagus.      39.94         NA      17.05       5.03         NA      62.02        090
43108...............  ..............  A               Removal of esophagus.      34.14         NA      14.21       4.27         NA      52.62        090
43112...............  ..............  A               Removal of esophagus.      43.43         NA      18.14       5.61         NA      67.18        090
43113...............  ..............  A               Removal of esophagus.      35.22         NA      15.11       4.43         NA      54.76        090
43116...............  ..............  A               Partial removal of         31.17         NA      16.69       3.02         NA      50.88        090
                                                       esophagus.
43117...............  ..............  A               Partial removal of         39.94         NA      16.29       4.98         NA      61.21        090
                                                       esophagus.
43118...............  ..............  A               Partial removal of         33.15         NA      13.79       4.27         NA      51.21        090
                                                       esophagus.
43121...............  ..............  A               Partial removal of         29.15         NA      12.68       4.06         NA      45.89        090
                                                       esophagus.
43122...............  ..............  A               Partial removal of         39.94         NA      16.40       5.11         NA      61.45        090
                                                       esophagus.
43123...............  ..............  A               Partial removal of         33.15         NA      14.10       4.49         NA      51.74        090
                                                       esophagus.
43124...............  ..............  A               Removal of esophagus.      27.28         NA      13.09       3.28         NA      43.65        090
43130...............  ..............  A               Removal of esophagus       11.73         NA       7.57       1.22         NA      20.52        090
                                                       pouch.
43135...............  ..............  A               Removal of esophagus       16.08         NA       8.11       2.16         NA      26.35        090
                                                       pouch.
43200...............  ..............  A               Esophagus endoscopy..       1.59       4.15       1.07       0.13       5.87       2.79        000
43201...............  ..............  A               Esoph scope w/              2.09       4.61       1.10       0.13       6.83       3.32        000
                                                       submucous inj.
43202...............  ..............  A               Esophagus endoscopy,        1.89       5.59       0.94       0.16       7.64       2.99        000
                                                       biopsy.
43204...............  ..............  A               Esoph scope w/              3.76         NA       1.52       0.30         NA       5.58        000
                                                       sclerosis inj.
43205...............  ..............  A               Esophagus endoscopy/        3.78         NA       1.52       0.29         NA       5.59        000
                                                       ligation.
43215...............  ..............  A               Esophagus endoscopy..       2.60         NA       1.20       0.23         NA       4.03        000
43216...............  ..............  A               Esophagus endoscopy/        2.40         NA       1.19       0.20         NA       3.79        000
                                                       lesion.
43217...............  ..............  A               Esophagus endoscopy..       2.90       7.02       1.19       0.25      10.17       4.34        000
43219...............  ..............  A               Esophagus endoscopy..       2.80         NA       1.35       0.23         NA       4.38        000
43220...............  ..............  A               Esoph endoscopy,            2.10         NA       0.97       0.17         NA       3.24        000
                                                       dilation.
43226...............  ..............  A               Esoph endoscopy,            2.34         NA       1.03       0.19         NA       3.56        000
                                                       dilation.
43227...............  ..............  A               Esoph endoscopy,            3.59         NA       1.45       0.28         NA       5.32        000
                                                       repair.
43228...............  ..............  A               Esoph endoscopy,            3.76         NA       1.55       0.35         NA       5.66        000
                                                       ablation.
43231...............  ..............  A               Esoph endoscopy w/us        3.19         NA       1.31       0.23         NA       4.73        000
                                                       exam.
43232...............  ..............  A               Esoph endoscopy w/us        4.47         NA       1.81       0.31         NA       6.59        000
                                                       fn bx.
43234...............  ..............  A               Upper GI endoscopy,         2.01       5.37       0.87       0.17       7.55       3.05        000
                                                       exam.
43235...............  ..............  A               Uppr gi endoscopy,          2.39       5.22       1.02       0.19       7.80       3.60        000
                                                       diagnosis.
43236...............  ..............  A               Uppr gi scope w/            2.92       6.45       1.22       0.19       9.56       4.33        000
                                                       submuc inj.
43237...............  ..............  A               Endoscopic us exam,         3.98         NA       1.59       0.43         NA       6.00        000
                                                       esoph.
43238...............  ..............  A               Uppr gi endoscopy w/        5.02         NA       1.96       0.43         NA       7.41        000
                                                       us fn bx.
43239...............  ..............  A               Upper GI endoscopy,         2.87       5.77       1.19       0.23       8.87       4.29        000
                                                       biopsy.
43240...............  ..............  A               Esoph endoscope w/          6.85         NA       2.60       0.54         NA       9.99        000
                                                       drain cyst.
43241...............  ..............  A               Upper GI endoscopy          2.59         NA       1.10       0.21         NA       3.90        000
                                                       with tube.
43242...............  ..............  A               Uppr gi endoscopy w/        7.30         NA       2.73       0.53         NA      10.56        000
                                                       us fn bx.
43243...............  ..............  A               Upper gi endoscopy &        4.56         NA       1.79       0.34         NA       6.69        000
                                                       inject.
43244...............  ..............  A               Upper GI endoscopy/         5.04         NA       1.96       0.37         NA       7.37        000
                                                       ligation.
43245...............  ..............  A               Uppr gi scope dilate        3.18         NA       1.30       0.28         NA       4.76        000
                                                       strictr.
43246...............  ..............  A               Place gastrostomy           4.32         NA       1.69       0.34         NA       6.35        000
                                                       tube.
43247...............  ..............  A               Operative upper GI          3.38         NA       1.37       0.27         NA       5.02        000
                                                       endoscopy.
43248...............  ..............  A               Uppr gi endoscopy/          3.15         NA       1.31       0.24         NA       4.70        000
                                                       guide wire.
43249...............  ..............  A               Esoph endoscopy,            2.90         NA       1.21       0.22         NA       4.33        000
                                                       dilation.
43250...............  ..............  A               Upper GI endoscopy/         3.20         NA       1.31       0.26         NA       4.77        000
                                                       tumor.
43251...............  ..............  A               Operative upper GI          3.69         NA       1.48       0.29         NA       5.46        000
                                                       endoscopy.
43255...............  ..............  A               Operative upper GI          4.81         NA       1.88       0.36         NA       7.05        000
                                                       endoscopy.
43256...............  ..............  A               Uppr gi endoscopy w         4.34         NA       1.71       0.37         NA       6.42        000
                                                       stent.
43258...............  ..............  A               Operative upper GI          4.54         NA       1.78       0.35         NA       6.67        000
                                                       endoscopy.
43259...............  ..............  A               Endoscopic ultrasound       5.19         NA       1.99       0.36         NA       7.54        000
                                                       exam.
43260...............  ..............  A               Endo                        5.95         NA       2.28       0.44         NA       8.67        000
                                                       cholangiopancreatogr
                                                       aph.
43261...............  ..............  A               Endo                        6.26         NA       2.39       0.46         NA       9.11        000
                                                       cholangiopancreatogr
                                                       aph.
43262...............  ..............  A               Endo                        7.38         NA       2.78       0.55         NA      10.71        000
                                                       cholangiopancreatogr
                                                       aph.
43263...............  ..............  A               Endo                        7.28         NA       2.76       0.55         NA      10.59        000
                                                       cholangiopancreatogr
                                                       aph.
43264...............  ..............  A               Endo                        8.89         NA       3.31       0.66         NA      12.86        000
                                                       cholangiopancreatogr
                                                       aph.
43265...............  ..............  A               Endo                       10.00         NA       3.69       0.74         NA      14.43        000
                                                       cholangiopancreatogr
                                                       aph.
43267...............  ..............  A               Endo                        7.38         NA       2.78       0.56         NA      10.72        000
                                                       cholangiopancreatogr
                                                       aph.
43268...............  ..............  A               Endo                        7.38         NA       2.88       0.55         NA      10.81        000
                                                       cholangiopancreatogr
                                                       aph.
43269...............  ..............  A               Endo                        8.20         NA       3.07       0.61         NA      11.88        000
                                                       cholangiopancreatogr
                                                       aph.
43271...............  ..............  A               Endo                        7.38         NA       2.77       0.54         NA      10.69        000
                                                       cholangiopancreatogr
                                                       aph.
43272...............  ..............  A               Endo                        7.38         NA       2.78       0.55         NA      10.71        000
                                                       cholangiopancreatogr
                                                       aph.
43280...............  ..............  A               Laparoscopy,               17.22         NA       7.28       2.20         NA      26.70        090
                                                       fundoplasty.
43300...............  ..............  A               Repair of esophagus..       9.13         NA       6.45       1.01         NA      16.59        090
43305...............  ..............  A               Repair esophagus and       17.36         NA      10.72       1.53         NA      29.61        090
                                                       fistula.
43310...............  ..............  A               Repair of esophagus..      25.35         NA      11.08       3.44         NA      39.87        090
43312...............  ..............  A               Repair esophagus and       28.38         NA      11.93       3.43         NA      43.74        090
                                                       fistula.
43313...............  ..............  A               Esophagoplasty             45.21         NA      18.82       6.55         NA      70.58        090
                                                       congenital.

[[Page 47622]]

 
43314...............  ..............  A               Tracheo-                   50.19         NA      19.15       6.67         NA      76.01        090
                                                       esophagoplasty cong.
43320...............  ..............  A               Fuse esophagus &           19.90         NA       9.21       2.41         NA      31.52        090
                                                       stomach.
43324...............  ..............  A               Revise esophagus &         20.54         NA       8.77       2.59         NA      31.90        090
                                                       stomach.
43325...............  ..............  A               Revise esophagus &         20.03         NA       8.79       2.54         NA      31.36        090
                                                       stomach.
43326...............  ..............  A               Revise esophagus &         19.71         NA       9.29       2.63         NA      31.63        090
                                                       stomach.
43330...............  ..............  A               Repair of esophagus..      19.74         NA       8.54       2.51         NA      30.79        090
43331...............  ..............  A               Repair of esophagus..      20.10         NA       9.79       2.65         NA      32.54        090
43340...............  ..............  A               Fuse esophagus &           19.58         NA       8.97       2.49         NA      31.04        090
                                                       intestine.
43341...............  ..............  A               Fuse esophagus &           20.82         NA      10.03       2.89         NA      33.74        090
                                                       intestine.
43350...............  ..............  A               Surgical opening,          15.76         NA       8.46       1.78         NA      26.00        090
                                                       esophagus.
43351...............  ..............  A               Surgical opening,          18.32         NA       9.79       2.46         NA      30.57        090
                                                       esophagus.
43352...............  ..............  A               Surgical opening,          15.24         NA       8.39       1.85         NA      25.48        090
                                                       esophagus.
43360...............  ..............  A               Gastrointestinal           35.65         NA      15.07       4.26         NA      54.98        090
                                                       repair.
43361...............  ..............  A               Gastrointestinal           40.44         NA      16.88       4.52         NA      61.84        090
                                                       repair.
43400...............  ..............  A               Ligate esophagus           21.17         NA       9.45       2.04         NA      32.66        090
                                                       veins.
43401...............  ..............  A               Esophagus surgery for      22.06         NA       9.49       2.61         NA      34.16        090
                                                       veins.
43405...............  ..............  A               Ligate/staple              19.98         NA       9.57       2.56         NA      32.11        090
                                                       esophagus.
43410...............  ..............  A               Repair esophagus           13.45         NA       7.64       1.63         NA      22.72        090
                                                       wound.
43415...............  ..............  A               Repair esophagus           24.96         NA      11.73       3.34         NA      40.03        090
                                                       wound.
43420...............  ..............  A               Repair esophagus           14.33         NA       7.45       1.38         NA      23.16        090
                                                       opening.
43425...............  ..............  A               Repair esophagus           21.00         NA       9.97       2.62         NA      33.59        090
                                                       opening.
43450...............  ..............  A               Dilate esophagus.....       1.38       2.67       0.69       0.11       4.16       2.18        000
43453...............  ..............  A               Dilate esophagus.....       1.51       6.11       0.73       0.11       7.73       2.35        000
43456...............  ..............  A               Dilate esophagus.....       2.57      13.83       1.10       0.20      16.60       3.87        000
43458...............  ..............  A               Dilate esophagus.....       3.06       6.69       1.28       0.25      10.00       4.59        000
43460...............  ..............  A               Pressure treatment          3.79         NA       1.48       0.31         NA       5.58        000
                                                       esophagus.
43500...............  ..............  A               Surgical opening of        11.03         NA       4.98       1.39         NA      17.40        090
                                                       stomach.
43501...............  ..............  A               Surgical repair of         20.01         NA       8.31       2.57         NA      30.89        090
                                                       stomach.
43502...............  ..............  A               Surgical repair of         23.10         NA       9.45       2.75         NA      35.30        090
                                                       stomach.
43510...............  ..............  A               Surgical opening of        13.06         NA       6.61       1.54         NA      21.21        090
                                                       stomach.
43520...............  ..............  A               Incision of pyloric         9.98         NA       5.27       1.30         NA      16.55        090
                                                       muscle.
43600...............  ..............  A               Biopsy of stomach....       1.91         NA       0.66       0.15         NA       2.72        000
43605...............  ..............  A               Biopsy of stomach....      11.96         NA       5.28       1.54         NA      18.78        090
43610...............  ..............  A               Excision of stomach        14.58         NA       6.16       1.88         NA      22.62        090
                                                       lesion.
43611...............  ..............  A               Excision of stomach        17.81         NA       7.56       2.30         NA      27.67        090
                                                       lesion.
43620...............  ..............  A               Removal of stomach...      29.99         NA      11.80       3.85         NA      45.64        090
43621...............  ..............  A               Removal of stomach...      30.68         NA      11.98       3.94         NA      46.60        090
43622...............  ..............  A               Removal of stomach...      32.48         NA      12.58       4.17         NA      49.23        090
43631...............  ..............  A               Removal of stomach,        22.56         NA       9.15       2.90         NA      34.61        090
                                                       partial.
43632...............  ..............  A               Removal of stomach,        22.56         NA       9.15       2.90         NA      34.61        090
                                                       partial.
43633...............  ..............  A               Removal of stomach,        23.07         NA       9.32       2.96         NA      35.35        090
                                                       partial.
43634...............  ..............  A               Removal of stomach,        25.08         NA      10.08       3.13         NA      38.29        090
                                                       partial.
43635...............  ..............  A               Removal of stomach,         2.06         NA       0.70       0.27         NA       3.03        ZZZ
                                                       partial.
43638...............  ..............  A               Removal of stomach,        28.96         NA      11.87       3.72         NA      44.55        090
                                                       partial.
43639...............  ..............  A               Removal of stomach,        29.61         NA      11.68       3.78         NA      45.07        090
                                                       partial.
43640...............  ..............  A               Vagotomy & pylorus         16.99         NA       7.26       2.19         NA      26.44        090
                                                       repair.
43641...............  ..............  A               Vagotomy & pylorus         17.24         NA       7.37       2.16         NA      26.77        090
                                                       repair.
43651...............  ..............  A               Laparoscopy, vagus         10.13         NA       4.76       1.32         NA      16.21        090
                                                       nerve.
43652...............  ..............  A               Laparoscopy, vagus         12.13         NA       5.75       1.51         NA      19.39        090
                                                       nerve.
43653...............  ..............  A               Laparoscopy,                7.72         NA       4.19       0.98         NA      12.89        090
                                                       gastrostomy.
43750...............  ..............  A               Place gastrostomy           4.48         NA       2.19       0.43         NA       7.10        010
                                                       tube.
43752...............  ..............  A               Nasal/orogastric w/         0.68       0.23       0.22       0.02       0.93       0.92        000
                                                       stent.
43760...............  ..............  A               Change gastrostomy          1.10       2.10       0.45       0.09       3.29       1.64        000
                                                       tube.
43761...............  ..............  A               Reposition                  2.01       1.19       0.66       0.14       3.34       2.81        000
                                                       gastrostomy tube.
43800...............  ..............  A               Reconstruction of          13.67         NA       5.91       1.76         NA      21.34        090
                                                       pylorus.
43810...............  ..............  A               Fusion of stomach and      14.63         NA       6.19       1.91         NA      22.73        090
                                                       bowel.
43820...............  ..............  A               Fusion of stomach and      15.35         NA       6.42       1.96         NA      23.73        090
                                                       bowel.
43825...............  ..............  A               Fusion of stomach and      19.19         NA       8.01       2.45         NA      29.65        090
                                                       bowel.
43830...............  ..............  A               Place gastrostomy           9.52         NA       4.85       1.18         NA      15.55        090
                                                       tube.
43831...............  ..............  A               Place gastrostomy           7.83         NA       4.52       1.00         NA      13.35        090
                                                       tube.
43832...............  ..............  A               Place gastrostomy          15.58         NA       6.86       1.94         NA      24.38        090
                                                       tube.
43840...............  ..............  A               Repair of stomach          15.54         NA       6.77       2.00         NA      24.31        090
                                                       lesion.
43842...............  ..............  A               Gastroplasty for           18.44         NA       7.95       2.40         NA      28.79        090
                                                       obesity.
43843...............  ..............  A               Gastroplasty for           18.62         NA       7.91       2.45         NA      28.98        090
                                                       obesity.
43846...............  ..............  A               Gastric bypass for         24.01         NA      10.17       3.09         NA      37.27        090
                                                       obesity.
43847...............  ..............  A               Gastric bypass for         26.88         NA      11.07       3.49         NA      41.44        090
                                                       obesity.
43848...............  ..............  A               Revision gastroplasty      29.35         NA      11.99       3.80         NA      45.14        090
43850...............  ..............  A               Revise stomach-bowel       24.68         NA       9.81       3.17         NA      37.66        090
                                                       fusion.
43855...............  ..............  A               Revise stomach-bowel       26.12         NA      10.32       3.43         NA      39.87        090
                                                       fusion.
43860...............  ..............  A               Revise stomach-bowel       24.96         NA       9.97       3.19         NA      38.12        090
                                                       fusion.
43865...............  ..............  A               Revise stomach-bowel       26.48         NA      10.50       3.46         NA      40.44        090
                                                       fusion.
43870...............  ..............  A               Repair stomach              9.68         NA       4.53       1.21         NA      15.42        090
                                                       opening.
43880...............  ..............  A               Repair stomach-bowel       24.61         NA       9.90       3.11         NA      37.62        090
                                                       fistula.
44005...............  ..............  A               Freeing of bowel           16.21         NA       6.73       2.06         NA      25.00        090
                                                       adhesion.
44010...............  ..............  A               Incision of small          12.50         NA       5.46       1.60         NA      19.56        090
                                                       bowel.

[[Page 47623]]

 
44015...............  ..............  A               Insert needle cath          2.62         NA       0.88       0.33         NA       3.83        ZZZ
                                                       bowel.
44020...............  ..............  A               Explore small              13.97         NA       5.94       1.77         NA      21.68        090
                                                       intestine.
44021...............  ..............  A               Decompress small           14.06         NA       5.98       1.78         NA      21.82        090
                                                       bowel.
44025...............  ..............  A               Incision of large          14.26         NA       6.03       1.81         NA      22.10        090
                                                       bowel.
44050...............  ..............  A               Reduce bowel               14.01         NA       5.96       1.79         NA      21.76        090
                                                       obstruction.
44055...............  ..............  A               Correct malrotation        21.97         NA       8.73       2.81         NA      33.51        090
                                                       of bowel.
44100...............  ..............  A               Biopsy of bowel......       2.01         NA       0.71       0.17         NA       2.89        000
44110...............  ..............  A               Excise intestine           11.79         NA       5.24       1.48         NA      18.51        090
                                                       lesion(s).
44111...............  ..............  A               Excision of bowel          14.27         NA       6.12       1.80         NA      22.19        090
                                                       lesion(s).
44120...............  ..............  A               Removal of small           16.97         NA       7.08       2.13         NA      26.18        090
                                                       intestine.
44121...............  ..............  A               Removal of small            4.44         NA       1.52       0.55         NA       6.51        ZZZ
                                                       intestine.
44125...............  ..............  A               Removal of small           17.51         NA       7.26       2.19         NA      26.96        090
                                                       intestine.
44126...............  ..............  A               Enterectomy w/o            35.45         NA      14.10       4.60         NA      54.15        090
                                                       taper, cong.
44127...............  ..............  A               Enterectomy w/taper,       40.94         NA      15.69       5.41         NA      62.04        090
                                                       cong.
44128...............  ..............  A               Enterectomy cong, add-      4.44         NA       1.53       0.59         NA       6.56        ZZZ
                                                       on.
44130...............  ..............  A               Bowel to bowel fusion      14.47         NA       6.22       1.80         NA      22.49        090
44139...............  ..............  A               Mobilization of colon       2.23         NA       0.76       0.28         NA       3.27        ZZZ
44140...............  ..............  A               Partial removal of         20.97         NA       8.64       2.62         NA      32.23        090
                                                       colon.
44141...............  ..............  A               Partial removal of         19.48         NA      10.04       2.42         NA      31.94        090
                                                       colon.
44143...............  ..............  A               Partial removal of         22.96         NA      10.69       2.91         NA      36.56        090
                                                       colon.
44144...............  ..............  A               Partial removal of         21.50         NA       9.62       2.71         NA      33.83        090
                                                       colon.
44145...............  ..............  A               Partial removal of         26.38         NA      10.80       3.22         NA      40.40        090
                                                       colon.
44146...............  ..............  A               Partial removal of         27.50         NA      12.85       3.35         NA      43.70        090
                                                       colon.
44147...............  ..............  A               Partial removal of         20.68         NA       8.68       2.48         NA      31.84        090
                                                       colon.
44150...............  ..............  A               Removal of colon.....      23.91         NA      12.03       2.98         NA      38.92        090
44151...............  ..............  A               Removal of colon/          26.84         NA      13.39       3.39         NA      43.62        090
                                                       ileostomy.
44152...............  ..............  A               Removal of colon/          27.79         NA      11.59       3.40         NA      42.78        090
                                                       ileostomy.
44153...............  ..............  A               Removal of colon/          30.54         NA      14.38       3.30         NA      48.22        090
                                                       ileostomy.
44155...............  ..............  A               Removal of colon/          27.82         NA      13.30       3.25         NA      44.37        090
                                                       ileostomy.
44156...............  ..............  A               Removal of colon/          30.74         NA      15.03       3.95         NA      49.72        090
                                                       ileostomy.
44160...............  ..............  A               Removal of colon.....      18.59         NA       7.74       2.31         NA      28.64        090
44200...............  ..............  A               Laparoscopy,               14.42         NA       6.19       1.75         NA      22.36        090
                                                       enterolysis.
44201...............  ..............  A               Laparoscopy,                9.77         NA       4.66       1.25         NA      15.68        090
                                                       jejunostomy.
44202...............  ..............  A               Lap resect s/              22.01         NA       8.92       2.71         NA      33.64        090
                                                       intestine singl.
44203...............  ..............  A               Lap resect s/               4.44         NA       1.49       0.56         NA       6.49        ZZZ
                                                       intestine, addl.
44204...............  ..............  A               Laparo partial             25.04         NA       9.94       3.05         NA      38.03        090
                                                       colectomy.
44205...............  ..............  A               Lap colectomy part w/      22.20         NA       8.83       2.69         NA      33.72        090
                                                       ileum.
44206...............  ..............  A               Lap part colectomy w/      26.96         NA      11.22       2.91         NA      41.09        090
                                                       stoma.
44207...............  ..............  A               L colectomy/               29.96         NA      11.46       3.22         NA      44.64        090
                                                       coloproctostomy.
44208...............  ..............  A               L colectomy/               31.95         NA      13.09       3.35         NA      48.39        090
                                                       coloproctostomy.
44210...............  ..............  A               Laparo total               27.96         NA      11.83       2.98         NA      42.77        090
                                                       proctocolectomy.
44211...............  ..............  A               Laparo total               34.95         NA      14.61       3.35         NA      52.91        090
                                                       proctocolectomy.
44212...............  ..............  A               Laparo total               32.45         NA      13.59       3.25         NA      49.29        090
                                                       proctocolectomy.
44300...............  ..............  A               Open bowel to skin...      12.09         NA       5.49       1.55         NA      19.13        090
44310...............  ..............  A               Ileostomy/jejunostomy      15.93         NA       6.69       1.94         NA      24.56        090
44312...............  ..............  A               Revision of ileostomy       8.01         NA       3.99       0.90         NA      12.90        090
44314...............  ..............  A               Revision of ileostomy      15.03         NA       6.55       1.73         NA      23.31        090
44316...............  ..............  A               Devise bowel pouch...      21.06         NA       8.54       2.41         NA      32.01        090
44320...............  ..............  A               Colostomy............      17.61         NA       7.65       2.21         NA      27.47        090
44322...............  ..............  A               Colostomy with             11.96         NA       8.59       1.51         NA      22.06        090
                                                       biopsies.
44340...............  ..............  A               Revision of colostomy       7.71         NA       4.27       0.97         NA      12.95        090
44345...............  ..............  A               Revision of colostomy      15.41         NA       6.88       1.92         NA      24.21        090
44346...............  ..............  A               Revision of colostomy      16.96         NA       7.38       2.07         NA      26.41        090
44360...............  ..............  A               Small bowel endoscopy       2.59         NA       1.10       0.19         NA       3.88        000
44361...............  ..............  A               Small bowel endoscopy/      2.87         NA       1.20       0.21         NA       4.28        000
                                                       biopsy.
44363...............  ..............  A               Small bowel endoscopy       3.49         NA       1.38       0.26         NA       5.13        000
44364...............  ..............  A               Small bowel endoscopy       3.73         NA       1.49       0.28         NA       5.50        000
44365...............  ..............  A               Small bowel endoscopy       3.31         NA       1.36       0.25         NA       4.92        000
44366...............  ..............  A               Small bowel endoscopy       4.40         NA       1.73       0.32         NA       6.45        000
44369...............  ..............  A               Small bowel endoscopy       4.51         NA       1.73       0.34         NA       6.58        000
44370...............  ..............  A               Small bowel endoscopy/      4.79         NA       1.97       0.36         NA       7.12        000
                                                       stent.
44372...............  ..............  A               Small bowel endoscopy       4.40         NA       1.72       0.35         NA       6.47        000
44373...............  ..............  A               Small bowel endoscopy       3.49         NA       1.42       0.26         NA       5.17        000
44376...............  ..............  A               Small bowel endoscopy       5.25         NA       2.02       0.41         NA       7.68        000
44377...............  ..............  A               Small bowel endoscopy/      5.52         NA       2.13       0.40         NA       8.05        000
                                                       biopsy.
44378...............  ..............  A               Small bowel endoscopy       7.12         NA       2.69       0.53         NA      10.34        000
44379...............  ..............  A               S bowel endoscope w/        7.46         NA       2.91       0.55         NA      10.92        000
                                                       stent.
44380...............  ..............  A               Small bowel endoscopy       1.05         NA       0.55       0.08         NA       1.68        000
44382...............  ..............  A               Small bowel endoscopy       1.27         NA       0.63       0.12         NA       2.02        000
44383...............  ..............  A               Ileoscopy w/stent....       2.94         NA       1.27       0.24         NA       4.45        000
44385...............  ..............  A               Endoscopy of bowel          1.82       3.35       0.75       0.15       5.32       2.72        000
                                                       pouch.
44386...............  ..............  A               Endoscopy, bowel            2.12       6.68       0.88       0.19       8.99       3.19        000
                                                       pouch/biop.
44388...............  ..............  A               Colonoscopy..........       2.82       5.14       1.15       0.26       8.22       4.23        000
44389...............  ..............  A               Colonoscopy with            3.13       6.70       1.27       0.27      10.10       4.67        000
                                                       biopsy.
44390...............  ..............  A               Colonoscopy for             3.82       7.19       1.49       0.30      11.31       5.61        000
                                                       foreign body.

[[Page 47624]]

 
44391...............  ..............  A               Colonoscopy for             4.31       8.84       1.69       0.34      13.49       6.34        000
                                                       bleeding.
44392...............  ..............  A               Colonoscopy &               3.81       6.66       1.49       0.34      10.81       5.64        000
                                                       polypectomy.
44393...............  ..............  A               Colonoscopy, lesion         4.83       6.99       1.86       0.41      12.23       7.10        000
                                                       removal.
44394...............  ..............  A               Colonoscopy w/snare..       4.42       7.90       1.72       0.39      12.71       6.53        000
44397...............  ..............  A               Colonoscopy w/stent..       4.70         NA       1.78       0.42         NA       6.90        000
44500...............  ..............  A               Intro,                      0.49         NA       0.16       0.03         NA       0.68        000
                                                       gastrointestinal
                                                       tube.
44602...............  ..............  A               Suture, small              16.01         NA       6.38       2.00         NA      24.39        090
                                                       intestine.
44603...............  ..............  A               Suture, small              18.63         NA       7.26       2.37         NA      28.26        090
                                                       intestine.
44604...............  ..............  A               Suture, large              16.01         NA       6.45       2.02         NA      24.48        090
                                                       intestine.
44605...............  ..............  A               Repair of bowel            19.50         NA       8.38       2.46         NA      30.34        090
                                                       lesion.
44615...............  ..............  A               Intestinal                 15.91         NA       6.67       1.99         NA      24.57        090
                                                       stricturoplasty.
44620...............  ..............  A               Repair bowel opening.      12.18         NA       5.32       1.47         NA      18.97        090
44625...............  ..............  A               Repair bowel opening.      15.03         NA       6.30       1.82         NA      23.15        090
44626...............  ..............  A               Repair bowel opening.      25.32         NA       9.80       3.19         NA      38.31        090
44640...............  ..............  A               Repair bowel-skin          21.62         NA       8.57       2.71         NA      32.90        090
                                                       fistula.
44650...............  ..............  A               Repair bowel fistula.      22.54         NA       8.87       2.79         NA      34.20        090
44660...............  ..............  A               Repair bowel-bladder       21.33         NA       8.33       2.21         NA      31.87        090
                                                       fistula.
44661...............  ..............  A               Repair bowel-bladder       24.77         NA       9.54       2.80         NA      37.11        090
                                                       fistula.
44680...............  ..............  A               Surgical revision,         15.38         NA       6.44       1.95         NA      23.77        090
                                                       intestine.
44700...............  ..............  A               Suspend bowel w/           16.09         NA       6.65       1.79         NA      24.53        090
                                                       prosthesis.
44701...............  ..............  A               Intraop colon lavage        3.10         NA       1.05       0.28         NA       4.43        ZZZ
                                                       add-on.
44800...............  ..............  A               Excision of bowel          11.21         NA       5.39       1.40         NA      18.00        090
                                                       pouch.
44820...............  ..............  A               Excision of mesentery      12.07         NA       5.48       1.53         NA      19.08        090
                                                       lesion.
44850...............  ..............  A               Repair of mesentery..      10.72         NA       5.00       1.35         NA      17.07        090
44900...............  ..............  A               Drain app abscess,         10.12         NA       4.70       1.29         NA      16.11        090
                                                       open.
44901...............  ..............  A               Drain app abscess,          3.37      28.20       1.11       0.22      31.79       4.70        000
                                                       percut.
44950...............  ..............  A               Appendectomy.........       9.99         NA       4.31       1.27         NA      15.57        090
44955...............  ..............  A               Appendectomy add-on..       1.53         NA       0.54       0.19         NA       2.26        ZZZ
44960...............  ..............  A               Appendectomy.........      12.32         NA       5.34       1.59         NA      19.25        090
44970...............  ..............  A               Laparoscopy,                8.69         NA       4.21       1.12         NA      14.02        090
                                                       appendectomy.
45000...............  ..............  A               Drainage of pelvic          4.51         NA       2.96       0.50         NA       7.97        090
                                                       abscess.
45005...............  ..............  A               Drainage of rectal          1.99       4.08       1.59       0.24       6.31       3.82        010
                                                       abscess.
45020...............  ..............  A               Drainage of rectal          4.71         NA       3.28       0.53         NA       8.52        090
                                                       abscess.
45100...............  ..............  A               Biopsy of rectum.....       3.67         NA       2.37       0.41         NA       6.45        090
45108...............  ..............  A               Removal of anorectal        4.75         NA       2.78       0.59         NA       8.12        090
                                                       lesion.
45110...............  ..............  A               Removal of rectum....      27.96         NA      12.39       3.35         NA      43.70        090
45111...............  ..............  A               Partial removal of         16.46         NA       7.17       2.00         NA      25.63        090
                                                       rectum.
45112...............  ..............  A               Removal of rectum....      30.49         NA      11.75       3.51         NA      45.75        090
45113...............  ..............  A               Partial proctectomy..      30.53         NA      12.59       3.53         NA      46.65        090
45114...............  ..............  A               Partial removal of         27.28         NA      10.85       3.32         NA      41.45        090
                                                       rectum.
45116...............  ..............  A               Partial removal of         24.54         NA      10.01       2.90         NA      37.45        090
                                                       rectum.
45119...............  ..............  A               Remove rectum w/           30.79         NA      12.44       3.30         NA      46.53        090
                                                       reservoir.
45120...............  ..............  A               Removal of rectum....      24.56         NA      10.12       3.04         NA      37.72        090
45121...............  ..............  A               Removal of rectum and      27.00         NA      11.10       3.37         NA      41.47        090
                                                       colon.
45123...............  ..............  A               Partial proctectomy..      16.68         NA       6.85       1.85         NA      25.38        090
45126...............  ..............  A               Pelvic exenteration..      45.09         NA      19.20       4.86         NA      69.15        090
45130...............  ..............  A               Excision of rectal         16.42         NA       6.76       1.75         NA      24.93        090
                                                       prolapse.
45135...............  ..............  A               Excision of rectal         19.25         NA       8.42       2.33         NA      30.00        090
                                                       prolapse.
45136...............  ..............  A               Excise ileoanal            27.26         NA      12.45       2.93         NA      42.64        090
                                                       reservior.
45150...............  ..............  A               Excision of rectal          5.66         NA       2.97       0.58         NA       9.21        090
                                                       stricture.
45160...............  ..............  A               Excision of rectal         15.30         NA       6.64       1.64         NA      23.58        090
                                                       lesion.
45170...............  ..............  A               Excision of rectal         11.47         NA       5.24       1.35         NA      18.06        090
                                                       lesion.
45190...............  ..............  A               Destruction, rectal         9.73         NA       4.66       1.13         NA      15.52        090
                                                       tumor.
45300...............  ..............  A               Proctosigmoidoscopy         0.38       1.55       0.29       0.04       1.97       0.71        000
                                                       dx.
45303...............  ..............  A               Proctosigmoidoscopy         0.44      18.84       0.33       0.04      19.32       0.81        000
                                                       dilate.
45305...............  ..............  A               Proctosigmoidoscopy w/      1.01       2.65       0.50       0.11       3.77       1.62        000
                                                       bx.
45307...............  ..............  A               Proctosigmoidoscopy         0.94       3.07       0.48       0.10       4.11       1.52        000
                                                       fb.
45308...............  ..............  A               Proctosigmoidoscopy         0.83       2.00       0.44       0.09       2.92       1.36        000
                                                       removal.
45309...............  ..............  A               Proctosigmoidoscopy         2.01       2.83       0.84       0.22       5.06       3.07        000
                                                       removal.
45315...............  ..............  A               Proctosigmoidoscopy         1.40       2.89       0.64       0.16       4.45       2.20        000
                                                       removal.
45317...............  ..............  A               Proctosigmoidoscopy         1.50       2.44       0.66       0.15       4.09       2.31        000
                                                       bleed.
45320...............  ..............  A               Proctosigmoidoscopy         1.58       2.93       0.71       0.15       4.66       2.44        000
                                                       ablate.
45321...............  ..............  A               Proctosigmoidoscopy         1.17         NA       0.56       0.13         NA       1.86        000
                                                       volvul.
45327...............  ..............  A               Proctosigmoidoscopy w/      1.65         NA       0.69       0.16         NA       2.50        000
                                                       stent.
45330...............  ..............  A               Diagnostic                  0.96       2.30       0.50       0.08       3.34       1.54        000
                                                       sigmoidoscopy.
45331...............  ..............  A               Sigmoidoscopy and           1.15       3.11       0.59       0.09       4.35       1.83        000
                                                       biopsy.
45332...............  ..............  A               Sigmoidoscopy w/fb          1.79       5.05       0.80       0.15       6.99       2.74        000
                                                       removal.
45333...............  ..............  A               Sigmoidoscopy &             1.79       4.91       0.80       0.15       6.85       2.74        000
                                                       polypectomy.
45334...............  ..............  A               Sigmoidoscopy for           2.73         NA       1.14       0.21         NA       4.08        000
                                                       bleeding.
45335...............  ..............  A               Sigmoidoscopy w/            1.46       3.22       0.69       0.04       4.72       2.19        000
                                                       submuc inj.
45337...............  ..............  A               Sigmoidoscopy &             2.36         NA       1.00       0.22         NA       3.58        000
                                                       decompress.
45338...............  ..............  A               Sigmoidoscopy w/tumr        2.34       5.24       1.00       0.20       7.78       3.54        000
                                                       remove.
45339...............  ..............  A               Sigmoidoscopy w/            3.14       3.47       1.28       0.26       6.87       4.68        000
                                                       ablate tumr.
45340...............  ..............  A               Sig w/balloon               1.89       6.18       0.83       0.04       8.11       2.76        000
                                                       dilation.
45341...............  ..............  A               Sigmoidoscopy w/            2.60         NA       1.07       0.20         NA       3.87        000
                                                       ultrasound.

[[Page 47625]]

 
45342...............  ..............  A               Sigmoidoscopy w/us          4.05         NA       1.55       0.30         NA       5.90        000
                                                       guide bx.
45345...............  ..............  A               Sigmoidoscopy w/stent       2.92         NA       1.16       0.24         NA       4.32        000
45355...............  ..............  A               Surgical colonoscopy.       3.51         NA       1.38       0.35         NA       5.24        000
45378...............  ..............  A               Diagnostic                  3.69       6.20       1.47       0.24      10.13       5.40        000
                                                       colonoscopy.
45378...............  53............  A               Diagnostic                  0.96       2.30       0.50       0.08       3.34       1.54        000
                                                       colonoscopy.
45379...............  ..............  A               Colonoscopy w/fb            4.68       7.75       1.81       0.38      12.81       6.87        000
                                                       removal.
45380...............  ..............  A               Colonoscopy and             4.43       7.26       1.73       0.35      12.04       6.51        000
                                                       biopsy.
45381...............  ..............  A               Colonoscopy,                4.19       7.17       1.65       0.31      11.67       6.15        000
                                                       submucous inj.
45382...............  ..............  A               Colonoscopy/control         5.68      10.01       2.18       0.43      16.12       8.29        000
                                                       bleeding.
45383...............  ..............  A               Lesion removal              5.86       7.99       2.22       0.48      14.33       8.56        000
                                                       colonoscopy.
45384...............  ..............  A               Lesion remove               4.69       6.85       1.82       0.38      11.92       6.89        000
                                                       colonoscopy.
45385...............  ..............  A               Lesion removal              5.30       7.86       2.03       0.42      13.58       7.75        000
                                                       colonoscopy.
45386...............  ..............  A               Colonoscopy dilate          4.57      12.46       1.77       0.31      17.34       6.65        000
                                                       stricture.
45387...............  ..............  A               Colonoscopy w/stent..       5.90         NA       2.33       0.49         NA       8.72        000
45500...............  ..............  A               Repair of rectum.....       7.28         NA       3.58       0.73         NA      11.59        090
45505...............  ..............  A               Repair of rectum.....       7.57         NA       3.86       0.83         NA      12.26        090
45520...............  ..............  A               Treatment of rectal         0.55       1.65       0.37       0.05       2.25       0.97        000
                                                       prolapse.
45540...............  ..............  A               Correct rectal             16.25         NA       6.82       1.84         NA      24.91        090
                                                       prolapse.
45541...............  ..............  A               Correct rectal             13.38         NA       5.96       1.53         NA      20.87        090
                                                       prolapse.
45550...............  ..............  A               Repair rectum/remove       22.97         NA       9.23       2.61         NA      34.81        090
                                                       sigmoid.
45560...............  ..............  A               Repair of rectocele..      10.56         NA       5.09       1.14         NA      16.79        090
45562...............  ..............  A               Exploration/repair of      15.36         NA       7.00       1.81         NA      24.17        090
                                                       rectum.
45563...............  ..............  A               Exploration/repair of      23.43         NA      10.52       2.95         NA      36.90        090
                                                       rectum.
45800...............  ..............  A               Repair rect/bladder        17.74         NA       7.45       1.89         NA      27.08        090
                                                       fistula.
45805...............  ..............  A               Repair fistula w/          20.75         NA       9.52       2.32         NA      32.59        090
                                                       colostomy.
45820...............  ..............  A               Repair rectourethral       18.45         NA       7.64       1.66         NA      27.75        090
                                                       fistula.
45825...............  ..............  A               Repair fistula w/          21.22         NA       9.83       2.15         NA      33.20        090
                                                       colostomy.
45900...............  ..............  A               Reduction of rectal         2.61         NA       1.51       0.29         NA       4.41        010
                                                       prolapse.
45905...............  ..............  A               Dilation of anal            2.30         NA       1.43       0.27         NA       4.00        010
                                                       sphincter.
45910...............  ..............  A               Dilation of rectal          2.80         NA       1.67       0.28         NA       4.75        010
                                                       narrowing.
45915...............  ..............  A               Remove rectal               3.14       4.36       2.10       0.30       7.80       5.54        010
                                                       obstruction.
46020...............  ..............  A               Placement of seton...       2.90       2.35       1.86       0.35       5.60       5.11        010
46030...............  ..............  A               Removal of rectal           1.23       1.35       0.71       0.14       2.72       2.08        010
                                                       marker.
46040...............  ..............  A               Incision of rectal          4.95       5.52       3.61       0.60      11.07       9.16        090
                                                       abscess.
46045...............  ..............  A               Incision of rectal          4.31         NA       2.91       0.53         NA       7.75        090
                                                       abscess.
46050...............  ..............  A               Incision of anal            1.19       2.56       0.85       0.14       3.89       2.18        010
                                                       abscess.
46060...............  ..............  A               Incision of rectal          5.68         NA       3.28       0.67         NA       9.63        090
                                                       abscess.
46070...............  ..............  A               Incision of anal            2.71         NA       1.86       0.20         NA       4.77        090
                                                       septum.
46080...............  ..............  A               Incision of anal            2.49       2.38       1.13       0.30       5.17       3.92        010
                                                       sphincter.
46083...............  ..............  A               Incise external             1.40       2.55       0.94       0.15       4.10       2.49        010
                                                       hemorrhoid.
46200...............  ..............  A               Removal of anal             3.41       3.87       2.88       0.39       7.67       6.68        090
                                                       fissure.
46210...............  ..............  A               Removal of anal crypt       2.67       5.16       2.64       0.31       8.14       5.62        090
46211...............  ..............  A               Removal of anal             4.24       5.44       3.52       0.52      10.20       8.28        090
                                                       crypts.
46220...............  ..............  A               Removal of anal tag..       1.56       2.22       0.93       0.18       3.96       2.67        010
46221...............  ..............  A               Ligation of                 2.04       2.65       1.75       0.22       4.91       4.01        010
                                                       hemorrhoid(s).
46230...............  ..............  A               Removal of anal tags.       2.57       3.00       1.27       0.29       5.86       4.13        010
46250...............  ..............  A               Hemorrhoidectomy.....       3.88       5.34       2.62       0.46       9.68       6.96        090
46255...............  ..............  A               Hemorrhoidectomy.....       4.59       5.87       2.84       0.57      11.03       8.00        090
46257...............  ..............  A               Remove hemorrhoids &        5.39         NA       2.89       0.64         NA       8.92        090
                                                       fissure.
46258...............  ..............  A               Remove hemorrhoids &        5.72         NA       3.29       0.68         NA       9.69        090
                                                       fistula.
46260...............  ..............  A               Hemorrhoidectomy.....       6.36         NA       3.23       0.75         NA      10.34        090
46261...............  ..............  A               Remove hemorrhoids &        7.07         NA       3.64       0.81         NA      11.52        090
                                                       fissure.
46262...............  ..............  A               Remove hemorrhoids &        7.49         NA       3.77       0.85         NA      12.11        090
                                                       fistula.
46270...............  ..............  A               Removal of anal             3.71       5.02       2.85       0.46       9.19       7.02        090
                                                       fistula.
46275...............  ..............  A               Removal of anal             4.55       4.65       2.98       0.51       9.71       8.04        090
                                                       fistula.
46280...............  ..............  A               Removal of anal             5.97         NA       3.29       0.66         NA       9.92        090
                                                       fistula.
46285...............  ..............  A               Removal of anal             4.08       3.76       2.75       0.45       8.29       7.28        090
                                                       fistula.
46288...............  ..............  A               Repair anal fistula..       7.12         NA       3.71       0.79         NA      11.62        090
46320...............  ..............  A               Removal of hemorrhoid       1.61       2.14       0.86       0.17       3.92       2.64        010
                                                       clot.
46500...............  ..............  A               Injection into              1.61       2.12       1.16       0.16       3.89       2.93        010
                                                       hemorrhoid(s).
46600...............  ..............  A               Diagnostic anoscopy..       0.50       1.57       0.35       0.05       2.12       0.90        000
46604...............  ..............  A               Anoscopy and dilation       1.31       9.16       0.62       0.13      10.60       2.06        000
46606...............  ..............  A               Anoscopy and biopsy..       0.81       3.81       0.43       0.09       4.71       1.33        000
46608...............  ..............  A               Anoscopy, remove for        1.51       4.44       0.65       0.16       6.11       2.32        000
                                                       body.
46610...............  ..............  A               Anoscopy, remove            1.32       4.05       0.61       0.15       5.52       2.08        000
                                                       lesion.
46611...............  ..............  A               Anoscopy.............       1.81       3.36       0.78       0.19       5.36       2.78        000
46612...............  ..............  A               Anoscopy, remove            2.34       5.21       0.98       0.28       7.83       3.60        000
                                                       lesions.
46614...............  ..............  A               Anoscopy, control           2.01       2.33       0.84       0.20       4.54       3.05        000
                                                       bleeding.
46615...............  ..............  A               Anoscopy.............       2.68       2.50       1.07       0.32       5.50       4.07        000
46700...............  ..............  A               Repair of anal              9.12         NA       4.23       0.93         NA      14.28        090
                                                       stricture.
46705...............  ..............  A               Repair of anal              6.89         NA       3.72       0.91         NA      11.52        090
                                                       stricture.
46706...............  ..............  A               Repr of anal fistula        2.39         NA       1.25       0.51         NA       4.15        010
                                                       w/glue.
46715...............  ..............  A               Repair of anovaginal        7.19         NA       3.61       0.92         NA      11.72        090
                                                       fistula.
46716...............  ..............  A               Repair of anovaginal       15.05         NA       7.95       1.57         NA      24.57        090
                                                       fistula.
46730...............  ..............  A               Construction of            26.71         NA      11.99       1.71         NA      40.41        090
                                                       absent anus.

[[Page 47626]]

 
46735...............  ..............  A               Construction of            32.12         NA      13.51       3.18         NA      48.81        090
                                                       absent anus.
46740...............  ..............  A               Construction of            29.96         NA      13.16       2.89         NA      46.01        090
                                                       absent anus.
46742...............  ..............  A               Repair of                  35.75         NA      17.47       4.73         NA      57.95        090
                                                       imperforated anus.
46744...............  ..............  A               Repair of cloacal          52.55         NA      21.07       3.83         NA      77.45        090
                                                       anomaly.
46746...............  ..............  A               Repair of cloacal          58.13         NA      25.05       3.03         NA      86.21        090
                                                       anomaly.
46748...............  ..............  A               Repair of cloacal          64.11         NA      23.66       3.34         NA      91.11        090
                                                       anomaly.
46750...............  ..............  A               Repair of anal             10.23         NA       5.08       1.13         NA      16.44        090
                                                       sphincter.
46751...............  ..............  A               Repair of anal              8.76         NA       5.50       0.94         NA      15.20        090
                                                       sphincter.
46753...............  ..............  A               Reconstruction of           8.28         NA       3.86       0.97         NA      13.11        090
                                                       anus.
46754...............  ..............  A               Removal of suture           2.20       3.66       1.68       0.19       6.05       4.07        010
                                                       from anus.
46760...............  ..............  A               Repair of anal             14.41         NA       7.09       1.57         NA      23.07        090
                                                       sphincter.
46761...............  ..............  A               Repair of anal             13.82         NA       6.04       1.48         NA      21.34        090
                                                       sphincter.
46762...............  ..............  A               Implant artificial         12.69         NA       5.53       1.24         NA      19.46        090
                                                       sphincter.
46900...............  ..............  A               Destruction, anal           1.91       2.59       1.28       0.18       4.68       3.37        010
                                                       lesion(s).
46910...............  ..............  A               Destruction, anal           1.86       2.92       1.06       0.19       4.97       3.11        010
                                                       lesion(s).
46916...............  ..............  A               Cryosurgery, anal           1.86       3.17       1.40       0.16       5.19       3.42        010
                                                       lesion(s).
46917...............  ..............  A               Laser surgery, anal         1.86       9.19       1.12       0.21      11.26       3.19        010
                                                       lesions.
46922...............  ..............  A               Excision of anal            1.86       3.29       1.08       0.21       5.36       3.15        010
                                                       lesion(s).
46924...............  ..............  A               Destruction, anal           2.76       8.72       1.36       0.27      11.75       4.39        010
                                                       lesion(s).
46934...............  ..............  A               Destruction of              3.50       5.10       2.97       0.31       8.91       6.78        090
                                                       hemorrhoids.
46935...............  ..............  A               Destruction of              2.43       3.49       1.21       0.22       6.14       3.86        010
                                                       hemorrhoids.
46936...............  ..............  A               Destruction of              3.68       4.89       2.50       0.36       8.93       6.54        090
                                                       hemorrhoids.
46937...............  ..............  A               Cryotherapy of rectal       2.69       2.77       1.23       0.28       5.74       4.20        010
                                                       lesion.
46938...............  ..............  A               Cryotherapy of rectal       4.65       4.00       3.06       0.58       9.23       8.29        090
                                                       lesion.
46940...............  ..............  A               Treatment of anal           2.32       1.99       1.09       0.22       4.53       3.63        010
                                                       fissure.
46942...............  ..............  A               Treatment of anal           2.04       1.83       1.02       0.19       4.06       3.25        010
                                                       fissure.
46945...............  ..............  A               Ligation of                 1.84       3.36       2.49       0.19       5.39       4.52        090
                                                       hemorrhoids.
46946...............  ..............  A               Ligation of                 2.58       3.79       2.40       0.26       6.63       5.24        090
                                                       hemorrhoids.
47000...............  ..............  A               Needle biopsy of            1.90       3.07       0.63       0.12       5.09       2.65        000
                                                       liver.
47001...............  ..............  A               Needle biopsy, liver        1.90         NA       0.65       0.24         NA       2.79        ZZZ
                                                       add-on.
47010...............  ..............  A               Open drainage, liver       15.99         NA       8.40       1.74         NA      26.13        090
                                                       lesion.
47011...............  ..............  A               Percut drain, liver         3.69         NA       1.20       0.23         NA       5.12        000
                                                       lesion.
47015...............  ..............  A               Inject/aspirate liver      15.09         NA       7.49       1.78         NA      24.36        090
                                                       cyst.
47100...............  ..............  A               Wedge biopsy of liver      11.65         NA       6.04       1.48         NA      19.17        090
47120...............  ..............  A               Partial removal of         35.45         NA      15.15       4.53         NA      55.13        090
                                                       liver.
47122...............  ..............  A               Extensive removal of       55.05         NA      21.45       6.99         NA      83.49        090
                                                       liver.
47125...............  ..............  A               Partial removal of         49.12         NA      19.51       6.23         NA      74.86        090
                                                       liver.
47130...............  ..............  A               Partial removal of         53.27         NA      20.97       6.80         NA      81.04        090
                                                       liver.
47135...............  ..............  R               Transplantation of         81.40         NA      31.49       9.89         NA     122.78        090
                                                       liver.
47136...............  ..............  R               Transplantation of         68.50         NA      26.99       8.36         NA     103.85        090
                                                       liver.
47140...............  ..............  A               Partial removal,           54.92         NA      22.25       4.87         NA      82.04        090
                                                       donor liver.
47141...............  ..............  A               Partial removal,           67.40         NA      26.87       4.87         NA      99.14        090
                                                       donor liver.
47142...............  ..............  A               Partial removal,           74.89         NA      29.43       4.87         NA     109.19        090
                                                       donor liver.
47300...............  ..............  A               Surgery for liver          15.06         NA       7.23       1.91         NA      24.20        090
                                                       lesion.
47350...............  ..............  A               Repair liver wound...      19.53         NA       8.86       2.48         NA      30.87        090
47360...............  ..............  A               Repair liver wound...      26.88         NA      11.59       3.35         NA      41.82        090
47361...............  ..............  A               Repair liver wound...      47.05         NA      18.51       5.77         NA      71.33        090
47362...............  ..............  A               Repair liver wound...      18.48         NA       8.73       2.31         NA      29.52        090
47370...............  ..............  A               Laparo ablate liver        19.66         NA       8.13       2.27         NA      30.06        090
                                                       tumor rf.
47371...............  ..............  A               Laparo ablate liver        19.66         NA       8.14       2.11         NA      29.91        090
                                                       cryosurg.
47380...............  ..............  A               Open ablate liver          22.97         NA       9.34       2.69         NA      35.00        090
                                                       tumor rf.
47381...............  ..............  A               Open ablate liver          23.24         NA       9.58       2.39         NA      35.21        090
                                                       tumor cryo.
47382...............  ..............  A               Percut ablate liver        15.17         NA       6.06       0.80         NA      22.03        010
                                                       rf.
47400...............  ..............  A               Incision of liver          32.44         NA      13.43       3.46         NA      49.33        090
                                                       duct.
47420...............  ..............  A               Incision of bile duct      19.85         NA       8.75       2.54         NA      31.14        090
47425...............  ..............  A               Incision of bile duct      19.80         NA       8.81       2.46         NA      31.07        090
47460...............  ..............  A               Incise bile duct           18.01         NA       8.38       2.00         NA      28.39        090
                                                       sphincter.
47480...............  ..............  A               Incision of                10.80         NA       5.92       1.38         NA      18.10        090
                                                       gallbladder.
47490...............  ..............  A               Incision of                 7.22         NA       5.58       0.44         NA      13.24        090
                                                       gallbladder.
47500...............  ..............  A               Injection for liver x-      1.96         NA       0.64       0.12         NA       2.72        000
                                                       rays.
47505...............  ..............  A               Injection for liver x-      0.76         NA       0.25       0.05         NA       1.06        000
                                                       rays.
47510...............  ..............  A               Insert catheter, bile       7.82         NA       5.00       0.50         NA      13.32        090
                                                       duct.
47511...............  ..............  A               Insert bile duct           10.48         NA       5.07       0.64         NA      16.19        090
                                                       drain.
47525...............  ..............  A               Change bile duct            5.54      12.22       2.80       0.33      18.09       8.67        010
                                                       catheter.
47530...............  ..............  A               Revise/reinsert bile        5.84      25.23       3.70       0.38      31.45       9.92        090
                                                       tube.
47550...............  ..............  A               Bile duct endoscopy         3.02         NA       1.02       0.39         NA       4.43        ZZZ
                                                       add-on.
47552...............  ..............  A               Biliary endoscopy           6.03         NA       2.40       0.44         NA       8.87        000
                                                       thru skin.
47553...............  ..............  A               Biliary endoscopy           6.34         NA       2.06       0.41         NA       8.81        000
                                                       thru skin.
47554...............  ..............  A               Biliary endoscopy           9.05         NA       3.38       0.96         NA      13.39        000
                                                       thru skin.
47555...............  ..............  A               Biliary endoscopy           7.55         NA       2.45       0.46         NA      10.46        000
                                                       thru skin.
47556...............  ..............  A               Biliary endoscopy           8.55         NA       2.77       0.51         NA      11.83        000
                                                       thru skin.
47560...............  ..............  A               Laparoscopy w/              4.88         NA       1.66       0.59         NA       7.13        000
                                                       cholangio.
47561...............  ..............  A               Laparo w/cholangio/         5.17         NA       1.91       0.65         NA       7.73        000
                                                       biopsy.
47562...............  ..............  A               Laparoscopic               11.07         NA       4.98       1.42         NA      17.47        090
                                                       cholecystectomy.
47563...............  ..............  A               Laparo                     11.92         NA       5.29       1.52         NA      18.73        090
                                                       cholecystectomy/
                                                       graph.

[[Page 47627]]

 
47564...............  ..............  A               Laparo                     14.21         NA       5.94       1.82         NA      21.97        090
                                                       cholecystectomy/
                                                       explr.
47570...............  ..............  A               Laparo                     12.56         NA       5.36       1.60         NA      19.52        090
                                                       cholecystoenterostom
                                                       y.
47600...............  ..............  A               Removal of                 13.56         NA       6.15       1.73         NA      21.44        090
                                                       gallbladder.
47605...............  ..............  A               Removal of                 14.67         NA       6.50       1.88         NA      23.05        090
                                                       gallbladder.
47610...............  ..............  A               Removal of                 18.79         NA       7.94       2.41         NA      29.14        090
                                                       gallbladder.
47612...............  ..............  A               Removal of                 18.75         NA       7.88       2.40         NA      29.03        090
                                                       gallbladder.
47620...............  ..............  A               Removal of                 20.61         NA       8.52       2.68         NA      31.81        090
                                                       gallbladder.
47630...............  ..............  A               Remove bile duct            9.10         NA       4.86       0.69         NA      14.65        090
                                                       stone.
47700...............  ..............  A               Exploration of bile        15.60         NA       7.43       1.89         NA      24.92        090
                                                       ducts.
47701...............  ..............  A               Bile duct revision...      27.77         NA      11.49       3.55         NA      42.81        090
47711...............  ..............  A               Excision of bile duct      23.00         NA       9.92       2.93         NA      35.85        090
                                                       tumor.
47712...............  ..............  A               Excision of bile duct      30.19         NA      12.41       3.93         NA      46.53        090
                                                       tumor.
47715...............  ..............  A               Excision of bile duct      18.77         NA       8.42       2.38         NA      29.57        090
                                                       cyst.
47716...............  ..............  A               Fusion of bile duct        16.42         NA       7.83       2.08         NA      26.33        090
                                                       cyst.
47720...............  ..............  A               Fuse gallbladder &         15.89         NA       7.48       2.03         NA      25.40        090
                                                       bowel.
47721...............  ..............  A               Fuse upper gi              19.09         NA       8.57       2.46         NA      30.12        090
                                                       structures.
47740...............  ..............  A               Fuse gallbladder &         18.45         NA       8.38       2.43         NA      29.26        090
                                                       bowel.
47741...............  ..............  A               Fuse gallbladder &         21.31         NA       9.28       2.63         NA      33.22        090
                                                       bowel.
47760...............  ..............  A               Fuse bile ducts and        25.81         NA      10.84       3.32         NA      39.97        090
                                                       bowel.
47765...............  ..............  A               Fuse liver ducts &         24.84         NA      10.80       3.21         NA      38.85        090
                                                       bowel.
47780...............  ..............  A               Fuse bile ducts and        26.46         NA      11.20       3.43         NA      41.09        090
                                                       bowel.
47785...............  ..............  A               Fuse bile ducts and        31.13         NA      12.91       4.04         NA      48.08        090
                                                       bowel.
47800...............  ..............  A               Reconstruction of          23.27         NA      10.06       2.94         NA      36.27        090
                                                       bile ducts.
47801...............  ..............  A               Placement, bile duct       15.15         NA       8.15       1.24         NA      24.54        090
                                                       support.
47802...............  ..............  A               Fuse liver duct &          21.52         NA       9.68       2.73         NA      33.93        090
                                                       intestine.
47900...............  ..............  A               Suture bile duct           19.87         NA       8.87       2.57         NA      31.31        090
                                                       injury.
48000...............  ..............  A               Drainage of abdomen..      28.03         NA      11.49       3.40         NA      42.92        090
48001...............  ..............  A               Placement of drain,        35.40         NA      13.87       4.47         NA      53.74        090
                                                       pancreas.
48005...............  ..............  A               Resect/debride             42.11         NA      16.53       5.41         NA      64.05        090
                                                       pancreas.
48020...............  ..............  A               Removal of pancreatic      15.68         NA       7.29       2.12         NA      25.09        090
                                                       stone.
48100...............  ..............  A               Biopsy of pancreas,        12.21         NA       5.61       1.54         NA      19.36        090
                                                       open.
48102...............  ..............  A               Needle biopsy,              4.67       7.95       1.94       0.29      12.91       6.90        010
                                                       pancreas.
48120...............  ..............  A               Removal of pancreas        15.83         NA       6.86       1.98         NA      24.67        090
                                                       lesion.
48140...............  ..............  A               Partial removal of         22.91         NA       9.53       2.91         NA      35.35        090
                                                       pancreas.
48145...............  ..............  A               Partial removal of         23.98         NA       9.84       3.09         NA      36.91        090
                                                       pancreas.
48146...............  ..............  A               Pancreatectomy.......      26.36         NA      11.98       3.40         NA      41.74        090
48148...............  ..............  A               Removal of pancreatic      17.31         NA       7.62       2.20         NA      27.13        090
                                                       duct.
48150...............  ..............  A               Partial removal of         47.93         NA      19.49       6.18         NA      73.60        090
                                                       pancreas.
48152...............  ..............  A               Pancreatectomy.......      43.68         NA      18.20       5.68         NA      67.56        090
48153...............  ..............  A               Pancreatectomy.......      47.82         NA      19.54       6.19         NA      73.55        090
48154...............  ..............  A               Pancreatectomy.......      44.03         NA      18.23       5.74         NA      68.00        090
48155...............  ..............  A               Removal of pancreas..      24.60         NA      11.69       3.14         NA      39.43        090
48180...............  ..............  A               Fuse pancreas and          24.68         NA      10.16       3.22         NA      38.06        090
                                                       bowel.
48400...............  ..............  A               Injection, intraop          1.95         NA       0.64       0.16         NA       2.75        ZZZ
                                                       add-on.
48500...............  ..............  A               Surgery of pancreatic      15.26         NA       7.34       2.04         NA      24.64        090
                                                       cyst.
48510...............  ..............  A               Drain pancreatic           14.29         NA       7.43       1.80         NA      23.52        090
                                                       pseudocyst.
48511...............  ..............  A               Drain pancreatic            3.99      21.20       1.30       0.25      25.44       5.54        000
                                                       pseudocyst.
48520...............  ..............  A               Fuse pancreas cyst         15.57         NA       6.70       1.99         NA      24.26        090
                                                       and bowel.
48540...............  ..............  A               Fuse pancreas cyst         19.69         NA       8.11       2.50         NA      30.30        090
                                                       and bowel.
48545...............  ..............  A               Pancreatorrhaphy.....      18.15         NA       7.99       2.30         NA      28.44        090
48547...............  ..............  A               Duodenal exclusion...      25.79         NA      10.48       3.28         NA      39.55        090
48554...............  ..............  R               Transpl allograft          34.12         NA      18.29       4.19         NA      56.60        090
                                                       pancreas.
48556...............  ..............  A               Removal, allograft         15.69         NA       8.07       1.96         NA      25.72        090
                                                       pancreas.
49000...............  ..............  A               Exploration of             11.66         NA       5.38       1.44         NA      18.48        090
                                                       abdomen.
49002...............  ..............  A               Reopening of abdomen.      10.47         NA       5.04       1.33         NA      16.84        090
49010...............  ..............  A               Exploration behind         12.26         NA       5.91       1.49         NA      19.66        090
                                                       abdomen.
49020...............  ..............  A               Drain abdominal            22.81         NA      10.19       2.71         NA      35.71        090
                                                       abscess.
49021...............  ..............  A               Drain abdominal             3.37      21.58       1.11       0.21      25.16       4.69        000
                                                       abscess.
49040...............  ..............  A               Drain, open, abdom         13.50         NA       6.44       1.65         NA      21.59        090
                                                       abscess.
49041...............  ..............  A               Drain, percut, abdom        3.99      19.76       1.31       0.25      24.00       5.55        000
                                                       abscess.
49060...............  ..............  A               Drain, open, retrop        15.84         NA       7.44       1.64         NA      24.92        090
                                                       abscess.
49061...............  ..............  A               Drain, percut,              3.69      19.95       1.21       0.22      23.86       5.12        000
                                                       retroper absc.
49062...............  ..............  A               Drain to peritoneal        11.34         NA       5.46       1.40         NA      18.20        090
                                                       cavity.
49080...............  ..............  A               Puncture, peritoneal        1.35       4.15       0.45       0.09       5.59       1.89        000
                                                       cavity.
49081...............  ..............  A               Removal of abdominal        1.26       2.66       0.43       0.09       4.01       1.78        000
                                                       fluid.
49085...............  ..............  A               Remove abdomen             12.12         NA       5.51       1.43         NA      19.06        090
                                                       foreign body.
49180...............  ..............  A               Biopsy, abdominal           1.73       3.14       0.56       0.11       4.98       2.40        000
                                                       mass.
49200...............  ..............  A               Removal of abdominal       10.23         NA       5.05       1.14         NA      16.42        090
                                                       lesion.
49201...............  ..............  A               Remove abdom lesion,       14.82         NA       7.06       1.77         NA      23.65        090
                                                       complex.
49215...............  ..............  A               Excise sacral spine        33.45         NA      14.04       4.29         NA      51.78        090
                                                       tumor.
49220...............  ..............  A               Multiple surgery,          14.86         NA       6.65       1.83         NA      23.34        090
                                                       abdomen.
49250...............  ..............  A               Excision of umbilicus       8.34         NA       4.30       1.05         NA      13.69        090
49255...............  ..............  A               Removal of omentum...      11.12         NA       5.63       1.39         NA      18.14        090
49320...............  ..............  A               Diag laparo separate        5.09         NA       2.63       0.63         NA       8.35        010
                                                       proc.
49321...............  ..............  A               Laparoscopy, biopsy..       5.39         NA       2.64       0.68         NA       8.71        010

[[Page 47628]]

 
49322...............  ..............  A               Laparoscopy,                5.69         NA       2.99       0.70         NA       9.38        010
                                                       aspiration.
49323...............  ..............  A               Laparo drain                9.47         NA       4.49       1.12         NA      15.08        090
                                                       lymphocele.
49400...............  ..............  A               Air injection into          1.88       3.16       0.62       0.16       5.20       2.66        000
                                                       abdomen.
49419...............  ..............  A               Insrt abdom cath for        6.64         NA       3.55       0.70         NA      10.89        090
                                                       chemotx.
49420...............  ..............  A               Insert abdom drain,         2.22         NA       1.09       0.21         NA       3.52        000
                                                       temp.
49421...............  ..............  A               Insert abdom drain,         5.53         NA       3.17       0.70         NA       9.40        090
                                                       perm.
49422...............  ..............  A               Remove perm cannula/        6.24         NA       2.89       0.80         NA       9.93        010
                                                       catheter.
49423...............  ..............  A               Exchange drainage           1.46      14.40       0.52       0.09      15.95       2.07        000
                                                       catheter.
49424...............  ..............  A               Assess cyst, contrast       0.76       3.92       0.29       0.05       4.73       1.10        000
                                                       inject.
49425...............  ..............  A               Insert abdomen-venous      11.35         NA       5.62       1.52         NA      18.49        090
                                                       drain.
49426...............  ..............  A               Revise abdomen-venous       9.62         NA       4.78       1.23         NA      15.63        090
                                                       shunt.
49427...............  ..............  A               Injection, abdominal        0.89         NA       0.30       0.06         NA       1.25        000
                                                       shunt.
49428...............  ..............  A               Ligation of shunt....       6.05         NA       3.92       0.84         NA      10.81        010
49429...............  ..............  A               Removal of shunt.....       7.39         NA       3.42       0.99         NA      11.80        010
49491...............  ..............  A               Rpr hern preemie           11.11         NA       5.04       1.47         NA      17.62        090
                                                       reduc.
49492...............  ..............  A               Rpr ing hern premie,       14.01         NA       6.10       1.64         NA      21.75        090
                                                       blocked.
49495...............  ..............  A               Rpr ing hernia baby,        5.88         NA       2.97       0.78         NA       9.63        090
                                                       reduc.
49496...............  ..............  A               Rpr ing hernia baby,        8.78         NA       4.33       1.10         NA      14.21        090
                                                       blocked.
49500...............  ..............  A               Rpr ing hernia, init,       5.47         NA       3.13       0.62         NA       9.22        090
                                                       reduce.
49501...............  ..............  A               Rpr ing hernia, init        8.87         NA       4.21       1.13         NA      14.21        090
                                                       blocked.
49505...............  ..............  A               Prp i/hern init             7.59         NA       3.75       0.99         NA      12.33        090
                                                       reduc>5 yr.
49507...............  ..............  A               Prp i/hern init             9.56         NA       4.50       1.24         NA      15.30        090
                                                       block>5 yr.
49520...............  ..............  A               Rerepair ing hernia,        9.62         NA       4.46       1.24         NA      15.32        090
                                                       reduce.
49521...............  ..............  A               Rerepair ing hernia,       11.95         NA       5.25       1.56         NA      18.76        090
                                                       blocked.
49525...............  ..............  A               Repair ing hernia,          8.56         NA       4.10       1.09         NA      13.75        090
                                                       sliding.
49540...............  ..............  A               Repair lumbar hernia.      10.37         NA       4.77       1.34         NA      16.48        090
49550...............  ..............  A               Rpr rem hernia, init,       8.62         NA       4.14       1.12         NA      13.88        090
                                                       reduce.
49553...............  ..............  A               Rpr fem hernia, init        9.43         NA       4.43       1.22         NA      15.08        090
                                                       blocked.
49555...............  ..............  A               Rerepair fem hernia,        9.02         NA       4.29       1.17         NA      14.48        090
                                                       reduce.
49557...............  ..............  A               Rerepair fem hernia,       11.13         NA       5.00       1.44         NA      17.57        090
                                                       blocked.
49560...............  ..............  A               Rpr ventral hern           11.55         NA       5.17       1.48         NA      18.20        090
                                                       init, reduc.
49561...............  ..............  A               Rpr ventral hern           14.23         NA       6.07       1.83         NA      22.13        090
                                                       init, block.
49565...............  ..............  A               Rerepair ventrl hern,      11.55         NA       5.24       1.48         NA      18.27        090
                                                       reduce.
49566...............  ..............  A               Rerepair ventrl hern,      14.38         NA       6.14       1.85         NA      22.37        090
                                                       block.
49568...............  ..............  A               Hernia repair w/mesh.       4.88         NA       1.67       0.63         NA       7.18        ZZZ
49570...............  ..............  A               Rpr epigastric hern,        5.68         NA       3.18       0.73         NA       9.59        090
                                                       reduce.
49572...............  ..............  A               Rpr epigastric hern,        6.72         NA       3.48       0.86         NA      11.06        090
                                                       blocked.
49580...............  ..............  A               Rpr umbil hern, reduc       4.10         NA       2.62       0.52         NA       7.24        090
                                                       < 5 yr.
49582...............  ..............  A               Rpr umbil hern, block       6.64         NA       3.51       0.86         NA      11.01        090
                                                       < 5 yr.
49585...............  ..............  A               Rpr umbil hern, reduc       6.22         NA       3.32       0.79         NA      10.33        090
                                                       > 5 yr.
49587...............  ..............  A               Rpr umbil hern, block       7.55         NA       3.75       0.97         NA      12.27        090
                                                       > 5 yr.
49590...............  ..............  A               Repair spigilian            8.53         NA       4.11       1.09         NA      13.73        090
                                                       hernia.
49600...............  ..............  A               Repair umbilical           10.94         NA       5.35       1.31         NA      17.60        090
                                                       lesion.
49605...............  ..............  A               Repair umbilical           75.89         NA      28.48       9.95         NA     114.32        090
                                                       lesion.
49606...............  ..............  A               Repair umbilical           18.57         NA       7.72       2.43         NA      28.72        090
                                                       lesion.
49610...............  ..............  A               Repair umbilical           10.48         NA       5.24       0.57         NA      16.29        090
                                                       lesion.
49611...............  ..............  A               Repair umbilical            8.91         NA       7.31       0.78         NA      17.00        090
                                                       lesion.
49650...............  ..............  A               Laparo hernia repair        6.26         NA       3.20       0.90         NA      10.36        090
                                                       initial.
49651...............  ..............  A               Laparo hernia repair        8.23         NA       4.06       1.10         NA      13.39        090
                                                       recur.
49900...............  ..............  A               Repair of abdominal        12.26         NA       6.23       1.55         NA      20.04        090
                                                       wall.
49904...............  ..............  A               Omental flap, extra-       19.97         NA      15.17       2.52         NA      37.66        090
                                                       abdom.
49905...............  ..............  A               Omental flap, intra-        6.54         NA       2.29       0.79         NA       9.62        ZZZ
                                                       abdom.
50010...............  ..............  A               Exploration of kidney      10.96         NA       5.21       0.93         NA      17.10        090
50020...............  ..............  A               Renal abscess, open        14.64         NA       7.73       1.27         NA      23.64        090
                                                       drain.
50021...............  ..............  A               Renal abscess, percut       3.37      21.89       1.10       0.20      25.46       4.67        000
                                                       drain.
50040...............  ..............  A               Drainage of kidney...      14.92         NA       6.80       1.03         NA      22.75        090
50045...............  ..............  A               Exploration of kidney      15.44         NA       6.59       1.24         NA      23.27        090
50060...............  ..............  A               Removal of kidney          19.27         NA       7.81       1.46         NA      28.54        090
                                                       stone.
50065...............  ..............  A               Incision of kidney...      20.76         NA       6.09       1.48         NA      28.33        090
50070...............  ..............  A               Incision of kidney...      20.29         NA       8.20       1.48         NA      29.97        090
50075...............  ..............  A               Removal of kidney          25.30         NA       9.88       1.93         NA      37.11        090
                                                       stone.
50080...............  ..............  A               Removal of kidney          14.69         NA       6.27       1.04         NA      22.00        090
                                                       stone.
50081...............  ..............  A               Removal of kidney          21.77         NA       8.74       1.57         NA      32.08        090
                                                       stone.
50100...............  ..............  A               Revise kidney blood        16.07         NA       7.77       1.78         NA      25.62        090
                                                       vessels.
50120...............  ..............  A               Exploration of kidney      15.89         NA       6.75       1.19         NA      23.83        090
50125...............  ..............  A               Explore and drain          16.50         NA       6.96       1.34         NA      24.80        090
                                                       kidney.
50130...............  ..............  A               Removal of kidney          17.26         NA       7.16       1.30         NA      25.72        090
                                                       stone.
50135...............  ..............  A               Exploration of kidney      19.15         NA       7.76       1.43         NA      28.34        090
50200...............  ..............  A               Biopsy of kidney.....       2.63         NA       1.29       0.16         NA       4.08        000
50205...............  ..............  A               Biopsy of kidney.....      11.29         NA       5.01       1.28         NA      17.58        090
50220...............  ..............  A               Remove kidney, open..      17.12         NA       7.22       1.44         NA      25.78        090
50225...............  ..............  A               Removal kidney open,       20.20         NA       8.13       1.58         NA      29.91        090
                                                       complex.
50230...............  ..............  A               Removal kidney open,       22.04         NA       8.56       1.70         NA      32.30        090
                                                       radical.
50234...............  ..............  A               Removal of kidney &        22.37         NA       8.81       1.67         NA      32.85        090
                                                       ureter.
50236...............  ..............  A               Removal of kidney &        24.82         NA      10.23       1.88         NA      36.93        090
                                                       ureter.

[[Page 47629]]

 
50240...............  ..............  A               Partial removal of         21.97         NA       8.99       1.66         NA      32.62        090
                                                       kidney.
50280...............  ..............  A               Removal of kidney          15.65         NA       6.67       1.29         NA      23.61        090
                                                       lesion.
50290...............  ..............  A               Removal of kidney          14.71         NA       6.45       1.22         NA      22.38        090
                                                       lesion.
50320...............  ..............  A               Removal of donor           22.18         NA      10.66       2.33         NA      35.17        090
                                                       kidney.
50340...............  ..............  A               Removal of kidney....      12.13         NA       6.49       1.66         NA      20.28        090
50360...............  ..............  A               Transplantation of         31.48         NA      15.48       3.73         NA      50.69        090
                                                       kidney.
50365...............  ..............  A               Transplantation of         36.75         NA      18.26       4.25         NA      59.26        090
                                                       kidney.
50370...............  ..............  A               Remove transplanted        13.70         NA       7.15       1.55         NA      22.40        090
                                                       kidney.
50380...............  ..............  A               Reimplantation of          20.73         NA      12.06       2.53         NA      35.32        090
                                                       kidney.
50390...............  ..............  A               Drainage of kidney          1.96         NA       0.64       0.12         NA       2.72        000
                                                       lesion.
50392...............  ..............  A               Insert kidney drain..       3.37         NA       1.52       0.21         NA       5.10        000
50393...............  ..............  A               Insert ureteral tube.       4.15         NA       1.77       0.26         NA       6.18        000
50394...............  ..............  A               Injection for kidney        0.76       3.04       0.66       0.05       3.85       1.47        000
                                                       x-ray.
50395...............  ..............  A               Create passage to           3.37         NA       1.50       0.21         NA       5.08        000
                                                       kidney.
50396...............  ..............  A               Measure kidney              2.09         NA       1.08       0.13         NA       3.30        000
                                                       pressure.
50398...............  ..............  A               Change kidney tube...       1.46      16.30       0.52       0.09      17.85       2.07        000
50400...............  ..............  A               Revision of kidney/        19.47         NA       7.86       1.49         NA      28.82        090
                                                       ureter.
50405...............  ..............  A               Revision of kidney/        23.89         NA       9.01       1.79         NA      34.69        090
                                                       ureter.
50500...............  ..............  A               Repair of kidney           19.54         NA       8.39       1.96         NA      29.89        090
                                                       wound.
50520...............  ..............  A               Close kidney-skin          17.20         NA       7.41       1.55         NA      26.16        090
                                                       fistula.
50525...............  ..............  A               Repair renal-abdomen       22.24         NA       8.99       2.30         NA      33.53        090
                                                       fistula.
50526...............  ..............  A               Repair renal-abdomen       23.98         NA       9.84       4.17         NA      37.99        090
                                                       fistula.
50540...............  ..............  A               Revision of horseshoe      19.90         NA       8.32       1.76         NA      29.98        090
                                                       kidney.
50541...............  ..............  A               Laparo ablate renal        15.98         NA       6.47       1.22         NA      23.67        090
                                                       cyst.
50542...............  ..............  A               Laparo ablate renal        19.97         NA       8.11       1.66         NA      29.74        090
                                                       mass.
50543...............  ..............  A               Laparo partial             25.46         NA      10.17       1.66         NA      37.29        090
                                                       nephrectomy.
50544...............  ..............  A               Laparoscopy,               22.37         NA       8.51       1.69         NA      32.57        090
                                                       pyeloplasty.
50545...............  ..............  A               Laparo radical             23.96         NA       9.17       1.82         NA      34.95        090
                                                       nephrectomy.
50546...............  ..............  A               Laparoscopic               20.45         NA       8.35       1.60         NA      30.40        090
                                                       nephrectomy.
50547...............  ..............  A               Laparo removal donor       25.46         NA      11.10       2.80         NA      39.36        090
                                                       kidney.
50548...............  ..............  A               Laparo remove w/           24.36         NA       9.15       1.84         NA      35.35        090
                                                       ureter.
50551...............  ..............  A               Kidney endoscopy.....       5.59       4.14       1.96       0.40      10.13       7.95        000
50553...............  ..............  A               Kidney endoscopy.....       5.98       4.35       2.16       0.39      10.72       8.53        000
50555...............  ..............  A               Kidney endoscopy &          6.52       4.82       2.33       0.49      11.83       9.34        000
                                                       biopsy.
50557...............  ..............  A               Kidney endoscopy &          6.61       4.57       2.29       0.48      11.66       9.38        000
                                                       treatment.
50559...............  ..............  A               Renal endoscopy/            6.77       5.30       2.78       0.41      12.48       9.96        000
                                                       radiotracer.
50561...............  ..............  A               Kidney endoscopy &          7.58       5.08       2.64       0.55      13.21      10.77        000
                                                       treatment.
50562...............  ..............  A               Renal scope w/tumor        10.90         NA       4.27       0.48         NA      15.65        090
                                                       resect.
50570...............  ..............  A               Kidney endoscopy.....       9.53         NA       3.20       0.66         NA      13.39        000
50572...............  ..............  A               Kidney endoscopy.....      10.33         NA       3.49       0.87         NA      14.69        000
50574...............  ..............  A               Kidney endoscopy &         11.00         NA       3.74       0.74         NA      15.48        000
                                                       biopsy.
50575...............  ..............  A               Kidney endoscopy.....      13.96         NA       4.62       1.00         NA      19.58        000
50576...............  ..............  A               Kidney endoscopy &         10.97         NA       3.65       0.76         NA      15.38        000
                                                       treatment.
50578...............  ..............  A               Renal endoscopy/           11.33         NA       3.79       0.81         NA      15.93        000
                                                       radiotracer.
50580...............  ..............  A               Kidney endoscopy &         11.84         NA       3.95       0.84         NA      16.63        000
                                                       treatment.
50590...............  ..............  A               Fragmenting of kidney       9.08      12.49       4.11       0.66      22.23      13.85        090
                                                       stone.
50600...............  ..............  A               Exploration of ureter      15.82         NA       6.66       1.34         NA      23.82        090
50605...............  ..............  A               Insert ureteral            15.44         NA       6.73       1.44         NA      23.61        090
                                                       support.
50610...............  ..............  A               Removal of ureter          15.90         NA       6.96       1.28         NA      24.14        090
                                                       stone.
50620...............  ..............  A               Removal of ureter          15.14         NA       6.32       1.12         NA      22.58        090
                                                       stone.
50630...............  ..............  A               Removal of ureter          14.92         NA       6.27       1.14         NA      22.33        090
                                                       stone.
50650...............  ..............  A               Removal of ureter....      17.38         NA       7.21       1.26         NA      25.85        090
50660...............  ..............  A               Removal of ureter....      19.52         NA       7.94       1.55         NA      29.01        090
50684...............  ..............  A               Injection for ureter        0.76       5.00       0.47       0.05       5.81       1.28        000
                                                       x-ray.
50686...............  ..............  A               Measure ureter              1.51       3.43       0.82       0.11       5.05       2.44        000
                                                       pressure.
50688...............  ..............  A               Change of ureter tube       1.17         NA       1.06       0.07         NA       2.30        010
50690...............  ..............  A               Injection for ureter        1.16       1.80       0.72       0.08       3.04       1.96        000
                                                       x-ray.
50700...............  ..............  A               Revision of ureter...      15.19         NA       7.10       1.25         NA      23.54        090
50715...............  ..............  A               Release of ureter....      18.87         NA       8.73       2.06         NA      29.66        090
50722...............  ..............  A               Release of ureter....      16.33         NA       7.80       1.88         NA      26.01        090
50725...............  ..............  A               Release/revise ureter      18.46         NA       8.04       1.58         NA      28.08        090
50727...............  ..............  A               Revise ureter........       8.17         NA       4.27       0.65         NA      13.09        090
50728...............  ..............  A               Revise ureter........      12.00         NA       5.55       1.05         NA      18.60        090
50740...............  ..............  A               Fusion of ureter &         18.39         NA       7.73       1.88         NA      28.00        090
                                                       kidney.
50750...............  ..............  A               Fusion of ureter &         19.48         NA       7.97       1.54         NA      28.99        090
                                                       kidney.
50760...............  ..............  A               Fusion of ureters....      18.39         NA       7.67       1.53         NA      27.59        090
50770...............  ..............  A               Splicing of ureters..      19.48         NA       7.96       1.61         NA      29.05        090
50780...............  ..............  A               Reimplant ureter in        18.33         NA       7.58       1.59         NA      27.50        090
                                                       bladder.
50782...............  ..............  A               Reimplant ureter in        19.51         NA       8.80       1.61         NA      29.92        090
                                                       bladder.
50783...............  ..............  A               Reimplant ureter in        20.52         NA       8.20       1.64         NA      30.36        090
                                                       bladder.
50785...............  ..............  A               Reimplant ureter in        20.49         NA       8.28       1.63         NA      30.40        090
                                                       bladder.
50800...............  ..............  A               Implant ureter in          14.50         NA       6.46       1.23         NA      22.19        090
                                                       bowel.
50810...............  ..............  A               Fusion of ureter &         20.02         NA       9.08       2.16         NA      31.26        090
                                                       bowel.
50815...............  ..............  A               Urine shunt to             19.90         NA       8.43       1.62         NA      29.95        090
                                                       intestine.
50820...............  ..............  A               Construct bowel            21.86         NA       8.62       1.83         NA      32.31        090
                                                       bladder.

[[Page 47630]]

 
50825...............  ..............  A               Construct bowel            28.14         NA      11.10       2.14         NA      41.38        090
                                                       bladder.
50830...............  ..............  A               Revise urine flow....      31.23         NA      12.15       2.58         NA      45.96        090
50840...............  ..............  A               Replace ureter by          19.97         NA       8.42       1.56         NA      29.95        090
                                                       bowel.
50845...............  ..............  A               Appendico-vesicostomy      20.86         NA       8.89       1.53         NA      31.28        090
50860...............  ..............  A               Transplant ureter to       15.34         NA       6.61       1.21         NA      23.16        090
                                                       skin.
50900...............  ..............  A               Repair of ureter.....      13.60         NA       6.13       1.26         NA      20.99        090
50920...............  ..............  A               Closure ureter/skin        14.31         NA       6.56       1.13         NA      22.00        090
                                                       fistula.
50930...............  ..............  A               Closure ureter/bowel       18.69         NA       7.96       1.28         NA      27.93        090
                                                       fistula.
50940...............  ..............  A               Release of ureter....      14.49         NA       6.39       1.40         NA      22.28        090
50945...............  ..............  A               Laparoscopy                16.97         NA       7.02       1.18         NA      25.17        090
                                                       ureterolithotomy.
50947...............  ..............  A               Laparo new ureter/         24.46         NA       9.66       1.97         NA      36.09        090
                                                       bladder.
50948...............  ..............  A               Laparo new ureter/         22.47         NA       8.67       1.60         NA      32.74        090
                                                       bladder.
50951...............  ..............  A               Endoscopy of ureter..       5.83       4.28       2.05       0.42      10.53       8.30        000
50953...............  ..............  A               Endoscopy of ureter..       6.23       4.40       2.36       0.44      11.07       9.03        000
50955...............  ..............  A               Ureter endoscopy &          6.74       6.66       2.68       0.46      13.86       9.88        000
                                                       biopsy.
50957...............  ..............  A               Ureter endoscopy &          6.78       4.56       2.37       0.48      11.82       9.63        000
                                                       treatment.
50959...............  ..............  A               Ureter endoscopy &          4.39         NA       1.88       0.25         NA       6.52        000
                                                       tracer.
50961...............  ..............  A               Ureter endoscopy &          6.04       4.36       2.18       0.42      10.82       8.64        000
                                                       treatment.
50970...............  ..............  A               Ureter endoscopy.....       7.13         NA       2.45       0.50         NA      10.08        000
50972...............  ..............  A               Ureter endoscopy &          6.88         NA       2.46       0.50         NA       9.84        000
                                                       catheter.
50974...............  ..............  A               Ureter endoscopy &          9.16         NA       3.10       0.63         NA      12.89        000
                                                       biopsy.
50976...............  ..............  A               Ureter endoscopy &          9.03         NA       3.06       0.64         NA      12.73        000
                                                       treatment.
50978...............  ..............  A               Ureter endoscopy &          5.09         NA       1.83       0.36         NA       7.28        000
                                                       tracer.
50980...............  ..............  A               Ureter endoscopy &          6.84         NA       2.36       0.51         NA       9.71        000
                                                       treatment.
51000...............  ..............  A               Drainage of bladder..       0.78       1.97       0.24       0.06       2.81       1.08        000
51005...............  ..............  A               Drainage of bladder..       1.02       4.75       0.34       0.09       5.86       1.45        000
51010...............  ..............  A               Drainage of bladder..       3.52       5.59       1.87       0.28       9.39       5.67        010
51020...............  ..............  A               Incise & treat              6.70         NA       3.91       0.53         NA      11.14        090
                                                       bladder.
51030...............  ..............  A               Incise & treat              6.76         NA       4.04       0.56         NA      11.36        090
                                                       bladder.
51040...............  ..............  A               Incise & drain              4.39         NA       2.82       0.33         NA       7.54        090
                                                       bladder.
51045...............  ..............  A               Incise bladder/drain        6.76         NA       4.00       0.58         NA      11.34        090
                                                       ureter.
51050...............  ..............  A               Removal of bladder          6.91         NA       3.69       0.50         NA      11.10        090
                                                       stone.
51060...............  ..............  A               Removal of ureter           8.84         NA       4.56       0.68         NA      14.08        090
                                                       stone.
51065...............  ..............  A               Remove ureter               8.84         NA       4.40       0.67         NA      13.91        090
                                                       calculus.
51080...............  ..............  A               Drainage of bladder         5.95         NA       3.61       0.47         NA      10.03        090
                                                       abscess.
51500...............  ..............  A               Removal of bladder         10.12         NA       5.03       1.10         NA      16.25        090
                                                       cyst.
51520...............  ..............  A               Removal of bladder          9.28         NA       4.72       0.72         NA      14.72        090
                                                       lesion.
51525...............  ..............  A               Removal of bladder         13.95         NA       6.17       1.05         NA      21.17        090
                                                       lesion.
51530...............  ..............  A               Removal of bladder         12.36         NA       5.80       1.12         NA      19.28        090
                                                       lesion.
51535...............  ..............  A               Repair of ureter           12.55         NA       6.16       1.20         NA      19.91        090
                                                       lesion.
51550...............  ..............  A               Partial removal of         15.64         NA       6.78       1.37         NA      23.79        090
                                                       bladder.
51555...............  ..............  A               Partial removal of         21.20         NA       8.71       1.80         NA      31.71        090
                                                       bladder.
51565...............  ..............  A               Revise bladder &           21.59         NA       9.01       1.69         NA      32.29        090
                                                       ureter(s).
51570...............  ..............  A               Removal of bladder...      24.20         NA       9.81       1.89         NA      35.90        090
51575...............  ..............  A               Removal of bladder &       30.40         NA      12.10       2.27         NA      44.77        090
                                                       nodes.
51580...............  ..............  A               Remove bladder/revise      31.03         NA      12.58       2.29         NA      45.90        090
                                                       tract.
51585...............  ..............  A               Removal of bladder &       35.18         NA      13.77       2.80         NA      51.75        090
                                                       nodes.
51590...............  ..............  A               Remove bladder/revise      32.61         NA      12.69       2.43         NA      47.73        090
                                                       tract.
51595...............  ..............  A               Remove bladder/revise      37.08         NA      14.19       2.74         NA      54.01        090
                                                       tract.
51596...............  ..............  A               Remove bladder/create      39.46         NA      15.30       2.88         NA      57.64        090
                                                       pouch.
51597...............  ..............  A               Removal of pelvic          38.29         NA      14.91       2.97         NA      56.17        090
                                                       structures.
51600...............  ..............  A               Injection for bladder       0.88       5.08       0.29       0.06       6.02       1.23        000
                                                       x-ray.
51605...............  ..............  A               Preparation for             0.64       6.03       0.35       0.04       6.71       1.03        000
                                                       bladder xray.
51610...............  ..............  A               Injection for bladder       1.05       2.33       0.60       0.07       3.45       1.72        000
                                                       x-ray.
51700...............  ..............  A               Irrigation of bladder       0.88       1.60       0.28       0.06       2.54       1.22        000
51701...............  ..............  A               Insert bladder              0.50       1.57       0.19       0.04       2.11       0.73        000
                                                       catheter.
51702...............  ..............  A               Insert temp bladder         0.50       2.08       0.24       0.04       2.62       0.78        000
                                                       cath.
51703...............  ..............  A               Insert bladder cath,        1.47       2.72       0.56       0.08       4.27       2.11        000
                                                       complex.
51705...............  ..............  A               Change of bladder           1.02       2.27       0.62       0.07       3.36       1.71        010
                                                       tube.
51710...............  ..............  A               Change of bladder           1.49       3.32       0.77       0.11       4.92       2.37        010
                                                       tube.
51715...............  ..............  A               Endoscopic injection/       3.73       3.88       1.35       0.29       7.90       5.37        000
                                                       implant.
51720...............  ..............  A               Treatment of bladder        1.96       1.74       0.69       0.14       3.84       2.79        000
                                                       lesion.
51725...............  ..............  A               Simple cystometrogram       1.51       5.58         NA       0.16       7.25         NA        000
51725...............  26............  A               Simple cystometrogram       1.51       0.49       0.49       0.12       2.12       2.12        000
51725...............  TC............  A               Simple cystometrogram       0.00       5.09         NA       0.04       5.13         NA        000
51726...............  ..............  A               Complex                     1.71       7.48         NA       0.18       9.37         NA        000
                                                       cystometrogram.
51726...............  26............  A               Complex                     1.71       0.56       0.56       0.13       2.40       2.40        000
                                                       cystometrogram.
51726...............  TC............  A               Complex                     0.00       6.92         NA       0.05       6.97         NA        000
                                                       cystometrogram.
51736...............  ..............  A               Urine flow                  0.61       0.58         NA       0.06       1.25         NA        000
                                                       measurement.
51736...............  26............  A               Urine flow                  0.61       0.20       0.20       0.05       0.86       0.86        000
                                                       measurement.
51736...............  TC............  A               Urine flow                  0.00       0.38         NA       0.01       0.39         NA        000
                                                       measurement.
51741...............  ..............  A               Electro-uroflowmetry,       1.14       0.80         NA       0.11       2.05         NA        000
                                                       first.
51741...............  26............  A               Electro-uroflowmetry,       1.14       0.37       0.37       0.09       1.60       1.60        000
                                                       first.
51741...............  TC............  A               Electro-uroflowmetry,       0.00       0.43         NA       0.02       0.45         NA        000
                                                       first.
51772...............  ..............  A               Urethra pressure            1.61       5.58         NA       0.19       7.38         NA        000
                                                       profile.

[[Page 47631]]

 
51772...............  26............  A               Urethra pressure            1.61       0.55       0.55       0.14       2.30       2.30        000
                                                       profile.
51772...............  TC............  A               Urethra pressure            0.00       5.03         NA       0.05       5.08         NA        000
                                                       profile.
51784...............  ..............  A               Anal/urinary muscle         1.53       3.99         NA       0.16       5.68         NA        000
                                                       study.
51784...............  26............  A               Anal/urinary muscle         1.53       0.50       0.50       0.12       2.15       2.15        000
                                                       study.
51784...............  TC............  A               Anal/urinary muscle         0.00       3.48         NA       0.04       3.52         NA        000
                                                       study.
51785...............  ..............  A               Anal/urinary muscle         1.53       4.44         NA       0.15       6.12         NA        000
                                                       study.
51785...............  26............  A               Anal/urinary muscle         1.53       0.50       0.50       0.11       2.14       2.14        000
                                                       study.
51785...............  TC............  A               Anal/urinary muscle         0.00       3.94         NA       0.04       3.98         NA        000
                                                       study.
51792...............  ..............  A               Urinary reflex study.       1.10       5.99         NA       0.20       7.29         NA        000
51792...............  26............  A               Urinary reflex study.       1.10       0.41       0.41       0.07       1.58       1.58        000
51792...............  TC............  A               Urinary reflex study.       0.00       5.57         NA       0.13       5.70         NA        000
51795...............  ..............  A               Urine voiding               1.53       7.28         NA       0.22       9.03         NA        000
                                                       pressure study.
51795...............  26............  A               Urine voiding               1.53       0.50       0.50       0.12       2.15       2.15        000
                                                       pressure study.
51795...............  TC............  A               Urine voiding               0.00       6.78         NA       0.10       6.88         NA        000
                                                       pressure study.
51797...............  ..............  A               Intraabdominal              1.60       5.76         NA       0.17       7.53         NA        000
                                                       pressure test.
51797...............  26............  A               Intraabdominal              1.60       0.52       0.52       0.12       2.24       2.24        000
                                                       pressure test.
51797...............  TC............  A               Intraabdominal              0.00       5.23         NA       0.05       5.28         NA        000
                                                       pressure test.
51798...............  ..............  A               Us urine capacity           0.00       0.34         NA       0.08       0.42         NA        XXX
                                                       measure.
51800...............  ..............  A               Revision of bladder/       17.39         NA       7.60       1.38         NA      26.37        090
                                                       urethra.
51820...............  ..............  A               Revision of urinary        17.86         NA       8.38       1.90         NA      28.14        090
                                                       tract.
51840...............  ..............  A               Attach bladder/            10.69         NA       5.56       1.10         NA      17.35        090
                                                       urethra.
51841...............  ..............  A               Attach bladder/            13.01         NA       6.37       1.30         NA      20.68        090
                                                       urethra.
51845...............  ..............  A               Repair bladder neck..       9.72         NA       4.80       0.81         NA      15.33        090
51860...............  ..............  A               Repair of bladder          12.00         NA       5.83       1.20         NA      19.03        090
                                                       wound.
51865...............  ..............  A               Repair of bladder          15.02         NA       6.74       1.33         NA      23.09        090
                                                       wound.
51880...............  ..............  A               Repair of bladder           7.65         NA       4.02       0.70         NA      12.37        090
                                                       opening.
51900...............  ..............  A               Repair bladder/vagina      12.95         NA       6.13       1.15         NA      20.23        090
                                                       lesion.
51920...............  ..............  A               Close bladder-uterus       11.79         NA       5.68       0.90         NA      18.37        090
                                                       fistula.
51925...............  ..............  A               Hysterectomy/bladder       15.56         NA       8.75       1.38         NA      25.69        090
                                                       repair.
51940...............  ..............  A               Correction of bladder      28.39         NA      12.23       2.39         NA      43.01        090
                                                       defect.
51960...............  ..............  A               Revision of bladder &      22.98         NA       9.74       1.73         NA      34.45        090
                                                       bowel.
51980...............  ..............  A               Construct bladder          11.34         NA       5.42       0.88         NA      17.64        090
                                                       opening.
51990...............  ..............  A               Laparo urethral            12.48         NA       6.13       1.41         NA      20.02        090
                                                       suspension.
51992...............  ..............  A               Laparo sling               13.99         NA       6.19       1.36         NA      21.54        090
                                                       operation.
52000...............  ..............  A               Cystoscopy...........       2.01       3.29       0.76       0.15       5.45       2.92        000
52001...............  ..............  A               Cystoscopy, removal         5.44       5.06       1.86       0.17      10.67       7.47        000
                                                       of clots.
52005...............  ..............  A               Cystoscopy & ureter         2.37       5.54       0.89       0.17       8.08       3.43        000
                                                       catheter.
52007...............  ..............  A               Cystoscopy and biopsy       3.02      16.43       1.15       0.22      19.67       4.39        000
52010...............  ..............  A               Cystoscopy & duct           3.02      10.81       1.15       0.22      14.05       4.39        000
                                                       catheter.
52204...............  ..............  A               Cystoscopy...........       2.37      14.45       0.90       0.17      16.99       3.44        000
52214...............  ..............  A               Cystoscopy and              3.70      37.93       1.33       0.27      41.90       5.30        000
                                                       treatment.
52224...............  ..............  A               Cystoscopy and              3.14      36.30       1.15       0.22      39.66       4.51        000
                                                       treatment.
52234...............  ..............  A               Cystoscopy and              4.62         NA       1.65       0.33         NA       6.60        000
                                                       treatment.
52235...............  ..............  A               Cystoscopy and              5.44         NA       1.93       0.39         NA       7.76        000
                                                       treatment.
52240...............  ..............  A               Cystoscopy and              9.71         NA       3.29       0.69         NA      13.69        000
                                                       treatment.
52250...............  ..............  A               Cystoscopy and              4.49         NA       1.65       0.33         NA       6.47        000
                                                       radiotracer.
52260...............  ..............  A               Cystoscopy and              3.91         NA       1.42       0.29         NA       5.62        000
                                                       treatment.
52265...............  ..............  A               Cystoscopy and              2.94      13.28       1.11       0.22      16.44       4.27        000
                                                       treatment.
52270...............  ..............  A               Cystoscopy & revise         3.36      10.99       1.24       0.24      14.59       4.84        000
                                                       urethra.
52275...............  ..............  A               Cystoscopy & revise         4.69      15.48       1.66       0.34      20.51       6.69        000
                                                       urethra.
52276...............  ..............  A               Cystoscopy and              4.99         NA       1.78       0.36         NA       7.13        000
                                                       treatment.
52277...............  ..............  A               Cystoscopy and              6.16         NA       2.22       0.45         NA       8.83        000
                                                       treatment.
52281...............  ..............  A               Cystoscopy and              2.80       7.07       1.08       0.20      10.07       4.08        000
                                                       treatment.
52282...............  ..............  A               Cystoscopy, implant         6.39         NA       2.23       0.46         NA       9.08        000
                                                       stent.
52283...............  ..............  A               Cystoscopy and              3.73       3.94       1.38       0.27       7.94       5.38        000
                                                       treatment.
52285...............  ..............  A               Cystoscopy and              3.60       4.00       1.33       0.27       7.87       5.20        000
                                                       treatment.
52290...............  ..............  A               Cystoscopy and              4.58         NA       1.65       0.33         NA       6.56        000
                                                       treatment.
52300...............  ..............  A               Cystoscopy and              5.30         NA       1.90       0.38         NA       7.58        000
                                                       treatment.
52301...............  ..............  A               Cystoscopy and              5.50         NA       1.99       0.48         NA       7.97        000
                                                       treatment.
52305...............  ..............  A               Cystoscopy and              5.30         NA       1.85       0.39         NA       7.54        000
                                                       treatment.
52310...............  ..............  A               Cystoscopy and              2.81       4.68       1.03       0.20       7.69       4.04        000
                                                       treatment.
52315...............  ..............  A               Cystoscopy and              5.20       8.68       1.83       0.37      14.25       7.40        000
                                                       treatment.
52317...............  ..............  A               Remove bladder stone.       6.71      28.82       2.27       0.48      36.01       9.46        000
52318...............  ..............  A               Remove bladder stone.       9.18         NA       3.09       0.66         NA      12.93        000
52320...............  ..............  A               Cystoscopy and              4.69         NA       1.63       0.34         NA       6.66        000
                                                       treatment.
52325...............  ..............  A               Cystoscopy, stone           6.15         NA       2.10       0.44         NA       8.69        000
                                                       removal.
52327...............  ..............  A               Cystoscopy, inject          5.18      31.67       1.81       0.39      37.24       7.38        000
                                                       material.
52330...............  ..............  A               Cystoscopy and              5.03      38.66       1.74       0.36      44.05       7.13        000
                                                       treatment.
52332...............  ..............  A               Cystoscopy and              2.83       5.73       1.05       0.21       8.77       4.09        000
                                                       treatment.
52334...............  ..............  A               Create passage to           4.82         NA       1.73       0.34         NA       6.89        000
                                                       kidney.
52341...............  ..............  A               Cysto w/ureter              5.99         NA       2.21       0.43         NA       8.63        000
                                                       stricture tx.
52342...............  ..............  A               Cysto w/up stricture        6.49         NA       2.34       0.47         NA       9.30        000
                                                       tx.
52343...............  ..............  A               Cysto w/renal               7.19         NA       2.57       0.51         NA      10.27        000
                                                       stricture tx.
52344...............  ..............  A               Cysto/uretero, stone        7.69         NA       2.79       0.56         NA      11.04        000
                                                       remove.
52345...............  ..............  A               Cysto/uretero w/up          8.19         NA       2.95       0.58         NA      11.72        000
                                                       stricture.

[[Page 47632]]

 
52346...............  ..............  A               Cystouretero w/renal        9.22         NA       3.27       0.67         NA      13.16        000
                                                       strict.
52347...............  ..............  A               Cystoscopy, resect          5.27         NA       1.70       0.38         NA       7.35        000
                                                       ducts.
52351...............  ..............  A               Cystouretero & or           5.85         NA       2.14       0.42         NA       8.41        000
                                                       pyeloscope.
52352...............  ..............  A               Cystouretero w/stone        6.87         NA       2.50       0.49         NA       9.86        000
                                                       remove.
52353...............  ..............  A               Cystouretero w/             7.96         NA       2.85       0.57         NA      11.38        000
                                                       lithotripsy.
52354...............  ..............  A               Cystouretero w/biopsy       7.33         NA       2.66       0.53         NA      10.52        000
52355...............  ..............  A               Cystouretero w/excise       8.81         NA       3.13       0.63         NA      12.57        000
                                                       tumor.
52400...............  ..............  A               Cystouretero w/congen       9.67         NA       3.75       0.69         NA      14.11        090
                                                       repr.
52450...............  ..............  A               Incision of prostate.       7.63         NA       3.68       0.55         NA      11.86        090
52500...............  ..............  A               Revision of bladder         8.46         NA       3.92       0.60         NA      12.98        090
                                                       neck.
52510...............  ..............  A               Dilation prostatic          6.71         NA       3.12       0.49         NA      10.32        090
                                                       urethra.
52601...............  ..............  A               Prostatectomy (TURP).      12.35         NA       5.11       0.88         NA      18.34        090
52606...............  ..............  A               Control postop              8.12         NA       3.55       0.58         NA      12.25        090
                                                       bleeding.
52612...............  ..............  A               Prostatectomy, first        7.97         NA       3.74       0.57         NA      12.28        090
                                                       stage.
52614...............  ..............  A               Prostatectomy, second       6.83         NA       3.35       0.49         NA      10.67        090
                                                       stage.
52620...............  ..............  A               Remove residual             6.60         NA       2.98       0.47         NA      10.05        090
                                                       prostate.
52630...............  ..............  A               Remove prostate             7.25         NA       3.19       0.52         NA      10.96        090
                                                       regrowth.
52640...............  ..............  A               Relieve bladder             6.61         NA       2.96       0.47         NA      10.04        090
                                                       contracture.
52647...............  ..............  A               Laser surgery of           10.34      73.74       4.53       0.74      84.82      15.61        090
                                                       prostate.
52648...............  ..............  A               Laser surgery of           11.19         NA       4.79       0.80         NA      16.78        090
                                                       prostate.
52700...............  ..............  A               Drainage of prostate        6.79         NA       3.18       0.49         NA      10.46        090
                                                       abscess.
53000...............  ..............  A               Incision of urethra..       2.28         NA       1.55       0.16         NA       3.99        010
53010...............  ..............  A               Incision of urethra..       3.63         NA       2.97       0.26         NA       6.86        090
53020...............  ..............  A               Incision of urethra..       1.77       2.99       0.67       0.13       4.89       2.57        000
53025...............  ..............  A               Incision of urethra..       1.13       3.71       0.51       0.09       4.93       1.73        000
53040...............  ..............  A               Drainage of urethra         6.39         NA       3.43       0.47         NA      10.29        090
                                                       abscess.
53060...............  ..............  A               Drainage of urethra         2.63       2.09       1.37       0.27       4.99       4.27        010
                                                       abscess.
53080...............  ..............  A               Drainage of urinary         6.28         NA       6.06       0.55         NA      12.89        090
                                                       leakage.
53085...............  ..............  A               Drainage of urinary        10.25         NA       7.45       0.92         NA      18.62        090
                                                       leakage.
53200...............  ..............  A               Biopsy of urethra....       2.59       1.32       0.98       0.20       4.11       3.77        000
53210...............  ..............  A               Removal of urethra...      12.55         NA       5.91       1.00         NA      19.46        090
53215...............  ..............  A               Removal of urethra...      15.56         NA       6.69       1.13         NA      23.38        090
53220...............  ..............  A               Treatment of urethra        6.99         NA       3.79       0.54         NA      11.32        090
                                                       lesion.
53230...............  ..............  A               Removal of urethra          9.57         NA       4.76       0.72         NA      15.05        090
                                                       lesion.
53235...............  ..............  A               Removal of urethra         10.12         NA       4.96       0.79         NA      15.87        090
                                                       lesion.
53240...............  ..............  A               Surgery for urethra         6.44         NA       3.59       0.54         NA      10.57        090
                                                       pouch.
53250...............  ..............  A               Removal of urethra          5.88         NA       3.35       0.50         NA       9.73        090
                                                       gland.
53260...............  ..............  A               Treatment of urethra        2.98       2.25       1.42       0.26       5.49       4.66        010
                                                       lesion.
53265...............  ..............  A               Treatment of urethra        3.12       2.71       1.42       0.24       6.07       4.78        010
                                                       lesion.
53270...............  ..............  A               Removal of urethra          3.09       2.20       1.54       0.32       5.61       4.95        010
                                                       gland.
53275...............  ..............  A               Repair of urethra           4.52         NA       2.24       0.33         NA       7.09        010
                                                       defect.
53400...............  ..............  A               Revise urethra, stage      12.75         NA       6.02       1.04         NA      19.81        090
                                                       1.
53405...............  ..............  A               Revise urethra, stage      14.46         NA       6.37       1.22         NA      22.05        090
                                                       2.
53410...............  ..............  A               Reconstruction of          16.42         NA       7.12       1.21         NA      24.75        090
                                                       urethra.
53415...............  ..............  A               Reconstruction of          19.38         NA       7.40       1.46         NA      28.24        090
                                                       urethra.
53420...............  ..............  A               Reconstruct urethra,       14.06         NA       6.43       0.98         NA      21.47        090
                                                       stage 1.
53425...............  ..............  A               Reconstruct urethra,       15.96         NA       6.96       1.16         NA      24.08        090
                                                       stage 2.
53430...............  ..............  A               Reconstruction of          16.32         NA       7.05       1.27         NA      24.64        090
                                                       urethra.
53431...............  ..............  A               Reconstruct urethra/       19.86         NA       8.09       1.44         NA      29.39        090
                                                       bladder.
53440...............  ..............  A               Male sling procedure.      13.60         NA       5.97       0.89         NA      20.46        090
53442...............  ..............  A               Remove/revise male         11.55         NA       5.45       0.61         NA      17.61        090
                                                       sling.
53444...............  ..............  A               Insert tandem cuff...      13.38         NA       5.87       0.99         NA      20.24        090
53445...............  ..............  A               Insert uro/ves nck         14.04         NA       7.14       1.03         NA      22.21        090
                                                       sphincter.
53446...............  ..............  A               Remove uro sphincter.      10.21         NA       5.21       0.74         NA      16.16        090
53447...............  ..............  A               Remove/replace ur          13.47         NA       6.41       0.98         NA      20.86        090
                                                       sphincter.
53448...............  ..............  A               Remov/replc ur             21.12         NA       9.03       1.51         NA      31.66        090
                                                       sphinctr comp.
53449...............  ..............  A               Repair uro sphincter.       9.69         NA       4.77       0.65         NA      15.11        090
53450...............  ..............  A               Revision of urethra..       6.13         NA       3.35       0.44         NA       9.92        090
53460...............  ..............  A               Revision of urethra..       7.11         NA       3.75       0.53         NA      11.39        090
53500...............  ..............  A               Urethrlys, transvag w/     12.19         NA       6.19       0.91         NA      19.29        090
                                                        scope.
53502...............  ..............  A               Repair of urethra           7.62         NA       4.06       0.63         NA      12.31        090
                                                       injury.
53505...............  ..............  A               Repair of urethra           7.62         NA       3.92       0.55         NA      12.09        090
                                                       injury.
53510...............  ..............  A               Repair of urethra          10.09         NA       5.23       0.74         NA      16.06        090
                                                       injury.
53515...............  ..............  A               Repair of urethra          13.29         NA       5.98       0.95         NA      20.22        090
                                                       injury.
53520...............  ..............  A               Repair of urethra           8.67         NA       4.53       0.64         NA      13.84        090
                                                       defect.
53600...............  ..............  A               Dilate urethra              1.21       1.14       0.42       0.09       2.44       1.72        000
                                                       stricture.
53601...............  ..............  A               Dilate urethra              0.98       1.26       0.37       0.07       2.31       1.42        000
                                                       stricture.
53605...............  ..............  A               Dilate urethra              1.28         NA       0.41       0.09         NA       1.78        000
                                                       stricture.
53620...............  ..............  A               Dilate urethra              1.62       1.99       0.59       0.12       3.73       2.33        000
                                                       stricture.
53621...............  ..............  A               Dilate urethra              1.35       2.06       0.49       0.10       3.51       1.94        000
                                                       stricture.
53660...............  ..............  A               Dilation of urethra..       0.71       1.31       0.31       0.05       2.07       1.07        000
53661...............  ..............  A               Dilation of urethra..       0.72       1.30       0.29       0.05       2.07       1.06        000
53665...............  ..............  A               Dilation of urethra..       0.76         NA       0.25       0.06         NA       1.07        000
53850...............  ..............  A               Prostatic microwave         9.44      94.10       3.94       0.67     104.21      14.05        090
                                                       thermotx.
53852...............  ..............  A               Prostatic rf thermotx       9.87      88.49       4.37       0.70      99.06      14.94        090

[[Page 47633]]

 
53853...............  ..............  A               Prostatic water             5.23      55.09       2.85       0.29      60.61       8.37        090
                                                       thermother.
54000...............  ..............  A               Slitting of prepuce..       1.54       2.91       0.93       0.11       4.56       2.58        010
54001...............  ..............  A               Slitting of prepuce..       2.19       3.18       1.11       0.16       5.53       3.46        010
54015...............  ..............  A               Drain penis lesion...       5.31         NA       2.55       0.40         NA       8.26        010
54050...............  ..............  A               Destruction, penis          1.24       1.67       1.04       0.10       3.01       2.38        010
                                                       lesion(s).
54055...............  ..............  A               Destruction, penis          1.22       1.57       0.80       0.09       2.88       2.11        010
                                                       lesion(s).
54056...............  ..............  A               Cryosurgery, penis          1.24       1.70       1.14       0.10       3.04       2.48        010
                                                       lesion(s).
54057...............  ..............  A               Laser surg, penis           1.24       2.22       0.83       0.09       3.55       2.16        010
                                                       lesion(s).
54060...............  ..............  A               Excision of penis           1.93       3.09       1.06       0.15       5.17       3.14        010
                                                       lesion(s).
54065...............  ..............  A               Destruction, penis          2.42       2.63       1.23       0.19       5.24       3.84        010
                                                       lesion(s).
54100...............  ..............  A               Biopsy of penis......       1.90       2.82       0.82       0.15       4.87       2.87        000
54105...............  ..............  A               Biopsy of penis......       3.49       4.28       1.93       0.25       8.02       5.67        010
54110...............  ..............  A               Treatment of penis         10.11         NA       4.75       0.74         NA      15.60        090
                                                       lesion.
54111...............  ..............  A               Treat penis lesion,        13.55         NA       5.75       0.96         NA      20.26        090
                                                       graft.
54112...............  ..............  A               Treat penis lesion,        15.84         NA       6.78       1.13         NA      23.75        090
                                                       graft.
54115...............  ..............  A               Treatment of penis          6.14       4.37       3.45       0.44      10.95      10.03        090
                                                       lesion.
54120...............  ..............  A               Partial removal of          9.96         NA       4.67       0.72         NA      15.35        090
                                                       penis.
54125...............  ..............  A               Removal of penis.....      13.51         NA       5.82       0.99         NA      20.32        090
54130...............  ..............  A               Remove penis & nodes.      20.11         NA       8.16       1.43         NA      29.70        090
54135...............  ..............  A               Remove penis & nodes.      26.32         NA      10.15       1.87         NA      38.34        090
54150...............  ..............  A               Circumcision.........       1.81       4.53       0.97       0.19       6.53       2.97        010
54152...............  ..............  A               Circumcision.........       2.31         NA       1.20       0.19         NA       3.70        010
54160...............  ..............  A               Circumcision.........       2.48       4.13       1.09       0.19       6.80       3.76        010
54161...............  ..............  A               Circumcision.........       3.27         NA       1.56       0.24         NA       5.07        010
54162...............  ..............  A               Lysis penil circumic        3.00       4.63       1.44       0.22       7.85       4.66        010
                                                       lesion.
54163...............  ..............  A               Repair of                   3.00         NA       2.00       0.22         NA       5.22        010
                                                       circumcision.
54164...............  ..............  A               Frenulotomy of penis.       2.50         NA       1.83       0.18         NA       4.51        010
54200...............  ..............  A               Treatment of penis          1.06       1.79       0.98       0.08       2.93       2.12        010
                                                       lesion.
54205...............  ..............  A               Treatment of penis          7.92         NA       4.73       0.56         NA      13.21        090
                                                       lesion.
54220...............  ..............  A               Treatment of penis          2.42       3.83       0.95       0.18       6.43       3.55        000
                                                       lesion.
54230...............  ..............  A               Prepare penis study..       1.34       1.08       0.63       0.10       2.52       2.07        000
54231...............  ..............  A               Dynamic                     2.04       1.38       0.87       0.15       3.57       3.06        000
                                                       cavernosometry.
54235...............  ..............  A               Penile injection.....       1.19       0.96       0.58       0.09       2.24       1.86        000
54240...............  ..............  A               Penis study..........       1.31       1.01         NA       0.17       2.49         NA        000
54240...............  26............  A               Penis study..........       1.31       0.43       0.43       0.11       1.85       1.85        000
54240...............  TC............  A               Penis study..........       0.00       0.59         NA       0.06       0.65         NA        000
54250...............  ..............  A               Penis study..........       2.22       0.92         NA       0.19       3.33         NA        000
54250...............  26............  A               Penis study..........       2.22       0.71       0.71       0.17       3.10       3.10        000
54250...............  TC............  A               Penis study..........       0.00       0.21         NA       0.02       0.23         NA        000
54300...............  ..............  A               Revision of penis....      10.39         NA       5.65       0.74         NA      16.78        090
54304...............  ..............  A               Revision of penis....      12.47         NA       6.43       0.92         NA      19.82        090
54308...............  ..............  A               Reconstruction of          11.81         NA       6.05       0.84         NA      18.70        090
                                                       urethra.
54312...............  ..............  A               Reconstruction of          13.55         NA       7.07       0.96         NA      21.58        090
                                                       urethra.
54316...............  ..............  A               Reconstruction of          16.79         NA       8.05       1.21         NA      26.05        090
                                                       urethra.
54318...............  ..............  A               Reconstruction of          11.23         NA       5.88       0.80         NA      17.91        090
                                                       urethra.
54322...............  ..............  A               Reconstruction of          12.99         NA       6.53       0.99         NA      20.51        090
                                                       urethra.
54324...............  ..............  A               Reconstruction of          16.29         NA       8.10       1.48         NA      25.87        090
                                                       urethra.
54326...............  ..............  A               Reconstruction of          15.70         NA       7.89       1.12         NA      24.71        090
                                                       urethra.
54328...............  ..............  A               Revise penis/urethra.      15.63         NA       7.33       1.11         NA      24.07        090
54332...............  ..............  A               Revise penis/urethra.      17.05         NA       7.82       1.21         NA      26.08        090
54336...............  ..............  A               Revise penis/urethra.      20.01         NA      10.59       1.42         NA      32.02        090
54340...............  ..............  A               Secondary urethral          8.90         NA       5.16       0.59         NA      14.65        090
                                                       surgery.
54344...............  ..............  A               Secondary urethral         15.92         NA       7.86       1.13         NA      24.91        090
                                                       surgery.
54348...............  ..............  A               Secondary urethral         17.12         NA       8.48       1.18         NA      26.78        090
                                                       surgery.
54352...............  ..............  A               Reconstruct urethra/       24.70         NA      11.36       1.81         NA      37.87        090
                                                       penis.
54360...............  ..............  A               Penis plastic surgery      11.91         NA       6.08       0.86         NA      18.85        090
54380...............  ..............  A               Repair penis.........      13.16         NA       6.78       1.00         NA      20.94        090
54385...............  ..............  A               Repair penis.........      15.37         NA       8.57       1.20         NA      25.14        090
54390...............  ..............  A               Repair penis and           21.58         NA       9.47       1.28         NA      32.33        090
                                                       bladder.
54400...............  ..............  A               Insert semi-rigid           8.98         NA       4.40       0.65         NA      14.03        090
                                                       prosthesis.
54401...............  ..............  A               Insert self-contd          10.26         NA       5.75       0.73         NA      16.74        090
                                                       prosthesis.
54405...............  ..............  A               Insert multi-comp          13.41         NA       5.98       0.99         NA      20.38        090
                                                       penis pros.
54406...............  ..............  A               Remove muti-comp           12.08         NA       5.41       0.88         NA      18.37        090
                                                       penis pros.
54408...............  ..............  A               Repair multi-comp          12.73         NA       5.72       0.92         NA      19.37        090
                                                       penis pros.
54410...............  ..............  A               Remove/replace penis       15.48         NA       6.61       1.13         NA      23.22        090
                                                       prosth.
54411...............  ..............  A               Remov/replc penis          15.98         NA       7.02       1.17         NA      24.17        090
                                                       pros, comp.
54415...............  ..............  A               Remove self-contd           8.19         NA       4.18       0.59         NA      12.96        090
                                                       penis pros.
54416...............  ..............  A               Remv/repl penis            10.85         NA       5.36       0.79         NA      17.00        090
                                                       contain pros.
54417...............  ..............  A               Remv/replc penis           14.17         NA       6.15       1.01         NA      21.33        090
                                                       pros, compl.
54420...............  ..............  A               Revision of penis....      11.40         NA       5.63       0.91         NA      17.94        090
54430...............  ..............  A               Revision of penis....      10.13         NA       5.16       0.73         NA      16.02        090
54435...............  ..............  A               Revision of penis....       6.11         NA       3.66       0.47         NA      10.24        090
54450...............  ..............  A               Preputial stretching.       1.12       0.95       0.44       0.08       2.15       1.64        000
54500...............  ..............  A               Biopsy of testis.....       1.31       0.60       0.56       0.11       2.02       1.98        000
54505...............  ..............  A               Biopsy of testis.....       3.45         NA       1.91       0.28         NA       5.64        010

[[Page 47634]]

 
54512...............  ..............  A               Excise lesion testis.       8.57         NA       4.12       0.65         NA      13.34        090
54520...............  ..............  A               Removal of testis....       5.22         NA       2.81       0.50         NA       8.53        090
54522...............  ..............  A               Orchiectomy, partial.       9.49         NA       4.85       0.91         NA      15.25        090
54530...............  ..............  A               Removal of testis....       8.57         NA       4.26       0.68         NA      13.51        090
54535...............  ..............  A               Extensive testis           12.14         NA       5.59       1.09         NA      18.82        090
                                                       surgery.
54550...............  ..............  A               Exploration for             7.77         NA       3.84       0.63         NA      12.24        090
                                                       testis.
54560...............  ..............  A               Exploration for            11.11         NA       5.20       0.96         NA      17.27        090
                                                       testis.
54600...............  ..............  A               Reduce testis torsion       7.00         NA       3.57       0.53         NA      11.10        090
54620...............  ..............  A               Suspension of testis.       4.89         NA       2.43       0.42         NA       7.74        010
54640...............  ..............  A               Suspension of testis.       6.89         NA       3.76       0.63         NA      11.28        090
54650...............  ..............  A               Orchiopexy (Fowler-        11.43         NA       5.45       1.41         NA      18.29        090
                                                       Stephens).
54660...............  ..............  A               Revision of testis...       5.10         NA       3.01       0.40         NA       8.51        090
54670...............  ..............  A               Repair testis injury.       6.40         NA       3.56       0.50         NA      10.46        090
54680...............  ..............  A               Relocation of              12.63         NA       6.22       1.23         NA      20.08        090
                                                       testis(es).
54690...............  ..............  A               Laparoscopy,               10.94         NA       4.99       1.23         NA      17.16        090
                                                       orchiectomy.
54692...............  ..............  A               Laparoscopy,               12.86         NA       5.40       1.05         NA      19.31        090
                                                       orchiopexy.
54700...............  ..............  A               Drainage of scrotum..       3.42         NA       1.93       0.28         NA       5.63        010
54800...............  ..............  A               Biopsy of epididymis.       2.33       0.94       0.89       0.22       3.49       3.44        000
54820...............  ..............  A               Exploration of              5.13         NA       2.96       0.39         NA       8.48        090
                                                       epididymis.
54830...............  ..............  A               Remove epididymis           5.37         NA       3.04       0.42         NA       8.83        090
                                                       lesion.
54840...............  ..............  A               Remove epididymis           5.19         NA       2.80       0.37         NA       8.36        090
                                                       lesion.
54860...............  ..............  A               Removal of epididymis       6.31         NA       3.33       0.46         NA      10.10        090
54861...............  ..............  A               Removal of epididymis       8.89         NA       4.33       0.64         NA      13.86        090
54900...............  ..............  A               Fusion of spermatic        13.18         NA       5.80       1.62         NA      20.60        090
                                                       ducts.
54901...............  ..............  A               Fusion of spermatic        17.91         NA       7.55       1.28         NA      26.74        090
                                                       ducts.
55000...............  ..............  A               Drainage of hydrocele       1.43       2.06       0.65       0.12       3.61       2.20        000
55040...............  ..............  A               Removal of hydrocele.       5.35         NA       2.92       0.44         NA       8.71        090
55041...............  ..............  A               Removal of hydroceles       7.73         NA       3.98       0.60         NA      12.31        090
55060...............  ..............  A               Repair of hydrocele..       5.51         NA       3.09       0.46         NA       9.06        090
55100...............  ..............  A               Drainage of scrotum         2.13       3.67       1.56       0.17       5.97       3.86        010
                                                       abscess.
55110...............  ..............  A               Explore scrotum......       5.69         NA       3.12       0.45         NA       9.26        090
55120...............  ..............  A               Removal of scrotum          5.08         NA       2.94       0.39         NA       8.41        090
                                                       lesion.
55150...............  ..............  A               Removal of scrotum...       7.21         NA       3.83       0.58         NA      11.62        090
55175...............  ..............  A               Revision of scrotum..       5.23         NA       3.00       0.40         NA       8.63        090
55180...............  ..............  A               Revision of scrotum..      10.70         NA       5.34       0.85         NA      16.89        090
55200...............  ..............  A               Incision of sperm           4.23      12.26       2.37       0.30      16.79       6.90        090
                                                       duct.
55250...............  ..............  A               Removal of sperm            3.29      11.44       2.21       0.26      14.99       5.76        090
                                                       duct(s).
55300...............  ..............  A               Prepare, sperm duct x-      3.50         NA       1.31       0.26         NA       5.07        000
                                                       ray.
55400...............  ..............  A               Repair of sperm duct.       8.48         NA       4.05       0.74         NA      13.27        090
55450...............  ..............  A               Ligation of sperm           4.11       6.96       1.86       0.29      11.36       6.26        010
                                                       duct.
55500...............  ..............  A               Removal of hydrocele.       5.58         NA       3.11       0.55         NA       9.24        090
55520...............  ..............  A               Removal of sperm cord       6.02         NA       3.28       0.73         NA      10.03        090
                                                       lesion.
55530...............  ..............  A               Revise spermatic cord       5.65         NA       3.03       0.46         NA       9.14        090
                                                       veins.
55535...............  ..............  A               Revise spermatic cord       6.55         NA       3.41       0.53         NA      10.49        090
                                                       veins.
55540...............  ..............  A               Revise hernia & sperm       7.66         NA       3.83       0.94         NA      12.43        090
                                                       veins.
55550...............  ..............  A               Laparo ligate               6.56         NA       3.29       0.66         NA      10.51        090
                                                       spermatic vein.
55600...............  ..............  A               Incise sperm duct           6.37         NA       3.35       0.59         NA      10.31        090
                                                       pouch.
55605...............  ..............  A               Incise sperm duct           7.95         NA       4.32       0.97         NA      13.24        090
                                                       pouch.
55650...............  ..............  A               Remove sperm duct          11.78         NA       5.29       0.95         NA      18.02        090
                                                       pouch.
55680...............  ..............  A               Remove sperm pouch          5.18         NA       2.98       0.47         NA       8.63        090
                                                       lesion.
55700...............  ..............  A               Biopsy of prostate...       1.57       4.18       0.64       0.11       5.86       2.32        000
55705...............  ..............  A               Biopsy of prostate...       4.56         NA       2.29       0.33         NA       7.18        010
55720...............  ..............  A               Drainage of prostate        7.63         NA       3.88       0.55         NA      12.06        090
                                                       abscess.
55725...............  ..............  A               Drainage of prostate        8.67         NA       4.55       0.74         NA      13.96        090
                                                       abscess.
55801...............  ..............  A               Removal of prostate..      17.77         NA       7.65       1.37         NA      26.79        090
55810...............  ..............  A               Extensive prostate         22.55         NA       8.99       1.66         NA      33.20        090
                                                       surgery.
55812...............  ..............  A               Extensive prostate         27.47         NA      11.03       2.22         NA      40.72        090
                                                       surgery.
55815...............  ..............  A               Extensive prostate         30.41         NA      11.94       2.39         NA      44.74        090
                                                       surgery.
55821...............  ..............  A               Removal of prostate..      14.23         NA       6.24       1.05         NA      21.52        090
55831...............  ..............  A               Removal of prostate..      15.60         NA       6.69       1.16         NA      23.45        090
55840...............  ..............  A               Extensive prostate         22.66         NA       9.33       1.68         NA      33.67        090
                                                       surgery.
55842...............  ..............  A               Extensive prostate         24.34         NA       9.89       1.82         NA      36.05        090
                                                       surgery.
55845...............  ..............  A               Extensive prostate         28.51         NA      10.99       2.13         NA      41.63        090
                                                       surgery.
55859...............  ..............  A               Percut/needle insert,      12.50         NA       5.87       0.88         NA      19.25        090
                                                       pros.
55860...............  ..............  A               Surgical exposure,         14.43         NA       6.45       0.99         NA      21.87        090
                                                       prostate.
55862...............  ..............  A               Extensive prostate         18.36         NA       7.88       1.31         NA      27.55        090
                                                       surgery.
55865...............  ..............  A               Extensive prostate         22.84         NA       9.29       1.73         NA      33.86        090
                                                       surgery.
55866...............  ..............  A               Laparo radical             30.69         NA      11.68       1.68         NA      44.05        090
                                                       prostatectomy.
55870...............  ..............  A               Electroejaculation...       2.58       1.53       1.08       0.17       4.28       3.83        000
55873...............  ..............  A               Cryoablate prostate..      19.44         NA       8.92       1.39         NA      29.75        090
56405...............  ..............  A               I & D of vulva/             1.44       1.33       1.14       0.17       2.94       2.75        010
                                                       perineum.
56420...............  ..............  A               Drainage of gland           1.39       2.28       1.05       0.15       3.82       2.59        010
                                                       abscess.
56440...............  ..............  A               Surgery for vulva           2.84         NA       1.71       0.34         NA       4.89        010
                                                       lesion.
56441...............  ..............  A               Lysis of labial             1.97       1.81       1.42       0.19       3.97       3.58        010
                                                       lesion(s).
56501...............  ..............  A               Destroy, vulva              1.53       1.78       1.25       0.18       3.49       2.96        010
                                                       lesions, sim.

[[Page 47635]]

 
56515...............  ..............  A               Destroy vulva lesion/       2.76       2.55       1.81       0.32       5.63       4.89        010
                                                       s compl.
56605...............  ..............  A               Biopsy of vulva/            1.10       1.08       0.46       0.13       2.31       1.69        000
                                                       perineum.
56606...............  ..............  A               Biopsy of vulva/            0.55       0.49       0.22       0.07       1.11       0.84        ZZZ
                                                       perineum.
56620...............  ..............  A               Partial removal of          7.46         NA       4.83       0.89         NA      13.18        090
                                                       vulva.
56625...............  ..............  A               Complete removal of         8.39         NA       5.39       1.00         NA      14.78        090
                                                       vulva.
56630...............  ..............  A               Extensive vulva            12.34         NA       6.96       1.45         NA      20.75        090
                                                       surgery.
56631...............  ..............  A               Extensive vulva            16.18         NA       8.98       1.92         NA      27.08        090
                                                       surgery.
56632...............  ..............  A               Extensive vulva            20.26         NA       9.64       2.35         NA      32.25        090
                                                       surgery.
56633...............  ..............  A               Extensive vulva            16.45         NA       8.71       1.93         NA      27.09        090
                                                       surgery.
56634...............  ..............  A               Extensive vulva            17.85         NA       9.60       2.09         NA      29.54        090
                                                       surgery.
56637...............  ..............  A               Extensive vulva            21.94         NA      11.24       2.56         NA      35.74        090
                                                       surgery.
56640...............  ..............  A               Extensive vulva            22.14         NA      10.78       2.61         NA      35.53        090
                                                       surgery.
56700...............  ..............  A               Partial removal of          2.52         NA       1.83       0.29         NA       4.64        010
                                                       hymen.
56720...............  ..............  A               Incision of hymen....       0.68         NA       0.51       0.08         NA       1.27        000
56740...............  ..............  A               Remove vagina gland         4.56         NA       2.56       0.55         NA       7.67        010
                                                       lesion.
56800...............  ..............  A               Repair of vagina.....       3.88         NA       2.18       0.44         NA       6.50        010
56805...............  ..............  A               Repair clitoris......      18.83         NA       9.38       2.08         NA      30.29        090
56810...............  ..............  A               Repair of perineum...       4.12         NA       2.29       0.48         NA       6.89        010
56820...............  ..............  A               Exam of vulva w/scope       1.50       1.32       0.65       0.11       2.93       2.26        000
56821...............  ..............  A               Exam/biopsy of vulva        2.05       1.76       0.91       0.15       3.96       3.11        000
                                                       w/scope.
57000...............  ..............  A               Exploration of vagina       2.97         NA       1.72       0.30         NA       4.99        010
57010...............  ..............  A               Drainage of pelvic          6.02         NA       3.83       0.69         NA      10.54        090
                                                       abscess.
57020...............  ..............  A               Drainage of pelvic          1.50       0.95       0.59       0.18       2.63       2.27        000
                                                       fluid.
57022...............  ..............  A               I & d vaginal               2.56         NA       1.50       0.27         NA       4.33        010
                                                       hematoma, pp.
57023...............  ..............  A               I & d vag hematoma,         4.74         NA       2.57       0.55         NA       7.86        010
                                                       non-ob.
57061...............  ..............  A               Destroy vag lesions,        1.25       1.66       1.12       0.15       3.06       2.52        010
                                                       simple.
57065...............  ..............  A               Destroy vag lesions,        2.61       2.30       1.68       0.31       5.22       4.60        010
                                                       complex.
57100...............  ..............  A               Biopsy of vagina.....       1.20       1.09       0.48       0.14       2.43       1.82        000
57105...............  ..............  A               Biopsy of vagina.....       1.69       1.79       1.43       0.20       3.68       3.32        010
57106...............  ..............  A               Remove vagina wall,         6.35         NA       4.19       0.73         NA      11.27        090
                                                       partial.
57107...............  ..............  A               Remove vagina tissue,      22.97         NA      10.45       2.67         NA      36.09        090
                                                       part.
57109...............  ..............  A               Vaginectomy partial w/     26.96         NA      11.28       3.10         NA      41.34        090
                                                       nodes.
57110...............  ..............  A               Remove vagina wall,        14.27         NA       7.28       1.67         NA      23.22        090
                                                       complete.
57111...............  ..............  A               Remove vagina tissue,      26.96         NA      12.58       2.95         NA      42.49        090
                                                       compl.
57112...............  ..............  A               Vaginectomy w/nodes,       28.96         NA      12.12       2.61         NA      43.69        090
                                                       compl.
57120...............  ..............  A               Closure of vagina....       7.40         NA       4.62       0.87         NA      12.89        090
57130...............  ..............  A               Remove vagina lesion.       2.43       2.16       1.54       0.27       4.86       4.24        010
57135...............  ..............  A               Remove vagina lesion.       2.67       2.27       1.65       0.31       5.25       4.63        010
57150...............  ..............  A               Treat vagina                0.55       1.10       0.21       0.07       1.72       0.83        000
                                                       infection.
57155...............  ..............  A               Insert uteri tandems/       6.26         NA       4.61       0.45         NA      11.32        090
                                                       ovoids.
57160...............  ..............  A               Insert pessary/other        0.89       1.01       0.34       0.10       2.00       1.33        000
                                                       device.
57170...............  ..............  A               Fitting of diaphragm/       0.91       1.49       0.33       0.11       2.51       1.35        000
                                                       cap.
57180...............  ..............  A               Treat vaginal               1.58       2.17       1.27       0.18       3.93       3.03        010
                                                       bleeding.
57200...............  ..............  A               Repair of vagina.....       3.93         NA       2.89       0.45         NA       7.27        090
57210...............  ..............  A               Repair vagina/              5.16         NA       3.43       0.61         NA       9.20        090
                                                       perineum.
57220...............  ..............  A               Revision of urethra..       4.30         NA       3.10       0.50         NA       7.90        090
57230...............  ..............  A               Repair of urethral          5.63         NA       3.40       0.57         NA       9.60        090
                                                       lesion.
57240...............  ..............  A               Repair bladder &            6.06         NA       3.81       0.62         NA      10.49        090
                                                       vagina.
57250...............  ..............  A               Repair rectum &             5.52         NA       3.57       0.64         NA       9.73        090
                                                       vagina.
57260...............  ..............  A               Repair of vagina.....       8.26         NA       4.83       0.96         NA      14.05        090
57265...............  ..............  A               Extensive repair of        11.32         NA       6.03       1.32         NA      18.67        090
                                                       vagina.
57268...............  ..............  A               Repair of bowel bulge       6.75         NA       4.19       0.78         NA      11.72        090
57270...............  ..............  A               Repair of bowel pouch      12.09         NA       6.24       1.39         NA      19.72        090
57280...............  ..............  A               Suspension of vagina.      15.02         NA       7.35       1.65         NA      24.02        090
57282...............  ..............  A               Repair of vaginal           8.85         NA       5.29       1.02         NA      15.16        090
                                                       prolapse.
57284...............  ..............  A               Repair paravaginal         12.68         NA       7.13       1.44         NA      21.25        090
                                                       defect.
57287...............  ..............  A               Revise/remove sling        10.69         NA       5.46       0.91         NA      17.06        090
                                                       repair.
57288...............  ..............  A               Repair bladder defect      13.00         NA       5.90       1.14         NA      20.04        090
57289...............  ..............  A               Repair bladder &           11.56         NA       6.03       1.17         NA      18.76        090
                                                       vagina.
57291...............  ..............  A               Construction of             7.94         NA       4.92       0.94         NA      13.80        090
                                                       vagina.
57292...............  ..............  A               Construct vagina with      13.07         NA       6.93       1.57         NA      21.57        090
                                                       graft.
57300...............  ..............  A               Repair rectum-vagina        7.60         NA       4.29       0.88         NA      12.77        090
                                                       fistula.
57305...............  ..............  A               Repair rectum-vagina       13.75         NA       6.26       1.67         NA      21.68        090
                                                       fistula.
57307...............  ..............  A               Fistula repair &           15.91         NA       7.02       1.96         NA      24.89        090
                                                       colostomy.
57308...............  ..............  A               Fistula repair,             9.93         NA       5.13       1.12         NA      16.18        090
                                                       transperine.
57310...............  ..............  A               Repair urethrovaginal       6.77         NA       3.86       0.57         NA      11.20        090
                                                       lesion.
57311...............  ..............  A               Repair urethrovaginal       7.97         NA       4.14       0.68         NA      12.79        090
                                                       lesion.
57320...............  ..............  A               Repair bladder-vagina       8.00         NA       4.39       0.65         NA      13.04        090
                                                       lesion.
57330...............  ..............  A               Repair bladder-vagina      12.33         NA       5.73       1.07         NA      19.13        090
                                                       lesion.
57335...............  ..............  A               Repair vagina........      18.70         NA       9.03       1.84         NA      29.57        090
57400...............  ..............  A               Dilation of vagina...       2.27         NA       1.11       0.26         NA       3.64        000
57410...............  ..............  A               Pelvic examination...       1.75       2.02       0.89       0.17       3.94       2.81        000
57415...............  ..............  A               Remove vaginal              2.17         NA       1.43       0.23         NA       3.83        010
                                                       foreign body.
57420...............  ..............  A               Exam of vagina w/           1.60       1.36       0.67       0.11       3.07       2.38        000
                                                       scope.
57421...............  ..............  A               Exam/biopsy of vag w/       2.20       1.85       0.96       0.15       4.20       3.31        000
                                                       scope.

[[Page 47636]]

 
57425...............  ..............  A               Laparoscopy, surg,         15.73         NA       6.63       1.74         NA      24.10        090
                                                       colpopexy.
57452...............  ..............  A               Exam of cervix w/           1.50       1.29       0.77       0.11       2.90       2.38        000
                                                       scope.
57454...............  ..............  A               Bx/curett of cervix w/      2.33       1.64       1.15       0.15       4.12       3.63        000
                                                       scope.
57455...............  ..............  A               Biopsy of cervix w/         1.99       1.72       0.87       0.15       3.86       3.01        000
                                                       scope.
57456...............  ..............  A               Endocerv curettage w/       1.85       1.65       0.82       0.15       3.65       2.82        000
                                                       scope.
57460...............  ..............  A               Bx of cervix w/scope,       2.83       5.85       1.37       0.33       9.01       4.53        000
                                                       leep.
57461...............  ..............  A               Conz of cervix w/           3.43       6.11       1.47       0.33       9.87       5.23        000
                                                       scope, leep.
57500...............  ..............  A               Biopsy of cervix.....       0.97       2.55       0.63       0.11       3.63       1.71        000
57505...............  ..............  A               Endocervical                1.14       1.47       1.10       0.13       2.74       2.37        010
                                                       curettage.
57510...............  ..............  A               Cauterization of            1.90       1.57       1.04       0.22       3.69       3.16        010
                                                       cervix.
57511...............  ..............  A               Cryocautery of cervix       1.90       1.83       1.38       0.22       3.95       3.50        010
57513...............  ..............  A               Laser surgery of            1.90       1.73       1.41       0.23       3.86       3.54        010
                                                       cervix.
57520...............  ..............  A               Conization of cervix.       4.03       3.93       2.88       0.48       8.44       7.39        090
57522...............  ..............  A               Conization of cervix.       3.35       3.15       2.46       0.40       6.90       6.21        090
57530...............  ..............  A               Removal of cervix....       4.78         NA       3.42       0.56         NA       8.76        090
57531...............  ..............  A               Removal of cervix,         27.96         NA      13.18       3.29         NA      44.43        090
                                                       radical.
57540...............  ..............  A               Removal of residual        12.20         NA       6.24       1.39         NA      19.83        090
                                                       cervix.
57545...............  ..............  A               Remove cervix/repair       13.01         NA       6.67       1.57         NA      21.25        090
                                                       pelvis.
57550...............  ..............  A               Removal of residual         5.52         NA       3.85       0.67         NA      10.04        090
                                                       cervix.
57555...............  ..............  A               Remove cervix/repair        8.94         NA       5.11       1.08         NA      15.13        090
                                                       vagina.
57556...............  ..............  A               Remove cervix, repair       8.36         NA       4.87       0.95         NA      14.18        090
                                                       bowel.
57700...............  ..............  A               Revision of cervix...       3.54         NA       3.08       0.40         NA       7.02        090
57720...............  ..............  A               Revision of cervix...       4.12         NA       3.14       0.49         NA       7.75        090
57800...............  ..............  A               Dilation of cervical        0.77       0.76       0.47       0.09       1.62       1.33        000
                                                       canal.
57820...............  ..............  A               D & c of residual           1.67       1.48       1.14       0.20       3.35       3.01        010
                                                       cervix.
58100...............  ..............  A               Biopsy of uterus            1.53       1.32       0.72       0.18       3.03       2.43        000
                                                       lining.
58120...............  ..............  A               Dilation and                3.27       2.30       1.87       0.39       5.96       5.53        010
                                                       curettage.
58140...............  ..............  A               Myomectomy abdom           14.58         NA       7.10       1.77         NA      23.45        090
                                                       method.
58145...............  ..............  A               Myomectomy vag method       8.03         NA       4.82       0.96         NA      13.81        090
58146...............  ..............  A               Myomectomy abdom           18.97         NA       8.90       1.77         NA      29.64        090
                                                       complex.
58150...............  ..............  A               Total hysterectomy...      15.22         NA       7.48       1.81         NA      24.51        090
58152...............  ..............  A               Total hysterectomy...      20.57         NA       9.83       2.39         NA      32.79        090
58180...............  ..............  A               Partial hysterectomy.      15.27         NA       7.44       1.83         NA      24.54        090
58200...............  ..............  A               Extensive                  21.56         NA      10.00       2.52         NA      34.08        090
                                                       hysterectomy.
58210...............  ..............  A               Extensive                  28.81         NA      13.20       3.31         NA      45.32        090
                                                       hysterectomy.
58240...............  ..............  A               Removal of pelvis          38.33         NA      17.63       4.33         NA      60.29        090
                                                       contents.
58260...............  ..............  A               Vaginal hysterectomy.      12.96         NA       6.68       1.54         NA      21.18        090
58262...............  ..............  A               Vag hyst including t/      14.75         NA       7.36       1.75         NA      23.86        090
                                                       o.
58263...............  ..............  A               Vag hyst w/t/o & vag       16.04         NA       7.86       1.90         NA      25.80        090
                                                       repair.
58267...............  ..............  A               Vag hyst w/urinary         17.01         NA       8.36       2.01         NA      27.38        090
                                                       repair.
58270...............  ..............  A               Vag hyst w/enterocele      14.24         NA       7.05       1.69         NA      22.98        090
                                                       repair.
58275...............  ..............  A               Hysterectomy/revise        15.74         NA       7.75       1.86         NA      25.35        090
                                                       vagina.
58280...............  ..............  A               Hysterectomy/revise        16.98         NA       8.23       1.99         NA      27.20        090
                                                       vagina.
58285...............  ..............  A               Extensive                  22.23         NA       9.97       2.65         NA      34.85        090
                                                       hysterectomy.
58290...............  ..............  A               Vag hyst complex.....      18.97         NA       9.10       1.48         NA      29.55        090
58291...............  ..............  A               Vag hyst incl t/o,         20.76         NA       9.86       1.75         NA      32.37        090
                                                       complex.
58292...............  ..............  A               Vag hyst t/o &             22.05         NA      10.34       1.90         NA      34.29        090
                                                       repair, compl.
58293...............  ..............  A               Vag hyst w/uro             23.03         NA      10.66       2.01         NA      35.70        090
                                                       repair, compl.
58294...............  ..............  A               Vag hyst w/                20.25         NA       9.54       1.69         NA      31.48        090
                                                       enterocele, compl.
58301...............  ..............  A               Remove intrauterine         1.27       1.32       0.48       0.14       2.73       1.89        000
                                                       device.
58321...............  ..............  A               Artificial                  0.92       1.15       0.37       0.11       2.18       1.40        000
                                                       insemination.
58322...............  ..............  A               Artificial                  1.10       1.21       0.42       0.13       2.44       1.65        000
                                                       insemination.
58323...............  ..............  A               Sperm washing........       0.23       0.53       0.09       0.03       0.79       0.35        000
58340...............  ..............  A               Catheter for                0.88       3.16       0.65       0.09       4.13       1.62        000
                                                       hysterography.
58345...............  ..............  A               Reopen fallopian tube       4.65         NA       2.43       0.33         NA       7.41        010
58346...............  ..............  A               Insert heyman uteri         6.74         NA       3.93       0.79         NA      11.46        090
                                                       capsule.
58350...............  ..............  A               Reopen fallopian tube       1.01       1.49       0.93       0.12       2.62       2.06        010
58353...............  ..............  A               Endometr ablate,            3.55      35.73       2.04       0.42      39.70       6.01        010
                                                       thermal.
58400...............  ..............  A               Suspension of uterus.       6.35         NA       3.96       0.75         NA      11.06        090
58410...............  ..............  A               Suspension of uterus.      12.71         NA       6.46       1.37         NA      20.54        090
58520...............  ..............  A               Repair of ruptured         11.90         NA       6.04       1.32         NA      19.26        090
                                                       uterus.
58540...............  ..............  A               Revision of uterus...      14.62         NA       6.95       1.76         NA      23.33        090
58545...............  ..............  A               Laparoscopic               14.58         NA       7.21       1.71         NA      23.50        090
                                                       myomectomy.
58546...............  ..............  A               Laparo-myomectomy,         18.97         NA       9.05       1.71         NA      29.73        090
                                                       complex.
58550...............  ..............  A               Laparo-asst vag            14.17         NA       7.28       1.70         NA      23.15        090
                                                       hysterectomy.
58552...............  ..............  A               Laparo-vag hyst incl       15.98         NA       8.00       1.70         NA      25.68        090
                                                       t/o.
58553...............  ..............  A               Laparo-vag hyst,           18.97         NA       8.93       1.54         NA      29.44        090
                                                       complex.
58554...............  ..............  A               Laparo-vag hyst w/t/       21.97         NA      10.41       1.54         NA      33.92        090
                                                       o, compl.
58555...............  ..............  A               Hysteroscopy, dx, sep       3.33       2.19       1.55       0.40       5.92       5.28        000
                                                       proc.
58558...............  ..............  A               Hysteroscopy, biopsy.       4.74         NA       2.17       0.57         NA       7.48        000
58559...............  ..............  A               Hysteroscopy, lysis..       6.16         NA       2.72       0.73         NA       9.61        000
58560...............  ..............  A               Hysteroscopy, resect        6.99         NA       3.07       0.84         NA      10.90        000
                                                       septum.
58561...............  ..............  A               Hysteroscopy, remove        9.99         NA       4.27       1.18         NA      15.44        000
                                                       myoma.
58562...............  ..............  A               Hysteroscopy, remove        5.20         NA       2.34       0.62         NA       8.16        000
                                                       fb.
 

[[Page 47637]]

 
58563...............  ..............  A               Hysteroscopy,               6.16      56.02       2.74       0.74      62.92       9.64        000
                                                       ablation.
58600...............  ..............  A               Division of fallopian       5.59         NA       3.35       0.67         NA       9.61        090
                                                       tube.
58605...............  ..............  A               Division of fallopian       4.99         NA       3.14       0.59         NA       8.72        090
                                                       tube.
58611...............  ..............  A               Ligate oviduct(s) add-      1.45         NA       0.57       0.17         NA       2.19        ZZZ
                                                       on.
58615...............  ..............  A               Occlude fallopian           3.89         NA       2.71       0.48         NA       7.08        010
                                                       tube(s).
58660...............  ..............  A               Laparoscopy, lysis...      11.27         NA       5.25       1.38         NA      17.90        090
58661...............  ..............  A               Laparoscopy, remove        11.03         NA       5.11       1.31         NA      17.45        010
                                                       adnexa.
58662...............  ..............  A               Laparoscopy, excise        11.77         NA       5.78       1.42         NA      18.97        090
                                                       lesions.
58670...............  ..............  A               Laparoscopy, tubal          5.59         NA       3.27       0.66         NA       9.52        090
                                                       cautery.
58671...............  ..............  A               Laparoscopy, tubal          5.59         NA       3.28       0.67         NA       9.54        090
                                                       block.
58672...............  ..............  A               Laparoscopy,               12.86         NA       6.21       1.49         NA      20.56        090
                                                       fimbrioplasty.
58673...............  ..............  A               Laparoscopy,               13.72         NA       6.59       1.68         NA      21.99        090
                                                       salpingostomy.
58700...............  ..............  A               Removal of fallopian       12.03         NA       5.99       1.47         NA      19.49        090
                                                       tube.
58720...............  ..............  A               Removal of ovary/          11.34         NA       5.79       1.36         NA      18.49        090
                                                       tube(s).
58740...............  ..............  A               Revise fallopian           13.98         NA       7.13       1.68         NA      22.79        090
                                                       tube(s).
58750...............  ..............  A               Repair oviduct.......      14.82         NA       7.37       1.72         NA      23.91        090
58752...............  ..............  A               Revise ovarian             14.82         NA       6.96       1.82         NA      23.60        090
                                                       tube(s).
58760...............  ..............  A               Remove tubal               13.11         NA       6.71       1.53         NA      21.35        090
                                                       obstruction.
58770...............  ..............  A               Create new tubal           13.95         NA       6.91       1.52         NA      22.38        090
                                                       opening.
58800...............  ..............  A               Drainage of ovarian         4.13       3.64       2.90       0.47       8.24       7.50        090
                                                       cyst(s).
58805...............  ..............  A               Drainage of ovarian         5.87         NA       3.53       0.66         NA      10.06        090
                                                       cyst(s).
58820...............  ..............  A               Drain ovary abscess,        4.21         NA       3.32       0.41         NA       7.94        090
                                                       open.
58822...............  ..............  A               Drain ovary abscess,       10.11         NA       5.22       1.23         NA      16.56        090
                                                       percut.
58823...............  ..............  A               Drain pelvic abscess,       3.37      21.77       1.12       0.25      25.39       4.74        000
                                                       percut.
58825...............  ..............  A               Transposition,             10.96         NA       5.80       1.33         NA      18.09        090
                                                       ovary(s).
58900...............  ..............  A               Biopsy of ovary(s)...       5.98         NA       3.59       0.70         NA      10.27        090
58920...............  ..............  A               Partial removal of         11.34         NA       5.60       1.37         NA      18.31        090
                                                       ovary(s).
58925...............  ..............  A               Removal of ovarian         11.34         NA       5.69       1.39         NA      18.42        090
                                                       cyst(s).
58940...............  ..............  A               Removal of ovary(s)..       7.28         NA       4.12       0.88         NA      12.28        090
58943...............  ..............  A               Removal of ovary(s)..      18.40         NA       8.73       2.19         NA      29.32        090
58950...............  ..............  A               Resect ovarian             16.90         NA       8.48       2.01         NA      27.39        090
                                                       malignancy.
58951...............  ..............  A               Resect ovarian             22.35         NA      10.52       2.62         NA      35.49        090
                                                       malignancy.
58952...............  ..............  A               Resect ovarian             24.97         NA      11.83       2.96         NA      39.76        090
                                                       malignancy.
58953...............  ..............  A               Tah, rad dissect for       31.95         NA      14.54       3.77         NA      50.26        090
                                                       debulk.
58954...............  ..............  A               Tah rad debulk/lymph       34.95         NA      15.68       4.14         NA      54.77        090
                                                       remove.
58960...............  ..............  A               Exploration of             14.63         NA       7.44       1.74         NA      23.81        090
                                                       abdomen.
58970...............  ..............  A               Retrieval of oocyte..       3.52       2.31       1.49       0.29       6.12       5.30        000
58976...............  ..............  A               Transfer of embryo...       3.82       2.65       1.82       0.47       6.94       6.11        000
59000...............  ..............  A               Amniocentesis,              1.30       2.08       0.67       0.31       3.69       2.28        000
                                                       diagnostic.
59001...............  ..............  A               Amniocentesis,              3.00         NA       1.40       0.71         NA       5.11        000
                                                       therapeutic.
59012...............  ..............  A               Fetal cord                  3.44         NA       1.53       0.82         NA       5.79        000
                                                       puncture,prenatal.
59015...............  ..............  A               Chorion biopsy.......       2.20       1.56       1.04       0.52       4.28       3.76        000
59020...............  ..............  A               Fetal contract stress       0.66       0.78         NA       0.26       1.70         NA        000
                                                       test.
59020...............  26............  A               Fetal contract stress       0.66       0.26       0.26       0.16       1.08       1.08        000
                                                       test.
59020...............  TC............  A               Fetal contract stress       0.00       0.52         NA       0.10       0.62         NA        000
                                                       test.
59025...............  ..............  A               Fetal non-stress test       0.53       0.44         NA       0.15       1.12         NA        000
59025...............  26............  A               Fetal non-stress test       0.53       0.21       0.21       0.13       0.87       0.87        000
59025...............  TC............  A               Fetal non-stress test       0.00       0.23         NA       0.02       0.25         NA        000
59030...............  ..............  A               Fetal scalp blood           1.99         NA       0.77       0.47         NA       3.23        000
                                                       sample.
59050...............  ..............  A               Fetal monitor w/            0.89         NA       0.35       0.21         NA       1.45        XXX
                                                       report.
59051...............  ..............  A               Fetal monitor/              0.74         NA       0.29       0.18         NA       1.21        XXX
                                                       interpret only.
59070...............  ..............  A               Transabdom amnioinfus       5.24       5.06       2.29       0.28      10.58       7.81        000
                                                       w/ us.
59072...............  ..............  A               Umbilical cord occlud       8.99         NA       3.11       0.16         NA      12.26        000
                                                       w/ us.
59074...............  ..............  A               Fetal fluid drainage        5.24       4.47       2.29       0.28       9.99       7.81        000
                                                       w/ us.
59076...............  ..............  A               Fetal shunt                 8.99         NA       3.11       0.16         NA      12.26        000
                                                       placement, w/ us.
59100...............  ..............  A               Remove uterus lesion.      12.33         NA       6.46       2.93         NA      21.72        090
59120...............  ..............  A               Treat ectopic              11.47         NA       6.24       2.73         NA      20.44        090
                                                       pregnancy.
59121...............  ..............  A               Treat ectopic              11.65         NA       6.32       2.77         NA      20.74        090
                                                       pregnancy.
59130...............  ..............  A               Treat ectopic              14.20         NA       4.86       1.96         NA      21.02        090
                                                       pregnancy.
59135...............  ..............  A               Treat ectopic              13.86         NA       7.22       3.00         NA      24.08        090
                                                       pregnancy.
59136...............  ..............  A               Treat ectopic              13.16         NA       6.61       2.85         NA      22.62        090
                                                       pregnancy.
59140...............  ..............  A               Treat ectopic               5.45       2.20       2.20       1.30       8.95       8.95        090
                                                       pregnancy.
59150...............  ..............  A               Treat ectopic              11.65         NA       6.02       2.77         NA      20.44        090
                                                       pregnancy.
59151...............  ..............  A               Treat ectopic              11.47         NA       6.06       2.73         NA      20.26        090
                                                       pregnancy.
59160...............  ..............  A               D & c after delivery.       2.71       3.29       2.13       0.64       6.64       5.48        010
59200...............  ..............  A               Insert cervical             0.79       1.19       0.30       0.19       2.17       1.28        000
                                                       dilator.
59300...............  ..............  A               Episiotomy or vaginal       2.41       2.20       0.95       0.57       5.18       3.93        000
                                                       repair.
59320...............  ..............  A               Revision of cervix...       2.48         NA       1.24       0.59         NA       4.31        000
59325...............  ..............  A               Revision of cervix...       4.06         NA       1.89       0.88         NA       6.83        000
59350...............  ..............  A               Repair of uterus.....       4.94         NA       1.86       1.18         NA       7.98        000
59400...............  ..............  A               Obstetrical care.....      23.03         NA      15.35       5.48         NA      43.86        MMM
59409...............  ..............  A               Obstetrical care.....      13.48         NA       5.29       3.21         NA      21.98        MMM
59410...............  ..............  A               Obstetrical care.....      14.76         NA       6.29       3.51         NA      24.56        MMM
59412...............  ..............  A               Antepartum                  1.71         NA       0.81       0.41         NA       2.93        MMM
                                                       manipulation.
59414...............  ..............  A               Deliver placenta.....       1.61         NA       0.64       0.38         NA       2.63        MMM

[[Page 47638]]

 
59425...............  ..............  A               Antepartum care only.       4.80       4.22       1.85       1.14      10.16       7.79        MMM
59426...............  ..............  A               Antepartum care only.       8.27       7.58       3.21       1.97      17.82      13.45        MMM
59430...............  ..............  A               Care after delivery..       2.13       1.23       0.93       0.51       3.87       3.57        MMM
59510...............  ..............  A               Cesarean delivery....      26.18         NA      17.26       6.23         NA      49.67        MMM
59514...............  ..............  A               Cesarean delivery          15.95         NA       6.19       3.79         NA      25.93        MMM
                                                       only.
59515...............  ..............  A               Cesarean delivery....      17.34         NA       7.81       4.13         NA      29.28        MMM
59525...............  ..............  A               Remove uterus after         8.53         NA       3.29       2.03         NA      13.85        ZZZ
                                                       cesarean.
59610...............  ..............  A               Vbac delivery........      24.58         NA      15.89       5.85         NA      46.32        MMM
59612...............  ..............  A               Vbac delivery only...      15.04         NA       6.03       3.58         NA      24.65        MMM
59614...............  ..............  A               Vbac care after            16.32         NA       6.91       3.88         NA      27.11        MMM
                                                       delivery.
59618...............  ..............  A               Attempted vbac             27.74         NA      18.29       6.60         NA      52.63        MMM
                                                       delivery.
59620...............  ..............  A               Attempted vbac             17.50         NA       6.74       4.17         NA      28.41        MMM
                                                       delivery only.
59622...............  ..............  A               Attempted vbac after       18.90         NA       8.61       4.50         NA      32.01        MMM
                                                       care.
59812...............  ..............  A               Treatment of                4.00         NA       2.54       0.95         NA       7.49        090
                                                       miscarriage.
59820...............  ..............  A               Care of miscarriage..       4.00       4.43       3.56       0.95       9.38       8.51        090
59821...............  ..............  A               Treatment of                4.46       4.26       3.40       1.06       9.78       8.92        090
                                                       miscarriage.
59830...............  ..............  A               Treat uterus                6.10         NA       3.99       1.45         NA      11.54        090
                                                       infection.
59840...............  ..............  R               Abortion.............       3.01         NA       2.12       0.72         NA       5.85        010
59841...............  ..............  R               Abortion.............       5.23       2.56       2.56       1.25       9.04       9.04        010
59850...............  ..............  R               Abortion.............       5.90         NA       3.25       1.28         NA      10.43        090
59851...............  ..............  R               Abortion.............       5.92         NA       3.73       1.41         NA      11.06        090
59852...............  ..............  R               Abortion.............       8.23         NA       5.05       1.79         NA      15.07        090
59855...............  ..............  R               Abortion.............       6.11         NA       3.55       1.45         NA      11.11        090
59856...............  ..............  R               Abortion.............       7.47         NA       4.05       1.62         NA      13.14        090
59857...............  ..............  R               Abortion.............       9.28         NA       4.59       2.00         NA      15.87        090
59866...............  ..............  R               Abortion (mpr).......       3.99         NA       1.82       0.87         NA       6.68        000
59870...............  ..............  A               Evacuate mole of            6.00         NA       4.42       1.43         NA      11.85        090
                                                       uterus.
59871...............  ..............  A               Remove cerclage             2.13       1.74       1.13       0.51       4.38       3.77        000
                                                       suture.
60000...............  ..............  A               Drain thyroid/tongue        1.76       1.94       1.73       0.14       3.84       3.63        010
                                                       cyst.
60001...............  ..............  A               Aspirate/inject             0.97       1.43       0.33       0.08       2.48       1.38        000
                                                       thyriod cyst.
60100...............  ..............  A               Biopsy of thyroid....       1.56       1.40       0.53       0.10       3.06       2.19        000
60200...............  ..............  A               Remove thyroid lesion       9.54         NA       6.08       1.01         NA      16.63        090
60210...............  ..............  A               Partial thyroid            10.86         NA       5.72       1.24         NA      17.82        090
                                                       excision.
60212...............  ..............  A               Partial thyroid            16.01         NA       7.75       1.59         NA      25.35        090
                                                       excision.
60220...............  ..............  A               Partial removal of         11.88         NA       6.24       1.34         NA      19.46        090
                                                       thyroid.
60225...............  ..............  A               Partial removal of         14.17         NA       7.48       1.65         NA      23.30        090
                                                       thyroid.
60240...............  ..............  A               Removal of thyroid...      16.04         NA       7.68       1.84         NA      25.56        090
60252...............  ..............  A               Removal of thyroid...      20.54         NA      10.20       2.28         NA      33.02        090
60254...............  ..............  A               Extensive thyroid          26.95         NA      14.28       2.75         NA      43.98        090
                                                       surgery.
60260...............  ..............  A               Repeat thyroid             17.44         NA       8.77       1.94         NA      28.15        090
                                                       surgery.
60270...............  ..............  A               Removal of thyroid...      20.24         NA      10.56       2.27         NA      33.07        090
60271...............  ..............  A               Removal of thyroid...      16.80         NA       8.70       1.83         NA      27.33        090
60280...............  ..............  A               Remove thyroid duct         5.86         NA       4.78       0.53         NA      11.17        090
                                                       lesion.
60281...............  ..............  A               Remove thyroid duct         8.52         NA       5.94       0.80         NA      15.26        090
                                                       lesion.
60500...............  ..............  A               Explore parathyroid        16.21         NA       7.47       1.98         NA      25.66        090
                                                       glands.
60502...............  ..............  A               Re-explore                 20.32         NA       9.41       2.50         NA      32.23        090
                                                       parathyroids.
60505...............  ..............  A               Explore parathyroid        21.46         NA      11.03       2.65         NA      35.14        090
                                                       glands.
60512...............  ..............  A               Autotransplant              4.44         NA       1.62       0.54         NA       6.60        ZZZ
                                                       parathyroid.
60520...............  ..............  A               Removal of thymus          16.78         NA       8.31       2.16         NA      27.25        090
                                                       gland.
60521...............  ..............  A               Removal of thymus          18.84         NA       9.57       1.92         NA      30.33        090
                                                       gland.
60522...............  ..............  A               Removal of thymus          23.06         NA      11.28       3.13         NA      37.47        090
                                                       gland.
60540...............  ..............  A               Explore adrenal gland      17.00         NA       7.58       1.75         NA      26.33        090
60545...............  ..............  A               Explore adrenal gland      19.85         NA       8.54       2.05         NA      30.44        090
60600...............  ..............  A               Remove carotid body        17.90         NA      10.76       2.15         NA      30.81        090
                                                       lesion.
60605...............  ..............  A               Remove carotid body        20.21         NA      12.59       2.45         NA      35.25        090
                                                       lesion.
60650...............  ..............  A               Laparoscopy                19.97         NA       7.95       2.32         NA      30.24        090
                                                       adrenalectomy.
61000...............  ..............  A               Remove cranial cavity       1.58         NA       0.96       0.17         NA       2.71        000
                                                       fluid.
61001...............  ..............  A               Remove cranial cavity       1.49         NA       1.07       0.18         NA       2.74        000
                                                       fluid.
61020...............  ..............  A               Remove brain cavity         1.51         NA       1.35       0.30         NA       3.16        000
                                                       fluid.
61026...............  ..............  A               Injection into brain        1.69         NA       1.40       0.25         NA       3.34        000
                                                       canal.
61050...............  ..............  A               Remove brain canal          1.51         NA       1.27       0.12         NA       2.90        000
                                                       fluid.
61055...............  ..............  A               Injection into brain        2.10         NA       1.43       0.16         NA       3.69        000
                                                       canal.
61070...............  ..............  A               Brain canal shunt           0.89         NA       1.03       0.14         NA       2.06        000
                                                       procedure.
61105...............  ..............  A               Twist drill hole.....       5.13         NA       3.93       1.26         NA      10.32        090
61107...............  ..............  A               Drill skull for             4.99         NA       2.52       1.24         NA       8.75        000
                                                       implantation.
61108...............  ..............  A               Drill skull for            10.17         NA       7.13       2.53         NA      19.83        090
                                                       drainage.
61120...............  ..............  A               Burr hole for               8.75         NA       5.99       2.04         NA      16.78        090
                                                       puncture.
61140...............  ..............  A               Pierce skull for           15.88         NA       9.87       3.63         NA      29.38        090
                                                       biopsy.
61150...............  ..............  A               Pierce skull for           17.54         NA      10.36       3.95         NA      31.85        090
                                                       drainage.
61151...............  ..............  A               Pierce skull for           12.40         NA       7.81       2.97         NA      23.18        090
                                                       drainage.
61154...............  ..............  A               Pierce skull & remove      14.97         NA       9.47       3.76         NA      28.20        090
                                                       clot.
61156...............  ..............  A               Pierce skull for           16.30         NA       9.82       4.03         NA      30.15        090
                                                       drainage.
61210...............  ..............  A               Pierce skull, implant       5.83         NA       2.91       1.45         NA      10.19        000
                                                       device.
61215...............  ..............  A               Insert brain-fluid          4.88         NA       4.00       1.21         NA      10.09        090
                                                       device.
61250...............  ..............  A               Pierce skull &             10.40         NA       6.84       2.15         NA      19.39        090
                                                       explore.

[[Page 47639]]

 
61253...............  ..............  A               Pierce skull &             12.34         NA       7.72       2.01         NA      22.07        090
                                                       explore.
61304...............  ..............  A               Open skull for             21.93         NA      12.83       4.96         NA      39.72        090
                                                       exploration.
61305...............  ..............  A               Open skull for             26.57         NA      15.30       6.08         NA      47.95        090
                                                       exploration.
61312...............  ..............  A               Open skull for             24.53         NA      15.03       5.60         NA      45.16        090
                                                       drainage.
61313...............  ..............  A               Open skull for             24.89         NA      14.79       5.79         NA      45.47        090
                                                       drainage.
61314...............  ..............  A               Open skull for             24.19         NA      13.03       5.53         NA      42.75        090
                                                       drainage.
61315...............  ..............  A               Open skull for             27.64         NA      16.00       6.33         NA      49.97        090
                                                       drainage.
61316...............  ..............  A               Implt cran bone flap        1.39         NA       0.60       0.52         NA       2.51        ZZZ
                                                       to abdo.
61320...............  ..............  A               Open skull for             25.58         NA      14.74       5.81         NA      46.13        090
                                                       drainage.
61321...............  ..............  A               Open skull for             28.46         NA      16.11       6.55         NA      51.12        090
                                                       drainage.
61322...............  ..............  A               Decompressive              29.46         NA      15.68       6.02         NA      51.16        090
                                                       craniotomy.
61323...............  ..............  A               Decompressive              30.95         NA      16.13       6.02         NA      53.10        090
                                                       lobectomy.
61330...............  ..............  A               Decompress eye socket      23.29         NA      13.70       3.67         NA      40.66        090
61332...............  ..............  A               Explore/biopsy eye         27.24         NA      15.57       4.76         NA      47.57        090
                                                       socket.
61333...............  ..............  A               Explore orbit/remove       27.91         NA      15.55       3.55         NA      47.01        090
                                                       lesion.
61334...............  ..............  A               Explore orbit/remove       18.24         NA      10.62       3.15         NA      32.01        090
                                                       object.
61340...............  ..............  A               Subtemporal                18.63         NA      11.12       4.26         NA      34.01        090
                                                       decompression.
61343...............  ..............  A               Incise skull (press        29.73         NA      16.81       6.70         NA      53.24        090
                                                       relief).
61345...............  ..............  A               Relieve cranial            27.16         NA      15.40       5.70         NA      48.26        090
                                                       pressure.
61440...............  ..............  A               Incise skull for           26.59         NA      14.21       6.88         NA      47.68        090
                                                       surgery.
61450...............  ..............  A               Incise skull for           25.91         NA      14.28       5.43         NA      45.62        090
                                                       surgery.
61458...............  ..............  A               Incise skull for           27.25         NA      15.50       6.24         NA      48.99        090
                                                       brain wound.
61460...............  ..............  A               Incise skull for           28.35         NA      16.40       5.35         NA      50.10        090
                                                       surgery.
61470...............  ..............  A               Incise skull for           26.02         NA      13.85       6.74         NA      46.61        090
                                                       surgery.
61480...............  ..............  A               Incise skull for           26.45         NA      15.27       6.10         NA      47.82        090
                                                       surgery.
61490...............  ..............  A               Incise skull for           25.62         NA      14.32       6.26         NA      46.20        090
                                                       surgery.
61500...............  ..............  A               Removal of skull           17.89         NA      10.80       3.71         NA      32.40        090
                                                       lesion.
61501...............  ..............  A               Remove infected skull      14.82         NA       9.21       3.00         NA      27.03        090
                                                       bone.
61510...............  ..............  A               Removal of brain           28.41         NA      16.68       6.49         NA      51.58        090
                                                       lesion.
61512...............  ..............  A               Remove brain lining        35.04         NA      19.66       8.06         NA      62.76        090
                                                       lesion.
61514...............  ..............  A               Removal of brain           25.22         NA      14.42       6.01         NA      45.65        090
                                                       abscess.
61516...............  ..............  A               Removal of brain           24.57         NA      14.27       5.43         NA      44.27        090
                                                       lesion.
61517...............  ..............  A               Implt brain chemotx         1.38         NA       0.64       0.10         NA       2.12        ZZZ
                                                       add-on.
61518...............  ..............  A               Removal of brain           37.26         NA      21.09       8.46         NA      66.81        090
                                                       lesion.
61519...............  ..............  A               Remove brain lining        41.33         NA      22.64       9.61         NA      73.58        090
                                                       lesion.
61520...............  ..............  A               Removal of brain           54.76         NA      30.31      10.02         NA      95.09        090
                                                       lesion.
61521...............  ..............  A               Removal of brain           44.41         NA      24.21       9.76         NA      78.38        090
                                                       lesion.
61522...............  ..............  A               Removal of brain           29.41         NA      16.42       6.78         NA      52.61        090
                                                       abscess.
61524...............  ..............  A               Removal of brain           27.82         NA      15.67       6.02         NA      49.51        090
                                                       lesion.
61526...............  ..............  A               Removal of brain           52.09         NA      29.46       7.10         NA      88.65        090
                                                       lesion.
61530...............  ..............  A               Removal of brain           43.79         NA      25.06       5.67         NA      74.52        090
                                                       lesion.
61531...............  ..............  A               Implant brain              14.61         NA       9.13       3.60         NA      27.34        090
                                                       electrodes.
61533...............  ..............  A               Implant brain              19.68         NA      11.54       4.43         NA      35.65        090
                                                       electrodes.
61534...............  ..............  A               Removal of brain           20.94         NA      12.10       5.32         NA      38.36        090
                                                       lesion.
61535...............  ..............  A               Remove brain               11.61         NA       7.43       2.81         NA      21.85        090
                                                       electrodes.
61536...............  ..............  A               Removal of brain           35.47         NA      19.78       7.56         NA      62.81        090
                                                       lesion.
61537...............  ..............  A               Removal of brain           24.96         NA      14.72       6.05         NA      45.73        090
                                                       tissue.
61538...............  ..............  A               Removal of brain           26.77         NA      15.31       6.05         NA      48.13        090
                                                       tissue.
61539...............  ..............  A               Removal of brain           32.03         NA      17.77       7.41         NA      57.21        090
                                                       tissue.
61540...............  ..............  A               Removal of brain           29.96         NA      17.23       7.41         NA      54.60        090
                                                       tissue.
61541...............  ..............  A               Incision of brain          28.81         NA      16.20       6.10         NA      51.11        090
                                                       tissue.
61542...............  ..............  A               Removal of brain           30.97         NA      17.82       7.83         NA      56.62        090
                                                       tissue.
61543...............  ..............  A               Removal of brain           29.18         NA      16.39       6.58         NA      52.15        090
                                                       tissue.
61544...............  ..............  A               Remove & treat brain       25.46         NA      13.84       5.73         NA      45.03        090
                                                       lesion.
61545...............  ..............  A               Excision of brain          43.73         NA      24.21      10.03         NA      77.97        090
                                                       tumor.
61546...............  ..............  A               Removal of pituitary       31.25         NA      17.49       7.15         NA      55.89        090
                                                       gland.
61548...............  ..............  A               Removal of pituitary       21.50         NA      12.79       3.31         NA      37.60        090
                                                       gland.
61550...............  ..............  A               Release of skull           14.63         NA       6.98       1.37         NA      22.98        090
                                                       seams.
61552...............  ..............  A               Release of skull           19.53         NA       9.14       5.06         NA      33.73        090
                                                       seams.
61556...............  ..............  A               Incise skull/sutures.      22.23         NA      11.37       5.12         NA      38.72        090
61557...............  ..............  A               Incise skull/sutures.      22.35         NA      13.62       5.79         NA      41.76        090
61558...............  ..............  A               Excision of skull/         25.54         NA      14.18       3.15         NA      42.87        090
                                                       sutures.
61559...............  ..............  A               Excision of skull/         32.74         NA      19.30       2.01         NA      54.05        090
                                                       sutures.
61563...............  ..............  A               Excision of skull          26.79         NA      15.25       5.75         NA      47.79        090
                                                       tumor.
61564...............  ..............  A               Excision of skull          33.78         NA      18.27       8.28         NA      60.33        090
                                                       tumor.
61566...............  ..............  A               Removal of brain           30.95         NA      17.75       6.05         NA      54.75        090
                                                       tissue.
61567...............  ..............  A               Incision of brain          35.45         NA      20.66       6.49         NA      62.60        090
                                                       tissue.
61570...............  ..............  A               Remove foreign body,       24.56         NA      13.90       5.07         NA      43.53        090
                                                       brain.
61571...............  ..............  A               Incise skull for           26.35         NA      15.13       5.77         NA      47.25        090
                                                       brain wound.
61575...............  ..............  A               Skull base/brainstem       34.31         NA      19.64       5.42         NA      59.37        090
                                                       surgery.
61576...............  ..............  A               Skull base/brainstem       52.35         NA      34.69       5.80         NA      92.84        090
                                                       surgery.
61580...............  ..............  A               Craniofacial               30.30         NA      25.50       3.37         NA      59.17        090
                                                       approach, skull.
61581...............  ..............  A               Craniofacial               34.55         NA      23.42       3.30         NA      61.27        090
                                                       approach, skull.
61582...............  ..............  A               Craniofacial               31.61         NA      27.28       6.96         NA      65.85        090
                                                       approach, skull.
61583...............  ..............  A               Craniofacial               36.16         NA      25.08       8.12         NA      69.36        090
                                                       approach, skull.

[[Page 47640]]

 
61584...............  ..............  A               Orbitocranial              34.60         NA      24.48       7.51         NA      66.59        090
                                                       approach/skull.
61585...............  ..............  A               Orbitocranial              38.55         NA      26.44       7.50         NA      72.49        090
                                                       approach/skull.
61586...............  ..............  A               Resect nasopharynx,        25.06         NA      22.52       4.95         NA      52.53        090
                                                       skull.
61590...............  ..............  A               Infratemporal              41.72         NA      28.54       5.11         NA      75.37        090
                                                       approach/skull.
61591...............  ..............  A               Infratemporal              43.61         NA      29.45       5.64         NA      78.70        090
                                                       approach/skull.
61592...............  ..............  A               Orbitocranial              39.58         NA      26.46       8.93         NA      74.97        090
                                                       approach/skull.
61595...............  ..............  A               Transtemporal              29.53         NA      22.27       3.81         NA      55.61        090
                                                       approach/skull.
61596...............  ..............  A               Transcochlear              35.58         NA      24.37       4.83         NA      64.78        090
                                                       approach/skull.
61597...............  ..............  A               Transcondylar              37.90         NA      22.96       8.56         NA      69.42        090
                                                       approach/skull.
61598...............  ..............  A               Transpetrosal              33.36         NA      23.18       5.50         NA      62.04        090
                                                       approach/skull.
61600...............  ..............  A               Resect/excise cranial      25.81         NA      19.72       3.60         NA      49.13        090
                                                       lesion.
61601...............  ..............  A               Resect/excise cranial      27.85         NA      20.46       6.16         NA      54.47        090
                                                       lesion.
61605...............  ..............  A               Resect/excise cranial      29.29         NA      21.89       2.90         NA      54.08        090
                                                       lesion.
61606...............  ..............  A               Resect/excise cranial      38.77         NA      25.10       8.22         NA      72.09        090
                                                       lesion.
61607...............  ..............  A               Resect/excise cranial      36.22         NA      23.74       6.58         NA      66.54        090
                                                       lesion.
61608...............  ..............  A               Resect/excise cranial      42.04         NA      26.54       9.67         NA      78.25        090
                                                       lesion.
61609...............  ..............  A               Transect artery,            9.88         NA       4.85       1.57         NA      16.30        ZZZ
                                                       sinus.
61610...............  ..............  A               Transect artery,           29.63         NA      13.11       4.25         NA      46.99        ZZZ
                                                       sinus.
61611...............  ..............  A               Transect artery,            7.41         NA       3.81       1.87         NA      13.09        ZZZ
                                                       sinus.
61612...............  ..............  A               Transect artery,           27.84         NA      13.29       2.08         NA      43.21        ZZZ
                                                       sinus.
61613...............  ..............  A               Remove aneurysm,           40.80         NA      26.22       8.76         NA      75.78        090
                                                       sinus.
61615...............  ..............  A               Resect/excise lesion,      32.02         NA      22.66       5.07         NA      59.75        090
                                                       skull.
61616...............  ..............  A               Resect/excise lesion,      43.27         NA      28.59       8.13         NA      79.99        090
                                                       skull.
61618...............  ..............  A               Repair dura..........      16.96         NA      10.46       3.42         NA      30.84        090
61619...............  ..............  A               Repair dura..........      20.68         NA      12.25       3.41         NA      36.34        090
61623...............  ..............  A               Endovasc tempory            9.95         NA       4.07       0.60         NA      14.62        000
                                                       vessel occl.
61624...............  ..............  A               Transcath occlusion,       20.12         NA       6.88       1.84         NA      28.84        000
                                                       cns.
61626...............  ..............  A               Transcath occlusion,       16.60         NA       5.50       1.17         NA      23.27        000
                                                       non-cns.
61680...............  ..............  A               Intracranial vessel        30.66         NA      17.44       7.03         NA      55.13        090
                                                       surgery.
61682...............  ..............  A               Intracranial vessel        61.48         NA      32.20      14.22         NA     107.90        090
                                                       surgery.
61684...............  ..............  A               Intracranial vessel        39.75         NA      21.99       9.24         NA      70.98        090
                                                       surgery.
61686...............  ..............  A               Intracranial vessel        64.39         NA      34.70      14.04         NA     113.13        090
                                                       surgery.
61690...............  ..............  A               Intracranial vessel        29.27         NA      16.72       7.58         NA      53.57        090
                                                       surgery.
61692...............  ..............  A               Intracranial vessel        51.79         NA      27.47      11.64         NA      90.90        090
                                                       surgery.
61697...............  ..............  A               Brain aneurysm repr,       50.44         NA      27.98      12.05         NA      90.47        090
                                                       complx.
61698...............  ..............  A               Brain aneurysm repr,       48.34         NA      26.67      11.01         NA      86.02        090
                                                       complx.
61700...............  ..............  A               Brain aneurysm repr,       50.44         NA      27.78      11.94         NA      90.16        090
                                                       simple.
61702...............  ..............  A               Inner skull vessel         48.34         NA      26.02      11.56         NA      85.92        090
                                                       surgery.
61703...............  ..............  A               Clamp neck artery....      17.44         NA      10.48       3.72         NA      31.64        090
61705...............  ..............  A               Revise circulation to      36.15         NA      19.24       8.11         NA      63.50        090
                                                       head.
61708...............  ..............  A               Revise circulation to      35.25         NA      15.14       2.67         NA      53.06        090
                                                       head.
61710...............  ..............  A               Revise circulation to      29.63         NA      13.63       3.78         NA      47.04        090
                                                       head.
61711...............  ..............  A               Fusion of skull            36.28         NA      19.80       8.36         NA      64.44        090
                                                       arteries.
61720...............  ..............  A               Incise skull/brain         16.74         NA       9.98       3.55         NA      30.27        090
                                                       surgery.
61735...............  ..............  A               Incise skull/brain         20.40         NA      12.16       3.83         NA      36.39        090
                                                       surgery.
61750...............  ..............  A               Incise skull/brain         18.17         NA      10.61       4.48         NA      33.26        090
                                                       biopsy.
61751...............  ..............  A               Brain biopsy w/ct/mr       17.59         NA      10.82       4.34         NA      32.75        090
                                                       guide.
61760...............  ..............  A               Implant brain              22.24         NA       8.73       5.49         NA      36.46        090
                                                       electrodes.
61770...............  ..............  A               Incise skull for           21.41         NA      12.26       4.44         NA      38.11        090
                                                       treatment.
61790...............  ..............  A               Treat trigeminal           10.84         NA       5.92       2.66         NA      19.42        090
                                                       nerve.
61791...............  ..............  A               Treat trigeminal           14.59         NA       8.92       3.51         NA      27.02        090
                                                       tract.
61793...............  ..............  A               Focus radiation beam.      17.21         NA      10.13       4.22         NA      31.56        090
61795...............  ..............  A               Brain surgery using         4.03         NA       2.03       0.80         NA       6.86        ZZZ
                                                       computer.
61850...............  ..............  A               Implant                    12.37         NA       7.68       1.98         NA      22.03        090
                                                       neuroelectrodes.
61860...............  ..............  A               Implant                    20.84         NA      12.07       4.87         NA      37.78        090
                                                       neuroelectrodes.
61863...............  ..............  A               Implant                    18.97         NA      11.76       4.66         NA      35.39        090
                                                       neuroelectrode.
61864...............  ..............  A               Implant                     4.49         NA       2.27       4.66         NA      11.42        ZZZ
                                                       neuroelectrde, add-l.
61867...............  ..............  A               Implant                    31.29         NA      18.00       4.66         NA      53.95        090
                                                       neuroelectrode.
61868...............  ..............  A               Implant                     7.91         NA       4.01       4.66         NA      16.58        ZZZ
                                                       neuroelectrde, add-l.
61870...............  ..............  A               Implant                    14.92         NA       9.73       2.05         NA      26.70        090
                                                       neuroelectrodes.
61875...............  ..............  A               Implant                    15.04         NA       8.57       2.39         NA      26.00        090
                                                       neuroelectrodes.
61880...............  ..............  A               Revise/remove               6.28         NA       4.59       1.50         NA      12.37        090
                                                       neuroelectrode.
61885...............  ..............  A               Implant neurostim one       5.84         NA       5.31       1.35         NA      12.50        090
                                                       array.
61886...............  ..............  A               Implant neurostim           7.99         NA       6.36       1.78         NA      16.13        090
                                                       arrays.
61888...............  ..............  A               Revise/remove               5.06         NA       3.67       1.22         NA       9.95        010
                                                       neuroreceiver.
62000...............  ..............  A               Treat skull fracture.      12.51         NA       5.50       1.28         NA      19.29        090
62005...............  ..............  A               Treat skull fracture.      16.15         NA       8.79       3.26         NA      28.20        090
62010...............  ..............  A               Treatment of head          19.78         NA      11.70       4.64         NA      36.12        090
                                                       injury.
62100...............  ..............  A               Repair brain fluid         22.00         NA      12.80       4.71         NA      39.51        090
                                                       leakage.
62115...............  ..............  A               Reduction of skull         21.63         NA      11.64       5.46         NA      38.73        090
                                                       defect.
62116...............  ..............  A               Reduction of skull         23.55         NA      13.36       1.92         NA      38.83        090
                                                       defect.
62117...............  ..............  A               Reduction of skull         26.56         NA      15.37       6.88         NA      48.81        090
                                                       defect.
62120...............  ..............  A               Repair skull cavity        23.31         NA      18.61       2.64         NA      44.56        090
                                                       lesion.
62121...............  ..............  A               Incise skull repair..      21.55         NA      15.41       3.49         NA      40.45        090
62140...............  ..............  A               Repair of skull            13.49         NA       8.33       3.02         NA      24.84        090
                                                       defect.

[[Page 47641]]

 
62141...............  ..............  A               Repair of skull            14.89         NA       9.06       3.26         NA      27.21        090
                                                       defect.
62142...............  ..............  A               Remove skull plate/        10.77         NA       7.00       2.41         NA      20.18        090
                                                       flap.
62143...............  ..............  A               Replace skull plate/       13.03         NA       8.05       3.02         NA      24.10        090
                                                       flap.
62145...............  ..............  A               Repair of skull &          18.79         NA      10.90       3.77         NA      33.46        090
                                                       brain.
62146...............  ..............  A               Repair of skull with       16.10         NA       9.64       3.20         NA      28.94        090
                                                       graft.
62147...............  ..............  A               Repair of skull with       19.31         NA      11.32       4.35         NA      34.98        090
                                                       graft.
62148...............  ..............  A               Retr bone flap to fix       2.00         NA       0.86       0.52         NA       3.38        ZZZ
                                                       skull.
62160...............  ..............  A               Neuroendoscopy add-on       3.00         NA       1.53       0.63         NA       5.16        ZZZ
62161...............  ..............  A               Dissect brain w/scope      19.97         NA      12.08       4.46         NA      36.51        090
62162...............  ..............  A               Remove colloid cyst w/     25.21         NA      15.07       6.96         NA      47.24        090
                                                       scope.
62163...............  ..............  A               Neuroendoscopy w/fb        15.48         NA       9.91       4.46         NA      29.85        090
                                                       removal.
62164...............  ..............  A               Remove brain tumor w/      27.46         NA      14.95       6.96         NA      49.37        090
                                                       scope.
62165...............  ..............  A               Remove pituit tumor w/     21.97         NA      13.34       4.38         NA      39.69        090
                                                       scope.
62180...............  ..............  A               Establish brain            21.03         NA      12.29       4.55         NA      37.87        090
                                                       cavity shunt.
62190...............  ..............  A               Establish brain            11.05         NA       7.09       2.67         NA      20.81        090
                                                       cavity shunt.
62192...............  ..............  A               Establish brain            12.23         NA       7.63       2.79         NA      22.65        090
                                                       cavity shunt.
62194...............  ..............  A               Replace/irrigate            5.02         NA       2.44       0.62         NA       8.08        010
                                                       catheter.
62200...............  ..............  A               Establish brain            18.29         NA      10.85       4.45         NA      33.59        090
                                                       cavity shunt.
62201...............  ..............  A               Brain cavity shunt w/      14.84         NA       9.45       2.88         NA      27.17        090
                                                       scope.
62220...............  ..............  A               Establish brain            12.98         NA       8.00       2.85         NA      23.83        090
                                                       cavity shunt.
62223...............  ..............  A               Establish brain            12.85         NA       8.25       2.83         NA      23.93        090
                                                       cavity shunt.
62225...............  ..............  A               Replace/irrigate            5.40         NA       4.10       1.32         NA      10.82        090
                                                       catheter.
62230...............  ..............  A               Replace/revise brain       10.52         NA       6.49       2.40         NA      19.41        090
                                                       shunt.
62252...............  ..............  A               Csf shunt reprogram..       0.74       1.47         NA       0.20       2.41         NA        XXX
62252...............  26............  A               Csf shunt reprogram..       0.74       0.37       0.37       0.18       1.29       1.29        XXX
62252...............  TC............  A               Csf shunt reprogram..       0.00       1.10         NA       0.02       1.12         NA        XXX
62256...............  ..............  A               Remove brain cavity         6.59         NA       4.71       1.57         NA      12.87        090
                                                       shunt.
62258...............  ..............  A               Replace brain cavity       14.52         NA       8.71       3.27         NA      26.50        090
                                                       shunt.
62263...............  ..............  A               Epidural lysis mult         6.13      12.79       3.22       0.40      19.32       9.75        010
                                                       sessions.
62264...............  ..............  A               Epidural lysis on           4.42       7.75       1.42       0.40      12.57       6.24        010
                                                       single day.
62268...............  ..............  A               Drain spinal cord           4.73      11.63       2.14       0.31      16.67       7.18        000
                                                       cyst.
62269...............  ..............  A               Needle biopsy, spinal       5.01      15.11       1.97       0.39      20.51       7.37        000
                                                       cord.
62270...............  ..............  A               Spinal fluid tap,           1.13       2.98       0.56       0.08       4.19       1.77        000
                                                       diagnostic.
62272...............  ..............  A               Drain cerebro spinal        1.35       3.60       0.71       0.17       5.12       2.23        000
                                                       fluid.
62273...............  ..............  A               Treat epidural spine        2.15       2.73       0.72       0.14       5.02       3.01        000
                                                       lesion.
62280...............  ..............  A               Treat spinal cord           2.63       6.99       1.01       0.23       9.85       3.87        010
                                                       lesion.
62281...............  ..............  A               Treat spinal cord           2.66       5.70       0.90       0.18       8.54       3.74        010
                                                       lesion.
62282...............  ..............  A               Treat spinal canal          2.33       8.43       0.92       0.17      10.93       3.42        010
                                                       lesion.
62284...............  ..............  A               Injection for               1.54       5.02       0.68       0.13       6.69       2.35        000
                                                       myelogram.
62287...............  ..............  A               Percutaneous                8.07         NA       5.55       0.69         NA      14.31        090
                                                       diskectomy.
62290...............  ..............  A               Inject for spine disk       3.00       7.19       1.38       0.26      10.45       4.64        000
                                                       x-ray.
62291...............  ..............  A               Inject for spine disk       2.91       5.99       1.23       0.28       9.18       4.42        000
                                                       x-ray.
62292...............  ..............  A               Injection into disk         7.85         NA       4.49       0.84         NA      13.18        090
                                                       lesion.
62294...............  ..............  A               Injection into spinal      11.81         NA       5.59       1.38         NA      18.78        090
                                                       artery.
62310...............  ..............  A               Inject spine c/t.....       1.91       4.85       0.65       0.12       6.88       2.68        000
62311...............  ..............  A               Inject spine l/s (cd)       1.54       4.94       0.60       0.10       6.58       2.24        000
62318...............  ..............  A               Inject spine w/cath,        2.04       5.76       0.65       0.13       7.93       2.82        000
                                                       c/t.
62319...............  ..............  A               Inject spine w/cath l/      1.87       5.03       0.61       0.12       7.02       2.60        000
                                                       s (cd).
62350...............  ..............  A               Implant spinal canal        6.86         NA       3.97       0.86         NA      11.69        090
                                                       cath.
62351...............  ..............  A               Implant spinal canal        9.99         NA       7.12       1.88         NA      18.99        090
                                                       cath.
62355...............  ..............  A               Remove spinal canal         5.44         NA       3.18       0.69         NA       9.31        090
                                                       catheter.
62360...............  ..............  A               Insert spine infusion       2.62         NA       2.71       0.33         NA       5.66        090
                                                       device.
62361...............  ..............  A               Implant spine               5.41         NA       3.94       0.69         NA      10.04        090
                                                       infusion pump.
62362...............  ..............  A               Implant spine               7.03         NA       4.37       1.08         NA      12.48        090
                                                       infusion pump.
62365...............  ..............  A               Remove spine infusion       5.41         NA       3.59       0.77         NA       9.77        090
                                                       device.
62367...............  26............  A               Analyze spine               0.48       0.13       0.13       0.03       0.64       0.64        XXX
                                                       infusion pump.
62368...............  26............  A               Analyze spine               0.75       0.19       0.19       0.06       1.00       1.00        XXX
                                                       infusion pump.
63001...............  ..............  A               Removal of spinal          15.80         NA       9.50       3.30         NA      28.60        090
                                                       lamina.
63003...............  ..............  A               Removal of spinal          15.93         NA       9.85       3.41         NA      29.19        090
                                                       lamina.
63005...............  ..............  A               Removal of spinal          14.90         NA       9.96       2.77         NA      27.63        090
                                                       lamina.
63011...............  ..............  A               Removal of spinal          14.50         NA       8.27       3.17         NA      25.94        090
                                                       lamina.
63012...............  ..............  A               Removal of spinal          15.38         NA      10.11       3.04         NA      28.53        090
                                                       lamina.
63015...............  ..............  A               Removal of spinal          19.32         NA      11.86       4.14         NA      35.32        090
                                                       lamina.
63016...............  ..............  A               Removal of spinal          19.17         NA      11.77       4.03         NA      34.97        090
                                                       lamina.
63017...............  ..............  A               Removal of spinal          15.92         NA      10.38       3.20         NA      29.50        090
                                                       lamina.
63020...............  ..............  A               Neck spine disk            14.79         NA       9.66       3.29         NA      27.74        090
                                                       surgery.
63030...............  ..............  A               Low back disk surgery      11.98         NA       8.41       2.43         NA      22.82        090
63035...............  ..............  A               Spinal disk surgery         3.15         NA       1.59       0.67         NA       5.41        ZZZ
                                                       add-on.
63040...............  ..............  A               Laminotomy, single         18.78         NA      11.49       4.07         NA      34.34        090
                                                       cervical.
63042...............  ..............  A               Laminotomy, single         17.44         NA      11.32       3.58         NA      32.34        090
                                                       lumbar.
63045...............  ..............  A               Removal of spinal          16.48         NA      10.34       3.47         NA      30.29        090
                                                       lamina.
63046...............  ..............  A               Removal of spinal          15.78         NA      10.17       3.17         NA      29.12        090
                                                       lamina.
63047...............  ..............  A               Removal of spinal          14.59         NA       9.88       2.77         NA      27.24        090
                                                       lamina.
63048...............  ..............  A               Remove spinal lamina        3.26         NA       1.66       0.63         NA       5.55        ZZZ
                                                       add-on.
63055...............  ..............  A               Decompress spinal          21.96         NA      13.12       4.73         NA      39.81        090
                                                       cord.

[[Page 47642]]

 
63056...............  ..............  A               Decompress spinal          20.33         NA      12.54       4.07         NA      36.94        090
                                                       cord.
63057...............  ..............  A               Decompress spine cord       5.25         NA       2.63       1.11         NA       8.99        ZZZ
                                                       add-on.
63064...............  ..............  A               Decompress spinal          24.57         NA      14.41       5.05         NA      44.03        090
                                                       cord.
63066...............  ..............  A               Decompress spine cord       3.26         NA       1.66       0.66         NA       5.58        ZZZ
                                                       add-on.
63075...............  ..............  A               Neck spine disk            19.38         NA      12.07       3.95         NA      35.40        090
                                                       surgery.
63076...............  ..............  A               Neck spine disk             4.04         NA       2.05       0.82         NA       6.91        ZZZ
                                                       surgery.
63077...............  ..............  A               Spine disk surgery,        21.41         NA      12.77       3.41         NA      37.59        090
                                                       thorax.
63078...............  ..............  A               Spine disk surgery,         3.28         NA       1.63       0.53         NA       5.44        ZZZ
                                                       thorax.
63081...............  ..............  A               Removal of vertebral       23.69         NA      14.30       4.86         NA      42.85        090
                                                       body.
63082...............  ..............  A               Remove vertebral body       4.36         NA       2.22       0.91         NA       7.49        ZZZ
                                                       add-on.
63085...............  ..............  A               Removal of vertebral       26.88         NA      15.45       4.23         NA      46.56        090
                                                       body.
63086...............  ..............  A               Remove vertebral body       3.19         NA       1.59       0.57         NA       5.35        ZZZ
                                                       add-on.
63087...............  ..............  A               Removal of vertebral       35.52         NA      19.43       5.70         NA      60.65        090
                                                       body.
63088...............  ..............  A               Remove vertebral body       4.32         NA       2.17       0.72         NA       7.21        ZZZ
                                                       add-on.
63090...............  ..............  A               Removal of vertebral       28.12         NA      16.01       4.09         NA      48.22        090
                                                       body.
63091...............  ..............  A               Remove vertebral body       3.03         NA       1.45       0.47         NA       4.95        ZZZ
                                                       add-on.
63101...............  ..............  A               Removal of vertebral       31.95         NA      19.28       5.05         NA      56.28        090
                                                       body.
63102...............  ..............  A               Removal of vertebral       31.95         NA      19.28       5.05         NA      56.28        090
                                                       body.
63103...............  ..............  A               Remove vertebral body       3.89         NA       2.03       0.66         NA       6.58        ZZZ
                                                       add-on.
63170...............  ..............  A               Incise spinal cord         19.80         NA      12.08       4.48         NA      36.36        090
                                                       tract(s).
63172...............  ..............  A               Drainage of spinal         17.63         NA      10.90       4.06         NA      32.59        090
                                                       cyst.
63173...............  ..............  A               Drainage of spinal         21.96         NA      13.06       4.95         NA      39.97        090
                                                       cyst.
63180...............  ..............  A               Revise spinal cord         18.24         NA      11.24       2.46         NA      31.94        090
                                                       ligaments.
63182...............  ..............  A               Revise spinal cord         20.47         NA      11.18       3.47         NA      35.12        090
                                                       ligaments.
63185...............  ..............  A               Incise spinal column/      15.02         NA       8.29       2.22         NA      25.53        090
                                                       nerves.
63190...............  ..............  A               Incise spinal column/      17.42         NA      10.34       3.35         NA      31.11        090
                                                       nerves.
63191...............  ..............  A               Incise spinal column/      17.51         NA      10.71       4.53         NA      32.75        090
                                                       nerves.
63194...............  ..............  A               Incise spinal column       19.16         NA      11.93       3.82         NA      34.91        090
                                                       & cord.
63195...............  ..............  A               Incise spinal column       18.81         NA      11.26       4.37         NA      34.44        090
                                                       & cord.
63196...............  ..............  A               Incise spinal column       22.27         NA      13.60       5.62         NA      41.49        090
                                                       & cord.
63197...............  ..............  A               Incise spinal column       21.08         NA      12.41       4.20         NA      37.69        090
                                                       & cord.
63198...............  ..............  A               Incise spinal column       25.34         NA       8.58       6.40         NA      40.32        090
                                                       & cord.
63199...............  ..............  A               Incise spinal column       26.85         NA      15.23       6.78         NA      48.86        090
                                                       & cord.
63200...............  ..............  A               Release of spinal          19.15         NA      11.50       4.31         NA      34.96        090
                                                       cord.
63250...............  ..............  A               Revise spinal cord         40.70         NA      19.92       8.81         NA      69.43        090
                                                       vessels.
63251...............  ..............  A               Revise spinal cord         41.14         NA      22.57       9.46         NA      73.17        090
                                                       vessels.
63252...............  ..............  A               Revise spinal cord         41.13         NA      22.22       9.52         NA      72.87        090
                                                       vessels.
63265...............  ..............  A               Excise intraspinal         21.53         NA      12.76       4.85         NA      39.14        090
                                                       lesion.
63266...............  ..............  A               Excise intraspinal         22.27         NA      13.18       4.89         NA      40.34        090
                                                       lesion.
63267...............  ..............  A               Excise intraspinal         17.92         NA      11.07       3.79         NA      32.78        090
                                                       lesion.
63268...............  ..............  A               Excise intraspinal         18.49         NA      10.38       3.01         NA      31.88        090
                                                       lesion.
63270...............  ..............  A               Excise intraspinal         26.76         NA      15.46       5.94         NA      48.16        090
                                                       lesion.
63271...............  ..............  A               Excise intraspinal         26.88         NA      15.56       6.38         NA      48.82        090
                                                       lesion.
63272...............  ..............  A               Excise intraspinal         25.28         NA      14.68       5.41         NA      45.37        090
                                                       lesion.
63273...............  ..............  A               Excise intraspinal         24.25         NA      14.33       6.05         NA      44.63        090
                                                       lesion.
63275...............  ..............  A               Biopsy/excise spinal       23.64         NA      13.77       5.20         NA      42.61        090
                                                       tumor.
63276...............  ..............  A               Biopsy/excise spinal       23.41         NA      13.67       5.16         NA      42.24        090
                                                       tumor.
63277...............  ..............  A               Biopsy/excise spinal       20.80         NA      12.51       4.32         NA      37.63        090
                                                       tumor.
63278...............  ..............  A               Biopsy/excise spinal       20.53         NA      12.38       4.07         NA      36.98        090
                                                       tumor.
63280...............  ..............  A               Biopsy/excise spinal       28.31         NA      16.30       6.47         NA      51.08        090
                                                       tumor.
63281...............  ..............  A               Biopsy/excise spinal       28.01         NA      16.16       6.41         NA      50.58        090
                                                       tumor.
63282...............  ..............  A               Biopsy/excise spinal       26.35         NA      15.32       6.03         NA      47.70        090
                                                       tumor.
63283...............  ..............  A               Biopsy/excise spinal       24.96         NA      14.65       5.64         NA      45.25        090
                                                       tumor.
63285...............  ..............  A               Biopsy/excise spinal       35.95         NA      19.92       9.19         NA      65.06        090
                                                       tumor.
63286...............  ..............  A               Biopsy/excise spinal       35.58         NA      19.88       8.10         NA      63.56        090
                                                       tumor.
63287...............  ..............  A               Biopsy/excise spinal       36.64         NA      20.41       8.00         NA      65.05        090
                                                       tumor.
63290...............  ..............  A               Biopsy/excise spinal       37.32         NA      20.57       9.00         NA      66.89        090
                                                       tumor.
63300...............  ..............  A               Removal of vertebral       24.39         NA      14.29       4.92         NA      43.60        090
                                                       body.
63301...............  ..............  A               Removal of vertebral       27.56         NA      15.54       5.21         NA      48.31        090
                                                       body.
63302...............  ..............  A               Removal of vertebral       27.77         NA      15.83       5.11         NA      48.71        090
                                                       body.
63303...............  ..............  A               Removal of vertebral       30.45         NA      16.89       4.99         NA      52.33        090
                                                       body.
63304...............  ..............  A               Removal of vertebral       30.28         NA      17.26       6.03         NA      53.57        090
                                                       body.
63305...............  ..............  A               Removal of vertebral       31.98         NA      18.03       5.92         NA      55.93        090
                                                       body.
63306...............  ..............  A               Removal of vertebral       32.17         NA      17.78       6.13         NA      56.08        090
                                                       body.
63307...............  ..............  A               Removal of vertebral       31.58         NA      16.79       4.80         NA      53.17        090
                                                       body.
63308...............  ..............  A               Remove vertebral body       5.24         NA       2.60       1.15         NA       8.99        ZZZ
                                                       add-on.
63600...............  ..............  A               Remove spinal cord         14.00         NA       5.41       1.29         NA      20.70        090
                                                       lesion.
63610...............  ..............  A               Stimulation of spinal       8.72      59.95       2.25       0.55      69.22      11.52        000
                                                       cord.
63615...............  ..............  A               Remove lesion of           16.26         NA       9.30       1.89         NA      27.45        090
                                                       spinal cord.
63650...............  ..............  A               Implant                     6.73         NA       3.19       0.54         NA      10.46        090
                                                       neuroelectrodes.
63655...............  ..............  A               Implant                    10.27         NA       6.90       2.07         NA      19.24        090
                                                       neuroelectrodes.
63660...............  ..............  A               Revise/remove               6.15         NA       3.63       0.80         NA      10.58        090
                                                       neuroelectrode.
63685...............  ..............  A               Implant neuroreceiver       7.03         NA       4.16       0.99         NA      12.18        090
63688...............  ..............  A               Revise/remove               5.38         NA       3.57       0.85         NA       9.80        090
                                                       neuroreceiver.
63700...............  ..............  A               Repair of spinal           16.51         NA      10.29       3.14         NA      29.94        090
                                                       herniation.

[[Page 47643]]

 
63702...............  ..............  A               Repair of spinal           18.45         NA      11.05       3.43         NA      32.93        090
                                                       herniation.
63704...............  ..............  A               Repair of spinal           21.15         NA      12.90       4.54         NA      38.59        090
                                                       herniation.
63706...............  ..............  A               Repair of spinal           24.07         NA      13.58       5.45         NA      43.10        090
                                                       herniation.
63707...............  ..............  A               Repair spinal fluid        11.24         NA       7.70       2.18         NA      21.12        090
                                                       leakage.
63709...............  ..............  A               Repair spinal fluid        14.30         NA       9.39       2.77         NA      26.46        090
                                                       leakage.
63710...............  ..............  A               Graft repair of spine      14.05         NA       9.04       3.02         NA      26.11        090
                                                       defect.
63740...............  ..............  A               Install spinal shunt.      11.34         NA       7.35       2.44         NA      21.13        090
63741...............  ..............  A               Install spinal shunt.       8.24         NA       4.76       1.69         NA      14.69        090
63744...............  ..............  A               Revision of spinal          8.09         NA       5.26       1.54         NA      14.89        090
                                                       shunt.
63746...............  ..............  A               Removal of spinal           6.42         NA       3.79       1.60         NA      11.81        090
                                                       shunt.
64400...............  ..............  A               N block inj,                1.11       1.89       0.43       0.09       3.09       1.63        000
                                                       trigeminal.
64402...............  ..............  A               N block inj, facial..       1.25       1.62       0.60       0.08       2.95       1.93        000
64405...............  ..............  A               N block inj,                1.32       1.46       0.46       0.09       2.87       1.87        000
                                                       occipital.
64408...............  ..............  A               N block inj, vagus...       1.41       1.58       0.85       0.09       3.08       2.35        000
64410...............  ..............  A               N block inj, phrenic.       1.43       2.52       0.47       0.09       4.04       1.99        000
64412...............  ..............  A               N block inj, spinal         1.18       2.66       0.43       0.08       3.92       1.69        000
                                                       accessor.
64413...............  ..............  A               N block inj, cervical       1.40       1.85       0.50       0.10       3.35       2.00        000
                                                       plexus.
64415...............  ..............  A               N block inj, brachial       1.48       2.81       0.46       0.10       4.39       2.04        000
                                                       plexus.
64416...............  ..............  A               N block cont infuse,        3.49         NA       0.79       0.10         NA       4.38        010
                                                       b plex.
64417...............  ..............  A               N block inj, axillary       1.44       3.04       0.49       0.12       4.60       2.05        000
64418...............  ..............  A               N block inj,                1.32       2.63       0.44       0.08       4.03       1.84        000
                                                       suprascapular.
64420...............  ..............  A               N block inj,                1.18       3.98       0.42       0.08       5.24       1.68        000
                                                       intercost, sng.
64421...............  ..............  A               N block inj,                1.68       6.19       0.52       0.12       7.99       2.32        000
                                                       intercost, mlt.
64425...............  ..............  A               N block inj ilio-ing/       1.75       1.65       0.54       0.14       3.54       2.43        000
                                                       hypogi.
64430...............  ..............  A               N block inj, pudendal       1.46       2.51       0.55       0.11       4.08       2.12        000
64435...............  ..............  A               N block inj,                1.45       2.52       0.69       0.17       4.14       2.31        000
                                                       paracervical.
64445...............  ..............  A               N block inj, sciatic,       1.48       2.68       0.50       0.10       4.26       2.08        000
                                                       sng.
64446...............  ..............  A               N blk inj, sciatic,         3.25         NA       1.01       0.10         NA       4.36        010
                                                       cont inf.
64447...............  ..............  A               N block inj fem,            1.50         NA       0.43       0.10         NA       2.03        000
                                                       single.
64448...............  ..............  A               N block inj fem, cont       3.00         NA       0.81       0.10         NA       3.91        010
                                                       inf.
64449...............  ..............  A               N block inj, lumbar         3.00         NA       0.96       0.10         NA       4.06        010
                                                       plexus.
64450...............  ..............  A               N block, other              1.27       1.24       0.48       0.10       2.61       1.85        000
                                                       peripheral.
64470...............  ..............  A               Inj paravertebral c/t       1.85       7.29       0.72       0.14       9.28       2.71        000
64472...............  ..............  A               Inj paravertebral c/t       1.29       2.35       0.34       0.09       3.73       1.72        ZZZ
                                                       add-on.
64475...............  ..............  A               Inj paravertebral l/s       1.41       6.93       0.63       0.11       8.45       2.15        000
64476...............  ..............  A               Inj paravertebral l/s       0.98       2.14       0.24       0.08       3.20       1.30        ZZZ
                                                       add-on.
64479...............  ..............  A               Inj foramen epidural        2.20       7.56       0.89       0.16       9.92       3.25        000
                                                       c/t.
64480...............  ..............  A               Inj foramen epidural        1.54       2.87       0.47       0.12       4.53       2.13        ZZZ
                                                       add-on.
64483...............  ..............  A               Inj foramen epidural        1.90       7.95       0.83       0.12       9.97       2.85        000
                                                       l/s.
64484...............  ..............  A               Inj foramen epidural        1.33       3.31       0.37       0.09       4.73       1.79        ZZZ
                                                       add-on.
64505...............  ..............  A               N block,                    1.36       1.25       0.66       0.09       2.70       2.11        000
                                                       spenopalatine gangl.
64508...............  ..............  A               N block, carotid            1.12       3.39       0.74       0.09       4.60       1.95        000
                                                       sinus s/p.
64510...............  ..............  A               N block, stellate           1.22       3.51       0.51       0.08       4.81       1.81        000
                                                       ganglion.
64517...............  ..............  A               N block inj, hypogas        2.20       2.73       0.87       0.11       5.04       3.18        000
                                                       plxs.
64520...............  ..............  A               N block, lumbar/            1.35       5.21       0.55       0.09       6.65       1.99        000
                                                       thoracic.
64530...............  ..............  A               N block inj, celiac         1.58       4.49       0.66       0.10       6.17       2.34        000
                                                       pelus.
64550...............  ..............  A               Apply neurostimulator       0.18       0.28       0.05       0.01       0.47       0.24        000
64553...............  ..............  A               Implant                     2.31       2.83       1.85       0.23       5.37       4.39        010
                                                       neuroelectrodes.
64555...............  ..............  A               Implant                     2.27       3.11       1.20       0.23       5.61       3.70        010
                                                       neuroelectrodes.
64560...............  ..............  A               Implant                     2.36       2.66       1.30       0.24       5.26       3.90        010
                                                       neuroelectrodes.
64561...............  ..............  A               Implant                     6.73      30.03       2.82       0.51      37.27      10.06        010
                                                       neuroelectrodes.
64565...............  ..............  A               Implant                     1.76       3.30       1.26       0.10       5.16       3.12        010
                                                       neuroelectrodes.
64573...............  ..............  A               Implant                     7.49         NA       5.25       1.48         NA      14.22        090
                                                       neuroelectrodes.
64575...............  ..............  A               Implant                     4.34         NA       2.69       0.45         NA       7.48        090
                                                       neuroelectrodes.
64577...............  ..............  A               Implant                     4.61         NA       3.30       0.61         NA       8.52        090
                                                       neuroelectrodes.
64580...............  ..............  A               Implant                     4.11         NA       3.57       0.23         NA       7.91        090
                                                       neuroelectrodes.
64581...............  ..............  A               Implant                    13.48         NA       5.36       1.05         NA      19.89        090
                                                       neuroelectrodes.
64585...............  ..............  A               Revise/remove               2.06      11.26       2.14       0.22      13.54       4.42        010
                                                       neuroelectrode.
64590...............  ..............  A               Implant neuroreceiver       2.40       7.15       2.28       0.23       9.78       4.91        010
64595...............  ..............  A               Revise/remove               1.73      10.42       1.93       0.22      12.37       3.88        010
                                                       neuroreceiver.
64600...............  ..............  A               Injection treatment         3.44       9.36       1.66       0.33      13.13       5.43        010
                                                       of nerve.
64605...............  ..............  A               Injection treatment         5.60       9.58       2.19       0.92      16.10       8.71        010
                                                       of nerve.
64610...............  ..............  A               Injection treatment         7.15       8.92       3.71       1.35      17.42      12.21        010
                                                       of nerve.
64612...............  ..............  A               Destroy nerve, face         1.96       2.48       1.32       0.12       4.56       3.40        010
                                                       muscle.
64613...............  ..............  A               Destroy nerve, spine        1.96       2.90       1.22       0.12       4.98       3.30        010
                                                       muscle.
64614...............  ..............  A               Destroy nerve, extrem       2.20       3.21       1.31       0.12       5.53       3.63        010
                                                       musc.
64620...............  ..............  A               Injection treatment         2.84       5.13       1.34       0.20       8.17       4.38        010
                                                       of nerve.
64622...............  ..............  A               Destr paravertebrl          3.00       7.82       1.38       0.21      11.03       4.59        010
                                                       nerve l/s.
64623...............  ..............  A               Destr paravertebral n       0.99       2.98       0.22       0.07       4.04       1.28        ZZZ
                                                       add-on.
64626...............  ..............  A               Destr paravertebrl          3.28       7.84       1.98       0.22      11.34       5.48        010
                                                       nerve c/t.
64627...............  ..............  A               Destr paravertebral n       1.16       4.58       0.27       0.08       5.82       1.51        ZZZ
                                                       add-on.
64630...............  ..............  A               Injection treatment         3.00       2.73       1.42       0.23       5.96       4.65        010
                                                       of nerve.
64640...............  ..............  A               Injection treatment         2.76       4.19       1.85       0.19       7.14       4.80        010
                                                       of nerve.
64680...............  ..............  A               Injection treatment         2.62       6.75       1.44       0.18       9.55       4.24        010
                                                       of nerve.
64681...............  ..............  A               Injection treatment         3.54       9.36       2.06       0.19      13.09       5.79        010
                                                       of nerve.

[[Page 47644]]

 
64702...............  ..............  A               Revise finger/toe           4.22         NA       3.86       0.60         NA       8.68        090
                                                       nerve.
64704...............  ..............  A               Revise hand/foot            4.56         NA       3.31       0.47         NA       8.34        090
                                                       nerve.
64708...............  ..............  A               Revise arm/leg nerve.       6.11         NA       4.87       0.92         NA      11.90        090
64712...............  ..............  A               Revision of sciatic         7.74         NA       4.98       0.98         NA      13.70        090
                                                       nerve.
64713...............  ..............  A               Revision of arm            10.98         NA       5.88       1.68         NA      18.54        090
                                                       nerve(s).
64714...............  ..............  A               Revise low back            10.31         NA       4.23       1.04         NA      15.58        090
                                                       nerve(s).
64716...............  ..............  A               Revision of cranial         6.30         NA       5.96       0.64         NA      12.90        090
                                                       nerve.
64718...............  ..............  A               Revise ulnar nerve at       5.98         NA       5.98       1.03         NA      12.99        090
                                                       elbow.
64719...............  ..............  A               Revise ulnar nerve at       4.84         NA       4.53       0.78         NA      10.15        090
                                                       wrist.
64721...............  ..............  A               Carpal tunnel surgery       4.28         NA       5.35       0.72         NA      10.35        090
64722...............  ..............  A               Relieve pressure on         4.69         NA       3.06       0.45         NA       8.20        090
                                                       nerve(s).
64726...............  ..............  A               Release foot/toe            4.17         NA       2.80       0.40         NA       7.37        090
                                                       nerve.
64727...............  ..............  A               Internal nerve              3.10         NA       1.50       0.49         NA       5.09        ZZZ
                                                       revision.
64732...............  ..............  A               Incision of brow            4.40         NA       3.52       0.81         NA       8.73        090
                                                       nerve.
64734...............  ..............  A               Incision of cheek           4.91         NA       4.05       0.95         NA       9.91        090
                                                       nerve.
64736...............  ..............  A               Incision of chin            4.59         NA       4.03       0.64         NA       9.26        090
                                                       nerve.
64738...............  ..............  A               Incision of jaw nerve       5.72         NA       4.61       1.24         NA      11.57        090
64740...............  ..............  A               Incision of tongue          5.58         NA       5.11       0.57         NA      11.26        090
                                                       nerve.
64742...............  ..............  A               Incision of facial          6.21         NA       4.70       0.57         NA      11.48        090
                                                       nerve.
64744...............  ..............  A               Incise nerve, back of       5.23         NA       3.78       1.03         NA      10.04        090
                                                       head.
64746...............  ..............  A               Incise diaphragm            5.92         NA       4.51       0.82         NA      11.25        090
                                                       nerve.
64752...............  ..............  A               Incision of vagus           7.05         NA       4.30       0.89         NA      12.24        090
                                                       nerve.
64755...............  ..............  A               Incision of stomach        13.50         NA       5.65       1.63         NA      20.78        090
                                                       nerves.
64760...............  ..............  A               Incision of vagus           6.95         NA       3.48       0.79         NA      11.22        090
                                                       nerve.
64761...............  ..............  A               Incision of pelvis          6.40         NA       3.54       0.45         NA      10.39        090
                                                       nerve.
64763...............  ..............  A               Incise hip/thigh            6.92         NA       5.23       0.98         NA      13.13        090
                                                       nerve.
64766...............  ..............  A               Incise hip/thigh            8.66         NA       5.26       1.11         NA      15.03        090
                                                       nerve.
64771...............  ..............  A               Sever cranial nerve..       7.34         NA       5.56       1.04         NA      13.94        090
64772...............  ..............  A               Incision of spinal          7.20         NA       4.93       1.25         NA      13.38        090
                                                       nerve.
64774...............  ..............  A               Remove skin nerve           5.16         NA       3.83       0.63         NA       9.62        090
                                                       lesion.
64776...............  ..............  A               Remove digit nerve          5.11         NA       3.70       0.66         NA       9.47        090
                                                       lesion.
64778...............  ..............  A               Digit nerve surgery         3.11         NA       1.50       0.46         NA       5.07        ZZZ
                                                       add-on.
64782...............  ..............  A               Remove limb nerve           6.22         NA       3.77       0.71         NA      10.70        090
                                                       lesion.
64783...............  ..............  A               Limb nerve surgery          3.71         NA       1.83       0.52         NA       6.06        ZZZ
                                                       add-on.
64784...............  ..............  A               Remove nerve lesion..       9.81         NA       6.60       1.39         NA      17.80        090
64786...............  ..............  A               Remove sciatic nerve       15.44         NA       9.84       2.52         NA      27.80        090
                                                       lesion.
64787...............  ..............  A               Implant nerve end....       4.29         NA       2.11       0.56         NA       6.96        ZZZ
64788...............  ..............  A               Remove skin nerve           4.60         NA       3.48       0.64         NA       8.72        090
                                                       lesion.
64790...............  ..............  A               Removal of nerve           11.29         NA       7.20       1.76         NA      20.25        090
                                                       lesion.
64792...............  ..............  A               Removal of nerve           14.90         NA       8.82       2.29         NA      26.01        090
                                                       lesion.
64795...............  ..............  A               Biopsy of nerve......       3.01         NA       1.58       0.50         NA       5.09        000
64802...............  ..............  A               Remove sympathetic          9.14         NA       5.15       1.17         NA      15.46        090
                                                       nerves.
64804...............  ..............  A               Remove sympathetic         14.62         NA       7.17       1.99         NA      23.78        090
                                                       nerves.
64809...............  ..............  A               Remove sympathetic         13.65         NA       5.77       1.79         NA      21.21        090
                                                       nerves.
64818...............  ..............  A               Remove sympathetic         10.28         NA       5.29       1.32         NA      16.89        090
                                                       nerves.
64820...............  ..............  A               Remove sympathetic         10.35         NA       7.14       1.54         NA      19.03        090
                                                       nerves.
64821...............  ..............  A               Remove sympathetic          8.74         NA       7.33       1.38         NA      17.45        090
                                                       nerves.
64822...............  ..............  A               Remove sympathetic          8.74         NA       7.22       1.33         NA      17.29        090
                                                       nerves.
64823...............  ..............  A               Remove sympathetic         10.35         NA       8.13       1.58         NA      20.06        090
                                                       nerves.
64831...............  ..............  A               Repair of digit nerve       9.43         NA       7.08       1.40         NA      17.91        090
64832...............  ..............  A               Repair nerve add-on..       5.65         NA       2.93       0.83         NA       9.41        ZZZ
64834...............  ..............  A               Repair of hand or          10.17         NA       7.09       1.57         NA      18.83        090
                                                       foot nerve.
64835...............  ..............  A               Repair of hand or          10.92         NA       7.70       1.61         NA      20.23        090
                                                       foot nerve.
64836...............  ..............  A               Repair of hand or          10.92         NA       7.67       1.63         NA      20.22        090
                                                       foot nerve.
64837...............  ..............  A               Repair nerve add-on..       6.25         NA       3.22       0.95         NA      10.42        ZZZ
64840...............  ..............  A               Repair of leg nerve..      13.00         NA       8.25       1.44         NA      22.69        090
64856...............  ..............  A               Repair/transpose           13.78         NA       9.18       2.06         NA      25.02        090
                                                       nerve.
64857...............  ..............  A               Repair arm/leg nerve.      14.47         NA       9.63       2.22         NA      26.32        090
64858...............  ..............  A               Repair sciatic nerve.      16.47         NA      10.77       2.98         NA      30.22        090
64859...............  ..............  A               Nerve surgery........       4.25         NA       2.19       0.59         NA       7.03        ZZZ
64861...............  ..............  A               Repair of arm nerves.      19.21         NA      11.78       4.24         NA      35.23        090
64862...............  ..............  A               Repair of low back         19.41         NA      11.93       2.98         NA      34.32        090
                                                       nerves.
64864...............  ..............  A               Repair of facial           12.53         NA       8.75       1.35         NA      22.63        090
                                                       nerve.
64865...............  ..............  A               Repair of facial           15.22         NA      13.44       1.82         NA      30.48        090
                                                       nerve.
64866...............  ..............  A               Fusion of facial/          15.72         NA      13.10       1.63         NA      30.45        090
                                                       other nerve.
64868...............  ..............  A               Fusion of facial/          14.02         NA      11.39       1.64         NA      27.05        090
                                                       other nerve.
64870...............  ..............  A               Fusion of facial/          15.97         NA       8.72       0.80         NA      25.49        090
                                                       other nerve.
64872...............  ..............  A               Subsequent repair of        1.99         NA       1.08       0.28         NA       3.35        ZZZ
                                                       nerve.
64874...............  ..............  A               Repair & revise nerve       2.98         NA       1.53       0.41         NA       4.92        ZZZ
                                                       add-on.
64876...............  ..............  A               Repair nerve/shorten        3.37         NA       1.27       0.47         NA       5.11        ZZZ
                                                       bone.
64885...............  ..............  A               Nerve graft, head or       17.50         NA      11.59       1.69         NA      30.78        090
                                                       neck.
64886...............  ..............  A               Nerve graft, head or       20.72         NA      13.52       2.06         NA      36.30        090
                                                       neck.
64890...............  ..............  A               Nerve graft, hand or       15.13         NA       9.99       2.24         NA      27.36        090
                                                       foot.
64891...............  ..............  A               Nerve graft, hand or       16.12         NA       7.60       1.38         NA      25.10        090
                                                       foot.
64892...............  ..............  A               Nerve graft, arm or        14.63         NA       8.87       1.97         NA      25.47        090
                                                       leg.

[[Page 47645]]

 
64893...............  ..............  A               Nerve graft, arm or        15.58         NA       9.87       2.28         NA      27.73        090
                                                       leg.
64895...............  ..............  A               Nerve graft, hand or       19.22         NA       9.65       2.43         NA      31.30        090
                                                       foot.
64896...............  ..............  A               Nerve graft, hand or       20.46         NA      11.00       1.97         NA      33.43        090
                                                       foot.
64897...............  ..............  A               Nerve graft, arm or        18.21         NA      10.69       2.61         NA      31.51        090
                                                       leg.
64898...............  ..............  A               Nerve graft, arm or        19.47         NA      11.79       2.14         NA      33.40        090
                                                       leg.
64901...............  ..............  A               Nerve graft add-on...      10.20         NA       5.25       1.22         NA      16.67        ZZZ
64902...............  ..............  A               Nerve graft add-on...      11.81         NA       5.95       1.43         NA      19.19        ZZZ
64905...............  ..............  A               Nerve pedicle              14.00         NA       8.50       1.53         NA      24.03        090
                                                       transfer.
64907...............  ..............  A               Nerve pedicle              18.80         NA      12.50       2.16         NA      33.46        090
                                                       transfer.
65091...............  ..............  A               Revise eye...........       6.45         NA       8.37       0.34         NA      15.16        090
65093...............  ..............  A               Revise eye with             6.86         NA       8.73       0.36         NA      15.95        090
                                                       implant.
65101...............  ..............  A               Removal of eye.......       7.02         NA       9.55       0.37         NA      16.94        090
65103...............  ..............  A               Remove eye/insert           7.56         NA       9.75       0.39         NA      17.70        090
                                                       implant.
65105...............  ..............  A               Remove eye/attach           8.48         NA      10.48       0.44         NA      19.40        090
                                                       implant.
65110...............  ..............  A               Removal of eye.......      13.93         NA      13.66       0.86         NA      28.45        090
65112...............  ..............  A               Remove eye/revise          16.36         NA      16.08       0.98         NA      33.42        090
                                                       socket.
65114...............  ..............  A               Remove eye/revise          17.50         NA      16.31       1.07         NA      34.88        090
                                                       socket.
65125...............  ..............  A               Revise ocular implant       3.12       8.84       3.59       0.18      12.14       6.89        090
65130...............  ..............  A               Insert ocular implant       7.14         NA       9.18       0.38         NA      16.70        090
65135...............  ..............  A               Insert ocular implant       7.32         NA       9.32       0.38         NA      17.02        090
65140...............  ..............  A               Attach ocular implant       8.01         NA       9.88       0.43         NA      18.32        090
65150...............  ..............  A               Revise ocular implant       6.25         NA       7.99       0.35         NA      14.59        090
65155...............  ..............  A               Reinsert ocular             8.65         NA      10.48       0.50         NA      19.63        090
                                                       implant.
65175...............  ..............  A               Removal of ocular           6.27         NA       8.49       0.34         NA      15.10        090
                                                       implant.
65205...............  ..............  A               Remove foreign body         0.71       0.64       0.30       0.04       1.39       1.05        000
                                                       from eye.
65210...............  ..............  A               Remove foreign body         0.84       0.81       0.38       0.04       1.69       1.26        000
                                                       from eye.
65220...............  ..............  A               Remove foreign body         0.71       0.65       0.29       0.05       1.41       1.05        000
                                                       from eye.
65222...............  ..............  A               Remove foreign body         0.93       0.89       0.38       0.05       1.87       1.36        000
                                                       from eye.
65235...............  ..............  A               Remove foreign body         7.56         NA       6.74       0.38         NA      14.68        090
                                                       from eye.
65260...............  ..............  A               Remove foreign body        10.94         NA       9.65       0.56         NA      21.15        090
                                                       from eye.
65265...............  ..............  A               Remove foreign body        12.57         NA      10.63       0.66         NA      23.86        090
                                                       from eye.
65270...............  ..............  A               Repair of eye wound..       1.90       5.24       1.39       0.10       7.24       3.39        010
65272...............  ..............  A               Repair of eye wound..       3.81       7.73       3.29       0.20      11.74       7.30        090
65273...............  ..............  A               Repair of eye wound..       4.35         NA       3.57       0.25         NA       8.17        090
65275...............  ..............  A               Repair of eye wound..       5.33       6.33       3.95       0.30      11.96       9.58        090
65280...............  ..............  A               Repair of eye wound..       7.65         NA       6.23       0.39         NA      14.27        090
65285...............  ..............  A               Repair of eye wound..      12.88         NA       9.20       0.65         NA      22.73        090
65286...............  ..............  A               Repair of eye wound..       5.50      11.17       4.62       0.28      16.95      10.40        090
65290...............  ..............  A               Repair of eye socket        5.40         NA       4.73       0.36         NA      10.49        090
                                                       wound.
65400...............  ..............  A               Removal of eye lesion       6.05       8.33       6.12       0.30      14.68      12.47        090
65410...............  ..............  A               Biopsy of cornea.....       1.47       2.11       0.97       0.07       3.65       2.51        000
65420...............  ..............  A               Removal of eye lesion       4.16       8.86       4.44       0.21      13.23       8.81        090
65426...............  ..............  A               Removal of eye lesion       5.24      10.19       4.92       0.26      15.69      10.42        090
65430...............  ..............  A               Corneal smear........       1.47       1.29       0.98       0.07       2.83       2.52        000
65435...............  ..............  A               Curette/treat cornea.       0.92       1.00       0.71       0.05       1.97       1.68        000
65436...............  ..............  A               Curette/treat cornea.       4.18       4.10       3.67       0.21       8.49       8.06        090
65450...............  ..............  A               Treatment of corneal        3.27       4.03       3.86       0.17       7.47       7.30        090
                                                       lesion.
65600...............  ..............  A               Revision of cornea...       3.39       5.49       3.03       0.17       9.05       6.59        090
65710...............  ..............  A               Corneal transplant...      12.33         NA      11.43       0.62         NA      24.38        090
65730...............  ..............  A               Corneal transplant...      14.23         NA      11.83       0.71         NA      26.77        090
65750...............  ..............  A               Corneal transplant...      14.98         NA      12.29       0.75         NA      28.02        090
65755...............  ..............  A               Corneal transplant...      14.87         NA      12.22       0.74         NA      27.83        090
65770...............  ..............  A               Revise cornea with         17.53         NA      13.20       0.87         NA      31.60        090
                                                       implant.
65772...............  ..............  A               Correction of               4.28       5.53       4.13       0.21      10.02       8.62        090
                                                       astigmatism.
65775...............  ..............  A               Correction of               5.78         NA       6.25       0.29         NA      12.32        090
                                                       astigmatism.
65780...............  ..............  A               Ocular reconst,            10.23         NA      10.30       0.45         NA      20.98        090
                                                       transplant.
65781...............  ..............  A               Ocular reconst,            17.64         NA      13.67       0.45         NA      31.76        090
                                                       transplant.
65782...............  ..............  A               Ocular reconst,            14.98         NA      11.99       0.45         NA      27.42        090
                                                       transplant.
65800...............  ..............  A               Drainage of eye......       1.91       1.79       1.18       0.10       3.80       3.19        000
65805...............  ..............  A               Drainage of eye......       1.91       2.17       1.18       0.10       4.18       3.19        000
65810...............  ..............  A               Drainage of eye......       4.86         NA       4.70       0.25         NA       9.81        090
65815...............  ..............  A               Drainage of eye......       5.04      10.02       4.81       0.26      15.32      10.11        090
65820...............  ..............  A               Relieve inner eye           8.12         NA       9.06       0.42         NA      17.60        090
                                                       pressure.
65850...............  ..............  A               Incision of eye......      10.50         NA       8.44       0.52         NA      19.46        090
65855...............  ..............  A               Laser surgery of eye.       3.84       4.32       3.10       0.19       8.35       7.13        010
65860...............  ..............  A               Incise inner eye            3.54       4.05       2.50       0.18       7.77       6.22        090
                                                       adhesions.
65865...............  ..............  A               Incise inner eye            5.59         NA       5.63       0.28         NA      11.50        090
                                                       adhesions.
65870...............  ..............  A               Incise inner eye            6.26         NA       6.41       0.31         NA      12.98        090
                                                       adhesions.
65875...............  ..............  A               Incise inner eye            6.53         NA       6.80       0.33         NA      13.66        090
                                                       adhesions.
65880...............  ..............  A               Incise inner eye            7.08         NA       7.04       0.35         NA      14.47        090
                                                       adhesions.
65900...............  ..............  A               Remove eye lesion....      10.91         NA      10.42       0.56         NA      21.89        090
65920...............  ..............  A               Remove implant of eye       8.39         NA       8.17       0.42         NA      16.98        090
65930...............  ..............  A               Remove blood clot           7.43         NA       6.84       0.37         NA      14.64        090
                                                       from eye.
66020...............  ..............  A               Injection treatment         1.59       3.13       1.43       0.08       4.80       3.10        010
                                                       of eye.
66030...............  ..............  A               Injection treatment         1.25       2.97       1.28       0.06       4.28       2.59        010
                                                       of eye.

[[Page 47646]]

 
66130...............  ..............  A               Remove eye lesion....       7.68       9.64       5.60       0.39      17.71      13.67        090
66150...............  ..............  A               Glaucoma surgery.....       8.29         NA       9.41       0.44         NA      18.14        090
66155...............  ..............  A               Glaucoma surgery.....       8.28         NA       9.37       0.43         NA      18.08        090
66160...............  ..............  A               Glaucoma surgery.....      10.15         NA      10.20       0.52         NA      20.87        090
66165...............  ..............  A               Glaucoma surgery.....       8.00         NA       9.24       0.42         NA      17.66        090
66170...............  ..............  A               Glaucoma surgery.....      12.14         NA      12.23       0.61         NA      24.98        090
66172...............  ..............  A               Incision of eye......      15.02         NA      15.21       0.75         NA      30.98        090
66180...............  ..............  A               Implant eye shunt....      14.53         NA      10.76       0.73         NA      26.02        090
66185...............  ..............  A               Revise eye shunt.....       8.13         NA       7.38       0.41         NA      15.92        090
66220...............  ..............  A               Repair eye lesion....       7.76         NA       7.11       0.41         NA      15.28        090
66225...............  ..............  A               Repair/graft eye           11.03         NA       8.73       0.55         NA      20.31        090
                                                       lesion.
66250...............  ..............  A               Follow-up surgery of        5.97      11.71       5.48       0.30      17.98      11.75        090
                                                       eye.
66500...............  ..............  A               Incision of iris.....       3.70         NA       4.65       0.19         NA       8.54        090
66505...............  ..............  A               Incision of iris.....       4.07         NA       4.99       0.20         NA       9.26        090
66600...............  ..............  A               Remove iris and             8.67         NA       8.23       0.44         NA      17.34        090
                                                       lesion.
66605...............  ..............  A               Removal of iris......      12.77         NA      10.02       0.79         NA      23.58        090
66625...............  ..............  A               Removal of iris......       5.12         NA       4.73       0.27         NA      10.12        090
66630...............  ..............  A               Removal of iris......       6.15         NA       5.70       0.31         NA      12.16        090
66635...............  ..............  A               Removal of iris......       6.24         NA       5.74       0.32         NA      12.30        090
66680...............  ..............  A               Repair iris & ciliary       5.43         NA       5.27       0.27         NA      10.97        090
                                                       body.
66682...............  ..............  A               Repair iris & ciliary       6.20         NA       6.61       0.31         NA      13.12        090
                                                       body.
66700...............  ..............  A               Destruction, ciliary        4.77       5.25       3.93       0.25      10.27       8.95        090
                                                       body.
66710...............  ..............  A               Destruction, ciliary        4.77       5.17       3.84       0.24      10.18       8.85        090
                                                       body.
66720...............  ..............  A               Destruction, ciliary        4.77       5.82       4.71       0.26      10.85       9.74        090
                                                       body.
66740...............  ..............  A               Destruction, ciliary        4.77       5.09       3.97       0.24      10.10       8.98        090
                                                       body.
66761...............  ..............  A               Revision of iris.....       4.06       5.59       4.31       0.21       9.86       8.58        090
66762...............  ..............  A               Revision of iris.....       4.57       5.66       4.28       0.23      10.46       9.08        090
66770...............  ..............  A               Removal of inner eye        5.17       6.09       4.80       0.26      11.52      10.23        090
                                                       lesion.
66820...............  ..............  A               Incision, secondary         3.88         NA       5.83       0.19         NA       9.90        090
                                                       cataract.
66821...............  ..............  A               After cataract laser        2.35       3.81       3.63       0.11       6.27       6.09        090
                                                       surgery.
66825...............  ..............  A               Reposition                  8.22         NA       9.07       0.40         NA      17.69        090
                                                       intraocular lens.
66830...............  ..............  A               Removal of lens             8.19         NA       6.95       0.40         NA      15.54        090
                                                       lesion.
66840...............  ..............  A               Removal of lens             7.90         NA       6.86       0.39         NA      15.15        090
                                                       material.
66850...............  ..............  A               Removal of lens             9.10         NA       7.64       0.45         NA      17.19        090
                                                       material.
66852...............  ..............  A               Removal of lens             9.96         NA       8.10       0.50         NA      18.56        090
                                                       material.
66920...............  ..............  A               Extraction of lens...       8.85         NA       7.30       0.44         NA      16.59        090
66930...............  ..............  A               Extraction of lens...      10.16         NA       8.14       0.51         NA      18.81        090
66940...............  ..............  A               Extraction of lens...       8.92         NA       7.67       0.44         NA      17.03        090
66982...............  ..............  A               Cataract surgery,          13.48         NA       9.86       0.63         NA      23.97        090
                                                       complex.
66983...............  ..............  A               Cataract surg w/iol,        8.98         NA       6.11       0.21         NA      15.30        090
                                                       1 stage.
66984...............  ..............  A               Cataract surg w/iol,       10.21         NA       7.41       0.42         NA      18.04        090
                                                       1 stage.
66985...............  ..............  A               Insert lens                 8.38         NA       7.45       0.39         NA      16.22        090
                                                       prosthesis.
66986...............  ..............  A               Exchange lens              12.26         NA       9.17       0.60         NA      22.03        090
                                                       prosthesis.
66990...............  ..............  A               Ophthalmic endoscope        1.51         NA       0.69       0.07         NA       2.27        ZZZ
                                                       add-on.
67005...............  ..............  A               Partial removal of          5.69         NA       4.37       0.29         NA      10.35        090
                                                       eye fluid.
67010...............  ..............  A               Partial removal of          6.86         NA       4.91       0.34         NA      12.11        090
                                                       eye fluid.
67015...............  ..............  A               Release of eye fluid.       6.91         NA       6.46       0.35         NA      13.72        090
67025...............  ..............  A               Replace eye fluid....       6.83       9.24       6.22       0.34      16.41      13.39        090
67027...............  ..............  A               Implant eye drug           10.83         NA       8.00       0.55         NA      19.38        090
                                                       system.
67028...............  ..............  A               Injection eye drug...       2.52       2.70       1.45       0.13       5.35       4.10        000
67030...............  ..............  A               Incise inner eye            4.83         NA       5.85       0.25         NA      10.93        090
                                                       strands.
67031...............  ..............  A               Laser surgery, eye          3.66       4.61       3.64       0.18       8.45       7.48        090
                                                       strands.
67036...............  ..............  A               Removal of inner eye       11.87         NA       9.12       0.60         NA      21.59        090
                                                       fluid.
67038...............  ..............  A               Strip retinal              21.21         NA      15.49       1.07         NA      37.77        090
                                                       membrane.
67039...............  ..............  A               Laser treatment of         14.50         NA      12.18       0.73         NA      27.41        090
                                                       retina.
67040...............  ..............  A               Laser treatment of         17.20         NA      13.68       0.87         NA      31.75        090
                                                       retina.
67101...............  ..............  A               Repair detached             7.52       9.13       6.53       0.38      17.03      14.43        090
                                                       retina.
67105...............  ..............  A               Repair detached             7.40       8.09       6.15       0.37      15.86      13.92        090
                                                       retina.
67107...............  ..............  A               Repair detached            14.82         NA      11.30       0.74         NA      26.86        090
                                                       retina.
67108...............  ..............  A               Repair detached            20.79         NA      14.41       1.05         NA      36.25        090
                                                       retina.
67110...............  ..............  A               Repair detached             8.80      10.24       7.39       0.44      19.48      16.63        090
                                                       retina.
67112...............  ..............  A               Rerepair detached          16.83         NA      11.81       0.85         NA      29.49        090
                                                       retina.
67115...............  ..............  A               Release encircling          4.98         NA       5.08       0.25         NA      10.31        090
                                                       material.
67120...............  ..............  A               Remove eye implant          5.97       8.59       5.52       0.30      14.86      11.79        090
                                                       material.
67121...............  ..............  A               Remove eye implant         10.65         NA       8.53       0.53         NA      19.71        090
                                                       material.
67141...............  ..............  A               Treatment of retina..       5.19       5.85       4.86       0.26      11.30      10.31        090
67145...............  ..............  A               Treatment of retina..       5.36       5.72       4.93       0.27      11.35      10.56        090
67208...............  ..............  A               Treatment of retinal        6.69       6.12       5.51       0.34      13.15      12.54        090
                                                       lesion.
67210...............  ..............  A               Treatment of retinal        8.81       6.58       5.87       0.44      15.83      15.12        090
                                                       lesion.
67218...............  ..............  A               Treatment of retinal       18.50         NA      12.15       0.93         NA      31.58        090
                                                       lesion.
67220...............  ..............  A               Treatment of choroid       13.11      10.43       9.01       0.66      24.20      22.78        090
                                                       lesion.
67221...............  ..............  R               Ocular photodynamic         4.00       4.34       1.80       0.20       8.54       6.00        000
                                                       ther.
67225...............  ..............  A               Eye photodynamic ther       0.47       0.25       0.21       0.02       0.74       0.70        ZZZ
                                                       add-on.
67227...............  ..............  A               Treatment of retinal        6.57       6.58       5.52       0.33      13.48      12.42        090
                                                       lesion.
67228...............  ..............  A               Treatment of retinal       12.72      11.49       8.54       0.64      24.85      21.90        090
                                                       lesion.

[[Page 47647]]

 
67250...............  ..............  A               Reinforce eye wall...       8.65         NA       9.18       0.43         NA      18.26        090
67255...............  ..............  A               Reinforce/graft eye         8.89         NA       9.91       0.45         NA      19.25        090
                                                       wall.
67311...............  ..............  A               Revise eye muscle....       6.64         NA       6.02       0.37         NA      13.03        090
67312...............  ..............  A               Revise two eye              8.53         NA       6.75       0.44         NA      15.72        090
                                                       muscles.
67314...............  ..............  A               Revise eye muscle....       7.51         NA       6.55       0.40         NA      14.46        090
67316...............  ..............  A               Revise two eye              9.65         NA       7.50       0.51         NA      17.66        090
                                                       muscles.
67318...............  ..............  A               Revise eye muscle(s).       7.84         NA       6.93       0.41         NA      15.18        090
67320...............  ..............  A               Revise eye muscle(s)        4.32         NA       1.95       0.23         NA       6.50        ZZZ
                                                       add-on.
67331...............  ..............  A               Eye surgery follow-up       4.05         NA       1.82       0.21         NA       6.08        ZZZ
                                                       add-on.
67332...............  ..............  A               Rerevise eye muscles        4.48         NA       2.02       0.24         NA       6.74        ZZZ
                                                       add-on.
67334...............  ..............  A               Revise eye muscle w/        3.97         NA       1.79       0.20         NA       5.96        ZZZ
                                                       suture.
67335...............  ..............  A               Eye suture during           2.49         NA       1.12       0.13         NA       3.74        ZZZ
                                                       surgery.
67340...............  ..............  A               Revise eye muscle add-      4.92         NA       2.20       0.26         NA       7.38        ZZZ
                                                       on.
67343...............  ..............  A               Release eye tissue...       7.34         NA       6.50       0.42         NA      14.26        090
67345...............  ..............  A               Destroy nerve of eye        2.96       2.58       2.01       0.18       5.72       5.15        010
                                                       muscle.
67350...............  ..............  A               Biopsy eye muscle....       2.87         NA       1.86       0.15         NA       4.88        000
67400...............  ..............  A               Explore/biopsy eye          9.75         NA      11.27       0.58         NA      21.60        090
                                                       socket.
67405...............  ..............  A               Explore/drain eye           7.92         NA       9.78       0.49         NA      18.19        090
                                                       socket.
67412...............  ..............  A               Explore/treat eye           9.49         NA      10.95       0.53         NA      20.97        090
                                                       socket.
67413...............  ..............  A               Explore/treat eye           9.99         NA      10.78       0.56         NA      21.33        090
                                                       socket.
67414...............  ..............  A               Explr/decompress eye       11.11         NA      12.06       0.66         NA      23.83        090
                                                       socket.
67415...............  ..............  A               Aspiration, orbital         1.76         NA       0.76       0.09         NA       2.61        000
                                                       contents.
67420...............  ..............  A               Explore/treat eye          20.03         NA      17.39       1.21         NA      38.63        090
                                                       socket.
67430...............  ..............  A               Explore/treat eye          13.37         NA      15.08       0.84         NA      29.29        090
                                                       socket.
67440...............  ..............  A               Explore/drain eye          13.07         NA      14.27       0.76         NA      28.10        090
                                                       socket.
67445...............  ..............  A               Explr/decompress eye       14.40         NA      13.93       0.92         NA      29.25        090
                                                       socket.
67450...............  ..............  A               Explore/biopsy eye         13.49         NA      14.71       0.75         NA      28.95        090
                                                       socket.
67500...............  ..............  A               Inject/treat eye            0.79       0.67       0.29       0.05       1.51       1.13        000
                                                       socket.
67505...............  ..............  A               Inject/treat eye            0.82       0.69       0.31       0.05       1.56       1.18        000
                                                       socket.
67515...............  ..............  A               Inject/treat eye            0.61       0.59       0.38       0.03       1.23       1.02        000
                                                       socket.
67550...............  ..............  A               Insert eye socket          10.17         NA      11.29       0.66         NA      22.12        090
                                                       implant.
67560...............  ..............  A               Revise eye socket          10.58         NA      11.37       0.70         NA      22.65        090
                                                       implant.
67570...............  ..............  A               Decompress optic           13.56         NA      13.60       0.82         NA      27.98        090
                                                       nerve.
67700...............  ..............  A               Drainage of eyelid          1.35       6.05       1.27       0.07       7.47       2.69        010
                                                       abscess.
67710...............  ..............  A               Incision of eyelid...       1.02       5.40       1.20       0.05       6.47       2.27        010
67715...............  ..............  A               Incision of eyelid          1.22       5.39       1.29       0.06       6.67       2.57        010
                                                       fold.
67800...............  ..............  A               Remove eyelid lesion.       1.38       1.62       1.03       0.07       3.07       2.48        010
67801...............  ..............  A               Remove eyelid lesions       1.88       1.96       1.26       0.10       3.94       3.24        010
67805...............  ..............  A               Remove eyelid lesions       2.22       2.52       1.64       0.12       4.86       3.98        010
67808...............  ..............  A               Remove eyelid               3.79         NA       3.77       0.21         NA       7.77        090
                                                       lesion(s).
67810...............  ..............  A               Biopsy of eyelid.....       1.48       3.34       0.67       0.11       4.93       2.26        000
67820...............  ..............  A               Revise eyelashes.....       0.89       0.60       0.56       0.04       1.53       1.49        000
67825...............  ..............  A               Revise eyelashes.....       1.38       1.73       1.41       0.07       3.18       2.86        010
67830...............  ..............  A               Revise eyelashes.....       1.70       5.55       1.50       0.09       7.34       3.29        010
67835...............  ..............  A               Revise eyelashes.....       5.55         NA       4.61       0.29         NA      10.45        090
67840...............  ..............  A               Remove eyelid lesion.       2.04       5.49       1.65       0.11       7.64       3.80        010
67850...............  ..............  A               Treat eyelid lesion..       1.69       3.37       1.46       0.11       5.17       3.26        010
67875...............  ..............  A               Closure of eyelid by        1.35       3.31       0.94       0.08       4.74       2.37        000
                                                       suture.
67880...............  ..............  A               Revision of eyelid...       3.79       6.63       3.79       0.20      10.62       7.78        090
67882...............  ..............  A               Revision of eyelid...       5.06       7.65       4.80       0.27      12.98      10.13        090
67900...............  ..............  A               Repair brow defect...       6.13       9.05       5.23       0.39      15.57      11.75        090
67901...............  ..............  A               Repair eyelid defect.       6.96         NA       5.38       0.53         NA      12.87        090
67902...............  ..............  A               Repair eyelid defect.       7.02         NA       5.44       0.46         NA      12.92        090
67903...............  ..............  A               Repair eyelid defect.       6.36       9.58       5.47       0.44      16.38      12.27        090
67904...............  ..............  A               Repair eyelid defect.       6.25       9.69       5.22       0.41      16.35      11.88        090
67906...............  ..............  A               Repair eyelid defect.       6.78       5.39       5.02       0.44      12.61      12.24        090
67908...............  ..............  A               Repair eyelid defect.       5.12       7.04       5.24       0.30      12.46      10.66        090
67909...............  ..............  A               Revise eyelid defect.       5.39       8.03       4.93       0.32      13.74      10.64        090
67911...............  ..............  A               Revise eyelid defect.       5.26         NA       4.77       0.31         NA      10.34        090
67912...............  ..............  A               Correction eyelid w/        5.67      18.69       5.46       0.28      24.64      11.41        090
                                                       implant.
67914...............  ..............  A               Repair eyelid defect.       3.67       6.35       3.04       0.21      10.23       6.92        090
67915...............  ..............  A               Repair eyelid defect.       3.18       6.00       2.80       0.17       9.35       6.15        090
67916...............  ..............  A               Repair eyelid defect.       5.30       8.06       4.76       0.30      13.66      10.36        090
67917...............  ..............  A               Repair eyelid defect.       6.01       8.47       5.07       0.37      14.85      11.45        090
67921...............  ..............  A               Repair eyelid defect.       3.39       6.21       2.89       0.18       9.78       6.46        090
67922...............  ..............  A               Repair eyelid defect.       3.06       5.93       2.75       0.16       9.15       5.97        090
67923...............  ..............  A               Repair eyelid defect.       5.87       8.14       4.97       0.32      14.33      11.16        090
67924...............  ..............  A               Repair eyelid defect.       5.78       8.94       4.68       0.32      15.04      10.78        090
67930...............  ..............  A               Repair eyelid wound..       3.60       5.74       2.17       0.20       9.54       5.97        010
67935...............  ..............  A               Repair eyelid wound..       6.21       8.53       4.40       0.39      15.13      11.00        090
67938...............  ..............  A               Remove eyelid foreign       1.33       5.40       1.27       0.07       6.80       2.67        010
                                                       body.
67950...............  ..............  A               Revision of eyelid...       5.81       8.63       5.19       0.36      14.80      11.36        090
67961...............  ..............  A               Revision of eyelid...       5.68       8.68       5.01       0.33      14.69      11.02        090
67966...............  ..............  A               Revision of eyelid...       6.56       9.13       5.53       0.39      16.08      12.48        090
67971...............  ..............  A               Reconstruction of           9.78         NA       7.27       0.54         NA      17.59        090
                                                       eyelid.

[[Page 47648]]

 
67973...............  ..............  A               Reconstruction of          12.85         NA       9.29       0.73         NA      22.87        090
                                                       eyelid.
67974...............  ..............  A               Reconstruction of          12.82         NA       9.21       0.70         NA      22.73        090
                                                       eyelid.
67975...............  ..............  A               Reconstruction of           9.12         NA       6.94       0.49         NA      16.55        090
                                                       eyelid.
68020...............  ..............  A               Incise/drain eyelid         1.37       1.41       1.21       0.07       2.85       2.65        010
                                                       lining.
68040...............  ..............  A               Treatment of eyelid         0.85       0.71       0.43       0.04       1.60       1.32        000
                                                       lesions.
68100...............  ..............  A               Biopsy of eyelid            1.35       3.25       0.95       0.07       4.67       2.37        000
                                                       lining.
68110...............  ..............  A               Remove eyelid lining        1.77       4.10       1.64       0.09       5.96       3.50        010
                                                       lesion.
68115...............  ..............  A               Remove eyelid lining        2.36       5.97       1.91       0.12       8.45       4.39        010
                                                       lesion.
68130...............  ..............  A               Remove eyelid lining        4.92       8.72       4.59       0.25      13.89       9.76        090
                                                       lesion.
68135...............  ..............  A               Remove eyelid lining        1.84       1.81       1.65       0.09       3.74       3.58        010
                                                       lesion.
68200...............  ..............  A               Treat eyelid by             0.49       0.54       0.33       0.02       1.05       0.84        000
                                                       injection.
68320...............  ..............  A               Revise/graft eyelid         5.36      11.29       5.52       0.29      16.94      11.17        090
                                                       lining.
68325...............  ..............  A               Revise/graft eyelid         7.35         NA       6.53       0.41         NA      14.29        090
                                                       lining.
68326...............  ..............  A               Revise/graft eyelid         7.14         NA       6.40       0.38         NA      13.92        090
                                                       lining.
68328...............  ..............  A               Revise/graft eyelid         8.17         NA       7.26       0.55         NA      15.98        090
                                                       lining.
68330...............  ..............  A               Revise eyelid lining.       4.82       9.41       4.71       0.25      14.48       9.78        090
68335...............  ..............  A               Revise/graft eyelid         7.18         NA       6.37       0.36         NA      13.91        090
                                                       lining.
68340...............  ..............  A               Separate eyelid             4.16       8.89       4.10       0.21      13.26       8.47        090
                                                       adhesions.
68360...............  ..............  A               Revise eyelid lining.       4.36       8.05       4.18       0.22      12.63       8.76        090
68362...............  ..............  A               Revise eyelid lining.       7.33         NA       6.40       0.37         NA      14.10        090
68371...............  ..............  A               Harvest eye tissue,         4.89         NA       4.73       0.45         NA      10.07        010
                                                       alograft.
68400...............  ..............  A               Incise/drain tear           1.69       5.92       1.83       0.09       7.70       3.61        010
                                                       gland.
68420...............  ..............  A               Incise/drain tear sac       2.30       6.22       2.11       0.12       8.64       4.53        010
68440...............  ..............  A               Incise tear duct            0.94       2.09       1.27       0.05       3.08       2.26        010
                                                       opening.
68500...............  ..............  A               Removal of tear gland      11.00         NA       9.73       0.63         NA      21.36        090
68505...............  ..............  A               Partial removal, tear      10.92         NA      10.59       0.61         NA      22.12        090
                                                       gland.
68510...............  ..............  A               Biopsy of tear gland.       4.60       7.35       2.09       0.24      12.19       6.93        000
68520...............  ..............  A               Removal of tear sac..       7.50         NA       7.41       0.39         NA      15.30        090
68525...............  ..............  A               Biopsy of tear sac...       4.42         NA       2.01       0.24         NA       6.67        000
68530...............  ..............  A               Clearance of tear           3.65       8.19       2.64       0.20      12.04       6.49        010
                                                       duct.
68540...............  ..............  A               Remove tear gland          10.58         NA       9.38       0.53         NA      20.49        090
                                                       lesion.
68550...............  ..............  A               Remove tear gland          13.24         NA      11.33       0.66         NA      25.23        090
                                                       lesion.
68700...............  ..............  A               Repair tear ducts....       6.59         NA       5.97       0.35         NA      12.91        090
68705...............  ..............  A               Revise tear duct            2.06       4.19       1.78       0.10       6.35       3.94        010
                                                       opening.
68720...............  ..............  A               Create tear sac drain       8.95         NA       7.86       0.50         NA      17.31        090
68745...............  ..............  A               Create tear duct            8.62         NA       7.86       0.43         NA      16.91        090
                                                       drain.
68750...............  ..............  A               Create tear duct            8.65         NA       8.27       0.46         NA      17.38        090
                                                       drain.
68760...............  ..............  A               Close tear duct             1.73       3.55       1.63       0.09       5.37       3.45        010
                                                       opening.
68761...............  ..............  A               Close tear duct             1.36       2.27       1.32       0.07       3.70       2.75        010
                                                       opening.
68770...............  ..............  A               Close tear system           7.01       3.17       3.17       0.36      10.54      10.54        090
                                                       fistula.
68801...............  ..............  A               Dilate tear duct            0.94       1.95       1.48       0.05       2.94       2.47        010
                                                       opening.
68810...............  ..............  A               Probe nasolacrimal          1.90       3.66       2.67       0.11       5.67       4.68        010
                                                       duct.
68811...............  ..............  A               Probe nasolacrimal          2.35         NA       2.40       0.14         NA       4.89        010
                                                       duct.
68815...............  ..............  A               Probe nasolacrimal          3.20       8.27       2.81       0.18      11.65       6.19        010
                                                       duct.
68840...............  ..............  A               Explore/irrigate tear       1.25       1.61       1.12       0.06       2.92       2.43        010
                                                       ducts.
68850...............  ..............  A               Injection for tear          0.80       0.88       0.67       0.04       1.72       1.51        000
                                                       sac x-ray.
69000...............  ..............  A               Drain external ear          1.45       2.89       1.38       0.12       4.46       2.95        010
                                                       lesion.
69005...............  ..............  A               Drain external ear          2.11       2.93       1.83       0.18       5.22       4.12        010
                                                       lesion.
69020...............  ..............  A               Drain outer ear canal       1.48       3.97       2.07       0.12       5.57       3.67        010
                                                       lesion.
69100...............  ..............  A               Biopsy of external          0.81       1.71       0.39       0.07       2.59       1.27        000
                                                       ear.
69105...............  ..............  A               Biopsy of external          0.85       2.32       0.77       0.07       3.24       1.69        000
                                                       ear canal.
69110...............  ..............  A               Remove external ear,        3.43       6.73       4.46       0.34      10.50       8.23        090
                                                       partial.
69120...............  ..............  A               Removal of external         4.04         NA       6.16       0.39         NA      10.59        090
                                                       ear.
69140...............  ..............  A               Remove ear canal            7.96         NA      13.21       0.67         NA      21.84        090
                                                       lesion(s).
69145...............  ..............  A               Remove ear canal            2.62       5.73       3.28       0.22       8.57       6.12        090
                                                       lesion(s).
69150...............  ..............  A               Extensive ear canal        13.41         NA      13.32       1.27         NA      28.00        090
                                                       surgery.
69155...............  ..............  A               Extensive ear/neck         20.77         NA      19.43       1.84         NA      42.04        090
                                                       surgery.
69200...............  ..............  A               Clear outer ear canal       0.77       2.38       0.56       0.06       3.21       1.39        000
69205...............  ..............  A               Clear outer ear canal       1.20         NA       1.35       0.10         NA       2.65        010
69210...............  ..............  A               Remove impacted ear         0.61       0.63       0.23       0.05       1.29       0.89        000
                                                       wax.
69220...............  ..............  A               Clean out mastoid           0.83       2.35       0.74       0.07       3.25       1.64        000
                                                       cavity.
69222...............  ..............  A               Clean out mastoid           1.40       3.82       2.05       0.12       5.34       3.57        010
                                                       cavity.
69300...............  ..............  R               Revise external ear..       6.35         NA       4.21       0.75         NA      11.31        YYY
69310...............  ..............  A               Rebuild outer ear          10.77         NA      16.18       0.89         NA      27.84        090
                                                       canal.
69320...............  ..............  A               Rebuild outer ear          16.93         NA      21.71       1.45         NA      40.09        090
                                                       canal.
69400...............  ..............  A               Inflate middle ear          0.83       2.16       0.67       0.07       3.06       1.57        000
                                                       canal.
69401...............  ..............  A               Inflate middle ear          0.63       1.24       0.65       0.05       1.92       1.33        000
                                                       canal.
69405...............  ..............  A               Catheterize middle          2.63       3.46       2.29       0.21       6.30       5.13        010
                                                       ear canal.
69410...............  ..............  A               Inset middle ear            0.33       2.12       0.48       0.03       2.48       0.84        000
                                                       (baffle).
69420...............  ..............  A               Incision of eardrum..       1.33       3.12       1.58       0.11       4.56       3.02        010
69421...............  ..............  A               Incision of eardrum..       1.73         NA       2.15       0.16         NA       4.04        010
69424...............  ..............  A               Remove ventilating          0.85       2.17       0.68       0.07       3.09       1.60        000
                                                       tube.
69433...............  ..............  A               Create eardrum              1.52       3.09       1.64       0.13       4.74       3.29        010
                                                       opening.
69436...............  ..............  A               Create eardrum              1.96         NA       2.27       0.19         NA       4.42        010
                                                       opening.
69440...............  ..............  A               Exploration of middle       7.56         NA       8.71       0.62         NA      16.89        090
                                                       ear.

[[Page 47649]]

 
69450...............  ..............  A               Eardrum revision.....       5.56         NA       6.99       0.45         NA      13.00        090
69501...............  ..............  A               Mastoidectomy........       9.06         NA       8.96       0.76         NA      18.78        090
69502...............  ..............  A               Mastoidectomy........      12.36         NA      11.54       1.03         NA      24.93        090
69505...............  ..............  A               Remove mastoid             12.97         NA      17.11       1.08         NA      31.16        090
                                                       structures.
69511...............  ..............  A               Extensive mastoid          13.50         NA      17.39       1.09         NA      31.98        090
                                                       surgery.
69530...............  ..............  A               Extensive mastoid          19.16         NA      21.52       1.44         NA      42.12        090
                                                       surgery.
69535...............  ..............  A               Remove part of             36.09         NA      31.85       2.98         NA      70.92        090
                                                       temporal bone.
69540...............  ..............  A               Remove ear lesion....       1.20       3.71       1.95       0.10       5.01       3.25        010
69550...............  ..............  A               Remove ear lesion....      10.97         NA      14.79       0.90         NA      26.66        090
69552...............  ..............  A               Remove ear lesion....      19.43         NA      20.60       1.55         NA      41.58        090
69554...............  ..............  A               Remove ear lesion....      33.11         NA      30.18       2.94         NA      66.23        090
69601...............  ..............  A               Mastoid surgery            13.22         NA      12.60       1.07         NA      26.89        090
                                                       revision.
69602...............  ..............  A               Mastoid surgery            13.56         NA      13.16       1.05         NA      27.77        090
                                                       revision.
69603...............  ..............  A               Mastoid surgery            14.00         NA      18.26       1.14         NA      33.40        090
                                                       revision.
69604...............  ..............  A               Mastoid surgery            14.00         NA      13.63       0.92         NA      28.55        090
                                                       revision.
69605...............  ..............  A               Mastoid surgery            18.46         NA      20.85       1.51         NA      40.82        090
                                                       revision.
69610...............  ..............  A               Repair of eardrum....       4.42       5.50       3.26       0.36      10.28       8.04        010
69620...............  ..............  A               Repair of eardrum....       5.88      11.03       6.25       0.48      17.39      12.61        090
69631...............  ..............  A               Repair eardrum              9.85         NA      11.13       0.81         NA      21.79        090
                                                       structures.
69632...............  ..............  A               Rebuild eardrum            12.73         NA      13.39       1.04         NA      27.16        090
                                                       structures.
69633...............  ..............  A               Rebuild eardrum            12.08         NA      12.97       0.99         NA      26.04        090
                                                       structures.
69635...............  ..............  A               Repair eardrum             13.31         NA      16.66       1.08         NA      31.05        090
                                                       structures.
69636...............  ..............  A               Rebuild eardrum            15.20         NA      19.18       1.23         NA      35.61        090
                                                       structures.
69637...............  ..............  A               Rebuild eardrum            15.09         NA      19.11       1.25         NA      35.45        090
                                                       structures.
69641...............  ..............  A               Revise middle ear &        12.69         NA      12.70       1.04         NA      26.43        090
                                                       mastoid.
69642...............  ..............  A               Revise middle ear &        16.81         NA      16.19       1.37         NA      34.37        090
                                                       mastoid.
69643...............  ..............  A               Revise middle ear &        15.30         NA      14.73       1.26         NA      31.29        090
                                                       mastoid.
69644...............  ..............  A               Revise middle ear &        16.94         NA      20.30       1.38         NA      38.62        090
                                                       mastoid.
69645...............  ..............  A               Revise middle ear &        16.36         NA      19.92       1.35         NA      37.63        090
                                                       mastoid.
69646...............  ..............  A               Revise middle ear &        17.96         NA      20.65       1.48         NA      40.09        090
                                                       mastoid.
69650...............  ..............  A               Release middle ear          9.65         NA       9.85       0.78         NA      20.28        090
                                                       bone.
69660...............  ..............  A               Revise middle ear          11.88         NA      11.13       0.95         NA      23.96        090
                                                       bone.
69661...............  ..............  A               Revise middle ear          15.72         NA      14.62       1.29         NA      31.63        090
                                                       bone.
69662...............  ..............  A               Revise middle ear          15.42         NA      13.68       1.26         NA      30.36        090
                                                       bone.
69666...............  ..............  A               Repair middle ear           9.74         NA       9.91       0.79         NA      20.44        090
                                                       structures.
69667...............  ..............  A               Repair middle ear           9.75         NA       9.92       0.79         NA      20.46        090
                                                       structures.
69670...............  ..............  A               Remove mastoid air         11.49         NA      11.65       0.96         NA      24.10        090
                                                       cells.
69676...............  ..............  A               Remove middle ear           9.51         NA      10.67       0.84         NA      21.02        090
                                                       nerve.
69700...............  ..............  A               Close mastoid fistula       8.22         NA       9.20       0.66         NA      18.08        090
69711...............  ..............  A               Remove/repair hearing      10.42         NA      10.74       0.85         NA      22.01        090
                                                       aid.
69714...............  ..............  A               Implant temple bone w/     13.98         NA      12.61       1.21         NA      27.80        090
                                                       stimul.
69715...............  ..............  A               Temple bne implnt w/       18.22         NA      14.96       1.49         NA      34.67        090
                                                       stimulat.
69717...............  ..............  A               Temple bone implant        14.96         NA      14.46       1.35         NA      30.77        090
                                                       revision.
69718...............  ..............  A               Revise temple bone         18.47         NA      15.26       1.62         NA      35.35        090
                                                       implant.
69720...............  ..............  A               Release facial nerve.      14.36         NA      14.43       1.24         NA      30.03        090
69725...............  ..............  A               Release facial nerve.      25.34         NA      20.02       2.29         NA      47.65        090
69740...............  ..............  A               Repair facial nerve..      15.94         NA      13.37       1.58         NA      30.89        090
69745...............  ..............  A               Repair facial nerve..      16.66         NA      14.91       1.36         NA      32.93        090
69801...............  ..............  A               Incise inner ear.....       8.55         NA       9.41       0.70         NA      18.66        090
69802...............  ..............  A               Incise inner ear.....      13.08         NA      12.25       1.07         NA      26.40        090
69805...............  ..............  A               Explore inner ear....      13.80         NA      11.82       1.16         NA      26.78        090
69806...............  ..............  A               Explore inner ear....      12.33         NA      10.99       1.04         NA      24.36        090
69820...............  ..............  A               Establish inner ear        10.32         NA      11.19       0.82         NA      22.33        090
                                                       window.
69840...............  ..............  A               Revise inner ear           10.24         NA      13.15       0.74         NA      24.13        090
                                                       window.
69905...............  ..............  A               Remove inner ear.....      11.08         NA      11.29       0.90         NA      23.27        090
69910...............  ..............  A               Remove inner ear &         13.61         NA      11.88       1.10         NA      26.59        090
                                                       mastoid.
69915...............  ..............  A               Incise inner ear           21.20         NA      16.39       1.70         NA      39.29        090
                                                       nerve.
69930...............  ..............  A               Implant cochlear           16.78         NA      14.68       1.38         NA      32.84        090
                                                       device.
69950...............  ..............  A               Incise inner ear           25.60         NA      18.82       3.07         NA      47.49        090
                                                       nerve.
69955...............  ..............  A               Release facial nerve.      27.00         NA      21.29       2.77         NA      51.06        090
69960...............  ..............  A               Release inner ear          27.00         NA      19.98       2.69         NA      49.67        090
                                                       canal.
69970...............  ..............  A               Remove inner ear           29.99         NA      23.17       2.73         NA      55.89        090
                                                       lesion.
69990...............  ..............  R               Microsurgery add-on..       3.46         NA       1.78       0.81         NA       6.05        ZZZ
70010...............  ..............  A               Contrast x-ray of           1.19       4.72         NA       0.28       6.19         NA        XXX
                                                       brain.
70010...............  26............  A               Contrast x-ray of           1.19       0.39       0.39       0.06       1.64       1.64        XXX
                                                       brain.
70010...............  TC............  A               Contrast x-ray of           0.00       4.32         NA       0.22       4.54         NA        XXX
                                                       brain.
70015...............  ..............  A               Contrast x-ray of           1.19       1.74         NA       0.14       3.07         NA        XXX
                                                       brain.
70015...............  26............  A               Contrast x-ray of           1.19       0.39       0.39       0.06       1.64       1.64        XXX
                                                       brain.
70015...............  TC............  A               Contrast x-ray of           0.00       1.35         NA       0.08       1.43         NA        XXX
                                                       brain.
70030...............  ..............  A               X-ray eye for foreign       0.17       0.47         NA       0.03       0.67         NA        XXX
                                                       body.
70030...............  26............  A               X-ray eye for foreign       0.17       0.06       0.06       0.01       0.24       0.24        XXX
                                                       body.
70030...............  TC............  A               X-ray eye for foreign       0.00       0.42         NA       0.02       0.44         NA        XXX
                                                       body.
70100...............  ..............  A               X-ray exam of jaw....       0.18       0.58         NA       0.03       0.79         NA        XXX
70100...............  26............  A               X-ray exam of jaw....       0.18       0.06       0.06       0.01       0.25       0.25        XXX
70100...............  TC............  A               X-ray exam of jaw....       0.00       0.52         NA       0.02       0.54         NA        XXX

[[Page 47650]]

 
70110...............  ..............  A               X-ray exam of jaw....       0.25       0.70         NA       0.05       1.00         NA        XXX
70110...............  26............  A               X-ray exam of jaw....       0.25       0.08       0.08       0.01       0.34       0.34        XXX
70110...............  TC............  A               X-ray exam of jaw....       0.00       0.62         NA       0.04       0.66         NA        XXX
70120...............  ..............  A               X-ray exam of               0.18       0.68         NA       0.05       0.91         NA        XXX
                                                       mastoids.
70120...............  26............  A               X-ray exam of               0.18       0.06       0.06       0.01       0.25       0.25        XXX
                                                       mastoids.
70120...............  TC............  A               X-ray exam of               0.00       0.62         NA       0.04       0.66         NA        XXX
                                                       mastoids.
70130...............  ..............  A               X-ray exam of               0.34       0.89         NA       0.07       1.30         NA        XXX
                                                       mastoids.
70130...............  26............  A               X-ray exam of               0.34       0.11       0.11       0.02       0.47       0.47        XXX
                                                       mastoids.
70130...............  TC............  A               X-ray exam of               0.00       0.78         NA       0.05       0.83         NA        XXX
                                                       mastoids.
70134...............  ..............  A               X-ray exam of middle        0.34       0.85         NA       0.07       1.26         NA        XXX
                                                       ear.
70134...............  26............  A               X-ray exam of middle        0.34       0.11       0.11       0.02       0.47       0.47        XXX
                                                       ear.
70134...............  TC............  A               X-ray exam of middle        0.00       0.73         NA       0.05       0.78         NA        XXX
                                                       ear.
70140...............  ..............  A               X-ray exam of facial        0.19       0.68         NA       0.05       0.92         NA        XXX
                                                       bones.
70140...............  26............  A               X-ray exam of facial        0.19       0.06       0.06       0.01       0.26       0.26        XXX
                                                       bones.
70140...............  TC............  A               X-ray exam of facial        0.00       0.62         NA       0.04       0.66         NA        XXX
                                                       bones.
70150...............  ..............  A               X-ray exam of facial        0.26       0.87         NA       0.06       1.19         NA        XXX
                                                       bones.
70150...............  26............  A               X-ray exam of facial        0.26       0.08       0.08       0.01       0.35       0.35        XXX
                                                       bones.
70150...............  TC............  A               X-ray exam of facial        0.00       0.78         NA       0.05       0.83         NA        XXX
                                                       bones.
70160...............  ..............  A               X-ray exam of nasal         0.17       0.58         NA       0.03       0.78         NA        XXX
                                                       bones.
70160...............  26............  A               X-ray exam of nasal         0.17       0.06       0.06       0.01       0.24       0.24        XXX
                                                       bones.
70160...............  TC............  A               X-ray exam of nasal         0.00       0.52         NA       0.02       0.54         NA        XXX
                                                       bones.
70170...............  ..............  A               X-ray exam of tear          0.30       1.04         NA       0.07       1.41         NA        XXX
                                                       duct.
70170...............  26............  A               X-ray exam of tear          0.30       0.10       0.10       0.01       0.41       0.41        XXX
                                                       duct.
70170...............  TC............  A               X-ray exam of tear          0.00       0.95         NA       0.06       1.01         NA        XXX
                                                       duct.
70190...............  ..............  A               X-ray exam of eye           0.21       0.69         NA       0.05       0.95         NA        XXX
                                                       sockets.
70190...............  26............  A               X-ray exam of eye           0.21       0.07       0.07       0.01       0.29       0.29        XXX
                                                       sockets.
70190...............  TC............  A               X-ray exam of eye           0.00       0.62         NA       0.04       0.66         NA        XXX
                                                       sockets.
70200...............  ..............  A               X-ray exam of eye           0.28       0.87         NA       0.06       1.21         NA        XXX
                                                       sockets.
70200...............  26............  A               X-ray exam of eye           0.28       0.09       0.09       0.01       0.38       0.38        XXX
                                                       sockets.
70200...............  TC............  A               X-ray exam of eye           0.00       0.78         NA       0.05       0.83         NA        XXX
                                                       sockets.
70210...............  ..............  A               X-ray exam of sinuses       0.17       0.67         NA       0.05       0.89         NA        XXX
70210...............  26............  A               X-ray exam of sinuses       0.17       0.06       0.06       0.01       0.24       0.24        XXX
70210...............  TC............  A               X-ray exam of sinuses       0.00       0.62         NA       0.04       0.66         NA        XXX
70220...............  ..............  A               X-ray exam of sinuses       0.25       0.86         NA       0.06       1.17         NA        XXX
70220...............  26............  A               X-ray exam of sinuses       0.25       0.08       0.08       0.01       0.34       0.34        XXX
70220...............  TC............  A               X-ray exam of sinuses       0.00       0.78         NA       0.05       0.83         NA        XXX
70240...............  ..............  A               X-ray exam, pituitary       0.19       0.48         NA       0.03       0.70         NA        XXX
                                                       saddle.
70240...............  26............  A               X-ray exam, pituitary       0.19       0.06       0.06       0.01       0.26       0.26        XXX
                                                       saddle.
70240...............  TC............  A               X-ray exam, pituitary       0.00       0.42         NA       0.02       0.44         NA        XXX
                                                       saddle.
70250...............  ..............  A               X-ray exam of skull..       0.24       0.70         NA       0.05       0.99         NA        XXX
70250...............  26............  A               X-ray exam of skull..       0.24       0.08       0.08       0.01       0.33       0.33        XXX
70250...............  TC............  A               X-ray exam of skull..       0.00       0.62         NA       0.04       0.66         NA        XXX
70260...............  ..............  A               X-ray exam of skull..       0.34       1.00         NA       0.08       1.42         NA        XXX
70260...............  26............  A               X-ray exam of skull..       0.34       0.11       0.11       0.02       0.47       0.47        XXX
70260...............  TC............  A               X-ray exam of skull..       0.00       0.89         NA       0.06       0.95         NA        XXX
70300...............  ..............  A               X-ray exam of teeth..       0.10       0.31         NA       0.03       0.44         NA        XXX
70300...............  26............  A               X-ray exam of teeth..       0.10       0.05       0.05       0.01       0.16       0.16        XXX
70300...............  TC............  A               X-ray exam of teeth..       0.00       0.26         NA       0.02       0.28         NA        XXX
70310...............  ..............  A               X-ray exam of teeth..       0.16       0.49         NA       0.03       0.68         NA        XXX
70310...............  26............  A               X-ray exam of teeth..       0.16       0.08       0.08       0.01       0.25       0.25        XXX
70310...............  TC............  A               X-ray exam of teeth..       0.00       0.42         NA       0.02       0.44         NA        XXX
70320...............  ..............  A               Full mouth x-ray of         0.22       0.86         NA       0.06       1.14         NA        XXX
                                                       teeth.
70320...............  26............  A               Full mouth x-ray of         0.22       0.08       0.08       0.01       0.31       0.31        XXX
                                                       teeth.
70320...............  TC............  A               Full mouth x-ray of         0.00       0.78         NA       0.05       0.83         NA        XXX
                                                       teeth.
70328...............  ..............  A               X-ray exam of jaw           0.18       0.55         NA       0.03       0.76         NA        XXX
                                                       joint.
70328...............  26............  A               X-ray exam of jaw           0.18       0.06       0.06       0.01       0.25       0.25        XXX
                                                       joint.
70328...............  TC............  A               X-ray exam of jaw           0.00       0.49         NA       0.02       0.51         NA        XXX
                                                       joint.
70330...............  ..............  A               X-ray exam of jaw           0.24       0.92         NA       0.06       1.22         NA        XXX
                                                       joints.
70330...............  26............  A               X-ray exam of jaw           0.24       0.08       0.08       0.01       0.33       0.33        XXX
                                                       joints.
70330...............  TC............  A               X-ray exam of jaw           0.00       0.84         NA       0.05       0.89         NA        XXX
                                                       joints.
70332...............  ..............  A               X-ray exam of jaw           0.54       2.29         NA       0.15       2.98         NA        XXX
                                                       joint.
70332...............  26............  A               X-ray exam of jaw           0.54       0.20       0.20       0.03       0.77       0.77        XXX
                                                       joint.
70332...............  TC............  A               X-ray exam of jaw           0.00       2.09         NA       0.12       2.21         NA        XXX
                                                       joint.
70336...............  ..............  A               Magnetic image, jaw         1.48      11.67         NA       0.66      13.81         NA        XXX
                                                       joint.
70336...............  26............  A               Magnetic image, jaw         1.48       0.49       0.49       0.07       2.04       2.04        XXX
                                                       joint.
70336...............  TC............  A               Magnetic image, jaw         0.00      11.19         NA       0.59      11.78         NA        XXX
                                                       joint.
70350...............  ..............  A               X-ray head for              0.17       0.45         NA       0.03       0.65         NA        XXX
                                                       orthodontia.
70350...............  26............  A               X-ray head for              0.17       0.07       0.07       0.01       0.25       0.25        XXX
                                                       orthodontia.
70350...............  TC............  A               X-ray head for              0.00       0.38         NA       0.02       0.40         NA        XXX
                                                       orthodontia.
70355...............  ..............  A               Panoramic x-ray of          0.20       0.64         NA       0.05       0.89         NA        XXX
                                                       jaws.
70355...............  26............  A               Panoramic x-ray of          0.20       0.07       0.07       0.01       0.28       0.28        XXX
                                                       jaws.
70355...............  TC............  A               Panoramic x-ray of          0.00       0.57         NA       0.04       0.61         NA        XXX
                                                       jaws.
70360...............  ..............  A               X-ray exam of neck...       0.17       0.47         NA       0.03       0.67         NA        XXX
70360...............  26............  A               X-ray exam of neck...       0.17       0.06       0.06       0.01       0.24       0.24        XXX
70360...............  TC............  A               X-ray exam of neck...       0.00       0.42         NA       0.02       0.44         NA        XXX

[[Page 47651]]

 
70370...............  ..............  A               Throat x-ray &              0.32       1.41         NA       0.08       1.81         NA        XXX
                                                       fluoroscopy.
70370...............  26............  A               Throat x-ray &              0.32       0.10       0.10       0.01       0.43       0.43        XXX
                                                       fluoroscopy.
70370...............  TC............  A               Throat x-ray &              0.00       1.30         NA       0.07       1.37         NA        XXX
                                                       fluoroscopy.
70371...............  ..............  A               Speech evaluation,          0.84       2.37         NA       0.16       3.37         NA        XXX
                                                       complex.
70371...............  26............  A               Speech evaluation,          0.84       0.27       0.27       0.04       1.15       1.15        XXX
                                                       complex.
70371...............  TC............  A               Speech evaluation,          0.00       2.09         NA       0.12       2.21         NA        XXX
                                                       complex.
70373...............  ..............  A               Contrast x-ray of           0.44       1.92         NA       0.13       2.49         NA        XXX
                                                       larynx.
70373...............  26............  A               Contrast x-ray of           0.44       0.14       0.14       0.02       0.60       0.60        XXX
                                                       larynx.
70373...............  TC............  A               Contrast x-ray of           0.00       1.78         NA       0.11       1.89         NA        XXX
                                                       larynx.
70380...............  ..............  A               X-ray exam of               0.17       0.72         NA       0.05       0.94         NA        XXX
                                                       salivary gland.
70380...............  26............  A               X-ray exam of               0.17       0.06       0.06       0.01       0.24       0.24        XXX
                                                       salivary gland.
70380...............  TC............  A               X-ray exam of               0.00       0.67         NA       0.04       0.71         NA        XXX
                                                       salivary gland.
70390...............  ..............  A               X-ray exam of               0.38       1.90         NA       0.13       2.41         NA        XXX
                                                       salivary duct.
70390...............  26............  A               X-ray exam of               0.38       0.12       0.12       0.02       0.52       0.52        XXX
                                                       salivary duct.
70390...............  TC............  A               X-ray exam of               0.00       1.78         NA       0.11       1.89         NA        XXX
                                                       salivary duct.
70450...............  ..............  A               Ct head/brain w/o dye       0.85       4.99         NA       0.29       6.13         NA        XXX
70450...............  26............  A               Ct head/brain w/o dye       0.85       0.28       0.28       0.04       1.17       1.17        XXX
70450...............  TC............  A               Ct head/brain w/o dye       0.00       4.71         NA       0.25       4.96         NA        XXX
70460...............  ..............  A               Ct head/brain w/dye..       1.13       6.02         NA       0.35       7.50         NA        XXX
70460...............  26............  A               Ct head/brain w/dye..       1.13       0.37       0.37       0.05       1.55       1.55        XXX
70460...............  TC............  A               Ct head/brain w/dye..       0.00       5.65         NA       0.30       5.95         NA        XXX
70470...............  ..............  A               Ct head/brain w/o & w/      1.27       7.47         NA       0.43       9.17         NA        XXX
                                                        dye.
70470...............  26............  A               Ct head/brain w/o & w/      1.27       0.42       0.42       0.06       1.75       1.75        XXX
                                                        dye.
70470...............  TC............  A               Ct head/brain w/o & w/      0.00       7.06         NA       0.37       7.43         NA        XXX
                                                        dye.
70480...............  ..............  A               Ct orbit/ear/fossa w/       1.28       5.13         NA       0.31       6.72         NA        XXX
                                                       o dye.
70480...............  26............  A               Ct orbit/ear/fossa w/       1.28       0.42       0.42       0.06       1.76       1.76        XXX
                                                       o dye.
70480...............  TC............  A               Ct orbit/ear/fossa w/       0.00       4.71         NA       0.25       4.96         NA        XXX
                                                       o dye.
70481...............  ..............  A               Ct orbit/ear/fossa w/       1.38       6.10         NA       0.36       7.84         NA        XXX
                                                       dye.
70481...............  26............  A               Ct orbit/ear/fossa w/       1.38       0.45       0.45       0.06       1.89       1.89        XXX
                                                       dye.
70481...............  TC............  A               Ct orbit/ear/fossa w/       0.00       5.65         NA       0.30       5.95         NA        XXX
                                                       dye.
70482...............  ..............  A               Ct orbit/ear/fossa w/       1.45       7.53         NA       0.44       9.42         NA        XXX
                                                       o&w dye.
70482...............  26............  A               Ct orbit/ear/fossa w/       1.45       0.47       0.47       0.07       1.99       1.99        XXX
                                                       o&w dye.
70482...............  TC............  A               Ct orbit/ear/fossa w/       0.00       7.06         NA       0.37       7.43         NA        XXX
                                                       o&w dye.
70486...............  ..............  A               Ct maxillofacial w/o        1.14       5.08         NA       0.30       6.52         NA        XXX
                                                       dye.
70486...............  26............  A               Ct maxillofacial w/o        1.14       0.37       0.37       0.05       1.56       1.56        XXX
                                                       dye.
70486...............  TC............  A               Ct maxillofacial w/o        0.00       4.71         NA       0.25       4.96         NA        XXX
                                                       dye.
70487...............  ..............  A               Ct maxillofacial w/         1.30       6.07         NA       0.36       7.73         NA        XXX
                                                       dye.
70487...............  26............  A               Ct maxillofacial w/         1.30       0.43       0.43       0.06       1.79       1.79        XXX
                                                       dye.
70487...............  TC............  A               Ct maxillofacial w/         0.00       5.65         NA       0.30       5.95         NA        XXX
                                                       dye.
70488...............  ..............  A               Ct maxillofacial w/o        1.42       7.52         NA       0.43       9.37         NA        XXX
                                                       & w dye.
70488...............  26............  A               Ct maxillofacial w/o        1.42       0.46       0.46       0.06       1.94       1.94        XXX
                                                       & w dye.
70488...............  TC............  A               Ct maxillofacial w/o        0.00       7.06         NA       0.37       7.43         NA        XXX
                                                       & w dye.
70490...............  ..............  A               Ct soft tissue neck w/      1.28       5.13         NA       0.31       6.72         NA        XXX
                                                       o dye.
70490...............  26............  A               Ct soft tissue neck w/      1.28       0.42       0.42       0.06       1.76       1.76        XXX
                                                       o dye.
70490...............  TC............  A               Ct soft tissue neck w/      0.00       4.71         NA       0.25       4.96         NA        XXX
                                                       o dye.
70491...............  ..............  A               Ct soft tissue neck w/      1.38       6.10         NA       0.36       7.84         NA        XXX
                                                       dye.
70491...............  26............  A               Ct soft tissue neck w/      1.38       0.45       0.45       0.06       1.89       1.89        XXX
                                                       dye.
70491...............  TC............  A               Ct soft tissue neck w/      0.00       5.65         NA       0.30       5.95         NA        XXX
                                                       dye.
70492...............  ..............  A               Ct sft tsue nck w/o &       1.45       7.53         NA       0.44       9.42         NA        XXX
                                                       w/dye.
70492...............  26............  A               Ct sft tsue nck w/o &       1.45       0.47       0.47       0.07       1.99       1.99        XXX
                                                       w/dye.
70492...............  TC............  A               Ct sft tsue nck w/o &       0.00       7.06         NA       0.37       7.43         NA        XXX
                                                       w/dye.
70496...............  ..............  A               Ct angiography, head.       1.75      11.16         NA       0.66      13.57         NA        XXX
70496...............  26............  A               Ct angiography, head.       1.75       0.57       0.57       0.08       2.40       2.40        XXX
70496...............  TC............  A               Ct angiography, head.       0.00      10.59         NA       0.58      11.17         NA        XXX
70498...............  ..............  A               Ct angiography, neck.       1.75      11.16         NA       0.66      13.57         NA        XXX
70498...............  26............  A               Ct angiography, neck.       1.75       0.57       0.57       0.08       2.40       2.40        XXX
70498...............  TC............  A               Ct angiography, neck.       0.00      10.59         NA       0.58      11.17         NA        XXX
70540...............  ..............  A               Mri orbit/face/neck w/      1.35      11.63         NA       0.45      13.43         NA        XXX
                                                       o dye.
70540...............  26............  A               Mri orbit/face/neck w/      1.35       0.44       0.44       0.06       1.85       1.85        XXX
                                                       o dye.
70540...............  TC............  A               Mri orbit/face/neck w/      0.00      11.19         NA       0.39      11.58         NA        XXX
                                                       o dye.
70542...............  ..............  A               Mri orbit/face/neck w/      1.62      13.95         NA       0.54      16.11         NA        XXX
                                                       dye.
70542...............  26............  A               Mri orbit/face/neck w/      1.62       0.53       0.53       0.07       2.22       2.22        XXX
                                                       dye.
70542...............  TC............  A               Mri orbit/face/neck w/      0.00      13.42         NA       0.47      13.89         NA        XXX
                                                       dye.
70543...............  ..............  A               Mri orbt/fac/nck w/o        2.15      25.55         NA       0.94      28.64         NA        XXX
                                                       & w dye.
70543...............  26............  A               Mri orbt/fac/nck w/o        2.15       0.71       0.71       0.10       2.96       2.96        XXX
                                                       & w dye.
70543...............  TC............  A               Mri orbt/fac/nck w/o        0.00      24.84         NA       0.84      25.68         NA        XXX
                                                       & w dye.
70544...............  ..............  A               Mr angiography head w/      1.20      11.58         NA       0.64      13.42         NA        XXX
                                                       o dye.
70544...............  26............  A               Mr angiography head w/      1.20       0.39       0.39       0.05       1.64       1.64        XXX
                                                       o dye.
70544...............  TC............  A               Mr angiography head w/      0.00      11.19         NA       0.59      11.78         NA        XXX
                                                       o dye.
70545...............  ..............  A               Mr angiography head w/      1.20      11.58         NA       0.65      13.43         NA        XXX
                                                       dye.
70545...............  26............  A               Mr angiography head w/      1.20       0.39       0.39       0.06       1.65       1.65        XXX
                                                       dye.
70545...............  TC............  A               Mr angiography head w/      0.00      11.19         NA       0.59      11.78         NA        XXX
                                                       dye.
70546...............  ..............  A               Mr angiograph head w/       1.80      22.96         NA       0.67      25.43         NA        XXX
                                                       o&w dye.
70546...............  26............  A               Mr angiograph head w/       1.80       0.59       0.59       0.08       2.47       2.47        XXX
                                                       o&w dye.
70546...............  TC............  A               Mr angiograph head w/       0.00      22.37         NA       0.59      22.96         NA        XXX
                                                       o&w dye.

[[Page 47652]]

 
70547...............  ..............  A               Mr angiography neck w/      1.20      11.58         NA       0.64      13.42         NA        XXX
                                                       o dye.
70547...............  26............  A               Mr angiography neck w/      1.20       0.39       0.39       0.05       1.64       1.64        XXX
                                                       o dye.
70547...............  TC............  A               Mr angiography neck w/      0.00      11.19         NA       0.59      11.78         NA        XXX
                                                       o dye.
70548...............  ..............  A               Mr angiography neck w/      1.20      11.58         NA       0.64      13.42         NA        XXX
                                                       dye.
70548...............  26............  A               Mr angiography neck w/      1.20       0.39       0.39       0.05       1.64       1.64        XXX
                                                       dye.
70548...............  TC............  A               Mr angiography neck w/      0.00      11.19         NA       0.59      11.78         NA        XXX
                                                       dye.
70549...............  ..............  A               Mr angiograph neck w/       1.80      22.97         NA       0.67      25.44         NA        XXX
                                                       o&w dye.
70549...............  26............  A               Mr angiograph neck w/       1.80       0.59       0.59       0.08       2.47       2.47        XXX
                                                       o&w dye.
70549...............  TC............  A               Mr angiograph neck w/       0.00      22.37         NA       0.59      22.96         NA        XXX
                                                       o&w dye.
70551...............  ..............  A               Mri brain w/o dye....       1.48      11.67         NA       0.66      13.81         NA        XXX
70551...............  26............  A               Mri brain w/o dye....       1.48       0.49       0.49       0.07       2.04       2.04        XXX
70551...............  TC............  A               Mri brain w/o dye....       0.00      11.19         NA       0.59      11.78         NA        XXX
70552...............  ..............  A               Mri brain w/ dye.....       1.78      14.01         NA       0.79      16.58         NA        XXX
70552...............  26............  A               Mri brain w/ dye.....       1.78       0.59       0.59       0.09       2.46       2.46        XXX
70552...............  TC............  A               Mri brain w/ dye.....       0.00      13.42         NA       0.70      14.12         NA        XXX
70553...............  ..............  A               Mri brain w/o & w/          2.36      25.62         NA       1.42      29.40         NA        XXX
                                                       dye.
70553...............  26............  A               Mri brain w/o & w/          2.36       0.77       0.77       0.11       3.24       3.24        XXX
                                                       dye.
70553...............  TC............  A               Mri brain w/o & w/          0.00      24.84         NA       1.31      26.15         NA        XXX
                                                       dye.
70557...............  26............  A               Mri brain w/o dye....       2.90       1.12       1.12       0.08       4.10       4.10        XXX
70558...............  26............  A               Mri brain w/ dye.....       3.20       1.23       1.23       0.10       4.53       4.53        XXX
70559...............  26............  A               Mri brain w/o & w/          3.20       1.23       1.23       0.12       4.55       4.55        XXX
                                                       dye.
71010...............  ..............  A               Chest x-ray..........       0.18       0.53         NA       0.03       0.74         NA        XXX
71010...............  26............  A               Chest x-ray..........       0.18       0.06       0.06       0.01       0.25       0.25        XXX
71010...............  TC............  A               Chest x-ray..........       0.00       0.47         NA       0.02       0.49         NA        XXX
71015...............  ..............  A               Chest x-ray..........       0.21       0.59         NA       0.03       0.83         NA        XXX
71015...............  26............  A               Chest x-ray..........       0.21       0.07       0.07       0.01       0.29       0.29        XXX
71015...............  TC............  A               Chest x-ray..........       0.00       0.52         NA       0.02       0.54         NA        XXX
71020...............  ..............  A               Chest x-ray..........       0.22       0.69         NA       0.05       0.96         NA        XXX
71020...............  26............  A               Chest x-ray..........       0.22       0.07       0.07       0.01       0.30       0.30        XXX
71020...............  TC............  A               Chest x-ray..........       0.00       0.62         NA       0.04       0.66         NA        XXX
71021...............  ..............  A               Chest x-ray..........       0.27       0.82         NA       0.06       1.15         NA        XXX
71021...............  26............  A               Chest x-ray..........       0.27       0.09       0.09       0.01       0.37       0.37        XXX
71021...............  TC............  A               Chest x-ray..........       0.00       0.73         NA       0.05       0.78         NA        XXX
71022...............  ..............  A               Chest x-ray..........       0.31       0.83         NA       0.06       1.20         NA        XXX
71022...............  26............  A               Chest x-ray..........       0.31       0.10       0.10       0.01       0.42       0.42        XXX
71022...............  TC............  A               Chest x-ray..........       0.00       0.73         NA       0.05       0.78         NA        XXX
71023...............  ..............  A               Chest x-ray and             0.38       0.91         NA       0.07       1.36         NA        XXX
                                                       fluoroscopy.
71023...............  26............  A               Chest x-ray and             0.38       0.13       0.13       0.02       0.53       0.53        XXX
                                                       fluoroscopy.
71023...............  TC............  A               Chest x-ray and             0.00       0.78         NA       0.05       0.83         NA        XXX
                                                       fluoroscopy.
71030...............  ..............  A               Chest x-ray..........       0.31       0.88         NA       0.06       1.25         NA        XXX
71030...............  26............  A               Chest x-ray..........       0.31       0.10       0.10       0.01       0.42       0.42        XXX
71030...............  TC............  A               Chest x-ray..........       0.00       0.78         NA       0.05       0.83         NA        XXX
71034...............  ..............  A               Chest x-ray and             0.46       1.60         NA       0.10       2.16         NA        XXX
                                                       fluoroscopy.
71034...............  26............  A               Chest x-ray and             0.46       0.16       0.16       0.02       0.64       0.64        XXX
                                                       fluoroscopy.
71034...............  TC............  A               Chest x-ray and             0.00       1.44         NA       0.08       1.52         NA        XXX
                                                       fluoroscopy.
71035...............  ..............  A               Chest x-ray..........       0.18       0.58         NA       0.03       0.79         NA        XXX
71035...............  26............  A               Chest x-ray..........       0.18       0.06       0.06       0.01       0.25       0.25        XXX
71035...............  TC............  A               Chest x-ray..........       0.00       0.52         NA       0.02       0.54         NA        XXX
71040...............  ..............  A               Contrast x-ray of           0.58       1.65         NA       0.11       2.34         NA        XXX
                                                       bronchi.
71040...............  26............  A               Contrast x-ray of           0.58       0.19       0.19       0.03       0.80       0.80        XXX
                                                       bronchi.
71040...............  TC............  A               Contrast x-ray of           0.00       1.46         NA       0.08       1.54         NA        XXX
                                                       bronchi.
71060...............  ..............  A               Contrast x-ray of           0.74       2.44         NA       0.17       3.35         NA        XXX
                                                       bronchi.
71060...............  26............  A               Contrast x-ray of           0.74       0.24       0.24       0.04       1.02       1.02        XXX
                                                       bronchi.
71060...............  TC............  A               Contrast x-ray of           0.00       2.20         NA       0.13       2.33         NA        XXX
                                                       bronchi.
71090...............  ..............  A               X-ray & pacemaker           0.54       1.89         NA       0.13       2.56         NA        XXX
                                                       insertion.
71090...............  26............  A               X-ray & pacemaker           0.54       0.21       0.21       0.02       0.77       0.77        XXX
                                                       insertion.
71090...............  TC............  A               X-ray & pacemaker           0.00       1.68         NA       0.11       1.79         NA        XXX
                                                       insertion.
71100...............  ..............  A               X-ray exam of ribs...       0.22       0.64         NA       0.05       0.91         NA        XXX
71100...............  26............  A               X-ray exam of ribs...       0.22       0.07       0.07       0.01       0.30       0.30        XXX
71100...............  TC............  A               X-ray exam of ribs...       0.00       0.57         NA       0.04       0.61         NA        XXX
71101...............  ..............  A               X-ray exam of ribs/         0.27       0.75         NA       0.05       1.07         NA        XXX
                                                       chest.
71101...............  26............  A               X-ray exam of ribs/         0.27       0.09       0.09       0.01       0.37       0.37        XXX
                                                       chest.
71101...............  TC............  A               X-ray exam of ribs/         0.00       0.67         NA       0.04       0.71         NA        XXX
                                                       chest.
71110...............  ..............  A               X-ray exam of ribs...       0.27       0.87         NA       0.06       1.20         NA        XXX
71110...............  26............  A               X-ray exam of ribs...       0.27       0.09       0.09       0.01       0.37       0.37        XXX
71110...............  TC............  A               X-ray exam of ribs...       0.00       0.78         NA       0.05       0.83         NA        XXX
71111...............  ..............  A               X-ray exam of ribs/         0.32       0.99         NA       0.07       1.38         NA        XXX
                                                       chest.
71111...............  26............  A               X-ray exam of ribs/         0.32       0.10       0.10       0.01       0.43       0.43        XXX
                                                       chest.
71111...............  TC............  A               X-ray exam of ribs/         0.00       0.89         NA       0.06       0.95         NA        XXX
                                                       chest.
71120...............  ..............  A               X-ray exam of               0.20       0.71         NA       0.05       0.96         NA        XXX
                                                       breastbone.
71120...............  26............  A               X-ray exam of               0.20       0.07       0.07       0.01       0.28       0.28        XXX
                                                       breastbone.
71120...............  TC............  A               X-ray exam of               0.00       0.65         NA       0.04       0.69         NA        XXX
                                                       breastbone.
71130...............  ..............  A               X-ray exam of               0.22       0.78         NA       0.05       1.05         NA        XXX
                                                       breastbone.
71130...............  26............  A               X-ray exam of               0.22       0.07       0.07       0.01       0.30       0.30        XXX
                                                       breastbone.
71130...............  TC............  A               X-ray exam of               0.00       0.70         NA       0.04       0.74         NA        XXX
                                                       breastbone.

[[Page 47653]]

 
71250...............  ..............  A               Ct thorax w/o dye....       1.16       6.28         NA       0.36       7.80         NA        XXX
71250...............  26............  A               Ct thorax w/o dye....       1.16       0.38       0.38       0.05       1.59       1.59        XXX
71250...............  TC............  A               Ct thorax w/o dye....       0.00       5.90         NA       0.31       6.21         NA        XXX
71260...............  ..............  A               Ct thorax w/dye......       1.24       7.46         NA       0.43       9.13         NA        XXX
71260...............  26............  A               Ct thorax w/dye......       1.24       0.40       0.40       0.06       1.70       1.70        XXX
71260...............  TC............  A               Ct thorax w/dye......       0.00       7.06         NA       0.37       7.43         NA        XXX
71270...............  ..............  A               Ct thorax w/o & w/          1.38       9.28         NA       0.52      11.18         NA        XXX
                                                       dye.
71270...............  26............  A               Ct thorax w/o & w/          1.38       0.45       0.45       0.06       1.89       1.89        XXX
                                                       dye.
71270...............  TC............  A               Ct thorax w/o & w/          0.00       8.83         NA       0.46       9.29         NA        XXX
                                                       dye.
71275...............  ..............  A               Ct angiography, chest       1.92      12.99         NA       0.48      15.39         NA        XXX
71275...............  26............  A               Ct angiography, chest       1.92       0.63       0.63       0.09       2.64       2.64        XXX
71275...............  TC............  A               Ct angiography, chest       0.00      12.36         NA       0.39      12.75         NA        XXX
71550...............  ..............  A               Mri chest w/o dye....       1.46      11.66         NA       0.52      13.64         NA        XXX
71550...............  26............  A               Mri chest w/o dye....       1.46       0.48       0.48       0.07       2.01       2.01        XXX
71550...............  TC............  A               Mri chest w/o dye....       0.00      11.19         NA       0.45      11.64         NA        XXX
71551...............  ..............  A               Mri chest w/dye......       1.73      13.98         NA       0.60      16.31         NA        XXX
71551...............  26............  A               Mri chest w/dye......       1.73       0.56       0.56       0.08       2.37       2.37        XXX
71551...............  TC............  A               Mri chest w/dye......       0.00      13.42         NA       0.52      13.94         NA        XXX
71552...............  ..............  A               Mri chest w/o & w/dye       2.26      25.58         NA       0.78      28.62         NA        XXX
71552...............  26............  A               Mri chest w/o & w/dye       2.26       0.74       0.74       0.10       3.10       3.10        XXX
71552...............  TC............  A               Mri chest w/o & w/dye       0.00      24.84         NA       0.68      25.52         NA        XXX
71555...............  ..............  R               Mri angio chest w or        1.81      11.78         NA       0.67      14.26         NA        XXX
                                                       w/o dye.
71555...............  26............  R               Mri angio chest w or        1.81       0.60       0.60       0.08       2.49       2.49        XXX
                                                       w/o dye.
71555...............  TC............  R               Mri angio chest w or        0.00      11.19         NA       0.59      11.78         NA        XXX
                                                       w/o dye.
72010...............  ..............  A               X-ray exam of spine..       0.45       1.17         NA       0.08       1.70         NA        XXX
72010...............  26............  A               X-ray exam of spine..       0.45       0.15       0.15       0.02       0.62       0.62        XXX
72010...............  TC............  A               X-ray exam of spine..       0.00       1.02         NA       0.06       1.08         NA        XXX
72020...............  ..............  A               X-ray exam of spine..       0.15       0.46         NA       0.03       0.64         NA        XXX
72020...............  26............  A               X-ray exam of spine..       0.15       0.05       0.05       0.01       0.21       0.21        XXX
72020...............  TC............  A               X-ray exam of spine..       0.00       0.42         NA       0.02       0.44         NA        XXX
72040...............  ..............  A               X-ray exam of neck          0.22       0.67         NA       0.05       0.94         NA        XXX
                                                       spine.
72040...............  26............  A               X-ray exam of neck          0.22       0.07       0.07       0.01       0.30       0.30        XXX
                                                       spine.
72040...............  TC............  A               X-ray exam of neck          0.00       0.60         NA       0.04       0.64         NA        XXX
                                                       spine.
72050...............  ..............  A               X-ray exam of neck          0.31       0.99         NA       0.07       1.37         NA        XXX
                                                       spine.
72050...............  26............  A               X-ray exam of neck          0.31       0.10       0.10       0.01       0.42       0.42        XXX
                                                       spine.
72050...............  TC............  A               X-ray exam of neck          0.00       0.89         NA       0.06       0.95         NA        XXX
                                                       spine.
72052...............  ..............  A               X-ray exam of neck          0.36       1.25         NA       0.08       1.69         NA        XXX
                                                       spine.
72052...............  26............  A               X-ray exam of neck          0.36       0.12       0.12       0.02       0.50       0.50        XXX
                                                       spine.
72052...............  TC............  A               X-ray exam of neck          0.00       1.13         NA       0.06       1.19         NA        XXX
                                                       spine.
72069...............  ..............  A               X-ray exam of trunk         0.22       0.57         NA       0.03       0.82         NA        XXX
                                                       spine.
72069...............  26............  A               X-ray exam of trunk         0.22       0.08       0.08       0.01       0.31       0.31        XXX
                                                       spine.
72069...............  TC............  A               X-ray exam of trunk         0.00       0.49         NA       0.02       0.51         NA        XXX
                                                       spine.
72070...............  ..............  A               X-ray exam of               0.22       0.72         NA       0.05       0.99         NA        XXX
                                                       thoracic spine.
72070...............  26............  A               X-ray exam of               0.22       0.07       0.07       0.01       0.30       0.30        XXX
                                                       thoracic spine.
72070...............  TC............  A               X-ray exam of               0.00       0.65         NA       0.04       0.69         NA        XXX
                                                       thoracic spine.
72072...............  ..............  A               X-ray exam of               0.22       0.81         NA       0.06       1.09         NA        XXX
                                                       thoracic spine.
72072...............  26............  A               X-ray exam of               0.22       0.07       0.07       0.01       0.30       0.30        XXX
                                                       thoracic spine.
72072...............  TC............  A               X-ray exam of               0.00       0.73         NA       0.05       0.78         NA        XXX
                                                       thoracic spine.
72074...............  ..............  A               X-ray exam of               0.22       0.98         NA       0.07       1.27         NA        XXX
                                                       thoracic spine.
72074...............  26............  A               X-ray exam of               0.22       0.07       0.07       0.01       0.30       0.30        XXX
                                                       thoracic spine.
72074...............  TC............  A               X-ray exam of               0.00       0.91         NA       0.06       0.97         NA        XXX
                                                       thoracic spine.
72080...............  ..............  A               X-ray exam of trunk         0.22       0.74         NA       0.05       1.01         NA        XXX
                                                       spine.
72080...............  26............  A               X-ray exam of trunk         0.22       0.07       0.07       0.01       0.30       0.30        XXX
                                                       spine.
72080...............  TC............  A               X-ray exam of trunk         0.00       0.67         NA       0.04       0.71         NA        XXX
                                                       spine.
72090...............  ..............  A               X-ray exam of trunk         0.28       0.76         NA       0.05       1.09         NA        XXX
                                                       spine.
72090...............  26............  A               X-ray exam of trunk         0.28       0.09       0.09       0.01       0.38       0.38        XXX
                                                       spine.
72090...............  TC............  A               X-ray exam of trunk         0.00       0.67         NA       0.04       0.71         NA        XXX
                                                       spine.
72100...............  ..............  A               X-ray exam of lower         0.22       0.74         NA       0.05       1.01         NA        XXX
                                                       spine.
72100...............  26............  A               X-ray exam of lower         0.22       0.07       0.07       0.01       0.30       0.30        XXX
                                                       spine.
72100...............  TC............  A               X-ray exam of lower         0.00       0.67         NA       0.04       0.71         NA        XXX
                                                       spine.
72110...............  ..............  A               X-ray exam of lower         0.31       1.01         NA       0.07       1.39         NA        XXX
                                                       spine.
72110...............  26............  A               X-ray exam of lower         0.31       0.10       0.10       0.01       0.42       0.42        XXX
                                                       spine.
72110...............  TC............  A               X-ray exam of lower         0.00       0.91         NA       0.06       0.97         NA        XXX
                                                       spine.
72114...............  ..............  A               X-ray exam of lower         0.36       1.31         NA       0.08       1.75         NA        XXX
                                                       spine.
72114...............  26............  A               X-ray exam of lower         0.36       0.12       0.12       0.02       0.50       0.50        XXX
                                                       spine.
72114...............  TC............  A               X-ray exam of lower         0.00       1.19         NA       0.06       1.25         NA        XXX
                                                       spine.
72120...............  ..............  A               X-ray exam of lower         0.22       0.96         NA       0.07       1.25         NA        XXX
                                                       spine.
72120...............  26............  A               X-ray exam of lower         0.22       0.07       0.07       0.01       0.30       0.30        XXX
                                                       spine.
72120...............  TC............  A               X-ray exam of lower         0.00       0.89         NA       0.06       0.95         NA        XXX
                                                       spine.
72125...............  ..............  A               Ct neck spine w/o dye       1.16       6.28         NA       0.36       7.80         NA        XXX
72125...............  26............  A               Ct neck spine w/o dye       1.16       0.38       0.38       0.05       1.59       1.59        XXX
72125...............  TC............  A               Ct neck spine w/o dye       0.00       5.90         NA       0.31       6.21         NA        XXX
72126...............  ..............  A               Ct neck spine w/dye..       1.22       7.45         NA       0.43       9.10         NA        XXX
72126...............  26............  A               Ct neck spine w/dye..       1.22       0.40       0.40       0.06       1.68       1.68        XXX
72126...............  TC............  A               Ct neck spine w/dye..       0.00       7.06         NA       0.37       7.43         NA        XXX

[[Page 47654]]

 
72127...............  ..............  A               Ct neck spine w/o & w/      1.27       9.25         NA       0.52      11.04         NA        XXX
                                                       dye.
72127...............  26............  A               Ct neck spine w/o & w/      1.27       0.42       0.42       0.06       1.75       1.75        XXX
                                                       dye.
72127...............  TC............  A               Ct neck spine w/o & w/      0.00       8.83         NA       0.46       9.29         NA        XXX
                                                       dye.
72128...............  ..............  A               Ct chest spine w/o          1.16       6.28         NA       0.36       7.80         NA        XXX
                                                       dye.
72128...............  26............  A               Ct chest spine w/o          1.16       0.38       0.38       0.05       1.59       1.59        XXX
                                                       dye.
72128...............  TC............  A               Ct chest spine w/o          0.00       5.90         NA       0.31       6.21         NA        XXX
                                                       dye.
72129...............  ..............  A               Ct chest spine w/dye.       1.22       7.45         NA       0.43       9.10         NA        XXX
72129...............  26............  A               Ct chest spine w/dye.       1.22       0.40       0.40       0.06       1.68       1.68        XXX
72129...............  TC............  A               Ct chest spine w/dye.       0.00       7.06         NA       0.37       7.43         NA        XXX
72130...............  ..............  A               Ct chest spine w/o &        1.27       9.25         NA       0.52      11.04         NA        XXX
                                                       w/dye.
72130...............  26............  A               Ct chest spine w/o &        1.27       0.42       0.42       0.06       1.75       1.75        XXX
                                                       w/dye.
72130...............  TC............  A               Ct chest spine w/o &        0.00       8.83         NA       0.46       9.29         NA        XXX
                                                       w/dye.
72131...............  ..............  A               Ct lumbar spine w/o         1.16       6.28         NA       0.36       7.80         NA        XXX
                                                       dye.
72131...............  26............  A               Ct lumbar spine w/o         1.16       0.38       0.38       0.05       1.59       1.59        XXX
                                                       dye.
72131...............  TC............  A               Ct lumbar spine w/o         0.00       5.90         NA       0.31       6.21         NA        XXX
                                                       dye.
72132...............  ..............  A               Ct lumbar spine w/dye       1.22       7.45         NA       0.43       9.10         NA        XXX
72132...............  26............  A               Ct lumbar spine w/dye       1.22       0.40       0.40       0.06       1.68       1.68        XXX
72132...............  TC............  A               Ct lumbar spine w/dye       0.00       7.06         NA       0.37       7.43         NA        XXX
72133...............  ..............  A               Ct lumbar spine w/o &       1.27       9.25         NA       0.52      11.04         NA        XXX
                                                       w/dye.
72133...............  26............  A               Ct lumbar spine w/o &       1.27       0.42       0.42       0.06       1.75       1.75        XXX
                                                       w/dye.
72133...............  TC............  A               Ct lumbar spine w/o &       0.00       8.83         NA       0.46       9.29         NA        XXX
                                                       w/dye.
72141...............  ..............  A               Mri neck spine w/o          1.60      11.71         NA       0.66      13.97         NA        XXX
                                                       dye.
72141...............  26............  A               Mri neck spine w/o          1.60       0.53       0.53       0.07       2.20       2.20        XXX
                                                       dye.
72141...............  TC............  A               Mri neck spine w/o          0.00      11.19         NA       0.59      11.78         NA        XXX
                                                       dye.
72142...............  ..............  A               Mri neck spine w/dye.       1.92      14.06         NA       0.79      16.77         NA        XXX
72142...............  26............  A               Mri neck spine w/dye.       1.92       0.64       0.64       0.09       2.65       2.65        XXX
72142...............  TC............  A               Mri neck spine w/dye.       0.00      13.42         NA       0.70      14.12         NA        XXX
72146...............  ..............  A               Mri chest spine w/o         1.60      12.95         NA       0.71      15.26         NA        XXX
                                                       dye.
72146...............  26............  A               Mri chest spine w/o         1.60       0.52       0.52       0.07       2.19       2.19        XXX
                                                       dye.
72146...............  TC............  A               Mri chest spine w/o         0.00      12.42         NA       0.64      13.06         NA        XXX
                                                       dye.
72147...............  ..............  A               Mri chest spine w/dye       1.92      14.05         NA       0.79      16.76         NA        XXX
72147...............  26............  A               Mri chest spine w/dye       1.92       0.63       0.63       0.09       2.64       2.64        XXX
72147...............  TC............  A               Mri chest spine w/dye       0.00      13.42         NA       0.70      14.12         NA        XXX
72148...............  ..............  A               Mri lumbar spine w/o        1.48      12.91         NA       0.71      15.10         NA        XXX
                                                       dye.
72148...............  26............  A               Mri lumbar spine w/o        1.48       0.49       0.49       0.07       2.04       2.04        XXX
                                                       dye.
72148...............  TC............  A               Mri lumbar spine w/o        0.00      12.42         NA       0.64      13.06         NA        XXX
                                                       dye.
72149...............  ..............  A               Mri lumbar spine w/         1.78      14.01         NA       0.79      16.58         NA        XXX
                                                       dye.
72149...............  26............  A               Mri lumbar spine w/         1.78       0.59       0.59       0.09       2.46       2.46        XXX
                                                       dye.
72149...............  TC............  A               Mri lumbar spine w/         0.00      13.42         NA       0.70      14.12         NA        XXX
                                                       dye.
72156...............  ..............  A               Mri neck spine w/o &        2.57      25.69         NA       1.43      29.69         NA        XXX
                                                       w/dye.
72156...............  26............  A               Mri neck spine w/o &        2.57       0.85       0.85       0.12       3.54       3.54        XXX
                                                       w/dye.
72156...............  TC............  A               Mri neck spine w/o &        0.00      24.84         NA       1.31      26.15         NA        XXX
                                                       w/dye.
72157...............  ..............  A               Mri chest spine w/o &       2.57      25.68         NA       1.43      29.68         NA        XXX
                                                       w/dye.
72157...............  26............  A               Mri chest spine w/o &       2.57       0.84       0.84       0.12       3.53       3.53        XXX
                                                       w/dye.
72157...............  TC............  A               Mri chest spine w/o &       0.00      24.84         NA       1.31      26.15         NA        XXX
                                                       w/dye.
72158...............  ..............  A               Mri lumbar spine w/o        2.36      25.62         NA       1.42      29.40         NA        XXX
                                                       & w/dye.
72158...............  26............  A               Mri lumbar spine w/o        2.36       0.77       0.77       0.11       3.24       3.24        XXX
                                                       & w/dye.
72158...............  TC............  A               Mri lumbar spine w/o        0.00      24.84         NA       1.31      26.15         NA        XXX
                                                       & w/dye.
72170...............  ..............  A               X-ray exam of pelvis.       0.17       0.58         NA       0.03       0.78         NA        XXX
72170...............  26............  A               X-ray exam of pelvis.       0.17       0.06       0.06       0.01       0.24       0.24        XXX
72170...............  TC............  A               X-ray exam of pelvis.       0.00       0.52         NA       0.02       0.54         NA        XXX
72190...............  ..............  A               X-ray exam of pelvis.       0.21       0.74         NA       0.05       1.00         NA        XXX
72190...............  26............  A               X-ray exam of pelvis.       0.21       0.07       0.07       0.01       0.29       0.29        XXX
72190...............  TC............  A               X-ray exam of pelvis.       0.00       0.67         NA       0.04       0.71         NA        XXX
72191...............  ..............  A               Ct angiograph pelv w/       1.81      12.60         NA       0.47      14.88         NA        XXX
                                                       o&w/dye.
72191...............  26............  A               Ct angiograph pelv w/       1.81       0.60       0.60       0.08       2.49       2.49        XXX
                                                       o&w/dye.
72191...............  TC............  A               Ct angiograph pelv w/       0.00      12.01         NA       0.39      12.40         NA        XXX
                                                       o&w/dye.
72192...............  ..............  A               Ct pelvis w/o dye....       1.09       6.25         NA       0.36       7.70         NA        XXX
72192...............  26............  A               Ct pelvis w/o dye....       1.09       0.36       0.36       0.05       1.50       1.50        XXX
72192...............  TC............  A               Ct pelvis w/o dye....       0.00       5.90         NA       0.31       6.21         NA        XXX
72193...............  ..............  A               Ct pelvis w/dye......       1.16       7.21         NA       0.41       8.78         NA        XXX
72193...............  26............  A               Ct pelvis w/dye......       1.16       0.38       0.38       0.05       1.59       1.59        XXX
72193...............  TC............  A               Ct pelvis w/dye......       0.00       6.83         NA       0.36       7.19         NA        XXX
72194...............  ..............  A               Ct pelvis w/o & w/dye       1.22       8.87         NA       0.48      10.57         NA        XXX
72194...............  26............  A               Ct pelvis w/o & w/dye       1.22       0.40       0.40       0.05       1.67       1.67        XXX
72194...............  TC............  A               Ct pelvis w/o & w/dye       0.00       8.47         NA       0.43       8.90         NA        XXX
72195...............  ..............  A               Mri pelvis w/o dye...       1.46      11.66         NA       0.52      13.64         NA        XXX
72195...............  26............  A               Mri pelvis w/o dye...       1.46       0.48       0.48       0.07       2.01       2.01        XXX
72195...............  TC............  A               Mri pelvis w/o dye...       0.00      11.19         NA       0.45      11.64         NA        XXX
72196...............  ..............  A               Mri pelvis w/dye.....       1.73      13.98         NA       0.60      16.31         NA        XXX
72196...............  26............  A               Mri pelvis w/dye.....       1.73       0.56       0.56       0.08       2.37       2.37        XXX
72196...............  TC............  A               Mri pelvis w/dye.....       0.00      13.42         NA       0.52      13.94         NA        XXX
72197...............  ..............  A               Mri pelvis w/o & w/         2.26      25.58         NA       1.02      28.86         NA        XXX
                                                       dye.
72197...............  26............  A               Mri pelvis w/o & w/         2.26       0.74       0.74       0.10       3.10       3.10        XXX
                                                       dye.
72197...............  TC............  A               Mri pelvis w/o & w/         0.00      24.84         NA       0.92      25.76         NA        XXX
                                                       dye.

[[Page 47655]]

 
72198...............  ..............  A               Mr angio pelvis w/o &       1.80      11.77         NA       0.69      14.26         NA        XXX
                                                       w/dye.
72198...............  26............  A               Mr angio pelvis w/o &       1.80       0.59       0.59       0.10       2.49       2.49        XXX
                                                       w/dye.
72198...............  TC............  A               Mr angio pelvis w/o &       0.00      11.19         NA       0.59      11.78         NA        XXX
                                                       w/dye.
72200...............  ..............  A               X-ray exam sacroiliac       0.17       0.58         NA       0.03       0.78         NA        XXX
                                                       joints.
72200...............  26............  A               X-ray exam sacroiliac       0.17       0.06       0.06       0.01       0.24       0.24        XXX
                                                       joints.
72200...............  TC............  A               X-ray exam sacroiliac       0.00       0.52         NA       0.02       0.54         NA        XXX
                                                       joints.
72202...............  ..............  A               X-ray exam sacroiliac       0.19       0.68         NA       0.05       0.92         NA        XXX
                                                       joints.
72202...............  26............  A               X-ray exam sacroiliac       0.19       0.06       0.06       0.01       0.26       0.26        XXX
                                                       joints.
72202...............  TC............  A               X-ray exam sacroiliac       0.00       0.62         NA       0.04       0.66         NA        XXX
                                                       joints.
72220...............  ..............  A               X-ray exam of               0.17       0.63         NA       0.05       0.85         NA        XXX
                                                       tailbone.
72220...............  26............  A               X-ray exam of               0.17       0.06       0.06       0.01       0.24       0.24        XXX
                                                       tailbone.
72220...............  TC............  A               X-ray exam of               0.00       0.57         NA       0.04       0.61         NA        XXX
                                                       tailbone.
72240...............  ..............  A               Contrast x-ray of           0.91       5.03         NA       0.29       6.23         NA        XXX
                                                       neck spine.
72240...............  26............  A               Contrast x-ray of           0.91       0.29       0.29       0.04       1.24       1.24        XXX
                                                       neck spine.
72240...............  TC............  A               Contrast x-ray of           0.00       4.74         NA       0.25       4.99         NA        XXX
                                                       neck spine.
72255...............  ..............  A               Contrast x-ray,             0.91       4.59         NA       0.26       5.76         NA        XXX
                                                       thorax spine.
72255...............  26............  A               Contrast x-ray,             0.91       0.27       0.27       0.04       1.22       1.22        XXX
                                                       thorax spine.
72255...............  TC............  A               Contrast x-ray,             0.00       4.32         NA       0.22       4.54         NA        XXX
                                                       thorax spine.
72265...............  ..............  A               Contrast x-ray, lower       0.83       4.32         NA       0.26       5.41         NA        XXX
                                                       spine.
72265...............  26............  A               Contrast x-ray, lower       0.83       0.25       0.25       0.04       1.12       1.12        XXX
                                                       spine.
72265...............  TC............  A               Contrast x-ray, lower       0.00       4.06         NA       0.22       4.28         NA        XXX
                                                       spine.
72270...............  ..............  A               Contrast x-ray, spine       1.33       6.51         NA       0.40       8.24         NA        XXX
72270...............  26............  A               Contrast x-ray, spine       1.33       0.42       0.42       0.07       1.82       1.82        XXX
72270...............  TC............  A               Contrast x-ray, spine       0.00       6.09         NA       0.33       6.42         NA        XXX
72275...............  ..............  A               Epidurography........       0.76       2.29         NA       0.27       3.32         NA        XXX
72275...............  26............  A               Epidurography........       0.76       0.20       0.20       0.05       1.01       1.01        XXX
72275...............  TC............  A               Epidurography........       0.00       2.09         NA       0.22       2.31         NA        XXX
72285...............  ..............  A               X-ray c/t spine disk.       1.16       8.72         NA       0.50      10.38         NA        XXX
72285...............  26............  A               X-ray c/t spine disk.       1.16       0.35       0.35       0.07       1.58       1.58        XXX
72285...............  TC............  A               X-ray c/t spine disk.       0.00       8.37         NA       0.43       8.80         NA        XXX
72295...............  ..............  A               X-ray of lower spine        0.83       8.11         NA       0.46       9.40         NA        XXX
                                                       disk.
72295...............  26............  A               X-ray of lower spine        0.83       0.27       0.27       0.06       1.16       1.16        XXX
                                                       disk.
72295...............  TC............  A               X-ray of lower spine        0.00       7.85         NA       0.40       8.25         NA        XXX
                                                       disk.
73000...............  ..............  A               X-ray exam of collar        0.16       0.57         NA       0.03       0.76         NA        XXX
                                                       bone.
73000...............  26............  A               X-ray exam of collar        0.16       0.05       0.05       0.01       0.22       0.22        XXX
                                                       bone.
73000...............  TC............  A               X-ray exam of collar        0.00       0.52         NA       0.02       0.54         NA        XXX
                                                       bone.
73010...............  ..............  A               X-ray exam of               0.17       0.58         NA       0.03       0.78         NA        XXX
                                                       shoulder blade.
73010...............  26............  A               X-ray exam of               0.17       0.06       0.06       0.01       0.24       0.24        XXX
                                                       shoulder blade.
73010...............  TC............  A               X-ray exam of               0.00       0.52         NA       0.02       0.54         NA        XXX
                                                       shoulder blade.
73020...............  ..............  A               X-ray exam of               0.15       0.52         NA       0.03       0.70         NA        XXX
                                                       shoulder.
73020...............  26............  A               X-ray exam of               0.15       0.05       0.05       0.01       0.21       0.21        XXX
                                                       shoulder.
73020...............  TC............  A               X-ray exam of               0.00       0.47         NA       0.02       0.49         NA        XXX
                                                       shoulder.
73030...............  ..............  A               X-ray exam of               0.18       0.63         NA       0.05       0.86         NA        XXX
                                                       shoulder.
73030...............  26............  A               X-ray exam of               0.18       0.06       0.06       0.01       0.25       0.25        XXX
                                                       shoulder.
73030...............  TC............  A               X-ray exam of               0.00       0.57         NA       0.04       0.61         NA        XXX
                                                       shoulder.
73040...............  ..............  A               Contrast x-ray of           0.54       2.27         NA       0.14       2.95         NA        XXX
                                                       shoulder.
73040...............  26............  A               Contrast x-ray of           0.54       0.18       0.18       0.02       0.74       0.74        XXX
                                                       shoulder.
73040...............  TC............  A               Contrast x-ray of           0.00       2.09         NA       0.12       2.21         NA        XXX
                                                       shoulder.
73050...............  ..............  A               X-ray exam of               0.20       0.73         NA       0.05       0.98         NA        XXX
                                                       shoulders.
73050...............  26............  A               X-ray exam of               0.20       0.07       0.07       0.01       0.28       0.28        XXX
                                                       shoulders.
73050...............  TC............  A               X-ray exam of               0.00       0.67         NA       0.04       0.71         NA        XXX
                                                       shoulders.
73060...............  ..............  A               X-ray exam of humerus       0.17       0.63         NA       0.05       0.85         NA        XXX
73060...............  26............  A               X-ray exam of humerus       0.17       0.06       0.06       0.01       0.24       0.24        XXX
73060...............  TC............  A               X-ray exam of humerus       0.00       0.57         NA       0.04       0.61         NA        XXX
73070...............  ..............  A               X-ray exam of elbow..       0.15       0.57         NA       0.03       0.75         NA        XXX
73070...............  26............  A               X-ray exam of elbow..       0.15       0.05       0.05       0.01       0.21       0.21        XXX
73070...............  TC............  A               X-ray exam of elbow..       0.00       0.52         NA       0.02       0.54         NA        XXX
73080...............  ..............  A               X-ray exam of elbow..       0.17       0.63         NA       0.05       0.85         NA        XXX
73080...............  26............  A               X-ray exam of elbow..       0.17       0.06       0.06       0.01       0.24       0.24        XXX
73080...............  TC............  A               X-ray exam of elbow..       0.00       0.57         NA       0.04       0.61         NA        XXX
73085...............  ..............  A               Contrast x-ray of           0.54       2.28         NA       0.15       2.97         NA        XXX
                                                       elbow.
73085...............  26............  A               Contrast x-ray of           0.54       0.18       0.18       0.03       0.75       0.75        XXX
                                                       elbow.
73085...............  TC............  A               Contrast x-ray of           0.00       2.09         NA       0.12       2.21         NA        XXX
                                                       elbow.
73090...............  ..............  A               X-ray exam of forearm       0.16       0.57         NA       0.03       0.76         NA        XXX
73090...............  26............  A               X-ray exam of forearm       0.16       0.05       0.05       0.01       0.22       0.22        XXX
73090...............  TC............  A               X-ray exam of forearm       0.00       0.52         NA       0.02       0.54         NA        XXX
73092...............  ..............  A               X-ray exam of arm,          0.16       0.54         NA       0.03       0.73         NA        XXX
                                                       infant.
73092...............  26............  A               X-ray exam of arm,          0.16       0.05       0.05       0.01       0.22       0.22        XXX
                                                       infant.
73092...............  TC............  A               X-ray exam of arm,          0.00       0.49         NA       0.02       0.51         NA        XXX
                                                       infant.
73100...............  ..............  A               X-ray exam of wrist..       0.16       0.55         NA       0.03       0.74         NA        XXX
73100...............  26............  A               X-ray exam of wrist..       0.16       0.05       0.05       0.01       0.22       0.22        XXX
73100...............  TC............  A               X-ray exam of wrist..       0.00       0.49         NA       0.02       0.51         NA        XXX
73110...............  ..............  A               X-ray exam of wrist..       0.17       0.59         NA       0.03       0.79         NA        XXX
73110...............  26............  A               X-ray exam of wrist..       0.17       0.06       0.06       0.01       0.24       0.24        XXX
73110...............  TC............  A               X-ray exam of wrist..       0.00       0.53         NA       0.02       0.55         NA        XXX

[[Page 47656]]

 
73115...............  ..............  A               Contrast x-ray of           0.54       1.76         NA       0.13       2.43         NA        XXX
                                                       wrist.
73115...............  26............  A               Contrast x-ray of           0.54       0.18       0.18       0.03       0.75       0.75        XXX
                                                       wrist.
73115...............  TC............  A               Contrast x-ray of           0.00       1.57         NA       0.10       1.67         NA        XXX
                                                       wrist.
73120...............  ..............  A               X-ray exam of hand...       0.16       0.55         NA       0.03       0.74         NA        XXX
73120...............  26............  A               X-ray exam of hand...       0.16       0.05       0.05       0.01       0.22       0.22        XXX
73120...............  TC............  A               X-ray exam of hand...       0.00       0.49         NA       0.02       0.51         NA        XXX
73130...............  ..............  A               X-ray exam of hand...       0.17       0.59         NA       0.03       0.79         NA        XXX
73130...............  26............  A               X-ray exam of hand...       0.17       0.06       0.06       0.01       0.24       0.24        XXX
73130...............  TC............  A               X-ray exam of hand...       0.00       0.53         NA       0.02       0.55         NA        XXX
73140...............  ..............  A               X-ray exam of               0.13       0.46         NA       0.03       0.62         NA        XXX
                                                       finger(s).
73140...............  26............  A               X-ray exam of               0.13       0.04       0.04       0.01       0.18       0.18        XXX
                                                       finger(s).
73140...............  TC............  A               X-ray exam of               0.00       0.42         NA       0.02       0.44         NA        XXX
                                                       finger(s).
73200...............  ..............  A               Ct upper extremity w/       1.09       5.31         NA       0.30       6.70         NA        XXX
                                                       o dye.
73200...............  26............  A               Ct upper extremity w/       1.09       0.36       0.36       0.05       1.50       1.50        XXX
                                                       o dye.
73200...............  TC............  A               Ct upper extremity w/       0.00       4.95         NA       0.25       5.20         NA        XXX
                                                       o dye.
73201...............  ..............  A               Ct upper extremity w/       1.16       6.28         NA       0.36       7.80         NA        XXX
                                                       dye.
73201...............  26............  A               Ct upper extremity w/       1.16       0.38       0.38       0.05       1.59       1.59        XXX
                                                       dye.
73201...............  TC............  A               Ct upper extremity w/       0.00       5.90         NA       0.31       6.21         NA        XXX
                                                       dye.
73202...............  ..............  A               Ct uppr extremity w/        1.22       7.81         NA       0.44       9.47         NA        XXX
                                                       o&w/dye.
73202...............  26............  A               Ct uppr extremity w/        1.22       0.40       0.40       0.05       1.67       1.67        XXX
                                                       o&w/dye.
73202...............  TC............  A               Ct uppr extremity w/        0.00       7.41         NA       0.39       7.80         NA        XXX
                                                       o&w/dye.
73206...............  ..............  A               Ct angio upr extrm w/       1.81      11.54         NA       0.47      13.82         NA        XXX
                                                       o&w/dye.
73206...............  26............  A               Ct angio upr extrm w/       1.81       0.59       0.59       0.08       2.48       2.48        XXX
                                                       o&w/dye.
73206...............  TC............  A               Ct angio upr extrm w/       0.00      10.94         NA       0.39      11.33         NA        XXX
                                                       o&w/dye.
73218...............  ..............  A               Mri upper extremity w/      1.35      11.63         NA       0.45      13.43         NA        XXX
                                                       o dye.
73218...............  26............  A               Mri upper extremity w/      1.35       0.44       0.44       0.06       1.85       1.85        XXX
                                                       o dye.
73218...............  TC............  A               Mri upper extremity w/      0.00      11.19         NA       0.39      11.58         NA        XXX
                                                       o dye.
73219...............  ..............  A               Mri upper extremity w/      1.62      13.95         NA       0.54      16.11         NA        XXX
                                                       dye.
73219...............  26............  A               Mri upper extremity w/      1.62       0.53       0.53       0.07       2.22       2.22        XXX
                                                       dye.
73219...............  TC............  A               Mri upper extremity w/      0.00      13.42         NA       0.47      13.89         NA        XXX
                                                       dye.
73220...............  ..............  A               Mri uppr extremity w/       2.15      25.55         NA       0.94      28.64         NA        XXX
                                                       o&w/dye.
73220...............  26............  A               Mri uppr extremity w/       2.15       0.71       0.71       0.10       2.96       2.96        XXX
                                                       o&w/dye.
73220...............  TC............  A               Mri uppr extremity w/       0.00      24.84         NA       0.84      25.68         NA        XXX
                                                       o&w/dye.
73221...............  ..............  A               Mri joint upr extrem        1.35      11.63         NA       0.45      13.43         NA        XXX
                                                       w/o dye.
73221...............  26............  A               Mri joint upr extrem        1.35       0.44       0.44       0.06       1.85       1.85        XXX
                                                       w/o dye.
73221...............  TC............  A               Mri joint upr extrem        0.00      11.19         NA       0.39      11.58         NA        XXX
                                                       w/o dye.
73222...............  ..............  A               Mri joint upr extrem        1.62      13.95         NA       0.54      16.11         NA        XXX
                                                       w/dye.
73222...............  26............  A               Mri joint upr extrem        1.62       0.53       0.53       0.07       2.22       2.22        XXX
                                                       w/dye.
73222...............  TC............  A               Mri joint upr extrem        0.00      13.42         NA       0.47      13.89         NA        XXX
                                                       w/dye.
73223...............  ..............  A               Mri joint upr extr w/       2.15      25.55         NA       0.94      28.64         NA        XXX
                                                       o&w/dye.
73223...............  26............  A               Mri joint upr extr w/       2.15       0.71       0.71       0.10       2.96       2.96        XXX
                                                       o&w/dye.
73223...............  TC............  A               Mri joint upr extr w/       0.00      24.84         NA       0.84      25.68         NA        XXX
                                                       o&w/dye.
73500...............  ..............  A               X-ray exam of hip....       0.17       0.53         NA       0.03       0.73         NA        XXX
73500...............  26............  A               X-ray exam of hip....       0.17       0.06       0.06       0.01       0.24       0.24        XXX
73500...............  TC............  A               X-ray exam of hip....       0.00       0.47         NA       0.02       0.49         NA        XXX
73510...............  ..............  A               X-ray exam of hip....       0.21       0.64         NA       0.05       0.90         NA        XXX
73510...............  26............  A               X-ray exam of hip....       0.21       0.07       0.07       0.01       0.29       0.29        XXX
73510...............  TC............  A               X-ray exam of hip....       0.00       0.57         NA       0.04       0.61         NA        XXX
73520...............  ..............  A               X-ray exam of hips...       0.26       0.75         NA       0.05       1.06         NA        XXX
73520...............  26............  A               X-ray exam of hips...       0.26       0.09       0.09       0.01       0.36       0.36        XXX
73520...............  TC............  A               X-ray exam of hips...       0.00       0.67         NA       0.04       0.71         NA        XXX
73525...............  ..............  A               Contrast x-ray of hip       0.54       2.27         NA       0.15       2.96         NA        XXX
73525...............  26............  A               Contrast x-ray of hip       0.54       0.18       0.18       0.03       0.75       0.75        XXX
73525...............  TC............  A               Contrast x-ray of hip       0.00       2.09         NA       0.12       2.21         NA        XXX
73530...............  ..............  A               X-ray exam of hip....       0.29       0.62         NA       0.03       0.94         NA        XXX
73530...............  26............  A               X-ray exam of hip....       0.29       0.10       0.10       0.01       0.40       0.40        XXX
73530...............  TC............  A               X-ray exam of hip....       0.00       0.52         NA       0.02       0.54         NA        XXX
73540...............  ..............  A               X-ray exam of pelvis        0.20       0.64         NA       0.05       0.89         NA        XXX
                                                       & hips.
73540...............  26............  A               X-ray exam of pelvis        0.20       0.07       0.07       0.01       0.28       0.28        XXX
                                                       & hips.
73540...............  TC............  A               X-ray exam of pelvis        0.00       0.57         NA       0.04       0.61         NA        XXX
                                                       & hips.
73542...............  ..............  A               X-ray exam,                 0.59       2.25         NA       0.15       2.99         NA        XXX
                                                       sacroiliac joint.
73542...............  26............  A               X-ray exam,                 0.59       0.16       0.16       0.03       0.78       0.78        XXX
                                                       sacroiliac joint.
73542...............  TC............  A               X-ray exam,                 0.00       2.09         NA       0.12       2.21         NA        XXX
                                                       sacroiliac joint.
73550...............  ..............  A               X-ray exam of thigh..       0.17       0.63         NA       0.05       0.85         NA        XXX
73550...............  26............  A               X-ray exam of thigh..       0.17       0.06       0.06       0.01       0.24       0.24        XXX
73550...............  TC............  A               X-ray exam of thigh..       0.00       0.57         NA       0.04       0.61         NA        XXX
73560...............  ..............  A               X-ray exam of knee, 1       0.17       0.58         NA       0.03       0.78         NA        XXX
                                                       or 2.
73560...............  26............  A               X-ray exam of knee, 1       0.17       0.06       0.06       0.01       0.24       0.24        XXX
                                                       or 2.
73560...............  TC............  A               X-ray exam of knee, 1       0.00       0.52         NA       0.02       0.54         NA        XXX
                                                       or 2.
73562...............  ..............  A               X-ray exam of knee, 3       0.18       0.63         NA       0.05       0.86         NA        XXX
73562...............  26............  A               X-ray exam of knee, 3       0.18       0.06       0.06       0.01       0.25       0.25        XXX
73562...............  TC............  A               X-ray exam of knee, 3       0.00       0.57         NA       0.04       0.61         NA        XXX
73564...............  ..............  A               X-ray exam, knee, 4         0.22       0.69         NA       0.05       0.96         NA        XXX
                                                       or more.
73564...............  26............  A               X-ray exam, knee, 4         0.22       0.07       0.07       0.01       0.30       0.30        XXX
                                                       or more.
73564...............  TC............  A               X-ray exam, knee, 4         0.00       0.62         NA       0.04       0.66         NA        XXX
                                                       or more.

[[Page 47657]]

 
73565...............  ..............  A               X-ray exam of knees..       0.17       0.55         NA       0.03       0.75         NA        XXX
73565...............  26............  A               X-ray exam of knees..       0.17       0.06       0.06       0.01       0.24       0.24        XXX
73565...............  TC............  A               X-ray exam of knees..       0.00       0.49         NA       0.02       0.51         NA        XXX
73580...............  ..............  A               Contrast x-ray of           0.54       2.79         NA       0.17       3.50         NA        XXX
                                                       knee joint.
73580...............  26............  A               Contrast x-ray of           0.54       0.17       0.17       0.03       0.74       0.74        XXX
                                                       knee joint.
73580...............  TC............  A               Contrast x-ray of           0.00       2.62         NA       0.14       2.76         NA        XXX
                                                       knee joint.
73590...............  ..............  A               X-ray exam of lower         0.17       0.58         NA       0.03       0.78         NA        XXX
                                                       leg.
73590...............  26............  A               X-ray exam of lower         0.17       0.06       0.06       0.01       0.24       0.24        XXX
                                                       leg.
73590...............  TC............  A               X-ray exam of lower         0.00       0.52         NA       0.02       0.54         NA        XXX
                                                       leg.
73592...............  ..............  A               X-ray exam of leg,          0.16       0.55         NA       0.03       0.74         NA        XXX
                                                       infant.
73592...............  26............  A               X-ray exam of leg,          0.16       0.05       0.05       0.01       0.22       0.22        XXX
                                                       infant.
73592...............  TC............  A               X-ray exam of leg,          0.00       0.49         NA       0.02       0.51         NA        XXX
                                                       infant.
73600...............  ..............  A               X-ray exam of ankle..       0.16       0.55         NA       0.03       0.74         NA        XXX
73600...............  26............  A               X-ray exam of ankle..       0.16       0.05       0.05       0.01       0.22       0.22        XXX
73600...............  TC............  A               X-ray exam of ankle..       0.00       0.49         NA       0.02       0.51         NA        XXX
73610...............  ..............  A               X-ray exam of ankle..       0.17       0.59         NA       0.03       0.79         NA        XXX
73610...............  26............  A               X-ray exam of ankle..       0.17       0.06       0.06       0.01       0.24       0.24        XXX
73610...............  TC............  A               X-ray exam of ankle..       0.00       0.53         NA       0.02       0.55         NA        XXX
73615...............  ..............  A               Contrast x-ray of           0.54       2.28         NA       0.15       2.97         NA        XXX
                                                       ankle.
73615...............  26............  A               Contrast x-ray of           0.54       0.18       0.18       0.03       0.75       0.75        XXX
                                                       ankle.
73615...............  TC............  A               Contrast x-ray of           0.00       2.09         NA       0.12       2.21         NA        XXX
                                                       ankle.
73620...............  ..............  A               X-ray exam of foot...       0.16       0.55         NA       0.03       0.74         NA        XXX
73620...............  26............  A               X-ray exam of foot...       0.16       0.05       0.05       0.01       0.22       0.22        XXX
73620...............  TC............  A               X-ray exam of foot...       0.00       0.49         NA       0.02       0.51         NA        XXX
73630...............  ..............  A               X-ray exam of foot...       0.17       0.59         NA       0.03       0.79         NA        XXX
73630...............  26............  A               X-ray exam of foot...       0.17       0.06       0.06       0.01       0.24       0.24        XXX
73630...............  TC............  A               X-ray exam of foot...       0.00       0.53         NA       0.02       0.55         NA        XXX
73650...............  ..............  A               X-ray exam of heel...       0.16       0.53         NA       0.03       0.72         NA        XXX
73650...............  26............  A               X-ray exam of heel...       0.16       0.05       0.05       0.01       0.22       0.22        XXX
73650...............  TC............  A               X-ray exam of heel...       0.00       0.47         NA       0.02       0.49         NA        XXX
73660...............  ..............  A               X-ray exam of toe(s).       0.13       0.46         NA       0.03       0.62         NA        XXX
73660...............  26............  A               X-ray exam of toe(s).       0.13       0.04       0.04       0.01       0.18       0.18        XXX
73660...............  TC............  A               X-ray exam of toe(s).       0.00       0.42         NA       0.02       0.44         NA        XXX
73700...............  ..............  A               Ct lower extremity w/       1.09       5.31         NA       0.30       6.70         NA        XXX
                                                       o dye.
73700...............  26............  A               Ct lower extremity w/       1.09       0.36       0.36       0.05       1.50       1.50        XXX
                                                       o dye.
73700...............  TC............  A               Ct lower extremity w/       0.00       4.95         NA       0.25       5.20         NA        XXX
                                                       o dye.
73701...............  ..............  A               Ct lower extremity w/       1.16       6.28         NA       0.36       7.80         NA        XXX
                                                       dye.
73701...............  26............  A               Ct lower extremity w/       1.16       0.38       0.38       0.05       1.59       1.59        XXX
                                                       dye.
73701...............  TC............  A               Ct lower extremity w/       0.00       5.90         NA       0.31       6.21         NA        XXX
                                                       dye.
73702...............  ..............  A               Ct lwr extremity w/         1.22       7.81         NA       0.45       9.48         NA        XXX
                                                       o&w/dye.
73702...............  26............  A               Ct lwr extremity w/         1.22       0.40       0.40       0.06       1.68       1.68        XXX
                                                       o&w/dye.
73702...............  TC............  A               Ct lwr extremity w/         0.00       7.41         NA       0.39       7.80         NA        XXX
                                                       o&w/dye.
73706...............  ..............  A               Ct angio lwr extr w/        1.90      11.57         NA       0.48      13.95         NA        XXX
                                                       o&w/dye.
73706...............  26............  A               Ct angio lwr extr w/        1.90       0.62       0.62       0.09       2.61       2.61        XXX
                                                       o&w/dye.
73706...............  TC............  A               Ct angio lwr extr w/        0.00      10.94         NA       0.39      11.33         NA        XXX
                                                       o&w/dye.
73718...............  ..............  A               Mri lower extremity w/      1.35      11.63         NA       0.45      13.43         NA        XXX
                                                       o dye.
73718...............  26............  A               Mri lower extremity w/      1.35       0.44       0.44       0.06       1.85       1.85        XXX
                                                       o dye.
73718...............  TC............  A               Mri lower extremity w/      0.00      11.19         NA       0.39      11.58         NA        XXX
                                                       o dye.
73719...............  ..............  A               Mri lower extremity w/      1.62      13.95         NA       0.54      16.11         NA        XXX
                                                       dye.
73719...............  26............  A               Mri lower extremity w/      1.62       0.53       0.53       0.07       2.22       2.22        XXX
                                                       dye.
73719...............  TC............  A               Mri lower extremity w/      0.00      13.42         NA       0.47      13.89         NA        XXX
                                                       dye.
73720...............  ..............  A               Mri lwr extremity w/        2.15      25.55         NA       0.94      28.64         NA        XXX
                                                       o&w/dye.
73720...............  26............  A               Mri lwr extremity w/        2.15       0.70       0.70       0.10       2.95       2.95        XXX
                                                       o&w/dye.
73720...............  TC............  A               Mri lwr extremity w/        0.00      24.84         NA       0.84      25.68         NA        XXX
                                                       o&w/dye.
73721...............  ..............  A               Mri jnt of lwr extre        1.35      11.63         NA       0.45      13.43         NA        XXX
                                                       w/o dye.
73721...............  26............  A               Mri jnt of lwr extre        1.35       0.44       0.44       0.06       1.85       1.85        XXX
                                                       w/o dye.
73721...............  TC............  A               Mri jnt of lwr extre        0.00      11.19         NA       0.39      11.58         NA        XXX
                                                       w/o dye.
73722...............  ..............  A               Mri joint of lwr extr       1.62      13.95         NA       0.55      16.12         NA        XXX
                                                       w/dye.
73722...............  26............  A               Mri joint of lwr extr       1.62       0.53       0.53       0.08       2.23       2.23        XXX
                                                       w/dye.
73722...............  TC............  A               Mri joint of lwr extr       0.00      13.42         NA       0.47      13.89         NA        XXX
                                                       w/dye.
73723...............  ..............  A               Mri joint lwr extr w/       2.15      25.55         NA       0.94      28.64         NA        XXX
                                                       o&w/dye.
73723...............  26............  A               Mri joint lwr extr w/       2.15       0.71       0.71       0.10       2.96       2.96        XXX
                                                       o&w/dye.
73723...............  TC............  A               Mri joint lwr extr w/       0.00      24.84         NA       0.84      25.68         NA        XXX
                                                       o&w/dye.
73725...............  ..............  R               Mr ang lwr ext w or w/      1.82      11.78         NA       0.67      14.27         NA        XXX
                                                       o dye.
73725...............  26............  R               Mr ang lwr ext w or w/      1.82       0.60       0.60       0.08       2.50       2.50        XXX
                                                       o dye.
73725...............  TC............  R               Mr ang lwr ext w or w/      0.00      11.19         NA       0.59      11.78         NA        XXX
                                                       o dye.
74000...............  ..............  A               X-ray exam of abdomen       0.18       0.58         NA       0.03       0.79         NA        XXX
74000...............  26............  A               X-ray exam of abdomen       0.18       0.06       0.06       0.01       0.25       0.25        XXX
74000...............  TC............  A               X-ray exam of abdomen       0.00       0.52         NA       0.02       0.54         NA        XXX
74010...............  ..............  A               X-ray exam of abdomen       0.23       0.64         NA       0.05       0.92         NA        XXX
74010...............  26............  A               X-ray exam of abdomen       0.23       0.07       0.07       0.01       0.31       0.31        XXX
74010...............  TC............  A               X-ray exam of abdomen       0.00       0.57         NA       0.04       0.61         NA        XXX
74020...............  ..............  A               X-ray exam of abdomen       0.27       0.71         NA       0.05       1.03         NA        XXX
74020...............  26............  A               X-ray exam of abdomen       0.27       0.09       0.09       0.01       0.37       0.37        XXX
74020...............  TC............  A               X-ray exam of abdomen       0.00       0.62         NA       0.04       0.66         NA        XXX

[[Page 47658]]

 
74022...............  ..............  A               X-ray exam series,          0.32       0.84         NA       0.06       1.22         NA        XXX
                                                       abdomen.
74022...............  26............  A               X-ray exam series,          0.32       0.10       0.10       0.01       0.43       0.43        XXX
                                                       abdomen.
74022...............  TC............  A               X-ray exam series,          0.00       0.73         NA       0.05       0.78         NA        XXX
                                                       abdomen.
74150...............  ..............  A               Ct abdomen w/o dye...       1.19       6.03         NA       0.35       7.57         NA        XXX
74150...............  26............  A               Ct abdomen w/o dye...       1.19       0.39       0.39       0.05       1.63       1.63        XXX
74150...............  TC............  A               Ct abdomen w/o dye...       0.00       5.65         NA       0.30       5.95         NA        XXX
74160...............  ..............  A               Ct abdomen w/dye.....       1.27       7.25         NA       0.42       8.94         NA        XXX
74160...............  26............  A               Ct abdomen w/dye.....       1.27       0.41       0.41       0.06       1.74       1.74        XXX
74160...............  TC............  A               Ct abdomen w/dye.....       0.00       6.83         NA       0.36       7.19         NA        XXX
74170...............  ..............  A               Ct abdomen w/o &w /         1.40       8.93         NA       0.49      10.82         NA        XXX
                                                       dye.
74170...............  26............  A               Ct abdomen w/o &w /         1.40       0.46       0.46       0.06       1.92       1.92        XXX
                                                       dye.
74170...............  TC............  A               Ct abdomen w/o &w /         0.00       8.47         NA       0.43       8.90         NA        XXX
                                                       dye.
74175...............  ..............  A               Ct angio abdom w/o &        1.90      12.63         NA       0.48      15.01         NA        XXX
                                                       w/dye.
74175...............  26............  A               Ct angio abdom w/o &        1.90       0.62       0.62       0.09       2.61       2.61        XXX
                                                       w/dye.
74175...............  TC............  A               Ct angio abdom w/o &        0.00      12.01         NA       0.39      12.40         NA        XXX
                                                       w/dye.
74181...............  ..............  A               Mri abdomen w/o dye..       1.46      11.66         NA       0.52      13.64         NA        XXX
74181...............  26............  A               Mri abdomen w/o dye..       1.46       0.48       0.48       0.07       2.01       2.01        XXX
74181...............  TC............  A               Mri abdomen w/o dye..       0.00      11.19         NA       0.45      11.64         NA        XXX
74182...............  ..............  A               Mri abdomen w/dye....       1.73      13.98         NA       0.60      16.31         NA        XXX
74182...............  26............  A               Mri abdomen w/dye....       1.73       0.56       0.56       0.08       2.37       2.37        XXX
74182...............  TC............  A               Mri abdomen w/dye....       0.00      13.42         NA       0.52      13.94         NA        XXX
74183...............  ..............  A               Mri abdomen w/o & w/        2.26      25.58         NA       1.02      28.86         NA        XXX
                                                       dye.
74183...............  26............  A               Mri abdomen w/o & w/        2.26       0.74       0.74       0.10       3.10       3.10        XXX
                                                       dye.
74183...............  TC............  A               Mri abdomen w/o & w/        0.00      24.84         NA       0.92      25.76         NA        XXX
                                                       dye.
74185...............  ..............  R               Mri angio, abdom w          1.80      11.78         NA       0.67      14.25         NA        XXX
                                                       orw/o dye.
74185...............  26............  R               Mri angio, abdom w          1.80       0.59       0.59       0.08       2.47       2.47        XXX
                                                       orw/o dye.
74185...............  TC............  R               Mri angio, abdom w          0.00      11.19         NA       0.59      11.78         NA        XXX
                                                       orw/o dye.
74190...............  ..............  A               X-ray exam of               0.48       1.46         NA       0.09       2.03         NA        XXX
                                                       peritoneum.
74190...............  26............  A               X-ray exam of               0.48       0.16       0.16       0.02       0.66       0.66        XXX
                                                       peritoneum.
74190...............  TC............  A               X-ray exam of               0.00       1.30         NA       0.07       1.37         NA        XXX
                                                       peritoneum.
74210...............  ..............  A               Contrst x-ray exam of       0.36       1.30         NA       0.08       1.74         NA        XXX
                                                       throat.
74210...............  26............  A               Contrst x-ray exam of       0.36       0.12       0.12       0.02       0.50       0.50        XXX
                                                       throat.
74210...............  TC............  A               Contrst x-ray exam of       0.00       1.19         NA       0.06       1.25         NA        XXX
                                                       throat.
74220...............  ..............  A               Contrast x-ray,             0.46       1.34         NA       0.08       1.88         NA        XXX
                                                       esophagus.
74220...............  26............  A               Contrast x-ray,             0.46       0.15       0.15       0.02       0.63       0.63        XXX
                                                       esophagus.
74220...............  TC............  A               Contrast x-ray,             0.00       1.19         NA       0.06       1.25         NA        XXX
                                                       esophagus.
74230...............  ..............  A               Cine/vid x-ray,             0.53       1.48         NA       0.09       2.10         NA        XXX
                                                       throat/esoph.
74230...............  26............  A               Cine/vid x-ray,             0.53       0.17       0.17       0.02       0.72       0.72        XXX
                                                       throat/esoph.
74230...............  TC............  A               Cine/vid x-ray,             0.00       1.30         NA       0.07       1.37         NA        XXX
                                                       throat/esoph.
74235...............  ..............  A               Remove esophagus            1.19       3.01         NA       0.19       4.39         NA        XXX
                                                       obstruction.
74235...............  26............  A               Remove esophagus            1.19       0.39       0.39       0.05       1.63       1.63        XXX
                                                       obstruction.
74235...............  TC............  A               Remove esophagus            0.00       2.62         NA       0.14       2.76         NA        XXX
                                                       obstruction.
74240...............  ..............  A               X-ray exam, upper gi        0.69       1.68         NA       0.11       2.48         NA        XXX
                                                       tract.
74240...............  26............  A               X-ray exam, upper gi        0.69       0.22       0.22       0.03       0.94       0.94        XXX
                                                       tract.
74240...............  TC............  A               X-ray exam, upper gi        0.00       1.46         NA       0.08       1.54         NA        XXX
                                                       tract.
74241...............  ..............  A               X-ray exam, upper gi        0.69       1.71         NA       0.11       2.51         NA        XXX
                                                       tract.
74241...............  26............  A               X-ray exam, upper gi        0.69       0.22       0.22       0.03       0.94       0.94        XXX
                                                       tract.
74241...............  TC............  A               X-ray exam, upper gi        0.00       1.49         NA       0.08       1.57         NA        XXX
                                                       tract.
74245...............  ..............  A               X-ray exam, upper gi        0.91       2.67         NA       0.17       3.75         NA        XXX
                                                       tract.
74245...............  26............  A               X-ray exam, upper gi        0.91       0.30       0.30       0.04       1.25       1.25        XXX
                                                       tract.
74245...............  TC............  A               X-ray exam, upper gi        0.00       2.37         NA       0.13       2.50         NA        XXX
                                                       tract.
74246...............  ..............  A               Contrst x-ray uppr gi       0.69       1.87         NA       0.13       2.69         NA        XXX
                                                       tract.
74246...............  26............  A               Contrst x-ray uppr gi       0.69       0.23       0.23       0.03       0.95       0.95        XXX
                                                       tract.
74246...............  TC............  A               Contrst x-ray uppr gi       0.00       1.64         NA       0.10       1.74         NA        XXX
                                                       tract.
74247...............  ..............  A               Contrst x-ray uppr gi       0.69       1.90         NA       0.14       2.73         NA        XXX
                                                       tract.
74247...............  26............  A               Contrst x-ray uppr gi       0.69       0.23       0.23       0.03       0.95       0.95        XXX
                                                       tract.
74247...............  TC............  A               Contrst x-ray uppr gi       0.00       1.68         NA       0.11       1.79         NA        XXX
                                                       tract.
74249...............  ..............  A               Contrst x-ray uppr gi       0.91       2.86         NA       0.18       3.95         NA        XXX
                                                       tract.
74249...............  26............  A               Contrst x-ray uppr gi       0.91       0.30       0.30       0.04       1.25       1.25        XXX
                                                       tract.
74249...............  TC............  A               Contrst x-ray uppr gi       0.00       2.57         NA       0.14       2.71         NA        XXX
                                                       tract.
74250...............  ..............  A               X-ray exam of small         0.47       1.46         NA       0.09       2.02         NA        XXX
                                                       bowel.
74250...............  26............  A               X-ray exam of small         0.47       0.15       0.15       0.02       0.64       0.64        XXX
                                                       bowel.
74250...............  TC............  A               X-ray exam of small         0.00       1.30         NA       0.07       1.37         NA        XXX
                                                       bowel.
74251...............  ..............  A               X-ray exam of small         0.69       1.53         NA       0.10       2.32         NA        XXX
                                                       bowel.
74251...............  26............  A               X-ray exam of small         0.69       0.22       0.22       0.03       0.94       0.94        XXX
                                                       bowel.
74251...............  TC............  A               X-ray exam of small         0.00       1.30         NA       0.07       1.37         NA        XXX
                                                       bowel.
74260...............  ..............  A               X-ray exam of small         0.50       1.65         NA       0.10       2.25         NA        XXX
                                                       bowel.
74260...............  26............  A               X-ray exam of small         0.50       0.16       0.16       0.02       0.68       0.68        XXX
                                                       bowel.
74260...............  TC............  A               X-ray exam of small         0.00       1.49         NA       0.08       1.57         NA        XXX
                                                       bowel.
74270...............  ..............  A               Contrast x-ray exam         0.69       1.92         NA       0.14       2.75         NA        XXX
                                                       of colon.
74270...............  26............  A               Contrast x-ray exam         0.69       0.22       0.22       0.03       0.94       0.94        XXX
                                                       of colon.
74270...............  TC............  A               Contrast x-ray exam         0.00       1.70         NA       0.11       1.81         NA        XXX
                                                       of colon.
74280...............  ..............  A               Contrast x-ray exam         0.99       2.55         NA       0.17       3.71         NA        XXX
                                                       of colon.
74280...............  26............  A               Contrast x-ray exam         0.99       0.32       0.32       0.04       1.35       1.35        XXX
                                                       of colon.
74280...............  TC............  A               Contrast x-ray exam         0.00       2.23         NA       0.13       2.36         NA        XXX
                                                       of colon.

[[Page 47659]]

 
74283...............  ..............  A               Contrast x-ray exam         2.02       3.22         NA       0.23       5.47         NA        XXX
                                                       of colon.
74283...............  26............  A               Contrast x-ray exam         2.02       0.66       0.66       0.09       2.77       2.77        XXX
                                                       of colon.
74283...............  TC............  A               Contrast x-ray exam         0.00       2.56         NA       0.14       2.70         NA        XXX
                                                       of colon.
74290...............  ..............  A               Contrast x-ray,             0.32       0.84         NA       0.06       1.22         NA        XXX
                                                       gallbladder.
74290...............  26............  A               Contrast x-ray,             0.32       0.10       0.10       0.01       0.43       0.43        XXX
                                                       gallbladder.
74290...............  TC............  A               Contrast x-ray,             0.00       0.73         NA       0.05       0.78         NA        XXX
                                                       gallbladder.
74291...............  ..............  A               Contrast x-rays,            0.20       0.48         NA       0.03       0.71         NA        XXX
                                                       gallbladder.
74291...............  26............  A               Contrast x-rays,            0.20       0.07       0.07       0.01       0.28       0.28        XXX
                                                       gallbladder.
74291...............  TC............  A               Contrast x-rays,            0.00       0.42         NA       0.02       0.44         NA        XXX
                                                       gallbladder.
74300...............  26............  A               X-ray bile ducts/           0.36       0.12       0.12       0.02       0.50       0.50        XXX
                                                       pancreas.
74301...............  26............  A               X-rays at surgery add-      0.21       0.07       0.07       0.01       0.29       0.29        ZZZ
                                                       on.
74305...............  ..............  A               X-ray bile ducts/           0.42       0.92         NA       0.07       1.41         NA        XXX
                                                       pancreas.
74305...............  26............  A               X-ray bile ducts/           0.42       0.14       0.14       0.02       0.58       0.58        XXX
                                                       pancreas.
74305...............  TC............  A               X-ray bile ducts/           0.00       0.78         NA       0.05       0.83         NA        XXX
                                                       pancreas.
74320...............  ..............  A               Contrast x-ray of           0.54       3.32         NA       0.19       4.05         NA        XXX
                                                       bile ducts.
74320...............  26............  A               Contrast x-ray of           0.54       0.18       0.18       0.02       0.74       0.74        XXX
                                                       bile ducts.
74320...............  TC............  A               Contrast x-ray of           0.00       3.15         NA       0.17       3.32         NA        XXX
                                                       bile ducts.
74327...............  ..............  A               X-ray bile stone            0.70       1.98         NA       0.14       2.82         NA        XXX
                                                       removal.
74327...............  26............  A               X-ray bile stone            0.70       0.23       0.23       0.03       0.96       0.96        XXX
                                                       removal.
74327...............  TC............  A               X-ray bile stone            0.00       1.76         NA       0.11       1.87         NA        XXX
                                                       removal.
74328...............  ..............  A               X-ray bile duct             0.70       3.38         NA       0.20       4.28         NA        XXX
                                                       endoscopy.
74328...............  26............  A               X-ray bile duct             0.70       0.23       0.23       0.03       0.96       0.96        XXX
                                                       endoscopy.
74328...............  TC............  A               X-ray bile duct             0.00       3.15         NA       0.17       3.32         NA        XXX
                                                       endoscopy.
74329...............  ..............  A               X-ray for pancreas          0.70       3.38         NA       0.20       4.28         NA        XXX
                                                       endoscopy.
74329...............  26............  A               X-ray for pancreas          0.70       0.23       0.23       0.03       0.96       0.96        XXX
                                                       endoscopy.
74329...............  TC............  A               X-ray for pancreas          0.00       3.15         NA       0.17       3.32         NA        XXX
                                                       endoscopy.
74330...............  ..............  A               X-ray bile/panc             0.90       3.44         NA       0.21       4.55         NA        XXX
                                                       endoscopy.
74330...............  26............  A               X-ray bile/panc             0.90       0.29       0.29       0.04       1.23       1.23        XXX
                                                       endoscopy.
74330...............  TC............  A               X-ray bile/panc             0.00       3.15         NA       0.17       3.32         NA        XXX
                                                       endoscopy.
74340...............  ..............  A               X-ray guide for GI          0.54       2.79         NA       0.16       3.49         NA        XXX
                                                       tube.
74340...............  26............  A               X-ray guide for GI          0.54       0.18       0.18       0.02       0.74       0.74        XXX
                                                       tube.
74340...............  TC............  A               X-ray guide for GI          0.00       2.62         NA       0.14       2.76         NA        XXX
                                                       tube.
74350...............  ..............  A               X-ray guide, stomach        0.76       3.39         NA       0.20       4.35         NA        XXX
                                                       tube.
74350...............  26............  A               X-ray guide, stomach        0.76       0.25       0.25       0.03       1.04       1.04        XXX
                                                       tube.
74350...............  TC............  A               X-ray guide, stomach        0.00       3.15         NA       0.17       3.32         NA        XXX
                                                       tube.
74355...............  ..............  A               X-ray guide,                0.76       2.86         NA       0.17       3.79         NA        XXX
                                                       intestinal tube.
74355...............  26............  A               X-ray guide,                0.76       0.25       0.25       0.03       1.04       1.04        XXX
                                                       intestinal tube.
74355...............  TC............  A               X-ray guide,                0.00       2.62         NA       0.14       2.76         NA        XXX
                                                       intestinal tube.
74360...............  ..............  A               X-ray guide, GI             0.54       3.33         NA       0.19       4.06         NA        XXX
                                                       dilation.
74360...............  26............  A               X-ray guide, GI             0.54       0.19       0.19       0.02       0.75       0.75        XXX
                                                       dilation.
74360...............  TC............  A               X-ray guide, GI             0.00       3.15         NA       0.17       3.32         NA        XXX
                                                       dilation.
74363...............  ..............  A               X-ray, bile duct            0.88       6.38         NA       0.37       7.63         NA        XXX
                                                       dilation.
74363...............  26............  A               X-ray, bile duct            0.88       0.29       0.29       0.04       1.21       1.21        XXX
                                                       dilation.
74363...............  TC............  A               X-ray, bile duct            0.00       6.09         NA       0.33       6.42         NA        XXX
                                                       dilation.
74400...............  ..............  A               Contrst x-ray,              0.49       1.84         NA       0.13       2.46         NA        XXX
                                                       urinary tract.
74400...............  26............  A               Contrst x-ray,              0.49       0.16       0.16       0.02       0.67       0.67        XXX
                                                       urinary tract.
74400...............  TC............  A               Contrst x-ray,              0.00       1.68         NA       0.11       1.79         NA        XXX
                                                       urinary tract.
74410...............  ..............  A               Contrst x-ray,              0.49       2.11         NA       0.13       2.73         NA        XXX
                                                       urinary tract.
74410...............  26............  A               Contrst x-ray,              0.49       0.16       0.16       0.02       0.67       0.67        XXX
                                                       urinary tract.
74410...............  TC............  A               Contrst x-ray,              0.00       1.95         NA       0.11       2.06         NA        XXX
                                                       urinary tract.
74415...............  ..............  A               Contrst x-ray,              0.49       2.27         NA       0.14       2.90         NA        XXX
                                                       urinary tract.
74415...............  26............  A               Contrst x-ray,              0.49       0.16       0.16       0.02       0.67       0.67        XXX
                                                       urinary tract.
74415...............  TC............  A               Contrst x-ray,              0.00       2.11         NA       0.12       2.23         NA        XXX
                                                       urinary tract.
74420...............  ..............  A               Contrst x-ray,              0.36       2.73         NA       0.16       3.25         NA        XXX
                                                       urinary tract.
74420...............  26............  A               Contrst x-ray,              0.36       0.12       0.12       0.02       0.50       0.50        XXX
                                                       urinary tract.
74420...............  TC............  A               Contrst x-ray,              0.00       2.62         NA       0.14       2.76         NA        XXX
                                                       urinary tract.
74425...............  ..............  A               Contrst x-ray,              0.36       1.42         NA       0.09       1.87         NA        XXX
                                                       urinary tract.
74425...............  26............  A               Contrst x-ray,              0.36       0.12       0.12       0.02       0.50       0.50        XXX
                                                       urinary tract.
74425...............  TC............  A               Contrst x-ray,              0.00       1.30         NA       0.07       1.37         NA        XXX
                                                       urinary tract.
74430...............  ..............  A               Contrast x-ray,             0.32       1.16         NA       0.08       1.56         NA        XXX
                                                       bladder.
74430...............  26............  A               Contrast x-ray,             0.32       0.10       0.10       0.02       0.44       0.44        XXX
                                                       bladder.
74430...............  TC............  A               Contrast x-ray,             0.00       1.05         NA       0.06       1.11         NA        XXX
                                                       bladder.
74440...............  ..............  A               X-ray, male genital         0.38       1.25         NA       0.08       1.71         NA        XXX
                                                       tract.
74440...............  26............  A               X-ray, male genital         0.38       0.12       0.12       0.02       0.52       0.52        XXX
                                                       tract.
74440...............  TC............  A               X-ray, male genital         0.00       1.13         NA       0.06       1.19         NA        XXX
                                                       tract.
74445...............  ..............  A               X-ray exam of penis..       1.14       1.50         NA       0.12       2.76         NA        XXX
74445...............  26............  A               X-ray exam of penis..       1.14       0.37       0.37       0.06       1.57       1.57        XXX
74445...............  TC............  A               X-ray exam of penis..       0.00       1.13         NA       0.06       1.19         NA        XXX
74450...............  ..............  A               X-ray, urethra/             0.33       1.56         NA       0.10       1.99         NA        XXX
                                                       bladder.
74450...............  26............  A               X-ray, urethra/             0.33       0.11       0.11       0.02       0.46       0.46        XXX
                                                       bladder.
74450...............  TC............  A               X-ray, urethra/             0.00       1.46         NA       0.08       1.54         NA        XXX
                                                       bladder.
74455...............  ..............  A               X-ray, urethra/             0.33       1.68         NA       0.12       2.13         NA        XXX
                                                       bladder.
74455...............  26............  A               X-ray, urethra/             0.33       0.11       0.11       0.02       0.46       0.46        XXX
                                                       bladder.
74455...............  TC............  A               X-ray, urethra/             0.00       1.57         NA       0.10       1.67         NA        XXX
                                                       bladder.
74470...............  ..............  A               X-ray exam of kidney        0.54       1.42         NA       0.10       2.06         NA        XXX
                                                       lesion.

[[Page 47660]]

 
74470...............  26............  A               X-ray exam of kidney        0.54       0.18       0.18       0.03       0.75       0.75        XXX
                                                       lesion.
74470...............  TC............  A               X-ray exam of kidney        0.00       1.25         NA       0.07       1.32         NA        XXX
                                                       lesion.
74475...............  ..............  A               X-ray control, cath         0.54       4.24         NA       0.24       5.02         NA        XXX
                                                       insert.
74475...............  26............  A               X-ray control, cath         0.54       0.18       0.18       0.02       0.74       0.74        XXX
                                                       insert.
74475...............  TC............  A               X-ray control, cath         0.00       4.06         NA       0.22       4.28         NA        XXX
                                                       insert.
74480...............  ..............  A               X-ray control, cath         0.54       4.24         NA       0.24       5.02         NA        XXX
                                                       insert.
74480...............  26............  A               X-ray control, cath         0.54       0.18       0.18       0.02       0.74       0.74        XXX
                                                       insert.
74480...............  TC............  A               X-ray control, cath         0.00       4.06         NA       0.22       4.28         NA        XXX
                                                       insert.
74485...............  ..............  A               X-ray guide, GU             0.54       3.32         NA       0.20       4.06         NA        XXX
                                                       dilation.
74485...............  26............  A               X-ray guide, GU             0.54       0.17       0.17       0.03       0.74       0.74        XXX
                                                       dilation.
74485...............  TC............  A               X-ray guide, GU             0.00       3.15         NA       0.17       3.32         NA        XXX
                                                       dilation.
74710...............  ..............  A               X-ray measurement of        0.34       1.16         NA       0.08       1.58         NA        XXX
                                                       pelvis.
74710...............  26............  A               X-ray measurement of        0.34       0.11       0.11       0.02       0.47       0.47        XXX
                                                       pelvis.
74710...............  TC............  A               X-ray measurement of        0.00       1.05         NA       0.06       1.11         NA        XXX
                                                       pelvis.
74740...............  ..............  A               X-ray, female genital       0.38       1.43         NA       0.09       1.90         NA        XXX
                                                       tract.
74740...............  26............  A               X-ray, female genital       0.38       0.13       0.13       0.02       0.53       0.53        XXX
                                                       tract.
74740...............  TC............  A               X-ray, female genital       0.00       1.30         NA       0.07       1.37         NA        XXX
                                                       tract.
74742...............  ..............  A               X-ray, fallopian tube       0.61       3.35         NA       0.20       4.16         NA        XXX
74742...............  26............  A               X-ray, fallopian tube       0.61       0.20       0.20       0.03       0.84       0.84        XXX
74742...............  TC............  A               X-ray, fallopian tube       0.00       3.15         NA       0.17       3.32         NA        XXX
74775...............  ..............  A               X-ray exam of               0.62       1.66         NA       0.11       2.39         NA        XXX
                                                       perineum.
74775...............  26............  A               X-ray exam of               0.62       0.21       0.21       0.03       0.86       0.86        XXX
                                                       perineum.
74775...............  TC............  A               X-ray exam of               0.00       1.46         NA       0.08       1.54         NA        XXX
                                                       perineum.
75552...............  ..............  A               Heart mri for morph w/      1.60      11.71         NA       0.66      13.97         NA        XXX
                                                       o dye.
75552...............  26............  A               Heart mri for morph w/      1.60       0.53       0.53       0.07       2.20       2.20        XXX
                                                       o dye.
75552...............  TC............  A               Heart mri for morph w/      0.00      11.19         NA       0.59      11.78         NA        XXX
                                                       o dye.
75553...............  ..............  A               Heart mri for morph w/      2.00      11.84         NA       0.68      14.52         NA        XXX
                                                       dye.
75553...............  26............  A               Heart mri for morph w/      2.00       0.65       0.65       0.09       2.74       2.74        XXX
                                                       dye.
75553...............  TC............  A               Heart mri for morph w/      0.00      11.19         NA       0.59      11.78         NA        XXX
                                                       dye.
75554...............  ..............  A               Cardiac MRI/function.       1.83      11.83         NA       0.66      14.32         NA        XXX
75554...............  26............  A               Cardiac MRI/function.       1.83       0.64       0.64       0.07       2.54       2.54        XXX
75554...............  TC............  A               Cardiac MRI/function.       0.00      11.19         NA       0.59      11.78         NA        XXX
75555...............  ..............  A               Cardiac MRI/limited         1.74      11.82         NA       0.66      14.22         NA        XXX
                                                       study.
75555...............  26............  A               Cardiac MRI/limited         1.74       0.64       0.64       0.07       2.45       2.45        XXX
                                                       study.
75555...............  TC............  A               Cardiac MRI/limited         0.00      11.19         NA       0.59      11.78         NA        XXX
                                                       study.
75600...............  ..............  A               Contrast x-ray exam         0.49      12.76         NA       0.67      13.92         NA        XXX
                                                       of aorta.
75600...............  26............  A               Contrast x-ray exam         0.49       0.19       0.19       0.02       0.70       0.70        XXX
                                                       of aorta.
75600...............  TC............  A               Contrast x-ray exam         0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       of aorta.
75605...............  ..............  A               Contrast x-ray exam         1.14      12.97         NA       0.70      14.81         NA        XXX
                                                       of aorta.
75605...............  26............  A               Contrast x-ray exam         1.14       0.40       0.40       0.05       1.59       1.59        XXX
                                                       of aorta.
75605...............  TC............  A               Contrast x-ray exam         0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       of aorta.
75625...............  ..............  A               Contrast x-ray exam         1.14      12.95         NA       0.71      14.80         NA        XXX
                                                       of aorta.
75625...............  26............  A               Contrast x-ray exam         1.14       0.38       0.38       0.06       1.58       1.58        XXX
                                                       of aorta.
75625...............  TC............  A               Contrast x-ray exam         0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       of aorta.
75630...............  ..............  A               X-ray aorta, leg            1.79      13.72         NA       0.79      16.30         NA        XXX
                                                       arteries.
75630...............  26............  A               X-ray aorta, leg            1.79       0.61       0.61       0.10       2.50       2.50        XXX
                                                       arteries.
75630...............  TC............  A               X-ray aorta, leg            0.00      13.11         NA       0.69      13.80         NA        XXX
                                                       arteries.
75635...............  ..............  A               Ct angio abdominal          2.40      16.68         NA       0.50      19.58         NA        XXX
                                                       arteries.
75635...............  26............  A               Ct angio abdominal          2.40       0.79       0.79       0.11       3.30       3.30        XXX
                                                       arteries.
75635...............  TC............  A               Ct angio abdominal          0.00      15.89         NA       0.39      16.28         NA        XXX
                                                       arteries.
75650...............  ..............  A               Artery x-rays, head &       1.49      13.07         NA       0.72      15.28         NA        XXX
                                                       neck.
75650...............  26............  A               Artery x-rays, head &       1.49       0.49       0.49       0.07       2.05       2.05        XXX
                                                       neck.
75650...............  TC............  A               Artery x-rays, head &       0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       neck.
75658...............  ..............  A               Artery x-rays, arm...       1.31      13.05         NA       0.72      15.08         NA        XXX
75658...............  26............  A               Artery x-rays, arm...       1.31       0.47       0.47       0.07       1.85       1.85        XXX
75658...............  TC............  A               Artery x-rays, arm...       0.00      12.58         NA       0.65      13.23         NA        XXX
75660...............  ..............  A               Artery x-rays, head &       1.31      13.02         NA       0.72      15.05         NA        XXX
                                                       neck.
75660...............  26............  A               Artery x-rays, head &       1.31       0.44       0.44       0.07       1.82       1.82        XXX
                                                       neck.
75660...............  TC............  A               Artery x-rays, head &       0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       neck.
75662...............  ..............  A               Artery x-rays, head &       1.66      13.17         NA       0.73      15.56         NA        XXX
                                                       neck.
75662...............  26............  A               Artery x-rays, head &       1.66       0.59       0.59       0.08       2.33       2.33        XXX
                                                       neck.
75662...............  TC............  A               Artery x-rays, head &       0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       neck.
75665...............  ..............  A               Artery x-rays, head &       1.31      13.01         NA       0.74      15.06         NA        XXX
                                                       neck.
75665...............  26............  A               Artery x-rays, head &       1.31       0.44       0.44       0.09       1.84       1.84        XXX
                                                       neck.
75665...............  TC............  A               Artery x-rays, head &       0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       neck.
75671...............  ..............  A               Artery x-rays, head &       1.66      13.12         NA       0.73      15.51         NA        XXX
                                                       neck.
75671...............  26............  A               Artery x-rays, head &       1.66       0.55       0.55       0.08       2.29       2.29        XXX
                                                       neck.
75671...............  TC............  A               Artery x-rays, head &       0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       neck.
75676...............  ..............  A               Artery x-rays, neck..       1.31      13.01         NA       0.73      15.05         NA        XXX
75676...............  26............  A               Artery x-rays, neck..       1.31       0.44       0.44       0.08       1.83       1.83        XXX
75676...............  TC............  A               Artery x-rays, neck..       0.00      12.58         NA       0.65      13.23         NA        XXX
75680...............  ..............  A               Artery x-rays, neck..       1.66      13.12         NA       0.73      15.51         NA        XXX
75680...............  26............  A               Artery x-rays, neck..       1.66       0.55       0.55       0.08       2.29       2.29        XXX
75680...............  TC............  A               Artery x-rays, neck..       0.00      12.58         NA       0.65      13.23         NA        XXX
75685...............  ..............  A               Artery x-rays, spine.       1.31      13.01         NA       0.72      15.04         NA        XXX

[[Page 47661]]

 
75685...............  26............  A               Artery x-rays, spine.       1.31       0.43       0.43       0.07       1.81       1.81        XXX
75685...............  TC............  A               Artery x-rays, spine.       0.00      12.58         NA       0.65      13.23         NA        XXX
75705...............  ..............  A               Artery x-rays, spine.       2.18      13.31         NA       0.78      16.27         NA        XXX
75705...............  26............  A               Artery x-rays, spine.       2.18       0.73       0.73       0.13       3.04       3.04        XXX
75705...............  TC............  A               Artery x-rays, spine.       0.00      12.58         NA       0.65      13.23         NA        XXX
75710...............  ..............  A               Artery x-rays, arm/         1.14      12.96         NA       0.71      14.81         NA        XXX
                                                       leg.
75710...............  26............  A               Artery x-rays, arm/         1.14       0.39       0.39       0.06       1.59       1.59        XXX
                                                       leg.
75710...............  TC............  A               Artery x-rays, arm/         0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       leg.
75716...............  ..............  A               Artery x-rays, arms/        1.31      13.01         NA       0.72      15.04         NA        XXX
                                                       legs.
75716...............  26............  A               Artery x-rays, arms/        1.31       0.43       0.43       0.07       1.81       1.81        XXX
                                                       legs.
75716...............  TC............  A               Artery x-rays, arms/        0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       legs.
75722...............  ..............  A               Artery x-rays, kidney       1.14      12.97         NA       0.71      14.82         NA        XXX
75722...............  26............  A               Artery x-rays, kidney       1.14       0.40       0.40       0.06       1.60       1.60        XXX
75722...............  TC............  A               Artery x-rays, kidney       0.00      12.58         NA       0.65      13.23         NA        XXX
75724...............  ..............  A               Artery x-rays,              1.49      13.13         NA       0.71      15.33         NA        XXX
                                                       kidneys.
75724...............  26............  A               Artery x-rays,              1.49       0.56       0.56       0.06       2.11       2.11        XXX
                                                       kidneys.
75724...............  TC............  A               Artery x-rays,              0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       kidneys.
75726...............  ..............  A               Artery x-rays,              1.14      12.95         NA       0.70      14.79         NA        XXX
                                                       abdomen.
75726...............  26............  A               Artery x-rays,              1.14       0.37       0.37       0.05       1.56       1.56        XXX
                                                       abdomen.
75726...............  TC............  A               Artery x-rays,              0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       abdomen.
75731...............  ..............  A               Artery x-rays,              1.14      12.95         NA       0.70      14.79         NA        XXX
                                                       adrenal gland.
75731...............  26............  A               Artery x-rays,              1.14       0.37       0.37       0.05       1.56       1.56        XXX
                                                       adrenal gland.
75731...............  TC............  A               Artery x-rays,              0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       adrenal gland.
75733...............  ..............  A               Artery x-rays,              1.31      13.01         NA       0.70      15.02         NA        XXX
                                                       adrenals.
75733...............  26............  A               Artery x-rays,              1.31       0.43       0.43       0.05       1.79       1.79        XXX
                                                       adrenals.
75733...............  TC............  A               Artery x-rays,              0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       adrenals.
75736...............  ..............  A               Artery x-rays, pelvis       1.14      12.95         NA       0.71      14.80         NA        XXX
75736...............  26............  A               Artery x-rays, pelvis       1.14       0.37       0.37       0.06       1.57       1.57        XXX
75736...............  TC............  A               Artery x-rays, pelvis       0.00      12.58         NA       0.65      13.23         NA        XXX
75741...............  ..............  A               Artery x-rays, lung..       1.31      13.01         NA       0.71      15.03         NA        XXX
75741...............  26............  A               Artery x-rays, lung..       1.31       0.43       0.43       0.06       1.80       1.80        XXX
75741...............  TC............  A               Artery x-rays, lung..       0.00      12.58         NA       0.65      13.23         NA        XXX
75743...............  ..............  A               Artery x-rays, lungs.       1.66      13.12         NA       0.73      15.51         NA        XXX
75743...............  26............  A               Artery x-rays, lungs.       1.66       0.54       0.54       0.08       2.28       2.28        XXX
75743...............  TC............  A               Artery x-rays, lungs.       0.00      12.58         NA       0.65      13.23         NA        XXX
75746...............  ..............  A               Artery x-rays, lung..       1.14      12.95         NA       0.70      14.79         NA        XXX
75746...............  26............  A               Artery x-rays, lung..       1.14       0.38       0.38       0.05       1.57       1.57        XXX
75746...............  TC............  A               Artery x-rays, lung..       0.00      12.58         NA       0.65      13.23         NA        XXX
75756...............  ..............  A               Artery x-rays, chest.       1.14      13.02         NA       0.69      14.85         NA        XXX
75756...............  26............  A               Artery x-rays, chest.       1.14       0.45       0.45       0.04       1.63       1.63        XXX
75756...............  TC............  A               Artery x-rays, chest.       0.00      12.58         NA       0.65      13.23         NA        XXX
75774...............  ..............  A               Artery x-ray, each          0.36      12.70         NA       0.67      13.73         NA        ZZZ
                                                       vessel.
75774...............  26............  A               Artery x-ray, each          0.36       0.12       0.12       0.02       0.50       0.50        ZZZ
                                                       vessel.
75774...............  TC............  A               Artery x-ray, each          0.00      12.58         NA       0.65      13.23         NA        ZZZ
                                                       vessel.
75790...............  ..............  A               Visualize A-V shunt..       1.84       1.95         NA       0.18       3.97         NA        XXX
75790...............  26............  A               Visualize A-V shunt..       1.84       0.60       0.60       0.10       2.54       2.54        XXX
75790...............  TC............  A               Visualize A-V shunt..       0.00       1.35         NA       0.08       1.43         NA        XXX
75801...............  ..............  A               Lymph vessel x-ray,         0.81       5.67         NA       0.37       6.85         NA        XXX
                                                       arm/leg.
75801...............  26............  A               Lymph vessel x-ray,         0.81       0.27       0.27       0.08       1.16       1.16        XXX
                                                       arm/leg.
75801...............  TC............  A               Lymph vessel x-ray,         0.00       5.40         NA       0.29       5.69         NA        XXX
                                                       arm/leg.
75803...............  ..............  A               Lymph vessel x-             1.17       5.79         NA       0.34       7.30         NA        XXX
                                                       ray,arms/legs.
75803...............  26............  A               Lymph vessel x-             1.17       0.38       0.38       0.05       1.60       1.60        XXX
                                                       ray,arms/legs.
75803...............  TC............  A               Lymph vessel x-             0.00       5.40         NA       0.29       5.69         NA        XXX
                                                       ray,arms/legs.
75805...............  ..............  A               Lymph vessel x-ray,         0.81       6.36         NA       0.38       7.55         NA        XXX
                                                       trunk.
75805...............  26............  A               Lymph vessel x-ray,         0.81       0.27       0.27       0.05       1.13       1.13        XXX
                                                       trunk.
75805...............  TC............  A               Lymph vessel x-ray,         0.00       6.09         NA       0.33       6.42         NA        XXX
                                                       trunk.
75807...............  ..............  A               Lymph vessel x-ray,         1.17       6.47         NA       0.39       8.03         NA        XXX
                                                       trunk.
75807...............  26............  A               Lymph vessel x-ray,         1.17       0.38       0.38       0.06       1.61       1.61        XXX
                                                       trunk.
75807...............  TC............  A               Lymph vessel x-ray,         0.00       6.09         NA       0.33       6.42         NA        XXX
                                                       trunk.
75809...............  ..............  A               Nonvascular shunt, x-       0.47       0.94         NA       0.07       1.48         NA        XXX
                                                       ray.
75809...............  26............  A               Nonvascular shunt, x-       0.47       0.15       0.15       0.02       0.64       0.64        XXX
                                                       ray.
75809...............  TC............  A               Nonvascular shunt, x-       0.00       0.78         NA       0.05       0.83         NA        XXX
                                                       ray.
75810...............  ..............  A               Vein x-ray, spleen/         1.14      12.95         NA       0.70      14.79         NA        XXX
                                                       liver.
75810...............  26............  A               Vein x-ray, spleen/         1.14       0.37       0.37       0.05       1.56       1.56        XXX
                                                       liver.
75810...............  TC............  A               Vein x-ray, spleen/         0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       liver.
75820...............  ..............  A               Vein x-ray, arm/leg..       0.70       1.17         NA       0.10       1.97         NA        XXX
75820...............  26............  A               Vein x-ray, arm/leg..       0.70       0.23       0.23       0.04       0.97       0.97        XXX
75820...............  TC............  A               Vein x-ray, arm/leg..       0.00       0.95         NA       0.06       1.01         NA        XXX
75822...............  ..............  A               Vein x-ray, arms/legs       1.06       1.82         NA       0.13       3.01         NA        XXX
75822...............  26............  A               Vein x-ray, arms/legs       1.06       0.35       0.35       0.05       1.46       1.46        XXX
75822...............  TC............  A               Vein x-ray, arms/legs       0.00       1.48         NA       0.08       1.56         NA        XXX
75825...............  ..............  A               Vein x-ray, trunk....       1.14      12.95         NA       0.72      14.81         NA        XXX
75825...............  26............  A               Vein x-ray, trunk....       1.14       0.37       0.37       0.07       1.58       1.58        XXX
75825...............  TC............  A               Vein x-ray, trunk....       0.00      12.58         NA       0.65      13.23         NA        XXX
75827...............  ..............  A               Vein x-ray, chest....       1.14      12.95         NA       0.71      14.80         NA        XXX

[[Page 47662]]

 
75827...............  26............  A               Vein x-ray, chest....       1.14       0.37       0.37       0.06       1.57       1.57        XXX
75827...............  TC............  A               Vein x-ray, chest....       0.00      12.58         NA       0.65      13.23         NA        XXX
75831...............  ..............  A               Vein x-ray, kidney...       1.14      12.94         NA       0.70      14.78         NA        XXX
75831...............  26............  A               Vein x-ray, kidney...       1.14       0.37       0.37       0.06       1.57       1.57        XXX
75831...............  TC............  A               Vein x-ray, kidney...       0.00      12.58         NA       0.65      13.23         NA        XXX
75833...............  ..............  A               Vein x-ray, kidneys..       1.49      13.06         NA       0.73      15.28         NA        XXX
75833...............  26............  A               Vein x-ray, kidneys..       1.49       0.49       0.49       0.08       2.06       2.06        XXX
75833...............  TC............  A               Vein x-ray, kidneys..       0.00      12.58         NA       0.65      13.23         NA        XXX
75840...............  ..............  A               Vein x-ray, adrenal         1.14      12.95         NA       0.70      14.79         NA        XXX
                                                       gland.
75840...............  26............  A               Vein x-ray, adrenal         1.14       0.38       0.38       0.05       1.57       1.57        XXX
                                                       gland.
75840...............  TC............  A               Vein x-ray, adrenal         0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       gland.
75842...............  ..............  A               Vein x-ray, adrenal         1.49      13.06         NA       0.73      15.28         NA        XXX
                                                       glands.
75842...............  26............  A               Vein x-ray, adrenal         1.49       0.48       0.48       0.08       2.05       2.05        XXX
                                                       glands.
75842...............  TC............  A               Vein x-ray, adrenal         0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       glands.
75860...............  ..............  A               Vein x-ray, neck.....       1.14      12.97         NA       0.70      14.81         NA        XXX
75860...............  26............  A               Vein x-ray, neck.....       1.14       0.39       0.39       0.05       1.58       1.58        XXX
75860...............  TC............  A               Vein x-ray, neck.....       0.00      12.58         NA       0.65      13.23         NA        XXX
75870...............  ..............  A               Vein x-ray, skull....       1.14      12.96         NA       0.71      14.81         NA        XXX
75870...............  26............  A               Vein x-ray, skull....       1.14       0.39       0.39       0.06       1.59       1.59        XXX
75870...............  TC............  A               Vein x-ray, skull....       0.00      12.58         NA       0.65      13.23         NA        XXX
75872...............  ..............  A               Vein x-ray, skull....       1.14      12.95         NA       0.76      14.85         NA        XXX
75872...............  26............  A               Vein x-ray, skull....       1.14       0.37       0.37       0.11       1.62       1.62        XXX
75872...............  TC............  A               Vein x-ray, skull....       0.00      12.58         NA       0.65      13.23         NA        XXX
75880...............  ..............  A               Vein x-ray, eye             0.70       1.18         NA       0.10       1.98         NA        XXX
                                                       socket.
75880...............  26............  A               Vein x-ray, eye             0.70       0.23       0.23       0.04       0.97       0.97        XXX
                                                       socket.
75880...............  TC............  A               Vein x-ray, eye             0.00       0.95         NA       0.06       1.01         NA        XXX
                                                       socket.
75885...............  ..............  A               Vein x-ray, liver....       1.44      13.04         NA       0.72      15.20         NA        XXX
75885...............  26............  A               Vein x-ray, liver....       1.44       0.47       0.47       0.07       1.98       1.98        XXX
75885...............  TC............  A               Vein x-ray, liver....       0.00      12.58         NA       0.65      13.23         NA        XXX
75887...............  ..............  A               Vein x-ray, liver....       1.44      13.04         NA       0.72      15.20         NA        XXX
75887...............  26............  A               Vein x-ray, liver....       1.44       0.47       0.47       0.07       1.98       1.98        XXX
75887...............  TC............  A               Vein x-ray, liver....       0.00      12.58         NA       0.65      13.23         NA        XXX
75889...............  ..............  A               Vein x-ray, liver....       1.14      12.95         NA       0.70      14.79         NA        XXX
75889...............  26............  A               Vein x-ray, liver....       1.14       0.37       0.37       0.05       1.56       1.56        XXX
75889...............  TC............  A               Vein x-ray, liver....       0.00      12.58         NA       0.65      13.23         NA        XXX
75891...............  ..............  A               Vein x-ray, liver....       1.14      12.95         NA       0.70      14.79         NA        XXX
75891...............  26............  A               Vein x-ray, liver....       1.14       0.37       0.37       0.05       1.56       1.56        XXX
75891...............  TC............  A               Vein x-ray, liver....       0.00      12.58         NA       0.65      13.23         NA        XXX
75893...............  ..............  A               Venous sampling by          0.54      12.75         NA       0.68      13.97         NA        XXX
                                                       catheter.
75893...............  26............  A               Venous sampling by          0.54       0.18       0.18       0.03       0.75       0.75        XXX
                                                       catheter.
75893...............  TC............  A               Venous sampling by          0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       catheter.
75894...............  ..............  A               X-rays, transcath           1.31      24.52         NA       1.35      27.18         NA        XXX
                                                       therapy.
75894...............  26............  A               X-rays, transcath           1.31       0.43       0.43       0.08       1.82       1.82        XXX
                                                       therapy.
75894...............  TC............  A               X-rays, transcath           0.00      24.09         NA       1.27      25.36         NA        XXX
                                                       therapy.
75896...............  ..............  A               X-rays, transcath           1.31      21.40         NA       1.16      23.87         NA        XXX
                                                       therapy.
75896...............  26............  A               X-rays, transcath           1.31       0.45       0.45       0.06       1.82       1.82        XXX
                                                       therapy.
75896...............  TC............  A               X-rays, transcath           0.00      20.95         NA       1.10      22.05         NA        XXX
                                                       therapy.
75898...............  ..............  A               Follow-up angiography       1.65       1.60         NA       0.14       3.39         NA        XXX
75898...............  26............  A               Follow-up angiography       1.65       0.55       0.55       0.08       2.28       2.28        XXX
75898...............  TC............  A               Follow-up angiography       0.00       1.05         NA       0.06       1.11         NA        XXX
75900...............  ..............  A               Arterial catheter           0.49      21.09         NA       1.14      22.72         NA        XXX
                                                       exchange.
75900...............  26............  A               Arterial catheter           0.49       0.16       0.16       0.03       0.68       0.68        XXX
                                                       exchange.
75900...............  TC............  A               Arterial catheter           0.00      20.93         NA       1.11      22.04         NA        XXX
                                                       exchange.
75901...............  ..............  A               Remove cva device           0.49       1.46         NA       1.04       2.99         NA        XXX
                                                       obstruct.
75901...............  26............  A               Remove cva device           0.49       0.16       0.16       0.21       0.86       0.86        XXX
                                                       obstruct.
75901...............  TC............  A               Remove cva device           0.00       1.30         NA       0.83       2.13         NA        XXX
                                                       obstruct.
75902...............  ..............  A               Remove cva lumen            0.39       1.43         NA       0.86       2.68         NA        XXX
                                                       obstruct.
75902...............  26............  A               Remove cva lumen            0.39       0.13       0.13       0.03       0.55       0.55        XXX
                                                       obstruct.
75902...............  TC............  A               Remove cva lumen            0.00       1.30         NA       0.83       2.13         NA        XXX
                                                       obstruct.
75940...............  ..............  A               X-ray placement, vein       0.54      12.75         NA       0.68      13.97         NA        XXX
                                                       filter.
75940...............  26............  A               X-ray placement, vein       0.54       0.18       0.18       0.03       0.75       0.75        XXX
                                                       filter.
75940...............  TC............  A               X-ray placement, vein       0.00      12.58         NA       0.65      13.23         NA        XXX
                                                       filter.
75945...............  ..............  A               Intravascular us.....       0.40       4.70         NA       0.27       5.37         NA        XXX
75945...............  26............  A               Intravascular us.....       0.40       0.14       0.14       0.03       0.57       0.57        XXX
75945...............  TC............  A               Intravascular us.....       0.00       4.56         NA       0.24       4.80         NA        XXX
75946...............  ..............  A               Intravascular us add-       0.40       2.42         NA       0.18       3.00         NA        ZZZ
                                                       on.
75946...............  26............  A               Intravascular us add-       0.40       0.14       0.14       0.05       0.59       0.59        ZZZ
                                                       on.
75946...............  TC............  A               Intravascular us add-       0.00       2.29         NA       0.13       2.42         NA        ZZZ
                                                       on.
75952...............  26............  A               Endovasc repair abdom       4.49       1.49       1.49       0.43       6.41       6.41        XXX
                                                       aorta.
75953...............  26............  A               Abdom aneurysm              1.36       0.45       0.45       0.13       1.94       1.94        XXX
                                                       endovas rpr.
75954...............  26............  A               Iliac aneurysm              2.25       0.77       0.77       0.05       3.07       3.07        XXX
                                                       endovas rpr.
75960...............  ..............  A               Transcatheter intro,        0.82      15.16         NA       0.82      16.80         NA        XXX
                                                       stent.
75960...............  26............  A               Transcatheter intro,        0.82       0.28       0.28       0.05       1.15       1.15        XXX
                                                       stent.
75960...............  TC............  A               Transcatheter intro,        0.00      14.87         NA       0.77      15.64         NA        XXX
                                                       stent.
75961...............  ..............  A               Retrieval, broken           4.24      11.87         NA       0.76      16.87         NA        XXX
                                                       catheter.

[[Page 47663]]

 
75961...............  26............  A               Retrieval, broken           4.24       1.39       1.39       0.21       5.84       5.84        XXX
                                                       catheter.
75961...............  TC............  A               Retrieval, broken           0.00      10.48         NA       0.55      11.03         NA        XXX
                                                       catheter.
75962...............  ..............  A               Repair arterial             0.54      15.90         NA       0.86      17.30         NA        XXX
                                                       blockage.
75962...............  26............  A               Repair arterial             0.54       0.18       0.18       0.03       0.75       0.75        XXX
                                                       blockage.
75962...............  TC............  A               Repair arterial             0.00      15.71         NA       0.83      16.54         NA        XXX
                                                       blockage.
75964...............  ..............  A               Repair artery               0.36       8.50         NA       0.45       9.31         NA        ZZZ
                                                       blockage, each.
75964...............  26............  A               Repair artery               0.36       0.12       0.12       0.02       0.50       0.50        ZZZ
                                                       blockage, each.
75964...............  TC............  A               Repair artery               0.00       8.38         NA       0.43       8.81         NA        ZZZ
                                                       blockage, each.
75966...............  ..............  A               Repair arterial             1.31      16.18         NA       0.89      18.38         NA        XXX
                                                       blockage.
75966...............  26............  A               Repair arterial             1.31       0.46       0.46       0.06       1.83       1.83        XXX
                                                       blockage.
75966...............  TC............  A               Repair arterial             0.00      15.71         NA       0.83      16.54         NA        XXX
                                                       blockage.
75968...............  ..............  A               Repair artery               0.36       8.51         NA       0.45       9.32         NA        ZZZ
                                                       blockage, each.
75968...............  26............  A               Repair artery               0.36       0.13       0.13       0.02       0.51       0.51        ZZZ
                                                       blockage, each.
75968...............  TC............  A               Repair artery               0.00       8.38         NA       0.43       8.81         NA        ZZZ
                                                       blockage, each.
75970...............  ..............  A               Vascular biopsy......       0.83      11.80         NA       0.64      13.27         NA        XXX
75970...............  26............  A               Vascular biopsy......       0.83       0.28       0.28       0.04       1.15       1.15        XXX
75970...............  TC............  A               Vascular biopsy......       0.00      11.52         NA       0.60      12.12         NA        XXX
75978...............  ..............  A               Repair venous               0.54      15.89         NA       0.86      17.29         NA        XXX
                                                       blockage.
75978...............  26............  A               Repair venous               0.54       0.18       0.18       0.03       0.75       0.75        XXX
                                                       blockage.
75978...............  TC............  A               Repair venous               0.00      15.71         NA       0.83      16.54         NA        XXX
                                                       blockage.
75980...............  ..............  A               Contrast xray exam          1.44       5.87         NA       0.36       7.67         NA        XXX
                                                       bile duct.
75980...............  26............  A               Contrast xray exam          1.44       0.47       0.47       0.07       1.98       1.98        XXX
                                                       bile duct.
75980...............  TC............  A               Contrast xray exam          0.00       5.40         NA       0.29       5.69         NA        XXX
                                                       bile duct.
75982...............  ..............  A               Contrast xray exam          1.44       6.56         NA       0.40       8.40         NA        XXX
                                                       bile duct.
75982...............  26............  A               Contrast xray exam          1.44       0.47       0.47       0.07       1.98       1.98        XXX
                                                       bile duct.
75982...............  TC............  A               Contrast xray exam          0.00       6.09         NA       0.33       6.42         NA        XXX
                                                       bile duct.
75984...............  ..............  A               Xray control catheter       0.72       2.18         NA       0.14       3.04         NA        XXX
                                                       change.
75984...............  26............  A               Xray control catheter       0.72       0.23       0.23       0.03       0.98       0.98        XXX
                                                       change.
75984...............  TC............  A               Xray control catheter       0.00       1.95         NA       0.11       2.06         NA        XXX
                                                       change.
75989...............  ..............  A               Abscess drainage            1.19       3.53         NA       0.22       4.94         NA        XXX
                                                       under x-ray.
75989...............  26............  A               Abscess drainage            1.19       0.39       0.39       0.05       1.63       1.63        XXX
                                                       under x-ray.
75989...............  TC............  A               Abscess drainage            0.00       3.15         NA       0.17       3.32         NA        XXX
                                                       under x-ray.
75992...............  ..............  A               Atherectomy, x-ray          0.54      15.90         NA       0.86      17.30         NA        XXX
                                                       exam.
75992...............  26............  A               Atherectomy, x-ray          0.54       0.19       0.19       0.03       0.76       0.76        XXX
                                                       exam.
75992...............  TC............  A               Atherectomy, x-ray          0.00      15.71         NA       0.83      16.54         NA        XXX
                                                       exam.
75993...............  ..............  A               Atherectomy, x-ray          0.36       8.51         NA       0.45       9.32         NA        ZZZ
                                                       exam.
75993...............  26............  A               Atherectomy, x-ray          0.36       0.13       0.13       0.02       0.51       0.51        ZZZ
                                                       exam.
75993...............  TC............  A               Atherectomy, x-ray          0.00       8.38         NA       0.43       8.81         NA        ZZZ
                                                       exam.
75994...............  ..............  A               Atherectomy, x-ray          1.31      16.18         NA       0.87      18.36         NA        XXX
                                                       exam.
75994...............  26............  A               Atherectomy, x-ray          1.31       0.46       0.46       0.04       1.81       1.81        XXX
                                                       exam.
75994...............  TC............  A               Atherectomy, x-ray          0.00      15.71         NA       0.83      16.54         NA        XXX
                                                       exam.
75995...............  ..............  A               Atherectomy, x-ray          1.31      16.18         NA       0.91      18.40         NA        XXX
                                                       exam.
75995...............  26............  A               Atherectomy, x-ray          1.31       0.47       0.47       0.08       1.86       1.86        XXX
                                                       exam.
75995...............  TC............  A               Atherectomy, x-ray          0.00      15.71         NA       0.83      16.54         NA        XXX
                                                       exam.
75996...............  ..............  A               Atherectomy, x-ray          0.36       8.50         NA       0.44       9.30         NA        ZZZ
                                                       exam.
75996...............  26............  A               Atherectomy, x-ray          0.36       0.12       0.12       0.01       0.49       0.49        ZZZ
                                                       exam.
75996...............  TC............  A               Atherectomy, x-ray          0.00       8.38         NA       0.43       8.81         NA        ZZZ
                                                       exam.
75998...............  ..............  A               Fluoroguide for vein        0.38       1.43         NA       0.11       1.92         NA        ZZZ
                                                       device.
75998...............  26............  A               Fluoroguide for vein        0.38       0.13       0.13       0.01       0.52       0.52        ZZZ
                                                       device.
75998...............  TC............  A               Fluoroguide for vein        0.00       1.30         NA       0.10       1.40         NA        ZZZ
                                                       device.
76000...............  ..............  A               Fluoroscope                 0.17       1.36         NA       0.08       1.61         NA        XXX
                                                       examination.
76000...............  26............  A               Fluoroscope                 0.17       0.05       0.05       0.01       0.23       0.23        XXX
                                                       examination.
76000...............  TC............  A               Fluoroscope                 0.00       1.30         NA       0.07       1.37         NA        XXX
                                                       examination.
76001...............  ..............  A               Fluoroscope exam,           0.67       2.84         NA       0.18       3.69         NA        XXX
                                                       extensive.
76001...............  26............  A               Fluoroscope exam,           0.67       0.22       0.22       0.04       0.93       0.93        XXX
                                                       extensive.
76001...............  TC............  A               Fluoroscope exam,           0.00       2.62         NA       0.14       2.76         NA        XXX
                                                       extensive.
76003...............  ..............  A               Needle localization         0.54       1.47         NA       0.10       2.11         NA        XXX
                                                       by x-ray.
76003...............  26............  A               Needle localization         0.54       0.17       0.17       0.03       0.74       0.74        XXX
                                                       by x-ray.
76003...............  TC............  A               Needle localization         0.00       1.30         NA       0.07       1.37         NA        XXX
                                                       by x-ray.
76005...............  ..............  A               Fluoroguide for spine       0.60       1.46         NA       0.11       2.17         NA        XXX
                                                       inject.
76005...............  26............  A               Fluoroguide for spine       0.60       0.15       0.15       0.04       0.79       0.79        XXX
                                                       inject.
76005...............  TC............  A               Fluoroguide for spine       0.00       1.30         NA       0.07       1.37         NA        XXX
                                                       inject.
76006...............  ..............  A               X-ray stress view....       0.41       0.18       0.18       0.06       0.65       0.65        XXX
76010...............  ..............  A               X-ray, nose to rectum       0.18       0.58         NA       0.03       0.79         NA        XXX
76010...............  26............  A               X-ray, nose to rectum       0.18       0.06       0.06       0.01       0.25       0.25        XXX
76010...............  TC............  A               X-ray, nose to rectum       0.00       0.52         NA       0.02       0.54         NA        XXX
76012...............  26............  A               Percut vertebroplasty       1.31       0.47       0.47       0.09       1.87       1.87        XXX
                                                       fluor.
76013...............  26............  A               Percut                      1.38       0.47       0.47       0.08       1.93       1.93        XXX
                                                       vertebroplasty, ct.
76020...............  ..............  A               X-rays for bone age..       0.19       0.58         NA       0.03       0.80         NA        XXX
76020...............  26............  A               X-rays for bone age..       0.19       0.06       0.06       0.01       0.26       0.26        XXX
76020...............  TC............  A               X-rays for bone age..       0.00       0.52         NA       0.02       0.54         NA        XXX
76040...............  ..............  A               X-rays, bone                0.27       0.87         NA       0.06       1.20         NA        XXX
                                                       evaluation.
76040...............  26............  A               X-rays, bone                0.27       0.09       0.09       0.01       0.37       0.37        XXX
                                                       evaluation.
76040...............  TC............  A               X-rays, bone                0.00       0.78         NA       0.05       0.83         NA        XXX
                                                       evaluation.
76061...............  ..............  A               X-rays, bone survey..       0.45       1.14         NA       0.08       1.67         NA        XXX

[[Page 47664]]

 
76061...............  26............  A               X-rays, bone survey..       0.45       0.15       0.15       0.02       0.62       0.62        XXX
76061...............  TC............  A               X-rays, bone survey..       0.00       0.99         NA       0.06       1.05         NA        XXX
76062...............  ..............  A               X-rays, bone survey..       0.54       1.61         NA       0.10       2.25         NA        XXX
76062...............  26............  A               X-rays, bone survey..       0.54       0.18       0.18       0.02       0.74       0.74        XXX
76062...............  TC............  A               X-rays, bone survey..       0.00       1.44         NA       0.08       1.52         NA        XXX
76065...............  ..............  A               X-rays, bone                0.70       0.97         NA       0.08       1.75         NA        XXX
                                                       evaluation.
76065...............  26............  A               X-rays, bone                0.70       0.23       0.23       0.03       0.96       0.96        XXX
                                                       evaluation.
76065...............  TC............  A               X-rays, bone                0.00       0.73         NA       0.05       0.78         NA        XXX
                                                       evaluation.
76066...............  ..............  A               Joint survey, single        0.31       1.21         NA       0.08       1.60         NA        XXX
                                                       view.
76066...............  26............  A               Joint survey, single        0.31       0.10       0.10       0.02       0.43       0.43        XXX
                                                       view.
76066...............  TC............  A               Joint survey, single        0.00       1.11         NA       0.06       1.17         NA        XXX
                                                       view.
76070...............  ..............  A               Ct bone density,            0.25       3.03         NA       0.17       3.45         NA        XXX
                                                       axial.
76070...............  26............  A               Ct bone density,            0.25       0.08       0.08       0.01       0.34       0.34        XXX
                                                       axial.
76070...............  TC............  A               Ct bone density,            0.00       2.94         NA       0.16       3.10         NA        XXX
                                                       axial.
76071...............  ..............  A               Ct bone density,            0.22       3.02         NA       0.06       3.30         NA        XXX
                                                       peripheral.
76071...............  26............  A               Ct bone density,            0.22       0.07       0.07       0.01       0.30       0.30        XXX
                                                       peripheral.
76071...............  TC............  A               Ct bone density,            0.00       2.94         NA       0.05       2.99         NA        XXX
                                                       peripheral.
76075...............  ..............  A               Dexa, axial skeleton        0.30       3.19         NA       0.18       3.67         NA        XXX
                                                       study.
76075...............  26............  A               Dexa, axial skeleton        0.30       0.10       0.10       0.01       0.41       0.41        XXX
                                                       study.
76075...............  TC............  A               Dexa, axial skeleton        0.00       3.09         NA       0.17       3.26         NA        XXX
                                                       study.
76076...............  ..............  A               Dexa, peripheral            0.22       0.83         NA       0.06       1.11         NA        XXX
                                                       study.
76076...............  26............  A               Dexa, peripheral            0.22       0.07       0.07       0.01       0.30       0.30        XXX
                                                       study.
76076...............  TC............  A               Dexa, peripheral            0.00       0.75         NA       0.05       0.80         NA        XXX
                                                       study.
76078...............  ..............  A               Radiographic                0.20       0.82         NA       0.06       1.08         NA        XXX
                                                       absorptiometry.
76078...............  26............  A               Radiographic                0.20       0.07       0.07       0.01       0.28       0.28        XXX
                                                       absorptiometry.
76078...............  TC............  A               Radiographic                0.00       0.75         NA       0.05       0.80         NA        XXX
                                                       absorptiometry.
76080...............  ..............  A               X-ray exam of fistula       0.54       1.23         NA       0.08       1.85         NA        XXX
76080...............  26............  A               X-ray exam of fistula       0.54       0.18       0.18       0.02       0.74       0.74        XXX
76080...............  TC............  A               X-ray exam of fistula       0.00       1.05         NA       0.06       1.11         NA        XXX
76082...............  ..............  A               Computer mammogram          0.06       0.43         NA       0.01       0.50         NA        ZZZ
                                                       add-on.
76082...............  26............  A               Computer mammogram          0.06       0.02       0.02       0.00       0.08       0.08        ZZZ
                                                       add-on.
76082...............  TC............  A               Computer mammogram          0.00       0.42         NA       0.01       0.43         NA        ZZZ
                                                       add-on.
76083...............  ..............  A               Computer mammogram          0.06       0.43         NA       0.01       0.50         NA        ZZZ
                                                       add-on.
76083...............  26............  A               Computer mammogram          0.06       0.02       0.02       0.00       0.08       0.08        ZZZ
                                                       add-on.
76083...............  TC............  A               Computer mammogram          0.00       0.42         NA       0.01       0.43         NA        ZZZ
                                                       add-on.
76086...............  ..............  A               X-ray of mammary duct       0.36       2.73         NA       0.16       3.25         NA        XXX
76086...............  26............  A               X-ray of mammary duct       0.36       0.12       0.12       0.02       0.50       0.50        XXX
76086...............  TC............  A               X-ray of mammary duct       0.00       2.62         NA       0.14       2.76         NA        XXX
76088...............  ..............  A               X-ray of mammary            0.45       3.80         NA       0.21       4.46         NA        XXX
                                                       ducts.
76088...............  26............  A               X-ray of mammary            0.45       0.15       0.15       0.02       0.62       0.62        XXX
                                                       ducts.
76088...............  TC............  A               X-ray of mammary            0.00       3.66         NA       0.19       3.85         NA        XXX
                                                       ducts.
76090...............  ..............  A               Mammogram, one breast       0.70       1.28         NA       0.09       2.07         NA        XXX
76090...............  26............  A               Mammogram, one breast       0.70       0.23       0.23       0.03       0.96       0.96        XXX
76090...............  TC............  A               Mammogram, one breast       0.00       1.05         NA       0.06       1.11         NA        XXX
76091...............  ..............  A               Mammogram, both             0.87       1.59         NA       0.11       2.57         NA        XXX
                                                       breasts.
76091...............  26............  A               Mammogram, both             0.87       0.28       0.28       0.04       1.19       1.19        XXX
                                                       breasts.
76091...............  TC............  A               Mammogram, both             0.00       1.30         NA       0.07       1.37         NA        XXX
                                                       breasts.
76092...............  ..............  A               Mammogram, screening.       0.70       1.45         NA       0.10       2.25         NA        XXX
76092...............  26............  A               Mammogram, screening.       0.70       0.23       0.23       0.03       0.96       0.96        XXX
76092...............  TC............  A               Mammogram, screening.       0.00       1.23         NA       0.07       1.30         NA        XXX
76093...............  ..............  A               Magnetic image,             1.63      18.13         NA       0.99      20.75         NA        XXX
                                                       breast.
76093...............  26............  A               Magnetic image,             1.63       0.53       0.53       0.07       2.23       2.23        XXX
                                                       breast.
76093...............  TC............  A               Magnetic image,             0.00      17.59         NA       0.92      18.51         NA        XXX
                                                       breast.
76094...............  ..............  A               Magnetic image, both        1.63      24.40         NA       1.31      27.34         NA        XXX
                                                       breasts.
76094...............  26............  A               Magnetic image, both        1.63       0.53       0.53       0.07       2.23       2.23        XXX
                                                       breasts.
76094...............  TC............  A               Magnetic image, both        0.00      23.87         NA       1.24      25.11         NA        XXX
                                                       breasts.
76095...............  ..............  A               Stereotactic breast         1.59       7.67         NA       0.47       9.73         NA        XXX
                                                       biopsy.
76095...............  26............  A               Stereotactic breast         1.59       0.52       0.52       0.10       2.21       2.21        XXX
                                                       biopsy.
76095...............  TC............  A               Stereotactic breast         0.00       7.15         NA       0.37       7.52         NA        XXX
                                                       biopsy.
76096...............  ..............  A               X-ray of needle wire,       0.56       1.49         NA       0.10       2.15         NA        XXX
                                                       breast.
76096...............  26............  A               X-ray of needle wire,       0.56       0.18       0.18       0.03       0.77       0.77        XXX
                                                       breast.
76096...............  TC............  A               X-ray of needle wire,       0.00       1.30         NA       0.07       1.37         NA        XXX
                                                       breast.
76098...............  ..............  A               X-ray exam, breast          0.16       0.47         NA       0.03       0.66         NA        XXX
                                                       specimen.
76098...............  26............  A               X-ray exam, breast          0.16       0.05       0.05       0.01       0.22       0.22        XXX
                                                       specimen.
76098...............  TC............  A               X-ray exam, breast          0.00       0.42         NA       0.02       0.44         NA        XXX
                                                       specimen.
76100...............  ..............  A               X-ray exam of body          0.58       1.43         NA       0.10       2.11         NA        XXX
                                                       section.
76100...............  26............  A               X-ray exam of body          0.58       0.19       0.19       0.03       0.80       0.80        XXX
                                                       section.
76100...............  TC............  A               X-ray exam of body          0.00       1.25         NA       0.07       1.32         NA        XXX
                                                       section.
76101...............  ..............  A               Complex body section        0.58       1.61         NA       0.11       2.30         NA        XXX
                                                       x-ray.
76101...............  26............  A               Complex body section        0.58       0.19       0.19       0.03       0.80       0.80        XXX
                                                       x-ray.
76101...............  TC............  A               Complex body section        0.00       1.42         NA       0.08       1.50         NA        XXX
                                                       x-ray.
76102...............  ..............  A               Complex body section        0.58       1.92         NA       0.14       2.64         NA        XXX
                                                       x-rays.
76102...............  26............  A               Complex body section        0.58       0.19       0.19       0.03       0.80       0.80        XXX
                                                       x-rays.
76102...............  TC............  A               Complex body section        0.00       1.73         NA       0.11       1.84         NA        XXX
                                                       x-rays.
76120...............  ..............  A               Cine/video x-rays....       0.38       1.18         NA       0.08       1.64         NA        XXX

[[Page 47665]]

 
76120...............  26............  A               Cine/video x-rays....       0.38       0.13       0.13       0.02       0.53       0.53        XXX
76120...............  TC............  A               Cine/video x-rays....       0.00       1.05         NA       0.06       1.11         NA        XXX
76125...............  ..............  A               Cine/video x-rays add-      0.27       0.87         NA       0.06       1.20         NA        ZZZ
                                                       on.
76125...............  26............  A               Cine/video x-rays add-      0.27       0.09       0.09       0.01       0.37       0.37        ZZZ
                                                       on.
76125...............  TC............  A               Cine/video x-rays add-      0.00       0.78         NA       0.05       0.83         NA        ZZZ
                                                       on.
76150...............  ..............  A               X-ray exam, dry             0.00       0.42         NA       0.02       0.44         NA        XXX
                                                       process.
76355...............  ..............  A               Ct scan for                 1.21       8.64         NA       0.48      10.33         NA        XXX
                                                       localization.
76355...............  26............  A               Ct scan for                 1.21       0.40       0.40       0.06       1.67       1.67        XXX
                                                       localization.
76355...............  TC............  A               Ct scan for                 0.00       8.24         NA       0.42       8.66         NA        XXX
                                                       localization.
76360...............  ..............  A               Ct scan for needle          1.16       8.62         NA       0.47      10.25         NA        XXX
                                                       biopsy.
76360...............  26............  A               Ct scan for needle          1.16       0.38       0.38       0.05       1.59       1.59        XXX
                                                       biopsy.
76360...............  TC............  A               Ct scan for needle          0.00       8.24         NA       0.42       8.66         NA        XXX
                                                       biopsy.
76362...............  ..............  A               Ct guide for tissue         3.99       9.54         NA       1.64      15.17         NA        XXX
                                                       ablation.
76362...............  26............  A               Ct guide for tissue         3.99       1.30       1.30       0.18       5.47       5.47        XXX
                                                       ablation.
76362...............  TC............  A               Ct guide for tissue         0.00       8.24         NA       1.46       9.70         NA        XXX
                                                       ablation.
76370...............  ..............  A               Ct scan for therapy         0.85       3.22         NA       0.20       4.27         NA        XXX
                                                       guide.
76370...............  26............  A               Ct scan for therapy         0.85       0.28       0.28       0.04       1.17       1.17        XXX
                                                       guide.
76370...............  TC............  A               Ct scan for therapy         0.00       2.94         NA       0.16       3.10         NA        XXX
                                                       guide.
76375...............  ..............  A               3d/holograph reconstr       0.16       3.58         NA       0.19       3.93         NA        XXX
                                                       add-on.
76375...............  26............  A               3d/holograph reconstr       0.16       0.05       0.05       0.01       0.22       0.22        XXX
                                                       add-on.
76375...............  TC............  A               3d/holograph reconstr       0.00       3.53         NA       0.18       3.71         NA        XXX
                                                       add-on.
76380...............  ..............  A               CAT scan follow-up          0.98       3.81         NA       0.22       5.01         NA        XXX
                                                       study.
76380...............  26............  A               CAT scan follow-up          0.98       0.32       0.32       0.04       1.34       1.34        XXX
                                                       study.
76380...............  TC............  A               CAT scan follow-up          0.00       3.49         NA       0.18       3.67         NA        XXX
                                                       study.
76393...............  ..............  A               Mr guidance for             1.50      11.68         NA       0.65      13.83         NA        XXX
                                                       needle place.
76393...............  26............  A               Mr guidance for             1.50       0.50       0.50       0.10       2.10       2.10        XXX
                                                       needle place.
76393...............  TC............  A               Mr guidance for             0.00      11.19         NA       0.55      11.74         NA        XXX
                                                       needle place.
76394...............  ..............  A               Mri for tissue              4.24      12.57         NA       1.80      18.61         NA        XXX
                                                       ablation.
76394...............  26............  A               Mri for tissue              4.24       1.38       1.38       0.24       5.86       5.86        XXX
                                                       ablation.
76394...............  TC............  A               Mri for tissue              0.00      11.19         NA       1.56      12.75         NA        XXX
                                                       ablation.
76400...............  ..............  A               Magnetic image, bone        1.60      11.71         NA       0.66      13.97         NA        XXX
                                                       marrow.
76400...............  26............  A               Magnetic image, bone        1.60       0.52       0.52       0.07       2.19       2.19        XXX
                                                       marrow.
76400...............  TC............  A               Magnetic image, bone        0.00      11.19         NA       0.59      11.78         NA        XXX
                                                       marrow.
76506...............  ..............  A               Echo exam of head....       0.63       1.66         NA       0.12       2.41         NA        XXX
76506...............  26............  A               Echo exam of head....       0.63       0.24       0.24       0.04       0.91       0.91        XXX
76506...............  TC............  A               Echo exam of head....       0.00       1.42         NA       0.08       1.50         NA        XXX
76511...............  ..............  A               Echo exam of eye.....       0.94       1.85         NA       0.10       2.89         NA        XXX
76511...............  26............  A               Echo exam of eye.....       0.94       0.40       0.40       0.03       1.37       1.37        XXX
76511...............  TC............  A               Echo exam of eye.....       0.00       1.45         NA       0.07       1.52         NA        XXX
76512...............  ..............  A               Echo exam of eye.....       0.66       1.73         NA       0.12       2.51         NA        XXX
76512...............  26............  A               Echo exam of eye.....       0.66       0.29       0.29       0.02       0.97       0.97        XXX
76512...............  TC............  A               Echo exam of eye.....       0.00       1.44         NA       0.10       1.54         NA        XXX
76513...............  ..............  A               Echo exam of eye,           0.66       1.82         NA       0.12       2.60         NA        XXX
                                                       water bath.
76513...............  26............  A               Echo exam of eye,           0.66       0.29       0.29       0.02       0.97       0.97        XXX
                                                       water bath.
76513...............  TC............  A               Echo exam of eye,           0.00       1.52         NA       0.10       1.62         NA        XXX
                                                       water bath.
76514...............  ..............  A               Echo exam of eye,           0.17       0.13         NA       0.02       0.32         NA        XXX
                                                       thickness.
76514...............  26............  A               Echo exam of eye,           0.17       0.08       0.08       0.01       0.26       0.26        XXX
                                                       thickness.
76514...............  TC............  A               Echo exam of eye,           0.00       0.05         NA       0.01       0.06         NA        XXX
                                                       thickness.
76516...............  ..............  A               Echo exam of eye.....       0.54       1.46         NA       0.08       2.08         NA        XXX
76516...............  26............  A               Echo exam of eye.....       0.54       0.24       0.24       0.01       0.79       0.79        XXX
76516...............  TC............  A               Echo exam of eye.....       0.00       1.22         NA       0.07       1.29         NA        XXX
76519...............  ..............  A               Echo exam of eye.....       0.54       1.56         NA       0.08       2.18         NA        XXX
76519...............  26............  A               Echo exam of eye.....       0.54       0.24       0.24       0.01       0.79       0.79        XXX
76519...............  TC............  A               Echo exam of eye.....       0.00       1.32         NA       0.07       1.39         NA        XXX
76529...............  ..............  A               Echo exam of eye.....       0.57       1.38         NA       0.10       2.05         NA        XXX
76529...............  26............  A               Echo exam of eye.....       0.57       0.24       0.24       0.02       0.83       0.83        XXX
76529...............  TC............  A               Echo exam of eye.....       0.00       1.14         NA       0.08       1.22         NA        XXX
76536...............  ..............  A               Us exam of head and         0.56       1.60         NA       0.11       2.27         NA        XXX
                                                       neck.
76536...............  26............  A               Us exam of head and         0.56       0.18       0.18       0.03       0.77       0.77        XXX
                                                       neck.
76536...............  TC............  A               Us exam of head and         0.00       1.42         NA       0.08       1.50         NA        XXX
                                                       neck.
76604...............  ..............  A               Us exam, chest, b-          0.55       1.48         NA       0.10       2.13         NA        XXX
                                                       scan.
76604...............  26............  A               Us exam, chest, b-          0.55       0.18       0.18       0.03       0.76       0.76        XXX
                                                       scan.
76604...............  TC............  A               Us exam, chest, b-          0.00       1.30         NA       0.07       1.37         NA        XXX
                                                       scan.
76645...............  ..............  A               Us exam, breast(s)...       0.54       1.23         NA       0.08       1.85         NA        XXX
76645...............  26............  A               Us exam, breast(s)...       0.54       0.18       0.18       0.02       0.74       0.74        XXX
76645...............  TC............  A               Us exam, breast(s)...       0.00       1.05         NA       0.06       1.11         NA        XXX
76700...............  ..............  A               Us exam, abdom,             0.81       2.23         NA       0.15       3.19         NA        XXX
                                                       complete.
76700...............  26............  A               Us exam, abdom,             0.81       0.26       0.26       0.04       1.11       1.11        XXX
                                                       complete.
76700...............  TC............  A               Us exam, abdom,             0.00       1.97         NA       0.11       2.08         NA        XXX
                                                       complete.
76705...............  ..............  A               Echo exam of abdomen.       0.59       1.61         NA       0.11       2.31         NA        XXX
76705...............  26............  A               Echo exam of abdomen.       0.59       0.19       0.19       0.03       0.81       0.81        XXX
76705...............  TC............  A               Echo exam of abdomen.       0.00       1.42         NA       0.08       1.50         NA        XXX
76770...............  ..............  A               Us exam abdo back           0.74       2.21         NA       0.14       3.09         NA        XXX
                                                       wall, comp.
76770...............  26............  A               Us exam abdo back           0.74       0.24       0.24       0.03       1.01       1.01        XXX
                                                       wall, comp.
76770...............  TC............  A               Us exam abdo back           0.00       1.97         NA       0.11       2.08         NA        XXX
                                                       wall, comp.

[[Page 47666]]

 
76775...............  ..............  A               Us exam abdo back           0.58       1.61         NA       0.11       2.30         NA        XXX
                                                       wall, lim.
76775...............  26............  A               Us exam abdo back           0.58       0.19       0.19       0.03       0.80       0.80        XXX
                                                       wall, lim.
76775...............  TC............  A               Us exam abdo back           0.00       1.42         NA       0.08       1.50         NA        XXX
                                                       wall, lim.
76778...............  ..............  A               Us exam kidney              0.74       2.21         NA       0.14       3.09         NA        XXX
                                                       transplant.
76778...............  26............  A               Us exam kidney              0.74       0.24       0.24       0.03       1.01       1.01        XXX
                                                       transplant.
76778...............  TC............  A               Us exam kidney              0.00       1.97         NA       0.11       2.08         NA        XXX
                                                       transplant.
76800...............  ..............  A               Us exam, spinal canal       1.13       1.76         NA       0.14       3.03         NA        XXX
76800...............  26............  A               Us exam, spinal canal       1.13       0.34       0.34       0.06       1.53       1.53        XXX
76800...............  TC............  A               Us exam, spinal canal       0.00       1.42         NA       0.08       1.50         NA        XXX
76801...............  ..............  A               Ob us < 14 wks,             0.99       2.43         NA       0.17       3.59         NA        XXX
                                                       single fetus.
76801...............  26............  A               Ob us < 14 wks,             0.99       0.34       0.34       0.05       1.38       1.38        XXX
                                                       single fetus.
76801...............  TC............  A               Ob us < 14 wks,             0.00       2.09         NA       0.12       2.21         NA        XXX
                                                       single fetus.
76802...............  ..............  A               Ob us < 14 wks, add-l       0.83       1.34         NA       0.17       2.34         NA        ZZZ
                                                       fetus.
76802...............  26............  A               Ob us < 14 wks, add-l       0.83       0.29       0.29       0.05       1.17       1.17        ZZZ
                                                       fetus.
76802...............  TC............  A               Ob us < 14 wks, add-l       0.00       1.05         NA       0.12       1.17         NA        ZZZ
                                                       fetus.
76805...............  ..............  A               Ob us >/= 14 wks,           0.99       2.43         NA       0.17       3.59         NA        XXX
                                                       sngl fetus.
76805...............  26............  A               Ob us >/= 14 wks,           0.99       0.34       0.34       0.05       1.38       1.38        XXX
                                                       sngl fetus.
76805...............  TC............  A               Ob us >/= 14 wks,           0.00       2.09         NA       0.12       2.21         NA        XXX
                                                       sngl fetus.
76810...............  ..............  A               Ob us >/= 14 wks,           0.98       1.39         NA       0.31       2.68         NA        ZZZ
                                                       addl fetus.
76810...............  26............  A               Ob us >/= 14 wks,           0.98       0.34       0.34       0.09       1.41       1.41        ZZZ
                                                       addl fetus.
76810...............  TC............  A               Ob us >/= 14 wks,           0.00       1.05         NA       0.22       1.27         NA        ZZZ
                                                       addl fetus.
76811...............  ..............  A               Ob us, detailed, sngl       1.90       4.23         NA       0.48       6.61         NA        XXX
                                                       fetus.
76811...............  26............  A               Ob us, detailed, sngl       1.90       0.71       0.71       0.05       2.66       2.66        XXX
                                                       fetus.
76811...............  TC............  A               Ob us, detailed, sngl       0.00       3.52         NA       0.43       3.95         NA        XXX
                                                       fetus.
76812...............  ..............  A               Ob us, detailed, addl       1.78       1.71         NA       0.50       3.99         NA        ZZZ
                                                       fetus.
76812...............  26............  A               Ob us, detailed, addl       1.78       0.66       0.66       0.09       2.53       2.53        ZZZ
                                                       fetus.
76812...............  TC............  A               Ob us, detailed, addl       0.00       1.05         NA       0.41       1.46         NA        ZZZ
                                                       fetus.
76815...............  ..............  A               Ob us, limited,             0.65       1.65         NA       0.11       2.41         NA        XXX
                                                       fetus(s).
76815...............  26............  A               Ob us, limited,             0.65       0.23       0.23       0.03       0.91       0.91        XXX
                                                       fetus(s).
76815...............  TC............  A               Ob us, limited,             0.00       1.42         NA       0.08       1.50         NA        XXX
                                                       fetus(s).
76816...............  ..............  A               Ob us, follow-up, per       0.85       1.42         NA       0.09       2.36         NA        XXX
                                                       fetus.
76816...............  26............  A               Ob us, follow-up, per       0.85       0.31       0.31       0.03       1.19       1.19        XXX
                                                       fetus.
76816...............  TC............  A               Ob us, follow-up, per       0.00       1.11         NA       0.06       1.17         NA        XXX
                                                       fetus.
76817...............  ..............  A               Transvaginal us,            0.75       1.78         NA       0.09       2.62         NA        XXX
                                                       obstetric.
76817...............  26............  A               Transvaginal us,            0.75       0.26       0.26       0.03       1.04       1.04        XXX
                                                       obstetric.
76817...............  TC............  A               Transvaginal us,            0.00       1.52         NA       0.06       1.58         NA        XXX
                                                       obstetric.
76818...............  ..............  A               Fetal biophys profile       1.05       2.00         NA       0.15       3.20         NA        XXX
                                                       w/nst.
76818...............  26............  A               Fetal biophys profile       1.05       0.39       0.39       0.05       1.49       1.49        XXX
                                                       w/nst.
76818...............  TC............  A               Fetal biophys profile       0.00       1.61         NA       0.10       1.71         NA        XXX
                                                       w/nst.
76819...............  ..............  A               Fetal biophys profil        0.77       1.89         NA       0.14       2.80         NA        XXX
                                                       w/o nst.
76819...............  26............  A               Fetal biophys profil        0.77       0.28       0.28       0.04       1.09       1.09        XXX
                                                       w/o nst.
76819...............  TC............  A               Fetal biophys profil        0.00       1.61         NA       0.10       1.71         NA        XXX
                                                       w/o nst.
76825...............  ..............  A               Echo exam of fetal          1.67       2.57         NA       0.18       4.42         NA        XXX
                                                       heart.
76825...............  26............  A               Echo exam of fetal          1.67       0.60       0.60       0.07       2.34       2.34        XXX
                                                       heart.
76825...............  TC............  A               Echo exam of fetal          0.00       1.97         NA       0.11       2.08         NA        XXX
                                                       heart.
76826...............  ..............  A               Echo exam of fetal          0.83       0.99         NA       0.09       1.91         NA        XXX
                                                       heart.
76826...............  26............  A               Echo exam of fetal          0.83       0.29       0.29       0.04       1.16       1.16        XXX
                                                       heart.
76826...............  TC............  A               Echo exam of fetal          0.00       0.70         NA       0.05       0.75         NA        XXX
                                                       heart.
76827...............  ..............  A               Echo exam of fetal          0.58       1.93         NA       0.15       2.66         NA        XXX
                                                       heart.
76827...............  26............  A               Echo exam of fetal          0.58       0.21       0.21       0.03       0.82       0.82        XXX
                                                       heart.
76827...............  TC............  A               Echo exam of fetal          0.00       1.72         NA       0.12       1.84         NA        XXX
                                                       heart.
76828...............  ..............  A               Echo exam of fetal          0.56       1.32         NA       0.11       1.99         NA        XXX
                                                       heart.
76828...............  26............  A               Echo exam of fetal          0.56       0.21       0.21       0.03       0.80       0.80        XXX
                                                       heart.
76828...............  TC............  A               Echo exam of fetal          0.00       1.11         NA       0.08       1.19         NA        XXX
                                                       heart.
76830...............  ..............  A               Transvaginal us, non-       0.69       1.74         NA       0.13       2.56         NA        XXX
                                                       ob.
76830...............  26............  A               Transvaginal us, non-       0.69       0.23       0.23       0.03       0.95       0.95        XXX
                                                       ob.
76830...............  TC............  A               Transvaginal us, non-       0.00       1.52         NA       0.10       1.62         NA        XXX
                                                       ob.
76831...............  ..............  A               Echo exam, uterus....       0.72       1.77         NA       0.13       2.62         NA        XXX
76831...............  26............  A               Echo exam, uterus....       0.72       0.25       0.25       0.03       1.00       1.00        XXX
76831...............  TC............  A               Echo exam, uterus....       0.00       1.52         NA       0.10       1.62         NA        XXX
76856...............  ..............  A               Us exam, pelvic,            0.69       1.74         NA       0.13       2.56         NA        XXX
                                                       complete.
76856...............  26............  A               Us exam, pelvic,            0.69       0.23       0.23       0.03       0.95       0.95        XXX
                                                       complete.
76856...............  TC............  A               Us exam, pelvic,            0.00       1.52         NA       0.10       1.62         NA        XXX
                                                       complete.
76857...............  ..............  A               Us exam, pelvic,            0.38       1.83         NA       0.08       2.29         NA        XXX
                                                       limited.
76857...............  26............  A               Us exam, pelvic,            0.38       0.12       0.12       0.02       0.52       0.52        XXX
                                                       limited.
76857...............  TC............  A               Us exam, pelvic,            0.00       1.70         NA       0.06       1.76         NA        XXX
                                                       limited.
76870...............  ..............  A               Us exam, scrotum.....       0.64       1.72         NA       0.13       2.49         NA        XXX
76870...............  26............  A               Us exam, scrotum.....       0.64       0.21       0.21       0.03       0.88       0.88        XXX
76870...............  TC............  A               Us exam, scrotum.....       0.00       1.52         NA       0.10       1.62         NA        XXX
76872...............  ..............  A               Us, transrectal......       0.69       2.25         NA       0.14       3.08         NA        XXX
76872...............  26............  A               Us, transrectal......       0.69       0.22       0.22       0.04       0.95       0.95        XXX
76872...............  TC............  A               Us, transrectal......       0.00       2.02         NA       0.10       2.12         NA        XXX
76873...............  ..............  A               Echograp trans r,           1.55       2.59         NA       0.25       4.39         NA        XXX
                                                       pros study.
76873...............  26............  A               Echograp trans r,           1.55       0.50       0.50       0.09       2.14       2.14        XXX
                                                       pros study.
76873...............  TC............  A               Echograp trans r,           0.00       2.09         NA       0.16       2.25         NA        XXX
                                                       pros study.

[[Page 47667]]

 
76880...............  ..............  A               Us exam, extremity...       0.59       1.61         NA       0.11       2.31         NA        XXX
76880...............  26............  A               Us exam, extremity...       0.59       0.19       0.19       0.03       0.81       0.81        XXX
76880...............  TC............  A               Us exam, extremity...       0.00       1.42         NA       0.08       1.50         NA        XXX
76885...............  ..............  A               Us exam infant hips,        0.74       1.76         NA       0.13       2.63         NA        XXX
                                                       dynamic.
76885...............  26............  A               Us exam infant hips,        0.74       0.24       0.24       0.03       1.01       1.01        XXX
                                                       dynamic.
76885...............  TC............  A               Us exam infant hips,        0.00       1.52         NA       0.10       1.62         NA        XXX
                                                       dynamic.
76886...............  ..............  A               Us exam infant hips,        0.62       1.62         NA       0.11       2.35         NA        XXX
                                                       static.
76886...............  26............  A               Us exam infant hips,        0.62       0.20       0.20       0.03       0.85       0.85        XXX
                                                       static.
76886...............  TC............  A               Us exam infant hips,        0.00       1.42         NA       0.08       1.50         NA        XXX
                                                       static.
76930...............  ..............  A               Echo guide,                 0.67       1.77         NA       0.12       2.56         NA        XXX
                                                       cardiocentesis.
76930...............  26............  A               Echo guide,                 0.67       0.25       0.25       0.02       0.94       0.94        XXX
                                                       cardiocentesis.
76930...............  TC............  A               Echo guide,                 0.00       1.52         NA       0.10       1.62         NA        XXX
                                                       cardiocentesis.
76932...............  ..............  A               Echo guide for heart        0.67       1.77         NA       0.12       2.56         NA        XXX
                                                       biopsy.
76932...............  26............  A               Echo guide for heart        0.67       0.25       0.25       0.02       0.94       0.94        XXX
                                                       biopsy.
76932...............  TC............  A               Echo guide for heart        0.00       1.52         NA       0.10       1.62         NA        XXX
                                                       biopsy.
76936...............  ..............  A               Echo guide for artery       1.99       6.94         NA       0.47       9.40         NA        XXX
                                                       repair.
76936...............  26............  A               Echo guide for artery       1.99       0.66       0.66       0.13       2.78       2.78        XXX
                                                       repair.
76936...............  TC............  A               Echo guide for artery       0.00       6.28         NA       0.34       6.62         NA        XXX
                                                       repair.
76937...............  ..............  A               Us guide, vascular          0.30       0.47         NA       0.13       0.90         NA        ZZZ
                                                       access.
76937...............  26............  A               Us guide, vascular          0.30       0.10       0.10       0.03       0.43       0.43        ZZZ
                                                       access.
76937...............  TC............  A               Us guide, vascular          0.00       0.38         NA       0.10       0.48         NA        ZZZ
                                                       access.
76940...............  ..............  A               Us guide, tissue            2.00       2.17         NA       0.48       4.65         NA        XXX
                                                       ablation.
76940...............  26............  A               Us guide, tissue            2.00       0.65       0.65       0.19       2.84       2.84        XXX
                                                       ablation.
76940...............  TC............  A               Us guide, tissue            0.00       1.52         NA       0.29       1.81         NA        XXX
                                                       ablation.
76941...............  ..............  A               Echo guide for              1.34       2.00         NA       0.14       3.48         NA        XXX
                                                       transfusion.
76941...............  26............  A               Echo guide for              1.34       0.47       0.47       0.06       1.87       1.87        XXX
                                                       transfusion.
76941...............  TC............  A               Echo guide for              0.00       1.52         NA       0.08       1.60         NA        XXX
                                                       transfusion.
76942...............  ..............  A               Echo guide for biopsy       0.67       3.03         NA       0.13       3.83         NA        XXX
76942...............  26............  A               Echo guide for biopsy       0.67       0.22       0.22       0.03       0.92       0.92        XXX
76942...............  TC............  A               Echo guide for biopsy       0.00       2.81         NA       0.10       2.91         NA        XXX
76945...............  ..............  A               Echo guide, villus          0.67       1.75         NA       0.11       2.53         NA        XXX
                                                       sampling.
76945...............  26............  A               Echo guide, villus          0.67       0.22       0.22       0.03       0.92       0.92        XXX
                                                       sampling.
76945...............  TC............  A               Echo guide, villus          0.00       1.52         NA       0.08       1.60         NA        XXX
                                                       sampling.
76946...............  ..............  A               Echo guide for              0.38       1.66         NA       0.12       2.16         NA        XXX
                                                       amniocentesis.
76946...............  26............  A               Echo guide for              0.38       0.14       0.14       0.02       0.54       0.54        XXX
                                                       amniocentesis.
76946...............  TC............  A               Echo guide for              0.00       1.52         NA       0.10       1.62         NA        XXX
                                                       amniocentesis.
76948...............  ..............  A               Echo guide, ova             0.38       1.64         NA       0.12       2.14         NA        XXX
                                                       aspiration.
76948...............  26............  A               Echo guide, ova             0.38       0.13       0.13       0.02       0.53       0.53        XXX
                                                       aspiration.
76948...............  TC............  A               Echo guide, ova             0.00       1.52         NA       0.10       1.62         NA        XXX
                                                       aspiration.
76950...............  ..............  A               Echo guidance               0.58       1.49         NA       0.10       2.17         NA        XXX
                                                       radiotherapy.
76950...............  26............  A               Echo guidance               0.58       0.19       0.19       0.03       0.80       0.80        XXX
                                                       radiotherapy.
76950...............  TC............  A               Echo guidance               0.00       1.30         NA       0.07       1.37         NA        XXX
                                                       radiotherapy.
76965...............  ..............  A               Echo guidance               1.34       5.99         NA       0.38       7.71         NA        XXX
                                                       radiotherapy.
76965...............  26............  A               Echo guidance               1.34       0.43       0.43       0.09       1.86       1.86        XXX
                                                       radiotherapy.
76965...............  TC............  A               Echo guidance               0.00       5.56         NA       0.29       5.85         NA        XXX
                                                       radiotherapy.
76970...............  ..............  A               Ultrasound exam             0.40       1.18         NA       0.08       1.66         NA        XXX
                                                       follow-up.
76970...............  26............  A               Ultrasound exam             0.40       0.13       0.13       0.02       0.55       0.55        XXX
                                                       follow-up.
76970...............  TC............  A               Ultrasound exam             0.00       1.05         NA       0.06       1.11         NA        XXX
                                                       follow-up.
76975...............  ..............  A               GI endoscopic               0.81       1.79         NA       0.14       2.74         NA        XXX
                                                       ultrasound.
76975...............  26............  A               GI endoscopic               0.81       0.28       0.28       0.04       1.13       1.13        XXX
                                                       ultrasound.
76975...............  TC............  A               GI endoscopic               0.00       1.52         NA       0.10       1.62         NA        XXX
                                                       ultrasound.
76977...............  ..............  A               Us bone density             0.05       0.84         NA       0.05       0.94         NA        XXX
                                                       measure.
76977...............  26............  A               Us bone density             0.05       0.02       0.02       0.00       0.07       0.07        XXX
                                                       measure.
76977...............  TC............  A               Us bone density             0.00       0.82         NA       0.05       0.87         NA        XXX
                                                       measure.
76986...............  ..............  A               Ultrasound guide            1.20       3.01         NA       0.24       4.45         NA        XXX
                                                       intraoper.
76986...............  26............  A               Ultrasound guide            1.20       0.40       0.40       0.10       1.70       1.70        XXX
                                                       intraoper.
76986...............  TC............  A               Ultrasound guide            0.00       2.62         NA       0.14       2.76         NA        XXX
                                                       intraoper.
77261...............  ..............  A               Radiation therapy           1.39       0.51       0.51       0.07       1.97       1.97        XXX
                                                       planning.
77262...............  ..............  A               Radiation therapy           2.11       0.76       0.76       0.11       2.98       2.98        XXX
                                                       planning.
77263...............  ..............  A               Radiation therapy           3.14       1.11       1.11       0.16       4.41       4.41        XXX
                                                       planning.
77280...............  ..............  A               Set radiation therapy       0.70       3.69         NA       0.22       4.61         NA        XXX
                                                       field.
77280...............  26............  A               Set radiation therapy       0.70       0.22       0.22       0.04       0.96       0.96        XXX
                                                       field.
77280...............  TC............  A               Set radiation therapy       0.00       3.46         NA       0.18       3.64         NA        XXX
                                                       field.
77285...............  ..............  A               Set radiation therapy       1.05       5.89         NA       0.35       7.29         NA        XXX
                                                       field.
77285...............  26............  A               Set radiation therapy       1.05       0.34       0.34       0.05       1.44       1.44        XXX
                                                       field.
77285...............  TC............  A               Set radiation therapy       0.00       5.56         NA       0.30       5.86         NA        XXX
                                                       field.
77290...............  ..............  A               Set radiation therapy       1.56       6.99         NA       0.43       8.98         NA        XXX
                                                       field.
77290...............  26............  A               Set radiation therapy       1.56       0.50       0.50       0.08       2.14       2.14        XXX
                                                       field.
77290...............  TC............  A               Set radiation therapy       0.00       6.50         NA       0.35       6.85         NA        XXX
                                                       field.
77295...............  ..............  A               Set radiation therapy       4.56      29.34         NA       1.72      35.62         NA        XXX
                                                       field.
77295...............  26............  A               Set radiation therapy       4.56       1.46       1.46       0.24       6.26       6.26        XXX
                                                       field.
77295...............  TC............  A               Set radiation therapy       0.00      27.88         NA       1.48      29.36         NA        XXX
                                                       field.
77300...............  ..............  A               Radiation therapy           0.62       1.54         NA       0.10       2.26         NA        XXX
                                                       dose plan.
77300...............  26............  A               Radiation therapy           0.62       0.20       0.20       0.03       0.85       0.85        XXX
                                                       dose plan.
77300...............  TC............  A               Radiation therapy           0.00       1.34         NA       0.07       1.41         NA        XXX
                                                       dose plan.

[[Page 47668]]

 
77301...............  ..............  A               Radiotherapy dose           7.99      30.44         NA       1.88      40.31         NA        XXX
                                                       plan, imrt.
77301...............  26............  A               Radiotherapy dose           7.99       2.55       2.55       0.40      10.94      10.94        XXX
                                                       plan, imrt.
77301...............  TC............  A               Radiotherapy dose           0.00      27.88         NA       1.48      29.36         NA        XXX
                                                       plan, imrt.
77305...............  ..............  A               Teletx isodose plan         0.70       2.08         NA       0.15       2.93         NA        XXX
                                                       simple.
77305...............  26............  A               Teletx isodose plan         0.70       0.23       0.23       0.04       0.97       0.97        XXX
                                                       simple.
77305...............  TC............  A               Teletx isodose plan         0.00       1.85         NA       0.11       1.96         NA        XXX
                                                       simple.
77310...............  ..............  A               Teletx isodose plan         1.05       2.66         NA       0.18       3.89         NA        XXX
                                                       intermed.
77310...............  26............  A               Teletx isodose plan         1.05       0.34       0.34       0.05       1.44       1.44        XXX
                                                       intermed.
77310...............  TC............  A               Teletx isodose plan         0.00       2.33         NA       0.13       2.46         NA        XXX
                                                       intermed.
77315...............  ..............  A               Teletx isodose plan         1.56       3.15         NA       0.22       4.93         NA        XXX
                                                       complex.
77315...............  26............  A               Teletx isodose plan         1.56       0.50       0.50       0.08       2.14       2.14        XXX
                                                       complex.
77315...............  TC............  A               Teletx isodose plan         0.00       2.65         NA       0.14       2.79         NA        XXX
                                                       complex.
77321...............  ..............  A               Special teletx port         0.95       4.34         NA       0.26       5.55         NA        XXX
                                                       plan.
77321...............  26............  A               Special teletx port         0.95       0.30       0.30       0.05       1.30       1.30        XXX
                                                       plan.
77321...............  TC............  A               Special teletx port         0.00       4.03         NA       0.21       4.24         NA        XXX
                                                       plan.
77326...............  ..............  A               Brachytx isodose calc       0.93       2.65         NA       0.18       3.76         NA        XXX
                                                       simp.
77326...............  26............  A               Brachytx isodose calc       0.93       0.30       0.30       0.05       1.28       1.28        XXX
                                                       simp.
77326...............  TC............  A               Brachytx isodose calc       0.00       2.35         NA       0.13       2.48         NA        XXX
                                                       simp.
77327...............  ..............  A               Brachytx isodose calc       1.39       3.91         NA       0.25       5.55         NA        XXX
                                                       interm.
77327...............  26............  A               Brachytx isodose calc       1.39       0.44       0.44       0.07       1.90       1.90        XXX
                                                       interm.
77327...............  TC............  A               Brachytx isodose calc       0.00       3.46         NA       0.18       3.64         NA        XXX
                                                       interm.
77328...............  ..............  A               Brachytx isodose plan       2.09       5.62         NA       0.36       8.07         NA        XXX
                                                       compl.
77328...............  26............  A               Brachytx isodose plan       2.09       0.67       0.67       0.11       2.87       2.87        XXX
                                                       compl.
77328...............  TC............  A               Brachytx isodose plan       0.00       4.95         NA       0.25       5.20         NA        XXX
                                                       compl.
77331...............  ..............  A               Special radiation           0.87       0.78         NA       0.06       1.71         NA        XXX
                                                       dosimetry.
77331...............  26............  A               Special radiation           0.87       0.28       0.28       0.04       1.19       1.19        XXX
                                                       dosimetry.
77331...............  TC............  A               Special radiation           0.00       0.50         NA       0.02       0.52         NA        XXX
                                                       dosimetry.
77332...............  ..............  A               Radiation treatment         0.54       1.51         NA       0.10       2.15         NA        XXX
                                                       aid(s).
77332...............  26............  A               Radiation treatment         0.54       0.17       0.17       0.03       0.74       0.74        XXX
                                                       aid(s).
77332...............  TC............  A               Radiation treatment         0.00       1.34         NA       0.07       1.41         NA        XXX
                                                       aid(s).
77333...............  ..............  A               Radiation treatment         0.84       2.16         NA       0.15       3.15         NA        XXX
                                                       aid(s).
77333...............  26............  A               Radiation treatment         0.84       0.27       0.27       0.04       1.15       1.15        XXX
                                                       aid(s).
77333...............  TC............  A               Radiation treatment         0.00       1.89         NA       0.11       2.00         NA        XXX
                                                       aid(s).
77334...............  ..............  A               Radiation treatment         1.24       3.64         NA       0.23       5.11         NA        XXX
                                                       aid(s).
77334...............  26............  A               Radiation treatment         1.24       0.40       0.40       0.06       1.70       1.70        XXX
                                                       aid(s).
77334...............  TC............  A               Radiation treatment         0.00       3.24         NA       0.17       3.41         NA        XXX
                                                       aid(s).
77336...............  ..............  A               Radiation physics           0.00       2.97         NA       0.16       3.13         NA        XXX
                                                       consult.
77370...............  ..............  A               Radiation physics           0.00       3.48         NA       0.18       3.66         NA        XXX
                                                       consult.
77401...............  ..............  A               Radiation treatment         0.00       1.77         NA       0.11       1.88         NA        XXX
                                                       delivery.
77402...............  ..............  A               Radiation treatment         0.00       1.77         NA       0.11       1.88         NA        XXX
                                                       delivery.
77403...............  ..............  A               Radiation treatment         0.00       1.77         NA       0.11       1.88         NA        XXX
                                                       delivery.
77404...............  ..............  A               Radiation treatment         0.00       1.77         NA       0.11       1.88         NA        XXX
                                                       delivery.
77406...............  ..............  A               Radiation treatment         0.00       1.77         NA       0.11       1.88         NA        XXX
                                                       delivery.
77407...............  ..............  A               Radiation treatment         0.00       2.08         NA       0.12       2.20         NA        XXX
                                                       delivery.
77408...............  ..............  A               Radiation treatment         0.00       2.08         NA       0.12       2.20         NA        XXX
                                                       delivery.
77409...............  ..............  A               Radiation treatment         0.00       2.08         NA       0.12       2.20         NA        XXX
                                                       delivery.
77411...............  ..............  A               Radiation treatment         0.00       2.08         NA       0.12       2.20         NA        XXX
                                                       delivery.
77412...............  ..............  A               Radiation treatment         0.00       2.33         NA       0.13       2.46         NA        XXX
                                                       delivery.
77413...............  ..............  A               Radiation treatment         0.00       2.33         NA       0.13       2.46         NA        XXX
                                                       delivery.
77414...............  ..............  A               Radiation treatment         0.00       2.33         NA       0.13       2.46         NA        XXX
                                                       delivery.
77416...............  ..............  A               Radiation treatment         0.00       2.33         NA       0.13       2.46         NA        XXX
                                                       delivery.
77417...............  ..............  A               Radiology port              0.00       0.59         NA       0.04       0.63         NA        XXX
                                                       film(s).
77418...............  ..............  A               Radiation tx                0.00      17.95         NA       0.13      18.08         NA        XXX
                                                       delivery, imrt.
77427...............  ..............  A               Radiation tx                3.31       1.06       1.06       0.17       4.54       4.54        090
                                                       management, x5.
77431...............  ..............  A               Radiation therapy           1.81       0.68       0.68       0.09       2.58       2.58        XXX
                                                       management.
77432...............  ..............  A               Stereotactic                7.92       2.91       2.91       0.42      11.25      11.25        XXX
                                                       radiation trmt.
77470...............  ..............  A               Special radiation           2.09      11.79         NA       0.70      14.58         NA        XXX
                                                       treatment.
77470...............  26............  A               Special radiation           2.09       0.67       0.67       0.11       2.87       2.87        XXX
                                                       treatment.
77470...............  TC............  A               Special radiation           0.00      11.13         NA       0.59      11.72         NA        XXX
                                                       treatment.
77600...............  ..............  R               Hyperthermia                1.56       3.54         NA       0.24       5.34         NA        XXX
                                                       treatment.
77600...............  26............  R               Hyperthermia                1.56       0.50       0.50       0.08       2.14       2.14        XXX
                                                       treatment.
77600...............  TC............  R               Hyperthermia                0.00       3.04         NA       0.16       3.20         NA        XXX
                                                       treatment.
77605...............  ..............  R               Hyperthermia                2.09       4.72         NA       0.33       7.14         NA        XXX
                                                       treatment.
77605...............  26............  R               Hyperthermia                2.09       0.66       0.66       0.11       2.86       2.86        XXX
                                                       treatment.
77605...............  TC............  R               Hyperthermia                0.00       4.05         NA       0.22       4.27         NA        XXX
                                                       treatment.
77610...............  ..............  R               Hyperthermia                1.56       3.55         NA       0.24       5.35         NA        XXX
                                                       treatment.
77610...............  26............  R               Hyperthermia                1.56       0.51       0.51       0.07       2.14       2.14        XXX
                                                       treatment.
77610...............  TC............  R               Hyperthermia                0.00       3.04         NA       0.16       3.20         NA        XXX
                                                       treatment.
77615...............  ..............  R               Hyperthermia                2.09       4.72         NA       0.33       7.14         NA        XXX
                                                       treatment.
77615...............  26............  R               Hyperthermia                2.09       0.66       0.66       0.11       2.86       2.86        XXX
                                                       treatment.
77615...............  TC............  R               Hyperthermia                0.00       4.05         NA       0.22       4.27         NA        XXX
                                                       treatment.
77620...............  ..............  R               Hyperthermia                1.56       3.56         NA       0.23       5.35         NA        XXX
                                                       treatment.
77620...............  26............  R               Hyperthermia                1.56       0.52       0.52       0.19       2.27       2.27        XXX
                                                       treatment.
77620...............  TC............  R               Hyperthermia                0.00       3.04         NA       0.16       3.20         NA        XXX
                                                       treatment.
77750...............  ..............  A               Infuse radioactive          4.90       2.91         NA       0.32       8.13         NA        090
                                                       materials.

[[Page 47669]]

 
77750...............  26............  A               Infuse radioactive          4.90       1.58       1.58       0.25       6.73       6.73        090
                                                       materials.
77750...............  TC............  A               Infuse radioactive          0.00       1.33         NA       0.07       1.40         NA        090
                                                       materials.
77761...............  ..............  A               Apply intrcav radiat        3.80       3.59         NA       0.33       7.72         NA        090
                                                       simple.
77761...............  26............  A               Apply intrcav radiat        3.80       1.09       1.09       0.19       5.08       5.08        090
                                                       simple.
77761...............  TC............  A               Apply intrcav radiat        0.00       2.50         NA       0.14       2.64         NA        090
                                                       simple.
77762...............  ..............  A               Apply intrcav radiat        5.71       5.43         NA       0.48      11.62         NA        090
                                                       interm.
77762...............  26............  A               Apply intrcav radiat        5.71       1.83       1.83       0.29       7.83       7.83        090
                                                       interm.
77762...............  TC............  A               Apply intrcav radiat        0.00       3.60         NA       0.19       3.79         NA        090
                                                       interm.
77763...............  ..............  A               Apply intrcav radiat        8.56       7.21         NA       0.67      16.44         NA        090
                                                       compl.
77763...............  26............  A               Apply intrcav radiat        8.56       2.73       2.73       0.44      11.73      11.73        090
                                                       compl.
77763...............  TC............  A               Apply intrcav radiat        0.00       4.48         NA       0.23       4.71         NA        090
                                                       compl.
77776...............  ..............  A               Apply interstit             4.65       3.12         NA       0.48       8.25         NA        090
                                                       radiat simpl.
77776...............  26............  A               Apply interstit             4.65       0.95       0.95       0.35       5.95       5.95        090
                                                       radiat simpl.
77776...............  TC............  A               Apply interstit             0.00       2.17         NA       0.13       2.30         NA        090
                                                       radiat simpl.
77777...............  ..............  A               Apply interstit             7.47       6.59         NA       0.62      14.68         NA        090
                                                       radiat inter.
77777...............  26............  A               Apply interstit             7.47       2.37       2.37       0.40      10.24      10.24        090
                                                       radiat inter.
77777...............  TC............  A               Apply interstit             0.00       4.23         NA       0.22       4.45         NA        090
                                                       radiat inter.
77778...............  ..............  A               Apply interstit            11.17       8.69         NA       0.85      20.71         NA        090
                                                       radiat compl.
77778...............  26............  A               Apply interstit            11.17       3.56       3.56       0.58      15.31      15.31        090
                                                       radiat compl.
77778...............  TC............  A               Apply interstit             0.00       5.12         NA       0.27       5.39         NA        090
                                                       radiat compl.
77781...............  ..............  A               High intensity              1.66      20.80         NA       1.14      23.60         NA        090
                                                       brachytherapy.
77781...............  26............  A               High intensity              1.66       0.53       0.53       0.08       2.27       2.27        090
                                                       brachytherapy.
77781...............  TC............  A               High intensity              0.00      20.27         NA       1.06      21.33         NA        090
                                                       brachytherapy.
77782...............  ..............  A               High intensity              2.49      21.07         NA       1.19      24.75         NA        090
                                                       brachytherapy.
77782...............  26............  A               High intensity              2.49       0.80       0.80       0.13       3.42       3.42        090
                                                       brachytherapy.
77782...............  TC............  A               High intensity              0.00      20.27         NA       1.06      21.33         NA        090
                                                       brachytherapy.
77783...............  ..............  A               High intensity              3.72      21.46         NA       1.25      26.43         NA        090
                                                       brachytherapy.
77783...............  26............  A               High intensity              3.72       1.19       1.19       0.19       5.10       5.10        090
                                                       brachytherapy.
77783...............  TC............  A               High intensity              0.00      20.27         NA       1.06      21.33         NA        090
                                                       brachytherapy.
77784...............  ..............  A               High intensity              5.60      22.06         NA       1.35      29.01         NA        090
                                                       brachytherapy.
77784...............  26............  A               High intensity              5.60       1.79       1.79       0.29       7.68       7.68        090
                                                       brachytherapy.
77784...............  TC............  A               High intensity              0.00      20.27         NA       1.06      21.33         NA        090
                                                       brachytherapy.
77789...............  ..............  A               Apply surface               1.12       0.82         NA       0.08       2.02         NA        000
                                                       radiation.
77789...............  26............  A               Apply surface               1.12       0.37       0.37       0.06       1.55       1.55        000
                                                       radiation.
77789...............  TC............  A               Apply surface               0.00       0.45         NA       0.02       0.47         NA        000
                                                       radiation.
77790...............  ..............  A               Radiation handling...       1.05       0.84         NA       0.07       1.96         NA        XXX
77790...............  26............  A               Radiation handling...       1.05       0.34       0.34       0.05       1.44       1.44        XXX
77790...............  TC............  A               Radiation handling...       0.00       0.50         NA       0.02       0.52         NA        XXX
78000...............  ..............  A               Thyroid, single             0.19       1.03         NA       0.07       1.29         NA        XXX
                                                       uptake.
78000...............  26............  A               Thyroid, single             0.19       0.06       0.06       0.01       0.26       0.26        XXX
                                                       uptake.
78000...............  TC............  A               Thyroid, single             0.00       0.97         NA       0.06       1.03         NA        XXX
                                                       uptake.
78001...............  ..............  A               Thyroid, multiple           0.26       1.39         NA       0.08       1.73         NA        XXX
                                                       uptakes.
78001...............  26............  A               Thyroid, multiple           0.26       0.09       0.09       0.01       0.36       0.36        XXX
                                                       uptakes.
78001...............  TC............  A               Thyroid, multiple           0.00       1.30         NA       0.07       1.37         NA        XXX
                                                       uptakes.
78003...............  ..............  A               Thyroid suppress/           0.33       1.07         NA       0.07       1.47         NA        XXX
                                                       stimul.
78003...............  26............  A               Thyroid suppress/           0.33       0.11       0.11       0.01       0.45       0.45        XXX
                                                       stimul.
78003...............  TC............  A               Thyroid suppress/           0.00       0.97         NA       0.06       1.03         NA        XXX
                                                       stimul.
78006...............  ..............  A               Thyroid imaging with        0.49       2.54         NA       0.15       3.18         NA        XXX
                                                       uptake.
78006...............  26............  A               Thyroid imaging with        0.49       0.16       0.16       0.02       0.67       0.67        XXX
                                                       uptake.
78006...............  TC............  A               Thyroid imaging with        0.00       2.37         NA       0.13       2.50         NA        XXX
                                                       uptake.
78007...............  ..............  A               Thyroid image, mult         0.50       2.73         NA       0.16       3.39         NA        XXX
                                                       uptakes.
78007...............  26............  A               Thyroid image, mult         0.50       0.17       0.17       0.02       0.69       0.69        XXX
                                                       uptakes.
78007...............  TC............  A               Thyroid image, mult         0.00       2.57         NA       0.14       2.71         NA        XXX
                                                       uptakes.
78010...............  ..............  A               Thyroid imaging......       0.39       1.94         NA       0.13       2.46         NA        XXX
78010...............  26............  A               Thyroid imaging......       0.39       0.13       0.13       0.02       0.54       0.54        XXX
78010...............  TC............  A               Thyroid imaging......       0.00       1.81         NA       0.11       1.92         NA        XXX
78011...............  ..............  A               Thyroid imaging with        0.45       2.55         NA       0.15       3.15         NA        XXX
                                                       flow.
78011...............  26............  A               Thyroid imaging with        0.45       0.15       0.15       0.02       0.62       0.62        XXX
                                                       flow.
78011...............  TC............  A               Thyroid imaging with        0.00       2.40         NA       0.13       2.53         NA        XXX
                                                       flow.
78015...............  ..............  A               Thyroid met imaging..       0.67       2.79         NA       0.17       3.63         NA        XXX
78015...............  26............  A               Thyroid met imaging..       0.67       0.23       0.23       0.03       0.93       0.93        XXX
78015...............  TC............  A               Thyroid met imaging..       0.00       2.57         NA       0.14       2.71         NA        XXX
78016...............  ..............  A               Thyroid met imaging/        0.82       3.76         NA       0.21       4.79         NA        XXX
                                                       studies.
78016...............  26............  A               Thyroid met imaging/        0.82       0.28       0.28       0.03       1.13       1.13        XXX
                                                       studies.
78016...............  TC............  A               Thyroid met imaging/        0.00       3.47         NA       0.18       3.65         NA        XXX
                                                       studies.
78018...............  ..............  A               Thyroid met imaging,        0.86       5.71         NA       0.33       6.90         NA        XXX
                                                       body.
78018...............  26............  A               Thyroid met imaging,        0.86       0.29       0.29       0.04       1.19       1.19        XXX
                                                       body.
78018...............  TC............  A               Thyroid met imaging,        0.00       5.41         NA       0.29       5.70         NA        XXX
                                                       body.
78020...............  ..............  A               Thyroid met uptake...       0.60       1.51         NA       0.17       2.28         NA        ZZZ
78020...............  26............  A               Thyroid met uptake...       0.60       0.21       0.21       0.03       0.84       0.84        ZZZ
78020...............  TC............  A               Thyroid met uptake...       0.00       1.30         NA       0.14       1.44         NA        ZZZ
78070...............  ..............  A               Parathyroid nuclear         0.82       4.54         NA       0.15       5.51         NA        XXX
                                                       imaging.
78070...............  26............  A               Parathyroid nuclear         0.82       0.28       0.28       0.04       1.14       1.14        XXX
                                                       imaging.
78070...............  TC............  A               Parathyroid nuclear         0.00       4.27         NA       0.11       4.38         NA        XXX
                                                       imaging.
78075...............  ..............  A               Adrenal nuclear             0.74       5.68         NA       0.32       6.74         NA        XXX
                                                       imaging.

[[Page 47670]]

 
78075...............  26............  A               Adrenal nuclear             0.74       0.26       0.26       0.03       1.03       1.03        XXX
                                                       imaging.
78075...............  TC............  A               Adrenal nuclear             0.00       5.41         NA       0.29       5.70         NA        XXX
                                                       imaging.
78102...............  ..............  A               Bone marrow imaging,        0.55       2.23         NA       0.14       2.92         NA        XXX
                                                       ltd.
78102...............  26............  A               Bone marrow imaging,        0.55       0.19       0.19       0.02       0.76       0.76        XXX
                                                       ltd.
78102...............  TC............  A               Bone marrow imaging,        0.00       2.04         NA       0.12       2.16         NA        XXX
                                                       ltd.
78103...............  ..............  A               Bone marrow imaging,        0.75       3.42         NA       0.20       4.37         NA        XXX
                                                       mult.
78103...............  26............  A               Bone marrow imaging,        0.75       0.26       0.26       0.03       1.04       1.04        XXX
                                                       mult.
78103...............  TC............  A               Bone marrow imaging,        0.00       3.17         NA       0.17       3.34         NA        XXX
                                                       mult.
78104...............  ..............  A               Bone marrow imaging,        0.80       4.33         NA       0.26       5.39         NA        XXX
                                                       body.
78104...............  26............  A               Bone marrow imaging,        0.80       0.27       0.27       0.04       1.11       1.11        XXX
                                                       body.
78104...............  TC............  A               Bone marrow imaging,        0.00       4.06         NA       0.22       4.28         NA        XXX
                                                       body.
78110...............  ..............  A               Plasma volume, single       0.19       1.02         NA       0.07       1.28         NA        XXX
78110...............  26............  A               Plasma volume, single       0.19       0.07       0.07       0.01       0.27       0.27        XXX
78110...............  TC............  A               Plasma volume, single       0.00       0.95         NA       0.06       1.01         NA        XXX
78111...............  ..............  A               Plasma volume,              0.22       2.65         NA       0.15       3.02         NA        XXX
                                                       multiple.
78111...............  26............  A               Plasma volume,              0.22       0.08       0.08       0.01       0.31       0.31        XXX
                                                       multiple.
78111...............  TC............  A               Plasma volume,              0.00       2.57         NA       0.14       2.71         NA        XXX
                                                       multiple.
78120...............  ..............  A               Red cell mass, single       0.23       1.81         NA       0.12       2.16         NA        XXX
78120...............  26............  A               Red cell mass, single       0.23       0.08       0.08       0.01       0.32       0.32        XXX
78120...............  TC............  A               Red cell mass, single       0.00       1.73         NA       0.11       1.84         NA        XXX
78121...............  ..............  A               Red cell mass,              0.32       3.02         NA       0.15       3.49         NA        XXX
                                                       multiple.
78121...............  26............  A               Red cell mass,              0.32       0.11       0.11       0.01       0.44       0.44        XXX
                                                       multiple.
78121...............  TC............  A               Red cell mass,              0.00       2.91         NA       0.14       3.05         NA        XXX
                                                       multiple.
78122...............  ..............  A               Blood volume.........       0.45       4.75         NA       0.26       5.46         NA        XXX
78122...............  26............  A               Blood volume.........       0.45       0.16       0.16       0.02       0.63       0.63        XXX
78122...............  TC............  A               Blood volume.........       0.00       4.59         NA       0.24       4.83         NA        XXX
78130...............  ..............  A               Red cell survival           0.61       3.06         NA       0.17       3.84         NA        XXX
                                                       study.
78130...............  26............  A               Red cell survival           0.61       0.21       0.21       0.03       0.85       0.85        XXX
                                                       study.
78130...............  TC............  A               Red cell survival           0.00       2.85         NA       0.14       2.99         NA        XXX
                                                       study.
78135...............  ..............  A               Red cell survival           0.64       5.08         NA       0.28       6.00         NA        XXX
                                                       kinetics.
78135...............  26............  A               Red cell survival           0.64       0.22       0.22       0.03       0.89       0.89        XXX
                                                       kinetics.
78135...............  TC............  A               Red cell survival           0.00       4.86         NA       0.25       5.11         NA        XXX
                                                       kinetics.
78140...............  ..............  A               Red cell                    0.61       4.13         NA       0.24       4.98         NA        XXX
                                                       sequestration.
78140...............  26............  A               Red cell                    0.61       0.20       0.20       0.03       0.84       0.84        XXX
                                                       sequestration.
78140...............  TC............  A               Red cell                    0.00       3.93         NA       0.21       4.14         NA        XXX
                                                       sequestration.
78160...............  ..............  A               Plasma iron turnover.       0.33       3.78         NA       0.20       4.31         NA        XXX
78160...............  26............  A               Plasma iron turnover.       0.33       0.12       0.12       0.01       0.46       0.46        XXX
78160...............  TC............  A               Plasma iron turnover.       0.00       3.66         NA       0.19       3.85         NA        XXX
78162...............  ..............  A               Radioiron absorption        0.45       3.38         NA       0.18       4.01         NA        XXX
                                                       exam.
78162...............  26............  A               Radioiron absorption        0.45       0.19       0.19       0.01       0.65       0.65        XXX
                                                       exam.
78162...............  TC............  A               Radioiron absorption        0.00       3.19         NA       0.17       3.36         NA        XXX
                                                       exam.
78170...............  ..............  A               Red cell iron               0.41       5.44         NA       0.30       6.15         NA        XXX
                                                       utilization.
78170...............  26............  A               Red cell iron               0.41       0.14       0.14       0.02       0.57       0.57        XXX
                                                       utilization.
78170...............  TC............  A               Red cell iron               0.00       5.30         NA       0.28       5.58         NA        XXX
                                                       utilization.
78172...............  26............  A               Total body iron             0.53       0.17       0.17       0.02       0.72       0.72        XXX
                                                       estimation.
78185...............  ..............  A               Spleen imaging.......       0.40       2.49         NA       0.15       3.04         NA        XXX
78185...............  26............  A               Spleen imaging.......       0.40       0.14       0.14       0.02       0.56       0.56        XXX
78185...............  TC............  A               Spleen imaging.......       0.00       2.35         NA       0.13       2.48         NA        XXX
78190...............  ..............  A               Platelet survival,          1.09       6.10         NA       0.34       7.53         NA        XXX
                                                       kinetics.
78190...............  26............  A               Platelet survival,          1.09       0.39       0.39       0.04       1.52       1.52        XXX
                                                       kinetics.
78190...............  TC............  A               Platelet survival,          0.00       5.70         NA       0.30       6.00         NA        XXX
                                                       kinetics.
78191...............  ..............  A               Platelet survival....       0.61       7.53         NA       0.40       8.54         NA        XXX
78191...............  26............  A               Platelet survival....       0.61       0.20       0.20       0.03       0.84       0.84        XXX
78191...............  TC............  A               Platelet survival....       0.00       7.33         NA       0.37       7.70         NA        XXX
78195...............  ..............  A               Lymph system imaging.       1.20       4.47         NA       0.28       5.95         NA        XXX
78195...............  26............  A               Lymph system imaging.       1.20       0.41       0.41       0.06       1.67       1.67        XXX
78195...............  TC............  A               Lymph system imaging.       0.00       4.06         NA       0.22       4.28         NA        XXX
78201...............  ..............  A               Liver imaging........       0.44       2.50         NA       0.15       3.09         NA        XXX
78201...............  26............  A               Liver imaging........       0.44       0.15       0.15       0.02       0.61       0.61        XXX
78201...............  TC............  A               Liver imaging........       0.00       2.35         NA       0.13       2.48         NA        XXX
78202...............  ..............  A               Liver imaging with          0.51       3.05         NA       0.16       3.72         NA        XXX
                                                       flow.
78202...............  26............  A               Liver imaging with          0.51       0.17       0.17       0.02       0.70       0.70        XXX
                                                       flow.
78202...............  TC............  A               Liver imaging with          0.00       2.88         NA       0.14       3.02         NA        XXX
                                                       flow.
78205...............  ..............  A               Liver imaging (3D)...       0.71       6.14         NA       0.34       7.19         NA        XXX
78205...............  26............  A               Liver imaging (3D)...       0.71       0.24       0.24       0.03       0.98       0.98        XXX
78205...............  TC............  A               Liver imaging (3D)...       0.00       5.90         NA       0.31       6.21         NA        XXX
78206...............  ..............  A               Liver image (3d) with       0.96       6.23         NA       0.15       7.34         NA        XXX
                                                       flow.
78206...............  26............  A               Liver image (3d) with       0.96       0.33       0.33       0.04       1.33       1.33        XXX
                                                       flow.
78206...............  TC............  A               Liver image (3d) with       0.00       5.90         NA       0.11       6.01         NA        XXX
                                                       flow.
78215...............  ..............  A               Liver and spleen            0.49       3.10         NA       0.16       3.75         NA        XXX
                                                       imaging.
78215...............  26............  A               Liver and spleen            0.49       0.16       0.16       0.02       0.67       0.67        XXX
                                                       imaging.
78215...............  TC............  A               Liver and spleen            0.00       2.93         NA       0.14       3.07         NA        XXX
                                                       imaging.
78216...............  ..............  A               Liver & spleen image/       0.57       3.67         NA       0.20       4.44         NA        XXX
                                                       flow.
78216...............  26............  A               Liver & spleen image/       0.57       0.19       0.19       0.02       0.78       0.78        XXX
                                                       flow.
78216...............  TC............  A               Liver & spleen image/       0.00       3.47         NA       0.18       3.65         NA        XXX
                                                       flow.

[[Page 47671]]

 
78220...............  ..............  A               Liver function study.       0.49       3.88         NA       0.21       4.58         NA        XXX
78220...............  26............  A               Liver function study.       0.49       0.16       0.16       0.02       0.67       0.67        XXX
78220...............  TC............  A               Liver function study.       0.00       3.72         NA       0.19       3.91         NA        XXX
78223...............  ..............  A               Hepatobiliary imaging       0.84       3.94         NA       0.23       5.01         NA        XXX
78223...............  26............  A               Hepatobiliary imaging       0.84       0.28       0.28       0.04       1.16       1.16        XXX
78223...............  TC............  A               Hepatobiliary imaging       0.00       3.66         NA       0.19       3.85         NA        XXX
78230...............  ..............  A               Salivary gland              0.45       2.32         NA       0.15       2.92         NA        XXX
                                                       imaging.
78230...............  26............  A               Salivary gland              0.45       0.15       0.15       0.02       0.62       0.62        XXX
                                                       imaging.
78230...............  TC............  A               Salivary gland              0.00       2.17         NA       0.13       2.30         NA        XXX
                                                       imaging.
78231...............  ..............  A               Serial salivary             0.52       3.35         NA       0.19       4.06         NA        XXX
                                                       imaging.
78231...............  26............  A               Serial salivary             0.52       0.18       0.18       0.02       0.72       0.72        XXX
                                                       imaging.
78231...............  TC............  A               Serial salivary             0.00       3.17         NA       0.17       3.34         NA        XXX
                                                       imaging.
78232...............  ..............  A               Salivary gland              0.47       3.70         NA       0.20       4.37         NA        XXX
                                                       function exam.
78232...............  26............  A               Salivary gland              0.47       0.16       0.16       0.02       0.65       0.65        XXX
                                                       function exam.
78232...............  TC............  A               Salivary gland              0.00       3.53         NA       0.18       3.71         NA        XXX
                                                       function exam.
78258...............  ..............  A               Esophageal motility         0.74       3.12         NA       0.17       4.03         NA        XXX
                                                       study.
78258...............  26............  A               Esophageal motility         0.74       0.25       0.25       0.03       1.02       1.02        XXX
                                                       study.
78258...............  TC............  A               Esophageal motility         0.00       2.88         NA       0.14       3.02         NA        XXX
                                                       study.
78261...............  ..............  A               Gastric mucosa              0.69       4.33         NA       0.25       5.27         NA        XXX
                                                       imaging.
78261...............  26............  A               Gastric mucosa              0.69       0.24       0.24       0.03       0.96       0.96        XXX
                                                       imaging.
78261...............  TC............  A               Gastric mucosa              0.00       4.09         NA       0.22       4.31         NA        XXX
                                                       imaging.
78262...............  ..............  A               Gastroesophageal            0.68       4.48         NA       0.25       5.41         NA        XXX
                                                       reflux exam.
78262...............  26............  A               Gastroesophageal            0.68       0.23       0.23       0.03       0.94       0.94        XXX
                                                       reflux exam.
78262...............  TC............  A               Gastroesophageal            0.00       4.25         NA       0.22       4.47         NA        XXX
                                                       reflux exam.
78264...............  ..............  A               Gastric emptying            0.78       4.38         NA       0.25       5.41         NA        XXX
                                                       study.
78264...............  26............  A               Gastric emptying            0.78       0.26       0.26       0.03       1.07       1.07        XXX
                                                       study.
78264...............  TC............  A               Gastric emptying            0.00       4.12         NA       0.22       4.34         NA        XXX
                                                       study.
78270...............  ..............  A               Vit B-12 absorption         0.20       1.61         NA       0.11       1.92         NA        XXX
                                                       exam.
78270...............  26............  A               Vit B-12 absorption         0.20       0.07       0.07       0.01       0.28       0.28        XXX
                                                       exam.
78270...............  TC............  A               Vit B-12 absorption         0.00       1.54         NA       0.10       1.64         NA        XXX
                                                       exam.
78271...............  ..............  A               Vit b-12 absrp exam,        0.20       1.71         NA       0.11       2.02         NA        XXX
                                                       int fac.
78271...............  26............  A               Vit b-12 absrp exam,        0.20       0.07       0.07       0.01       0.28       0.28        XXX
                                                       int fac.
78271...............  TC............  A               Vit b-12 absrp exam,        0.00       1.64         NA       0.10       1.74         NA        XXX
                                                       int fac.
78272...............  ..............  A               Vit B-12 absorp,            0.27       2.41         NA       0.14       2.82         NA        XXX
                                                       combined.
78272...............  26............  A               Vit B-12 absorp,            0.27       0.09       0.09       0.01       0.37       0.37        XXX
                                                       combined.
78272...............  TC............  A               Vit B-12 absorp,            0.00       2.32         NA       0.13       2.45         NA        XXX
                                                       combined.
78278...............  ..............  A               Acute GI blood loss         0.99       5.19         NA       0.29       6.47         NA        XXX
                                                       imaging.
78278...............  26............  A               Acute GI blood loss         0.99       0.33       0.33       0.04       1.36       1.36        XXX
                                                       imaging.
78278...............  TC............  A               Acute GI blood loss         0.00       4.86         NA       0.25       5.11         NA        XXX
                                                       imaging.
78282...............  26............  A               GI protein loss exam.       0.38       0.13       0.13       0.02       0.53       0.53        XXX
78290...............  ..............  A               Meckel-s divert exam.       0.68       3.27         NA       0.19       4.14         NA        XXX
78290...............  26............  A               Meckel-s divert exam.       0.68       0.23       0.23       0.03       0.94       0.94        XXX
78290...............  TC............  A               Meckel-s divert exam.       0.00       3.04         NA       0.16       3.20         NA        XXX
78291...............  ..............  A               Leveen/shunt patency        0.88       3.36         NA       0.20       4.44         NA        XXX
                                                       exam.
78291...............  26............  A               Leveen/shunt patency        0.88       0.30       0.30       0.04       1.22       1.22        XXX
                                                       exam.
78291...............  TC............  A               Leveen/shunt patency        0.00       3.06         NA       0.16       3.22         NA        XXX
                                                       exam.
78300...............  ..............  A               Bone imaging, limited       0.62       2.69         NA       0.17       3.48         NA        XXX
                                                       area.
78300...............  26............  A               Bone imaging, limited       0.62       0.21       0.21       0.03       0.86       0.86        XXX
                                                       area.
78300...............  TC............  A               Bone imaging, limited       0.00       2.48         NA       0.14       2.62         NA        XXX
                                                       area.
78305...............  ..............  A               Bone imaging,               0.83       3.93         NA       0.23       4.99         NA        XXX
                                                       multiple areas.
78305...............  26............  A               Bone imaging,               0.83       0.28       0.28       0.04       1.15       1.15        XXX
                                                       multiple areas.
78305...............  TC............  A               Bone imaging,               0.00       3.66         NA       0.19       3.85         NA        XXX
                                                       multiple areas.
78306...............  ..............  A               Bone imaging, whole         0.86       4.55         NA       0.26       5.67         NA        XXX
                                                       body.
78306...............  26............  A               Bone imaging, whole         0.86       0.29       0.29       0.04       1.19       1.19        XXX
                                                       body.
78306...............  TC............  A               Bone imaging, whole         0.00       4.27         NA       0.22       4.49         NA        XXX
                                                       body.
78315...............  ..............  A               Bone imaging, 3 phase       1.02       5.11         NA       0.29       6.42         NA        XXX
78315...............  26............  A               Bone imaging, 3 phase       1.02       0.34       0.34       0.04       1.40       1.40        XXX
78315...............  TC............  A               Bone imaging, 3 phase       0.00       4.77         NA       0.25       5.02         NA        XXX
78320...............  ..............  A               Bone imaging (3D)....       1.04       6.26         NA       0.36       7.66         NA        XXX
78320...............  26............  A               Bone imaging (3D)....       1.04       0.36       0.36       0.05       1.45       1.45        XXX
78320...............  TC............  A               Bone imaging (3D)....       0.00       5.90         NA       0.31       6.21         NA        XXX
78350...............  ..............  A               Bone mineral, single        0.22       0.83         NA       0.06       1.11         NA        XXX
                                                       photon.
78350...............  26............  A               Bone mineral, single        0.22       0.07       0.07       0.01       0.30       0.30        XXX
                                                       photon.
78350...............  TC............  A               Bone mineral, single        0.00       0.75         NA       0.05       0.80         NA        XXX
                                                       photon.
78414...............  26............  A               Non-imaging heart           0.45       0.16       0.16       0.02       0.63       0.63        XXX
                                                       function.
78428...............  ..............  A               Cardiac shunt imaging       0.78       2.54         NA       0.16       3.48         NA        XXX
78428...............  26............  A               Cardiac shunt imaging       0.78       0.29       0.29       0.03       1.10       1.10        XXX
78428...............  TC............  A               Cardiac shunt imaging       0.00       2.25         NA       0.13       2.38         NA        XXX
78445...............  ..............  A               Vascular flow imaging       0.49       2.02         NA       0.13       2.64         NA        XXX
78445...............  26............  A               Vascular flow imaging       0.49       0.17       0.17       0.02       0.68       0.68        XXX
78445...............  TC............  A               Vascular flow imaging       0.00       1.85         NA       0.11       1.96         NA        XXX
78455...............  ..............  A               Venous thrombosis           0.73       4.22         NA       0.24       5.19         NA        XXX
                                                       study.
78455...............  26............  A               Venous thrombosis           0.73       0.25       0.25       0.03       1.01       1.01        XXX
                                                       study.
78455...............  TC............  A               Venous thrombosis           0.00       3.98         NA       0.21       4.19         NA        XXX
                                                       study.
78456...............  ..............  A               Acute venous thrombus       1.00       4.32         NA       0.33       5.65         NA        XXX
                                                       image.

[[Page 47672]]

 
78456...............  26............  A               Acute venous thrombus       1.00       0.34       0.34       0.04       1.38       1.38        XXX
                                                       image.
78456...............  TC............  A               Acute venous thrombus       0.00       3.98         NA       0.29       4.27         NA        XXX
                                                       image.
78457...............  ..............  A               Venous thrombosis           0.77       2.91         NA       0.18       3.86         NA        XXX
                                                       imaging.
78457...............  26............  A               Venous thrombosis           0.77       0.26       0.26       0.04       1.07       1.07        XXX
                                                       imaging.
78457...............  TC............  A               Venous thrombosis           0.00       2.65         NA       0.14       2.79         NA        XXX
                                                       imaging.
78458...............  ..............  A               Ven thrombosis              0.90       4.34         NA       0.25       5.49         NA        XXX
                                                       images, bilat.
78458...............  26............  A               Ven thrombosis              0.90       0.32       0.32       0.04       1.26       1.26        XXX
                                                       images, bilat.
78458...............  TC............  A               Ven thrombosis              0.00       4.02         NA       0.21       4.23         NA        XXX
                                                       images, bilat.
78459...............  26............  R               Heart muscle imaging        1.50       0.57       0.57       0.06       2.13       2.13        XXX
                                                       (PET).
78460...............  ..............  A               Heart muscle blood,         0.86       2.65         NA       0.17       3.68         NA        XXX
                                                       single.
78460...............  26............  A               Heart muscle blood,         0.86       0.29       0.29       0.04       1.19       1.19        XXX
                                                       single.
78460...............  TC............  A               Heart muscle blood,         0.00       2.35         NA       0.13       2.48         NA        XXX
                                                       single.
78461...............  ..............  A               Heart muscle blood,         1.23       5.14         NA       0.30       6.67         NA        XXX
                                                       multiple.
78461...............  26............  A               Heart muscle blood,         1.23       0.43       0.43       0.05       1.71       1.71        XXX
                                                       multiple.
78461...............  TC............  A               Heart muscle blood,         0.00       4.71         NA       0.25       4.96         NA        XXX
                                                       multiple.
78464...............  ..............  A               Heart image (3d),           1.09       7.44         NA       0.41       8.94         NA        XXX
                                                       single.
78464...............  26............  A               Heart image (3d),           1.09       0.38       0.38       0.04       1.51       1.51        XXX
                                                       single.
78464...............  TC............  A               Heart image (3d),           0.00       7.06         NA       0.37       7.43         NA        XXX
                                                       single.
78465...............  ..............  A               Heart image (3d),           1.46      12.30         NA       0.68      14.44         NA        XXX
                                                       multiple.
78465...............  26............  A               Heart image (3d),           1.46       0.52       0.52       0.06       2.04       2.04        XXX
                                                       multiple.
78465...............  TC............  A               Heart image (3d),           0.00      11.77         NA       0.62      12.39         NA        XXX
                                                       multiple.
78466...............  ..............  A               Heart infarct image..       0.69       2.86         NA       0.17       3.72         NA        XXX
78466...............  26............  A               Heart infarct image..       0.69       0.24       0.24       0.03       0.96       0.96        XXX
78466...............  TC............  A               Heart infarct image..       0.00       2.62         NA       0.14       2.76         NA        XXX
78468...............  ..............  A               Heart infarct image         0.80       3.93         NA       0.22       4.95         NA        XXX
                                                       (ef).
78468...............  26............  A               Heart infarct image         0.80       0.27       0.27       0.03       1.10       1.10        XXX
                                                       (ef).
78468...............  TC............  A               Heart infarct image         0.00       3.66         NA       0.19       3.85         NA        XXX
                                                       (ef).
78469...............  ..............  A               Heart infarct image         0.92       5.53         NA       0.31       6.76         NA        XXX
                                                       (3D).
78469...............  26............  A               Heart infarct image         0.92       0.31       0.31       0.03       1.26       1.26        XXX
                                                       (3D).
78469...............  TC............  A               Heart infarct image         0.00       5.21         NA       0.28       5.49         NA        XXX
                                                       (3D).
78472...............  ..............  A               Gated heart, planar,        0.98       5.84         NA       0.34       7.16         NA        XXX
                                                       single.
78472...............  26............  A               Gated heart, planar,        0.98       0.34       0.34       0.04       1.36       1.36        XXX
                                                       single.
78472...............  TC............  A               Gated heart, planar,        0.00       5.50         NA       0.30       5.80         NA        XXX
                                                       single.
78473...............  ..............  A               Gated heart, multiple       1.47       8.75         NA       0.48      10.70         NA        XXX
78473...............  26............  A               Gated heart, multiple       1.47       0.51       0.51       0.06       2.04       2.04        XXX
78473...............  TC............  A               Gated heart, multiple       0.00       8.24         NA       0.42       8.66         NA        XXX
78478...............  ..............  A               Heart wall motion add-      0.62       1.78         NA       0.12       2.52         NA        XXX
                                                       on.
78478...............  26............  A               Heart wall motion add-      0.62       0.22       0.22       0.02       0.86       0.86        XXX
                                                       on.
78478...............  TC............  A               Heart wall motion add-      0.00       1.55         NA       0.10       1.65         NA        XXX
                                                       on.
78480...............  ..............  A               Heart function add-on       0.62       1.78         NA       0.12       2.52         NA        XXX
78480...............  26............  A               Heart function add-on       0.62       0.22       0.22       0.02       0.86       0.86        XXX
78480...............  TC............  A               Heart function add-on       0.00       1.55         NA       0.10       1.65         NA        XXX
78481...............  ..............  A               Heart first pass,           0.98       5.57         NA       0.32       6.87         NA        XXX
                                                       single.
78481...............  26............  A               Heart first pass,           0.98       0.36       0.36       0.04       1.38       1.38        XXX
                                                       single.
78481...............  TC............  A               Heart first pass,           0.00       5.21         NA       0.28       5.49         NA        XXX
                                                       single.
78483...............  ..............  A               Heart first pass,           1.47       8.39         NA       0.46      10.32         NA        XXX
                                                       multiple.
78483...............  26............  A               Heart first pass,           1.47       0.54       0.54       0.05       2.06       2.06        XXX
                                                       multiple.
78483...............  TC............  A               Heart first pass,           0.00       7.86         NA       0.41       8.27         NA        XXX
                                                       multiple.
78494...............  ..............  A               Heart image, spect...       1.19       7.47         NA       0.35       9.01         NA        XXX
78494...............  26............  A               Heart image, spect...       1.19       0.42       0.42       0.05       1.66       1.66        XXX
78494...............  TC............  A               Heart image, spect...       0.00       7.06         NA       0.30       7.36         NA        XXX
78496...............  ..............  A               Heart first pass add-       0.50       7.24         NA       0.32       8.06         NA        ZZZ
                                                       on.
78496...............  26............  A               Heart first pass add-       0.50       0.18       0.18       0.02       0.70       0.70        ZZZ
                                                       on.
78496...............  TC............  A               Heart first pass add-       0.00       7.06         NA       0.30       7.36         NA        ZZZ
                                                       on.
78580...............  ..............  A               Lung perfusion              0.74       3.67         NA       0.21       4.62         NA        XXX
                                                       imaging.
78580...............  26............  A               Lung perfusion              0.74       0.25       0.25       0.03       1.02       1.02        XXX
                                                       imaging.
78580...............  TC............  A               Lung perfusion              0.00       3.43         NA       0.18       3.61         NA        XXX
                                                       imaging.
78584...............  ..............  A               Lung V/Q image single       0.99       3.52         NA       0.21       4.72         NA        XXX
                                                       breath.
78584...............  26............  A               Lung V/Q image single       0.99       0.32       0.32       0.04       1.35       1.35        XXX
                                                       breath.
78584...............  TC............  A               Lung V/Q image single       0.00       3.19         NA       0.17       3.36         NA        XXX
                                                       breath.
78585...............  ..............  A               Lung V/Q imaging.....       1.09       5.99         NA       0.35       7.43         NA        XXX
78585...............  26............  A               Lung V/Q imaging.....       1.09       0.36       0.36       0.05       1.50       1.50        XXX
78585...............  TC............  A               Lung V/Q imaging.....       0.00       5.63         NA       0.30       5.93         NA        XXX
78586...............  ..............  A               Aerosol lung image,         0.40       2.72         NA       0.16       3.28         NA        XXX
                                                       single.
78586...............  26............  A               Aerosol lung image,         0.40       0.13       0.13       0.02       0.55       0.55        XXX
                                                       single.
78586...............  TC............  A               Aerosol lung image,         0.00       2.59         NA       0.14       2.73         NA        XXX
                                                       single.
78587...............  ..............  A               Aerosol lung image,         0.49       2.96         NA       0.16       3.61         NA        XXX
                                                       multiple.
78587...............  26............  A               Aerosol lung image,         0.49       0.16       0.16       0.02       0.67       0.67        XXX
                                                       multiple.
78587...............  TC............  A               Aerosol lung image,         0.00       2.80         NA       0.14       2.94         NA        XXX
                                                       multiple.
78588...............  ..............  A               Perfusion lung image.       1.09       3.56         NA       0.23       4.88         NA        XXX
78588...............  26............  A               Perfusion lung image.       1.09       0.36       0.36       0.05       1.50       1.50        XXX
78588...............  TC............  A               Perfusion lung image.       0.00       3.19         NA       0.18       3.37         NA        XXX
78591...............  ..............  A               Vent image, 1 breath,       0.40       2.98         NA       0.16       3.54         NA        XXX
                                                       1 proj.
78591...............  26............  A               Vent image, 1 breath,       0.40       0.13       0.13       0.02       0.55       0.55        XXX
                                                       1 proj.
78591...............  TC............  A               Vent image, 1 breath,       0.00       2.85         NA       0.14       2.99         NA        XXX
                                                       1 proj.

[[Page 47673]]

 
78593...............  ..............  A               Vent image, 1 proj,         0.49       3.61         NA       0.20       4.30         NA        XXX
                                                       gas.
78593...............  26............  A               Vent image, 1 proj,         0.49       0.16       0.16       0.02       0.67       0.67        XXX
                                                       gas.
78593...............  TC............  A               Vent image, 1 proj,         0.00       3.45         NA       0.18       3.63         NA        XXX
                                                       gas.
78594...............  ..............  A               Vent image, mult            0.53       5.15         NA       0.27       5.95         NA        XXX
                                                       proj, gas.
78594...............  26............  A               Vent image, mult            0.53       0.18       0.18       0.02       0.73       0.73        XXX
                                                       proj, gas.
78594...............  TC............  A               Vent image, mult            0.00       4.97         NA       0.25       5.22         NA        XXX
                                                       proj, gas.
78596...............  ..............  A               Lung differential           1.27       7.48         NA       0.43       9.18         NA        XXX
                                                       function.
78596...............  26............  A               Lung differential           1.27       0.42       0.42       0.06       1.75       1.75        XXX
                                                       function.
78596...............  TC............  A               Lung differential           0.00       7.06         NA       0.37       7.43         NA        XXX
                                                       function.
78600...............  ..............  A               Brain imaging, ltd          0.44       3.03         NA       0.16       3.63         NA        XXX
                                                       static.
78600...............  26............  A               Brain imaging, ltd          0.44       0.15       0.15       0.02       0.61       0.61        XXX
                                                       static.
78600...............  TC............  A               Brain imaging, ltd          0.00       2.88         NA       0.14       3.02         NA        XXX
                                                       static.
78601...............  ..............  A               Brain imaging, ltd w/       0.51       3.57         NA       0.20       4.28         NA        XXX
                                                       flow.
78601...............  26............  A               Brain imaging, ltd w/       0.51       0.17       0.17       0.02       0.70       0.70        XXX
                                                       flow.
78601...............  TC............  A               Brain imaging, ltd w/       0.00       3.40         NA       0.18       3.58         NA        XXX
                                                       flow.
78605...............  ..............  A               Brain imaging,              0.53       3.58         NA       0.20       4.31         NA        XXX
                                                       complete.
78605...............  26............  A               Brain imaging,              0.53       0.18       0.18       0.02       0.73       0.73        XXX
                                                       complete.
78605...............  TC............  A               Brain imaging,              0.00       3.40         NA       0.18       3.58         NA        XXX
                                                       complete.
78606...............  ..............  A               Brain imaging, compl        0.64       4.07         NA       0.24       4.95         NA        XXX
                                                       w/flow.
78606...............  26............  A               Brain imaging, compl        0.64       0.21       0.21       0.03       0.88       0.88        XXX
                                                       w/flow.
78606...............  TC............  A               Brain imaging, compl        0.00       3.86         NA       0.21       4.07         NA        XXX
                                                       w/flow.
78607...............  ..............  A               Brain imaging (3D)...       1.23       6.97         NA       0.40       8.60         NA        XXX
78607...............  26............  A               Brain imaging (3D)...       1.23       0.43       0.43       0.05       1.71       1.71        XXX
78607...............  TC............  A               Brain imaging (3D)...       0.00       6.54         NA       0.35       6.89         NA        XXX
78610...............  ..............  A               Brain flow imaging          0.30       1.68         NA       0.11       2.09         NA        XXX
                                                       only.
78610...............  26............  A               Brain flow imaging          0.30       0.11       0.11       0.01       0.42       0.42        XXX
                                                       only.
78610...............  TC............  A               Brain flow imaging          0.00       1.57         NA       0.10       1.67         NA        XXX
                                                       only.
78615...............  ..............  A               Cerebral vascular           0.42       3.99         NA       0.23       4.64         NA        XXX
                                                       flow image.
78615...............  26............  A               Cerebral vascular           0.42       0.15       0.15       0.02       0.59       0.59        XXX
                                                       flow image.
78615...............  TC............  A               Cerebral vascular           0.00       3.84         NA       0.21       4.05         NA        XXX
                                                       flow image.
78630...............  ..............  A               Cerebrospinal fluid         0.68       5.26         NA       0.30       6.24         NA        XXX
                                                       scan.
78630...............  26............  A               Cerebrospinal fluid         0.68       0.23       0.23       0.03       0.94       0.94        XXX
                                                       scan.
78630...............  TC............  A               Cerebrospinal fluid         0.00       5.03         NA       0.27       5.30         NA        XXX
                                                       scan.
78635...............  ..............  A               CSF ventriculography.       0.61       2.77         NA       0.16       3.54         NA        XXX
78635...............  26............  A               CSF ventriculography.       0.61       0.23       0.23       0.02       0.86       0.86        XXX
78635...............  TC............  A               CSF ventriculography.       0.00       2.54         NA       0.14       2.68         NA        XXX
78645...............  ..............  A               CSF shunt evaluation.       0.57       3.62         NA       0.20       4.39         NA        XXX
78645...............  26............  A               CSF shunt evaluation.       0.57       0.19       0.19       0.02       0.78       0.78        XXX
78645...............  TC............  A               CSF shunt evaluation.       0.00       3.43         NA       0.18       3.61         NA        XXX
78647...............  ..............  A               Cerebrospinal fluid         0.90       6.21         NA       0.35       7.46         NA        XXX
                                                       scan.
78647...............  26............  A               Cerebrospinal fluid         0.90       0.31       0.31       0.04       1.25       1.25        XXX
                                                       scan.
78647...............  TC............  A               Cerebrospinal fluid         0.00       5.90         NA       0.31       6.21         NA        XXX
                                                       scan.
78650...............  ..............  A               CSF leakage imaging..       0.61       4.84         NA       0.27       5.72         NA        XXX
78650...............  26............  A               CSF leakage imaging..       0.61       0.21       0.21       0.03       0.85       0.85        XXX
78650...............  TC............  A               CSF leakage imaging..       0.00       4.63         NA       0.24       4.87         NA        XXX
78660...............  ..............  A               Nuclear exam of tear        0.53       2.29         NA       0.14       2.96         NA        XXX
                                                       flow.
78660...............  26............  A               Nuclear exam of tear        0.53       0.18       0.18       0.02       0.73       0.73        XXX
                                                       flow.
78660...............  TC............  A               Nuclear exam of tear        0.00       2.11         NA       0.12       2.23         NA        XXX
                                                       flow.
78700...............  ..............  A               Kidney imaging,             0.45       3.19         NA       0.18       3.82         NA        XXX
                                                       static.
78700...............  26............  A               Kidney imaging,             0.45       0.15       0.15       0.02       0.62       0.62        XXX
                                                       static.
78700...............  TC............  A               Kidney imaging,             0.00       3.04         NA       0.16       3.20         NA        XXX
                                                       static.
78701...............  ..............  A               Kidney imaging with         0.49       3.71         NA       0.20       4.40         NA        XXX
                                                       flow.
78701...............  26............  A               Kidney imaging with         0.49       0.16       0.16       0.02       0.67       0.67        XXX
                                                       flow.
78701...............  TC............  A               Kidney imaging with         0.00       3.55         NA       0.18       3.73         NA        XXX
                                                       flow.
78704...............  ..............  A               Imaging renogram.....       0.74       4.19         NA       0.24       5.17         NA        XXX
78704...............  26............  A               Imaging renogram.....       0.74       0.25       0.25       0.03       1.02       1.02        XXX
78704...............  TC............  A               Imaging renogram.....       0.00       3.95         NA       0.21       4.16         NA        XXX
78707...............  ..............  A               Kidney flow/function        0.96       4.78         NA       0.27       6.01         NA        XXX
                                                       image.
78707...............  26............  A               Kidney flow/function        0.96       0.32       0.32       0.04       1.32       1.32        XXX
                                                       image.
78707...............  TC............  A               Kidney flow/function        0.00       4.46         NA       0.23       4.69         NA        XXX
                                                       image.
78708...............  ..............  A               Kidney flow/function        1.21       4.87         NA       0.28       6.36         NA        XXX
                                                       image.
78708...............  26............  A               Kidney flow/function        1.21       0.41       0.41       0.05       1.67       1.67        XXX
                                                       image.
78708...............  TC............  A               Kidney flow/function        0.00       4.46         NA       0.23       4.69         NA        XXX
                                                       image.
78709...............  ..............  A               Kidney flow/function        1.41       4.93         NA       0.29       6.63         NA        XXX
                                                       image.
78709...............  26............  A               Kidney flow/function        1.41       0.47       0.47       0.06       1.94       1.94        XXX
                                                       image.
78709...............  TC............  A               Kidney flow/function        0.00       4.46         NA       0.23       4.69         NA        XXX
                                                       image.
78710...............  ..............  A               Kidney imaging (3D)..       0.66       6.12         NA       0.34       7.12         NA        XXX
78710...............  26............  A               Kidney imaging (3D)..       0.66       0.22       0.22       0.03       0.91       0.91        XXX
78710...............  TC............  A               Kidney imaging (3D)..       0.00       5.90         NA       0.31       6.21         NA        XXX
78715...............  ..............  A               Renal vascular flow         0.30       1.68         NA       0.11       2.09         NA        XXX
                                                       exam.
78715...............  26............  A               Renal vascular flow         0.30       0.11       0.11       0.01       0.42       0.42        XXX
                                                       exam.
78715...............  TC............  A               Renal vascular flow         0.00       1.57         NA       0.10       1.67         NA        XXX
                                                       exam.
78725...............  ..............  A               Kidney function study       0.38       1.90         NA       0.13       2.41         NA        XXX
78725...............  26............  A               Kidney function study       0.38       0.13       0.13       0.02       0.53       0.53        XXX
78725...............  TC............  A               Kidney function study       0.00       1.78         NA       0.11       1.89         NA        XXX

[[Page 47674]]

 
78730...............  ..............  A               Urinary bladder             0.36       1.58         NA       0.10       2.04         NA        XXX
                                                       retention.
78730...............  26............  A               Urinary bladder             0.36       0.12       0.12       0.02       0.50       0.50        XXX
                                                       retention.
78730...............  TC............  A               Urinary bladder             0.00       1.46         NA       0.08       1.54         NA        XXX
                                                       retention.
78740...............  ..............  A               Ureteral reflux study       0.57       2.30         NA       0.15       3.02         NA        XXX
78740...............  26............  A               Ureteral reflux study       0.57       0.19       0.19       0.03       0.79       0.79        XXX
78740...............  TC............  A               Ureteral reflux study       0.00       2.11         NA       0.12       2.23         NA        XXX
78760...............  ..............  A               Testicular imaging...       0.66       2.89         NA       0.17       3.72         NA        XXX
78760...............  26............  A               Testicular imaging...       0.66       0.22       0.22       0.03       0.91       0.91        XXX
78760...............  TC............  A               Testicular imaging...       0.00       2.67         NA       0.14       2.81         NA        XXX
78761...............  ..............  A               Testicular imaging/         0.71       3.43         NA       0.20       4.34         NA        XXX
                                                       flow.
78761...............  26............  A               Testicular imaging/         0.71       0.24       0.24       0.03       0.98       0.98        XXX
                                                       flow.
78761...............  TC............  A               Testicular imaging/         0.00       3.19         NA       0.17       3.36         NA        XXX
                                                       flow.
78800...............  ..............  A               Tumor imaging,              0.66       3.62         NA       0.22       4.50         NA        XXX
                                                       limited area.
78800...............  26............  A               Tumor imaging,              0.66       0.22       0.22       0.04       0.92       0.92        XXX
                                                       limited area.
78800...............  TC............  A               Tumor imaging,              0.00       3.40         NA       0.18       3.58         NA        XXX
                                                       limited area.
78801...............  ..............  A               Tumor imaging, mult         0.79       4.48         NA       0.27       5.54         NA        XXX
                                                       areas.
78801...............  26............  A               Tumor imaging, mult         0.79       0.27       0.27       0.05       1.11       1.11        XXX
                                                       areas.
78801...............  TC............  A               Tumor imaging, mult         0.00       4.22         NA       0.22       4.44         NA        XXX
                                                       areas.
78802...............  ..............  A               Tumor imaging, whole        0.86       5.81         NA       0.34       7.01         NA        XXX
                                                       body.
78802...............  26............  A               Tumor imaging, whole        0.86       0.29       0.29       0.04       1.19       1.19        XXX
                                                       body.
78802...............  TC............  A               Tumor imaging, whole        0.00       5.52         NA       0.30       5.82         NA        XXX
                                                       body.
78803...............  ..............  A               Tumor imaging (3D)...       1.09       6.93         NA       0.40       8.42         NA        XXX
78803...............  26............  A               Tumor imaging (3D)...       1.09       0.38       0.38       0.05       1.52       1.52        XXX
78803...............  TC............  A               Tumor imaging (3D)...       0.00       6.54         NA       0.35       6.89         NA        XXX
78804...............  ..............  A               Tumor imaging, whole        1.07      11.41         NA       0.34      12.82         NA        XXX
                                                       body.
78804...............  26............  A               Tumor imaging, whole        1.07       0.37       0.37       0.04       1.48       1.48        XXX
                                                       body.
78804...............  TC............  A               Tumor imaging, whole        0.00      11.04         NA       0.30      11.34         NA        XXX
                                                       body.
78805...............  ..............  A               Abscess imaging, ltd        0.73       3.65         NA       0.21       4.59         NA        XXX
                                                       area.
78805...............  26............  A               Abscess imaging, ltd        0.73       0.25       0.25       0.03       1.01       1.01        XXX
                                                       area.
78805...............  TC............  A               Abscess imaging, ltd        0.00       3.40         NA       0.18       3.58         NA        XXX
                                                       area.
78806...............  ..............  A               Abscess imaging,            0.86       6.71         NA       0.39       7.96         NA        XXX
                                                       whole body.
78806...............  26............  A               Abscess imaging,            0.86       0.29       0.29       0.04       1.19       1.19        XXX
                                                       whole body.
78806...............  TC............  A               Abscess imaging,            0.00       6.42         NA       0.35       6.77         NA        XXX
                                                       whole body.
78807...............  ..............  A               Nuclear localization/       1.09       6.93         NA       0.40       8.42         NA        XXX
                                                       abscess.
78807...............  26............  A               Nuclear localization/       1.09       0.39       0.39       0.05       1.53       1.53        XXX
                                                       abscess.
78807...............  TC............  A               Nuclear localization/       0.00       6.54         NA       0.35       6.89         NA        XXX
                                                       abscess.
78890...............  ..............  B               Nuclear medicine data       0.05       1.32         NA       0.07       1.44         NA        XXX
                                                       proc.
78890...............  26............  B               Nuclear medicine data       0.05       0.02       0.02       0.01       0.08       0.08        XXX
                                                       proc.
78890...............  TC............  B               Nuclear medicine data       0.00       1.30         NA       0.06       1.36         NA        XXX
                                                       proc.
78891...............  ..............  B               Nuclear med data proc       0.10       2.65         NA       0.14       2.89         NA        XXX
78891...............  26............  B               Nuclear med data proc       0.10       0.04       0.04       0.01       0.15       0.15        XXX
78891...............  TC............  B               Nuclear med data proc       0.00       2.62         NA       0.13       2.75         NA        XXX
79000...............  ..............  A               Init hyperthyroid           1.80       3.22         NA       0.22       5.24         NA        XXX
                                                       therapy.
79000...............  26............  A               Init hyperthyroid           1.80       0.60       0.60       0.08       2.48       2.48        XXX
                                                       therapy.
79000...............  TC............  A               Init hyperthyroid           0.00       2.62         NA       0.14       2.76         NA        XXX
                                                       therapy.
79001...............  ..............  A               Repeat hyperthyroid         1.05       1.66         NA       0.12       2.83         NA        XXX
                                                       therapy.
79001...............  26............  A               Repeat hyperthyroid         1.05       0.36       0.36       0.05       1.46       1.46        XXX
                                                       therapy.
79001...............  TC............  A               Repeat hyperthyroid         0.00       1.30         NA       0.07       1.37         NA        XXX
                                                       therapy.
79020...............  ..............  A               Thyroid ablation.....       1.81       3.21         NA       0.22       5.24         NA        XXX
79020...............  26............  A               Thyroid ablation.....       1.81       0.60       0.60       0.08       2.49       2.49        XXX
79020...............  TC............  A               Thyroid ablation.....       0.00       2.62         NA       0.14       2.76         NA        XXX
79030...............  ..............  A               Thyroid ablation,           2.10       3.32         NA       0.23       5.65         NA        XXX
                                                       carcinoma.
79030...............  26............  A               Thyroid ablation,           2.10       0.71       0.71       0.09       2.90       2.90        XXX
                                                       carcinoma.
79030...............  TC............  A               Thyroid ablation,           0.00       2.62         NA       0.14       2.76         NA        XXX
                                                       carcinoma.
79035...............  ..............  A               Thyroid metastatic          2.52       3.49         NA       0.25       6.26         NA        XXX
                                                       therapy.
79035...............  26............  A               Thyroid metastatic          2.52       0.87       0.87       0.11       3.50       3.50        XXX
                                                       therapy.
79035...............  TC............  A               Thyroid metastatic          0.00       2.62         NA       0.14       2.76         NA        XXX
                                                       therapy.
79100...............  ..............  A               Hematopoetic nuclear        1.32       3.08         NA       0.20       4.60         NA        XXX
                                                       therapy.
79100...............  26............  A               Hematopoetic nuclear        1.32       0.46       0.46       0.06       1.84       1.84        XXX
                                                       therapy.
79100...............  TC............  A               Hematopoetic nuclear        0.00       2.62         NA       0.14       2.76         NA        XXX
                                                       therapy.
79200...............  ..............  A               Intracavitary nuclear       1.99       3.30         NA       0.23       5.52         NA        XXX
                                                       trmt.
79200...............  26............  A               Intracavitary nuclear       1.99       0.69       0.69       0.09       2.77       2.77        XXX
                                                       trmt.
79200...............  TC............  A               Intracavitary nuclear       0.00       2.62         NA       0.14       2.76         NA        XXX
                                                       trmt.
79300...............  26............  A               Interstitial nuclear        1.60       0.56       0.56       0.08       2.24       2.24        XXX
                                                       therapy.
79400...............  ..............  A               Nonhemato nuclear           1.96       3.29         NA       0.23       5.48         NA        XXX
                                                       therapy.
79400...............  26............  A               Nonhemato nuclear           1.96       0.67       0.67       0.09       2.72       2.72        XXX
                                                       therapy.
79400...............  TC............  A               Nonhemato nuclear           0.00       2.62         NA       0.14       2.76         NA        XXX
                                                       therapy.
79403...............  ..............  A               Hematopoetic nuclear        2.25       5.16         NA       0.24       7.65         NA        XXX
                                                       therapy.
79403...............  26............  A               Hematopoetic nuclear        2.25       0.89       0.89       0.10       3.24       3.24        XXX
                                                       therapy.
79403...............  TC............  A               Hematopoetic nuclear        0.00       4.27         NA       0.14       4.41         NA        XXX
                                                       therapy.
79420...............  26............  A               Intravascular nuclear       1.51       0.49       0.49       0.07       2.07       2.07        XXX
                                                       ther.
79440...............  ..............  A               Nuclear joint therapy       1.99       3.34         NA       0.24       5.57         NA        XXX
79440...............  26............  A               Nuclear joint therapy       1.99       0.72       0.72       0.10       2.81       2.81        XXX
79440...............  TC............  A               Nuclear joint therapy       0.00       2.62         NA       0.14       2.76         NA        XXX
80500...............  ..............  A               Lab pathology               0.37       0.21       0.16       0.01       0.59       0.54        XXX
                                                       consultation.

[[Page 47675]]

 
80502...............  ..............  A               Lab pathology               1.33       0.55       0.55       0.06       1.94       1.94        XXX
                                                       consultation.
83020...............  26............  A               Hemoglobin                  0.37       0.15       0.15       0.01       0.53       0.53        XXX
                                                       electrophoresis.
83912...............  26............  A               Genetic examination..       0.37       0.12       0.12       0.01       0.50       0.50        XXX
84165...............  26............  A               Electrophoreisis of         0.37       0.14       0.14       0.01       0.52       0.52        XXX
                                                       proteins.
84181...............  26............  A               Western blot test....       0.37       0.14       0.14       0.02       0.53       0.53        XXX
84182...............  26............  A               Protein, western blot       0.37       0.16       0.16       0.01       0.54       0.54        XXX
                                                       test.
85060...............  ..............  A               Blood smear                 0.45       0.18       0.18       0.02       0.65       0.65        XXX
                                                       interpretation.
85097...............  ..............  A               Bone marrow                 0.94       2.02       0.42       0.04       3.00       1.40        XXX
                                                       interpretation.
85390...............  26............  A               Fibrinolysins screen.       0.37       0.13       0.13       0.02       0.52       0.52        XXX
85396...............  ..............  A               Clotting assay, whole       0.37         NA       0.16       0.04         NA       0.57        XXX
                                                       blood.
85576...............  26............  A               Blood platelet              0.37       0.16       0.16       0.02       0.55       0.55        XXX
                                                       aggregation.
86077...............  ..............  A               Physician blood bank        0.94       0.40       0.40       0.04       1.38       1.38        XXX
                                                       service.
86078...............  ..............  A               Physician blood bank        0.94       0.47       0.41       0.04       1.45       1.39        XXX
                                                       service.
86079...............  ..............  A               Physician blood bank        0.94       0.45       0.41       0.04       1.43       1.39        XXX
                                                       service.
86255...............  26............  A               Fluorescent antibody,       0.37       0.16       0.16       0.01       0.54       0.54        XXX
                                                       screen.
86256...............  26............  A               Fluorescent antibody,       0.37       0.15       0.15       0.01       0.53       0.53        XXX
                                                       titer.
86320...............  26............  A               Serum                       0.37       0.15       0.15       0.01       0.53       0.53        XXX
                                                       immunoelectrophoresi
                                                       s.
86325...............  26............  A               Other                       0.37       0.13       0.13       0.01       0.51       0.51        XXX
                                                       immunoelectrophoresi
                                                       s.
86327...............  26............  A               Immunoelectrophoresis       0.42       0.18       0.18       0.02       0.62       0.62        XXX
                                                       assay.
86334...............  26............  A               Immunofixation              0.37       0.16       0.16       0.01       0.54       0.54        XXX
                                                       procedure.
86490...............  ..............  A               Coccidioidomycosis          0.00       0.29         NA       0.02       0.31         NA        XXX
                                                       skin test.
86510...............  ..............  A               Histoplasmosis skin         0.00       0.32         NA       0.02       0.34         NA        XXX
                                                       test.
86580...............  ..............  A               TB intradermal test..       0.00       0.25         NA       0.02       0.27         NA        XXX
86585...............  ..............  A               TB tine test.........       0.00       0.20         NA       0.01       0.21         NA        XXX
87164...............  26............  A               Dark field                  0.37       0.12       0.12       0.01       0.50       0.50        XXX
                                                       examination.
87207...............  26............  A               Smear, special stain.       0.37       0.16       0.16       0.01       0.54       0.54        XXX
88104...............  ..............  A               Cytopathology, fluids       0.56       0.86         NA       0.04       1.46         NA        XXX
88104...............  26............  A               Cytopathology, fluids       0.56       0.24       0.24       0.02       0.82       0.82        XXX
88104...............  TC............  A               Cytopathology, fluids       0.00       0.62         NA       0.02       0.64         NA        XXX
88106...............  ..............  A               Cytopathology, fluids       0.56       1.37         NA       0.04       1.97         NA        XXX
88106...............  26............  A               Cytopathology, fluids       0.56       0.24       0.24       0.02       0.82       0.82        XXX
88106...............  TC............  A               Cytopathology, fluids       0.00       1.13         NA       0.02       1.15         NA        XXX
88107...............  ..............  A               Cytopathology, fluids       0.76       1.56         NA       0.05       2.37         NA        XXX
88107...............  26............  A               Cytopathology, fluids       0.76       0.33       0.33       0.03       1.12       1.12        XXX
88107...............  TC............  A               Cytopathology, fluids       0.00       1.23         NA       0.02       1.25         NA        XXX
88108...............  ..............  A               Cytopath, concentrate       0.56       1.22         NA       0.04       1.82         NA        XXX
                                                       tech.
88108...............  26............  A               Cytopath, concentrate       0.56       0.24       0.24       0.02       0.82       0.82        XXX
                                                       tech.
88108...............  TC............  A               Cytopath, concentrate       0.00       0.98         NA       0.02       1.00         NA        XXX
                                                       tech.
88112...............  ..............  A               Cytopath, cell              1.18       1.98         NA       0.04       3.20         NA        XXX
                                                       enhance tech.
88112...............  26............  A               Cytopath, cell              1.18       0.51       0.51       0.02       1.71       1.71        XXX
                                                       enhance tech.
88112...............  TC............  A               Cytopath, cell              0.00       1.47         NA       0.02       1.49         NA        XXX
                                                       enhance tech.
88125...............  ..............  A               Forensic                    0.26       0.09         NA       0.02       0.37         NA        XXX
                                                       cytopathology.
88125...............  26............  A               Forensic                    0.26       0.11       0.11       0.01       0.38       0.38        XXX
                                                       cytopathology.
88125...............  TC............  A               Forensic                    0.00      -0.03         NA       0.01      -0.02         NA        XXX
                                                       cytopathology.
88141...............  ..............  A               Cytopath, c/v,              0.42       0.15       0.15       0.02       0.59       0.59        XXX
                                                       interpret.
88160...............  ..............  A               Cytopath smear, other       0.50       0.85         NA       0.04       1.39         NA        XXX
                                                       source.
88160...............  26............  A               Cytopath smear, other       0.50       0.22       0.22       0.02       0.74       0.74        XXX
                                                       source.
88160...............  TC............  A               Cytopath smear, other       0.00       0.63         NA       0.02       0.65         NA        XXX
                                                       source.
88161...............  ..............  A               Cytopath smear, other       0.50       0.95         NA       0.04       1.49         NA        XXX
                                                       source.
88161...............  26............  A               Cytopath smear, other       0.50       0.21       0.21       0.02       0.73       0.73        XXX
                                                       source.
88161...............  TC............  A               Cytopath smear, other       0.00       0.74         NA       0.02       0.76         NA        XXX
                                                       source.
88162...............  ..............  A               Cytopath smear, other       0.76       1.04         NA       0.05       1.85         NA        XXX
                                                       source.
88162...............  26............  A               Cytopath smear, other       0.76       0.33       0.33       0.03       1.12       1.12        XXX
                                                       source.
88162...............  TC............  A               Cytopath smear, other       0.00       0.71         NA       0.02       0.73         NA        XXX
                                                       source.
88172...............  ..............  A               Cytopathology eval of       0.60       0.74         NA       0.04       1.38         NA        XXX
                                                       fna.
88172...............  26............  A               Cytopathology eval of       0.60       0.26       0.26       0.02       0.88       0.88        XXX
                                                       fna.
88172...............  TC............  A               Cytopathology eval of       0.00       0.48         NA       0.02       0.50         NA        XXX
                                                       fna.
88173...............  ..............  A               Cytopath eval, fna,         1.39       2.18         NA       0.07       3.64         NA        XXX
                                                       report.
88173...............  26............  A               Cytopath eval, fna,         1.39       0.60       0.60       0.05       2.04       2.04        XXX
                                                       report.
88173...............  TC............  A               Cytopath eval, fna,         0.00       1.58         NA       0.02       1.60         NA        XXX
                                                       report.
88180...............  ..............  A               Cell marker study....       0.36       1.27         NA       0.03       1.66         NA        XXX
88180...............  26............  A               Cell marker study....       0.36       0.16       0.16       0.01       0.53       0.53        XXX
88180...............  TC............  A               Cell marker study....       0.00       1.11         NA       0.02       1.13         NA        XXX
88182...............  ..............  A               Cell marker study....       0.77       2.04         NA       0.07       2.88         NA        XXX
88182...............  26............  A               Cell marker study....       0.77       0.33       0.33       0.03       1.13       1.13        XXX
88182...............  TC............  A               Cell marker study....       0.00       1.70         NA       0.04       1.74         NA        XXX
88291...............  ..............  A               Cyto/molecular report       0.52       0.18       0.18       0.03       0.73       0.73        XXX
88300...............  ..............  A               Surgical path, gross.       0.08       0.46         NA       0.01       0.55         NA        XXX
88300...............  26............  A               Surgical path, gross.       0.08       0.03       0.03       0.00       0.11       0.11        XXX
88300...............  TC............  A               Surgical path, gross.       0.00       0.42         NA       0.01       0.43         NA        XXX
88302...............  ..............  A               Tissue exam by              0.13       1.03         NA       0.02       1.18         NA        XXX
                                                       pathologist.
88302...............  26............  A               Tissue exam by              0.13       0.06       0.06       0.00       0.19       0.19        XXX
                                                       pathologist.
88302...............  TC............  A               Tissue exam by              0.00       0.97         NA       0.02       0.99         NA        XXX
                                                       pathologist.
88304...............  ..............  A               Tissue exam by              0.22       1.34         NA       0.03       1.59         NA        XXX
                                                       pathologist.
88304...............  26............  A               Tissue exam by              0.22       0.10       0.10       0.01       0.33       0.33        XXX
                                                       pathologist.

[[Page 47676]]

 
88304...............  TC............  A               Tissue exam by              0.00       1.24         NA       0.02       1.26         NA        XXX
                                                       pathologist.
88305...............  ..............  A               Tissue exam by              0.75       1.92         NA       0.07       2.74         NA        XXX
                                                       pathologist.
88305...............  26............  A               Tissue exam by              0.75       0.33       0.33       0.03       1.11       1.11        XXX
                                                       pathologist.
88305...............  TC............  A               Tissue exam by              0.00       1.59         NA       0.04       1.63         NA        XXX
                                                       pathologist.
88307...............  ..............  A               Tissue exam by              1.59       3.16         NA       0.12       4.87         NA        XXX
                                                       pathologist.
88307...............  26............  A               Tissue exam by              1.59       0.69       0.69       0.06       2.34       2.34        XXX
                                                       pathologist.
88307...............  TC............  A               Tissue exam by              0.00       2.47         NA       0.06       2.53         NA        XXX
                                                       pathologist.
88309...............  ..............  A               Tissue exam by              2.28       4.41         NA       0.15       6.84         NA        XXX
                                                       pathologist.
88309...............  26............  A               Tissue exam by              2.28       0.99       0.99       0.09       3.36       3.36        XXX
                                                       pathologist.
88309...............  TC............  A               Tissue exam by              0.00       3.43         NA       0.06       3.49         NA        XXX
                                                       pathologist.
88311...............  ..............  A               Decalcify tissue.....       0.24       0.24         NA       0.02       0.50         NA        XXX
88311...............  26............  A               Decalcify tissue.....       0.24       0.10       0.10       0.01       0.35       0.35        XXX
88311...............  TC............  A               Decalcify tissue.....       0.00       0.13         NA       0.01       0.14         NA        XXX
88312...............  ..............  A               Special stains.......       0.54       1.52         NA       0.03       2.09         NA        XXX
88312...............  26............  A               Special stains.......       0.54       0.23       0.23       0.02       0.79       0.79        XXX
88312...............  TC............  A               Special stains.......       0.00       1.28         NA       0.01       1.29         NA        XXX
88313...............  ..............  A               Special stains.......       0.24       1.25         NA       0.02       1.51         NA        XXX
88313...............  26............  A               Special stains.......       0.24       0.10       0.10       0.01       0.35       0.35        XXX
88313...............  TC............  A               Special stains.......       0.00       1.14         NA       0.01       1.15         NA        XXX
88314...............  ..............  A               Histochemical stain..       0.45       2.05         NA       0.04       2.54         NA        XXX
88314...............  26............  A               Histochemical stain..       0.45       0.19       0.19       0.02       0.66       0.66        XXX
88314...............  TC............  A               Histochemical stain..       0.00       1.86         NA       0.02       1.88         NA        XXX
88318...............  ..............  A               Chemical                    0.42       1.66         NA       0.03       2.11         NA        XXX
                                                       histochemistry.
88318...............  26............  A               Chemical                    0.42       0.18       0.18       0.02       0.62       0.62        XXX
                                                       histochemistry.
88318...............  TC............  A               Chemical                    0.00       1.48         NA       0.01       1.49         NA        XXX
                                                       histochemistry.
88319...............  ..............  A               Enzyme histochemistry       0.53       3.44         NA       0.04       4.01         NA        XXX
88319...............  26............  A               Enzyme histochemistry       0.53       0.23       0.23       0.02       0.78       0.78        XXX
88319...............  TC............  A               Enzyme histochemistry       0.00       3.21         NA       0.02       3.23         NA        XXX
88321...............  ..............  A               Microslide                  1.30       0.80       0.56       0.05       2.15       1.91        XXX
                                                       consultation.
88323...............  ..............  A               Microslide                  1.35       1.80         NA       0.07       3.22         NA        XXX
                                                       consultation.
88323...............  26............  A               Microslide                  1.35       0.58       0.58       0.05       1.98       1.98        XXX
                                                       consultation.
88323...............  TC............  A               Microslide                  0.00       1.22         NA       0.02       1.24         NA        XXX
                                                       consultation.
88325...............  ..............  A               Comprehensive review        2.22       2.97       0.96       0.10       5.29       3.28        XXX
                                                       of data.
88329...............  ..............  A               Path consult introp..       0.67       0.65       0.29       0.03       1.35       0.99        XXX
88331...............  ..............  A               Path consult intraop,       1.19       1.11         NA       0.09       2.39         NA        XXX
                                                       1 bloc.
88331...............  26............  A               Path consult intraop,       1.19       0.52       0.52       0.05       1.76       1.76        XXX
                                                       1 bloc.
88331...............  TC............  A               Path consult intraop,       0.00       0.60         NA       0.04       0.64         NA        XXX
                                                       1 bloc.
88332...............  ..............  A               Path consult intraop,       0.59       0.46         NA       0.04       1.09         NA        XXX
                                                       add-l.
88332...............  26............  A               Path consult intraop,       0.59       0.26       0.26       0.02       0.87       0.87        XXX
                                                       add-l.
88332...............  TC............  A               Path consult intraop,       0.00       0.21         NA       0.02       0.23         NA        XXX
                                                       add-l.
88342...............  ..............  A               Immunohistochemistry.       0.85       1.48         NA       0.05       2.38         NA        XXX
88342...............  26............  A               Immunohistochemistry.       0.85       0.37       0.37       0.03       1.25       1.25        XXX
88342...............  TC............  A               Immunohistochemistry.       0.00       1.11         NA       0.02       1.13         NA        XXX
88346...............  ..............  A               Immunofluorescent           0.86       1.57         NA       0.05       2.48         NA        XXX
                                                       study.
88346...............  26............  A               Immunofluorescent           0.86       0.37       0.37       0.03       1.26       1.26        XXX
                                                       study.
88346...............  TC............  A               Immunofluorescent           0.00       1.21         NA       0.02       1.23         NA        XXX
                                                       study.
88347...............  ..............  A               Immunofluorescent           0.86       1.27         NA       0.05       2.18         NA        XXX
                                                       study.
88347...............  26............  A               Immunofluorescent           0.86       0.35       0.35       0.03       1.24       1.24        XXX
                                                       study.
88347...............  TC............  A               Immunofluorescent           0.00       0.92         NA       0.02       0.94         NA        XXX
                                                       study.
88348...............  ..............  A               Electron microscopy..       1.51       9.58         NA       0.13      11.22         NA        XXX
88348...............  26............  A               Electron microscopy..       1.51       0.65       0.65       0.06       2.22       2.22        XXX
88348...............  TC............  A               Electron microscopy..       0.00       8.93         NA       0.07       9.00         NA        XXX
88349...............  ..............  A               Scanning electron           0.76       3.67         NA       0.09       4.52         NA        XXX
                                                       microscopy.
88349...............  26............  A               Scanning electron           0.76       0.33       0.33       0.03       1.12       1.12        XXX
                                                       microscopy.
88349...............  TC............  A               Scanning electron           0.00       3.34         NA       0.06       3.40         NA        XXX
                                                       microscopy.
88355...............  ..............  A               Analysis, skeletal          1.85       6.71         NA       0.13       8.69         NA        XXX
                                                       muscle.
88355...............  26............  A               Analysis, skeletal          1.85       0.80       0.80       0.07       2.72       2.72        XXX
                                                       muscle.
88355...............  TC............  A               Analysis, skeletal          0.00       5.91         NA       0.06       5.97         NA        XXX
                                                       muscle.
88356...............  ..............  A               Analysis, nerve......       3.02       3.80         NA       0.20       7.02         NA        XXX
88356...............  26............  A               Analysis, nerve......       3.02       1.27       1.27       0.13       4.42       4.42        XXX
88356...............  TC............  A               Analysis, nerve......       0.00       2.53         NA       0.07       2.60         NA        XXX
88358...............  ..............  A               Analysis, tumor......       0.95       0.71         NA       0.18       1.84         NA        XXX
88358...............  26............  A               Analysis, tumor......       0.95       0.41       0.41       0.11       1.47       1.47        XXX
88358...............  TC............  A               Analysis, tumor......       0.00       0.30         NA       0.07       0.37         NA        XXX
88361...............  ..............  A               Immunohistochemistry,       0.94       2.59         NA       0.18       3.71         NA        XXX
                                                       tumor.
88361...............  26............  A               Immunohistochemistry,       0.94       0.40       0.40       0.11       1.45       1.45        XXX
                                                       tumor.
88361...............  TC............  A               Immunohistochemistry,       0.00       2.19         NA       0.07       2.26         NA        XXX
                                                       tumor.
88362...............  ..............  A               Nerve teasing               2.17       4.73         NA       0.15       7.05         NA        XXX
                                                       preparations.
88362...............  26............  A               Nerve teasing               2.17       0.92       0.92       0.09       3.18       3.18        XXX
                                                       preparations.
88362...............  TC............  A               Nerve teasing               0.00       3.80         NA       0.06       3.86         NA        XXX
                                                       preparations.
88365...............  ..............  A               Tissue hybridization.       0.93       3.04         NA       0.06       4.03         NA        XXX
88365...............  26............  A               Tissue hybridization.       0.93       0.40       0.40       0.04       1.37       1.37        XXX
88365...............  TC............  A               Tissue hybridization.       0.00       2.63         NA       0.02       2.65         NA        XXX
88371...............  26............  A               Protein, western blot       0.37       0.13       0.13       0.02       0.52       0.52        XXX
                                                       tissue.
88372...............  26............  A               Protein analysis w/         0.37       0.16       0.16       0.01       0.54       0.54        XXX
                                                       probe.

[[Page 47677]]

 
89060...............  26............  A               Exam,synovial fluid         0.37       0.16       0.16       0.01       0.54       0.54        XXX
                                                       crystals.
89100...............  ..............  A               Sample intestinal           0.60       1.85       0.21       0.03       2.48       0.84        XXX
                                                       contents.
89105...............  ..............  A               Sample intestinal           0.50       2.24       0.17       0.02       2.76       0.69        XXX
                                                       contents.
89130...............  ..............  A               Sample stomach              0.45       1.74       0.13       0.03       2.22       0.61        XXX
                                                       contents.
89132...............  ..............  A               Sample stomach              0.19       1.54       0.06       0.01       1.74       0.26        XXX
                                                       contents.
89135...............  ..............  A               Sample stomach              0.79       1.91       0.25       0.03       2.73       1.07        XXX
                                                       contents.
89136...............  ..............  A               Sample stomach              0.21       1.78       0.09       0.01       2.00       0.31        XXX
                                                       contents.
89140...............  ..............  A               Sample stomach              0.94       2.12       0.27       0.04       3.10       1.25        XXX
                                                       contents.
89141...............  ..............  A               Sample stomach              0.85       2.82       0.34       0.03       3.70       1.22        XXX
                                                       contents.
89220...............  ..............  A               Sputum specimen             0.00         NA         NA       0.00         NA         NA        XXX
                                                       collection.
89230...............  ..............  A               Collect sweat for           0.00         NA         NA       0.00         NA         NA        XXX
                                                       test.
90471...............  ..............  A               Immunization admin...       0.00       0.20         NA       0.01       0.21         NA        XXX
90472...............  ..............  A               Immunization admin,         0.00       0.14         NA       0.01       0.15         NA        ZZZ
                                                       each add.
90780...............  ..............  A               IV infusion therapy,        0.17       2.14         NA       0.07       2.38         NA        XXX
                                                       1 hour.
90781...............  ..............  A               IV infusion,                0.17       0.46         NA       0.04       0.67         NA        ZZZ
                                                       additional hour.
90782...............  ..............  T               Injection, sc/im.....       0.17       0.31         NA       0.01       0.49         NA        XXX
90783...............  ..............  T               Injection, ia........       0.17       0.32         NA       0.02       0.51         NA        XXX
90784...............  ..............  T               Injection, iv........       0.17       0.80         NA       0.04       1.01         NA        XXX
90788...............  ..............  T               Injection of                0.17       0.27         NA       0.01       0.45         NA        XXX
                                                       antibiotic.
90801...............  ..............  A               Psy dx interview.....       2.80       1.17       0.93       0.08       4.05       3.81        XXX
90802...............  ..............  A               Intac psy dx                3.01       1.20       0.97       0.08       4.29       4.06        XXX
                                                       interview.
90804...............  ..............  A               Psytx, office, 20-30        1.21       0.49       0.38       0.03       1.73       1.62        XXX
                                                       min.
90805...............  ..............  A               Psytx, off, 20-30 min       1.37       0.50       0.42       0.04       1.91       1.83        XXX
                                                       w/e&m.
90806...............  ..............  A               Psytx, off, 45-50 min       1.86       0.70       0.60       0.05       2.61       2.51        XXX
90807...............  ..............  A               Psytx, off, 45-50 min       2.02       0.70       0.63       0.05       2.77       2.70        XXX
                                                       w/e&m.
90808...............  ..............  A               Psytx, office, 75-80        2.79       1.02       0.90       0.07       3.88       3.76        XXX
                                                       min.
90809...............  ..............  A               Psytx, off, 75-80, w/       2.95       1.00       0.92       0.08       4.03       3.95        XXX
                                                       e&m.
90810...............  ..............  A               Intac psytx, off, 20-       1.32       0.51       0.42       0.04       1.87       1.78        XXX
                                                       30 min.
90811...............  ..............  A               Intac psytx, 20-30, w/      1.48       0.57       0.46       0.04       2.09       1.98        XXX
                                                       e&m.
90812...............  ..............  A               Intac psytx, off, 45-       1.97       0.78       0.64       0.05       2.80       2.66        XXX
                                                       50 min.
90813...............  ..............  A               Intac psytx, 45-50          2.13       0.77       0.67       0.05       2.95       2.85        XXX
                                                       min w/e&m.
90814...............  ..............  A               Intac psytx, off, 75-       2.90       1.10       0.98       0.07       4.07       3.95        XXX
                                                       80 min.
90815...............  ..............  A               Intac psytx, 75-80 w/       3.06       1.05       0.95       0.07       4.18       4.08        XXX
                                                       e&m.
90816...............  ..............  A               Psytx, hosp, 20-30          1.25         NA       0.46       0.03         NA       1.74        XXX
                                                       min.
90817...............  ..............  A               Psytx, hosp, 20-30          1.41         NA       0.46       0.04         NA       1.91        XXX
                                                       min w/e&m.
90818...............  ..............  A               Psytx, hosp, 45-50          1.89         NA       0.69       0.05         NA       2.63        XXX
                                                       min.
90819...............  ..............  A               Psytx, hosp, 45-50          2.05         NA       0.65       0.05         NA       2.75        XXX
                                                       min w/e&m.
90821...............  ..............  A               Psytx, hosp, 75-80          2.83         NA       1.00       0.07         NA       3.90        XXX
                                                       min.
90822...............  ..............  A               Psytx, hosp, 75-80          2.99         NA       0.94       0.09         NA       4.02        XXX
                                                       min w/e&m.
90823...............  ..............  A               Intac psytx, hosp, 20-      1.36         NA       0.48       0.03         NA       1.87        XXX
                                                       30 min.
90824...............  ..............  A               Intac psytx, hsp 20-        1.52         NA       0.49       0.04         NA       2.05        XXX
                                                       30 w/e&m.
90826...............  ..............  A               Intac psytx, hosp, 45-      2.01         NA       0.72       0.05         NA       2.78        XXX
                                                       50 min.
90827...............  ..............  A               Intac psytx, hsp 45-        2.16         NA       0.68       0.05         NA       2.89        XXX
                                                       50 w/e&m.
90828...............  ..............  A               Intac psytx, hosp, 75-      2.94         NA       1.06       0.07         NA       4.07        XXX
                                                       80 min.
90829...............  ..............  A               Intac psytx, hsp 75-        3.10         NA       0.98       0.07         NA       4.15        XXX
                                                       80 w/e&m.
90845...............  ..............  A               Psychoanalysis.......       1.79       0.58       0.55       0.04       2.41       2.38        XXX
90846...............  ..............  R               Family psytx w/o            1.83       0.65       0.64       0.05       2.53       2.52        XXX
                                                       patient.
90847...............  ..............  R               Family psytx w/             2.21       0.81       0.76       0.06       3.08       3.03        XXX
                                                       patient.
90849...............  ..............  R               Multiple family group       0.59       0.27       0.24       0.02       0.88       0.85        XXX
                                                       psytx.
90853...............  ..............  A               Group psychotherapy..       0.59       0.25       0.23       0.02       0.86       0.84        XXX
90857...............  ..............  A               Intac group psytx....       0.63       0.29       0.25       0.02       0.94       0.90        XXX
90862...............  ..............  A               Medication management       0.95       0.40       0.32       0.03       1.38       1.30        XXX
90865...............  ..............  A               Narcosynthesis.......       2.84       1.38       0.91       0.11       4.33       3.86        XXX
90870...............  ..............  A               Electroconvulsive           1.88       1.43       0.59       0.05       3.36       2.52        000
                                                       therapy.
90880...............  ..............  A               Hypnotherapy.........       2.19       1.04       0.69       0.06       3.29       2.94        XXX
90885...............  ..............  B               Psy evaluation of           0.97       0.37       0.37       0.02       1.36       1.36        XXX
                                                       records.
90887...............  ..............  B               Consultation with           1.48       0.82       0.56       0.04       2.34       2.08        XXX
                                                       family.
90901...............  ..............  A               Biofeedback train,          0.41       0.65       0.14       0.02       1.08       0.57        000
                                                       any meth.
90911...............  ..............  A               Biofeedback peri/uro/       0.89       1.56       0.31       0.06       2.51       1.26        000
                                                       rectal.
90918...............  ..............  A               ESRD related               11.16       7.29       7.29       0.36      18.81      18.81        XXX
                                                       services, month.
90919...............  ..............  A               ESRD related                8.53       4.04       4.04       0.29      12.86      12.86        XXX
                                                       services, month.
90920...............  ..............  A               ESRD related                7.26       3.78       3.78       0.23      11.27      11.27        XXX
                                                       services, month.
90921...............  ..............  A               ESRD related                4.46       2.45       2.45       0.14       7.05       7.05        XXX
                                                       services, month.
90922...............  ..............  A               ESRD related                0.37       0.21       0.21       0.01       0.59       0.59        XXX
                                                       services, day.
90923...............  ..............  A               Esrd related                0.28       0.13       0.13       0.01       0.42       0.42        XXX
                                                       services, day.
90924...............  ..............  A               Esrd related                0.24       0.12       0.12       0.01       0.37       0.37        XXX
                                                       services, day.
90925...............  ..............  A               Esrd related                0.15       0.08       0.08       0.01       0.24       0.24        XXX
                                                       services, day.
90935...............  ..............  A               Hemodialysis, one           1.22         NA       0.67       0.04         NA       1.93        000
                                                       evaluation.
90937...............  ..............  A               Hemodialysis,               2.11         NA       0.97       0.08         NA       3.16        000
                                                       repeated eval.
90945...............  ..............  A               Dialysis, one               1.28         NA       0.69       0.05         NA       2.02        000
                                                       evaluation.
90947...............  ..............  A               Dialysis, repeated          2.16         NA       1.00       0.08         NA       3.24        000
                                                       eval.
90997...............  ..............  A               Hemoperfusion........       1.84         NA       0.66       0.06         NA       2.56        000
91000...............  ..............  A               Esophageal intubation       0.73       0.32         NA       0.04       1.09         NA        000
91000...............  26............  A               Esophageal intubation       0.73       0.24       0.24       0.03       1.00       1.00        000
91000...............  TC............  A               Esophageal intubation       0.00       0.08         NA       0.01       0.09         NA        000

[[Page 47678]]

 
91010...............  ..............  A               Esophagus motility          1.25       4.45         NA       0.12       5.82         NA        000
                                                       study.
91010...............  26............  A               Esophagus motility          1.25       0.44       0.44       0.06       1.75       1.75        000
                                                       study.
91010...............  TC............  A               Esophagus motility          0.00       4.01         NA       0.06       4.07         NA        000
                                                       study.
91011...............  ..............  A               Esophagus motility          1.50       5.27         NA       0.13       6.90         NA        000
                                                       study.
91011...............  26............  A               Esophagus motility          1.50       0.53       0.53       0.07       2.10       2.10        000
                                                       study.
91011...............  TC............  A               Esophagus motility          0.00       4.74         NA       0.06       4.80         NA        000
                                                       study.
91012...............  ..............  A               Esophagus motility          1.46       5.79         NA       0.14       7.39         NA        000
                                                       study.
91012...............  26............  A               Esophagus motility          1.46       0.51       0.51       0.07       2.04       2.04        000
                                                       study.
91012...............  TC............  A               Esophagus motility          0.00       5.28         NA       0.07       5.35         NA        000
                                                       study.
91020...............  ..............  A               Gastric motility.....       1.44       4.58         NA       0.13       6.15         NA        000
91020...............  26............  A               Gastric motility.....       1.44       0.49       0.49       0.07       2.00       2.00        000
91020...............  TC............  A               Gastric motility.....       0.00       4.10         NA       0.06       4.16         NA        000
91030...............  ..............  A               Acid perfusion of           0.91       2.45         NA       0.06       3.42         NA        000
                                                       esophagus.
91030...............  26............  A               Acid perfusion of           0.91       0.32       0.32       0.04       1.27       1.27        000
                                                       esophagus.
91030...............  TC............  A               Acid perfusion of           0.00       2.13         NA       0.02       2.15         NA        000
                                                       esophagus.
91032...............  ..............  A               Esophagus, acid             1.21       4.16         NA       0.12       5.49         NA        000
                                                       reflux test.
91032...............  26............  A               Esophagus, acid             1.21       0.42       0.42       0.06       1.69       1.69        000
                                                       reflux test.
91032...............  TC............  A               Esophagus, acid             0.00       3.74         NA       0.06       3.80         NA        000
                                                       reflux test.
91033...............  ..............  A               Prolonged acid reflux       1.30       4.24         NA       0.18       5.72         NA        000
                                                       test.
91033...............  26............  A               Prolonged acid reflux       1.30       0.45       0.45       0.07       1.82       1.82        000
                                                       test.
91033...............  TC............  A               Prolonged acid reflux       0.00       3.78         NA       0.11       3.89         NA        000
                                                       test.
91052...............  ..............  A               Gastric analysis test       0.79       2.47         NA       0.06       3.32         NA        000
91052...............  26............  A               Gastric analysis test       0.79       0.28       0.28       0.04       1.11       1.11        000
91052...............  TC............  A               Gastric analysis test       0.00       2.19         NA       0.02       2.21         NA        000
91055...............  ..............  A               Gastric intubation          0.94       2.94         NA       0.07       3.95         NA        000
                                                       for smear.
91055...............  26............  A               Gastric intubation          0.94       0.27       0.27       0.05       1.26       1.26        000
                                                       for smear.
91055...............  TC............  A               Gastric intubation          0.00       2.67         NA       0.02       2.69         NA        000
                                                       for smear.
91060...............  ..............  A               Gastric saline load         0.45       1.98         NA       0.04       2.47         NA        000
                                                       test.
91060...............  26............  A               Gastric saline load         0.45       0.14       0.14       0.02       0.61       0.61        000
                                                       test.
91060...............  TC............  A               Gastric saline load         0.00       1.84         NA       0.02       1.86         NA        000
                                                       test.
91065...............  ..............  A               Breath hydrogen test.       0.20       1.47         NA       0.03       1.70         NA        000
91065...............  26............  A               Breath hydrogen test.       0.20       0.07       0.07       0.01       0.28       0.28        000
91065...............  TC............  A               Breath hydrogen test.       0.00       1.40         NA       0.02       1.42         NA        000
91100...............  ..............  A               Pass intestine              1.08       2.85       0.28       0.07       4.00       1.43        000
                                                       bleeding tube.
91105...............  ..............  A               Gastric intubation          0.37       2.13       0.09       0.03       2.53       0.49        000
                                                       treatment.
91110...............  ..............  A               Gi tract capsule            3.64      22.19         NA       0.09      25.92         NA        XXX
                                                       endoscopy.
91110...............  26............  A               Gi tract capsule            3.64       1.27       1.27       0.02       4.93       4.93        XXX
                                                       endoscopy.
91110...............  TC............  A               Gi tract capsule            0.00      20.92         NA       0.07      20.99         NA        XXX
                                                       endoscopy.
91122...............  ..............  A               Anal pressure record.       1.77       5.10         NA       0.20       7.07         NA        000
91122...............  26............  A               Anal pressure record.       1.77       0.60       0.60       0.12       2.49       2.49        000
91122...............  TC............  A               Anal pressure record.       0.00       4.50         NA       0.08       4.58         NA        000
91132...............  26............  A               Electrogastrography..       0.52       0.18       0.18       0.03       0.73       0.73        XXX
91133...............  26............  A               Electrogastrography w/      0.66       0.23       0.23       0.03       0.92       0.92        XXX
                                                       test.
92002...............  ..............  A               Eye exam, new patient       0.88       0.97       0.34       0.02       1.87       1.24        XXX
92004...............  ..............  A               Eye exam, new patient       1.67       1.70       0.67       0.05       3.42       2.39        XXX
92012...............  ..............  A               Eye exam established        0.67       1.03       0.29       0.02       1.72       0.98        XXX
                                                       pat.
92014...............  ..............  A               Eye exam & treatment.       1.10       1.41       0.47       0.03       2.54       1.60        XXX
92018...............  ..............  A               New eye exam &              2.50         NA       1.07       0.07         NA       3.64        XXX
                                                       treatment.
92019...............  ..............  A               Eye exam & treatment.       1.31         NA       0.56       0.04         NA       1.91        XXX
92020...............  ..............  A               Special eye                 0.37       0.34       0.16       0.01       0.72       0.54        XXX
                                                       evaluation.
92060...............  ..............  A               Special eye                 0.69       0.74         NA       0.03       1.46         NA        XXX
                                                       evaluation.
92060...............  26............  A               Special eye                 0.69       0.29       0.29       0.02       1.00       1.00        XXX
                                                       evaluation.
92060...............  TC............  A               Special eye                 0.00       0.45         NA       0.01       0.46         NA        XXX
                                                       evaluation.
92065...............  ..............  A               Orthoptic/pleoptic          0.37       0.55         NA       0.02       0.94         NA        XXX
                                                       training.
92065...............  26............  A               Orthoptic/pleoptic          0.37       0.15       0.15       0.01       0.53       0.53        XXX
                                                       training.
92065...............  TC............  A               Orthoptic/pleoptic          0.00       0.40         NA       0.01       0.41         NA        XXX
                                                       training.
92070...............  ..............  A               Fitting of contact          0.70       1.07       0.32       0.02       1.79       1.04        XXX
                                                       lens.
92081...............  ..............  A               Visual field                0.36       0.95         NA       0.02       1.33         NA        XXX
                                                       examination(s).
92081...............  26............  A               Visual field                0.36       0.15       0.15       0.01       0.52       0.52        XXX
                                                       examination(s).
92081...............  TC............  A               Visual field                0.00       0.79         NA       0.01       0.80         NA        XXX
                                                       examination(s).
92082...............  ..............  A               Visual field                0.44       1.23         NA       0.02       1.69         NA        XXX
                                                       examination(s).
92082...............  26............  A               Visual field                0.44       0.19       0.19       0.01       0.64       0.64        XXX
                                                       examination(s).
92082...............  TC............  A               Visual field                0.00       1.05         NA       0.01       1.06         NA        XXX
                                                       examination(s).
92083...............  ..............  A               Visual field                0.50       1.43         NA       0.02       1.95         NA        XXX
                                                       examination(s).
92083...............  26............  A               Visual field                0.50       0.22       0.22       0.01       0.73       0.73        XXX
                                                       examination(s).
92083...............  TC............  A               Visual field                0.00       1.21         NA       0.01       1.22         NA        XXX
                                                       examination(s).
92100...............  ..............  A               Serial tonometry            0.92       1.35       0.36       0.03       2.30       1.31        XXX
                                                       exam(s).
92120...............  ..............  A               Tonography & eye            0.81       1.07       0.32       0.02       1.90       1.15        XXX
                                                       evaluation.
92130...............  ..............  A               Water provocation           0.81       1.28       0.37       0.02       2.11       1.20        XXX
                                                       tonography.
92135...............  ..............  A               Opthalmic dx imaging.       0.35       0.80         NA       0.02       1.17         NA        XXX
92135...............  26............  A               Opthalmic dx imaging.       0.35       0.15       0.15       0.01       0.51       0.51        XXX
92135...............  TC............  A               Opthalmic dx imaging.       0.00       0.65         NA       0.01       0.66         NA        XXX
92136...............  ..............  A               Ophthalmic biometry..       0.54       1.54         NA       0.08       2.16         NA        XXX
92136...............  26............  A               Ophthalmic biometry..       0.54       0.24       0.24       0.01       0.79       0.79        XXX
92136...............  TC............  A               Ophthalmic biometry..       0.00       1.30         NA       0.07       1.37         NA        XXX

[[Page 47679]]

 
92140...............  ..............  A               Glaucoma provocative        0.50       0.99       0.21       0.01       1.50       0.72        XXX
                                                       tests.
92225...............  ..............  A               Special eye exam,           0.38       0.22       0.16       0.01       0.61       0.55        XXX
                                                       initial.
92226...............  ..............  A               Special eye exam,           0.33       0.21       0.14       0.01       0.55       0.48        XXX
                                                       subsequent.
92230...............  ..............  A               Eye exam with photos.       0.60       1.54       0.20       0.02       2.16       0.82        XXX
92235...............  ..............  A               Eye exam with photos.       0.81       2.61         NA       0.08       3.50         NA        XXX
92235...............  26............  A               Eye exam with photos.       0.81       0.37       0.37       0.02       1.20       1.20        XXX
92235...............  TC............  A               Eye exam with photos.       0.00       2.25         NA       0.06       2.31         NA        XXX
92240...............  ..............  A               Icg angiography......       1.10       6.13         NA       0.09       7.32         NA        XXX
92240...............  26............  A               Icg angiography......       1.10       0.50       0.50       0.03       1.63       1.63        XXX
92240...............  TC............  A               Icg angiography......       0.00       5.64         NA       0.06       5.70         NA        XXX
92250...............  ..............  A               Eye exam with photos.       0.44       1.53         NA       0.02       1.99         NA        XXX
92250...............  26............  A               Eye exam with photos.       0.44       0.19       0.19       0.01       0.64       0.64        XXX
92250...............  TC............  A               Eye exam with photos.       0.00       1.34         NA       0.01       1.35         NA        XXX
92260...............  ..............  A               Ophthalmoscopy/             0.20       0.26       0.09       0.01       0.47       0.30        XXX
                                                       dynamometry.
92265...............  ..............  A               Eye muscle evaluation       0.81       1.51         NA       0.06       2.38         NA        XXX
92265...............  26............  A               Eye muscle evaluation       0.81       0.28       0.28       0.04       1.13       1.13        XXX
92265...............  TC............  A               Eye muscle evaluation       0.00       1.23         NA       0.02       1.25         NA        XXX
92270...............  ..............  A               Electro-oculography..       0.81       1.54         NA       0.05       2.40         NA        XXX
92270...............  26............  A               Electro-oculography..       0.81       0.33       0.33       0.03       1.17       1.17        XXX
92270...............  TC............  A               Electro-oculography..       0.00       1.21         NA       0.02       1.23         NA        XXX
92275...............  ..............  A               Electroretinography..       1.01       1.94         NA       0.05       3.00         NA        XXX
92275...............  26............  A               Electroretinography..       1.01       0.43       0.43       0.03       1.47       1.47        XXX
92275...............  TC............  A               Electroretinography..       0.00       1.52         NA       0.02       1.54         NA        XXX
92283...............  ..............  A               Color vision                0.17       0.84         NA       0.02       1.03         NA        XXX
                                                       examination.
92283...............  26............  A               Color vision                0.17       0.07       0.07       0.01       0.25       0.25        XXX
                                                       examination.
92283...............  TC............  A               Color vision                0.00       0.77         NA       0.01       0.78         NA        XXX
                                                       examination.
92284...............  ..............  A               Dark adaptation eye         0.24       1.88         NA       0.02       2.14         NA        XXX
                                                       exam.
92284...............  26............  A               Dark adaptation eye         0.24       0.08       0.08       0.01       0.33       0.33        XXX
                                                       exam.
92284...............  TC............  A               Dark adaptation eye         0.00       1.80         NA       0.01       1.81         NA        XXX
                                                       exam.
92285...............  ..............  A               Eye photography......       0.20       0.99         NA       0.02       1.21         NA        XXX
92285...............  26............  A               Eye photography......       0.20       0.09       0.09       0.01       0.30       0.30        XXX
92285...............  TC............  A               Eye photography......       0.00       0.91         NA       0.01       0.92         NA        XXX
92286...............  ..............  A               Internal eye                0.66       3.07         NA       0.04       3.77         NA        XXX
                                                       photography.
92286...............  26............  A               Internal eye                0.66       0.29       0.29       0.02       0.97       0.97        XXX
                                                       photography.
92286...............  TC............  A               Internal eye                0.00       2.78         NA       0.02       2.80         NA        XXX
                                                       photography.
92287...............  ..............  A               Internal eye                0.81       2.39       0.31       0.02       3.22       1.14        XXX
                                                       photography.
92311...............  ..............  A               Contact lens fitting.       1.08       1.10       0.35       0.04       2.22       1.47        XXX
92312...............  ..............  A               Contact lens fitting.       1.26       1.08       0.49       0.04       2.38       1.79        XXX
92313...............  ..............  A               Contact lens fitting.       0.92       1.07       0.28       0.02       2.01       1.22        XXX
92315...............  ..............  A               Prescription of             0.45       0.85       0.16       0.01       1.31       0.62        XXX
                                                       contact lens.
92316...............  ..............  A               Prescription of             0.68       0.91       0.29       0.02       1.61       0.99        XXX
                                                       contact lens.
92317...............  ..............  A               Prescription of             0.45       0.94       0.15       0.01       1.40       0.61        XXX
                                                       contact lens.
92325...............  ..............  A               Modification of             0.00       0.40         NA       0.01       0.41         NA        XXX
                                                       contact lens.
92326...............  ..............  A               Replacement of              0.00       1.63         NA       0.06       1.69         NA        XXX
                                                       contact lens.
92330...............  ..............  A               Fitting of artificial       1.08       0.99       0.32       0.03       2.10       1.43        XXX
                                                       eye.
92335...............  ..............  A               Fitting of artificial       0.45       0.91       0.16       0.02       1.38       0.63        XXX
                                                       eye.
92352...............  ..............  B               Special spectacles          0.37       0.68       0.14       0.01       1.06       0.52        XXX
                                                       fitting.
92353...............  ..............  B               Special spectacles          0.50       0.73       0.19       0.02       1.25       0.71        XXX
                                                       fitting.
92354...............  ..............  B               Special spectacles          0.00       8.84         NA       0.10       8.94         NA        XXX
                                                       fitting.
92355...............  ..............  B               Special spectacles          0.00       4.32         NA       0.01       4.33         NA        XXX
                                                       fitting.
92358...............  ..............  B               Eye prosthesis              0.00       0.97         NA       0.05       1.02         NA        XXX
                                                       service.
92371...............  ..............  B               Repair & adjust             0.00       0.62         NA       0.02       0.64         NA        XXX
                                                       spectacles.
92502...............  ..............  A               Ear and throat              1.51         NA       1.11       0.05         NA       2.67        000
                                                       examination.
92504...............  ..............  A               Ear microscopy              0.18       0.50       0.09       0.01       0.69       0.28        XXX
                                                       examination.
92506...............  ..............  A               Speech/hearing              0.86       2.60       0.40       0.03       3.49       1.29        XXX
                                                       evaluation.
92507...............  ..............  A               Speech/hearing              0.52       1.12       0.23       0.02       1.66       0.77        XXX
                                                       therapy.
92508...............  ..............  A               Speech/hearing              0.26       0.51       0.12       0.01       0.78       0.39        XXX
                                                       therapy.
92511...............  ..............  A               Nasopharyngoscopy....       0.84       3.32       0.78       0.03       4.19       1.65        000
92512...............  ..............  A               Nasal function              0.55       1.14       0.18       0.02       1.71       0.75        XXX
                                                       studies.
92516...............  ..............  A               Facial nerve function       0.43       1.17       0.22       0.02       1.62       0.67        XXX
                                                       test.
92520...............  ..............  A               Laryngeal function          0.76       0.51       0.39       0.03       1.30       1.18        XXX
                                                       studies.
92526...............  ..............  A               Oral function therapy       0.55       1.64       0.20       0.02       2.21       0.77        XXX
92541...............  ..............  A               Spontaneous nystagmus       0.40       1.03         NA       0.04       1.47         NA        XXX
                                                       test.
92541...............  26............  A               Spontaneous nystagmus       0.40       0.19       0.19       0.02       0.61       0.61        XXX
                                                       test.
92541...............  TC............  A               Spontaneous nystagmus       0.00       0.84         NA       0.02       0.86         NA        XXX
                                                       test.
92542...............  ..............  A               Positional nystagmus        0.33       1.14         NA       0.03       1.50         NA        XXX
                                                       test.
92542...............  26............  A               Positional nystagmus        0.33       0.16       0.16       0.01       0.50       0.50        XXX
                                                       test.
92542...............  TC............  A               Positional nystagmus        0.00       0.98         NA       0.02       1.00         NA        XXX
                                                       test.
92543...............  ..............  A               Caloric vestibular          0.10       0.57         NA       0.01       0.68         NA        XXX
                                                       test.
92543...............  26............  A               Caloric vestibular          0.10       0.05       0.05       0.00       0.15       0.15        XXX
                                                       test.
92543...............  TC............  A               Caloric vestibular          0.00       0.52         NA       0.01       0.53         NA        XXX
                                                       test.
92544...............  ..............  A               Optokinetic nystagmus       0.26       0.90         NA       0.03       1.19         NA        XXX
                                                       test.
92544...............  26............  A               Optokinetic nystagmus       0.26       0.12       0.12       0.01       0.39       0.39        XXX
                                                       test.
92544...............  TC............  A               Optokinetic nystagmus       0.00       0.78         NA       0.02       0.80         NA        XXX
                                                       test.
92545...............  ..............  A               Oscillating tracking        0.23       0.80         NA       0.03       1.06         NA        XXX
                                                       test.

[[Page 47680]]

 
92545...............  26............  A               Oscillating tracking        0.23       0.11       0.11       0.01       0.35       0.35        XXX
                                                       test.
92545...............  TC............  A               Oscillating tracking        0.00       0.69         NA       0.02       0.71         NA        XXX
                                                       test.
92546...............  ..............  A               Sinusoidal rotational       0.29       1.99         NA       0.03       2.31         NA        XXX
                                                       test.
92546...............  26............  A               Sinusoidal rotational       0.29       0.13       0.13       0.01       0.43       0.43        XXX
                                                       test.
92546...............  TC............  A               Sinusoidal rotational       0.00       1.86         NA       0.02       1.88         NA        XXX
                                                       test.
92547...............  ..............  A               Supplemental                0.00       0.08         NA       0.06       0.14         NA        ZZZ
                                                       electrical test.
92548...............  ..............  A               Posturography........       0.50       2.26         NA       0.15       2.91         NA        XXX
92548...............  26............  A               Posturography........       0.50       0.26       0.26       0.02       0.78       0.78        XXX
92548...............  TC............  A               Posturography........       0.00       2.00         NA       0.13       2.13         NA        XXX
92552...............  ..............  A               Pure tone audiometry,       0.00       0.44         NA       0.04       0.48         NA        XXX
                                                       air.
92553...............  ..............  A               Audiometry, air &           0.00       0.66         NA       0.06       0.72         NA        XXX
                                                       bone.
92555...............  ..............  A               Speech threshold            0.00       0.38         NA       0.04       0.42         NA        XXX
                                                       audiometry.
92556...............  ..............  A               Speech audiometry,          0.00       0.57         NA       0.06       0.63         NA        XXX
                                                       complete.
92557...............  ..............  A               Comprehensive hearing       0.00       1.19         NA       0.12       1.31         NA        XXX
                                                       test.
92561...............  ..............  A               Bekesy audiometry,          0.00       0.71         NA       0.06       0.77         NA        XXX
                                                       diagnosis.
92562...............  ..............  A               Loudness balance test       0.00       0.41         NA       0.04       0.45         NA        XXX
92563...............  ..............  A               Tone decay hearing          0.00       0.38         NA       0.04       0.42         NA        XXX
                                                       test.
92564...............  ..............  A               Sisi hearing test....       0.00       0.47         NA       0.05       0.52         NA        XXX
92565...............  ..............  A               Stenger test, pure          0.00       0.40         NA       0.04       0.44         NA        XXX
                                                       tone.
92567...............  ..............  A               Tympanometry.........       0.00       0.52         NA       0.06       0.58         NA        XXX
92568...............  ..............  A               Acoustic reflex             0.00       0.38         NA       0.04       0.42         NA        XXX
                                                       testing.
92569...............  ..............  A               Acoustic reflex decay       0.00       0.41         NA       0.04       0.45         NA        XXX
                                                       test.
92571...............  ..............  A               Filtered speech             0.00       0.39         NA       0.04       0.43         NA        XXX
                                                       hearing test.
92572...............  ..............  A               Staggered spondaic          0.00       0.09         NA       0.01       0.10         NA        XXX
                                                       word test.
92573...............  ..............  A               Lombard test.........       0.00       0.35         NA       0.04       0.39         NA        XXX
92575...............  ..............  A               Sensorineural acuity        0.00       0.30         NA       0.02       0.32         NA        XXX
                                                       test.
92576...............  ..............  A               Synthetic sentence          0.00       0.44         NA       0.05       0.49         NA        XXX
                                                       test.
92577...............  ..............  A               Stenger test, speech.       0.00       0.71         NA       0.07       0.78         NA        XXX
92579...............  ..............  A               Visual audiometry           0.00       0.72         NA       0.06       0.78         NA        XXX
                                                       (vra).
92582...............  ..............  A               Conditioning play           0.00       0.72         NA       0.06       0.78         NA        XXX
                                                       audiometry.
92583...............  ..............  A               Select picture              0.00       0.89         NA       0.08       0.97         NA        XXX
                                                       audiometry.
92584...............  ..............  A               Electrocochleography.       0.00       2.47         NA       0.21       2.68         NA        XXX
92585...............  ..............  A               Auditor evoke potent,       0.50       2.06         NA       0.17       2.73         NA        XXX
                                                       compre.
92585...............  26............  A               Auditor evoke potent,       0.50       0.21       0.21       0.03       0.74       0.74        XXX
                                                       compre.
92585...............  TC............  A               Auditor evoke potent,       0.00       1.84         NA       0.14       1.98         NA        XXX
                                                       compre.
92586...............  ..............  A               Auditor evoke potent,       0.00       1.84         NA       0.14       1.98         NA        XXX
                                                       limit.
92587...............  ..............  A               Evoked auditory test.       0.13       1.37         NA       0.11       1.61         NA        XXX
92587...............  26............  A               Evoked auditory test.       0.13       0.06       0.06       0.00       0.19       0.19        XXX
92587...............  TC............  A               Evoked auditory test.       0.00       1.30         NA       0.11       1.41         NA        XXX
92588...............  ..............  A               Evoked auditory test.       0.36       1.63         NA       0.14       2.13         NA        XXX
92588...............  26............  A               Evoked auditory test.       0.36       0.16       0.16       0.01       0.53       0.53        XXX
92588...............  TC............  A               Evoked auditory test.       0.00       1.47         NA       0.13       1.60         NA        XXX
92589...............  ..............  A               Auditory function           0.00       0.53         NA       0.06       0.59         NA        XXX
                                                       test(s).
92596...............  ..............  A               Ear protector               0.00       0.59         NA       0.06       0.65         NA        XXX
                                                       evaluation.
92597...............  ..............  A               Oral speech device          0.86       1.69       0.45       0.05       2.60       1.36        XXX
                                                       eval.
92601...............  ..............  A               Cochlear implt f/up         0.00       3.51         NA       0.05       3.56         NA        XXX
                                                       exam < 7.
92602...............  ..............  A               Reprogram cochlear          0.00       2.38         NA       0.05       2.43         NA        XXX
                                                       implt < 7.
92603...............  ..............  A               Cochlear implt f/up         0.00       2.15         NA       0.05       2.20         NA        XXX
                                                       exam 7 >.
92604...............  ..............  A               Reprogram cochlear          0.00       1.35         NA       0.05       1.40         NA        XXX
                                                       implt 7 >.
92607...............  ..............  A               Ex for speech device        0.00       3.08         NA       0.04       3.12         NA        XXX
                                                       rx, 1hr.
92608...............  ..............  A               Ex for speech device        0.00       0.56         NA       0.04       0.60         NA        XXX
                                                       rx addl.
92609...............  ..............  A               Use of speech device        0.00       1.65         NA       0.03       1.68         NA        XXX
                                                       service.
92610...............  ..............  A               Evaluate swallowing         0.00       3.43         NA       0.06       3.49         NA        XXX
                                                       function.
92611...............  ..............  A               Motion fluoroscopy/         0.00       3.43         NA       0.07       3.50         NA        XXX
                                                       swallow.
92612...............  ..............  A               Endoscopy swallow tst       1.27       2.75       0.66       0.08       4.10       2.01        XXX
                                                       (fees).
92613...............  ..............  A               Endoscopy swallow tst       0.71       0.40       0.39       0.05       1.16       1.15        XXX
                                                       (fees).
92614...............  ..............  A               Laryngoscopic sensory       1.27       2.00       0.66       0.08       3.35       2.01        XXX
                                                       test.
92615...............  ..............  A               Eval laryngoscopy           0.63       0.35       0.35       0.05       1.03       1.03        XXX
                                                       sense tst.
92616...............  ..............  A               Fees w/laryngeal            1.88       2.67       0.99       0.08       4.63       2.95        XXX
                                                       sense test.
92617...............  ..............  A               Interprt fees/              0.79       0.44       0.44       0.05       1.28       1.28        XXX
                                                       laryngeal test.
92950...............  ..............  A               Heart/lung                  3.79       4.25       0.97       0.26       8.30       5.02        000
                                                       resuscitation cpr.
92953...............  ..............  A               Temporary external          0.23         NA       0.07       0.01         NA       0.31        000
                                                       pacing.
92960...............  ..............  A               Cardioversion               2.25       6.45       1.17       0.08       8.78       3.50        000
                                                       electric, ext.
92961...............  ..............  A               Cardioversion,              4.59         NA       2.07       0.27         NA       6.93        000
                                                       electric, int.
92970...............  ..............  A               Cardioassist,               3.51         NA       1.05       0.19         NA       4.75        000
                                                       internal.
92971...............  ..............  A               Cardioassist,               1.77         NA       0.85       0.06         NA       2.68        000
                                                       external.
92973...............  ..............  A               Percut coronary             3.28         NA       1.29       0.11         NA       4.68        ZZZ
                                                       thrombectomy.
92974...............  ..............  A               Cath place, cardio          3.00         NA       1.18       0.10         NA       4.28        ZZZ
                                                       brachytx.
92975...............  ..............  A               Dissolve clot, heart        7.24         NA       2.80       0.23         NA      10.27        000
                                                       vessel.
92977...............  ..............  A               Dissolve clot, heart        0.00       8.04         NA       0.46       8.50         NA        XXX
                                                       vessel.
92978...............  ..............  A               Intravasc us, heart         1.80       5.26         NA       0.30       7.36         NA        ZZZ
                                                       add-on.
92978...............  26............  A               Intravasc us, heart         1.80       0.71       0.71       0.06       2.57       2.57        ZZZ
                                                       add-on.
92978...............  TC............  A               Intravasc us, heart         0.00       4.56         NA       0.24       4.80         NA        ZZZ
                                                       add-on.
92979...............  ..............  A               Intravasc us, heart         1.44       2.85         NA       0.20       4.49         NA        ZZZ
                                                       add-on.
92979...............  26............  A               Intravasc us, heart         1.44       0.56       0.56       0.07       2.07       2.07        ZZZ
                                                       add-on.

[[Page 47681]]

 
92979...............  TC............  A               Intravasc us, heart         0.00       2.29         NA       0.13       2.42         NA        ZZZ
                                                       add-on.
92980...............  ..............  A               Insert intracoronary       14.82         NA       6.03       1.04         NA      21.89        000
                                                       stent.
92981...............  ..............  A               Insert intracoronary        4.16         NA       1.63       0.29         NA       6.08        ZZZ
                                                       stent.
92982...............  ..............  A               Coronary artery            10.96         NA       4.52       0.77         NA      16.25        000
                                                       dilation.
92984...............  ..............  A               Coronary artery             2.97         NA       1.16       0.21         NA       4.34        ZZZ
                                                       dilation.
92986...............  ..............  A               Revision of aortic         21.77         NA      11.85       1.52         NA      35.14        090
                                                       valve.
92987...............  ..............  A               Revision of mitral         22.67         NA      12.23       1.58         NA      36.48        090
                                                       valve.
92990...............  ..............  A               Revision of pulmonary      17.31         NA       9.83       1.21         NA      28.35        090
                                                       valve.
92995...............  ..............  A               Coronary atherectomy.      12.07         NA       4.95       0.84         NA      17.86        000
92996...............  ..............  A               Coronary atherectomy        3.26         NA       1.27       0.23         NA       4.76        ZZZ
                                                       add-on.
92997...............  ..............  A               Pul art balloon repr,      11.98         NA       4.81       0.84         NA      17.63        000
                                                       percut.
92998...............  ..............  A               Pul art balloon repr,       5.99         NA       2.20       0.42         NA       8.61        ZZZ
                                                       percut.
93000...............  ..............  A               Electrocardiogram,          0.17       0.51         NA       0.03       0.71         NA        XXX
                                                       complete.
93005...............  ..............  A               Electrocardiogram,          0.00       0.45         NA       0.02       0.47         NA        XXX
                                                       tracing.
93010...............  ..............  A               Electrocardiogram           0.17       0.06       0.06       0.01       0.24       0.24        XXX
                                                       report.
93012...............  ..............  A               Transmission of ecg..       0.00       6.00         NA       0.18       6.18         NA        XXX
93014...............  ..............  A               Report on transmitted       0.52       0.19       0.19       0.02       0.73       0.73        XXX
                                                       ecg.
93015...............  ..............  A               Cardiovascular stress       0.75       1.96         NA       0.14       2.85         NA        XXX
                                                       test.
93016...............  ..............  A               Cardiovascular stress       0.45       0.17       0.17       0.02       0.64       0.64        XXX
                                                       test.
93017...............  ..............  A               Cardiovascular stress       0.00       1.68         NA       0.11       1.79         NA        XXX
                                                       test.
93018...............  ..............  A               Cardiovascular stress       0.30       0.11       0.11       0.01       0.42       0.42        XXX
                                                       test.
93024...............  ..............  A               Cardiac drug stress         1.17       1.57         NA       0.13       2.87         NA        XXX
                                                       test.
93024...............  26............  A               Cardiac drug stress         1.17       0.45       0.45       0.05       1.67       1.67        XXX
                                                       test.
93024...............  TC............  A               Cardiac drug stress         0.00       1.12         NA       0.08       1.20         NA        XXX
                                                       test.
93025...............  ..............  A               Microvolt t-wave            0.75       7.84         NA       0.14       8.73         NA        XXX
                                                       assess.
93025...............  26............  A               Microvolt t-wave            0.75       0.29       0.29       0.03       1.07       1.07        XXX
                                                       assess.
93025...............  TC............  A               Microvolt t-wave            0.00       7.55         NA       0.11       7.66         NA        XXX
                                                       assess.
93040...............  ..............  A               Rhythm ECG with             0.16       0.19         NA       0.02       0.37         NA        XXX
                                                       report.
93041...............  ..............  A               Rhythm ECG, tracing..       0.00       0.14         NA       0.01       0.15         NA        XXX
93042...............  ..............  A               Rhythm ECG, report...       0.16       0.05       0.05       0.01       0.22       0.22        XXX
93224...............  ..............  A               ECG monitor/report,         0.52       3.61         NA       0.24       4.37         NA        XXX
                                                       24 hrs.
93225...............  ..............  A               ECG monitor/record,         0.00       1.24         NA       0.08       1.32         NA        XXX
                                                       24 hrs.
93226...............  ..............  A               ECG monitor/report,         0.00       2.18         NA       0.14       2.32         NA        XXX
                                                       24 hrs.
93227...............  ..............  A               ECG monitor/review,         0.52       0.19       0.19       0.02       0.73       0.73        XXX
                                                       24 hrs.
93230...............  ..............  A               ECG monitor/report,         0.52       3.88         NA       0.26       4.66         NA        XXX
                                                       24 hrs.
93231...............  ..............  A               Ecg monitor/record,         0.00       1.52         NA       0.11       1.63         NA        XXX
                                                       24 hrs.
93232...............  ..............  A               ECG monitor/report,         0.00       2.17         NA       0.13       2.30         NA        XXX
                                                       24 hrs.
93233...............  ..............  A               ECG monitor/review,         0.52       0.19       0.19       0.02       0.73       0.73        XXX
                                                       24 hrs.
93235...............  ..............  A               ECG monitor/report,         0.45       2.78         NA       0.16       3.39         NA        XXX
                                                       24 hrs.
93236...............  ..............  A               ECG monitor/report,         0.00       2.62         NA       0.14       2.76         NA        XXX
                                                       24 hrs.
93237...............  ..............  A               ECG monitor/review,         0.45       0.16       0.16       0.02       0.63       0.63        XXX
                                                       24 hrs.
93268...............  ..............  A               ECG record/review....       0.52       7.43         NA       0.28       8.23         NA        XXX
93270...............  ..............  A               ECG recording........       0.00       1.24         NA       0.08       1.32         NA        XXX
93271...............  ..............  A               Ecg/monitoring and          0.00       6.00         NA       0.18       6.18         NA        XXX
                                                       analysis.
93272...............  ..............  A               Ecg/review, interpret       0.52       0.19       0.19       0.02       0.73       0.73        XXX
                                                       only.
93278...............  ..............  A               ECG/signal-averaged..       0.25       1.24         NA       0.12       1.61         NA        XXX
93278...............  26............  A               ECG/signal-averaged..       0.25       0.10       0.10       0.01       0.36       0.36        XXX
93278...............  TC............  A               ECG/signal-averaged..       0.00       1.15         NA       0.11       1.26         NA        XXX
93303...............  ..............  A               Echo transthoracic...       1.30       4.33         NA       0.28       5.91         NA        XXX
93303...............  26............  A               Echo transthoracic...       1.30       0.48       0.48       0.05       1.83       1.83        XXX
93303...............  TC............  A               Echo transthoracic...       0.00       3.85         NA       0.23       4.08         NA        XXX
93304...............  ..............  A               Echo transthoracic...       0.75       2.22         NA       0.16       3.13         NA        XXX
93304...............  26............  A               Echo transthoracic...       0.75       0.28       0.28       0.03       1.06       1.06        XXX
93304...............  TC............  A               Echo transthoracic...       0.00       1.94         NA       0.13       2.07         NA        XXX
93307...............  ..............  A               Echo exam of heart...       0.92       4.20         NA       0.26       5.38         NA        XXX
93307...............  26............  A               Echo exam of heart...       0.92       0.35       0.35       0.03       1.30       1.30        XXX
93307...............  TC............  A               Echo exam of heart...       0.00       3.85         NA       0.23       4.08         NA        XXX
93308...............  ..............  A               Echo exam of heart...       0.53       2.14         NA       0.15       2.82         NA        XXX
93308...............  26............  A               Echo exam of heart...       0.53       0.20       0.20       0.02       0.75       0.75        XXX
93308...............  TC............  A               Echo exam of heart...       0.00       1.94         NA       0.13       2.07         NA        XXX
93312...............  ..............  A               Echo transesophageal.       2.20       4.56         NA       0.37       7.13         NA        XXX
93312...............  26............  A               Echo transesophageal.       2.20       0.79       0.79       0.08       3.07       3.07        XXX
93312...............  TC............  A               Echo transesophageal.       0.00       3.77         NA       0.29       4.06         NA        XXX
93313...............  ..............  A               Echo transesophageal.       0.95         NA       0.21       0.06         NA       1.22        XXX
93314...............  ..............  A               Echo transesophageal.       1.25       4.24         NA       0.34       5.83         NA        XXX
93314...............  26............  A               Echo transesophageal.       1.25       0.47       0.47       0.05       1.77       1.77        XXX
93314...............  TC............  A               Echo transesophageal.       0.00       3.77         NA       0.29       4.06         NA        XXX
93315...............  26............  A               Echo transesophageal.       2.78       1.01       1.01       0.13       3.92       3.92        XXX
93316...............  ..............  A               Echo transesophageal.       0.95         NA       0.23       0.05         NA       1.23        XXX
93317...............  26............  A               Echo transesophageal.       1.83       0.66       0.66       0.09       2.58       2.58        XXX
93318...............  26............  A               Echo transesophageal        2.20       0.48       0.48       0.13       2.81       2.81        XXX
                                                       intraop.
93320...............  ..............  A               Doppler echo exam,          0.38       1.85         NA       0.13       2.36         NA        ZZZ
                                                       heart.
93320...............  26............  A               Doppler echo exam,          0.38       0.15       0.15       0.01       0.54       0.54        ZZZ
                                                       heart.
93320...............  TC............  A               Doppler echo exam,          0.00       1.71         NA       0.12       1.83         NA        ZZZ
                                                       heart.
93321...............  ..............  A               Doppler echo exam,          0.15       1.17         NA       0.09       1.41         NA        ZZZ
                                                       heart.

[[Page 47682]]

 
93321...............  26............  A               Doppler echo exam,          0.15       0.06       0.06       0.01       0.22       0.22        ZZZ
                                                       heart.
93321...............  TC............  A               Doppler echo exam,          0.00       1.11         NA       0.08       1.19         NA        ZZZ
                                                       heart.
93325...............  ..............  A               Doppler color flow          0.07       2.92         NA       0.21       3.20         NA        ZZZ
                                                       add-on.
93325...............  26............  A               Doppler color flow          0.07       0.03       0.03       0.00       0.10       0.10        ZZZ
                                                       add-on.
93325...............  TC............  A               Doppler color flow          0.00       2.90         NA       0.21       3.11         NA        ZZZ
                                                       add-on.
93350...............  ..............  A               Echo transthoracic...       1.48       2.32         NA       0.18       3.98         NA        XXX
93350...............  26............  A               Echo transthoracic...       1.48       0.57       0.57       0.05       2.10       2.10        XXX
93350...............  TC............  A               Echo transthoracic...       0.00       1.76         NA       0.13       1.89         NA        XXX
93501...............  ..............  A               Right heart                 3.02      18.02         NA       1.26      22.30         NA        000
                                                       catheterization.
93501...............  26............  A               Right heart                 3.02       1.15       1.15       0.21       4.38       4.38        000
                                                       catheterization.
93501...............  TC............  A               Right heart                 0.00      16.87         NA       1.05      17.92         NA        000
                                                       catheterization.
93503...............  ..............  A               Insert/place heart          2.91         NA       0.68       0.20         NA       3.79        000
                                                       catheter.
93505...............  ..............  A               Biopsy of heart             4.37       3.66         NA       0.48       8.51         NA        000
                                                       lining.
93505...............  26............  A               Biopsy of heart             4.37       1.68       1.68       0.32       6.37       6.37        000
                                                       lining.
93505...............  TC............  A               Biopsy of heart             0.00       1.98         NA       0.16       2.14         NA        000
                                                       lining.
93508...............  ..............  A               Cath placement,             4.09      14.65         NA       0.94      19.68         NA        000
                                                       angiography.
93508...............  26............  A               Cath placement,             4.09       2.07       2.07       0.29       6.45       6.45        000
                                                       angiography.
93508...............  TC............  A               Cath placement,             0.00      12.58         NA       0.65      13.23         NA        000
                                                       angiography.
93510...............  ..............  A               Left heart                  4.32      39.06         NA       2.60      45.98         NA        000
                                                       catheterization.
93510...............  26............  A               Left heart                  4.32       2.17       2.17       0.30       6.79       6.79        000
                                                       catheterization.
93510...............  TC............  A               Left heart                  0.00      36.89         NA       2.30      39.19         NA        000
                                                       catheterization.
93511...............  ..............  A               Left heart                  5.02      38.35         NA       2.58      45.95         NA        000
                                                       catheterization.
93511...............  26............  A               Left heart                  5.02       2.44       2.44       0.35       7.81       7.81        000
                                                       catheterization.
93511...............  TC............  A               Left heart                  0.00      35.91         NA       2.23      38.14         NA        000
                                                       catheterization.
93514...............  ..............  A               Left heart                  7.04      39.03         NA       2.72      48.79         NA        000
                                                       catheterization.
93514...............  26............  A               Left heart                  7.04       3.12       3.12       0.49      10.65      10.65        000
                                                       catheterization.
93514...............  TC............  A               Left heart                  0.00      35.91         NA       2.23      38.14         NA        000
                                                       catheterization.
93524...............  ..............  A               Left heart                  6.94      50.10         NA       3.42      60.46         NA        000
                                                       catheterization.
93524...............  26............  A               Left heart                  6.94       3.17       3.17       0.49      10.60      10.60        000
                                                       catheterization.
93524...............  TC............  A               Left heart                  0.00      46.93         NA       2.93      49.86         NA        000
                                                       catheterization.
93526...............  ..............  A               Rt & Lt heart               5.98      51.02         NA       3.44      60.44         NA        000
                                                       catheters.
93526...............  26............  A               Rt & Lt heart               5.98       2.81       2.81       0.42       9.21       9.21        000
                                                       catheters.
93526...............  TC............  A               Rt & Lt heart               0.00      48.21         NA       3.02      51.23         NA        000
                                                       catheters.
93527...............  ..............  A               Rt & Lt heart               7.27      50.24         NA       3.44      60.95         NA        000
                                                       catheters.
93527...............  26............  A               Rt & Lt heart               7.27       3.31       3.31       0.51      11.09      11.09        000
                                                       catheters.
93527...............  TC............  A               Rt & Lt heart               0.00      46.93         NA       2.93      49.86         NA        000
                                                       catheters.
93528...............  ..............  A               Rt & Lt heart               8.99      50.95         NA       3.56      63.50         NA        000
                                                       catheters.
93528...............  26............  A               Rt & Lt heart               8.99       4.02       4.02       0.63      13.64      13.64        000
                                                       catheters.
93528...............  TC............  A               Rt & Lt heart               0.00      46.93         NA       2.93      49.86         NA        000
                                                       catheters.
93529...............  ..............  A               Rt, lt heart                4.79      49.20         NA       3.26      57.25         NA        000
                                                       catheterization.
93529...............  26............  A               Rt, lt heart                4.79       2.27       2.27       0.33       7.39       7.39        000
                                                       catheterization.
93529...............  TC............  A               Rt, lt heart                0.00      46.93         NA       2.93      49.86         NA        000
                                                       catheterization.
93530...............  ..............  A               Rt heart cath,              4.22      18.80         NA       1.35      24.37         NA        000
                                                       congenital.
93530...............  26............  A               Rt heart cath,              4.22       1.93       1.93       0.30       6.45       6.45        000
                                                       congenital.
93530...............  TC............  A               Rt heart cath,              0.00      16.87         NA       1.05      17.92         NA        000
                                                       congenital.
93531...............  ..............  A               R & l heart cath,           8.34      51.79         NA       3.60      63.73         NA        000
                                                       congenital.
93531...............  26............  A               R & l heart cath,           8.34       3.58       3.58       0.58      12.50      12.50        000
                                                       congenital.
93531...............  TC............  A               R & l heart cath,           0.00      48.21         NA       3.02      51.23         NA        000
                                                       congenital.
93532...............  ..............  A               R & l heart cath,           9.99      51.17         NA       3.63      64.79         NA        000
                                                       congenital.
93532...............  26............  A               R & l heart cath,           9.99       4.25       4.25       0.70      14.94      14.94        000
                                                       congenital.
93532...............  TC............  A               R & l heart cath,           0.00      46.93         NA       2.93      49.86         NA        000
                                                       congenital.
93533...............  ..............  A               R & l heart cath,           6.69      49.72         NA       3.40      59.81         NA        000
                                                       congenital.
93533...............  26............  A               R & l heart cath,           6.69       2.80       2.80       0.47       9.96       9.96        000
                                                       congenital.
93533...............  TC............  A               R & l heart cath,           0.00      46.93         NA       2.93      49.86         NA        000
                                                       congenital.
93539...............  ..............  A               Injection, cardiac          0.40         NA       0.16       0.01         NA       0.57        000
                                                       cath.
93540...............  ..............  A               Injection, cardiac          0.43         NA       0.17       0.01         NA       0.61        000
                                                       cath.
93541...............  ..............  A               Injection for lung          0.29         NA       0.11       0.01         NA       0.41        000
                                                       angiogram.
93542...............  ..............  A               Injection for heart x-      0.29         NA       0.11       0.01         NA       0.41        000
                                                       rays.
93543...............  ..............  A               Injection for heart x-      0.29         NA       0.11       0.01         NA       0.41        000
                                                       rays.
93544...............  ..............  A               Injection for               0.25         NA       0.10       0.01         NA       0.36        000
                                                       aortography.
93545...............  ..............  A               Inject for coronary x-      0.40         NA       0.16       0.01         NA       0.57        000
                                                       rays.
93555...............  ..............  A               Imaging, cardiac cath       0.81       6.58         NA       0.37       7.76         NA        XXX
93555...............  26............  A               Imaging, cardiac cath       0.81       0.32       0.32       0.03       1.16       1.16        XXX
93555...............  TC............  A               Imaging, cardiac cath       0.00       6.26         NA       0.34       6.60         NA        XXX
93556...............  ..............  A               Imaging, cardiac cath       0.83      10.20         NA       0.54      11.57         NA        XXX
93556...............  26............  A               Imaging, cardiac cath       0.83       0.32       0.32       0.03       1.18       1.18        XXX
93556...............  TC............  A               Imaging, cardiac cath       0.00       9.87         NA       0.51      10.38         NA        XXX
93561...............  ..............  A               Cardiac output              0.50       0.68         NA       0.09       1.27         NA        000
                                                       measurement.
93561...............  26............  A               Cardiac output              0.50       0.16       0.16       0.03       0.69       0.69        000
                                                       measurement.
93561...............  TC............  A               Cardiac output              0.00       0.52         NA       0.06       0.58         NA        000
                                                       measurement.
93562...............  ..............  A               Cardiac output              0.16       0.37         NA       0.05       0.58         NA        000
                                                       measurement.
93562...............  26............  A               Cardiac output              0.16       0.05       0.05       0.01       0.22       0.22        000
                                                       measurement.
93562...............  TC............  A               Cardiac output              0.00       0.32         NA       0.04       0.36         NA        000
                                                       measurement.
93571...............  ..............  A               Heart flow reserve          1.80       5.24         NA       0.30       7.34         NA        ZZZ
                                                       measure.
93571...............  26............  A               Heart flow reserve          1.80       0.68       0.68       0.06       2.54       2.54        ZZZ
                                                       measure.

[[Page 47683]]

 
93571...............  TC............  A               Heart flow reserve          0.00       4.56         NA       0.24       4.80         NA        ZZZ
                                                       measure.
93572...............  ..............  A               Heart flow reserve          1.44       2.79         NA       0.18       4.41         NA        ZZZ
                                                       measure.
93572...............  26............  A               Heart flow reserve          1.44       0.50       0.50       0.05       1.99       1.99        ZZZ
                                                       measure.
93572...............  TC............  A               Heart flow reserve          0.00       2.29         NA       0.13       2.42         NA        ZZZ
                                                       measure.
93580...............  ..............  A               Transcath closure of       17.97         NA       7.37       1.37         NA      26.71        000
                                                       asd.
93581...............  ..............  A               Transcath closure of       24.39         NA       9.38       1.37         NA      35.14        000
                                                       vsd.
93600...............  ..............  A               Bundle of His               2.12       2.78         NA       0.29       5.19         NA        000
                                                       recording.
93600...............  26............  A               Bundle of His               2.12       0.83       0.83       0.16       3.11       3.11        000
                                                       recording.
93600...............  TC............  A               Bundle of His               0.00       1.95         NA       0.13       2.08         NA        000
                                                       recording.
93602...............  ..............  A               Intra-atrial                2.12       1.93         NA       0.24       4.29         NA        000
                                                       recording.
93602...............  26............  A               Intra-atrial                2.12       0.82       0.82       0.17       3.11       3.11        000
                                                       recording.
93602...............  TC............  A               Intra-atrial                0.00       1.11         NA       0.07       1.18         NA        000
                                                       recording.
93603...............  ..............  A               Right ventricular           2.12       2.49         NA       0.29       4.90         NA        000
                                                       recording.
93603...............  26............  A               Right ventricular           2.12       0.81       0.81       0.18       3.11       3.11        000
                                                       recording.
93603...............  TC............  A               Right ventricular           0.00       1.68         NA       0.11       1.79         NA        000
                                                       recording.
93609...............  ..............  A               Map tachycardia, add-       4.99       4.65         NA       0.50      10.14         NA        ZZZ
                                                       on.
93609...............  26............  A               Map tachycardia, add-       4.99       1.94       1.94       0.33       7.26       7.26        ZZZ
                                                       on.
93609...............  TC............  A               Map tachycardia, add-       0.00       2.71         NA       0.17       2.88         NA        ZZZ
                                                       on.
93610...............  ..............  A               Intra-atrial pacing..       3.02       2.51         NA       0.35       5.88         NA        000
93610...............  26............  A               Intra-atrial pacing..       3.02       1.16       1.16       0.25       4.43       4.43        000
93610...............  TC............  A               Intra-atrial pacing..       0.00       1.35         NA       0.10       1.45         NA        000
93612...............  ..............  A               Intraventricular            3.02       2.77         NA       0.36       6.15         NA        000
                                                       pacing.
93612...............  26............  A               Intraventricular            3.02       1.16       1.16       0.25       4.43       4.43        000
                                                       pacing.
93612...............  TC............  A               Intraventricular            0.00       1.61         NA       0.11       1.72         NA        000
                                                       pacing.
93613...............  ..............  A               Electrophys map 3d,         6.99         NA       2.75       0.63         NA      10.37        ZZZ
                                                       add-on.
93615...............  ..............  A               Esophageal recording.       0.99       0.58         NA       0.05       1.62         NA        000
93615...............  26............  A               Esophageal recording.       0.99       0.27       0.27       0.03       1.29       1.29        000
93615...............  TC............  A               Esophageal recording.       0.00       0.32         NA       0.02       0.34         NA        000
93616...............  ..............  A               Esophageal recording.       1.49       0.74         NA       0.10       2.33         NA        000
93616...............  26............  A               Esophageal recording.       1.49       0.43       0.43       0.08       2.00       2.00        000
93616...............  TC............  A               Esophageal recording.       0.00       0.32         NA       0.02       0.34         NA        000
93618...............  ..............  A               Heart rhythm pacing..       4.25       5.62         NA       0.54      10.41         NA        000
93618...............  26............  A               Heart rhythm pacing..       4.25       1.66       1.66       0.30       6.21       6.21        000
93618...............  TC............  A               Heart rhythm pacing..       0.00       3.96         NA       0.24       4.20         NA        000
93619...............  ..............  A               Electrophysiology           7.31      10.87         NA       0.98      19.16         NA        000
                                                       evaluation.
93619...............  26............  A               Electrophysiology           7.31       3.18       3.18       0.51      11.00      11.00        000
                                                       evaluation.
93619...............  TC............  A               Electrophysiology           0.00       7.69         NA       0.47       8.16         NA        000
                                                       evaluation.
93620...............  26............  A               Electrophysiology          11.57       4.83       4.83       0.81      17.21      17.21        000
                                                       evaluation.
93621...............  26............  A               Electrophysiology           2.10       0.82       0.82       0.15       3.07       3.07        ZZZ
                                                       evaluation.
93622...............  26............  A               Electrophysiology           3.10       1.20       1.20       0.22       4.52       4.52        ZZZ
                                                       evaluation.
93623...............  26............  A               Stimulation, pacing         2.85       1.11       1.11       0.20       4.16       4.16        ZZZ
                                                       heart.
93624...............  ..............  A               Electrophysiologic          4.80       4.17         NA       0.47       9.44         NA        000
                                                       study.
93624...............  26............  A               Electrophysiologic          4.80       2.19       2.19       0.34       7.33       7.33        000
                                                       study.
93624...............  TC............  A               Electrophysiologic          0.00       1.98         NA       0.13       2.11         NA        000
                                                       study.
93631...............  ..............  A               Heart pacing, mapping       7.59       8.90         NA       1.47      17.96         NA        000
93631...............  26............  A               Heart pacing, mapping       7.59       2.76       2.76       0.85      11.20      11.20        000
93631...............  TC............  A               Heart pacing, mapping       0.00       6.14         NA       0.62       6.76         NA        000
93640...............  ..............  A               Evaluation heart            3.51       8.52         NA       0.67      12.70         NA        000
                                                       device.
93640...............  26............  A               Evaluation heart            3.51       1.36       1.36       0.25       5.12       5.12        000
                                                       device.
93640...............  TC............  A               Evaluation heart            0.00       7.16         NA       0.42       7.58         NA        000
                                                       device.
93641...............  ..............  A               Electrophysiology           5.92       9.46         NA       0.84      16.22         NA        000
                                                       evaluation.
93641...............  26............  A               Electrophysiology           5.92       2.30       2.30       0.42       8.64       8.64        000
                                                       evaluation.
93641...............  TC............  A               Electrophysiology           0.00       7.16         NA       0.42       7.58         NA        000
                                                       evaluation.
93642...............  ..............  A               Electrophysiology           4.88       9.37         NA       0.58      14.83         NA        000
                                                       evaluation.
93642...............  26............  A               Electrophysiology           4.88       2.21       2.21       0.16       7.25       7.25        000
                                                       evaluation.
93642...............  TC............  A               Electrophysiology           0.00       7.16         NA       0.42       7.58         NA        000
                                                       evaluation.
93650...............  ..............  A               Ablate heart               10.49         NA       4.42       0.74         NA      15.65        000
                                                       dysrhythm focus.
93651...............  ..............  A               Ablate heart               16.23         NA       6.31       1.13         NA      23.67        000
                                                       dysrhythm focus.
93652...............  ..............  A               Ablate heart               17.65         NA       6.86       1.23         NA      25.74        000
                                                       dysrhythm focus.
93660...............  ..............  A               Tilt table evaluation       1.89       2.42         NA       0.08       4.39         NA        000
93660...............  26............  A               Tilt table evaluation       1.89       0.74       0.74       0.06       2.69       2.69        000
93660...............  TC............  A               Tilt table evaluation       0.00       1.68         NA       0.02       1.70         NA        000
93662...............  26............  A               Intracardiac ecg            2.80       1.10       1.10       0.09       3.99       3.99        ZZZ
                                                       (ice).
93701...............  ..............  A               Bioimpedance,               0.17       1.00         NA       0.02       1.19         NA        XXX
                                                       thoracic.
93701...............  26............  A               Bioimpedance,               0.17       0.07       0.07       0.01       0.25       0.25        XXX
                                                       thoracic.
93701...............  TC............  A               Bioimpedance,               0.00       0.94         NA       0.01       0.95         NA        XXX
                                                       thoracic.
93720...............  ..............  A               Total body                  0.17       1.16         NA       0.07       1.40         NA        XXX
                                                       plethysmography.
93721...............  ..............  A               Plethysmography             0.00       0.70         NA       0.06       0.76         NA        XXX
                                                       tracing.
93722...............  ..............  A               Plethysmography             0.17       0.05       0.05       0.01       0.23       0.23        XXX
                                                       report.
93724...............  ..............  A               Analyze pacemaker           4.88       5.86         NA       0.43      11.17         NA        000
                                                       system.
93724...............  26............  A               Analyze pacemaker           4.88       1.91       1.91       0.19       6.98       6.98        000
                                                       system.
93724...............  TC............  A               Analyze pacemaker           0.00       3.96         NA       0.24       4.20         NA        000
                                                       system.
93727...............  ..............  A               Analyze ilr system...       0.52       0.20       0.20       0.02       0.74       0.74        XXX
93731...............  ..............  A               Analyze pacemaker           0.45       0.67         NA       0.06       1.18         NA        XXX
                                                       system.
93731...............  26............  A               Analyze pacemaker           0.45       0.17       0.17       0.02       0.64       0.64        XXX
                                                       system.

[[Page 47684]]

 
93731...............  TC............  A               Analyze pacemaker           0.00       0.49         NA       0.04       0.53         NA        XXX
                                                       system.
93732...............  ..............  A               Analyze pacemaker           0.92       0.86         NA       0.07       1.85         NA        XXX
                                                       system.
93732...............  26............  A               Analyze pacemaker           0.92       0.35       0.35       0.03       1.30       1.30        XXX
                                                       system.
93732...............  TC............  A               Analyze pacemaker           0.00       0.51         NA       0.04       0.55         NA        XXX
                                                       system.
93733...............  ..............  A               Telephone analy,            0.17       0.79         NA       0.07       1.03         NA        XXX
                                                       pacemaker.
93733...............  26............  A               Telephone analy,            0.17       0.07       0.07       0.01       0.25       0.25        XXX
                                                       pacemaker.
93733...............  TC............  A               Telephone analy,            0.00       0.72         NA       0.06       0.78         NA        XXX
                                                       pacemaker.
93734...............  ..............  A               Analyze pacemaker           0.38       0.49         NA       0.03       0.90         NA        XXX
                                                       system.
93734...............  26............  A               Analyze pacemaker           0.38       0.14       0.14       0.01       0.53       0.53        XXX
                                                       system.
93734...............  TC............  A               Analyze pacemaker           0.00       0.35         NA       0.02       0.37         NA        XXX
                                                       system.
93735...............  ..............  A               Analyze pacemaker           0.74       0.73         NA       0.07       1.54         NA        XXX
                                                       system.
93735...............  26............  A               Analyze pacemaker           0.74       0.28       0.28       0.03       1.05       1.05        XXX
                                                       system.
93735...............  TC............  A               Analyze pacemaker           0.00       0.44         NA       0.04       0.48         NA        XXX
                                                       system.
93736...............  ..............  A               Telephonic analy,           0.15       0.69         NA       0.07       0.91         NA        XXX
                                                       pacemaker.
93736...............  26............  A               Telephonic analy,           0.15       0.06       0.06       0.01       0.22       0.22        XXX
                                                       pacemaker.
93736...............  TC............  A               Telephonic analy,           0.00       0.63         NA       0.06       0.69         NA        XXX
                                                       pacemaker.
93740...............  ..............  B               Temperature gradient        0.16       0.19         NA       0.02       0.37         NA        XXX
                                                       studies.
93740...............  26............  B               Temperature gradient        0.16       0.04       0.04       0.01       0.21       0.21        XXX
                                                       studies.
93740...............  TC............  B               Temperature gradient        0.00       0.15         NA       0.01       0.16         NA        XXX
                                                       studies.
93741...............  ..............  A               Analyze ht pace             0.80       0.98         NA       0.07       1.85         NA        XXX
                                                       device sngl.
93741...............  26............  A               Analyze ht pace             0.80       0.31       0.31       0.03       1.14       1.14        XXX
                                                       device sngl.
93741...............  TC............  A               Analyze ht pace             0.00       0.67         NA       0.04       0.71         NA        XXX
                                                       device sngl.
93742...............  ..............  A               Analyze ht pace             0.91       1.02         NA       0.07       2.00         NA        XXX
                                                       device sngl.
93742...............  26............  A               Analyze ht pace             0.91       0.36       0.36       0.03       1.30       1.30        XXX
                                                       device sngl.
93742...............  TC............  A               Analyze ht pace             0.00       0.67         NA       0.04       0.71         NA        XXX
                                                       device sngl.
93743...............  ..............  A               Analyze ht pace             1.03       1.13         NA       0.08       2.24         NA        XXX
                                                       device dual.
93743...............  26............  A               Analyze ht pace             1.03       0.40       0.40       0.04       1.47       1.47        XXX
                                                       device dual.
93743...............  TC............  A               Analyze ht pace             0.00       0.73         NA       0.04       0.77         NA        XXX
                                                       device dual.
93744...............  ..............  A               Analyze ht pace             1.18       1.12         NA       0.08       2.38         NA        XXX
                                                       device dual.
93744...............  26............  A               Analyze ht pace             1.18       0.46       0.46       0.04       1.68       1.68        XXX
                                                       device dual.
93744...............  TC............  A               Analyze ht pace             0.00       0.67         NA       0.04       0.71         NA        XXX
                                                       device dual.
93770...............  ..............  B               Measure venous              0.16       0.08         NA       0.02       0.26         NA        XXX
                                                       pressure.
93770...............  26............  B               Measure venous              0.16       0.05       0.05       0.01       0.22       0.22        XXX
                                                       pressure.
93770...............  TC............  B               Measure venous              0.00       0.03         NA       0.01       0.04         NA        XXX
                                                       pressure.
93784...............  ..............  A               Ambulatory BP               0.38       1.55         NA       0.03       1.96         NA        XXX
                                                       monitoring.
93786...............  ..............  A               Ambulatory BP               0.00       0.91         NA       0.01       0.92         NA        XXX
                                                       recording.
93788...............  ..............  A               Ambulatory BP               0.00       0.51         NA       0.01       0.52         NA        XXX
                                                       analysis.
93790...............  ..............  A               Review/report BP            0.38       0.13       0.13       0.01       0.52       0.52        XXX
                                                       recording.
93797...............  ..............  A               Cardiac rehab........       0.18       0.30       0.07       0.01       0.49       0.26        000
93798...............  ..............  A               Cardiac rehab/monitor       0.28       0.47       0.11       0.01       0.76       0.40        000
93875...............  ..............  A               Extracranial study...       0.22       2.10         NA       0.12       2.44         NA        XXX
93875...............  26............  A               Extracranial study...       0.22       0.08       0.08       0.01       0.31       0.31        XXX
93875...............  TC............  A               Extracranial study...       0.00       2.02         NA       0.11       2.13         NA        XXX
93880...............  ..............  A               Extracranial study...       0.60       5.06         NA       0.39       6.05         NA        XXX
93880...............  26............  A               Extracranial study...       0.60       0.20       0.20       0.04       0.84       0.84        XXX
93880...............  TC............  A               Extracranial study...       0.00       4.85         NA       0.35       5.20         NA        XXX
93882...............  ..............  A               Extracranial study...       0.40       3.31         NA       0.26       3.97         NA        XXX
93882...............  26............  A               Extracranial study...       0.40       0.14       0.14       0.04       0.58       0.58        XXX
93882...............  TC............  A               Extracranial study...       0.00       3.17         NA       0.22       3.39         NA        XXX
93886...............  ..............  A               Intracranial study...       0.94       6.05         NA       0.45       7.44         NA        XXX
93886...............  26............  A               Intracranial study...       0.94       0.37       0.37       0.06       1.37       1.37        XXX
93886...............  TC............  A               Intracranial study...       0.00       5.68         NA       0.39       6.07         NA        XXX
93888...............  ..............  A               Intracranial study...       0.62       3.85         NA       0.32       4.79         NA        XXX
93888...............  26............  A               Intracranial study...       0.62       0.23       0.23       0.05       0.90       0.90        XXX
93888...............  TC............  A               Intracranial study...       0.00       3.62         NA       0.27       3.89         NA        XXX
93922...............  ..............  A               Extremity study......       0.25       2.43         NA       0.15       2.83         NA        XXX
93922...............  26............  A               Extremity study......       0.25       0.08       0.08       0.02       0.35       0.35        XXX
93922...............  TC............  A               Extremity study......       0.00       2.34         NA       0.13       2.47         NA        XXX
93923...............  ..............  A               Extremity study......       0.45       3.68         NA       0.26       4.39         NA        XXX
93923...............  26............  A               Extremity study......       0.45       0.15       0.15       0.04       0.64       0.64        XXX
93923...............  TC............  A               Extremity study......       0.00       3.53         NA       0.22       3.75         NA        XXX
93924...............  ..............  A               Extremity study......       0.50       4.42         NA       0.30       5.22         NA        XXX
93924...............  26............  A               Extremity study......       0.50       0.17       0.17       0.05       0.72       0.72        XXX
93924...............  TC............  A               Extremity study......       0.00       4.25         NA       0.25       4.50         NA        XXX
93925...............  ..............  A               Lower extremity study       0.58       6.11         NA       0.39       7.08         NA        XXX
93925...............  26............  A               Lower extremity study       0.58       0.20       0.20       0.04       0.82       0.82        XXX
93925...............  TC............  A               Lower extremity study       0.00       5.91         NA       0.35       6.26         NA        XXX
93926...............  ..............  A               Lower extremity study       0.39       3.82         NA       0.27       4.48         NA        XXX
93926...............  26............  A               Lower extremity study       0.39       0.13       0.13       0.04       0.56       0.56        XXX
93926...............  TC............  A               Lower extremity study       0.00       3.69         NA       0.23       3.92         NA        XXX
93930...............  ..............  A               Upper extremity study       0.46       4.85         NA       0.41       5.72         NA        XXX
93930...............  26............  A               Upper extremity study       0.46       0.16       0.16       0.04       0.66       0.66        XXX
93930...............  TC............  A               Upper extremity study       0.00       4.69         NA       0.37       5.06         NA        XXX
93931...............  ..............  A               Upper extremity study       0.31       3.22         NA       0.27       3.80         NA        XXX
93931...............  26............  A               Upper extremity study       0.31       0.10       0.10       0.03       0.44       0.44        XXX

[[Page 47685]]

 
93931...............  TC............  A               Upper extremity study       0.00       3.12         NA       0.24       3.36         NA        XXX
93965...............  ..............  A               Extremity study......       0.35       2.48         NA       0.14       2.97         NA        XXX
93965...............  26............  A               Extremity study......       0.35       0.12       0.12       0.02       0.49       0.49        XXX
93965...............  TC............  A               Extremity study......       0.00       2.36         NA       0.12       2.48         NA        XXX
93970...............  ..............  A               Extremity study......       0.68       4.77         NA       0.45       5.90         NA        XXX
93970...............  26............  A               Extremity study......       0.68       0.23       0.23       0.05       0.96       0.96        XXX
93970...............  TC............  A               Extremity study......       0.00       4.54         NA       0.40       4.94         NA        XXX
93971...............  ..............  A               Extremity study......       0.45       3.28         NA       0.30       4.03         NA        XXX
93971...............  26............  A               Extremity study......       0.45       0.15       0.15       0.03       0.63       0.63        XXX
93971...............  TC............  A               Extremity study......       0.00       3.13         NA       0.27       3.40         NA        XXX
93975...............  ..............  A               Vascular study.......       1.80       6.91         NA       0.56       9.27         NA        XXX
93975...............  26............  A               Vascular study.......       1.80       0.60       0.60       0.13       2.53       2.53        XXX
93975...............  TC............  A               Vascular study.......       0.00       6.32         NA       0.43       6.75         NA        XXX
93976...............  ..............  A               Vascular study.......       1.21       3.92         NA       0.36       5.49         NA        XXX
93976...............  26............  A               Vascular study.......       1.21       0.40       0.40       0.06       1.67       1.67        XXX
93976...............  TC............  A               Vascular study.......       0.00       3.52         NA       0.30       3.82         NA        XXX
93978...............  ..............  A               Vascular study.......       0.65       4.17         NA       0.43       5.25         NA        XXX
93978...............  26............  A               Vascular study.......       0.65       0.22       0.22       0.06       0.93       0.93        XXX
93978...............  TC............  A               Vascular study.......       0.00       3.95         NA       0.37       4.32         NA        XXX
93979...............  ..............  A               Vascular study.......       0.44       3.00         NA       0.28       3.72         NA        XXX
93979...............  26............  A               Vascular study.......       0.44       0.15       0.15       0.04       0.63       0.63        XXX
93979...............  TC............  A               Vascular study.......       0.00       2.85         NA       0.24       3.09         NA        XXX
93980...............  ..............  A               Penile vascular study       1.25       2.88         NA       0.43       4.56         NA        XXX
93980...............  26............  A               Penile vascular study       1.25       0.41       0.41       0.09       1.75       1.75        XXX
93980...............  TC............  A               Penile vascular study       0.00       2.48         NA       0.34       2.82         NA        XXX
93981...............  ..............  A               Penile vascular study       0.44       2.96         NA       0.33       3.73         NA        XXX
93981...............  26............  A               Penile vascular study       0.44       0.14       0.14       0.02       0.60       0.60        XXX
93981...............  TC............  A               Penile vascular study       0.00       2.81         NA       0.31       3.12         NA        XXX
93990...............  ..............  A               Doppler flow testing.       0.25       3.76         NA       0.26       4.27         NA        XXX
93990...............  26............  A               Doppler flow testing.       0.25       0.09       0.09       0.03       0.37       0.37        XXX
93990...............  TC............  A               Doppler flow testing.       0.00       3.67         NA       0.23       3.90         NA        XXX
94010...............  ..............  A               Breathing capacity          0.17       0.69         NA       0.03       0.89         NA        XXX
                                                       test.
94010...............  26............  A               Breathing capacity          0.17       0.05       0.05       0.01       0.23       0.23        XXX
                                                       test.
94010...............  TC............  A               Breathing capacity          0.00       0.63         NA       0.02       0.65         NA        XXX
                                                       test.
94014...............  ..............  A               Patient recorded            0.52       0.77         NA       0.04       1.33         NA        XXX
                                                       spirometry.
94015...............  ..............  A               Patient recorded            0.00       0.60         NA       0.01       0.61         NA        XXX
                                                       spirometry.
94016...............  ..............  A               Review patient              0.52       0.16       0.16       0.03       0.71       0.71        XXX
                                                       spirometry.
94060...............  ..............  A               Evaluation of               0.31       1.10         NA       0.07       1.48         NA        XXX
                                                       wheezing.
94060...............  26............  A               Evaluation of               0.31       0.09       0.09       0.01       0.41       0.41        XXX
                                                       wheezing.
94060...............  TC............  A               Evaluation of               0.00       1.01         NA       0.06       1.07         NA        XXX
                                                       wheezing.
94070...............  ..............  A               Evaluation of               0.60       0.84         NA       0.13       1.57         NA        XXX
                                                       wheezing.
94070...............  26............  A               Evaluation of               0.60       0.18       0.18       0.03       0.81       0.81        XXX
                                                       wheezing.
94070...............  TC............  A               Evaluation of               0.00       0.66         NA       0.10       0.76         NA        XXX
                                                       wheezing.
94150...............  ..............  B               Vital capacity test..       0.07       0.48         NA       0.02       0.57         NA        XXX
94150...............  26............  B               Vital capacity test..       0.07       0.03       0.03       0.01       0.11       0.11        XXX
94150...............  TC............  B               Vital capacity test..       0.00       0.45         NA       0.01       0.46         NA        XXX
94200...............  ..............  A               Lung function test          0.11       0.46         NA       0.03       0.60         NA        XXX
                                                       (MBC/MVV).
94200...............  26............  A               Lung function test          0.11       0.03       0.03       0.01       0.15       0.15        XXX
                                                       (MBC/MVV).
94200...............  TC............  A               Lung function test          0.00       0.42         NA       0.02       0.44         NA        XXX
                                                       (MBC/MVV).
94240...............  ..............  A               Residual lung               0.26       0.67         NA       0.06       0.99         NA        XXX
                                                       capacity.
94240...............  26............  A               Residual lung               0.26       0.08       0.08       0.01       0.35       0.35        XXX
                                                       capacity.
94240...............  TC............  A               Residual lung               0.00       0.59         NA       0.05       0.64         NA        XXX
                                                       capacity.
94250...............  ..............  A               Expired gas                 0.11       0.65         NA       0.02       0.78         NA        XXX
                                                       collection.
94250...............  26............  A               Expired gas                 0.11       0.03       0.03       0.01       0.15       0.15        XXX
                                                       collection.
94250...............  TC............  A               Expired gas                 0.00       0.62         NA       0.01       0.63         NA        XXX
                                                       collection.
94260...............  ..............  A               Thoracic gas volume..       0.13       0.59         NA       0.05       0.77         NA        XXX
94260...............  26............  A               Thoracic gas volume..       0.13       0.04       0.04       0.01       0.18       0.18        XXX
94260...............  TC............  A               Thoracic gas volume..       0.00       0.55         NA       0.04       0.59         NA        XXX
94350...............  ..............  A               Lung nitrogen washout       0.26       0.77         NA       0.05       1.08         NA        XXX
                                                       curve.
94350...............  26............  A               Lung nitrogen washout       0.26       0.08       0.08       0.01       0.35       0.35        XXX
                                                       curve.
94350...............  TC............  A               Lung nitrogen washout       0.00       0.70         NA       0.04       0.74         NA        XXX
                                                       curve.
94360...............  ..............  A               Measure airflow             0.26       0.71         NA       0.07       1.04         NA        XXX
                                                       resistance.
94360...............  26............  A               Measure airflow             0.26       0.08       0.08       0.01       0.35       0.35        XXX
                                                       resistance.
94360...............  TC............  A               Measure airflow             0.00       0.63         NA       0.06       0.69         NA        XXX
                                                       resistance.
94370...............  ..............  A               Breath airway closing       0.26       0.74         NA       0.03       1.03         NA        XXX
                                                       volume.
94370...............  26............  A               Breath airway closing       0.26       0.08       0.08       0.01       0.35       0.35        XXX
                                                       volume.
94370...............  TC............  A               Breath airway closing       0.00       0.66         NA       0.02       0.68         NA        XXX
                                                       volume.
94375...............  ..............  A               Respiratory flow            0.31       0.62         NA       0.03       0.96         NA        XXX
                                                       volume loop.
94375...............  26............  A               Respiratory flow            0.31       0.09       0.09       0.01       0.41       0.41        XXX
                                                       volume loop.
94375...............  TC............  A               Respiratory flow            0.00       0.53         NA       0.02       0.55         NA        XXX
                                                       volume loop.
94400...............  ..............  A               CO2 breathing               0.40       0.86         NA       0.09       1.35         NA        XXX
                                                       response curve.
94400...............  26............  A               CO2 breathing               0.40       0.12       0.12       0.03       0.55       0.55        XXX
                                                       response curve.
94400...............  TC............  A               CO2 breathing               0.00       0.74         NA       0.06       0.80         NA        XXX
                                                       response curve.
94450...............  ..............  A               Hypoxia response            0.40       0.87         NA       0.04       1.31         NA        XXX
                                                       curve.
94450...............  26............  A               Hypoxia response            0.40       0.12       0.12       0.02       0.54       0.54        XXX
                                                       curve.

[[Page 47686]]

 
94450...............  TC............  A               Hypoxia response            0.00       0.75         NA       0.02       0.77         NA        XXX
                                                       curve.
94620...............  ..............  A               Pulmonary stress test/      0.64       2.54         NA       0.13       3.31         NA        XXX
                                                       simple.
94620...............  26............  A               Pulmonary stress test/      0.64       0.20       0.20       0.03       0.87       0.87        XXX
                                                       simple.
94620...............  TC............  A               Pulmonary stress test/      0.00       2.34         NA       0.10       2.44         NA        XXX
                                                       simple.
94621...............  ..............  A               Pulm stress test/           1.42       2.24         NA       0.16       3.82         NA        XXX
                                                       complex.
94621...............  26............  A               Pulm stress test/           1.42       0.43       0.43       0.06       1.91       1.91        XXX
                                                       complex.
94621...............  TC............  A               Pulm stress test/           0.00       1.80         NA       0.10       1.90         NA        XXX
                                                       complex.
94640...............  ..............  A               Airway inhalation           0.00       0.31         NA       0.02       0.33         NA        XXX
                                                       treatment.
94656...............  ..............  A               Initial ventilator          1.22       1.18       0.31       0.07       2.47       1.60        XXX
                                                       mgmt.
94657...............  ..............  A               Continued ventilator        0.83       1.00       0.25       0.04       1.87       1.12        XXX
                                                       mgmt.
94660...............  ..............  A               Pos airway pressure,        0.76       0.66       0.23       0.04       1.46       1.03        XXX
                                                       CPAP.
94662...............  ..............  A               Neg press                   0.76         NA       0.23       0.06         NA       1.05        XXX
                                                       ventilation, cnp.
94664...............  ..............  A               Evaluate pt use of          0.00       0.32         NA       0.04       0.36         NA        XXX
                                                       inhaler.
94667...............  ..............  A               Chest wall                  0.00       0.54         NA       0.05       0.59         NA        XXX
                                                       manipulation.
94668...............  ..............  A               Chest wall                  0.00       0.46         NA       0.02       0.48         NA        XXX
                                                       manipulation.
94680...............  ..............  A               Exhaled air analysis,       0.26       1.89         NA       0.07       2.22         NA        XXX
                                                       o2.
94680...............  26............  A               Exhaled air analysis,       0.26       0.08       0.08       0.01       0.35       0.35        XXX
                                                       o2.
94680...............  TC............  A               Exhaled air analysis,       0.00       1.81         NA       0.06       1.87         NA        XXX
                                                       o2.
94681...............  ..............  A               Exhaled air analysis,       0.20       2.58         NA       0.13       2.91         NA        XXX
                                                       o2/co2.
94681...............  26............  A               Exhaled air analysis,       0.20       0.06       0.06       0.01       0.27       0.27        XXX
                                                       o2/co2.
94681...............  TC............  A               Exhaled air analysis,       0.00       2.52         NA       0.12       2.64         NA        XXX
                                                       o2/co2.
94690...............  ..............  A               Exhaled air analysis.       0.07       2.02         NA       0.04       2.13         NA        XXX
94690...............  26............  A               Exhaled air analysis.       0.07       0.02       0.02       0.00       0.09       0.09        XXX
94690...............  TC............  A               Exhaled air analysis.       0.00       2.00         NA       0.04       2.04         NA        XXX
94720...............  ..............  A               Monoxide diffusing          0.26       1.02         NA       0.07       1.35         NA        XXX
                                                       capacity.
94720...............  26............  A               Monoxide diffusing          0.26       0.08       0.08       0.01       0.35       0.35        XXX
                                                       capacity.
94720...............  TC............  A               Monoxide diffusing          0.00       0.94         NA       0.06       1.00         NA        XXX
                                                       capacity.
94725...............  ..............  A               Membrane diffusion          0.26       2.94         NA       0.13       3.33         NA        XXX
                                                       capacity.
94725...............  26............  A               Membrane diffusion          0.26       0.08       0.08       0.01       0.35       0.35        XXX
                                                       capacity.
94725...............  TC............  A               Membrane diffusion          0.00       2.86         NA       0.12       2.98         NA        XXX
                                                       capacity.
94750...............  ..............  A               Pulmonary compliance        0.23       1.35         NA       0.05       1.63         NA        XXX
                                                       study.
94750...............  26............  A               Pulmonary compliance        0.23       0.07       0.07       0.01       0.31       0.31        XXX
                                                       study.
94750...............  TC............  A               Pulmonary compliance        0.00       1.29         NA       0.04       1.33         NA        XXX
                                                       study.
94760...............  ..............  T               Measure blood oxygen        0.00       0.04         NA       0.02       0.06         NA        XXX
                                                       level.
94761...............  ..............  T               Measure blood oxygen        0.00       0.07         NA       0.06       0.13         NA        XXX
                                                       level.
94762...............  ..............  A               Measure blood oxygen        0.00       0.49         NA       0.10       0.59         NA        XXX
                                                       level.
94770...............  ..............  A               Exhaled carbon              0.15       0.76         NA       0.08       0.99         NA        XXX
                                                       dioxide test.
94770...............  26............  A               Exhaled carbon              0.15       0.04       0.04       0.01       0.20       0.20        XXX
                                                       dioxide test.
94770...............  TC............  A               Exhaled carbon              0.00       0.72         NA       0.07       0.79         NA        XXX
                                                       dioxide test.
95004...............  ..............  A               Percut allergy skin         0.00       0.10         NA       0.01       0.11         NA        XXX
                                                       tests.
95010...............  ..............  A               Percut allergy              0.15       0.32       0.06       0.00       0.47       0.21        XXX
                                                       titrate test.
95015...............  ..............  A               Id allergy titrate-         0.15       0.14       0.06       0.01       0.30       0.22        XXX
                                                       drug/bug.
95024...............  ..............  A               Id allergy test, drug/      0.00       0.14         NA       0.01       0.15         NA        XXX
                                                       bug.
95027...............  ..............  A               Id allergy titrate-         0.00       0.14         NA       0.01       0.15         NA        XXX
                                                       airborne.
95028...............  ..............  A               Id allergy test-            0.00       0.23         NA       0.01       0.24         NA        XXX
                                                       delayed type.
95044...............  ..............  A               Allergy patch tests..       0.00       0.20         NA       0.01       0.21         NA        XXX
95052...............  ..............  A               Photo patch test.....       0.00       0.25         NA       0.01       0.26         NA        XXX
95056...............  ..............  A               Photosensitivity            0.00       0.17         NA       0.01       0.18         NA        XXX
                                                       tests.
95060...............  ..............  A               Eye allergy tests....       0.00       0.35         NA       0.02       0.37         NA        XXX
95065...............  ..............  A               Nose allergy test....       0.00       0.20         NA       0.01       0.21         NA        XXX
95070...............  ..............  A               Bronchial allergy           0.00       2.28         NA       0.02       2.30         NA        XXX
                                                       tests.
95071...............  ..............  A               Bronchial allergy           0.00       2.91         NA       0.02       2.93         NA        XXX
                                                       tests.
95075...............  ..............  A               Ingestion challenge         0.95       0.83       0.38       0.03       1.81       1.36        XXX
                                                       test.
95078...............  ..............  A               Provocative testing..       0.00       0.25         NA       0.02       0.27         NA        XXX
95115...............  ..............  A               Immunotherapy, one          0.00       0.39         NA       0.02       0.41         NA        000
                                                       injection.
95117...............  ..............  A               Immunotherapy               0.00       0.50         NA       0.02       0.52         NA        000
                                                       injections.
95144...............  ..............  A               Antigen therapy             0.06       0.19       0.02       0.00       0.25       0.08        000
                                                       services.
95145...............  ..............  A               Antigen therapy             0.06       0.32       0.02       0.00       0.38       0.08        000
                                                       services.
95146...............  ..............  A               Antigen therapy             0.06       0.44       0.03       0.00       0.50       0.09        000
                                                       services.
95147...............  ..............  A               Antigen therapy             0.06       0.42       0.02       0.00       0.48       0.08        000
                                                       services.
95148...............  ..............  A               Antigen therapy             0.06       0.58       0.03       0.00       0.64       0.09        000
                                                       services.
95149...............  ..............  A               Antigen therapy             0.06       0.80       0.03       0.00       0.86       0.09        000
                                                       services.
95165...............  ..............  A               Antigen therapy             0.06       0.19       0.02       0.00       0.25       0.08        000
                                                       services.
95170...............  ..............  A               Antigen therapy             0.06       0.13       0.02       0.00       0.19       0.08        000
                                                       services.
95180...............  ..............  A               Rapid desensitization       2.01       2.05       0.93       0.05       4.11       2.99        000
95250...............  ..............  A               Glucose monitoring,         0.00       4.22         NA       0.01       4.23         NA        XXX
                                                       cont.
95805...............  ..............  A               Multiple sleep              1.88      18.00         NA       0.43      20.31         NA        XXX
                                                       latency test.
95805...............  26............  A               Multiple sleep              1.88       0.66       0.66       0.09       2.63       2.63        XXX
                                                       latency test.
95805...............  TC............  A               Multiple sleep              0.00      17.35         NA       0.34      17.69         NA        XXX
                                                       latency test.
95806...............  ..............  A               Sleep study,                1.66       3.40         NA       0.39       5.45         NA        XXX
                                                       unattended.
95806...............  26............  A               Sleep study,                1.66       0.53       0.53       0.08       2.27       2.27        XXX
                                                       unattended.
95806...............  TC............  A               Sleep study,                0.00       2.87         NA       0.31       3.18         NA        XXX
                                                       unattended.
95807...............  ..............  A               Sleep study, attended       1.66      12.10         NA       0.50      14.26         NA        XXX
95807...............  26............  A               Sleep study, attended       1.66       0.53       0.53       0.08       2.27       2.27        XXX
95807...............  TC............  A               Sleep study, attended       0.00      11.57         NA       0.42      11.99         NA        XXX

[[Page 47687]]

 
95808...............  ..............  A               Polysomnography, 1-3.       2.65      13.54         NA       0.55      16.74         NA        XXX
95808...............  26............  A               Polysomnography, 1-3.       2.65       0.92       0.92       0.13       3.70       3.70        XXX
95808...............  TC............  A               Polysomnography, 1-3.       0.00      12.62         NA       0.42      13.04         NA        XXX
95810...............  ..............  A               Polysomnography, 4 or       3.52      18.02         NA       0.59      22.13         NA        XXX
                                                       more.
95810...............  26............  A               Polysomnography, 4 or       3.52       1.18       1.18       0.17       4.87       4.87        XXX
                                                       more.
95810...............  TC............  A               Polysomnography, 4 or       0.00      16.84         NA       0.42      17.26         NA        XXX
                                                       more.
95811...............  ..............  A               Polysomnography w/          3.79      19.53         NA       0.61      23.93         NA        XXX
                                                       cpap.
95811...............  26............  A               Polysomnography w/          3.79       1.27       1.27       0.18       5.24       5.24        XXX
                                                       cpap.
95811...............  TC............  A               Polysomnography w/          0.00      18.26         NA       0.43      18.69         NA        XXX
                                                       cpap.
95812...............  ..............  A               Eeg, 41-60 minutes...       1.08       4.03         NA       0.17       5.28         NA        XXX
95812...............  26............  A               Eeg, 41-60 minutes...       1.08       0.45       0.45       0.06       1.59       1.59        XXX
95812...............  TC............  A               Eeg, 41-60 minutes...       0.00       3.58         NA       0.11       3.69         NA        XXX
95813...............  ..............  A               Eeg, over 1 hour.....       1.73       5.04         NA       0.21       6.98         NA        XXX
95813...............  26............  A               Eeg, over 1 hour.....       1.73       0.70       0.70       0.10       2.53       2.53        XXX
95813...............  TC............  A               Eeg, over 1 hour.....       0.00       4.35         NA       0.11       4.46         NA        XXX
95816...............  ..............  A               Eeg, awake and drowsy       1.08       4.78         NA       0.16       6.02         NA        XXX
95816...............  26............  A               Eeg, awake and drowsy       1.08       0.46       0.46       0.06       1.60       1.60        XXX
95816...............  TC............  A               Eeg, awake and drowsy       0.00       4.32         NA       0.10       4.42         NA        XXX
95819...............  ..............  A               Eeg, awake and asleep       1.08       2.76         NA       0.16       4.00         NA        XXX
95819...............  26............  A               Eeg, awake and asleep       1.08       0.46       0.46       0.06       1.60       1.60        XXX
95819...............  TC............  A               Eeg, awake and asleep       0.00       2.30         NA       0.10       2.40         NA        XXX
95822...............  ..............  A               Eeg, coma or sleep          1.08       4.63         NA       0.19       5.90         NA        XXX
                                                       only.
95822...............  26............  A               Eeg, coma or sleep          1.08       0.46       0.46       0.06       1.60       1.60        XXX
                                                       only.
95822...............  TC............  A               Eeg, coma or sleep          0.00       4.18         NA       0.13       4.31         NA        XXX
                                                       only.
95824...............  26............  A               Eeg, cerebral death         0.74       0.31       0.31       0.04       1.09       1.09        XXX
                                                       only.
95827...............  ..............  A               Eeg, all night              1.08       2.69         NA       0.20       3.97         NA        XXX
                                                       recording.
95827...............  26............  A               Eeg, all night              1.08       0.41       0.41       0.06       1.55       1.55        XXX
                                                       recording.
95827...............  TC............  A               Eeg, all night              0.00       2.29         NA       0.14       2.43         NA        XXX
                                                       recording.
95829...............  ..............  A               Surgery                     6.20      31.16         NA       0.51      37.87         NA        XXX
                                                       electrocorticogram.
95829...............  26............  A               Surgery                     6.20       2.31       2.31       0.49       9.00       9.00        XXX
                                                       electrocorticogram.
95829...............  TC............  A               Surgery                     0.00      28.85         NA       0.02      28.87         NA        XXX
                                                       electrocorticogram.
95830...............  ..............  A               Insert electrodes for       1.70       3.29       0.73       0.10       5.09       2.53        XXX
                                                       EEG.
95831...............  ..............  A               Limb muscle testing,        0.28       0.46       0.13       0.02       0.76       0.43        XXX
                                                       manual.
95832...............  ..............  A               Hand muscle testing,        0.29       0.33       0.12       0.02       0.64       0.43        XXX
                                                       manual.
95833...............  ..............  A               Body muscle testing,        0.47       0.59       0.23       0.02       1.08       0.72        XXX
                                                       manual.
95834...............  ..............  A               Body muscle testing,        0.60       0.64       0.28       0.03       1.27       0.91        XXX
                                                       manual.
95851...............  ..............  A               Range of motion             0.16       0.37       0.08       0.01       0.54       0.25        XXX
                                                       measurements.
95852...............  ..............  A               Range of motion             0.11       0.26       0.05       0.01       0.38       0.17        XXX
                                                       measurements.
95857...............  ..............  A               Tensilon test........       0.53       0.60       0.23       0.03       1.16       0.79        XXX
95858...............  ..............  A               Tensilon test &             1.56       1.06         NA       0.12       2.74         NA        XXX
                                                       myogram.
95858...............  26............  A               Tensilon test &             1.56       0.67       0.67       0.08       2.31       2.31        XXX
                                                       myogram.
95858...............  TC............  A               Tensilon test &             0.00       0.40         NA       0.04       0.44         NA        XXX
                                                       myogram.
95860...............  ..............  A               Muscle test, one limb       0.96       1.43         NA       0.07       2.46         NA        XXX
95860...............  26............  A               Muscle test, one limb       0.96       0.42       0.42       0.05       1.43       1.43        XXX
95860...............  TC............  A               Muscle test, one limb       0.00       1.01         NA       0.02       1.03         NA        XXX
95861...............  ..............  A               Muscle test, 2 limbs.       1.54       1.41         NA       0.14       3.09         NA        XXX
95861...............  26............  A               Muscle test, 2 limbs.       1.54       0.67       0.67       0.08       2.29       2.29        XXX
95861...............  TC............  A               Muscle test, 2 limbs.       0.00       0.73         NA       0.06       0.79         NA        XXX
95863...............  ..............  A               Muscle test, 3 limbs.       1.87       1.74         NA       0.15       3.76         NA        XXX
95863...............  26............  A               Muscle test, 3 limbs.       1.87       0.80       0.80       0.09       2.76       2.76        XXX
95863...............  TC............  A               Muscle test, 3 limbs.       0.00       0.94         NA       0.06       1.00         NA        XXX
95864...............  ..............  A               Muscle test, 4 limbs.       1.99       2.64         NA       0.22       4.85         NA        XXX
95864...............  26............  A               Muscle test, 4 limbs.       1.99       0.87       0.87       0.10       2.96       2.96        XXX
95864...............  TC............  A               Muscle test, 4 limbs.       0.00       1.78         NA       0.12       1.90         NA        XXX
95867...............  ..............  A               Muscle test cran nerv       0.79       0.92         NA       0.08       1.79         NA        XXX
                                                       unilat.
95867...............  26............  A               Muscle test cran nerv       0.79       0.35       0.35       0.04       1.18       1.18        XXX
                                                       unilat.
95867...............  TC............  A               Muscle test cran nerv       0.00       0.58         NA       0.04       0.62         NA        XXX
                                                       unilat.
95868...............  ..............  A               Muscle test cran            1.18       1.21         NA       0.11       2.50         NA        XXX
                                                       nerve bilat.
95868...............  26............  A               Muscle test cran            1.18       0.51       0.51       0.06       1.75       1.75        XXX
                                                       nerve bilat.
95868...............  TC............  A               Muscle test cran            0.00       0.69         NA       0.05       0.74         NA        XXX
                                                       nerve bilat.
95869...............  ..............  A               Muscle test, thor           0.37       0.37         NA       0.04       0.78         NA        XXX
                                                       paraspinal.
95869...............  26............  A               Muscle test, thor           0.37       0.16       0.16       0.02       0.55       0.55        XXX
                                                       paraspinal.
95869...............  TC............  A               Muscle test, thor           0.00       0.21         NA       0.02       0.23         NA        XXX
                                                       paraspinal.
95870...............  ..............  A               Muscle test,                0.37       0.37         NA       0.04       0.78         NA        XXX
                                                       nonparaspinal.
95870...............  26............  A               Muscle test,                0.37       0.16       0.16       0.02       0.55       0.55        XXX
                                                       nonparaspinal.
95870...............  TC............  A               Muscle test,                0.00       0.21         NA       0.02       0.23         NA        XXX
                                                       nonparaspinal.
95872...............  ..............  A               Muscle test, one            1.50       1.23         NA       0.14       2.87         NA        XXX
                                                       fiber.
95872...............  26............  A               Muscle test, one            1.50       0.63       0.63       0.09       2.22       2.22        XXX
                                                       fiber.
95872...............  TC............  A               Muscle test, one            0.00       0.60         NA       0.05       0.65         NA        XXX
                                                       fiber.
95875...............  ..............  A               Limb exercise test...       1.10       1.45         NA       0.14       2.69         NA        XXX
95875...............  26............  A               Limb exercise test...       1.10       0.47       0.47       0.08       1.65       1.65        XXX
95875...............  TC............  A               Limb exercise test...       0.00       0.98         NA       0.06       1.04         NA        XXX
95900...............  ..............  A               Motor nerve                 0.42       1.26         NA       0.04       1.72         NA        XXX
                                                       conduction test.
95900...............  26............  A               Motor nerve                 0.42       0.18       0.18       0.02       0.62       0.62        XXX
                                                       conduction test.
95900...............  TC............  A               Motor nerve                 0.00       1.08         NA       0.02       1.10         NA        XXX
                                                       conduction test.

[[Page 47688]]

 
95903...............  ..............  A               Motor nerve                 0.60       1.20         NA       0.05       1.85         NA        XXX
                                                       conduction test.
95903...............  26............  A               Motor nerve                 0.60       0.26       0.26       0.03       0.89       0.89        XXX
                                                       conduction test.
95903...............  TC............  A               Motor nerve                 0.00       0.94         NA       0.02       0.96         NA        XXX
                                                       conduction test.
95904...............  ..............  A               Sense nerve                 0.34       1.09         NA       0.04       1.47         NA        XXX
                                                       conduction test.
95904...............  26............  A               Sense nerve                 0.34       0.15       0.15       0.02       0.51       0.51        XXX
                                                       conduction test.
95904...............  TC............  A               Sense nerve                 0.00       0.95         NA       0.02       0.97         NA        XXX
                                                       conduction test.
95920...............  ..............  A               Intraop nerve test          2.11       2.23         NA       0.24       4.58         NA        ZZZ
                                                       add-on.
95920...............  26............  A               Intraop nerve test          2.11       0.93       0.93       0.17       3.21       3.21        ZZZ
                                                       add-on.
95920...............  TC............  A               Intraop nerve test          0.00       1.30         NA       0.07       1.37         NA        ZZZ
                                                       add-on.
95921...............  ..............  A               Autonomic nerv              0.90       0.70         NA       0.06       1.66         NA        XXX
                                                       function test.
95921...............  26............  A               Autonomic nerv              0.90       0.33       0.33       0.04       1.27       1.27        XXX
                                                       function test.
95921...............  TC............  A               Autonomic nerv              0.00       0.38         NA       0.02       0.40         NA        XXX
                                                       function test.
95922...............  ..............  A               Autonomic nerv              0.96       0.78         NA       0.07       1.81         NA        XXX
                                                       function test.
95922...............  26............  A               Autonomic nerv              0.96       0.40       0.40       0.05       1.41       1.41        XXX
                                                       function test.
95922...............  TC............  A               Autonomic nerv              0.00       0.38         NA       0.02       0.40         NA        XXX
                                                       function test.
95923...............  ..............  A               Autonomic nerv              0.90       1.95         NA       0.07       2.92         NA        XXX
                                                       function test.
95923...............  26............  A               Autonomic nerv              0.90       0.38       0.38       0.05       1.33       1.33        XXX
                                                       function test.
95923...............  TC............  A               Autonomic nerv              0.00       1.57         NA       0.02       1.59         NA        XXX
                                                       function test.
95925...............  ..............  A               Somatosensory testing       0.54       1.13         NA       0.09       1.76         NA        XXX
95925...............  26............  A               Somatosensory testing       0.54       0.22       0.22       0.03       0.79       0.79        XXX
95925...............  TC............  A               Somatosensory testing       0.00       0.91         NA       0.06       0.97         NA        XXX
95926...............  ..............  A               Somatosensory testing       0.54       1.14         NA       0.09       1.77         NA        XXX
95926...............  26............  A               Somatosensory testing       0.54       0.23       0.23       0.03       0.80       0.80        XXX
95926...............  TC............  A               Somatosensory testing       0.00       0.91         NA       0.06       0.97         NA        XXX
95927...............  ..............  A               Somatosensory testing       0.54       1.16         NA       0.09       1.79         NA        XXX
95927...............  26............  A               Somatosensory testing       0.54       0.25       0.25       0.03       0.82       0.82        XXX
95927...............  TC............  A               Somatosensory testing       0.00       0.91         NA       0.06       0.97         NA        XXX
95930...............  ..............  A               Visual evoked               0.35       2.25         NA       0.03       2.63         NA        XXX
                                                       potential test.
95930...............  26............  A               Visual evoked               0.35       0.15       0.15       0.02       0.52       0.52        XXX
                                                       potential test.
95930...............  TC............  A               Visual evoked               0.00       2.10         NA       0.01       2.11         NA        XXX
                                                       potential test.
95933...............  ..............  A               Blink reflex test....       0.59       1.02         NA       0.10       1.71         NA        XXX
95933...............  26............  A               Blink reflex test....       0.59       0.24       0.24       0.04       0.87       0.87        XXX
95933...............  TC............  A               Blink reflex test....       0.00       0.78         NA       0.06       0.84         NA        XXX
95934...............  ..............  A               H-reflex test........       0.51       0.43         NA       0.04       0.98         NA        XXX
95934...............  26............  A               H-reflex test........       0.51       0.22       0.22       0.02       0.75       0.75        XXX
95934...............  TC............  A               H-reflex test........       0.00       0.21         NA       0.02       0.23         NA        XXX
95936...............  ..............  A               H-reflex test........       0.55       0.45         NA       0.05       1.05         NA        XXX
95936...............  26............  A               H-reflex test........       0.55       0.24       0.24       0.03       0.82       0.82        XXX
95936...............  TC............  A               H-reflex test........       0.00       0.21         NA       0.02       0.23         NA        XXX
95937...............  ..............  A               Neuromuscular               0.65       0.60         NA       0.08       1.33         NA        XXX
                                                       junction test.
95937...............  26............  A               Neuromuscular               0.65       0.27       0.27       0.06       0.98       0.98        XXX
                                                       junction test.
95937...............  TC............  A               Neuromuscular               0.00       0.34         NA       0.02       0.36         NA        XXX
                                                       junction test.
95950...............  ..............  A               Ambulatory eeg              1.51       4.98         NA       0.51       7.00         NA        XXX
                                                       monitoring.
95950...............  26............  A               Ambulatory eeg              1.51       0.63       0.63       0.08       2.22       2.22        XXX
                                                       monitoring.
95950...............  TC............  A               Ambulatory eeg              0.00       4.35         NA       0.43       4.78         NA        XXX
                                                       monitoring.
95951...............  26............  A               EEG monitoring/             5.99       2.54       2.54       0.34       8.87       8.87        XXX
                                                       videorecord.
95953...............  ..............  A               EEG monitoring/             3.08       7.61         NA       0.61      11.30         NA        XXX
                                                       computer.
95953...............  26............  A               EEG monitoring/             3.08       1.29       1.29       0.18       4.55       4.55        XXX
                                                       computer.
95953...............  TC............  A               EEG monitoring/             0.00       6.32         NA       0.43       6.75         NA        XXX
                                                       computer.
95954...............  ..............  A               EEG monitoring/giving       2.45       4.28         NA       0.19       6.92         NA        XXX
                                                       drugs.
95954...............  26............  A               EEG monitoring/giving       2.45       1.04       1.04       0.13       3.62       3.62        XXX
                                                       drugs.
95954...............  TC............  A               EEG monitoring/giving       0.00       3.24         NA       0.06       3.30         NA        XXX
                                                       drugs.
95955...............  ..............  A               EEG during surgery...       1.01       2.32         NA       0.23       3.56         NA        XXX
95955...............  26............  A               EEG during surgery...       1.01       0.36       0.36       0.06       1.43       1.43        XXX
95955...............  TC............  A               EEG during surgery...       0.00       1.96         NA       0.17       2.13         NA        XXX
95956...............  ..............  A               Eeg monitoring, cable/      3.08      15.93         NA       0.60      19.61         NA        XXX
                                                       radio.
95956...............  26............  A               Eeg monitoring, cable/      3.08       1.30       1.30       0.17       4.55       4.55        XXX
                                                       radio.
95956...............  TC............  A               Eeg monitoring, cable/      0.00      14.63         NA       0.43      15.06         NA        XXX
                                                       radio.
95957...............  ..............  A               EEG digital analysis.       1.98       2.55         NA       0.23       4.76         NA        XXX
95957...............  26............  A               EEG digital analysis.       1.98       0.85       0.85       0.11       2.94       2.94        XXX
95957...............  TC............  A               EEG digital analysis.       0.00       1.70         NA       0.12       1.82         NA        XXX
95958...............  ..............  A               EEG monitoring/             4.24       3.47         NA       0.39       8.10         NA        XXX
                                                       function test.
95958...............  26............  A               EEG monitoring/             4.24       1.73       1.73       0.26       6.23       6.23        XXX
                                                       function test.
95958...............  TC............  A               EEG monitoring/             0.00       1.74         NA       0.13       1.87         NA        XXX
                                                       function test.
95961...............  ..............  A               Electrode                   2.97       2.62         NA       0.53       6.12         NA        XXX
                                                       stimulation, brain.
95961...............  26............  A               Electrode                   2.97       1.32       1.32       0.46       4.75       4.75        XXX
                                                       stimulation, brain.
95961...............  TC............  A               Electrode                   0.00       1.30         NA       0.07       1.37         NA        XXX
                                                       stimulation, brain.
95962...............  ..............  A               Electrode stim, brain       3.21       2.69         NA       0.38       6.28         NA        ZZZ
                                                       add-on.
95962...............  26............  A               Electrode stim, brain       3.21       1.39       1.39       0.31       4.91       4.91        ZZZ
                                                       add-on.
95962...............  TC............  A               Electrode stim, brain       0.00       1.30         NA       0.07       1.37         NA        ZZZ
                                                       add-on.
95965...............  26............  A               Meg, spontaneous.....       7.99       3.41       3.41       0.41      11.81      11.81        XXX
95966...............  26............  A               Meg, evoked, single..       3.99       1.71       1.71       0.21       5.91       5.91        XXX
95967...............  26............  A               Meg, evoked, each add-      3.49       1.18       1.18       0.16       4.83       4.83        ZZZ
                                                       l.
95970...............  ..............  A               Analyze neurostim, no       0.45       0.86       0.14       0.03       1.34       0.62        XXX
                                                       prog.
95971...............  ..............  A               Analyze neurostim,          0.78       0.68       0.22       0.07       1.53       1.07        XXX
                                                       simple.

[[Page 47689]]

 
95972...............  ..............  A               Analyze neurostim,          1.50       1.21       0.49       0.14       2.85       2.13        XXX
                                                       complex.
95973...............  ..............  A               Analyze neurostim,          0.92       0.62       0.34       0.07       1.61       1.33        ZZZ
                                                       complex.
95974...............  ..............  A               Cranial neurostim,          3.00       1.70       1.29       0.18       4.88       4.47        XXX
                                                       complex.
95975...............  ..............  A               Cranial neurostim,          1.70       0.89       0.73       0.11       2.70       2.54        ZZZ
                                                       complex.
95990...............  ..............  A               Spin/brain pump refil       0.00       1.50         NA       0.06       1.56         NA        XXX
                                                       & main.
95991...............  ..............  A               Spin/brain pump refil       0.77       1.53       0.17       0.06       2.36       1.00        XXX
                                                       & main.
96000...............  ..............  A               Motion analysis,            1.80         NA       0.53       0.05         NA       2.38        XXX
                                                       video/3d.
96001...............  ..............  A               Motion test w/ft            2.15         NA       0.66       0.06         NA       2.87        XXX
                                                       press meas.
96002...............  ..............  A               Dynamic surface emg..       0.41         NA       0.15       0.01         NA       0.57        XXX
96003...............  ..............  A               Dynamic fine wire emg       0.37         NA       0.12       0.04         NA       0.53        XXX
96004...............  ..............  A               Phys review of motion       2.14       0.94       0.94       0.07       3.15       3.15        XXX
                                                       tests.
96100...............  ..............  A               Psychological testing       0.00       1.76         NA       0.18       1.94         NA        XXX
96105...............  ..............  A               Assessment of aphasia       0.00       1.76         NA       0.18       1.94         NA        XXX
96110...............  ..............  A               Developmental test,         0.00       0.18         NA       0.18       0.36         NA        XXX
                                                       lim.
96111...............  ..............  A               Developmental test,         2.60       1.05         NA       0.18       3.83         NA        XXX
                                                       extend.
96115...............  ..............  A               Neurobehavior status        0.00       1.76         NA       0.18       1.94         NA        XXX
                                                       exam.
96117...............  ..............  A               Neuropsych test             0.00       1.76         NA       0.18       1.94         NA        XXX
                                                       battery.
96150...............  ..............  A               Assess lth/behave,          0.50       0.18       0.18       0.01       0.69       0.69        XXX
                                                       init.
96151...............  ..............  A               Assess hlth/behave,         0.48       0.18       0.17       0.01       0.67       0.66        XXX
                                                       subseq.
96152...............  ..............  A               Intervene hlth/             0.46       0.17       0.16       0.01       0.64       0.63        XXX
                                                       behave, indiv.
96153...............  ..............  A               Intervene hlth/             0.10       0.04       0.03       0.00       0.14       0.13        XXX
                                                       behave, group.
96154...............  ..............  A               Interv hlth/behav,          0.45       0.17       0.16       0.01       0.63       0.62        XXX
                                                       fam w/pt.
96400...............  ..............  A               Chemotherapy, sc/im..       0.17       1.13         NA       0.01       1.31         NA        XXX
96405...............  ..............  A               Intralesional chemo         0.52       2.33       0.24       0.03       2.88       0.79        000
                                                       admin.
96406...............  ..............  A               Intralesional chemo         0.80       3.11       0.29       0.03       3.94       1.12        000
                                                       admin.
96408...............  ..............  A               Chemotherapy, push          0.17       2.92         NA       0.06       3.15         NA        XXX
                                                       technique.
96410...............  ..............  A               Chemotherapy,infusion       0.17       4.15         NA       0.08       4.40         NA        XXX
                                                       method.
96412...............  ..............  A               Chemo, infuse method        0.17       0.73         NA       0.07       0.97         NA        ZZZ
                                                       add-on.
96414...............  ..............  A               Chemo, infuse method        0.17       5.23         NA       0.08       5.48         NA        XXX
                                                       add-on.
96420...............  ..............  A               Chemotherapy, push          0.17       2.82         NA       0.08       3.07         NA        XXX
                                                       technique.
96422...............  ..............  A               Chemotherapy,infusion       0.17       5.18         NA       0.08       5.43         NA        XXX
                                                       method.
96423...............  ..............  A               Chemo, infuse method        0.17       2.00         NA       0.02       2.19         NA        ZZZ
                                                       add-on.
96425...............  ..............  A               Chemotherapy,infusion       0.17       4.74         NA       0.08       4.99         NA        XXX
                                                       method.
96440...............  ..............  A               Chemotherapy,               2.37       8.44       1.24       0.16      10.97       3.77        000
                                                       intracavitary.
96445...............  ..............  A               Chemotherapy,               2.20       8.56       1.19       0.12      10.88       3.51        000
                                                       intracavitary.
96450...............  ..............  A               Chemotherapy, into          1.89       7.37       1.09       0.09       9.35       3.07        000
                                                       CNS.
96520...............  ..............  A               Port pump refill &          0.17       3.94         NA       0.06       4.17         NA        XXX
                                                       main.
96530...............  ..............  A               Syst pump refill &          0.17       2.86         NA       0.06       3.09         NA        XXX
                                                       main.
96542...............  ..............  A               Chemotherapy                1.42       4.45       0.65       0.07       5.94       2.14        XXX
                                                       injection.
96567...............  ..............  A               Photodynamic tx, skin       0.00       0.94         NA       0.04       0.98         NA        XXX
96570...............  ..............  A               Photodynamic tx, 30         1.10         NA       0.37       0.11         NA       1.58        ZZZ
                                                       min.
96571...............  ..............  A               Photodynamic tx, addl       0.55         NA       0.19       0.03         NA       0.77        ZZZ
                                                       15 min.
96900...............  ..............  A               Ultraviolet light           0.00       0.44         NA       0.02       0.46         NA        XXX
                                                       therapy.
96902...............  ..............  B               Trichogram...........       0.41       0.18       0.15       0.01       0.60       0.57        XXX
96910...............  ..............  A               Photochemotherapy           0.00       0.99         NA       0.04       1.03         NA        XXX
                                                       with UV-B.
96912...............  ..............  A               Photochemotherapy           0.00       1.26         NA       0.05       1.31         NA        XXX
                                                       with UV-A.
96913...............  ..............  A               Photochemotherapy, UV-      0.00       1.68         NA       0.10       1.78         NA        XXX
                                                       A or B.
96920...............  ..............  A               Laser tx, skin < 250        1.15       2.52       0.56       0.11       3.78       1.82        000
                                                       sq cm.
96921...............  ..............  A               Laser tx, skin 250-         1.17       2.60       0.57       0.11       3.88       1.85        000
                                                       500 sq cm.
96922...............  ..............  A               Laser tx, skin > 500        2.10       3.48       0.62       0.19       5.77       2.91        000
                                                       sq cm.
97001...............  ..............  A               Pt evaluation........       1.20       0.75       0.45       0.06       2.01       1.71        XXX
97002...............  ..............  A               Pt re-evaluation.....       0.60       0.45       0.23       0.02       1.07       0.85        XXX
97003...............  ..............  A               Ot evaluation........       1.20       0.88       0.40       0.07       2.15       1.67        XXX
97004...............  ..............  A               Ot re-evaluation.....       0.60       0.67       0.19       0.02       1.29       0.81        XXX
97010...............  ..............  B               Hot or cold packs           0.06       0.05         NA       0.01       0.12         NA        XXX
                                                       therapy.
97012...............  ..............  A               Mechanical traction         0.25       0.13         NA       0.01       0.39         NA        XXX
                                                       therapy.
97016...............  ..............  A               Vasopneumatic device        0.18       0.18         NA       0.01       0.37         NA        XXX
                                                       therapy.
97018...............  ..............  A               Paraffin bath therapy       0.06       0.10         NA       0.00       0.16         NA        XXX
97020...............  ..............  A               Microwave therapy....       0.06       0.05         NA       0.00       0.11         NA        XXX
97022...............  ..............  A               Whirlpool therapy....       0.17       0.21         NA       0.01       0.39         NA        XXX
97024...............  ..............  A               Diathermy treatment..       0.06       0.07         NA       0.00       0.13         NA        XXX
97026...............  ..............  A               Infrared therapy.....       0.06       0.06         NA       0.00       0.12         NA        XXX
97028...............  ..............  A               Ultraviolet therapy..       0.08       0.07         NA       0.00       0.15         NA        XXX
97032...............  ..............  A               Electrical                  0.25       0.16         NA       0.01       0.42         NA        XXX
                                                       stimulation.
97033...............  ..............  A               Electric current            0.26       0.27         NA       0.01       0.54         NA        XXX
                                                       therapy.
97034...............  ..............  A               Contrast bath therapy       0.21       0.15         NA       0.01       0.37         NA        XXX
97035...............  ..............  A               Ultrasound therapy...       0.21       0.10         NA       0.01       0.32         NA        XXX
97036...............  ..............  A               Hydrotherapy.........       0.28       0.32         NA       0.01       0.61         NA        XXX
97039...............  ..............  A               Physical therapy            0.20       0.10         NA       0.01       0.31         NA        XXX
                                                       treatment.
97110...............  ..............  A               Therapeutic exercises       0.45       0.27         NA       0.02       0.74         NA        XXX
97112...............  ..............  A               Neuromuscular               0.45       0.31         NA       0.02       0.78         NA        XXX
                                                       reeducation.
97113...............  ..............  A               Aquatic therapy/            0.44       0.39         NA       0.02       0.85         NA        XXX
                                                       exercises.
97116...............  ..............  A               Gait training therapy       0.40       0.24         NA       0.01       0.65         NA        XXX
97124...............  ..............  A               Massage therapy......       0.35       0.23         NA       0.01       0.59         NA        XXX
97139...............  ..............  A               Physical medicine           0.21       0.20         NA       0.01       0.42         NA        XXX
                                                       procedure.

[[Page 47690]]

 
97140...............  ..............  A               Manual therapy.......       0.43       0.25         NA       0.02       0.70         NA        XXX
97150...............  ..............  A               Group therapeutic           0.27       0.18         NA       0.02       0.47         NA        XXX
                                                       procedures.
97504...............  ..............  A               Orthotic training....       0.45       0.33         NA       0.03       0.81         NA        XXX
97520...............  ..............  A               Prosthetic training..       0.45       0.27         NA       0.02       0.74         NA        XXX
97530...............  ..............  A               Therapeutic                 0.44       0.32         NA       0.02       0.78         NA        XXX
                                                       activities.
97532...............  ..............  A               Cognitive skills            0.44       0.20         NA       0.01       0.65         NA        XXX
                                                       development.
97533...............  ..............  A               Sensory integration..       0.44       0.24         NA       0.01       0.69         NA        XXX
97535...............  ..............  A               Self care mngment           0.45       0.33         NA       0.01       0.79         NA        XXX
                                                       training.
97537...............  ..............  A               Community/work              0.45       0.26         NA       0.01       0.72         NA        XXX
                                                       reintegration.
97542...............  ..............  A               Wheelchair mngment          0.45       0.28         NA       0.01       0.74         NA        XXX
                                                       training.
97601...............  ..............  A               Wound(s) care,              0.50       0.49         NA       0.03       1.02         NA        XXX
                                                       selective.
97703...............  ..............  A               Prosthetic checkout..       0.25       0.41         NA       0.02       0.68         NA        XXX
97750...............  ..............  A               Physical performance        0.45       0.32         NA       0.02       0.79         NA        XXX
                                                       test.
97755...............  ..............  A               Assistive technology        0.62       0.28         NA       0.02       0.92         NA        XXX
                                                       assess.
97802...............  ..............  A               Medical nutrition,          0.00       0.47         NA       0.01       0.48         NA        XXX
                                                       indiv, in.
97803...............  ..............  A               Med nutrition, indiv,       0.00       0.47         NA       0.01       0.48         NA        XXX
                                                       subseq.
97804...............  ..............  A               Medical nutrition,          0.00       0.18         NA       0.01       0.19         NA        XXX
                                                       group.
98925...............  ..............  A               Osteopathic                 0.45       0.32       0.14       0.02       0.79       0.61        000
                                                       manipulation.
98926...............  ..............  A               Osteopathic                 0.65       0.42       0.25       0.03       1.10       0.93        000
                                                       manipulation.
98927...............  ..............  A               Osteopathic                 0.87       0.51       0.29       0.03       1.41       1.19        000
                                                       manipulation.
98928...............  ..............  A               Osteopathic                 1.03       0.60       0.34       0.04       1.67       1.41        000
                                                       manipulation.
98929...............  ..............  A               Osteopathic                 1.19       0.68       0.37       0.05       1.92       1.61        000
                                                       manipulation.
98940...............  ..............  A               Chiropractic                0.45       0.23       0.12       0.01       0.69       0.58        000
                                                       manipulation.
98941...............  ..............  A               Chiropractic                0.65       0.30       0.17       0.02       0.97       0.84        000
                                                       manipulation.
98942...............  ..............  A               Chiropractic                0.87       0.36       0.23       0.02       1.25       1.12        000
                                                       manipulation.
99141...............  ..............  B               Sedation, iv/im or          0.80       1.89       0.38       0.05       2.74       1.23        XXX
                                                       inhalant.
99142...............  ..............  B               Sedation, oral/rectal/      0.60       0.96       0.31       0.04       1.60       0.95        XXX
                                                       nasal.
99170...............  ..............  A               Anogenital exam,            1.75       1.80       0.55       0.10       3.65       2.40        000
                                                       child.
99175...............  ..............  A               Induction of vomiting       0.00       1.39         NA       0.10       1.49         NA        XXX
99183...............  ..............  A               Hyperbaric oxygen           2.34       4.07       0.72       0.16       6.57       3.22        XXX
                                                       therapy.
99185...............  ..............  A               Regional hypothermia.       0.00       0.64         NA       0.04       0.68         NA        XXX
99186...............  ..............  A               Total body                  0.00       1.78         NA       0.45       2.23         NA        XXX
                                                       hypothermia.
99195...............  ..............  A               Phlebotomy...........       0.00       0.44         NA       0.02       0.46         NA        XXX
99201...............  ..............  A               Office/outpatient           0.45       0.50       0.15       0.03       0.98       0.63        XXX
                                                       visit, new.
99202...............  ..............  A               Office/outpatient           0.88       0.79       0.31       0.05       1.72       1.24        XXX
                                                       visit, new.
99203...............  ..............  A               Office/outpatient           1.34       1.14       0.48       0.09       2.57       1.91        XXX
                                                       visit, new.
99204...............  ..............  A               Office/outpatient           2.00       1.51       0.71       0.12       3.63       2.83        XXX
                                                       visit, new.
99205...............  ..............  A               Office/outpatient           2.67       1.79       0.94       0.15       4.61       3.76        XXX
                                                       visit, new.
99211...............  ..............  A               Office/outpatient           0.17       0.40       0.06       0.01       0.58       0.24        XXX
                                                       visit, est.
99212...............  ..............  A               Office/outpatient           0.45       0.54       0.16       0.03       1.02       0.64        XXX
                                                       visit, est.
99213...............  ..............  A               Office/outpatient           0.67       0.70       0.23       0.03       1.40       0.93        XXX
                                                       visit, est.
99214...............  ..............  A               Office/outpatient           1.10       1.04       0.40       0.05       2.19       1.55        XXX
                                                       visit, est.
99215...............  ..............  A               Office/outpatient           1.77       1.34       0.65       0.09       3.20       2.51        XXX
                                                       visit, est.
99217...............  ..............  A               Observation care            1.28         NA       0.53       0.06         NA       1.87        XXX
                                                       discharge.
99218...............  ..............  A               Observation care.....       1.28         NA       0.44       0.06         NA       1.78        XXX
99219...............  ..............  A               Observation care.....       2.14         NA       0.72       0.10         NA       2.96        XXX
99220...............  ..............  A               Observation care.....       2.99         NA       1.02       0.14         NA       4.15        XXX
99221...............  ..............  A               Initial hospital care       1.28         NA       0.45       0.07         NA       1.80        XXX
99222...............  ..............  A               Initial hospital care       2.14         NA       0.74       0.10         NA       2.98        XXX
99223...............  ..............  A               Initial hospital care       2.99         NA       1.03       0.13         NA       4.15        XXX
99231...............  ..............  A               Subsequent hospital         0.64         NA       0.23       0.03         NA       0.90        XXX
                                                       care.
99232...............  ..............  A               Subsequent hospital         1.06         NA       0.37       0.05         NA       1.48        XXX
                                                       care.
99233...............  ..............  A               Subsequent hospital         1.51         NA       0.52       0.07         NA       2.10        XXX
                                                       care.
99234...............  ..............  A               Observ/hosp same date       2.56         NA       0.88       0.13         NA       3.57        XXX
99235...............  ..............  A               Observ/hosp same date       3.41         NA       1.15       0.16         NA       4.72        XXX
99236...............  ..............  A               Observ/hosp same date       4.26         NA       1.44       0.20         NA       5.90        XXX
99238...............  ..............  A               Hospital discharge          1.28         NA       0.54       0.05         NA       1.87        XXX
                                                       day.
99239...............  ..............  A               Hospital discharge          1.75         NA       0.60       0.07         NA       2.42        XXX
                                                       day.
99241...............  ..............  A               Office consultation..       0.64       0.64       0.22       0.05       1.33       0.91        XXX
99242...............  ..............  A               Office consultation..       1.29       1.05       0.46       0.10       2.44       1.85        XXX
99243...............  ..............  A               Office consultation..       1.72       1.39       0.63       0.13       3.24       2.48        XXX
99244...............  ..............  A               Office consultation..       2.58       1.82       0.92       0.16       4.56       3.66        XXX
99245...............  ..............  A               Office consultation..       3.42       2.29       1.24       0.21       5.92       4.87        XXX
99251...............  ..............  A               Initial inpatient           0.66         NA       0.24       0.05         NA       0.95        XXX
                                                       consult.
99252...............  ..............  A               Initial inpatient           1.32         NA       0.50       0.10         NA       1.92        XXX
                                                       consult.
99253...............  ..............  A               Initial inpatient           1.82         NA       0.68       0.11         NA       2.61        XXX
                                                       consult.
99254...............  ..............  A               Initial inpatient           2.64         NA       0.98       0.13         NA       3.75        XXX
                                                       consult.
99255...............  ..............  A               Initial inpatient           3.64         NA       1.34       0.18         NA       5.16        XXX
                                                       consult.
99261...............  ..............  A               Follow-up inpatient         0.42         NA       0.15       0.02         NA       0.59        XXX
                                                       consult.
99262...............  ..............  A               Follow-up inpatient         0.85         NA       0.31       0.04         NA       1.20        XXX
                                                       consult.
99263...............  ..............  A               Follow-up inpatient         1.27         NA       0.45       0.06         NA       1.78        XXX
                                                       consult.
99271...............  ..............  A               Confirmatory                0.45       0.56       0.16       0.03       1.04       0.64        XXX
                                                       consultation.
99272...............  ..............  A               Confirmatory                0.84       0.83       0.31       0.06       1.73       1.21        XXX
                                                       consultation.
99273...............  ..............  A               Confirmatory                1.19       1.12       0.45       0.10       2.41       1.74        XXX
                                                       consultation.
99274...............  ..............  A               Confirmatory                1.73       1.38       0.64       0.12       3.23       2.49        XXX
                                                       consultation.

[[Page 47691]]

 
99275...............  ..............  A               Confirmatory                2.31       1.66       0.84       0.15       4.12       3.30        XXX
                                                       consultation.
99281...............  ..............  A               Emergency dept visit.       0.33         NA       0.09       0.02         NA       0.44        XXX
99282...............  ..............  A               Emergency dept visit.       0.55         NA       0.14       0.04         NA       0.73        XXX
99283...............  ..............  A               Emergency dept visit.       1.24         NA       0.31       0.09         NA       1.64        XXX
99284...............  ..............  A               Emergency dept visit.       1.95         NA       0.47       0.14         NA       2.56        XXX
99285...............  ..............  A               Emergency dept visit.       3.06         NA       0.72       0.23         NA       4.01        XXX
99289...............  ..............  A               Ped crit care               4.79         NA       1.45       0.17         NA       6.41        XXX
                                                       transport.
99290...............  ..............  A               Ped crit care               2.40         NA       0.81       0.08         NA       3.29        ZZZ
                                                       transport addl.
99291...............  ..............  A               Critical care, first        3.99       2.59       1.28       0.21       6.79       5.48        XXX
                                                       hour.
99292...............  ..............  A               Critical care, add-l        2.00       0.91       0.63       0.11       3.02       2.74        ZZZ
                                                       30 min.
99293...............  ..............  A               Ped critical care,         15.98         NA       4.74       0.21         NA      20.93        XXX
                                                       initial.
99294...............  ..............  A               Ped critical care,          7.99         NA       2.39       0.21         NA      10.59        XXX
                                                       subseq.
99295...............  ..............  A               Neonate crit care,         18.46         NA       5.35       1.00         NA      24.81        XXX
                                                       initial.
99296...............  ..............  A               Neonate critical care       7.99         NA       2.53       0.34         NA      10.86        XXX
                                                       subseq.
99298...............  ..............  A               Ic for lbw infant <         2.75         NA       0.93       0.14         NA       3.82        XXX
                                                       1500 gm.
99299...............  ..............  A               Ic, lbw infant 1500-        2.50         NA       0.85       0.12         NA       3.47        XXX
                                                       2500 gm.
99301...............  ..............  A               Nursing facility care       1.20       0.50       0.50       0.05       1.75       1.75        XXX
99302...............  ..............  A               Nursing facility care       1.61       0.64       0.64       0.07       2.32       2.32        XXX
99303...............  ..............  A               Nursing facility care       2.01       0.76       0.76       0.09       2.86       2.86        XXX
99311...............  ..............  A               Nursing fac care,           0.60       0.28       0.28       0.03       0.91       0.91        XXX
                                                       subseq.
99312...............  ..............  A               Nursing fac care,           1.00       0.45       0.45       0.05       1.50       1.50        XXX
                                                       subseq.
99313...............  ..............  A               Nursing fac care,           1.42       0.62       0.62       0.07       2.11       2.11        XXX
                                                       subseq.
99315...............  ..............  A               Nursing fac discharge       1.13       0.46       0.46       0.05       1.64       1.64        XXX
                                                       day.
99316...............  ..............  A               Nursing fac discharge       1.50       0.59       0.59       0.07       2.16       2.16        XXX
                                                       day.
99321...............  ..............  A               Rest home visit, new        0.71       0.34         NA       0.04       1.09         NA        XXX
                                                       patient.
99322...............  ..............  A               Rest home visit, new        1.01       0.46         NA       0.06       1.53         NA        XXX
                                                       patient.
99323...............  ..............  A               Rest home visit, new        1.28       0.55         NA       0.06       1.89         NA        XXX
                                                       patient.
99331...............  ..............  A               Rest home visit, est        0.60       0.32         NA       0.03       0.95         NA        XXX
                                                       pat.
99332...............  ..............  A               Rest home visit, est        0.80       0.39         NA       0.04       1.23         NA        XXX
                                                       pat.
99333...............  ..............  A               Rest home visit, est        1.00       0.46         NA       0.05       1.51         NA        XXX
                                                       pat.
99341...............  ..............  A               Home visit, new             1.01       0.48         NA       0.06       1.55         NA        XXX
                                                       patient.
99342...............  ..............  A               Home visit, new             1.52       0.68         NA       0.09       2.29         NA        XXX
                                                       patient.
99343...............  ..............  A               Home visit, new             2.27       0.94         NA       0.12       3.33         NA        XXX
                                                       patient.
99344...............  ..............  A               Home visit, new             3.03       1.18         NA       0.15       4.36         NA        XXX
                                                       patient.
99345...............  ..............  A               Home visit, new             3.78       1.43         NA       0.18       5.39         NA        XXX
                                                       patient.
99347...............  ..............  A               Home visit, est             0.76       0.40         NA       0.04       1.20         NA        XXX
                                                       patient.
99348...............  ..............  A               Home visit, est             1.26       0.58         NA       0.06       1.90         NA        XXX
                                                       patient.
99349...............  ..............  A               Home visit, est             2.02       0.84         NA       0.10       2.96         NA        XXX
                                                       patient.
99350...............  ..............  A               Home visit, est             3.03       1.18         NA       0.15       4.36         NA        XXX
                                                       patient.
99354...............  ..............  A               Prolonged service,          1.77       0.77       0.65       0.08       2.62       2.50        ZZZ
                                                       office.
99355...............  ..............  A               Prolonged service,          1.77       0.75       0.62       0.08       2.60       2.47        ZZZ
                                                       office.
99356...............  ..............  A               Prolonged service,          1.71         NA       0.62       0.08         NA       2.41        ZZZ
                                                       inpatient.
99357...............  ..............  A               Prolonged service,          1.71         NA       0.63       0.08         NA       2.42        ZZZ
                                                       inpatient.
99374...............  ..............  B               Home health care            1.10       0.70       0.42       0.05       1.85       1.57        XXX
                                                       supervision.
99377...............  ..............  B               Hospice care                1.10       0.70       0.42       0.05       1.85       1.57        XXX
                                                       supervision.
99379...............  ..............  B               Nursing fac care            1.10       0.70       0.42       0.04       1.84       1.56        XXX
                                                       supervision.
99380...............  ..............  B               Nursing fac care            1.73       1.00       0.65       0.06       2.79       2.44        XXX
                                                       supervision.
99431...............  ..............  A               Initial care, normal        1.17         NA       0.38       0.04         NA       1.59        XXX
                                                       newborn.
99432...............  ..............  A               Newborn care, not in        1.26       0.93       0.40       0.05       2.24       1.71        XXX
                                                       hosp.
99433...............  ..............  A               Normal newborn care/        0.62         NA       0.20       0.03         NA       0.85        XXX
                                                       hospital.
99435...............  ..............  A               Newborn discharge day       1.50         NA       0.59       0.06         NA       2.15        XXX
                                                       hosp.
99436...............  ..............  A               Attendance, birth....       1.50         NA       0.47       0.11         NA       2.08        XXX
99440...............  ..............  A               Newborn resuscitation       2.93         NA       0.93       0.13         NA       3.99        XXX
G0030...............  26............  A               PET imaging prev PET        1.50       0.58       0.58       0.05       2.13       2.13        XXX
                                                       single.
G0031...............  26............  A               PET imaging prev PET        1.87       0.72       0.72       0.07       2.66       2.66        XXX
                                                       multple.
G0032...............  26............  A               PET follow SPECT            1.50       0.54       0.54       0.07       2.11       2.11        XXX
                                                       78464 singl.
G0033...............  26............  A               PET follow SPECT            1.87       0.73       0.73       0.07       2.67       2.67        XXX
                                                       78464 mult.
G0034...............  26............  A               PET follow SPECT            1.50       0.57       0.57       0.05       2.12       2.12        XXX
                                                       76865 singl.
G0035...............  26............  A               PET follow SPECT            1.87       0.72       0.72       0.07       2.66       2.66        XXX
                                                       78465 mult.
G0036...............  26............  A               PET follow cornry           1.50       0.56       0.56       0.05       2.11       2.11        XXX
                                                       angio sing.
G0037...............  26............  A               PET follow cornry           1.87       0.71       0.71       0.06       2.64       2.64        XXX
                                                       angio mult.
G0038...............  26............  A               PET follow myocard          1.50       0.52       0.52       0.06       2.08       2.08        XXX
                                                       perf sing.
G0039...............  26............  A               PET follow myocard          1.87       0.71       0.71       0.07       2.65       2.65        XXX
                                                       perf mult.
G0040...............  26............  A               PET follow stress           1.50       0.59       0.59       0.07       2.16       2.16        XXX
                                                       echo singl.
G0041...............  26............  A               PET follow stress           1.87       0.73       0.73       0.07       2.67       2.67        XXX
                                                       echo mult.
G0042...............  26............  A               PET follow                  1.50       0.61       0.61       0.05       2.16       2.16        XXX
                                                       ventriculogm sing.
G0043...............  26............  A               PET follow                  1.87       0.75       0.75       0.06       2.68       2.68        XXX
                                                       ventriculogm mult.
G0044...............  26............  A               PET following rest          1.50       0.59       0.59       0.05       2.14       2.14        XXX
                                                       ECG singl.
G0045...............  26............  A               PET following rest          1.87       0.72       0.72       0.06       2.65       2.65        XXX
                                                       ECG mult.
G0046...............  26............  A               PET follow stress ECG       1.50       0.59       0.59       0.05       2.14       2.14        XXX
                                                       singl.
G0047...............  26............  A               PET follow stress ECG       1.87       0.73       0.73       0.06       2.66       2.66        XXX
                                                       mult.
G0101...............  ..............  A               CA screen;pelvic/           0.45       0.52       0.17       0.02       0.99       0.64        XXX
                                                       breast exam.
G0102...............  ..............  A               Prostate ca                 0.17       0.40       0.06       0.01       0.58       0.24        XXX
                                                       screening; dre.
G0104...............  ..............  A               CA screen;flexi             0.96       2.30       0.50       0.08       3.34       1.54        000
                                                       sigmoidscope.
G0105...............  ..............  A               Colorectal scrn; hi         3.69       6.20       1.47       0.24      10.13       5.40        000
                                                       risk ind.

[[Page 47692]]

 
G0105...............  53............  A               Colorectal scrn; hi         0.96       2.30       0.50       0.08       3.34       1.54        000
                                                       risk ind.
G0106...............  ..............  A               Colon CA                    0.99       2.55         NA       0.17       3.71         NA        XXX
                                                       screen;barium enema.
G0106...............  26............  A               Colon CA                    0.99       0.32       0.32       0.04       1.35       1.35        XXX
                                                       screen;barium enema.
G0106...............  TC............  A               Colon CA                    0.00       2.23         NA       0.13       2.36         NA        XXX
                                                       screen;barium enema.
G0108...............  ..............  A               Diab manage trn per         0.00       0.83         NA       0.01       0.84         NA        XXX
                                                       indiv.
G0109...............  ..............  A               Diab manage trn ind/        0.00       0.48         NA       0.01       0.49         NA        XXX
                                                       group.
G0110...............  ..............  R               Nett pulm-rehab educ;       0.90       0.68       0.29       0.04       1.62       1.23        XXX
                                                       ind.
G0111...............  ..............  R               Nett pulm-rehab educ;       0.27       0.29       0.13       0.01       0.57       0.41        XXX
                                                       group.
G0112...............  ..............  R               Nett;nutrition guid,        1.72       1.21       0.65       0.07       3.00       2.44        XXX
                                                       initial.
G0113...............  ..............  R               Nett;nutrition              1.29       0.82       0.41       0.05       2.16       1.75        XXX
                                                       guid,subseqnt.
G0114...............  ..............  R               Nett; psychosocial          1.20       0.48       0.37       0.04       1.72       1.61        XXX
                                                       consult.
G0115...............  ..............  R               Nett; psychological         1.20       0.84       0.37       0.03       2.07       1.60        XXX
                                                       testing.
G0116...............  ..............  R               Nett; psychosocial          1.11       0.98       0.33       0.03       2.12       1.47        XXX
                                                       counsel.
G0117...............  ..............  T               Glaucoma scrn hgh           0.45       0.72       0.19       0.01       1.18       0.65        XXX
                                                       risk direc.
G0118...............  ..............  T               Glaucoma scrn hgh           0.17       0.53       0.06       0.00       0.70       0.23        XXX
                                                       risk direc.
G0120...............  ..............  A               Colon ca scrn; barium       0.99       2.55         NA       0.17       3.71         NA        XXX
                                                       enema.
G0120...............  26............  A               Colon ca scrn; barium       0.99       0.32       0.32       0.04       1.35       1.35        XXX
                                                       enema.
G0120...............  TC............  A               Colon ca scrn; barium       0.00       2.23         NA       0.13       2.36         NA        XXX
                                                       enema.
G0121...............  ..............  A               Colon ca scrn not hi        3.69       6.20       1.47       0.24      10.13       5.40        000
                                                       rsk ind.
G0121...............  53............  A               Colon ca scrn not hi        0.96       2.30       0.50       0.08       3.34       1.54        000
                                                       rsk ind.
G0124...............  ..............  A               Screen c/v thin layer       0.42       0.15       0.15       0.02       0.59       0.59        XXX
                                                       by MD.
G0125...............  26............  A               PET image pulmonary         1.50       0.52       0.52       0.07       2.09       2.09        XXX
                                                       nodule.
G0127...............  ..............  R               Trim nail(s).........       0.17       0.25       0.07       0.01       0.43       0.25        000
G0128...............  ..............  R               CORF skilled nursing        0.08       0.03       0.03       0.01       0.12       0.12        XXX
                                                       service.
G0130...............  ..............  A               Single energy x-ray         0.22       0.87         NA       0.06       1.15         NA        XXX
                                                       study.
G0130...............  26............  A               Single energy x-ray         0.22       0.07       0.07       0.01       0.30       0.30        XXX
                                                       study.
G0130...............  TC............  A               Single energy x-ray         0.00       0.80         NA       0.05       0.85         NA        XXX
                                                       study.
G0141...............  ..............  A               Scr c/v cyto,autosys        0.42       0.15       0.15       0.02       0.59       0.59        XXX
                                                       and md.
G0166...............  ..............  A               Extrnl counterpulse,        0.07       3.22       0.03       0.00       3.29       0.10        XXX
                                                       per tx.
G0168...............  ..............  A               Wound closure by            0.45       1.94       0.22       0.03       2.42       0.70        000
                                                       adhesive.
G0179...............  ..............  A               MD recertification          0.45       1.06         NA       0.02       1.53         NA        XXX
                                                       HHA PT.
G0180...............  ..............  A               MD certification HHA        0.67       1.29         NA       0.04       2.00         NA        XXX
                                                       patient.
G0181...............  ..............  A               Home health care            1.73       1.51         NA       0.08       3.32         NA        XXX
                                                       supervision.
G0182...............  ..............  A               Hospice care                1.73       1.71         NA       0.07       3.51         NA        XXX
                                                       supervision.
G0202...............  ..............  A               Screeningmammographyd       0.70       2.77         NA       0.10       3.57         NA        XXX
                                                       igital.
G0202...............  26............  A               Screeningmammographyd       0.70       0.23       0.23       0.03       0.96       0.96        XXX
                                                       igital.
G0202...............  TC............  A               Screeningmammographyd       0.00       2.54         NA       0.07       2.61         NA        XXX
                                                       igital.
G0204...............  ..............  A               Diagnosticmammography       0.87       2.78         NA       0.11       3.76         NA        XXX
                                                       digital.
G0204...............  26............  A               Diagnosticmammography       0.87       0.28       0.28       0.04       1.19       1.19        XXX
                                                       digital.
G0204...............  TC............  A               Diagnosticmammography       0.00       2.50         NA       0.07       2.57         NA        XXX
                                                       digital.
G0206...............  ..............  A               Diagnosticmammography       0.70       2.25         NA       0.09       3.04         NA        XXX
                                                       digital.
G0206...............  26............  A               Diagnosticmammography       0.70       0.23       0.23       0.03       0.96       0.96        XXX
                                                       digital.
G0206...............  TC............  A               Diagnosticmammography       0.00       2.02         NA       0.06       2.08         NA        XXX
                                                       digital.
G0210...............  26............  A               PET img wholebody           1.50       0.51       0.51       0.07       2.08       2.08        XXX
                                                       dxlung.
G0211...............  26............  A               PET img wholbody init       1.50       0.51       0.51       0.07       2.08       2.08        XXX
                                                       lung.
G0212...............  26............  A               PET img wholebod            1.50       0.51       0.51       0.06       2.07       2.07        XXX
                                                       restag lung.
G0213...............  26............  A               PET img wholbody dx..       1.50       0.51       0.51       0.07       2.08       2.08        XXX
G0214...............  26............  A               PET img wholebod init       1.50       0.51       0.51       0.07       2.08       2.08        XXX
G0215...............  26............  A               PETimg wholebod             1.50       0.51       0.51       0.06       2.07       2.07        XXX
                                                       restag.
G0216...............  26............  A               PET img wholebod dx         1.50       0.51       0.51       0.06       2.07       2.07        XXX
                                                       melanoma.
G0217...............  26............  A               PET img wholebod init       1.50       0.51       0.51       0.06       2.07       2.07        XXX
                                                       melan.
G0218...............  26............  A               PET img wholebod            1.50       0.52       0.52       0.06       2.08       2.08        XXX
                                                       restag mela.
G0220...............  26............  A               PET img wholebod dx         1.50       0.51       0.51       0.06       2.07       2.07        XXX
                                                       lymphoma.
G0221...............  26............  A               PET imag wholbod init       1.50       0.51       0.51       0.07       2.08       2.08        XXX
                                                       lympho.
G0222...............  26............  A               PET imag wholbod            1.50       0.52       0.52       0.06       2.08       2.08        XXX
                                                       resta lymph.
G0223...............  26............  A               PET imag wholbod reg        1.50       0.51       0.51       0.06       2.07       2.07        XXX
                                                       dx head.
G0224...............  26............  A               PET imag wholbod reg        1.50       0.51       0.51       0.06       2.07       2.07        XXX
                                                       ini hea.
G0225...............  26............  A               PET whol restag             1.50       0.52       0.52       0.06       2.08       2.08        XXX
                                                       headneckonly.
G0226...............  26............  A               PET img wholbody dx         1.50       0.53       0.53       0.06       2.09       2.09        XXX
                                                       esophagl.
G0227...............  26............  A               PET img wholbod ini         1.50       0.52       0.52       0.06       2.08       2.08        XXX
                                                       esophage.
G0228...............  26............  A               PET img wholbod restg       1.50       0.51       0.51       0.06       2.07       2.07        XXX
                                                       esopha.
G0229...............  26............  A               PET img metaboloc           1.50       0.52       0.52       0.07       2.09       2.09        XXX
                                                       brain pres.
G0230...............  26............  A               PET myocard viability       1.50       0.53       0.53       0.06       2.09       2.09        XXX
                                                       post.
G0231...............  26............  A               PET WhBD colorec;           1.50       0.51       0.51       0.06       2.07       2.07        XXX
                                                       gamma cam.
G0232...............  26............  A               PET whbd lymphoma;          1.50       0.52       0.52       0.06       2.08       2.08        XXX
                                                       gamma cam.
G0233...............  26............  A               PET whbd melanoma;          1.50       0.52       0.52       0.06       2.08       2.08        XXX
                                                       gamma cam.
G0234...............  26............  A               PET WhBD pulm nod;          1.50       0.52       0.52       0.06       2.08       2.08        XXX
                                                       gamma cam.
G0237...............  ..............  A               Therapeutic procd           0.00       0.47         NA       0.02       0.49         NA        XXX
                                                       strg endur.
G0238...............  ..............  A               Oth resp proc, indiv.       0.00       0.47         NA       0.02       0.49         NA        XXX
G0239...............  ..............  A               Oth resp proc, group.       0.00       0.32         NA       0.02       0.34         NA        XXX
G0245...............  ..............  R               Initial foot exam pt        0.88       0.79       0.31       0.05       1.72       1.24        XXX
                                                       lops.
G0246...............  ..............  R               Followup eval of foot       0.45       0.54       0.16       0.03       1.02       0.64        XXX
                                                       pt lop.
G0247...............  ..............  R               Routine footcare pt w       0.50       0.52       0.21       0.03       1.05       0.74        ZZZ
                                                       lops.
G0248...............  ..............  R               Demonstrate use home        0.00       6.61         NA       0.01       6.62         NA        XXX
                                                       inr mon.
G0249...............  ..............  R               Provide test                0.00       3.97         NA       0.01       3.98         NA        XXX
                                                       material,equipm.

[[Page 47693]]

 
G0250...............  ..............  R               MD review interpret         0.18       0.06       0.06       0.01       0.25       0.25        XXX
                                                       of test.
G0253...............  26............  A               PET image brst              1.87       0.63       0.63       0.06       2.56       2.56        XXX
                                                       dection recur.
G0254...............  26............  A               PET image brst eval         1.87       0.65       0.65       0.06       2.58       2.58        XXX
                                                       to tx.
G0268...............  ..............  A               Removal of impacted         0.61       0.63       0.24       0.02       1.26       0.87        000
                                                       wax md.
G0270...............  ..............  A               MNT subs tx for             0.00       0.47         NA       0.01       0.48         NA        XXX
                                                       change dx.
G0271...............  ..............  A               Group MNT 2 or more         0.00       0.18         NA       0.01       0.19         NA        XXX
                                                       30 mins.
G0275...............  ..............  A               Renal angio, cardiac        0.25         NA       0.10       0.01         NA       0.36        ZZZ
                                                       cath.
G0278...............  ..............  A               Iliac art                   0.25         NA       0.10       0.01         NA       0.36        ZZZ
                                                       angio,cardiac cath.
G0281...............  ..............  A               Elec stim unattend          0.18       0.11         NA       0.01       0.30         NA        XXX
                                                       for press.
G0283...............  ..............  A               Elec stim other than        0.18       0.11         NA       0.01       0.30         NA        XXX
                                                       wound.
G0288...............  ..............  A               Recon, CTA for surg         0.00      10.60         NA       0.18      10.78         NA        XXX
                                                       plan.
G0289...............  ..............  A               Arthro, loose body +        1.48         NA       0.80       0.33         NA       2.61        ZZZ
                                                       chondro.
G0296...............  26............  A               PET imge restag             1.87       0.71       0.71       0.08       2.66       2.66        XXX
                                                       thyrod cance.
G0308...............  ..............  A               ESRD related svc           12.74       8.54       8.54       0.42      21.70      21.70        XXX
                                                       4+mo<2yrs.
G0309...............  ..............  A               ESRD related svc 2-        10.61       7.10       7.10       0.36      18.07      18.07        XXX
                                                       3mo<2yrs.
G0310...............  ..............  A               ESRD related svc 1          8.49       5.68       5.68       0.28      14.45      14.45        XXX
                                                       visit<2yr.
G0311...............  ..............  A               ESRD related svs 4+mo       9.73       4.72       4.72       0.34      14.79      14.79        XXX
                                                       2-11yr.
G0312...............  ..............  A               ESRD relate svs 2-3         8.11       3.92       3.92       0.29      12.32      12.32        XXX
                                                       mo 2-11y.
G0313...............  ..............  A               ESRD related svs 1          6.49       3.14       3.14       0.22       9.85       9.85        XXX
                                                       mon 2-11y.
G0314...............  ..............  A               ESRD related svs 4+         8.28       4.42       4.42       0.27      12.97      12.97        XXX
                                                       mo 12-19.
G0315...............  ..............  A               ESRD related svs 2-         6.90       3.67       3.67       0.23      10.80      10.80        XXX
                                                       3mo 12-19.
G0316...............  ..............  A               ESRD relate svs 1           5.52       2.94       2.94       0.17       8.63       8.63        XXX
                                                       vist 12-19.
G0317...............  ..............  A               ESRD related svs 4+mo       5.09       2.86       2.86       0.17       8.12       8.12        XXX
                                                       20+yrs.
G0318...............  ..............  A               ESRD related svs 2-3        4.24       2.38       2.38       0.14       6.76       6.76        XXX
                                                       mo 20+y.
G0319...............  ..............  A               ESRD related svs 1          3.39       1.90       1.90       0.11       5.40       5.40        XXX
                                                       visit 20+.
G0320...............  ..............  A               ESRD related svs home      10.61       7.10       7.10       0.36      18.07      18.07        XXX
                                                       under2.
G0321...............  ..............  A               ESRDrelatedsvs home         8.11       3.92       3.92       0.23      12.26      12.26        XXX
                                                       mo 2-11y.
G0322...............  ..............  A               ESRD relate svs home        6.90       3.67       3.67       0.29      10.86      10.86        XXX
                                                       mo12-19.
G0323...............  ..............  A               ESRD related svs home       4.24       2.38       2.38       0.14       6.76       6.76        XXX
                                                       mo 20+.
G0324...............  ..............  A               ESRD related svs home/      0.35       0.24       0.24       0.01       0.60       0.60        XXX
                                                       dy<2y.
G0325...............  ..............  A               ESRD relate home/dy 2-      0.23       0.12       0.12       0.01       0.36       0.36        XXX
                                                       11 yr.
G0326...............  ..............  A               ESRD relate home/dy         0.27       0.13       0.13       0.01       0.41       0.41        XXX
                                                       12-19y.
G0327...............  ..............  A               ESRD relate home/dy         0.14       0.08       0.08       0.01       0.23       0.23        XXX
                                                       20+yrs.
G0329...............  ..............  A               Electromagntic tx for       0.06       0.12       0.02       0.01       0.19       0.09        XXX
                                                       ulcers.
G0XX1...............  ..............  A               Bone marrow aspir....       0.16       0.21       0.08       0.04       0.41       0.28        ZZZ
G0XX2...............  ..............  A               Preventative exam....       1.51       1.65       0.54       0.13       3.29       2.18        XXX
G0XX3...............  ..............  A               Venous mapping.......       0.45       3.28         NA       0.30       4.03         NA        XXX
G0XX3...............  26............  A               Venous mapping.......       0.45       0.15       0.15       0.03       0.63       0.63        XXX
G0XX3...............  TC............  A               Venous mapping.......       0.00       3.13         NA       0.27       3.40         NA        XXX
G0XX4...............  ..............  X               Hospice, pre-elect...       1.34       0.00       0.00       0.10       1.44       1.44        XXX
M0064...............  ..............  A               Visit for drug              0.37       0.34       0.12       0.01       0.72       0.50        XXX
                                                       monitoring.
P3001...............  ..............  A               Screening pap smear         0.42       0.15       0.15       0.02       0.59       0.59        XXX
                                                       by phys.
Q0035...............  ..............  A               Cardiokymography.....       0.17       0.45         NA       0.03       0.65         NA        XXX
Q0035...............  26............  A               Cardiokymography.....       0.17       0.06       0.06       0.01       0.24       0.24        XXX
Q0035...............  TC............  A               Cardiokymography.....       0.00       0.39         NA       0.02       0.41         NA        XXX
Q0091...............  ..............  A               Obtaining screen pap        0.37       0.67       0.14       0.02       1.06       0.53        XXX
                                                       smear.
Q0092...............  ..............  A               Set up port xray            0.00       0.32         NA       0.01       0.33         NA       XXX
                                                       equipment.
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ CPT codes and descriptions only are copyright 2004 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Apply.
\2\ Copyright 2004 American Dental Association. All rights reserved.
\3\ + Indicates RVUs are not used for Medicare payment.

    --------------------
Some of these codes have previously been refined and additional 
refinements were made by the PEAC.

All anesthesia codes were reviewed with the exception of 00104 abd 
00124.

CPT codes and descriptions are copyright 2004 by the AMA, all rights 
reserved.

[[Page 47693]]



    Addendum C.--Codes for Which We Received PEAC Recommendations on
                   Practice Expense Direct Cost Inputs
------------------------------------------------------------------------
          CPT  code                        Short descriptors
------------------------------------------------------------------------
00100                          Disability examination
00102                          Anesth, salivary gland
00103                          Anesth, repair of cleft lip
00120                          Anesth, blepharoplasty
00126                          Anesth, ear surgery
00140                          Anesth, tympanotomy
00142                          Anesth, procedures on eye
00144                          Anesth, lens surgery
00145                          Anesth, corneal transplant
00147                          Anesth, vitreoretinal surg
00148                          Anesth, iridectomy
00160                          Anesth, eye exam
00162                          Anesth, nose/sinus surgery
00164                          Anesth, nose/sinus surgery
00170                          Anesth, biopsy of nose
00172                          Anesth, procedure on mouth
00174                          Anesth, cleft palate repair
00176                          Anesth, pharyngeal surgery
00190                          Anesth, pharyngeal surgery
00192                          Anesth, face/skull bone surg
00210                          Anesth, facial bone surgery
00212                          Anesth, open head surgery
00214                          Anesth, skull drainage
00215                          Anesth, skull drainage
00216                          Anesth, skull repair/fract
00218                          Anesth, head vessel surgery
00220                          Anesth, special head surgery
00222                          Anesth, intrcrn nerve
00300                          Anesth, head nerve surgery
00320                          Anesth, head/neck/ptrunk
00322                          Anesth, neck organ, 1 & over
00326                          Anesth, biopsy of thyroid
00350                          Anesth, larynx/trach, < 1 yr

[[Page 47694]]

 
00352                          Anesth, neck vessel surgery
00400                          Anesth, neck vessel surgery
00402                          Anesth, skin, ext/per/atrunk
00404                          Anesth, surgery of breast
00406                          Anesth, surgery of breast
00410                          Anesth, surgery of breast
00450                          Anesth, correct heart rhythm
00452                          Anesth, surgery of shoulder
00454                          Anesth, surgery of shoulder
00470                          Anesth, collar bone biopsy
00472                          Anesth, removal of rib
00474                          Anesth, chest wall repair
00500                          Anesth, surgery of rib(s)
00520                          Anesth, esophageal surgery
00522                          Anesth, chest procedure
00524                          Anesth, chest lining biopsy
00528                          Anesth, chest drainage
00529                          Anesth, chest partition view
00530                          Anesth, chest partition view
00532                          Anesth, pacemaker insertion
00534                          Anesth, vascular access
00537                          Anesth, cardioverter/defib
00539                          Anesth, cardiac electrophys
00540                          Anesth, trach-bronch reconst
00541                          Anesth, chest surgery
00542                          Anesth, one lung ventilation
00546                          Anesth, release of lung
00548                          Anesth, lung,chest wall surg
00550                          Anesth, trachea,bronchi surg
00560                          Anesth, sternal debridement
00562                          Anesth, open heart surgery
00563                          Anesth, open heart surgery
00566                          Anesth, heart proc w/pump
00580                          Anesth, cabg w/o pump
00600                          Anesth, heart/lung transplnt
00604                          Anesth, spine, cord surgery
00620                          Anesth, sitting procedure
00622                          Anesth, spine, cord surgery
00630                          Anesth, removal of nerves
00632                          Anesth, spine, cord surgery
00634                          Anesth, removal of nerves
00635                          Anesth for chemonucleolysis
00640                          Anesth, lumbar puncture
00670                          Anesth, spine manipulation
00700                          Anesth, spine, cord surgery
00702                          Anesth, abdominal wall surg
00730                          Anesth, for liver biopsy
00740                          Anesth, abdominal wall surg
00750                          Anesth, upper gi visualize
00752                          Anesth, repair of hernia
00754                          Anesth, repair of hernia
00756                          Anesth, repair of hernia
00770                          Anesth, repair of hernia
00790                          Anesth, blood vessel repair
00792                          Anesth, surg upper abdomen
00794                          Anesth, hemorr/excise liver
00796                          Anesth, pancreas removal
00797                          Anesth, for liver transplant
00800                          Anesth, surgery for obesity
00802                          Anesth, abdominal wall surg
00810                          Anesth, fat layer removal
00820                          Anesth, low intestine scope
00830                          Anesth, abdominal wall surg
00832                          Anesth, repair of hernia
00834                          Anesth, repair of hernia
00836                          Anesth, hernia repair< 1 yr
00840                          Anesth hernia repair preemie
00842                          Anesth, surg lower abdomen
00844                          Anesth, amniocentesis
00846                          Anesth, pelvis surgery
00848                          Anesth, hysterectomy
00851                          Anesth, pelvic organ surg
00860                          Anesth, tubal ligation
00862                          Anesth, surgery of abdomen
00864                          Anesth, kidney/ureter surg
00865                          Anesth, removal of bladder
00866                          Anesth, removal of prostate
00868                          Anesth, removal of adrenal
00870                          Anesth, kidney transplant
00872                          Anesth, bladder stone surg
00873                          Anesth kidney stone destruct
00880                          Anesth kidney stone destruct
00882                          Anesth, abdomen vessel surg
00902                          Anesth, major vein ligation
00904                          Anesth, anorectal surgery
00906                          Anesth, perineal surgery
00908                          Anesth, removal of vulva
00910                          Anesth, removal of prostate
00912                          Anesth, bladder surgery
00914                          Anesth, bladder tumor surg
00916                          Anesth, removal of prostate
00918                          Anesth, bleeding control
00920                          Anesth, stone removal
00921                          Anesth, genitalia surgery
00922                          Anesth, vasectomy
00924                          Anesth, sperm duct surgery
00926                          Anesth, testis exploration
00928                          Anesth, removal of testis
00930                          Anesth, removal of testis
00932                          Anesth, testis suspension
00934                          Anesth, amputation of penis
00936                          Anesth, penis, nodes removal
00938                          Anesth, penis, nodes removal
00940                          Anesth, insert penis device
00942                          Anesth, vaginal procedures
00944                          Anesth, surg on vag/urethral
00948                          Anesth, vaginal hysterectomy
00950                          Anesth, repair of cervix
00952                          Anesth, vaginal endoscopy
01112                          Anesth, hysteroscope/graph
01120                          Anesth, bone aspirate/bx
01130                          Anesth, pelvis surgery
01140                          Anesth, body cast procedure
01150                          Anesth, amputation at pelvis
01160                          Anesth, pelvic tumor surgery
01170                          Anesth, pelvis procedure
01173                          Anesth, pelvis surgery
01180                          Anesth, fx repair, pelvis
01190                          Anesth, pelvis nerve removal
01200                          Anesth, pelvis nerve removal
01202                          Anesth, hip joint procedure
01210                          Anesth, arthroscopy of hip
01212                          Anesth, hip joint surgery
01214                          Anesth, hip disarticulation
01215                          Anesth, hip arthroplasty
01220                          Anesth, revise hip repair
01230                          Anesth, procedure on femur
01232                          Anesth, surgery of femur
01234                          Anesth, amputation of femur
01250                          Anesth, radical femur surg
01260                          Anesth, upper leg surgery
01270                          Anesth, upper leg veins surg
01272                          Anesth, thigh arteries surg
01274                          Anesth, femoral artery surg
01320                          Anesth, femoral embolectomy
01340                          Anesth, knee area surgery
01360                          Anesth, knee area procedure
01380                          Anesth, knee area surgery
01382                          Anesth, knee joint procedure
01390                          Anesth, dx knee arthroscopy
01392                          Anesth, knee area procedure
01400                          Anesth, knee area surgery
01402                          Anesth, knee joint surgery
01404                          Anesth, knee arthroplasty
01420                          Anesth, amputation at knee
01430                          Anesth, knee joint casting
01432                          Anesth, knee veins surgery
01440                          Anesth, knee vessel surg
01442                          Anesth, knee arteries surg
01444                          Anesth, knee artery surg
01462                          Anesth, knee artery repair
01464                          Anesth, lower leg procedure
01470                          Anesth, ankle/ft arthroscopy
01472                          Anesth, lower leg surgery
01474                          Anesth, achilles tendon surg
01480                          Anesth, lower leg surgery
01482                          Anesth, lower leg bone surg
01484                          Anesth, radical leg surgery
01486                          Anesth, lower leg revision
01490                          Anesth, ankle replacement
01500                          Anesth, lower leg casting
01502                          Anesth, leg arteries surg
01520                          Anesth, lwr leg embolectomy
01522                          Anesth, lower leg vein surg
01610                          Anesth, lower leg vein surg
01620                          Anesth, surgery of shoulder
01622                          Anesth, shoulder procedure
01630                          Anes dx shoulder arthroscopy
01632                          Anesth, surgery of shoulder
01634                          Anesth, surgery of shoulder
01636                          Anesth, shoulder joint amput
01638                          Anesth, forequarter amput
01650                          Anesth, shoulder replacement
01652                          Anesth, shoulder artery surg
01654                          Anesth, shoulder vessel surg
01656                          Anesth, shoulder vessel surg
01670                          Anesth, arm-leg vessel surg
01680                          Anesth, shoulder vein surg
01682                          Anesth, shoulder casting
01710                          Anesth, airplane cast
01712                          Anesth, elbow area surgery
01714                          Anesth, uppr arm tendon surg
01716                          Anesth, uppr arm tendon surg
01730                          Anesth, biceps tendon repair
01732                          Anesth, uppr arm procedure
01740                          Anesth, dx elbow arthroscopy
01742                          Anesth, upper arm surgery
01744                          Anesth, humerus surgery
01756                          Anesth, humerus repair

[[Page 47695]]

 
01758                          Anesth, radical humerus surg
01760                          Anesth, humeral lesion surg
01770                          Anesth, elbow replacement
01772                          Anesth, uppr arm artery surg
01780                          Anesth, uppr arm embolectomy
01782                          Anesth, upper arm vein surg
01810                          Anesth, uppr arm vein repair
01820                          Anesth, lower arm surgery
01829                          Anesth, lower arm procedure
01830                          Anesth, dx wrist arthroscopy
01832                          Anesth, lower arm surgery
01840                          Anesth, wrist replacement
01842                          Anesth, lwr arm artery surg
01844                          Anesth, lwr arm embolectomy
01850                          Anesth, vascular shunt surg
01852                          Anesth, lower arm vein surg
01860                          Anesth, lwr arm vein repair
01905                          Anesth, lower arm casting
01916                          Anes, spine inject, x-ray/re
01920                          Anesth, dx arteriography
01922                          Anesth, catheterize heart
01924                          Anesth, cat or MRI scan
01925                          Anes, ther interven rad, art
01926                          Anes, ther interven rad, car
01930                          Anes, tx interv rad hrt/cran
01931                          Anes, ther interven rad, vei
01932                          Anes, ther interven rad, tip
01933                          Anes, tx interv rad, th vein
01951                          Anes, tx interv rad, cran v
01952                          Anesth, burn, less 4 percent
01953                          Anesth, burn, 4-9 percent
01958                          Anesth, burn, each 9 percent
01960                          Anesth, antepartum manipul
01961                          Anesth, vaginal delivery
01962                          Anesth, cs delivery
01963                          Anesth, emer hysterectomy
01964                          Anesth, cs hysterectomy
01967                          Anesth, abortion procedures
01968                          Anesth/analg, vag delivery
01969                          Anes/analg cs deliver add-on
01990                          Anesth/analg cs hyst add-on
01991                          Support for organ donor
01992                          Anesth, nerve block/inj
01995                          Anesth, n block/inj, prone
01996                          Regional anesthesia limb
01999                          Hosp manage cont drug admin
10120                          Remove foreign body
10121                          Remove foreign body
10140                          Drainage of hematoma/fluid
10160                          Puncture drainage of lesion
10180                          Complex drainage, wound
11010                          Debride skin, fx
11011                          Debride skin/muscle, fx
11012                          Debride skin/muscle/bone, fx
11740                          Drain blood from under nail
11755                          Biopsy, nail unit
11760                          Repair of nail bed
11762                          Reconstruction of nail bed
11765                          Excision of nail fold, toe
11772                          Removal of pilonidal lesion
11920                          Correct skin color defects
11921                          Correct skin color defects
11922                          Correct skin color defects
11971                          Remove tissue expander(s)
12020                          Closure of split wound
12021                          Closure of split wound
12036                          Layer closure of wound(s)
12037                          Layer closure of wound(s)
12045                          Layer closure of wound(s)
13100                          Repair of wound or lesion
13101                          Repair of wound or lesion
13102                          Repair wound/lesion add-on
13120                          Repair of wound or lesion
13121                          Repair of wound or lesion
13122                          Repair wound/lesion add-on
13131                          Repair of wound or lesion
13132                          Repair of wound or lesion
13133                          Repair wound/lesion add-on
13150                          Repair of wound or lesion
13151                          Repair of wound or lesion
13152                          Repair of wound or lesion
13153                          Repair wound/lesion add-on
14000                          Skin tissue rearrangement
14001                          Skin tissue rearrangement
14020                          Skin tissue rearrangement
14021                          Skin tissue rearrangement
14040                          Skin tissue rearrangement
14060                          Skin tissue rearrangement
15050                          Skin pinch graft
15200                          Skin full graft
15201                          Skin full graft add-on
15220                          Skin full graft
15221                          Skin full graft add-on
15240                          Skin full graft
15241                          Skin full graft add-on
15260                          Skin full graft
15350                          Skin homograft
15351                          Skin homograft add-on
15400                          Skin heterograft
15401                          Skin heterograft add-on
15570                          Form skin pedicle flap
15572                          Form skin pedicle flap
15574                          Form skin pedicle flap
15576                          Form skin pedicle flap
15600                          Skin graft
15610                          Skin graft
15620                          Skin graft
15630                          Skin graft
15650                          Transfer skin pedicle flap
15740                          Island pedicle flap graft
15760                          Composite skin graft
15780                          Abrasion treatment of skin
15781                          Abrasion treatment of skin
15782                          Abrasion treatment of skin
15783                          Abrasion treatment of skin
15786                          Abrasion, lesion, single
15787                          Abrasion, lesions, add-on
15788                          Chemical peel, face, epiderm
15789                          Chemical peel, face, dermal
15792                          Chemical peel, nonfacial
15793                          Chemical peel, nonfacial
15810                          Salabrasion
15811                          Salabrasion
15835                          Excise excessive skin tissue
15837                          Excise excessive skin tissue
15839                          Excise excessive skin tissue
15860                          Test for blood flow in graft
19000                          Drainage of breast lesion
19001                          Drain breast lesion add-on
19020                          Incision of breast lesion
19030                          Injection for breast x-ray
19110                          Nipple exploration
19112                          Excise breast duct fistula
19291                          Place needle wire, breast
19295                          Place breast clip, percut
19350                          Breast reconstruction
19355                          Correct inverted nipple(s)
20000                          Incision of abscess
20005                          Incision of deep abscess
20100                          Explore wound, neck
20101                          Explore wound, chest
20102                          Explore wound, abdomen
20103                          Explore wound, extremity
20150                          Excise epiphyseal bar
20206                          Needle biopsy, muscle
20220                          Bone biopsy, trocar/needle
20225                          Bone biopsy, trocar/needle
20240                          Bone biopsy, excisional
20245                          Bone biopsy, excisional
20250                          Open bone biopsy
20251                          Open bone biopsy
20520                          Removal of foreign body
20525                          Removal of foreign body
20615                          Treatment of bone cyst
20650                          Insert and remove bone pin
20670                          Removal of support implant
20680                          Removal of support implant
20690                          Apply bone fixation device
20694                          Remove bone fixation device
20900                          Removal of bone for graft
20910                          Remove cartilage for graft
20922                          Removal of fascia for graft
20950                          Fluid pressure, muscle
20972                          Bone/skin graft, metatarsal
20974                          Electrical bone stimulation
20975                          Electrical bone stimulation
21025                          Excision of bone, lower jaw
21026                          Excision of facial bone(s)
21029                          Contour of face bone lesion
21030                          Excise max/zygoma b9 tumor
21031                          Remove exostosis, mandible
21032                          Remove exostosis, maxilla
21034                          Excise max/zygoma mlg tumor
21040                          Excise mandible lesion
21044                          Removal of jaw bone lesion
21045                          Extensive jaw surgery
21050                          Removal of jaw joint
21060                          Remove jaw joint cartilage
21070                          Remove coronoid process
21100                          Maxillofacial fixation
21110                          Interdental fixation
21116                          Injection, jaw joint x-ray
21120                          Reconstruction of chin
21121                          Reconstruction of chin
21122                          Reconstruction of chin
21123                          Reconstruction of chin
21125                          Augmentation, lower jaw bone
21127                          Augmentation, lower jaw bone
21137                          Reduction of forehead

[[Page 47696]]

 
21138                          Reduction of forehead
21139                          Reduction of forehead
21143                          Reconstruct midface, lefort
21150                          Reconstruct midface, lefort
21151                          Reconstruct midface, lefort
21154                          Reconstruct midface, lefort
21155                          Reconstruct midface, lefort
21159                          Reconstruct midface, lefort
21160                          Reconstruct midface, lefort
21188                          Reconstruction of midface
21195                          Reconst lwr jaw w/o fixation
21196                          Reconst lwr jaw w/fixation
21198                          Reconstr lwr jaw segment
21206                          Reconstruct upper jaw bone
21208                          Augmentation of facial bones
21209                          Reduction of facial bones
21210                          Face bone graft
21215                          Lower jaw bone graft
21235                          Ear cartilage graft
21244                          Reconstruction of lower jaw
21245                          Reconstruction of jaw
21246                          Reconstruction of jaw
21248                          Reconstruction of jaw
21249                          Reconstruction of jaw
21255                          Reconstruct lower jaw bone
21260                          Revise eye sockets
21261                          Revise eye sockets
21263                          Revise eye sockets
21267                          Revise eye sockets
21268                          Revise eye sockets
21270                          Augmentation, cheek bone
21295                          Revision of jaw muscle/bone
21296                          Revision of jaw muscle/bone
21315                          Treatment of nose fracture
21320                          Treatment of nose fracture
21325                          Treatment of nose fracture
21330                          Treatment of nose fracture
21335                          Treatment of nose fracture
21336                          Treat nasal septal fracture
21337                          Treat nasal septal fracture
21338                          Treat nasoethmoid fracture
21339                          Treat nasoethmoid fracture
21343                          Treatment of sinus fracture
21344                          Treatment of sinus fracture
21345                          Treat nose/jaw fracture
21346                          Treat nose/jaw fracture
21347                          Treat nose/jaw fracture
21355                          Treat cheek bone fracture
21356                          Treat cheek bone fracture
21360                          Treat cheek bone fracture
21365                          Treat cheek bone fracture
21385                          Treat eye socket fracture
21386                          Treat eye socket fracture
21387                          Treat eye socket fracture
21400                          Treat eye socket fracture
21401                          Treat eye socket fracture
21421                          Treat mouth roof fracture
21422                          Treat mouth roof fracture
21423                          Treat mouth roof fracture
21431                          Treat craniofacial fracture
21432                          Treat craniofacial fracture
21440                          Treat dental ridge fracture
21445                          Treat dental ridge fracture
21450                          Treat lower jaw fracture
21451                          Treat lower jaw fracture
21452                          Treat lower jaw fracture
21453                          Treat lower jaw fracture
21461                          Treat lower jaw fracture
21462                          Treat lower jaw fracture
21485                          Reset dislocated jaw
21493                          Treat hyoid bone fracture
21494                          Treat hyoid bone fracture
21495                          Treat hyoid bone fracture
21497                          Interdental wiring
21501                          Drain neck/chest lesion
21555                          Remove lesion, neck/chest
21700                          Revision of neck muscle
21720                          Revision of neck muscle
21800                          Treatment of rib fracture
21820                          Treat sternum fracture
21925                          Biopsy soft tissue of back
21930                          Remove lesion, back or flank
22305                          Treat spine process fracture
22310                          Treat spine fracture
22315                          Treat spine fracture
23000                          Removal of calcium deposits
23030                          Drain shoulder lesion
23031                          Drain shoulder bursa
23065                          Biopsy shoulder tissues
23066                          Biopsy shoulder tissues
23075                          Removal of shoulder lesion
23330                          Remove shoulder foreign body
23350                          Injection for shoulder x-ray
23500                          Treat clavicle fracture
23505                          Treat clavicle fracture
23520                          Treat clavicle dislocation
23525                          Treat clavicle dislocation
23540                          Treat clavicle dislocation
23545                          Treat clavicle dislocation
23570                          Treat shoulder blade fx
23575                          Treat shoulder blade fx
23600                          Treat humerus fracture
23605                          Treat humerus fracture
23620                          Treat humerus fracture
23625                          Treat humerus fracture
23650                          Treat shoulder dislocation
23665                          Treat dislocation/fracture
23675                          Treat dislocation/fracture
23700                          Fixation of shoulder
23921                          Amputation follow-up surgery
23930                          Drainage of arm lesion
23931                          Drainage of arm bursa
24065                          Biopsy arm/elbow soft tissue
24066                          Biopsy arm/elbow soft tissue
24075                          Remove arm/elbow lesion
24200                          Removal of arm foreign body
24201                          Removal of arm foreign body
24220                          Injection for elbow x-ray
24500                          Treat humerus fracture
24505                          Treat humerus fracture
24530                          Treat humerus fracture
24535                          Treat humerus fracture
24560                          Treat humerus fracture
24565                          Treat humerus fracture
24576                          Treat humerus fracture
24577                          Treat humerus fracture
24600                          Treat elbow dislocation
24640                          Treat elbow dislocation
24650                          Treat radius fracture
24655                          Treat radius fracture
24670                          Treat ulnar fracture
24675                          Treat ulnar fracture
25065                          Biopsy forearm soft tissues
25246                          Injection for wrist x-ray
25500                          Treat fracture of radius
25505                          Treat fracture of radius
25520                          Treat fracture of radius
25530                          Treat fracture of ulna
25535                          Treat fracture of ulna
25560                          Treat fracture radius & ulna
25565                          Treat fracture radius & ulna
25600                          Treat fracture radius/ulna
25605                          Treat fracture radius/ulna
25622                          Treat wrist bone fracture
25624                          Treat wrist bone fracture
25630                          Treat wrist bone fracture
25635                          Treat wrist bone fracture
25650                          Treat wrist bone fracture
25675                          Treat wrist dislocation
26600                          Treat metacarpal fracture
26605                          Treat metacarpal fracture
26641                          Treat thumb dislocation
26645                          Treat thumb fracture
26670                          Treat hand dislocation
26675                          Treat hand dislocation
26700                          Treat knuckle dislocation
26705                          Treat knuckle dislocation
26720                          Treat finger fracture, each
26725                          Treat finger fracture, each
26740                          Treat finger fracture, each
26742                          Treat finger fracture, each
26750                          Treat finger fracture, each
26755                          Treat finger fracture, each
26770                          Treat finger dislocation
26775                          Treat finger dislocation
26863                          Fuse/graft added joint
26991                          Drainage of pelvis bursa
27040                          Biopsy of soft tissues
27047                          Remove hip/pelvis lesion
27086                          Remove hip foreign body
27093                          Injection for hip x-ray
27095                          Injection for hip x-ray
27193                          Treat pelvic ring fracture
27194                          Treat pelvic ring fracture
27200                          Treat tail bone fracture
27220                          Treat hip socket fracture
27230                          Treat thigh fracture
27246                          Treat thigh fracture
27256                          Treat hip dislocation
27257                          Treat hip dislocation
27275                          Manipulation of hip joint
27301                          Drain thigh/knee lesion
27323                          Biopsy, thigh soft tissues
27327                          Removal of thigh lesion
27370                          Injection for knee x-ray
27372                          Removal of foreign body
27500                          Treatment of thigh fracture
27501                          Treatment of thigh fracture
27508                          Treatment of thigh fracture

[[Page 47697]]

 
27516                          Treat thigh fx growth plate
27517                          Treat thigh fx growth plate
27520                          Treat kneecap fracture
27530                          Treat knee fracture
27532                          Treat knee fracture
27538                          Treat knee fracture(s)
27550                          Treat knee dislocation
27560                          Treat kneecap dislocation
27570                          Fixation of knee joint
27603                          Drain lower leg lesion
27604                          Drain lower leg bursa
27605                          Incision of achilles tendon
27606                          Incision of achilles tendon
27613                          Biopsy lower leg soft tissue
27614                          Biopsy lower leg soft tissue
27618                          Remove lower leg lesion
27619                          Remove lower leg lesion
27630                          Removal of tendon lesion
27648                          Injection for ankle x-ray
27656                          Repair leg fascia defect
27658                          Repair of leg tendon, each
27659                          Repair of leg tendon, each
27664                          Repair of leg tendon, each
27665                          Repair of leg tendon, each
27685                          Revision of lower leg tendon
27686                          Revise lower leg tendons
27692                          Revise additional leg tendon
27730                          Repair of tibia epiphysis
27732                          Repair of fibula epiphysis
27740                          Repair of leg epiphyses
27742                          Repair of leg epiphyses
27750                          Treatment of tibia fracture
27752                          Treatment of tibia fracture
27760                          Treatment of ankle fracture
27762                          Treatment of ankle fracture
27780                          Treatment of fibula fracture
27781                          Treatment of fibula fracture
27786                          Treatment of ankle fracture
27788                          Treatment of ankle fracture
27808                          Treatment of ankle fracture
27810                          Treatment of ankle fracture
27816                          Treatment of ankle fracture
27818                          Treatment of ankle fracture
27824                          Treat lower leg fracture
27825                          Treat lower leg fracture
27830                          Treat lower leg dislocation
27860                          Fixation of ankle joint
28001                          Drainage of bursa of foot
28002                          Treatment of foot infection
28003                          Treatment of foot infection
28008                          Incision of foot fascia
28010                          Incision of toe tendon
28011                          Incision of toe tendons
28020                          Exploration of foot joint
28022                          Exploration of foot joint
28024                          Exploration of toe joint
28035                          Decompression of tibia nerve
28043                          Excision of foot lesion
28045                          Excision of foot lesion
28046                          Resection of tumor, foot
28050                          Biopsy of foot joint lining
28052                          Biopsy of foot joint lining
28054                          Biopsy of toe joint lining
28060                          Partial removal, foot fascia
28062                          Removal of foot fascia
28070                          Removal of foot joint lining
28072                          Removal of foot joint lining
28080                          Removal of foot lesion
28086                          Excise foot tendon sheath
28088                          Excise foot tendon sheath
28090                          Removal of foot lesion
28092                          Removal of toe lesions
28100                          Removal of ankle/heel lesion
28103                          Remove/graft foot lesion
28104                          Removal of foot lesion
28107                          Remove/graft foot lesion
28108                          Removal of toe lesions
28110                          Part removal of metatarsal
28111                          Part removal of metatarsal
28112                          Part removal of metatarsal
28113                          Part removal of metatarsal
28114                          Removal of metatarsal heads
28116                          Revision of foot
28118                          Removal of heel bone
28119                          Removal of heel spur
28120                          Part removal of ankle/heel
28122                          Partial removal of foot bone
28124                          Partial removal of toe
28126                          Partial removal of toe
28140                          Removal of metatarsal
28150                          Removal of toe
28153                          Partial removal of toe
28160                          Partial removal of toe
28173                          Extensive foot surgery
28175                          Extensive foot surgery
28190                          Removal of foot foreign body
28192                          Removal of foot foreign body
28193                          Removal of foot foreign body
28200                          Repair of foot tendon
28202                          Repair/graft of foot tendon
28208                          Repair of foot tendon
28210                          Repair/graft of foot tendon
28220                          Release of foot tendon
28222                          Release of foot tendons
28225                          Release of foot tendon
28226                          Release of foot tendons
28230                          Incision of foot tendon(s)
28232                          Incision of toe tendon
28234                          Incision of foot tendon
28238                          Revision of foot tendon
28288                          Partial removal of foot bone
28289                          Repair hallux rigidus
28290                          Correction of bunion
28292                          Correction of bunion
28294                          Correction of bunion
28296                          Correction of bunion
28297                          Correction of bunion
28298                          Correction of bunion
28299                          Correction of bunion
28300                          Incision of heel bone
28302                          Incision of ankle bone
28305                          Incise/graft midfoot bones
28400                          Treatment of heel fracture
28405                          Treatment of heel fracture
28430                          Treatment of ankle fracture
28435                          Treatment of ankle fracture
28450                          Treat midfoot fracture, each
28455                          Treat midfoot fracture, each
28470                          Treat metatarsal fracture
28475                          Treat metatarsal fracture
28490                          Treat big toe fracture
28495                          Treat big toe fracture
28510                          Treatment of toe fracture
28515                          Treatment of toe fracture
28530                          Treat sesamoid bone fracture
28540                          Treat foot dislocation
28545                          Treat foot dislocation
28570                          Treat foot dislocation
28575                          Treat foot dislocation
28600                          Treat foot dislocation
28605                          Treat foot dislocation
28630                          Treat toe dislocation
28635                          Treat toe dislocation
28636                          Treat toe dislocation
28660                          Treat toe dislocation
28665                          Treat toe dislocation
30115                          Removal of nose polyp(s)
30117                          Removal of intranasal lesion
30118                          Removal of intranasal lesion
30120                          Revision of nose
30124                          Removal of nose lesion
30125                          Removal of nose lesion
30130                          Removal of turbinate bones
30140                          Removal of turbinate bones
30150                          Partial removal of nose
30160                          Removal of nose
30320                          Remove nasal foreign body
30400                          Reconstruction of nose
30410                          Reconstruction of nose
30420                          Reconstruction of nose
30430                          Revision of nose
30435                          Revision of nose
30450                          Revision of nose
30460                          Revision of nose
30462                          Revision of nose
30465                          Repair nasal stenosis
30520                          Repair of nasal septum
30540                          Repair nasal defect
30545                          Repair nasal defect
30580                          Repair upper jaw fistula
30600                          Repair mouth/nose fistula
30620                          Intranasal reconstruction
30630                          Repair nasal septum defect
30801                          Cauterization, inner nose
30802                          Cauterization, inner nose
30915                          Ligation, nasal sinus artery
30920                          Ligation, upper jaw artery
31020                          Exploration, maxillary sinus
31030                          Exploration, maxillary sinus
31032                          Explore sinus, remove polyps
31040                          Exploration behind upper jaw
31050                          Exploration, sphenoid sinus
31051                          Sphenoid sinus surgery
31070                          Exploration of frontal sinus
31075                          Exploration of frontal sinus
31080                          Removal of frontal sinus
31081                          Removal of frontal sinus
31084                          Removal of frontal sinus
31085                          Removal of frontal sinus

[[Page 47698]]

 
31086                          Removal of frontal sinus
31087                          Removal of frontal sinus
31090                          Exploration of sinuses
31200                          Removal of ethmoid sinus
31201                          Removal of ethmoid sinus
31205                          Removal of ethmoid sinus
31225                          Removal of upper jaw
31230                          Removal of upper jaw
31300                          Removal of larynx lesion
31320                          Diagnostic incision, larynx
31360                          Removal of larynx
31365                          Removal of larynx
31367                          Partial removal of larynx
31368                          Partial removal of larynx
31370                          Partial removal of larynx
31375                          Partial removal of larynx
31380                          Partial removal of larynx
31382                          Partial removal of larynx
31390                          Removal of larynx & pharynx
31395                          Reconstruct larynx & pharynx
31400                          Revision of larynx
31420                          Removal of epiglottis
31502                          Change of windpipe airway
31580                          Revision of larynx
31582                          Revision of larynx
31584                          Treat larynx fracture
31585                          Treat larynx fracture
31586                          Treat larynx fracture
31587                          Revision of larynx
31588                          Revision of larynx
31590                          Reinnervate larynx
31595                          Larynx nerve surgery
31610                          Incision of windpipe
31611                          Surgery/speech prosthesis
31613                          Repair windpipe opening
31614                          Repair windpipe opening
31622                          Dx bronchoscope/wash
31623                          Dx bronchoscope/brush
31624                          Dx bronchoscope/lavage
31625                          Bronchoscopy w/biopsy(s)
31628                          Bronchoscopy/lung bx, each
31629                          Bronchoscopy/needle bx, each
31630                          Bronchoscopy dilate/fx repr
31631                          Bronchoscopy, dilate w/stent
31635                          Bronchoscopy w/fb removal
31640                          Bronchoscopy w/tumor excise
31641                          Bronchoscopy, treat blockage
31643                          Diag bronchoscope/catheter
31645                          Bronchoscopy, clear airways
31646                          Bronchoscopy, reclear airway
31656                          Bronchoscopy, inj for x-ray
31708                          Instill airway contrast dye
31710                          Insertion of airway catheter
31715                          Injection for bronchus x-ray
31717                          Bronchial brush biopsy
31720                          Clearance of airways
31725                          Clearance of airways
31750                          Repair of windpipe
31755                          Repair of windpipe
31800                          Repair of windpipe injury
31820                          Closure of windpipe lesion
31825                          Repair of windpipe defect
31830                          Revise windpipe scar
32002                          Treatment of collapsed lung
32020                          Insertion of chest tube
32201                          Drain, percut, lung lesion
32400                          Needle biopsy chest lining
32405                          Biopsy, lung or mediastinum
32420                          Puncture/clear lung
32851                          Lung transplant, single
32852                          Lung transplant with bypass
32853                          Lung transplant, double
32854                          Lung transplant with bypass
33010                          Drainage of heart sac
33011                          Repeat drainage of heart sac
33210                          Insertion of heart electrode
33211                          Insertion of heart electrode
33225                          L ventric pacing lead add-on
33508                          Endoscopic vein harvest
33935                          Transplantation, heart/lung
33945                          Transplantation of heart
33960                          External circulation assist
33967                          Insert ia percut device
33968                          Remove aortic assist device
33970                          Aortic circulation assist
33973                          Insert balloon device
33975                          Implant ventricular device
33976                          Implant ventricular device
33979                          Insert intracorporeal device
35450                          Repair arterial blockage
35452                          Repair arterial blockage
35454                          Repair arterial blockage
35456                          Repair arterial blockage
35458                          Repair arterial blockage
35459                          Repair arterial blockage
35460                          Repair venous blockage
35470                          Repair arterial blockage
35471                          Repair arterial blockage
35472                          Repair arterial blockage
35473                          Repair arterial blockage
35474                          Repair arterial blockage
35475                          Repair arterial blockage
35476                          Repair venous blockage
35480                          Atherectomy, open
35481                          Atherectomy, open
35482                          Atherectomy, open
35483                          Atherectomy, open
35484                          Atherectomy, open
35485                          Atherectomy, open
35572                          Harvest femoropopliteal vein
35697                          Reimplant artery each
36010                          Place catheter in vein
36011                          Place catheter in vein
36012                          Place catheter in vein
36013                          Place catheter in artery
36014                          Place catheter in artery
36015                          Place catheter in artery
36100                          Establish access to artery
36120                          Establish access to artery
36140                          Establish access to artery
36145                          Artery to vein shunt
36160                          Establish access to aorta
36200                          Place catheter in aorta
36215                          Place catheter in artery
36216                          Place catheter in artery
36217                          Place catheter in artery
36218                          Place catheter in artery
36245                          Place catheter in artery
36246                          Place catheter in artery
36247                          Place catheter in artery
36248                          Place catheter in artery
36420                          Vein access cutdown < 1 yr
36430                          Blood transfusion service
36481                          Insertion of catheter, vein
36500                          Insertion of catheter, vein
36514                          Apheresis plasma
36515                          Apheresis, adsorp/reinfuse
36516                          Apheresis, selective
36625                          Insertion catheter, artery
36680                          Insert needle, bone cavity
37195                          Thrombolytic therapy, stroke
37200                          Transcatheter biopsy
37203                          Transcatheter retrieval
37204                          Transcatheter occlusion
37209                          Exchange arterial catheter
37785                          Ligate/divide/excise vein
38200                          Injection for spleen x-ray
38204                          Bl donor search management
38205                          Harvest allogenic stem cells
38206                          Harvest auto stem cells
38207                          Cryopreserve stem cells
38208                          Thaw preserved stem cells
38209                          Wash harvest stem cells
38210                          T-cell depletion of harvest
38211                          Tumor cell deplete of harvst
38212                          Rbc depletion of harvest
38213                          Platelet deplete of harvest
38214                          Volume deplete of harvest
38215                          Harvest stem cell concentrte
38240                          Bone marrow/stem transplant
38241                          Bone marrow/stem transplant
38242                          Lymphocyte infuse transplant
38305                          Drainage, lymph node lesion
38308                          Incision of lymph channels
38380                          Thoracic duct procedure
38520                          Biopsy/removal, lymph nodes
38542                          Explore deep node(s), neck
38700                          Removal of lymph nodes, neck
38720                          Removal of lymph nodes, neck
38724                          Removal of lymph nodes, neck
40500                          Partial excision of lip
40510                          Partial excision of lip
40520                          Partial excision of lip
40525                          Reconstruct lip with flap
40527                          Reconstruct lip with flap
40530                          Partial removal of lip
40650                          Repair lip
40652                          Repair lip
40654                          Repair lip
40700                          Repair cleft lip/nasal
40701                          Repair cleft lip/nasal
40702                          Repair cleft lip/nasal
40720                          Repair cleft lip/nasal
40761                          Repair cleft lip/nasal
40800                          Drainage of mouth lesion
40801                          Drainage of mouth lesion
40804                          Removal, foreign body, mouth
40805                          Removal, foreign body, mouth
40806                          Incision of lip fold

[[Page 47699]]

 
40808                          Biopsy of mouth lesion
40810                          Excision of mouth lesion
40812                          Excise/repair mouth lesion
40814                          Excise/repair mouth lesion
40816                          Excision of mouth lesion
40818                          Excise oral mucosa for graft
40819                          Excise lip or cheek fold
40820                          Treatment of mouth lesion
40830                          Repair mouth laceration
40831                          Repair mouth laceration
40840                          Reconstruction of mouth
40842                          Reconstruction of mouth
40843                          Reconstruction of mouth
40844                          Reconstruction of mouth
40845                          Reconstruction of mouth
41005                          Drainage of mouth lesion
41006                          Drainage of mouth lesion
41007                          Drainage of mouth lesion
41008                          Drainage of mouth lesion
41009                          Drainage of mouth lesion
41010                          Incision of tongue fold
41015                          Drainage of mouth lesion
41016                          Drainage of mouth lesion
41017                          Drainage of mouth lesion
41018                          Drainage of mouth lesion
41110                          Excision of tongue lesion
41112                          Excision of tongue lesion
41113                          Excision of tongue lesion
41114                          Excision of tongue lesion
41115                          Excision of tongue fold
41116                          Excision of mouth lesion
41120                          Partial removal of tongue
41130                          Partial removal of tongue
41135                          Tongue and neck surgery
41140                          Removal of tongue
41145                          Tongue removal, neck surgery
41150                          Tongue, mouth, jaw surgery
41153                          Tongue, mouth, neck surgery
41155                          Tongue, jaw, & neck surgery
41500                          Fixation of tongue
41510                          Tongue to lip surgery
41520                          Reconstruction, tongue fold
41823                          Excision of gum lesion
41827                          Excision of gum lesion
41872                          Repair gum
41874                          Repair tooth socket
42107                          Excision lesion, mouth roof
42120                          Remove palate/lesion
42140                          Excision of uvula
42145                          Repair palate, pharynx/uvula
42200                          Reconstruct cleft palate
42205                          Reconstruct cleft palate
42210                          Reconstruct cleft palate
42215                          Reconstruct cleft palate
42220                          Reconstruct cleft palate
42225                          Reconstruct cleft palate
42226                          Lengthening of palate
42227                          Lengthening of palate
42235                          Repair palate
42260                          Repair nose to lip fistula
42305                          Drainage of salivary gland
42325                          Create salivary cyst drain
42326                          Create salivary cyst drain
42335                          Removal of salivary stone
42340                          Removal of salivary stone
42408                          Excision of salivary cyst
42409                          Drainage of salivary cyst
42410                          Excise parotid gland/lesion
42415                          Excise parotid gland/lesion
42420                          Excise parotid gland/lesion
42425                          Excise parotid gland/lesion
42426                          Excise parotid gland/lesion
42440                          Excise submaxillary gland
42450                          Excise sublingual gland
42500                          Repair salivary duct
42505                          Repair salivary duct
42507                          Parotid duct diversion
42508                          Parotid duct diversion
42509                          Parotid duct diversion
42510                          Parotid duct diversion
42550                          Injection for salivary x-ray
42600                          Closure of salivary fistula
42665                          Ligation of salivary duct
42725                          Drainage of throat abscess
42810                          Excision of neck cyst
42815                          Excision of neck cyst
42820                          Remove tonsils and adenoids
42821                          Remove tonsils and adenoids
42825                          Removal of tonsils
42826                          Removal of tonsils
42830                          Removal of adenoids
42831                          Removal of adenoids
42835                          Removal of adenoids
42836                          Removal of adenoids
42842                          Extensive surgery of throat
42844                          Extensive surgery of throat
42845                          Extensive surgery of throat
42860                          Excision of tonsil tags
42870                          Excision of lingual tonsil
42890                          Partial removal of pharynx
42892                          Revision of pharyngeal walls
42894                          Revision of pharyngeal walls
42950                          Reconstruction of throat
42953                          Repair throat, esophagus
42955                          Surgical opening of throat
42961                          Control throat bleeding
42962                          Control throat bleeding
42970                          Control nose/throat bleeding
42971                          Control nose/throat bleeding
42972                          Control nose/throat bleeding
43020                          Incision of esophagus
43030                          Throat muscle surgery
43600                          Biopsy of stomach
43761                          Reposition gastrostomy tube
44100                          Biopsy of bowel
44385                          Endoscopy of bowel pouch
44386                          Endoscopy, bowel pouch/biop
44500                          Intro, gastrointestinal tube
44701                          Intraop colon lavage add-on
44901                          Drain app abscess, percut
45005                          Drainage of rectal abscess
45520                          Treatment of rectal prolapse
45915                          Remove rectal obstruction
46040                          Incision of rectal abscess
46200                          Removal of anal fissure
46210                          Removal of anal crypt
46211                          Removal of anal crypts
46221                          Ligation of hemorrhoid(s)
46250                          Hemorrhoidectomy
46255                          Hemorrhoidectomy
46270                          Removal of anal fistula
46275                          Removal of anal fistula
46285                          Removal of anal fistula
46500                          Injection into hemorrhoid(s)
46900                          Destruction, anal lesion(s)
46910                          Destruction, anal lesion(s)
46934                          Destruction of hemorrhoids
46936                          Destruction of hemorrhoids
46938                          Cryotherapy of rectal lesion
46945                          Ligation of hemorrhoids
46946                          Ligation of hemorrhoids
47135                          Transplantation of liver
47136                          Transplantation of liver
47140                          Partial removal, donor liver
47141                          Partial removal, donor liver
47142                          Partial removal, donor liver
47500                          Injection for liver x-rays
47525                          Change bile duct catheter
47530                          Revise/reinsert bile tube
47553                          Biliary endoscopy thru skin
47556                          Biliary endoscopy thru skin
47561                          Laparo w/cholangio/biopsy
48511                          Drain pancreatic pseudocyst
48554                          Transpl allograft pancreas
48556                          Removal, allograft pancreas
49021                          Drain abdominal abscess
49041                          Drain, percut, abdom abscess
49061                          Drain, percut, retroper absc
49400                          Air injection into abdomen
49423                          Exchange drainage catheter
49424                          Assess cyst, contrast inject
49427                          Injection, abdominal shunt
49505                          Prp i/hern init reduc>5 yr
50010                          Exploration of kidney
50020                          Renal abscess, open drain
50021                          Renal abscess, percut drain
50040                          Drainage of kidney
50045                          Exploration of kidney
50060                          Removal of kidney stone
50065                          Incision of kidney
50070                          Incision of kidney
50075                          Removal of kidney stone
50080                          Removal of kidney stone
50081                          Removal of kidney stone
50100                          Revise kidney blood vessels
50120                          Exploration of kidney
50125                          Explore and drain kidney
50130                          Removal of kidney stone
50135                          Exploration of kidney
50200                          Biopsy of kidney
50205                          Biopsy of kidney
50220                          Remove kidney, open
50225                          Removal kidney open, complex
50230                          Removal kidney open, radical
50234                          Removal of kidney & ureter
50236                          Removal of kidney & ureter
50240                          Partial removal of kidney
50280                          Removal of kidney lesion
50290                          Removal of kidney lesion

[[Page 47700]]

 
50300                          Removal of donor kidney
50320                          Removal of donor kidney
50340                          Removal of kidney
50360                          Transplantation of kidney
50365                          Transplantation of kidney
50370                          Remove transplanted kidney
50380                          Reimplantation of kidney
50390                          Drainage of kidney lesion
50392                          Insert kidney drain
50393                          Insert ureteral tube
50394                          Injection for kidney x-ray
50395                          Create passage to kidney
50396                          Measure kidney pressure
50398                          Change kidney tube
50400                          Revision of kidney/ureter
50405                          Revision of kidney/ureter
50500                          Repair of kidney wound
50520                          Close kidney-skin fistula
50525                          Repair renal-abdomen fistula
50526                          Repair renal-abdomen fistula
50540                          Revision of horseshoe kidney
50541                          Laparo ablate renal cyst
50542                          Laparo ablate renal mass
50544                          Laparoscopy, pyeloplasty
50545                          Laparo radical nephrectomy
50546                          Laparoscopic nephrectomy
50547                          Laparo removal donor kidney
50548                          Laparo remove w/ ureter
50551                          Kidney endoscopy
50553                          Kidney endoscopy
50555                          Kidney endoscopy & biopsy
50555                          Kidney endoscopy & biopsy
50557                          Kidney endoscopy & treatment
50559                          Renal endoscopy/radiotracer
50561                          Kidney endoscopy & treatment
50562                          Renal scope w/tumor resect
50570                          Kidney endoscopy
50572                          Kidney endoscopy
50574                          Kidney endoscopy & biopsy
50575                          Kidney endoscopy
50576                          Kidney endoscopy & treatment
50578                          Renal endoscopy/radiotracer
50580                          Kidney endoscopy & treatment
50590                          Fragmenting of kidney stone
50600                          Exploration of ureter
50605                          Insert ureteral support
50610                          Removal of ureter stone
50620                          Removal of ureter stone
50630                          Removal of ureter stone
50650                          Removal of ureter
50660                          Removal of ureter
50684                          Injection for ureter x-ray
50686                          Measure ureter pressure
50688                          Change of ureter tube
50690                          Injection for ureter x-ray
50700                          Revision of ureter
50715                          Release of ureter
50722                          Release of ureter
50725                          Release/revise ureter
50727                          Revise ureter
50728                          Revise ureter
50740                          Fusion of ureter & kidney
50750                          Fusion of ureter & kidney
50760                          Fusion of ureters
50770                          Splicing of ureters
50780                          Reimplant ureter in bladder
50782                          Reimplant ureter in bladder
50783                          Reimplant ureter in bladder
50785                          Reimplant ureter in bladder
50800                          Implant ureter in bowel
50810                          Fusion of ureter & bowel
50815                          Urine shunt to intestine
50820                          Construct bowel bladder
50825                          Construct bowel bladder
50830                          Revise urine flow
50840                          Replace ureter by bowel
50845                          Appendico-vesicostomy
50860                          Transplant ureter to skin
50900                          Repair of ureter
50920                          Closure ureter/skin fistula
50930                          Closure ureter/bowel fistula
50940                          Release of ureter
50945                          Laparoscopy ureterolithotomy
50947                          Laparo new ureter/bladder
50948                          Laparo new ureter/bladder
50949                          Laparoscope proc, ureter
50951                          Endoscopy of ureter
50953                          Endoscopy of ureter
50955                          Ureter endoscopy & biopsy
50957                          Ureter endoscopy & treatment
50959                          Ureter endoscopy & tracer
50961                          Ureter endoscopy & treatment
50970                          Ureter endoscopy
50972                          Ureter endoscopy & catheter
50974                          Ureter endoscopy & biopsy
50976                          Ureter endoscopy & treatment
50978                          Ureter endoscopy & tracer
50980                          Ureter endoscopy & treatment
52007                          Cystoscopy and biopsy
52010                          Cystoscopy & duct catheter
52204                          Cystoscopy
52214                          Cystoscopy and treatment
52224                          Cystoscopy and treatment
52234                          Cystoscopy and treatment
52235                          Cystoscopy and treatment
52240                          Cystoscopy and treatment
52265                          Cystoscopy and treatment
52270                          Cystoscopy & revise urethra
52275                          Cystoscopy & revise urethra
52310                          Cystoscopy and treatment
52315                          Cystoscopy and treatment
52317                          Remove bladder stone
52327                          Cystoscopy, inject material
52330                          Cystoscopy and treatment
52332                          Cystoscopy and treatment
53040                          Drainage of urethra abscess
53060                          Drainage of urethra abscess
53200                          Biopsy of urethra
53260                          Treatment of urethra lesion
53265                          Treatment of urethra lesion
53270                          Removal of urethra gland
53605                          Dilate urethra stricture
53665                          Dilation of urethra
53850                          Prostatic microwave thermotx
53852                          Prostatic rf thermotx
53853                          Prostatic water thermother
54000                          Slitting of prepuce
54001                          Slitting of prepuce
54056                          Cryosurgery, penis lesion(s)
54057                          Laser surg, penis lesion(s)
54060                          Excision of penis lesion(s)
54065                          Destruction, penis lesion(s)
54105                          Biopsy of penis
54110                          Treatment of penis lesion
54111                          Treat penis lesion, graft
54112                          Treat penis lesion, graft
54115                          Treatment of penis lesion
54120                          Partial removal of penis
54125                          Removal of penis
54130                          Remove penis & nodes
54135                          Remove penis & nodes
54150                          Circumcision
54160                          Circumcision
54162                          Lysis penil circumic lesion
55110                          Explore scrotum
55120                          Removal of scrotum lesion
55150                          Removal of scrotum
55175                          Revision of scrotum
55180                          Revision of scrotum
55200                          Incision of sperm duct
55250                          Removal of sperm duct(s)
55400                          Repair of sperm duct
56605                          Biopsy of vulva/perineum
56700                          Partial removal of hymen
56720                          Incision of hymen
56740                          Remove vagina gland lesion
57100                          Biopsy of vagina
57105                          Biopsy of vagina
57160                          Insert pessary/other device
57400                          Dilation of vagina
57452                          Exam of cervix w/scope
57454                          Bx/curett of cervix w/scope
57460                          Bx of cervix w/scope, leep
57500                          Biopsy of cervix
57520                          Conization of cervix
57522                          Conization of cervix
58555                          Hysteroscopy, dx, sep proc
58558                          Hysteroscopy, biopsy
58559                          Hysteroscopy, lysis
58560                          Hysteroscopy, resect septum
58561                          Hysteroscopy, remove myoma
58562                          Hysteroscopy, remove fb
58800                          Drainage of ovarian cyst(s)
58823                          Drain pelvic abscess, percut
59030                          Fetal scalp blood sample
59140                          Treat ectopic pregnancy
59320                          Revision of cervix
59325                          Revision of cervix
59350                          Repair of uterus
59820                          Care of miscarriage
59821                          Treatment of miscarriage
61107                          Drill skull for implantation
61210                          Pierce skull, implant device
61316                          Implt cran bone flap to abdo
61517                          Implt brain chemotx add-on
61576                          Skull base/brainstem surgery
61864                          Implant neuroelectrde, add'l
61868                          Implant neuroelectrde, add'l
62120                          Repair skull cavity lesion

[[Page 47701]]

 
62121                          Incise skull repair
62148                          Retr bone flap to fix skull
62160                          Neuroendoscopy add-on
62270                          Spinal fluid tap, diagnostic
62272                          Drain cerebro spinal fluid
62273                          Treat epidural spine lesion
62280                          Treat spinal cord lesion
62281                          Treat spinal cord lesion
62282                          Treat spinal canal lesion
62284                          Injection for myelogram
62290                          Inject for spine disk x-ray
62291                          Inject for spine disk x-ray
62310                          Inject spine c/t
62311                          Inject spine l/s (cd)
62318                          Inject spine w/cath, c/t
62319                          Inject spine w/cath l/s (cd)
62367                          Analyze spine infusion pump
62368                          Analyze spine infusion pump
63048                          Remove spinal lamina add-on
63057                          Decompress spine cord add-on
63066                          Decompress spine cord add-on
63076                          Neck spine disk surgery
63078                          Spine disk surgery, thorax
63082                          Remove vertebral body add-on
63086                          Remove vertebral body add-on
63088                          Remove vertebral body add-on
63091                          Remove vertebral body add-on
63103                          Remove vertebral body add-on
63308                          Remove vertebral body add-on
64400                          N block inj, trigeminal
64402                          N block inj, facial
64405                          N block inj, occipital
64408                          N block inj, vagus
64410                          N block inj, phrenic
64412                          N block inj, spinal accessor
64413                          N block inj, cervical plexus
64415                          N block inj, brachial plexus
64417                          N block inj, axillary
64418                          N block inj, suprascapular
64420                          N block inj, intercost, sng
64421                          N block inj, intercost, mlt
64425                          N block inj ilio-ing/hypogi
64430                          N block inj, pudendal
64435                          N block inj, paracervical
64445                          N block inj, sciatic, sng
64450                          N block, other peripheral
64470                          Inj paravertebral c/t
64472                          Inj paravertebral c/t add-on
64475                          Inj paravertebral l/s
64476                          Inj paravertebral l/s add-on
64479                          Inj foramen epidural c/t
64480                          Inj foramen epidural add-on
64483                          Inj foramen epidural l/s
64484                          Inj foramen epidural add-on
64505                          N block, spenopalatine gangl
64508                          N block, carotid sinus s/p
64510                          N block, stellate ganglion
64520                          N block, lumbar/thoracic
64530                          N block inj, celiac pelus
64561                          Implant neuroelectrodes
64600                          Injection treatment of nerve
64605                          Injection treatment of nerve
64610                          Injection treatment of nerve
64612                          Destroy nerve, face muscle
64613                          Destroy nerve, spine muscle
64614                          Destroy nerve, extrem musc
64620                          Injection treatment of nerve
64622                          Destr paravertebrl nerve l/s
64623                          Destr paravertebral n add-on
64626                          Destr paravertebrl nerve c/t
64627                          Destr paravertebral n add-on
64630                          Injection treatment of nerve
64640                          Injection treatment of nerve
64680                          Injection treatment of nerve
64716                          Revision of cranial nerve
64740                          Incision of tongue nerve
64778                          Digit nerve surgery add-on
64864                          Repair of facial nerve
64865                          Repair of facial nerve
64866                          Fusion of facial/other nerve
64868                          Fusion of facial/other nerve
64885                          Nerve graft, head or neck
64886                          Nerve graft, head or neck
65125                          Revise ocular implant
65205                          Remove foreign body from eye
65210                          Remove foreign body from eye
65220                          Remove foreign body from eye
65222                          Remove foreign body from eye
65270                          Repair of eye wound
65272                          Repair of eye wound
65273                          Repair of eye wound
65275                          Repair of eye wound
65280                          Repair of eye wound
65285                          Repair of eye wound
65286                          Repair of eye wound
65290                          Repair of eye socket wound
65400                          Removal of eye lesion
65410                          Biopsy of cornea
65420                          Removal of eye lesion
65426                          Removal of eye lesion
65430                          Corneal smear
65435                          Curette/treat cornea
65436                          Curette/treat cornea
65450                          Treatment of corneal lesion
65600                          Revision of cornea
65771                          Radial keratotomy
65772                          Correction of astigmatism
65800                          Drainage of eye
65805                          Drainage of eye
65810                          Drainage of eye
65815                          Drainage of eye
65855                          Laser surgery of eye
65860                          Incise inner eye adhesions
66020                          Injection treatment of eye
66030                          Injection treatment of eye
66130                          Remove eye lesion
66250                          Follow-up surgery of eye
66625                          Removal of iris
66630                          Removal of iris
66635                          Removal of iris
66990                          Ophthalmic endoscope add-on
67025                          Replace eye fluid
67027                          Implant eye drug system
67028                          Injection eye drug
67031                          Laser surgery, eye strands
67101                          Repair detached retina
67105                          Repair detached retina
67107                          Repair detached retina
67108                          Repair detached retina
67110                          Repair detached retina
67112                          Rerepair detached retina
67115                          Release encircling material
67120                          Remove eye implant material
67121                          Remove eye implant material
67141                          Treatment of retina
67145                          Treatment of retina
67345                          Destroy nerve of eye muscle
67500                          Inject/treat eye socket
67505                          Inject/treat eye socket
67515                          Inject/treat eye socket
67700                          Drainage of eyelid abscess
67710                          Incision of eyelid
67715                          Incision of eyelid fold
67800                          Remove eyelid lesion
67801                          Remove eyelid lesions
67805                          Remove eyelid lesions
67808                          Remove eyelid lesion(s)
67820                          Revise eyelashes
67825                          Revise eyelashes
67830                          Revise eyelashes
67840                          Remove eyelid lesion
67850                          Treat eyelid lesion
67875                          Closure of eyelid by suture
67880                          Revision of eyelid
67882                          Revision of eyelid
67900                          Repair brow defect
67901                          Repair eyelid defect
67902                          Repair eyelid defect
67903                          Repair eyelid defect
67904                          Repair eyelid defect
67906                          Repair eyelid defect
67908                          Repair eyelid defect
67909                          Repair eyelid defect
67911                          Repair eyelid defect
67914                          Repair eyelid defect
67915                          Repair eyelid defect
67916                          Repair eyelid defect
67917                          Repair eyelid defect
67921                          Repair eyelid defect
67922                          Repair eyelid defect
67923                          Repair eyelid defect
67924                          Repair eyelid defect
67930                          Repair eyelid wound
67935                          Repair eyelid wound
67938                          Remove eyelid foreign body
67950                          Revision of eyelid
67961                          Revision of eyelid
67966                          Revision of eyelid
67971                          Reconstruction of eyelid
67973                          Reconstruction of eyelid
67974                          Reconstruction of eyelid
67975                          Reconstruction of eyelid
68020                          Incise/drain eyelid lining
68040                          Treatment of eyelid lesions
68100                          Biopsy of eyelid lining
68110                          Remove eyelid lining lesion
68115                          Remove eyelid lining lesion
68130                          Remove eyelid lining lesion
68135                          Remove eyelid lining lesion

[[Page 47702]]

 
68200                          Treat eyelid by injection
68320                          Revise/graft eyelid lining
68325                          Revise/graft eyelid lining
68326                          Revise/graft eyelid lining
68328                          Revise/graft eyelid lining
68330                          Revise eyelid lining
68335                          Revise/graft eyelid lining
68340                          Separate eyelid adhesions
68360                          Revise eyelid lining
68362                          Revise eyelid lining
68440                          Incise tear duct opening
68700                          Repair tear ducts
68705                          Revise tear duct opening
68760                          Close tear duct opening
68761                          Close tear duct opening
68770                          Close tear duct opening
68801                          Dilate tear duct opening
68810                          Probe nasolacrimal duct
68811                          Probe nasolacrimal duct
68815                          Probe nasolacrimal duct
68840                          Explore/irrigate tear ducts
68850                          Injection for tear sac x-ray
69110                          Remove external ear, partial
69120                          Removal of external ear
69140                          Remove ear canal lesion(s)
69145                          Remove ear canal lesion(s)
69150                          Extensive ear canal surgery
69155                          Extensive ear/neck surgery
69310                          Rebuild outer ear canal
69320                          Rebuild outer ear canal
69440                          Exploration of middle ear
69450                          Eardrum revision
69501                          Mastoidectomy
69502                          Mastoidectomy
69505                          Remove mastoid structures
69511                          Extensive mastoid surgery
69530                          Extensive mastoid surgery
69535                          Remove part of temporal bone
69550                          Remove ear lesion
69552                          Remove ear lesion
69554                          Remove ear lesion
69601                          Mastoid surgery revision
69602                          Mastoid surgery revision
69603                          Mastoid surgery revision
69604                          Mastoid surgery revision
69605                          Mastoid surgery revision
69620                          Repair of eardrum
69631                          Repair eardrum structures
69632                          Rebuild eardrum structures
69633                          Rebuild eardrum structures
69635                          Repair eardrum structures
69636                          Rebuild eardrum structures
69637                          Rebuild eardrum structures
69641                          Revise middle ear & mastoid
69642                          Revise middle ear & mastoid
69643                          Revise middle ear & mastoid
69644                          Revise middle ear & mastoid
69645                          Revise middle ear & mastoid
69646                          Revise middle ear & mastoid
69650                          Release middle ear bone
69660                          Revise middle ear bone
69661                          Revise middle ear bone
69662                          Revise middle ear bone
69666                          Repair middle ear structures
69667                          Repair middle ear structures
69670                          Remove mastoid air cells
69676                          Remove middle ear nerve
69700                          Close mastoid fistula
69711                          Remove/repair hearing aid
69714                          Implant temple bone w/stimul
69715                          Temple bne implnt w/stimulat
69717                          Temple bone implant revision
69718                          Revise temple bone implant
69720                          Release facial nerve
69725                          Release facial nerve
69740                          Repair facial nerve
69745                          Repair facial nerve
69801                          Incise inner ear
69802                          Incise inner ear
69805                          Explore inner ear
69806                          Explore inner ear
69820                          Establish inner ear window
69840                          Revise inner ear window
69905                          Remove inner ear
69910                          Remove inner ear & mastoid
69915                          Incise inner ear nerve
69930                          Implant cochlear device
69950                          Incise inner ear nerve
69955                          Release facial nerve
69960                          Release inner ear canal
69970                          Remove inner ear lesion
69990                          Microsurgery add-on
70010                          Contrast x-ray of brain
70015                          Contrast x-ray of brain
70030                          X-ray eye for foreign body
70100                          X-ray exam of jaw
70110                          X-ray exam of jaw
70120                          X-ray exam of mastoids
70130                          X-ray exam of mastoids
70134                          X-ray exam of middle ear
70140                          X-ray exam of facial bones
70150                          X-ray exam of facial bones
70160                          X-ray exam of nasal bones
70170                          X-ray exam of tear duct
70190                          X-ray exam of eye sockets
70200                          X-ray exam of eye sockets
70210                          X-ray exam of sinuses
70220                          X-ray exam of sinuses
70240                          X-ray exam, pituitary saddle
70250                          X-ray exam of skull
70260                          X-ray exam of skull
70300                          X-ray exam of teeth
70310                          X-ray exam of teeth
70320                          Full mouth x-ray of teeth
70328                          X-ray exam of jaw joint
70330                          X-ray exam of jaw joints
70332                          X-ray exam of jaw joint
70350                          X-ray head for orthodontia
70355                          Panoramic x-ray of jaws
70360                          X-ray exam of neck
70370                          Throat x-ray & fluoroscopy
70371                          Speech evaluation, complex
70373                          Contrast x-ray of larynx
70380                          X-ray exam of salivary gland
70390                          X-ray exam of salivary duct
70450                          Ct head/brain w/o dye
70460                          Ct head/brain w/dye
70470                          Ct head/brain w/o & w/ dye
70480                          Ct orbit/ear/fossa w/o dye
70481                          Ct orbit/ear/fossa w/dye
70482                          Ct orbit/ear/fossa w/o&w dye
70486                          Ct maxillofacial w/o dye
70487                          Ct maxillofacial w/dye
70488                          Ct maxillofacial w/o & w dye
70490                          Ct soft tissue neck w/o dye
70491                          Ct soft tissue neck w/dye
70492                          Ct sft tsue nck w/o & w/dye
70542                          Mri orbit/face/neck w/dye
70543                          Mri orbt/fac/nck w/o & w dye
70552                          Mri brain w/ dye
70553                          Mri brain w/o & w/ dye
70557                          Mri brain w/o dye
70558                          Mri brain w/ dye
70559                          Mri brain w/o & w/ dye
71010                          Chest x-ray
71015                          Chest x-ray
71020                          Chest x-ray
71021                          Chest x-ray
71022                          Chest x-ray
71023                          Chest x-ray and fluoroscopy
71030                          Chest x-ray
71034                          Chest x-ray and fluoroscopy
71035                          Chest x-ray
71040                          Contrast x-ray of bronchi
71060                          Contrast x-ray of bronchi
71090                          X-ray & pacemaker insertion
71100                          X-ray exam of ribs
71101                          X-ray exam of ribs/chest
71110                          X-ray exam of ribs
71111                          X-ray exam of ribs/ chest
71120                          X-ray exam of breastbone
71130                          X-ray exam of breastbone
71250                          Ct thorax w/o dye
71260                          Ct thorax w/dye
71270                          Ct thorax w/o & w/ dye
71551                          Mri chest w/dye
71552                          Mri chest w/o & w/dye
71555                          Mri angio chest w or w/o dye
72010                          X-ray exam of spine
72020                          X-ray exam of spine
72040                          X-ray exam of neck spine
72050                          X-ray exam of neck spine
72052                          X-ray exam of neck spine
72069                          X-ray exam of trunk spine
72070                          X-ray exam of thoracic spine
72072                          X-ray exam of thoracic spine
72074                          X-ray exam of thoracic spine
72080                          X-ray exam of trunk spine
72090                          X-ray exam of trunk spine
72100                          X-ray exam of lower spine
72110                          X-ray exam of lower spine
72114                          X-ray exam of lower spine
72120                          X-ray exam of lower spine
72125                          Ct neck spine w/o dye
72126                          Ct neck spine w/dye
72127                          Ct neck spine w/o & w/dye
72128                          Ct chest spine w/o dye
72129                          Ct chest spine w/dye
72130                          Ct chest spine w/o & w/dye

[[Page 47703]]

 
72131                          Ct lumbar spine w/o dye
72132                          Ct lumbar spine w/dye
72133                          Ct lumbar spine w/o & w/dye
72142                          Mri neck spine w/dye
72147                          Mri chest spine w/dye
72149                          Mri lumbar spine w/dye
72156                          Mri neck spine w/o & w/dye
72157                          Mri chest spine w/o & w/dye
72158                          Mri lumbar spine w/o & w/dye
72159                          Mr angio spine w/o&w/dye
72170                          X-ray exam of pelvis
72190                          X-ray exam of pelvis
72192                          Ct pelvis w/o dye
72193                          Ct pelvis w/dye
72194                          Ct pelvis w/o & w/dye
72196                          Mri pelvis w/dye
72197                          Mri pelvis w/o & w/dye
72198                          Mr angio pelvis w/o & w/dye
72200                          X-ray exam sacroiliac joints
72202                          X-ray exam sacroiliac joints
72220                          X-ray exam of tailbone
72240                          Contrast x-ray of neck spine
72255                          Contrast x-ray, thorax spine
72270                          Contrast x-ray, spine
72275                          Epidurography
72285                          X-ray c/t spine disk
72295                          X-ray of lower spine disk
73000                          X-ray exam of collar bone
73010                          X-ray exam of shoulder blade
73020                          X-ray exam of shoulder
73030                          X-ray exam of shoulder
73040                          Contrast x-ray of shoulder
73050                          X-ray exam of shoulders
73060                          X-ray exam of humerus
73070                          X-ray exam of elbow
73080                          X-ray exam of elbow
73085                          Contrast x-ray of elbow
73090                          X-ray exam of forearm
73092                          X-ray exam of arm, infant
73100                          X-ray exam of wrist
73110                          X-ray exam of wrist
73115                          Contrast x-ray of wrist
73120                          X-ray exam of hand
73130                          X-ray exam of hand
73140                          X-ray exam of finger(s)
73200                          Ct upper extremity w/o dye
73201                          Ct upper extremity w/dye
73202                          Ct uppr extremity w/o&w/dye
73219                          Mri upper extremity w/dye
73220                          Mri uppr extremity w/o&w/dye
73222                          Mri joint upr extrem w/dye
73223                          Mri joint upr extr w/o&w/dye
73225                          Mr angio upr extr w/o&w/dye
73500                          X-ray exam of hip
73510                          X-ray exam of hip
73520                          X-ray exam of hips
73525                          Contrast x-ray of hip
73530                          X-ray exam of hip
73540                          X-ray exam of pelvis & hips
73542                          X-ray exam, sacroiliac joint
73550                          X-ray exam of thigh
73560                          X-ray exam of knee, 1 or 2
73562                          X-ray exam of knee, 3
73564                          X-ray exam, knee, 4 or more
73565                          X-ray exam of knees
73580                          Contrast x-ray of knee joint
73590                          X-ray exam of lower leg
73592                          X-ray exam of leg, infant
73600                          X-ray exam of ankle
73610                          X-ray exam of ankle
73615                          Contrast x-ray of ankle
73620                          X-ray exam of foot
73630                          X-ray exam of foot
73650                          X-ray exam of heel
73660                          X-ray exam of toe(s)
73700                          Ct lower extremity w/o dye
73701                          Ct lower extremity w/dye
73702                          Ct lwr extremity w/o&w/dye
73719                          Mri lower extremity w/dye
73720                          Mri lwr extremity w/o&w/dye
73722                          Mri joint of lwr extr w/dye
73723                          Mri joint lwr extr w/o&w/dye
73725                          Mr ang lwr ext w or w/o dye
74000                          X-ray exam of abdomen
74010                          X-ray exam of abdomen
74020                          X-ray exam of abdomen
74022                          X-ray exam series, abdomen
74150                          Ct abdomen w/o dye
74160                          Ct abdomen w/dye
74170                          Ct abdomen w/o &w /dye
74182                          Mri abdomen w/dye
74183                          Mri abdomen w/o & w/dye
74185                          Mri angio, abdom w orw/o dye
74190                          X-ray exam of peritoneum
74210                          Contrst x-ray exam of throat
74220                          Contrast x-ray, esophagus
74230                          Cine/vid x-ray, throat/esoph
74235                          Remove esophagus obstruction
74240                          X-ray exam, upper gi tract
74241                          X-ray exam, upper gi tract
74245                          X-ray exam, upper gi tract
74246                          Contrst x-ray uppr gi tract
74247                          Contrst x-ray uppr gi tract
74249                          Contrst x-ray uppr gi tract
74251                          X-ray exam of small bowel
74260                          X-ray exam of small bowel
74270                          Contrast x-ray exam of colon
74280                          Contrast x-ray exam of colon
74283                          Contrast x-ray exam of colon
74290                          Contrast x-ray, gallbladder
74291                          Contrast x-rays, gallbladder
74300                          X-ray bile ducts/pancreas
74305                          X-ray bile ducts/pancreas
74320                          Contrast x-ray of bile ducts
74327                          X-ray bile stone removal
74328                          X-ray bile duct endoscopy
74329                          X-ray for pancreas endoscopy
74330                          X-ray bile/panc endoscopy
74340                          X-ray guide for GI tube
74350                          X-ray guide, stomach tube
74355                          X-ray guide, intestinal tube
74360                          X-ray guide, GI dilation
74363                          X-ray, bile duct dilation
74420                          Contrst x-ray, urinary tract
74425                          Contrst x-ray, urinary tract
74440                          X-ray, male genital tract
74445                          X-ray exam of penis
74450                          X-ray, urethra/bladder
74470                          X-ray exam of kidney lesion
74475                          X-ray control, cath insert
74480                          X-ray control, cath insert
74485                          X-ray guide, GU dilation
74710                          X-ray measurement of pelvis
74742                          X-ray, fallopian tube
74775                          X-ray exam of perineum
75553                          Heart mri for morph w/dye
75556                          Cardiac MRI/flow mapping
75600                          Contrast x-ray exam of aorta
75605                          Contrast x-ray exam of aorta
75625                          Contrast x-ray exam of aorta
75630                          X-ray aorta, leg arteries
75650                          Artery x-rays, head & neck
75658                          Artery x-rays, arm
75660                          Artery x-rays, head & neck
75662                          Artery x-rays, head & neck
75665                          Artery x-rays, head & neck
75671                          Artery x-rays, head & neck
75676                          Artery x-rays, neck
75680                          Artery x-rays, neck
75685                          Artery x-rays, spine
75705                          Artery x-rays, spine
74250                          X-ray exam of small bowel
75710                          Artery x-rays, arm/leg
75716                          Artery x-rays, arms/legs
75722                          Artery x-rays, kidney
75724                          Artery x-rays, kidneys
75726                          Artery x-rays, abdomen
75731                          Artery x-rays, adrenal gland
75733                          Artery x-rays, adrenals
75736                          Artery x-rays, pelvis
75741                          Artery x-rays, lung
75743                          Artery x-rays, lungs
75746                          Artery x-rays, lung
75756                          Artery x-rays, chest
75774                          Artery x-ray, each vessel
75790                          Visualize A-V shunt
75801                          Lymph vessel x-ray, arm/leg
75803                          Lymph vessel x-ray,arms/legs
75805                          Lymph vessel x-ray, trunk
75807                          Lymph vessel x-ray, trunk
75809                          Nonvascular shunt, x-ray
75810                          Vein x-ray, spleen/liver
75820                          Vein x-ray, arm/leg
75822                          Vein x-ray, arms/legs
75825                          Vein x-ray, trunk
75827                          Vein x-ray, chest
75831                          Vein x-ray, kidney
75833                          Vein x-ray, kidneys
75840                          Vein x-ray, adrenal gland
75842                          Vein x-ray, adrenal glands
75860                          Vein x-ray, neck
75870                          Vein x-ray, skull
75872                          Vein x-ray, skull
75880                          Vein x-ray, eye socket
75885                          Vein x-ray, liver
75887                          Vein x-ray, liver
75889                          Vein x-ray, liver
75891                          Vein x-ray, liver
75893                          Venous sampling by catheter

[[Page 47704]]

 
75894                          X-rays, transcath therapy
75896                          X-rays, transcath therapy
75898                          Follow-up angiography
75900                          Arterial catheter exchange
75940                          X-ray placement, vein filter
75952                          Endovasc repair abdom aorta
75953                          Abdom aneurysm endovas rpr
75954                          Iliac aneurysm endovas rpr
75960                          Transcatheter intro, stent
75961                          Retrieval, broken catheter
75962                          Repair arterial blockage
75964                          Repair artery blockage, each
75966                          Repair arterial blockage
75968                          Repair artery blockage, each
75970                          Vascular biopsy
75978                          Repair venous blockage
75980                          Contrast xray exam bile duct
75982                          Contrast xray exam bile duct
75984                          Xray control catheter change
75989                          Abscess drainage under x-ray
75992                          Atherectomy, x-ray exam
75993                          Atherectomy, x-ray exam
75994                          Atherectomy, x-ray exam
75995                          Atherectomy, x-ray exam
75996                          Atherectomy, x-ray exam
76001                          Fluoroscope exam, extensive
76003                          Needle localization by x-ray
76005                          Fluoroguide for spine inject
76006                          X-ray stress view
76010                          X-ray, nose to rectum
76012                          Percut vertebroplasty fluor
76013                          Percut vertebroplasty, ct
76020                          X-rays for bone age
76040                          X-rays, bone evaluation
76061                          X-rays, bone survey
76062                          X-rays, bone survey
76065                          X-rays, bone evaluation
76066                          Joint survey, single view
76070                          Ct bone density, axial
76075                          Dexa, axial skeleton study
76076                          Dexa, peripheral study
76078                          Radiographic absorptiometry
76080                          X-ray exam of fistula
76086                          X-ray of mammary duct
76088                          X-ray of mammary ducts
76090                          Mammogram, one breast
76091                          Mammogram, both breasts
76092                          Mammogram, screening
76093                          Magnetic image, breast
76094                          Magnetic image, both breasts
76095                          Stereotactic breast biopsy
76096                          X-ray of needle wire, breast
76096                          X-ray of needle wire, breast
76098                          X-ray exam, breast specimen
76100                          X-ray exam of body section
76101                          Complex body section x-ray
76102                          Complex body section x-rays
76350                          Special x-ray contrast study
76355                          Ct scan for localization
76360                          Ct scan for needle biopsy
76362                          Ct guide for tissue ablation
76362                          Ct guide for tissue ablation
76370                          Ct scan for therapy guide
76375                          3d/holograph reconstr add-on
76380                          CAT scan follow-up study
76390                          Mr spectroscopy
76394                          Mri for tissue ablation
76394                          Mri for tissue ablation
76604                          Us exam, chest, b-scan
76645                          Us exam, breast(s)
76700                          Us exam, abdom, complete
76705                          Echo exam of abdomen
76775                          Us exam abdo back wall, lim
76800                          Us exam, spinal canal
76886                          Us exam infant hips, static
76932                          Echo guide for heart biopsy
76936                          Echo guide for artery repair
76941                          Us guide, tissue ablation
76941                          Echo guide for transfusion
76945                          Echo guide for transfusion
76946                          Echo guide, villus sampling
76948                          Echo guide for amniocentesis
76950                          Echo guide, ova aspiration
76965                          Echo guidance radiotherapy
76970                          Echo guidance radiotherapy
76977                          Ultrasound exam follow-up
76986                          Us bone density measure
77295                          Ultrasound guide intraoper
77326                          Set radiation therapy field
77327                          Brachytx isodose calc simp
77328                          Brachytx isodose calc interm
77427                          Brachytx isodose plan compl
77431                          Radiation tx management, x5
77470                          Stereotactic radiation trmt
77600                          Special radiation treatment
77605                          Hyperthermia treatment
77610                          Hyperthermia treatment
77615                          Hyperthermia treatment
77620                          Hyperthermia treatment
77750                          Hyperthermia treatment
77761                          Infuse radioactive materials
77762                          Apply intrcav radiat simple
77763                          Apply intrcav radiat interm
77776                          Apply intrcav radiat compl
77777                          Apply interstit radiat simpl
77778                          Apply interstit radiat inter
77790                          Apply surface radiation
78000                          Radiation handling
78001                          Thyroid, single uptake
78003                          Thyroid, multiple uptakes
78006                          Thyroid suppress/stimul
78007                          Thyroid imaging with uptake
78010                          Thyroid image, mult uptakes
78011                          Thyroid imaging
78015                          Thyroid imaging with flow
78016                          Thyroid met imaging
78018                          Thyroid met imaging/studies
78020                          Thyroid met imaging, body
78070                          Thyroid met uptake
78075                          Parathyroid nuclear imaging
78102                          Adrenal nuclear imaging
78103                          Bone marrow imaging, ltd
78104                          Bone marrow imaging, mult
78110                          Bone marrow imaging, body
78111                          Plasma volume, single
78120                          Plasma volume, multiple
78121                          Red cell mass, single
78122                          Red cell mass, multiple
78130                          Blood volume
78135                          Red cell survival study
78140                          Red cell survival kinetics
78185                          Total body iron estimation
78190                          Spleen imaging
78191                          Platelet survival, kinetics
78195                          Platelet survival
78201                          Lymph system imaging
78202                          Liver imaging
78205                          Liver imaging with flow
78215                          Liver image (3d) with flow
78216                          Liver and spleen imaging
78220                          Liver & spleen image/flow
78223                          Liver function study
78230                          Hepatobiliary imaging
78231                          Salivary gland imaging
78232                          Serial salivary imaging
78258                          Salivary gland function exam
78261                          Esophageal motility study
78262                          Gastric mucosa imaging
78264                          Gastroesophageal reflux exam
78270                          Gastric emptying study
78271                          Vit B-12 absorption exam
78272                          Vit b-12 absrp exam, int fac
78278                          Vit B-12 absorp, combined
78290                          GI protein loss exam
78291                          Meckel's divert exam
78300                          Leveen/shunt patency exam
78305                          Bone imaging, limited area
78306                          Bone imaging, multiple areas
78315                          Bone imaging, whole body
78320                          Bone imaging, 3 phase
78428                          Bone mineral, dual photon
78445                          Cardiac shunt imaging
78456                          Venous thrombosis study
78457                          Acute venous thrombus image
78458                          Venous thrombosis imaging
78460                          Ven thrombosis images, bilat
78461                          Heart muscle blood, single
78464                          Heart muscle blood, multiple
78466                          Heart image (3d), single
78468                          Heart infarct image
78469                          Heart infarct image (ef)
78472                          Heart infarct image (3D)
78473                          Gated heart, planar, single
78478                          Gated heart, multiple
78480                          Heart wall motion add-on
78481                          Heart function add-on
78483                          Heart first pass, single
78494                          Heart first pass, multiple
78496                          Heart image, spect
78580                          Heart first pass add-on
78584                          Lung perfusion imaging
78585                          Lung V/Q image single breath
78586                          Lung V/Q imaging
78587                          Aerosol lung image, single
78588                          Aerosol lung image, multiple
78591                          Perfusion lung image
78593                          Vent image, 1 breath, 1 proj
78594                          Vent image, 1 proj, gas
78596                          Vent image, mult proj, gas

[[Page 47705]]

 
78601                          Brain imaging, ltd static
78605                          Brain imaging, ltd w/flow
78606                          Brain imaging, complete
78610                          Brain imaging (3D)
78615                          Brain flow imaging only
78630                          Cerebral vascular flow image
78635                          Cerebrospinal fluid scan
78645                          CSF ventriculography
78650                          Cerebrospinal fluid scan
78660                          CSF leakage imaging
78700                          Nuclear exam of tear flow
78701                          Kidney imaging, static
78704                          Kidney imaging with flow
78707                          Imaging renogram
78708                          Kidney flow/function image
78709                          Kidney flow/function image
78710                          Kidney flow/function image
78715                          Kidney imaging (3D)
78725                          Renal vascular flow exam
78730                          Kidney function study
78740                          Urinary bladder retention
78760                          Ureteral reflux study
78761                          Testicular imaging
78800                          Testicular imaging/flow
78801                          Tumor imaging, limited area
78802                          Tumor imaging, mult areas
78804                          Tumor imaging (3D)
78805                          Tumor imaging, whole body
78806                          Abscess imaging, ltd area
78890                          Nuclear localization/abscess
78891                          Nuclear medicine data proc
85396                          Nuclear joint therapy
88125                          TB tine test
88141                          Forensic cytopathology
88348                          Cytopath, c/v, interpret
88349                          Electron microscopy
90865                          Sample stomach contents
90870                          Narcosynthesis
90875                          Electroconvulsive therapy
90876                          Psychophysiological therapy
90885                          Hypnotherapy
91000                          Psy evaluation of records
91010                          Esophageal intubation
91011                          Esophagus motility study
91012                          Esophagus motility study
91020                          Esophagus motility study
91030                          Gastric motility
91052                          Prolonged acid reflux test
91055                          Gastric analysis test
91060                          Gastric intubation for smear
91065                          Gastric saline load test
91100                          Breath hydrogen test
91105                          Pass intestine bleeding tube
91122                          Gastric intubation treatment
91123                          Anal pressure record
91132                          Irrigate fecal impaction
91133                          Electrogastrography
92325                          Prescription of contact lens
92326                          Modification of contact lens
92354                          Fitting of artificial eye
92355                          Special spectacles fitting
92358                          Special spectacles fitting
92371                          Eye prosthesis service
92392                          Repair & adjust spectacles
92393                          Supply of low vision aids
92395                          Supply of artificial eye
92512                          Supply of contact lenses
92516                          Nasal function studies
92547                          Facial nerve function test
92548                          Supplemental electrical test
92565                          Posturography
92571                          Stenger test, pure tone
92572                          Filtered speech hearing test
92573                          Staggered spondaic word test
92575                          Lombard test
92576                          Sensorineural acuity test
92577                          Synthetic sentence test
92579                          Stenger test, speech
92582                          Visual audiometry (vra)
92583                          Conditioning play audiometry
92584                          Select picture audiometry
92585                          Electrocochleography
92586                          Auditor evoke potent, compre
92587                          Auditor evoke potent, limit
92588                          Evoked auditory test
92596                          Evoked auditory test
92950                          Oral speech device eval
92975                          Cardioassist, external
93012                          Dissolve clot, heart vessel
93014                          Transmission of ecg
93224                          Cardiac drug stress test
93225                          ECG monitor/report, 24 hrs
93226                          ECG monitor/record, 24 hrs
93227                          ECG monitor/report, 24 hrs
93230                          ECG monitor/review, 24 hrs
93231                          ECG monitor/report, 24 hrs
93232                          Ecg monitor/record, 24 hrs
93235                          ECG monitor/report, 24 hrs
93236                          ECG monitor/report, 24 hrs
93237                          ECG monitor/report, 24 hrs
93268                          ECG monitor/review, 24 hrs
93270                          ECG record/review
93271                          ECG recording
93272                          Ecg/monitoring and analysis
93278                          Ecg/review, interpret only
93318                          Echo transesophageal
93501                          Echo transesophageal intraop
93505                          Right heart catheterization
93508                          Biopsy of heart lining
93510                          Cath placement, angiography
93526                          Left heart catheterization
93555                          R & l heart cath, congenital
93556                          Imaging, cardiac cath
93609                          Heart flow reserve measure
93613                          Map tachycardia, add-on
93660                          Electrophys map 3d, add-on
93721                          Tilt table evaluation
93724                          Plethysmography tracing
93727                          Analyze pacemaker system
93731                          Analyze ilr system
93732                          Analyze pacemaker system
93734                          Analyze pacemaker system
93735                          Analyze pacemaker system
93741                          Analyze pacemaker system
93742                          Analyze ht pace device sngl
93743                          Analyze ht pace device sngl
93744                          Analyze ht pace device dual
93798                          Cardiac rehab
93980                          Cardiac rehab/monitor
93981                          Penile vascular study
94070                          Review patient spirometry
94450                          CO2 breathing response curve
94770                          Pulmonary compliance study
95044                          Breath recording, infant
95052                          Allergy patch tests
95056                          Photo patch test
95070                          Photosensitivity tests
95180                          Ingestion challenge test
95250                          Rapid desensitization
95806                          Multiple sleep latency test
95819                          Sleep study, attended
95824                          Eeg, awake and asleep
95824                          Eeg, cerebral death only
95827                          Eeg, cerebral death only
95858                          Tensilon test
95869                          Tensilon test & myogram
95872                          Muscle test, thor paraspinal
95920                          Limb exercise test
95925                          Intraop nerve test add-on
95926                          Somatosensory testing
95927                          Somatosensory testing
95930                          Somatosensory testing
95936                          Visual evoked potential test
95957                          Eeg monitoring, cable/radio
95958                          EEG digital analysis
95961                          EEG monitoring/function test
95962                          Electrode stimulation, brain
95970                          Meg, evoked, each add'l
95971                          Analyze neurostim, no prog
95972                          Analyze neurostim, simple
95973                          Analyze neurostim, complex
95974                          Analyze neurostim, complex
95975                          Cranial neurostim, complex
96902                          Ultraviolet light therapy
99026                          Wound(s) care, selective
99027                          In-hospital on call service
99170                          Out-of-hosp on call service
99175                          Anogenital exam, child
99183                          Induction of vomiting
99217                          Total body hypothermia
99218                          Observation care discharge
99219                          Observation care
99220                          Observation care
99221                          Observation care
99222                          Initial hospital care
99223                          Initial hospital care
99231                          Initial hospital care
99232                          Subsequent hospital care
99233                          Subsequent hospital care
99234                          Subsequent hospital care
99235                          Observ/hosp same date
99236                          Observ/hosp same date
99238                          Observ/hosp same date
99239                          Hospital discharge day
99251                          Office consultation
99252                          Initial inpatient consult
99253                          Initial inpatient consult
99254                          Initial inpatient consult
99255                          Initial inpatient consult

[[Page 47706]]

 
99261                          Initial inpatient consult
99262                          Follow-up inpatient consult
99263                          Follow-up inpatient consult
99271                          Follow-up inpatient consult
99272                          Confirmatory consultation
99273                          Confirmatory consultation
99274                          Confirmatory consultation
99275                          Confirmatory consultation
99281                          Confirmatory consultation
99282                          Emergency dept visit
99283                          Emergency dept visit
99284                          Emergency dept visit
99285                          Emergency dept visit
99288                          Emergency dept visit
99289                          Direct advanced life support
99290                          Ped crit care transport
99291                          Ped crit care transport addl
99292                          Critical care, first hour
99293                          Critical care, add'l 30 min
99294                          Ped critical care, initial
99295                          Ped critical care, subseq
99296                          Neonate crit care, initial
99298                          Neonate critical care subseq
99299                          Ic for lbw infant < 1500 gm
99301                          Ic, lbw infant 1500-2500 gm
99302                          Nursing facility care
99303                          Nursing facility care
99311                          Nursing facility care
99312                          Nursing fac care, subseq
99313                          Nursing fac care, subseq
99315                          Nursing fac care, subseq
99316                          Nursing fac discharge day
99321                          Nursing fac discharge day
99322                          Rest home visit, new patient
99323                          Rest home visit, new patient
99331                          Rest home visit, new patient
99332                          Rest home visit, est pat
99333                          Rest home visit, est pat
99341                          Rest home visit, est pat
99342                          Home visit, new patient
99343                          Home visit, new patient
99344                          Home visit, new patient
99345                          Home visit, new patient
99347                          Home visit, new patient
99348                          Home visit, est patient
99349                          Home visit, est patient
99350                          Home visit, est patient
99354                          Home visit, est patient
99355                          Prolonged service, office
99356                          Prolonged service, office
99357                          Prolonged service, inpatient
99358                          Prolonged service, inpatient
99359                          Prolonged serv, w/o contact
99360                          Prolonged serv, w/o contact
99361                          Physician standby services
99362                          Physician/team conference
99371                          Physician/team conference
99372                          Physician phone consultation
99373                          Physician phone consultation
99374                          Physician phone consultation
99375                          Home health care supervision
99377                          Home health care supervision
99378                          Hospice care supervision
99379                          Hospice care supervision
99380                          Nursing fac care supervision
99381                          Nursing fac care supervision
99382                          Prev visit, new, infant
99383                          Prev visit, new, age 1-4
99384                          Prev visit, new, age 5-11
99385                          Prev visit, new, age 12-17
99386                          Prev visit, new, age 18-39
99387                          Prev visit, new, age 40-64
99391                          Prev visit, new, 65 & over
99392                          Prev visit, est, infant
99393                          Prev visit, est, age 1-4
99394                          Prev visit, est, age 5-11
99395                          Prev visit, est, age 12-17
99396                          Prev visit, est, age 18-39
99397                          Prev visit, est, age 40-64
99401                          Prev visit, est, 65 & over
99402                          Preventive counseling, indiv
99403                          Preventive counseling, indiv
99404                          Preventive counseling, indiv
99411                          Preventive counseling, indiv
99412                          Preventive counseling, group
99420                          Preventive counseling, group
99431                          Health risk assessment test
99432                          Initial care, normal newborn
99433                          Newborn care, not in hosp
99435                          Normal newborn care/hospital
99436                          Newborn discharge day hosp
99440                          Attendance, birth
99450                          Newborn resuscitation
99455                          Life/disability evaluation
99456                          Disability examination
------------------------------------------------------------------------
Some of these codes have previously been refined and additional
  refinements were made by the PEAC.
All anesthesia codes were reviewed with the exception of 00104 abd
  00124.
CPT codes and descriptions are copyright 2004 by the AMA, all rights
  reserved.








  Federal Register / Vol. 69, No. 150 / Thursday, August 5, 2004 / 
Proposed Rules  

[[Page 47706]]




[[Page 47707]]



                               Addendum D.--Proposed Changes to Practice Expense Equipment Description, Life, and Pricing
--------------------------------------------------------------------------------------------------------------------------------------------------------
                         2004 practice expense equipment details                         2005 practice expense supply details (proposed)
    Equip code    --------------------------------------------------------------------------------------------------------------------------------------
                          Description         Life         Price              Description         Life         Price             Equipment category
--------------------------------------------------------------------------------------------------------------------------------------------------------
E54006...........  22 channel EEG (split to     7.0         $44,310.00  EEG, digital, prolonged       7         $46,750.00  Other Equipment
                    separate systems).                                   testing system
                                                                         (computer w-remote
                                                                         camera).
E54006...........  22 channel EEG (split to     7.0         $44,310.00  EEG, digital, standard        7         $21,000.00  Other Equipment
                    separate systems).                                   testing system
                                                                         (computer hardware &
                                                                         software).
E54004 +.........  22 channel EMG-EP            7.0         $66,650.00  EMG-NCV-EP system, 8         10         $59,500.00  Other Equipment
                    machine.                                             channel.
E51028...........  2-D Scanning                 5.0          $6,000.00  Deleted through PEAC     ......  .................  No Details
                    Densitometer.                                        refinement..
E55002...........  3 Channel ECG machine...     5.0          $4,800.00  ECG, 3-channel.........       7          $1,845.42  Other Equipment
E55005...........  3 channel ECG/BP monitor     5.0          $3,895.00  ECG, 3-channel (with          7          $4,322.50  Other Equipment
                                                                         SpO2, NIBP, temp,
                                                                         resp).
E51034...........  30 cm Water Phantom w/       5.0          $2,850.00  Deleted through PEAC     ......  .................  No Details
                    Manual positioner.                                   refinement..
E50002...........  35mm camera.............     5.0          $1,150.00  camera, 35mm system           5          $1,106.50  Documentation
                                                                         (medical grade).
E13623...........  37*, 60*, 90* degree        10.0            $682.00  oven, convection (lab).      10            $640.73  Laboratory
                    oven.
                   3-D Phantom.............     5.0          $1,084.00  phantom, 3-D...........      10          $1,084.00  Radiology
E51032...........  3-D Water Scanning           5.0         $56,000.00  Deleted through PEAC     ......  .................  No Details
                    Phantom.                                             refinement..
E71025...........  ABR machine, (Mikolay or     7.0         $23,000.00  ABR-auditory brainstem        7         $27,000.00  Other Equipment
                    Biologic).                                           response system.
                   Accelerator, 4 MV.......     5.0      $1,600,000.00  accelerator, 4-6 MV....       7      $1,408,491.00  Radiology
                   Accelerator, 6 MV.......     5.0      $1,770,708.00  accelerator, 4-6 MV....       7      $1,408,491.00  Radiology
                   Accelerator, 18 MV......     5.0      $1,741,018.00  accelerator, 6-18 MV...       7      $1,832,941.00  Radiology
                   Accelerator, 20 MV......     5.0
                   accelerator, 6-18 MV....       7      $1,832,941.00  Radiology..............
E52020...........  Acusonic Sequoia C0256..     5.0        $250,000.00  ultrasound,                   5        $248,000.00  Other Equipment
                                                                         echocardiography w-4
                                                                         transducers (Sequoia
                                                                         C256).
                   Adjustable computer          7.0            $895.00  table, motorized (for        15            $895.00  Furniture
                    table.                                               instruments-equipment).
                   ADL kit.................     7.0            $587.00  kit, ADL...............      10            $586.50  Other Equipment
                   ADL kit.................    10.0            $586.00  kit, ADL...............      10            $586.50  Other Equipment
                   aerosol machine.........     5.0  .................  Deleted (less than       ......  .................  No Details
                                                                         $500).
                   air compressor, safety..    10.0            $575.00  air compressor, safety.      12            $575.00  Other Equipment
E30026...........  Albarran bridge.........     7.5            $975.00  Albarran deflecting           3            $988.00  Scope
                                                                         bridge, single channel.
                   alternans system, CH2000     8.0         $29,400.00  cardiac monitor w-           10         $32,600.00  Other Equipment
                                                                         treadmill (microvolt,
                                                                         CH2000).
                   ambulation kit (canes,      10.0            $750.00  kit, ambulation........      10            $763.70  Other Equipment
                    walker, mirror, balance
                    board, crutches, safety
                    belt).
E52015...........  a-mode ultrasonic            5.0          $6,950.00  ultrasonic biometry, A-       5          $5,247.50  Other Equipment
                    biometry unit.                                       scan.
                   aneroid barometer.......     5.0            $550.00  barometer, aneroid.....       7            $587.50  Radiology
E30025...........  anesthesia machine......     7.0         $49,035.00  anesthesia machine (w-        7         $60,000.00  Other Equipment
                                                                         vaporizers).
E51084...........  angiographic room.......     5.0      $1,580,000.00  room, angiography......       5      $1,386,816.00  Room - Lane
E71010...........  anomaloscopes -              5.0         $10,500.00  anomaloscope,                10          $6,146.00  Other Equipment
                    diagnostic.                                          diagnostic (HMC).
E13116...........  anoscope & light source.     3.0            $550.00  anoscope with light           3            $657.62  Scope
                                                                         source.
E51038...........  Anthropomorphic Phantom.     5.0          $8,250.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
E51066...........  Applicator sets for HDR.     5.0          $3,333.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
E51068...........  Applicator sets for LDR.     5.0          $2,723.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
E72001...........  argon laser.............     5.0         $45,000.00  laser, argon (w-slit          5         $32,900.00  Other Equipment
                                                                         lamp adapter).
E72002...........  argon-krypton laser.....     5.0         $65,000.00  laser, argon-kripton...       5         $85,000.00  Other Equipment
E55035...........  ART signal averaging         7.5          $8,250.00  ECG signal averaging          5          $8,250.00  Other Equipment
                    machine.                                             system.
                   audio system, MRI.......    10.0         $16,000.00  intercom (incl. master,      10          $1,630.00  Other Equipment
                                                                         pt substation, power,
                                                                         wiring).
E71029...........  audiometer..............     7.0          $5,495.00  audiometer, clinical-        10          $6,250.00  Other Equipment
                                                                         diagnostic.
E71011...........  auto lensometer.........     5.0          $2,095.00  lensometer, auto.......       7          $2,995.00  Other Equipment
E71026...........  Autoacustic Emission         7.0          $7,995.00  OAE-otoacoustic               7          $7,780.00  Other Equipment
                    Equipment.                                           emission system.
E55024...........  Autobox V6200...........     8.0         $22,985.00  Vmax 62j (body                8         $21,055.00  Other Equipment
                                                                         plethysmograph
                                                                         autobox).
                   automated radio              5.0         $30,000.00  radiofrequency                5         $16,500.00  Other Equipment
                    frequency generator.                                 generator, TUNA
                                                                         procedure.
E52016...........  b scan ultrasonography..     5.0         $24,975.00  ultrasonic biometry, B-       5         $12,500.00  Other Equipment
                                                                         scan.
E13604...........  balance.................     7.0          $2,400.00  balance, analytic......      10          $4,001.67  Laboratory

[[Page 47708]]

 
                   balance board...........    10.0            $600.00  balance board..........      15            $509.66  Other Equipment
                   balance master..........    10.0         $12,500.00  balance assessment-           5         $13,500.00  Other Equipment
                                                                         retraining system
                                                                         (Balance Master).
                   balance scales..........    10.0            $995.00  balance, scale.........       7            $768.50  Laboratory
                   balance, analytic.......     7.0          $5,570.00  balance, analytic......      10          $4,001.67  Laboratory
E51004...........  basic radiology room....     5.0        $150,000.00  room, basic radiology..       5        $150,000.00  Room - Lane
E92002...........  bath tub................    10.0          $1,224.00  bath tub...............      10          $1,150.00  Furniture
                   bath, paraffin,             10.0          $3,349.00  paraffin bath, hand-          7          $2,406.50  Other Equipment
                    institutional.                                       foot (institutional).
                   beat-to-beat bp unit....     7.0         $14,900.00  arterial tonometry            7         $14,900.00  Other Equipment
                                                                         monitor (Colin Pilot).
E50005...........  Bio Impedance Body           7.0          $4,490.00  body analysis machine,       10          $2,151.32  Other Equipment
                    Weight Analysis Machine.                             bioimpedence.
                   biohazard hood..........    10.0          $7,612.00  hood, biohazard........      10          $6,884.25  Laboratory
                   bladder scanner with         5.0         $11,445.00  ultrasound, noninvasive       5         $11,450.00  Other Equipment
                    cart.                                                bladder scanner w-cart.
E72005...........  Blepharoplasty Tray.....     4.0          $1,949.53  instrument pack, medium       4          $1,500.00  Other Equipment
                                                                         ($1500 and up).
                   body analysis machine,       7.0          $2,700.00  body analysis machine,       10          $2,151.32  Other Equipment
                    bioimpedence.                                        bioimpedence.
                   Body Plethysmography         8.0         $45,000.00  Vmax 22d and 62j (PFT         8         $47,930.00  Other Equipment
                    Unit.                                                equip, autobox,
                                                                         computer system).
                   bone drill system,           4.0          $8,979.00  drill system, surgical,       3          $8,979.00  Other Equipment
                    surgical, small bone                                 small-micro (Stryker).
                    (Stryker).
                   bone saw, electric           7.5          $6,080.00  saw, surgical, electric      10          $6,080.00  Other Equipment
                    (Stryker).                                           (Stryker).
                   BTE primus..............    10.0         $45,820.00  rehab and testing             5         $45,820.00  Other Equipment
                                                                         system (BTE primus).
                   CAD processor unit......     8.0        $210,000.00  CAD processor unit            5        $210,000.00  Documentation
                                                                         (mammography).
                   Calibrated Chamber......     5.0            $500.00  calibration (AAPM             5            $500.00  Radiology
                                                                         ADCL), ion chamber.
                   Calibration Computer         5.0          $5,500.00  electrometer, PC-based,       5          $5,675.00  Radiology
                    with Software.                                       dual channel.
                   calibration equipment...     5.0          $5,000.00  electrometer, PC-based,       5          $5,675.00  Radiology
                                                                         dual channel.
                   caloric irrigator.......     7.0          $4,875.00  caloric stimulator, air       7          $5,950.00  Other Equipment
                                                                         or water.
E55017...........  camera (autoswitching)       5.0          $6,300.00  camera, remote-               5          $5,250.00  Documentation
                    with 16X zoom lens.                                  autoswitching.
                   camera, retinal topcon..     5.0         $78,000.00  camera, retinal (TRC          5         $37,000.00  Documentation
                                                                         50IX, w-ICG, filters,
                                                                         motor drives).
E13611...........  carbon coater...........     7.5          $6,200.00  Deleted (part of new     ......  .................  No Details
                                                                         system).
                   cardiac gating device...     5.0         $40,000.00  ECG R-wave trigger            7          $5,671.00  Other Equipment
                                                                         (gating) device.
E55016...........  cardiac monitor - 12         5.0         $18,726.00  cardiac monitor w-           10         $14,271.03  Other Equipment
                    lead- stress test                                    treadmill (12-lead PC-
                    monitor and treadmill.                               based ECG).
E53005...........  Cardiac Nuclear Camera       7.5        $675,000.00  camera system, cardiac,       5        $675,000.00  Documentation
                    System.                                              nuclear.
E55018...........  cardiac output monitor..     7.5         $22,790.00  ICG monitoring system         5         $28,625.00  Other Equipment
                                                                         (impedance
                                                                         cardiography).
E53003...........  Cardiac Phantom.........     7.5          $3,990.00  phantom, SPECT with          10          $3,042.00  Radiology
                                                                         cardiac insert.
E53026...........  Cardiofocal Collimators      5.0         $29,990.00  collimator, cardiofocal       7         $29,990.00  Radiology
                    (1Set).                                              set.
                   cardio-pulmonary stress      8.0         $58,751.00  Vmax 29c (cardio-pulm         8         $58,751.00  Other Equipment
                    testing system.                                      stress test equip,
                                                                         treadmill, computer
                                                                         system).
                   cardio-respiratory           5.0         $12,000.00  ECG, 3-channel (with          7          $4,322.50  Other Equipment
                    monitor.                                             SpO2, NIBP, temp,
                                                                         resp).
                   cart heating pan, Splint-   10.0            $790.00  water bath,                   7            $722.36  Radiology
                    Form 2000.                                           thermoplastic softener
                                                                         (20in x 12in).
                   cart, laboratory........    10.0            $585.00  cart, laboratory.......      10            $677.83  Furniture
                   cast cart...............    10.0          $5,000.00  cast cart..............      10          $3,808.00  Other Equipment
E30022...........  cast cutter.............     7.0          $1,295.00  cast cutter............      10          $1,160.62  Other Equipment
                   cast table..............    10.0         $25,000.00  casting table                10          $4,099.00  Furniture
                                                                         attachment, hip-spica
                                                                         cast.
                   cast vacuum.............     7.0          $1,476.00  cast vacuum............       8          $1,475.50  Other Equipment
                   casting frame...........    10.0         $12,500.00  casting table                10          $2,538.00  Furniture
                                                                         attachment, Risser.
E72007...........  Cataract Tray...........     4.0         $11,261.33  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..

[[Page 47709]]

 
E71112...........  Central (Pod) Equipment      7.0         $30,442.01  lane, central pod (oph)       7         $23,029.00  Room - Lane
                    Lane.
E13656...........  centrifuge..............     7.0          $3,250.00  centrifuge (with rotor)       7          $4,291.65  Laboratory
                   Cerrobend melting pots..     7.0          $1,500.00  alloy melter, digital,        7          $1,393.00  Radiology
                                                                         3 gallon.
E53046...........  Cesium 137 sources (6-       7.0         $43,580.00  Deleted through PEAC     ......  .................  No Details
                    10mg, 6-15mg, 6-20 mg,                               refinement..
                    2-25mg, 2-5mg) 3m.
                   chair, medical recliner     10.0            $829.03  chair, medical recliner      10            $829.03  Furniture
                    (chemo, phlebotomy).
                   chair, phlebotomy-            10               1200  chair, medical recliner      10            $829.03  Furniture
                    injection.
E91004...........  Chemo couch.............    10.0            $895.00  chair, medical recliner      10            $829.03  Furniture
E51086...........  chest room..............     5.0        $200,000.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
E30007...........  CO2 laser...............     5.0         $42,500.00  laser, CO2 (Star X)....       5          $7,795.00  Other Equipment
E55025...........  CO2 monitor.............     7.0          $7,495.00  CO2 respiratory profile       7          $7,995.00  Other Equipment
                                                                         monitor.
E53002...........  Colbalt-57 sheet flood       0.5          $2,790.00  Cobalt-57 Flood Source        5          $2,243.00  Radiology
                    source.                                              (47cm dia) (10 mCi).
E53002...........  Colbalt-57 sheet flood       7.5          $2,790.00  Cobalt-57 Flood Source        5          $2,243.00  Radiology
                    source.                                              (47cm dia) (10 mCi).
E53002...........  Colbalt-57 sheet flood       8.0          $2,790.00  Cobalt-57 Flood Source        5          $2,243.00  Radiology
                    source.                                              (47cm dia) (10 mCi).
E13110...........  colonoscope, video           3.0         $54,590.00  videoscope, colonoscopy       3         $23,650.00  Scope
                    (SPLIT: scope and video
                    system).
E13401...........  colposcope..............     3.0          $4,550.00  colposcope.............       8          $3,946.67  Scope
E71013...........  computer and VDT and         5.0          $9,000.00  computer and VDT and          5          $9,000.00  Documentation
                    software.                                            software.
E92013...........  computerized spinal         10.0          $9,995.00  range of motion               5          $7,995.00  Other Equipment
                    range of motion device.                              (spinal) device and
                                                                         software (Myo-Logic).
E71014...........  corneal topography unit.     5.0         $17,950.00  topography unit,              7         $13,495.00  Other Equipment
                                                                         corneal (Magellan).
                   CPAP/BiPAP remote            7.0  .................  CPAP/BiPAP remote             7  .................  Other Equipment
                    clinical unit.                                       clinical unit.
E13609...........  critical point dryer....    10.0          $8,000.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
E30015...........  cryostat................     7.0         $13,950.00  cryostat...............       7         $17,197.50  Other Equipment
E30014...........  cryostat knife sharpener     7.0          $6,234.00  microtome sharpener....      10          $6,400.00  Radiology
                   cryosurgery equipment        7.5          $2,750.00  cryosurgery equipment        10          $2,394.30  Other Equipment
                    package.                                             (for liquid nitrogen).
                   cryosurgery system, non-     7.5          $1,608.00  cryosurgery system, non-     10          $1,607.50  Other Equipment
                    ophthalmic.                                          ophthalmic.
                   cryosurgery system,          7.5          $5,245.00  cryosurgery system,           7          $5,245.00  Other Equipment
                    ophthalmic.                                          ophthalmic.
                   cryo-thermal unit.......     7.5  .................  cryo-thermal unit......      10  .................  Other Equipment
                   csf shunt reprogramming      5.0          $1,500.00  CSF shunt programmer          7          $2,392.00  Other Equipment
                    device (hand-held).                                  unit.
E51082...........  CT Room.................     5.0      $1,000,000.00  room, CT...............       5        $981,045.00  Room - Lane
E51018...........  CT-Based Virtual             5.0        $900,000.00  IMRT CT-based simulator       5        $975,000.00  Radiology
                    Simulator.
E13657...........  cytology thin prep           7.5         $35,000.00  cytology thinlayer            7         $54,000.00  Laboratory
                    processor.                                           processor (ThinPrep).
E51054...........  Daily Output QA Device,      5.0          $5,795.00  Deleted through PEAC     ......  .................  No Details
                    RMI (RBA-5).                                         refinement..
E13658...........  dark field microscope...     7.0          $4,500.00  microscope, polarized         7          $5,374.50  Laboratory
                                                                         (dark field).
                   data acquisition beat-to-    7.0         $14,496.00  arterial tonometry            7         $14,500.00  Other Equipment
                    beat analysis system.                                acquisition system (WR
                                                                         Testworks).
                   data acquisition/q-sart      7.0         $22,228.00  QSART acquisition             5         $28,000.00  Other Equipment
                    recording system.                                    system (Q-Sweat).
                   decloaking chamber......     7.5            $875.00  decloaking chamber            7          $1,249.00  Laboratory
                                                                         (DC2002).
                   decloaking chamber           7.5          $1,249.00  decloaking chamber            7          $1,249.00  Laboratory
                    (DC2002).                                            (DC2002).
E71001...........  dedicated slit lamp for     10.0          $6,561.00  slit lamp (Haag-             10          $7,435.00  Other Equipment
                    argon laser.                                         Streit), dedicated to
                                                                         laser use.
                   defibrillator...........     5.0  .................  defibrillator..........       5          $2,853.33  Other Equipment
                   DELETED.................  ......  .................  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
E51078...........  Dental X-ray............     5.0         $80,000.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
                   dermatome...............     5.0          $4,030.00  dermatome, electric....      10          $4,399.00  Other Equipment
E71102...........  Designed for Vision          7.0            $600.00  loupes, standard, up to       7            $836.67  Other Equipment
                    loupes.                                              3.5x.
E53036...........  Detector (Probe)........     5.0         $14,000.00  Detector (Probe).......       5         $14,000.00  Radiology
E51010...........  DEXA Unit Dual Energy X-     5.0         $49,500.00  densitometry unit,            5         $41,000.00  Radiology
                    ray Absorptiometry.                                  whole body, DXA.
                   dialysis access flow         5.0         $10,000.00  dialysis access flow          5         $10,000.00  Other Equipment
                    monitor.                                             monitor.
E13659...........  diamond knife...........    10.0          $3,100.00  diamond knife (4.0-           7          $3,400.00  Laboratory
                                                                         4.4mm) (electron
                                                                         microscopy).
E13660...........  diamond knife                7.0          $1,795.00  Deleted through PEAC     ......  .................  No Details
                    resharpener.                                         refinement..
E52002...........  diasonic software.......     5.0         $35,000.00  fetal monitor software.       5         $35,000.00  Other Equipment
E71015...........  diathermy machine.......     5.0          $3,120.00  diathermy, short wave        10          $8,185.00  Other Equipment
                                                                         (AutoTherm 395).
E71015...........  diathermy machine.......     5.0         $10,000.00  diathermy, short wave        10          $8,185.00  Other Equipment
                                                                         (AutoTherm 395).
                   differential analyzer...     7.0         $38,500.00  differential analyzer,        7         $37,216.67  Laboratory
                                                                         hematology.
                   differential counter,        7.0          $1,238.00  differential tally            5            $672.73  Laboratory
                    hematology.                                          counter, 12-channel.

[[Page 47710]]

 
E52007...........  Digital Aquisition Unit      5.0         $29,900.00  ultrasound,                   5         $29,900.00  Other Equipment
                    (Nova Microsonics Image                              echocardiography
                    Vue DCR or TomTec                                    digital acquisition
                    Freeland P90).                                       (Novo Microsonics,
                                                                         TomTec).
                   digital camera..........     5.0            $800.00  camera, digital (6            5            $946.16  Documentation
                                                                         mexapixel).
E51020...........  Digital Camera..........     5.0        $300,000.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
                   digital camera package..     5.0          $3,060.00  camera, digital system,       5          $3,570.98  Documentation
                                                                         12 megapixel (medical
                                                                         grade).
E13113...........  digitrapper (24-hr          10.0          $9,685.00  pH recorder, 24-hr            5          $6,900.00  Other Equipment
                    ambulatory pH monitor                                ambulatory
                    by Cynectics).                                       (Digitrapper).
                   discogram pressure           7.0  .................  discogram pressure            7            $600.00  Other Equipment
                    monitor.                                             monitor.
                   dissecting instrument        5.0            $596.00  instrument pack, basic        4            $500.00  Other Equipment
                    kit.                                                 ($500-$1499).
                   DNA image analyzer           7.0        $200,000.00  DNA image analyzer            7        $200,000.00  Laboratory
                    (ACIS).                                              (ACIS).
                   DNA image analyzer           7.5        $200,000.00  DNA image analyzer            7        $200,000.00  Laboratory
                    (ACIS).                                              (ACIS).
E30016...........  doppler.................     5.0          $1,350.00  doppler (fetal or             5            $708.22  Other Equipment
                                                                         vascular).
                   dose calibration source      5.0          $1,159.00  dose calibration source       5          $1,159.00  Radiology
                    vial set (Cs137, Co57,                               vial set (Cs137, Co57,
                    and Ba137).                                          and Ba137).
E51064...........  Dose Callibrator w/ Lead     5.0          $6,000.00  dose calibrator               5          $5,496.67  Radiology
                    Glass Sheild & Ce-137                                (Atomlab).
                    Standard.
                   Dosimetry software......     5.0         $21,000.00  radiation therapy             5         $21,000.00  Radiology
                                                                         dosimetry software
                                                                         (Argus QC).
E53034...........  Dual Photon Densitometer/    5.0         $65,000.00  densitometry unit,            5         $65,000.00  Radiology
                    Computer.                                            whole body, DPA.
                   dust extractor..........    10.0          $1,982.00  dust extractor.........       8            $500.00  Other Equipment
                   Dynavox/Dynamyte             7.0            $549.00  augmentative                  7            $604.00  Other Equipment
                    Wireless Backup and                                  communication -
                    computer backup.                                     DynaBeam access w-
                                                                         memory backup.
                   Dynovox 3100............     7.0          $6,995.00  augmentative                  7          $7,295.00  Other Equipment
                                                                         communication -
                                                                         DynaVox 3100.
E55009...........  ECG Burdick EK-10.......     7.0          $1,985.50  ECG, 1-channel                7          $1,506.00  Other Equipment
                                                                         (Burdick).
                   EECP system.............     5.0        $180,000.00  EECP, external                7        $150,000.00  Other Equipment
                                                                         counterpulsation
                                                                         system.
E11015...........  electric bed............    12.0          $2,024.00  bed, hospital, electric      12          $1,746.52  Furniture
E11010...........  electric table..........    15.0            $935.71  table, motorized (for        15            $895.00  Furniture
                                                                         instruments-
                                                                         equipment).doc.
E30005...........  electrocautery..........     7.0            $995.00  electrocautery-              10            $975.08  Other Equipment
                                                                         hyfrecator, up to 45
                                                                         watts.
                   electrogastrography         10.0         $20,750.00  EGG monitoring system..       7         $32,900.00  Other Equipment
                    machine system.
                   electro-oculography         10.0         $50,000.00  EOG, ERG, VEP                 7         $33,500.00  Other Equipment
                    machine.                                             electrodiagnostic unit.
                   electro-retinography        10.0         $50,000.00  EOG, ERG, VEP                 7         $33,500.00  Other Equipment
                    machine.                                             electrodiagnostic unit.
E30008...........  electro-surgical device.     7.0          $1,225.00  electrosurgical               7          $1,838.42  Other Equipment
                                                                         generator, up to 120
                                                                         watts.
E13641...........  embedding station.......     8.0          $8,200.00  tissue embedding center       8          $9,096.67  Laboratory
                   EMG biofeedback              5.0         $11,750.00  EMG biofeedback               8         $11,750.00  Other Equipment
                    continence training                                  continence training
                    system (Pathway                                      system (Pathway
                    CTS2000).                                            CTS2000).
E54012...........  EMG botox...............     7.0          $1,500.00  EMG botox..............       7          $1,500.00  Other Equipment
E54007...........  EMG Machine.............     7.0         $21,157.50  EMG-NCV-EP system, 2-4       10         $18,288.63  Other Equipment
                                                                         channel.
                   EMG, surface system (OT,     7.0         $10,995.00  EMG, surface system           8          $9,995.00  Other Equipment
                    PT, clinician)                                       (OT, PT, clinician)
                    (Therapist System).                                  (Therapist System).
E13118...........  endoscope, rigid,            3.0          $3,365.00  endoscope, rigid,             3          $3,394.00  Scope
                    cystoscopy.                                          cystoscopy.
E13402...........  endoscope, rigid,            3.0          $8,878.00  endoscope, rigid,             3          $4,990.50  Scope
                    hysteroscopy.                                        hysteroscopy.
                   endoscope, rigid,            3.0          $5,080.00  endoscope, rigid,             3          $3,095.67  Scope
                    laryngoscopy.                                        laryngoscopy.
                   endoscope, rigid,            3.0          $2,456.88  endoscope, rigid,             7          $2,456.88  Scope
                    otology.                                             otology.
                   endoscope, rigid,            3.0            $841.00  endoscope, rigid,             3            $841.38  Scope
                    sigmoidoscopy.                                       sigmoidoscopy.
E13126...........  endoscope, rigid,            3.0          $5,080.00  endoscope, rigid,             7          $2,414.17  Scope
                    sinoscopy.                                           sinoscopy.
                   endoscope, rigid,            3.0          $5,080.00  endoscope, rigid,             7          $2,414.17  Scope
                    sinoscopy.                                           sinoscopy.
E11005...........  endoscopy stretcher.....    10.0          $1,010.00  stretcher, endoscopy...      10          $2,414.00  Furniture
E71027...........  ENG Recorder............     7.0         $19,900.00  ENG recording system...       5         $19,900.00  Other Equipment

[[Page 47711]]

 
                   environmental module -      10.0         $30,000.00  environmental module -       15         $33,750.00  Room - Lane
                    car.                                                 car.
                   environmental module -      10.0         $50,000.00  environmental module -       15         $56,250.00  Room - Lane
                    kitchen.                                             kitchen.
                   environmental module -      10.0         $20,000.00  environmental module -       15         $22,500.00  Room - Lane
                    the workshop.                                        the workshop.
                   ergonomic kit...........    10.0          $2,285.00  kit, ergonomic (office)      10          $2,285.48  Other Equipment
E13114...........  esophogeal motility         10.0         $22,865.00  Deleted through PEAC     ......  .................  No Details
                    monitor (physiograph ).                              refinement..
                   evaluation system for       10.0         $16,500.00  evaluation system for         5         $17,495.00  Other Equipment
                    upper extremity/hand.                                upper extremity-hand
                                                                         (Greenleaf).
                   exam chair, reclining...    15.0          $1,000.00  chair, medical recliner      10            $829.03  Furniture
E30006...........  exam lamp...............    10.0          $1,850.00  light, exam............      10          $1,630.12  Other Equipment
E71109...........  Exam Lane...............     7.0         $31,046.15  lane, exam (oph).......       7         $30,453.33  Room - Lane
E11001...........  exam table..............    15.0          $1,360.00  table, exam............      15          $1,338.17  Furniture
                   exercise kit aquatic         5.0            $500.00  kit, aquatic exercise..      10            $500.00  Other Equipment
                    (boots, fins,
                    gloves,weights, cuffs,
                    spine safety board).
                   exercise staircase......    10.0            $870.00  stairs, ambulation           15            $793.67  Other Equipment
                                                                         training.
                   exercise staircase......    15.0            $870.00  stairs, ambulation           15            $793.67  Other Equipment
                                                                         training.
E71016...........  external 35 mm camera        5.0         $10,795.00  camera, 35mm system           5          $1,106.50  Documentation
                    with medical lenses.                                 (medical grade).
E51062...........  External Microwave          10.0          $7,250.00  Deleted through PEAC     ......  .................  No Details
                    Applicators (set of 5),                              refinement..
                    BSD.
                   Farmer Chamber..........     5.0          $1,500.00  chamber, Farmer-type...       7          $1,169.38  Radiology
E71002...........  Farnsworth-Munsell 100-      7.5            $556.00  Farnsworth-Munsell 100-       7            $626.50  Other Equipment
                    Hue Test or Nagel                                    Hue color vision test
                    anomoscoope, McBeth                                  w/software.
                    light.
E13404...........  fetal monitor...........     5.0          $9,435.00  fetal monitor..........       5          $5,415.95  Other Equipment
E11006...........  fiberoptic exam light       10.0            $608.75  light, fiberoptic             5          $1,992.92  Other Equipment
                    (combine with source).                               headlight w-source.
E13123...........  fiberscope, flexible,        3.0          $9,700.00  fiberscope, flexible,         3         $14,175.00  Scope
                    bronchoscopy.                                        bronchoscopy.
                   fiberscope, flexible,        3.0         $14,175.00  fiberscope, flexible,         3         $14,175.00  Scope
                    bronchoscopy.                                        bronchoscopy.
                   fiberscope, flexible,        3.0         $10,943.33  fiberscope, flexible,         3         $14,175.00  Scope
                    bronchoscopy w-forceps                               bronchoscopy.
                    (SPLIT: Scope/Forceps).
                   fiberscope, flexible,        3.0          $7,410.00  fiberscope, flexible,         3          $7,408.33  Scope
                    cystoscopy.                                          cystoscopy.
E13117...........  fiberscope, flexible,        3.0          $7,760.00  fiberscope, flexible,         3          $9,082.50  Scope
                    cystoscopy, with light                               cystoscopy, with light
                    source.                                              source.
E13124...........  fiberscope, flexible,        3.0          $5,080.00  fiberscope, flexible,         3          $6,301.93  Scope
                    rhinolaryngoscopy.                                   rhinolaryngoscopy.
                   fiberscope, flexible,        3.0          $5,080.00  fiberscope, flexible,         3          $6,301.93  Scope
                    rhinolaryngoscopy.                                   rhinolaryngoscopy.
E13101...........  fiberscope, flexible,        3.0          $5,803.00  fiberscope, flexible,         3          $5,803.33  Scope
                    sigmoidoscopy.                                       sigmoidoscopy.
                   fiberscope, flexible,        3.0          $5,803.00  fiberscope, flexible,         3          $5,803.33  Scope
                    sigmoidoscopy.                                       sigmoidoscopy.
E13121...........  fiberscope, flexible,        3.0         $12,920.00  fiberscope, flexible,         3         $12,595.00  Scope
                    ureteroscopy.                                        ureteroscopy.
                   film alternator.........    10.0         $30,000.00  film alternator              10         $27,500.00  Radiology
                                                                         (motorized film
                                                                         viewbox).
                   Film Densitometer.......     5.0          $1,580.00  densitometer, film.....       5          $1,435.00  Radiology
                   film dosimetry equipment     5.0         $28,500.00  film dosimetry                5         $30,840.00  Radiology
                    for IMRT.                                            equipment-software
                                                                         (RIT).
                   film printer, laser.....     5.0         $45,000.00  film processor, dry,          8         $69,950.00  Documentation
                                                                         laser.
                   film processor,              8.0         $25,000.00  film processor, wet....       8         $26,325.00  Documentation
                    precision calibrated.
                   fistula probes, set of 4     5.0            $560.00  Deleted (less than       ......  .................  No Details
                                                                         $500).
E13616...........  flow cytometer..........     5.0         $11,000.00  flow cytometer.........       5        $119,850.00  Laboratory
E13639...........  fluorescence microscope.     7.0         $12,000.00  microscope,                   7          $9,468.48  Laboratory
                                                                         fluorescence.
E51070...........  Fluroscopic unit, Mobile     5.0        $205,000.00  fluoroscopic system,          8         $73,000.00  Radiology
                    C-Arm.                                               mobile C-Arm.
                   food models.............     5.0            $700.00  food models............       4            $700.00  Other Equipment
E30021...........  foot & ankle surgery         4.0          $1,530.40  instrument pack, medium       4          $1,500.00  Other Equipment
                    instrument pack.                                     ($1500 and up).
                   forceps, biopsy.........     4.0          $1,310.00  endoscope forceps,            3          $1,243.33  Scope
                                                                         biopsy.
                   forceps, grasping.......     4.0            $735.00  endoscope forceps,            3            $745.67  Scope
                                                                         grasping.
E71103...........  full diameter trial lens     7.5          $1,180.00  lens set, trial, full        10            $904.93  Other Equipment
                    set.                                                 diameter, w-frame.
E13613...........  fume hood...............    10.0          $6,500.00  hood, fume.............      15          $4,778.46  Laboratory
                   gamma counter, automatic     7.5         $17,900.00  gamma counter,                7         $17,665.00  Radiology
                                                                         automatic.
E71003...........  Ganzfeld stimulator.....    10.0         $45,000.00  Ganzfeld stimulator....       7          $8,750.00  Other Equipment
                   gas cylinders...........     5.0          $8,000.00  laser gas cylinder (for       5          $1,140.00  Other Equipment
                                                                         excimer).
E13104...........  gastro cautery unit.....     7.0          $5,450.00  electrosurgical               7         $11,375.00  Other Equipment
                                                                         generator,
                                                                         gastrocautery.
E13106...........  gastroscope video            3.0         $52,990.00  videoscope, gastroscopy       3         $21,598.33  Scope
                    (SPLIT: scope and video
                    system).
E55022...........  Gating Device...........     5.0          $3,625.00  ECG R-wave trigger            7          $5,671.00  Other Equipment
                                                                         (gating) device.
                   generator, constant          3.0            $950.00  generator, constant          20            $950.00  Other Equipment
                    current.                                             current.

[[Page 47712]]

 
                   glucose monitor              5.0          $2,613.00  glucose continuous            5          $2,465.00  Other Equipment
                    continuous                                           monitoring system.
                    (incl.accessories).
E13666...........  GLX linear stainer......     7.5          $6,995.00  slide stainer,                7          $8,265.64  Laboratory
                                                                         automated, standard
                                                                         throughput.
E13637...........  grossing station........    10.0         $23,391.00  grossing station w-          20         $20,175.50  Laboratory
                                                                         heavy duty disposal.
                   halogen light (Edit          5.0          $5,080.00  light source, xenon....       5          $6,723.33  Other Equipment
                    light type).
                   halogen light cable.....     5.0  .................  Deleted (part of new     ......  .................  No Details
                                                                         system).
                   hand dexterity/sensory/      7.0          $1,407.00  kit, hand dexterity,         10          $1,561.40  Other Equipment
                    strength kit.                                        sensory, strength.
                   Hand Held Voice.........     7.0            $645.00  augmentative                  7            $695.00  Other Equipment
                                                                         communication - Hand
                                                                         Held Voice.
                   Hand Measurement Kit         7.0            $600.00  kit, hand evaluation...      10            $617.65  Other Equipment
                    (dynamometers,
                    goniometers, etc).
                   hand-case instrument set     4.0          $2,000.00  instrument pack, medium       4          $1,500.00  Other Equipment
                                                                         ($1500 and up).
E51072...........  HDR Afterload System,        5.0        $375,000.00  HDR Afterload System,         7        $375,000.00  Radiology
                    Nucletron - Oldelft.                                 Nucletron - Oldelft.
                   headmaster adapters          5.0          $1,675.00  augmentative                  7          $1,695.00  Other Equipment
                    (Accessibility).                                     communication -
                                                                         HeadMaster w-adapters.
E53006...........  Heavy Duty Imaging Table     7.5          $4,550.00  table, imaging.........      15          $5,188.33  Furniture
                   heavy-duty disposer.....     5.0          $1,506.00  Deleted (part of new     ......  .................  No Details
                                                                         system).
E71037...........  hilger nerve stimulator.     7.5          $1,805.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
E55008...........  Holter Monitor..........     7.0          $2,590.00  holter monitor.........       7          $1,413.43  Other Equipment
E55015...........  Holter monitor reader...     7.0         $14,995.00  holter analysys system.       7          $8,815.58  Other Equipment
E55015...........  Holter monitor reader...     7.0         $14,995.00  holter system with one        7         $11,303.90  Other Equipment
                                                                         recorder.
                   hood, biohazard.........    10.0          $7,612.00  hood, biohazard........      10          $6,884.25  Laboratory
                   hot wire cutter, Heustis     7.0         $28,600.00  Huestis block cutting        15         $22,030.00  Radiology
                                                                         machine w-attachments.
E92016...........  Hubbard tank............    15.0         $17,000.00  whirlpool (Hubbard           10         $15,195.00  Furniture
                                                                         tank).
E71005...........  Humphrey field analyzer      7.5         $27,950.00  Humphrey field analyzer       7         $27,000.00  Other Equipment
                    (or octopus).
E92006...........  hydroculator, cold......    10.0          $1,675.00  hydrocollator, cold....      10          $1,910.50  Other Equipment
E92007...........  hydroculator, hot.......    10.0          $1,265.00  hydrocollator, hot.....      10          $1,090.17  Other Equipment
E55033...........  Hydrogen gas analyzer...     7.5          $6,117.00  breath hydrogen               8          $4,895.00  Other Equipment
                                                                         analyzer (MicroLyzer).
                   hyperbaric chamber......    10.0        $125,000.00  hyperbaric chamber.....      15        $125,000.00  Other Equipment
E13652...........  image analyzer (CAS          5.0         $92,000.00  image analyzer (CAS           5         $92,000.00  Laboratory
                    system).                                             system).
                   Immittance bridge.......     7.0          $6,900.00  immittance, middle-ear       10          $4,995.00  Other Equipment
                                                                         analyzer.
                   impedance meter.........     7.0          $1,312.00  impedance meter, 32-          7          $1,120.00  Other Equipment
                                                                         channel.
                   IMRT physics tools......     5.0         $55,485.00  IMRT physics tools.....       5         $55,485.00  Radiology
E92012...........  inclinometer............    10.0            $520.00  Deleted (less than       ......  .................  No Details
                                                                         $500).
                   incubator...............    10.0            $795.00  incubator..............      10            $837.30  Laboratory
E13631...........  incubator (CO2).........    10.0          $6,000.00  incubator, CO2 (dry-         10          $5,842.99  Laboratory
                                                                         wall).
                   infrared ceiling lamps/      3.0          $2,000.00  light, infra-red,            10            $555.00  Other Equipment
                    temperature control.                                 ceiling mount.
E30023...........  infrared coagulator.....     7.0          $3,550.00  infrared coagulator          10          $3,087.50  Other Equipment
                                                                         (with hand applicator).
                   infrared illuminator....     7.0          $1,050.00  Deleted (part of new     ......  .................  No Details
                                                                         system).
E91001...........  infusion pump...........    10.0          $4,150.00  IV infusion pump.......      10          $2,384.45  Other Equipment
                   INR monitor, home.......     4.0          $2,000.00  INR monitor, home......       5          $2,000.00  Other Equipment
                   instrument pack, basic       4.0            $500.00  instrument pack, basic        4            $500.00  Other Equipment
                    (auricle).                                           ($500-$1499).
                   instrument pack, basic       4.0          $1,200.00  instrument pack, medium       4          $1,500.00  Other Equipment
                    (EPF).                                               ($1500 and up).
                   instrument pack, basic       4.0            $500.00  instrument pack, basic        4            $500.00  Other Equipment
                    (surgery).                                           ($500-$1499).
                   instrument pack, medium      4.0          $1,500.00  instrument pack, medium       4          $1,500.00  Other Equipment
                    (ear).                                               ($1500 and up).
                   instrument pack, medium      4.0          $1,500.00  instrument pack, medium       4          $1,500.00  Other Equipment
                    (intraoral biopsy).                                  ($1500 and up).
                   instrument pack, medium      4.0          $1,500.00  instrument pack, medium       4          $1,500.00  Other Equipment
                    (nasal endoscopy).                                   ($1500 and up).
                   instrument pack, medium      4.0          $1,500.00  instrument pack, medium       4          $1,500.00  Other Equipment
                    (nasal).                                             ($1500 and up).
                   instrument pack, medium      4.0          $1,500.00  instrument pack, medium       4          $1,500.00  Other Equipment
                    (otology POV).                                       ($1500 and up).
                   instrument pack, medium      4.0          $1,500.00  instrument pack, medium       4          $1,500.00  Other Equipment
                    (surgery).                                           ($1500 and up).
E92009...........  Intellect High Voltage      10.0          $1,395.00  electrotherapy                7          $1,923.00  Other Equipment
                    electrical stimulator.                               stimulator, high volt,
                                                                         2 channel.

[[Page 47713]]

 
                   Intellikeys.............     7.0            $525.00  augmentative                  7            $560.00  Other Equipment
                                                                         communication -
                                                                         IntelliKeys, Overlay,
                                                                         ClickIt.
E92020...........  Intercom................    10.0         $10,000.00  intercom (incl. master,      10          $1,630.00  Other Equipment
                                                                         pt substation, power,
                                                                         wiring).
                   intestinal imaging           7.0         $25,400.00  intestinal imaging            5
                    workstation.                                         workstation.
                   Other Equipment.........
E51042...........  Ion Chamber Array.......     5.0          $6,445.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
E71030...........  iontophoresis machine...     7.5          $1,500.00  iontophoresis machine..       8            $995.00  Other Equipment
                   isoalign device.........     5.0            $950.00  isocentric beam               5            $995.00  Radiology
                                                                         alignment device.
E92014...........  isokinetic                  10.0         $29,823.00  exercise equipment           15         $12,710.00  Other Equipment
                    strenghthening                                       (treadmill, bike,
                    equipment.                                           stepper, UBE, pulleys,
                                                                         balance board).
                   isokinetic testing           7.0         $45,820.00  rehab and testing             5         $45,820.00  Other Equipment
                    equipment.                                           system (BTE primus).
E50003...........  isokinetometer..........    10.0         $11,995.00  isokinetic evaluation         5         $39,900.00  Other Equipment
                                                                         system (Cybex NORM).
E91008...........  IVAC Injection Automatic     5.0          $2,500.00  IVAC Injection               10          $2,500.00  Other Equipment
                    Pump.                                                Automatic Pump.
E55010...........  King of Hearts-20            7.0          $1,750.00  Deleted through PEAC     ......  .................  No Details
                    (Instromedix).                                       refinement..
                   kit, capsule endoscopy    ......          $6,950.00  kit, capsule endoscopy       10          $6,950.00  Other Equipment
                    recorder.                                            recorder.
                   lacrimal probes.........     4.0  .................  Deleted (less than       ......  .................  No Details
                                                                         $500).
                   laryngeal injector......     4.0          $1,032.00  kit, laryngeal injector       3          $1,032.00  Other Equipment
E13405...........  laser...................     5.0         $23,500.00  laser (gs, uro, obg,          5         $59,890.00  Other Equipment
                                                                         ge) (Indigo Optima).
                   laser generator.........     5.0         $54,890.00  laser (gs, uro, obg,          5         $59,890.00  Other Equipment
                                                                         ge) (Indigo Optima).
                   laser printer for CT         5.0         $71,400.00  film processor, dry,          8         $69,950.00  Documentation
                    angiography.                                         laser.
                   Laser Targeting System..     5.0         $11,625.00  laser targeting system        5         $10,350.00  Radiology
                                                                         (4 diodes).
                   laser, ablation (gs,         5.0         $59,890.00  laser (gs, uro, obg,          5         $59,890.00  Other Equipment
                    uro, obg, ge) (Indigo                                ge) (Indigo Optima).
                    Optima).
                   laser, diode, for            5.0          $7,678.00  laser, diode, for             5          $7,678.00  Radiology
                    patient positioning                                  patient positioning
                    (Probe).                                             (Probe).
                   laser, excimer..........     5.0        $155,000.00  laser, excimer.........       5        $160,000.00  Other Equipment
E53001...........  lead safe...............    20.0          $3,375.00  safe, storage, lead-         15          $3,850.00  Radiology
                                                                         lined.
E13403...........  LEEP system.............     7.0          $4,670.00  electrosurgical system        7          $4,283.00  Other Equipment
                                                                         (w-smoke evac) (LEEP,
                                                                         Quantum).
E55014...........  life signs receiving         7.0          $3,800.00  pacemaker receiving           5          $3,995.00  Other Equipment
                    center.                                              software (GEMS Lite).
                   lift, chair and sling...    10.0          $3,000.00  lift, hydraulic, chair.      10          $4,848.65  Furniture
                   lift, hydraulic.........    10.0          $4,730.00  lift, hydraulic, chair.      10          $4,848.65  Furniture
                   light for photodynamic       5.0         $15,759.00  light, external PDT, w-       5          $8,810.00  Other Equipment
                    therapy, 400MW (BLU-U).                              probe set (LumaCare).
E13122...........  light source (combine        3.0          $1,700.00  light, fiberoptic             5          $1,992.92  Other Equipment
                    with headlight).                                     headlight w-source.
                   light, infrared.........     3.0            $500.00  light, infra-red, pole       10            $512.50  Other Equipment
                                                                         mount.
                   light, ultraviolet......     3.0            $630.00  light, ultra-violet....      10            $618.22  Other Equipment
E51056...........  Linear Accelerator -         5.0      $1,600,000.00  accelerator, 6-18 MV...       7      $1,832,941.00  Radiology
                    Cliniac-2100.
E30010...........  Liquid Nitro Tank w/        10.0          $1,529.00  cryosurgery system, non-     10          $1,607.50  Other Equipment
                    Cryac.                                               ophthalmic.
E30024...........  lithotriptor............     5.0      $1,375,000.00  lithotriptor, with C-         5        $440,000.00  Other Equipment
                                                                         arm (ESWL).
E11001...........  low mat table...........    10.0          $5,000.00  table, mat, hi-lo, 6 x       15          $4,521.67  Furniture
                                                                         8 platform.
                   low mat table...........    10.0          $5,000.00  table, mat, hi-lo, 6 x       15          $4,521.67  Furniture
                                                                         8 platform.
                   mammatome driver........     5.0         $27,750.00  breast biopsy device w-       5         $29,862.00  Other Equipment
                                                                         system (Mammotome).
                   mammography cassettes        5.0  .................  Deleted (less than       ......  .................  No Details
                    (4).                                                 $500).
E51016...........  Mammography Room........     5.0        $130,000.00  room, mammography......       5        $130,000.00  Room - Lane
                   mayo stand..............     7.0            $585.00  mayo stand.............      15            $530.76  Furniture
E30019...........  McGrowan ligator/Bander.     7.0            $625.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
E92010...........  mechanical traction.....    10.0          $2,090.00  traction system (hi-low      10          $5,654.83  Other Equipment
                                                                         table, digital unit,
                                                                         accessories).
                   medium energy collimator     5.0         $14,000.00  collimator, medium            7         $14,000.00  Radiology
                    (siemens 05232868).                                  energy (set of 2).
E13608...........  microprobe EDS x-ray         7.0         $42,500.00  Deleted (part of new     ......  .................  No Details
                    analysis.                                            system).
E13662...........  Microscope camera Konan      5.0          $6,995.00  camera system, specular       5         $26,100.00  Laboratory
                    SP 9000.                                             microscope.
E13601...........  microscope, compound....     7.0         $11,600.00  microscope, compound...       7         $11,621.35  Laboratory
E13606...........  microscope, dissecting..     7.0          $1,700.00  microscope, binocular -       7            $956.00  Laboratory
                                                                         dissecting.
E13618...........  microtome...............     7.0         $31,500.00  microtome..............       7         $13,369.00  Radiology
E13619...........  microtome knife              7.0          $7,200.00  microtome sharpener....      10          $6,400.00  Radiology
                    sharpener.
                   microwave...............    10.0  .................  diathermy, microwave...      10  .................  Other Equipment

[[Page 47714]]

 
E51060...........  Microwave Hypothermia       10.0        $550,000.00  Deleted through PEAC     ......  .................  No Details
                    System, BSD.                                         refinement..
                   mimic/controllers/crane.     5.0        $448,680.00  collimator, multileaf         7        $355,030.00  Radiology
                                                                         system w-autocrane
                                                                         (MIMiC).
E72004...........  Minor Equipment Pack....     4.0          $1,082.95  instrument pack, basic        4            $500.00  Other Equipment
                                                                         ($500-$1499).
E72006...........  Minor Surgical Pack.....     4.0          $1,596.88  instrument pack, medium       4          $1,500.00  Other Equipment
                                                                         ($1500 and up).
E30020...........  minor surgical tray.....     4.0            $572.20  instrument pack, basic        4            $500.00  Other Equipment
                                                                         ($500-$1499).
E53008...........  Mobile Source Storage       20.0          $3,650.00  Deleted through PEAC     ......  .................  No Details
                    Safes.                                               refinement..
E92017...........  mobolization/               10.0          $9,315.00  table, mobolization-         15          $8,195.00  Furniture
                    manipulation table.                                  manipulation (Lloyd's).
                   motor coordination kit..    10.0            $643.00  kit, motor coordination      10            $643.75  Other Equipment
                   Mount/wheel chair.......     7.0            $830.00  augmentative                  7            $765.00  Other Equipment
                                                                         communication -
                                                                         DynaVox wheelchair
                                                                         mount.doc.
E51058...........  MR Room.................     5.0      $3,140,000.00  room, MR...............       5      $1,961,375.00  Room - Lane
                   nasal pressure               7.0            $525.00  transducer, pressure,         7            $582.50  Other Equipment
                    transducer.                                          airflow sensor.
                   naturally speaking           5.0            $696.00  augmentative                  7            $699.95  Other Equipment
                    software, dragon                                     communication - Dragon
                    (Accessibility).                                     Naturally-Speaking.
E91010...........  Negative Flow Hood......    10.0          $2,000.00  hood, negative flow....      15          $2,400.00  Laboratory
E30028...........  nerve stimulator........     7.5            $523.80  nerve stimulator (eg,         7            $572.30  Other Equipment
                                                                         for nerve block).
E12002...........  neurobehavioral status       7.5            $717.00  neurobehavioral status        5            $717.00  Other Equipment
                    instrument-average.                                  instrument-average.
                   new item................  ......  .................  biofeedback equipment..       8  .................  Other Equipment
                   new item................  ......  .................  blood warmer...........       7          $3,840.00  Other Equipment
                   new item................  ......  .................  breast biopsy imaging         5        $234,000.00  Other Equipment
                                                                         system, stereotactic
                                                                         (imager, table,
                                                                         software).
                   new item................  ......  .................  camera, digital system,       5         $41,000.00  Documentation
                                                                         for electron
                                                                         microscopy.
                   new item................  ......  .................  cell separator system..       6         $59,320.00  Other Equipment
                   new item................  ......  .................  chair, thyroid imaging.      10          $2,200.00  Furniture
                   new item................  ......  .................  CO2 infrared analyzer         7          $4,500.00  Other Equipment
                                                                         (COSMO).
                   new item................  ......  .................  computer workstation,         5         $98,000.00  Documentation
                                                                         3D hyperthermia
                                                                         treatment planning.
                   new item................  ......  .................  computer workstation,         5        $130,216.50  Documentation
                                                                         3D radiation treatment
                                                                         planning.
                   new item................  ......  .................  computer workstation,         5         $45,926.00  Documentation
                                                                         3D reconstruction CT-
                                                                         MR.
                   new item................  ......  .................  computer workstation,         5        $105,403.00  Documentation
                                                                         brachytherapy
                                                                         treatment planning.
                   new item................  ......  .................  computer workstation,         5         $94,000.00  Documentation
                                                                         cardiac cath
                                                                         monitoring.
                   new item................  ......  .................  computer workstation,         5  .................  Documentation
                                                                         MRA post processing.
                   new item................  ......  .................  contrast media warmer..       7            $552.00  Other Equipment
                   new item................  ......  .................  cortical bipolar-             7  .................  Other Equipment
                                                                         biphasic stimulating
                                                                         equipment.
                   new item................  ......  .................  crash cart (unstocked).      10            $868.50  Furniture
                   new item................  ......  .................  cryosurgical probe,           7          $1,984.00  Other Equipment
                                                                         retina.
                   new item................  ......  .................  defibrillator w-ECG           5          $3,150.67  Other Equipment
                                                                         monitor.
                   new item................  ......  .................  densitometry unit,            5         $22,096.00  Radiology
                                                                         peripheral, SXA.
                   new item................  ......  .................  densitometry unit,            5         $13,225.00  Radiology
                                                                         peripheral, ultrasound.
                   new item................  ......  .................  dermabrader (Osada)....      10          $1,590.00  Other Equipment
                   new item................  ......  .................  drill, ophthalmology...       3  .................  Other Equipment
                   new item................  ......  .................  EEG analysis software..       5         $82,000.00  Other Equipment
                   new item................  ......  .................  EEG monitor, digital,         7  .................  Other Equipment
                                                                         portable.
                   new item................  ......  .................  electroconvulsive             5  .................  Other Equipment
                                                                         therapy machine.

[[Page 47715]]

 
                   new item................  ......  .................  external fixation,            4          $5,146.00  Other Equipment
                                                                         craniofacial halo
                                                                         (BlueDevice).
                   new item................  ......  .................  external fixation,            4          $4,508.00  Other Equipment
                                                                         mandible (Joe Hall
                                                                         Morris).
                   new item................  ......  .................  gamma camera system,          5        $406,816.80  Radiology
                                                                         single-dual head.
                   new item................  ......  .................  hyperthermia system, RF-      5        $790,353.00  Radiology
                                                                         deep and microwave.
                   new item................  ......  .................  hyperthermia system,          5        $360,000.00  Radiology
                                                                         ultrasound, external.
                   new item................  ......  .................  hyperthermia system,          5        $250,000.00  Radiology
                                                                         ultrasound,
                                                                         intracavitary.
                   new item................  ......  .................  intracavitary                 4         $10,321.50  Radiology
                                                                         applicator set (tandem
                                                                         and ovoids).
                   new item................  ......  .................  intra-compartmental           7          $1,737.00  Other Equipment
                                                                         pressure monitor
                                                                         device.
                   new item................  ......  .................  lens set, fitting, low       10          $4,750.00  Other Equipment
                                                                         vision.
                   new item................  ......  .................  liposorber system......       7          $7,800.00  Other Equipment
                   new item................  ......  .................  mammography reporting         5  .................  Documentation
                                                                         software.
                   new item................  ......  .................  manometry system              5         $39,400.00  Other Equipment
                                                                         (computer,
                                                                         transducers, catheter).
                   new item................  ......  .................  micropigmentation             7          $2,550.00  Other Equipment
                                                                         (tattoo) system.
                   new item................  ......  .................  microscope, electron,         7        $319,290.00  Laboratory
                                                                         transmission (TEM).
                   new item................  ......  .................  microtome, ultra.......       7         $25,950.00  Radiology
                   new item................  ......  .................  nuclide rod source set.       5          $1,395.00  Radiology
                   new item................  ......  .................  oximeter, whole blood..       5          $6,950.00  Other Equipment
                   new item................  ......  .................  oxygen system, portable       8            $569.89  Other Equipment
                   new item................  ......  .................  phantom, mammography-        10            $674.00  Radiology
                                                                         accreditation.
                   new item................  ......  .................  phantom, QCT                 10          $5,464.00  Radiology
                                                                         densitometry.
                   new item................  ......  .................  pump, water perfusion         7          $7,307.00  Other Equipment
                                                                         (for manometry).
                   new item................  ......  .................  radiation L-block            10            $725.00  Radiology
                                                                         tabletop shield.
                   new item................  ......  .................  radiusgauge............       7          $1,234.00  Other Equipment
                   new item................  ......  .................  resectoscope,                 3          $1,200.00  Scope
                                                                         continuous flow.
                   new item................  ......  .................  RGP lens modification         7            $540.00  Other Equipment
                                                                         unit.
                   new item................  ......  .................  rhinomanometer system         7         $10,800.00  Other Equipment
                                                                         (w-transducers and
                                                                         software).
                   new item................  ......  .................  sleep screening system,       5         $14,877.25  Other Equipment
                                                                         ambulatory (incl.
                                                                         hardware, software).
                   new item................  ......  .................  stepper, stabilizer,          7         $18,550.00  Radiology
                                                                         template (for
                                                                         brachytherapy
                                                                         treatment).
                   new item................  ......  .................  stirrups (for                10          $3,876.00  Radiology
                                                                         brachytherapy table).
                   new item................  ......  .................  stretcher chair........      10          $3,133.00  Furniture
                   new item................  ......  .................  table, brachytherapy         15         $28,900.00  Furniture
                                                                         treatment.
                   new item................  ......  .................  table, cystoscopy......      15  .................  Furniture
                   new item................  ......  .................  thyroid uptake system..       5         $13,995.00  Radiology
                   new item................  ......  .................  urethrotome, optical...       3          $1,881.00  Scope
                   new item................  ......  .................  vacuum deposition             7         $38,070.00  Laboratory
                                                                         system (Auto306).
                   new item................  ......  .................  x-ray, dental, intra-         5          $3,869.00  Radiology
                                                                         oral.
                   new item................  ......  .................  x-ray, dental,                5         $24,405.00  Radiology
                                                                         panoramic.
                   Non-amplified auditory       7.0          $1,295.00  augmentative                  7          $1,096.00  Other Equipment
                    trainer.                                             communication -
                                                                         auditory trainer.
E13406...........  NST, Non Stress Test....     5.0          $8,878.00  fetal monitor..........       5          $5,415.95  Other Equipment
                   nuclear pharmacy             5.0         $13,400.00  computer workstation,         5         $13,400.00  Documentation
                    management software (w-                              nuclear pharmacy
                    computer and printer)                                management (hardware
                    (NMIS).                                              and software).
                   Nucleus Crystal              7.0          $9,450.00  cochlear implant             10          $9,500.00  Other Equipment
                    Integrity Testing                                    testing system.
                    System.
                   Nucleus PCI.............     7.0          $8,000.00  cochlear implant              7          $9,000.00  Other Equipment
                                                                         programming system.
                   nutrition therapy            5.0            $500.00  nutrition therapy             5            $595.00  Other Equipment
                    software.                                            software (Nutritionist
                                                                         Pro).
E13102...........  Olympus halogen light...     3.0            $950.00  Deleted (part of new     ......  .................  No Details
                                                                         system).
E30013...........  operating microscope....     7.0          $5,400.00  microscope, operating..       7          $7,047.50  Other Equipment
E71019...........  ophthalmic telebinocular     7.5          $1,025.00  telebinocular,                7          $1,014.33  Other Equipment
                                                                         ophthalmic.
                   optical coherence            5.0         $25,950.00  Deleted through PEAC     ......  .................  No Details
                    biometer.                                            refinement..
                   optical disk reader.....     5.0          $4,000.00  optical drive (MO),           5          $2,050.00  Documentation
                                                                         external.
                   optical fibers..........     5.0          $3,236.00  laser optical delivery        5          $1,500.00  Other Equipment
                                                                         system (for excimer).

[[Page 47716]]

 
                   Orthovoltage Machine....     5.0        $140,000.00  orthovoltage                  5        $140,000.00  Radiology
                                                                         radiotherapy system.
                   OSHA ventilated hood....    10.0          $5,000.00  OSHA ventilated hood...      15          $5,000.00  Radiology
E13602...........  osmometer...............     7.0          $4,595.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
                   otoscope-ophthalmoscope.     3.0            $505.00  otoscope-ophthalmoscope      10            $694.00  Other Equipment
                                                                         (wall unit).
E54008...........  Oxford PT recorder......     7.0          $6,940.00  EEG recorder,                 7          $6,940.00  Other Equipment
                                                                         ambulatory.
E54009...........  Oxford review station...     7.0         $44,950.00  EEG review station,           5         $44,950.00  Other Equipment
                                                                         ambulatory.
                   Oximetry Recorder,           5.0          $3,660.00  pulse oxymetry                5          $3,660.00  Other Equipment
                    overnight/software.                                  recording software
                                                                         (prolonged monitoring).
                   oxygen concentrator.....    15.0          $3,806.00  oxygen concentrator (5-       8          $1,035.83  Other Equipment
                                                                         6 lpm).
                   oxygen tank.............    10.0  .................  Deleted (less than       ......  .................  No Details
                                                                         $500).
E55027...........  Oxygen uptake expired        7.0         $46,000.00  Vmax 229 (PFT equip,          8         $44,681.00  Other Equipment
                    gas analyzer.                                        computer system).
                   pacemaker follow-up          7.0         $22,000.00  pacemaker follow-up           7         $23,507.00  Other Equipment
                    system (e.g. paceart).                               system (incl software
                                                                         and hardware)
                                                                         (Paceart).
E71020...........  pachometer..............     5.0          $3,650.00  ultrasonic biometry,          5          $3,945.00  Other Equipment
                                                                         pachymeter.
E13638...........  paraffin dispenser......     7.5            $995.00  paraffin dispenser (two-     10          $1,520.00  Laboratory
                                                                         gallon).
                   paraffin dispenser, 5        7.0          $1,995.00  paraffin dispenser           10          $2,222.50  Laboratory
                    gal..                                                (five-gallon).
E92011...........  parallel bars...........    15.0          $1,755.00  parallel bars, platform      15          $1,670.67  Other Equipment
                                                                         mounted.
                   PC server...............     5.0         $25,000.00  computer, server.......       5         $25,000.00  Documentation
E52003...........  Pentium computer........     5.0          $2,800.00  computer, desktop, w-         5          $2,501.00  Documentation
                                                                         monitor.
                   percutaneous neuro test      4.0            $795.00  percutaneous neuro test       7            $795.00  Other Equipment
                    stimulator.                                          stimulator.
                   peripheral QCT scanner..     5.0         $55,000.00  densitometry unit,            5         $79,000.00  Radiology
                                                                         peripheral, QCT.
                   pessary stock kit.......    10.0          $1,824.00  Deleted (less than       ......  .................  No Details
                                                                         $500).
E13603...........  pH meter................     7.0          $1,000.00  pH conductivity meter..      10          $1,028.00  Laboratory
                   photochemotherapy unit &     5.0         $32,000.00  phototherapy unit,           10         $12,975.00  Other Equipment
                    lamps (200 ea/yr).                                   whole body, UVA-UVB.
                   photochemotherapy unit,      5.0          $1,525.00  phototherapy unit, hand-     10          $1,675.00  Other Equipment
                    hand/foot combo.                                     foot, UVA-UVB.
E13620...........  photographic enlarger...    10.0         $15,000.00  photographic enlarger..       5          $3,195.00  Documentation
E13621...........  photographic film           10.0          $6,000.00  film processor                8          $4,400.00  Laboratory
                    processor.                                           (electron microscopy).
                   physician analysis and       7.5         $35,000.00  computer workstation,         5         $55,097.00  Documentation
                    viewing station.                                     nuclear medicine
                                                                         analysis-viewing.
                   physician analysis/         10.0         $35,000.00  computer workstation,         5         $55,097.00  Documentation
                    viewing station.                                     nuclear medicine
                                                                         analysis-viewing.
                   physics support package      5.0         $12,500.00  Deleted (weekly          ......  .................  No Details
                    for intensity modulated                              training cost).
                    radiotherapy.
E91011...........  Plasma pheresis machine      7.5         $37,900.00  plasma pheresis machine       6         $37,900.00  Other Equipment
                    w/UV light source.                                   w/UV light source.
E11009...........  pneumatic chairs........    15.0            $697.60  Deleted (less than       ......  .................  No Details
                                                                         $500).
                   pneumatic tourniquet         5.0  .................  tourniquet system             7         $10,220.00  Other Equipment
                    device.                                              (Zimmer1200).
                   pool cleaner............    10.0          $1,500.00  pool cleaner...........      15          $1,372.15  Other Equipment
E11003...........  Power Table.............     7.5          $6,939.00  table, power...........      10          $6,153.63  Furniture
E11003...........  Power Table.............    10.0          $6,939.00  table, power...........      10          $6,153.63  Furniture
E11003...........  Power Table.............    15.0          $6,939.00  table, power...........      10          $6,153.63  Furniture
E13622...........  print washer............    10.0            $670.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
                   Printer (HP)............     5.0          $1,200.00  printer, laser, paper..       5          $1,199.00  Documentation
                   printer, dye, sublimated     5.0         $15,000.00  printer, dye                  5          $2,322.50  Documentation
                                                                         sublimation (photo,
                                                                         color).
                   printer, laser for CT...     5.0         $75,000.00  film processor, dry,          8         $69,950.00  Documentation
                                                                         laser.
                   printer, laser for CT        5.0         $71,400.00  film processor, dry,          8         $69,950.00  Documentation
                    angiography.                                         laser.
E51080...........  Processor (wet or dry)..     8.0         $55,000.00  film processor, wet....       8         $26,325.00  Documentation
E55011...........  Programmer: Intermedics.     7.0         $10,000.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
E55013...........  Programmers for              7.0         $10,000.00  programmer, pacemaker..       7         $10,000.00  Other Equipment
                    Pacemakers.
E55012...........  Programmers: Medtronic,      7.0         $11,000.00  programmer, for               7          $1,975.00  Other Equipment
                    CPI, Ventritex.                                      implanted medication
                                                                         pump (spine).
E55012...........  Programmers: Medtronic,      7.0         $11,000.00  programmer,                   7          $1,975.00  Other Equipment
                    CPI, Ventritex.                                      neurostimulator (w-
                                                                         printer).
E54011...........  Pt. Bedroom Furniture...    12.0          $1,824.00  bedroom furniture            12          $2,416.99  Furniture
                                                                         (hospital bed, table,
                                                                         reclining chair).

[[Page 47717]]

 
E30011...........  pulse dye laser.........     5.0        $125,000.00  laser, pulse dye.......       5         $78,500.00  Other Equipment
E55003...........  pulse oximeter..........     5.0            $885.00  pulse oximeter w-             7          $1,207.18  Other Equipment
                                                                         printer.
                   Radiation Source Meter..     7.0            $600.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
                   Radiation Survey Meter..     7.0          $1,117.00  radiation survey meter.       8            $756.25  Radiology
                   radiofrequency generator     7.0         $32,900.00  radiofrequency                5         $32,900.00  Other Equipment
                    (NEURO).                                             generator (NEURO).
E51005...........  Radiographic/                5.0        $475,000.00  room, radiographic-           5        $475,000.00  Room - Lane
                    fluoroscopic room.                                   fluoroscopic.
E51030...........  Radiographic/Fluroscopic     5.0         $15,995.00  Deleted through PEAC     ......  .................  No Details
                    Evaluation Unit, RMI                                 refinement..
                    4000.
                   radiopharmaceutical          5.0         $51,545.00  Deleted (split into      ......  .................  No Details
                    receiving area.                                      separate equipment
                                                                         items).
E11011...........  reclining exam chair        10.0          $4,495.00  chair with headrest,         15          $4,836.33  Furniture
                    with headrest.                                       exam, reclining.
E51022...........  Record and verify            5.0         $60,000.00  computer system, record       5         $60,000.00  Documentation
                    Computer (Varian).                                   and verify.
                   remote monitoring            7.0          $9,500.00  remote monitoring             5          $9,500.00  Other Equipment
                    service.                                             service
                                                                         (neurodiagnostics).
                   respiratory                  7.0  .................  Deleted (part of new     ......  .................  No Details
                    plethysmograph.                                      system).
                   retractor, hand.........     4.0          $1,566.20  instrument pack, medium       4          $1,500.00  Other Equipment
                                                                         ($1500 and up).
E54010...........  review master...........     7.0         $23,500.00  review master..........       5         $23,500.00  Other Equipment
                   review software (e.g.        5.0          $8,000.00  ultrasound,                   5          $8,000.00  Other Equipment
                    Prosolve).                                           echocardiography
                                                                         analyzer software
                                                                         (ProSolv).
E52013...........  Review Station: AG7300       5.0            $899.99  video SVHS VCR (medical       5          $1,250.00  Documentation
                    SVHS,17in..                                          grade).
E71036...........  Rhinomenometer..........     7.5          $3,150.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
E72010...........  Rigid Bone fixation          7.5         $20,000.00  Deleted through PEAC     ......  .................  No Details
                    system.                                              refinement..
E52014...........  Rigiscan................     7.5         $12,500.00  nocturnal penile              7          $9,000.00  Other Equipment
                                                                         tumescence monitor
                                                                         (Rigiscan Plus).
E13642...........  robotic cover slipper...     7.5         $32,288.00  slide coverslipper,           7         $30,143.00  Laboratory
                                                                         robotic.
E51087...........  Roesenthal dosimeter....     5.0          $1,995.00  dosimeter, aerosol           10          $1,795.00  Other Equipment
                                                                         provocation.
                   rotation chair..........     7.0         $91,059.00  CDP-computerized              7         $86,957.50  Other Equipment
                                                                         dynamic posturography
                                                                         system.
E13643...........  routine pap stainer.....     7.0         $20,000.00  slide stainer,                7         $14,085.68  Laboratory
                                                                         automated, high-volume
                                                                         throughput.
                   RVS System..............     7.0         $54,000.00  radiation virtual             5         $54,000.00  Radiology
                                                                         simulation system.
E50006...........  scale, high capacity....    10.0          $1,995.00  scale, high capacity         10          $1,726.33  Furniture
                                                                         (800 lb).
                   scale, new born              7.0          $1,276.00  scale, new born,             15          $1,279.41  Furniture
                    electronic.                                          digital.
E13607...........  scanning electron            7.0        $120,000.00  microscope, electron,         7        $178,725.00  Laboratory
                    microscope.                                          scanning (SEM) (with
                                                                         microprobe and x-ray
                                                                         microanalyzer).
                   Scanning Laser Device...     5.0         $60,000.00  tomographic device,           7         $49,950.00  Other Equipment
                                                                         optical coherence
                                                                         (OCT).
                   scope washer............     7.0  .................  endoscope disinfector,        7         $18,802.00  Scope
                                                                         rigid or fiberoptic, w-
                                                                         cart.
E71111...........  Screening Lane..........     7.0         $28,234.95  lane, screening (oph)..       7         $28,463.33  Room - Lane
E54003...........  Seizure Detection Device     7.0         $21,000.00  EEG, digital, prolonged       7         $46,750.00  Other Equipment
                                                                         testing system
                                                                         (computer w-remote
                                                                         camera).
                   sensitometer............     5.0          $2,500.00  sensitometer, film.....      10          $1,050.00  Radiology
                   sensory integration          8.0          $3,600.00  sensory integration          15          $3,600.00  Other Equipment
                    equipment.                                           equip (eg, ball pit,
                                                                         glider, trampoline,
                                                                         ramp).
                   sensory kit.............    10.0            $677.00  kit, sensory...........      10            $677.35  Other Equipment
E72008...........  septoplasty tray........     4.0            $725.76  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
                   shock wave machine......     5.0        $450,000.00  shock wave system......       5        $350,000.00  Other Equipment
E13103...........  sigmoidoscopic equipment    10.0          $3,340.00  cart, endoscopy imaging      10          $2,793.00  Scope
                    cart.                                                equipment.
                   simple ear instrument        4.0  .................  instrument pack, medium       4          $1,500.00  Other Equipment
                    pack.                                                ($1500 and up).
                   simple ear                   4.0  .................  instrument pack, medium       4          $1,500.00  Other Equipment
                    instrumentation pack.                                ($1500 and up).
                   Simulator, Varian.......     5.0        $595,000.00  IMRT x-ray-fluoroscopic-      5        $598,120.00  Radiology
                                                                         based simulator.
E51024...........  Simulator, Ximatron CF w/    5.0        $450,000.00  Deleted through PEAC     ......  .................  No Details
                    last Image hold.                                     refinement..
E53018...........  Single Head Anger            5.0        $300,000.00  gamma camera system,          5        $406,816.80  Radiology
                    Scintillation Camera.                                single-dual head.
E53020...........  Single Head or Dual Head     5.0        $575,000.00  gamma camera system,          5        $406,816.80  Radiology
                    Camera.                                              single-dual head.
E53032...........  Single Photon                5.0         $22,500.00  densitometry unit,            5         $22,500.00  Radiology
                    Densitometer/Computer.                               whole body, SPA.
E71028...........  Sinusoidal Harmonic          7.0         $70,080.00  CDP-computerized              7         $86,957.50  Other Equipment
                    Acceleration Chair.                                  dynamic posturography
                                                                         system.
                   sleep kit (includes          7.0            $630.00  Deleted (less than       ......  .................  No Details
                    snore sensor & leg kit).                             $500).
E13644...........  slide dryer oven........    10.0            $695.00  slide dryer............      10            $962.50  Laboratory
E13645...........  slide etcher............     7.5          $9,400.00  slide etcher-labeler...       7         $15,836.67  Laboratory

[[Page 47718]]

 
E13617...........  slide stainer...........     7.0         $13,000.00  slide stainer,                7         $14,085.68  Laboratory
                                                                         automated, high-volume
                                                                         throughput.
                   smoke evacuation system.    10.0  .................  Deleted (part of new     ......  .................  No Details
                                                                         system).
                   soft tissue procedure        4.0            $539.00  instrument pack, basic        4            $500.00  Other Equipment
                    pack.                                                ($500-$1499).
E30003...........  soft tissue tray........     4.0          $1,559.40  instrument pack, medium       4          $1,500.00  Other Equipment
                                                                         ($1500 and up).
E52009...........  Software (Paceart)......     5.0          $6,000.00  pacemaker follow-up           7         $23,507.00  Other Equipment
                                                                         system (incl software
                                                                         and hardware)
                                                                         (Paceart).
                   software, MR/PET/CT          5.0         $60,000.00  computer software, MR/        5         $60,000.00  Documentation
                    fusion.                                              PET/CT fusion.
                   software-woodcock            5.0            $728.00  cognitive abilities           5            $558.00  Other Equipment
                    johnson test/cognitive                               testing software
                    abilities.                                           (Woodcock Johnson).
E51046...........  Solid Water Calibration      5.0          $2,000.00  phantom, solid water         10          $2,109.50  Radiology
                    Phantom.                                             calibration check.
E13646...........  solvent recycling system     7.5         $22,000.00  solvent recycling             7         $13,995.00  Laboratory
                                                                         system.
E13614...........  sonicator...............     7.5            $600.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
E52010...........  Sony Color Video Printer     5.0         $10,500.00  Deleted (part of new     ......  .................  No Details
                                                                         system).
E52010...........  Sony Color Video Printer     5.0         $10,500.00  video printer, color          4          $2,295.00  Documentation
                    (combine with system).                               (Sony medical grade).
E71031...........  sound proof booth-           7.5         $11,900.00  audiometric soundproof       15         $33,518.00  Other Equipment
                    double walled.                                       booth (exam and
                                                                         control rooms).
                   sounds and followers         4.0            $508.00  instrument pack, basic        4            $500.00  Other Equipment
                    set, leforte, 12-24                                  ($500-$1499).
                    french.
                   sounds, female (set)....     4.0          $1,736.00  instrument pack, medium       4          $1,500.00  Other Equipment
                                                                         ($1500 and up).
                   sounds, male (set)......     4.0          $1,104.00  instrument pack, basic        4            $500.00  Other Equipment
                                                                         ($500-$1499).
                   sounds, VanBurden.......     4.0          $1,104.00  instrument pack, basic        4            $500.00  Other Equipment
                                                                         ($500-$1499).
                   source, 10 Ci Ir 192....     3.0         $22,000.00  source, 10 Ci Ir 192...       5         $22,000.00  Radiology
E53028...........  SPECT Three head Camera.     5.0        $565,000.00  gamma camera system,          5        $406,816.80  Radiology
                                                                         single-dual head.
                   spirometry instrument...     8.0         $37,974.00  Vmax 29s (spirometry          8         $26,875.00  Other Equipment
                                                                         testing equip,
                                                                         computer system).
E13610...........  sputter coater..........     7.5          $6,000.00  Deleted (part of new     ......  .................  No Details
                                                                         system).
                   stainer, automated           7.0          $8,253.00  slide stainer,                7          $8,265.64  Laboratory
                    hematology.                                          automated, standard
                                                                         throughput.
                   stairs, exercise........    10.0            $870.00  stairs, ambulation           15            $793.67  Other Equipment
                                                                         training.
                   stereotactic frame /         5.0  .................  cranial-skull tongs           5            $542.00  Other Equipment
                    tongs.                                               (Gardner-Wells).
                   stimulator with probe...     8.0  .................  Deleted (less than       ......  .................  No Details
                                                                         $500).
E11002...........  stretcher...............     5.0          $2,664.00  stretcher..............      10          $1,915.00  Furniture
E11002...........  stretcher...............    10.0          $2,664.00  stretcher..............      10          $1,915.00  Furniture
                   strontium-90 applicator.     4.0          $8,599.00  strontium-90 applicator       5          $8,599.00  Other Equipment
                   suction and pressure        15.0          $3,195.00  suction and pressure         10          $3,495.00  Other Equipment
                    cabinet, ENT (SMR).                                  cabinet, ENT (SMR).
E30001...........  suction machine, Gomco..    10.0            $732.20  suction machine (Gomco)      10            $743.21  Other Equipment
E72009...........  surgical drill system...     7.5         $19,800.00  drill system, surgical,      10         $15,933.00  Other Equipment
                                                                         large (Stryker).
E30009...........  surgical lamp...........    10.0          $3,650.00  light, surgical........      10          $4,489.13  Furniture
E30018...........  surgical loupes.........    10.0          $1,300.00  loupes, surgical,             7          $1,398.33  Other Equipment
                                                                         prism, up to 8.0x.
E53004...........  Survey Meter............     7.5            $650.00  radiation survey meter.       8            $756.25  Radiology
                   suspension system for        8.0          $2,500.00  sensory integration          10          $2,500.00  Other Equipment
                    sensory integration                                  equipment, suspension
                    equipment.                                           system.
E52012...........  SVHS video recorder.....     5.0            $599.00  Deleted (part of new     ......  .................  No Details
                                                                         system).
E52012...........  SVHS video recorder.....     5.0            $599.00  video SVHS VCR (medical       5          $1,250.00  Documentation
                                                                         grade).
                   swimming pool for           10.0         $37,500.00  aquatic therapy pool...      15         $36,000.00  Other Equipment
                    aquatic therapy.
                   switch kit..............     5.0          $1,910.00  augmentative                  7          $1,910.00  Other Equipment
                                                                         communication - AT
                                                                         switches (eg, arm,
                                                                         tongue, pneumatic).
                   table, back, mobile.....    10.0            $709.00  table, instrument,           15            $634.00  Furniture
                                                                         mobile.
                   table, fluoroscopy          10.0        $281,600.00  table, fluoroscopy.....      15        $281,600.00  Furniture
                    (Hydra Vision 64kW).
                   table, OR, tilt.........    10.0          $1,010.00  table, power...........      10          $6,153.63  Furniture
                   table, pedestal for OT..    15.0            $795.00  table, for seated OT         15            $718.67  Furniture
                                                                         therapy.

[[Page 47719]]

 
                   table, traction with leg    10.0          $3,770.00  Deleted (part of new     ......  .................  No Details
                    rest.                                                system).
                   table, treatment/work,      10.0          $2,905.00  table, treatment, hi-lo      15          $2,361.67  Furniture
                    adjustable height.
                   Tech Speak..............     7.0            $645.00  augmentative                  7            $645.00  Other Equipment
                                                                         communication - Tech
                                                                         Speak.
                   TEE transducer..........     5.0         $45,000.00  ultrasound, transducer        5         $45,000.00  Other Equipment
                                                                         (TEE Omniplane II).
                   test, clerical              10.0          $2,680.00  work samples, clerical        7          $2,680.00  Other Equipment
                    comprehension (Valpar).                              comprehension (Valpar
                                                                         5).
                   test, fine finger           10.0            $725.00  work samples, fine            7            $725.00  Other Equipment
                    dexterity (Valpar).                                  finger dexterity
                                                                         (Valpar 204).
                   test, physical capacity     10.0            $725.00  work samples, physical        7            $725.00  Other Equipment
                    and mobility (Valpar).                               capacity (Valpar 201).
E92023...........  Therapeutic exercise        15.0         $12,260.00  exercise equipment           15         $12,710.00  Other Equipment
                    equipment set.                                       (treadmill, bike,
                                                                         stepper, UBE, pulleys,
                                                                         balance board).
E92001...........  therapeutic ultrasound       7.0          $1,995.00  ultrasound unit,              7          $1,304.33  Other Equipment
                    unit.                                                therapeutic.
                   Tilt Table..............    10.0          $6,995.00  table, tilt (w-              15          $7,695.00  Furniture
                                                                         trendelenberg).
E13649...........  tissue processing fume       7.5          $6,400.00  hood, fume.............      15          $4,778.46  Laboratory
                    hood.
E13650...........  tissue processor........     7.0         $39,500.00  tissue processor.......       7         $33,593.00  Laboratory
                   TLD oven/annealing           5.0          $1,960.00  TLD annealing furnace..       7          $2,536.00  Laboratory
                    furnace.
E51048...........  TLD Reader..............     5.0         $13,000.00  TLD Reader.............       7         $14,390.00  Laboratory
                   Tonography Unit.........     5.0         $10,065.00  tonography unit........       7          $6,195.00  Other Equipment
                   tool set, valpar........     7.0          $1,765.00  work samples, small           7          $1,765.00  Other Equipment
                                                                         tools (Valpar 1).
                   topcon TRC 50 E.........     5.0         $28,790.00  camera, retinal (TRC          5         $37,000.00  Documentation
                                                                         50IX, w-ICG, filters,
                                                                         motor drives).
                   tourniquet device,           7.0         $12,500.00  tourniquet system             7         $10,220.00  Other Equipment
                    pneumatic.                                           (Zimmer1200).
                   Tracher 2000............     7.0          $1,895.00  augmentative                  7          $1,795.00  Other Equipment
                                                                         communication -
                                                                         Tracker 2000.
                   transthoracic echo           5.0         $15,000.00  Deleted (part of new     ......  .................  No Details
                    probe, pediatric, 8 mHz.                             system).
                   treadmill...............    10.0          $4,700.00  treadmill..............       8          $4,446.11  Other Equipment
E55020...........  Treadmill w/ ECG Monitor     8.0         $16,000.00  cardiac monitor w-           10         $14,271.03  Other Equipment
                                                                         treadmill (12-lead PC-
                                                                         based ECG).
E51050...........  Treatment Planning           5.0        $221,500.00  computer workstation,         5        $221,500.00  Documentation
                    Computer-3D (Focus).                                 3D teletherapy
                                                                         treatment planning.
                   treatment planning           5.0        $350,000.00  treatment planning            5        $350,545.00  Documentation
                    system for intensity                                 system, IMRT (Corvus w-
                    modulated radiotherapy.                              Peregrine 3D Monte
                                                                         Carlo).
                   Treatment Vault.........     7.0        $550,670.00  radiation treatment          15        $550,670.00  Radiology
                                                                         vault.
                   TUMT device.............     5.0         $60,000.00  TUMT system control           7         $29,995.00  Other Equipment
                                                                         unit.
E71032...........  tympanometer with            7.0          $2,700.00  tympanometer with            10          $2,648.53  Other Equipment
                    printer.                                             printer.
                   ultrasonic biometry,         5.0          $3,945.00  ultrasonic biometry,          5          $3,945.00  Other Equipment
                    pachymeter.                                          pachymeter.
E13663...........  ultrasonic instrument        7.5            $945.00  Deleted (indirect).....  ......  .................  No Details
                    cleaner.
E52019...........  Ultrasonic nebulizer....    10.0          $1,000.00  Deleted (CPT action)...  ......  .................  No Details
E52001...........  ultrasound color             5.0        $155,000.00  ultrasound color              5        $155,000.00  Other Equipment
                    doppler, transducers                                 doppler, transducers
                    and vaginal probe.                                   and vaginal probe.
E52018...........  Ultrasound Room.........     5.0        $272,000.00  room, ultrasound,             5        $369,945.00  Room - Lane
                                                                         general.
                   ultrasound table........    10.0          $4,495.00  table, ultrasound......      15          $5,823.33  Furniture
                   Ultrasound Unit.........     5.0         $30,000.00  ultrasound unit,              5         $29,999.00  Other Equipment
                                                                         Shimadzu.
E52005...........  ultrasound, shimatsu....     5.0         $35,000.00  ultrasound unit,              5         $29,999.00  Other Equipment
                                                                         Shimadzu.
                   urethotome, otis........     3.0          $1,735.00  urethrotome, Otis......       4          $1,697.50  Scope
E52006...........  urodynamics machine, 4-      5.0         $15,175.00  urodynamics system, 4-        5         $30,733.00  Other Equipment
                    channel video.                                       channel.
                   urodynamics machine, 6-      5.0        $115,578.00  urodynamics system, 6-        5        $115,578.00  Other Equipment
                    channel video.                                       channel, w-video.
                   uroflowmeter, digital, w-    5.0          $2,758.00  uroflowmeter, digital,        7          $2,758.00  Other Equipment
                    chair (Microflo).                                    w-chair.
                   uterine thermal balloon      5.0          $8,500.00  uterine thermal balloon       7          $8,500.00  Other Equipment
                    ablation system                                      ablation system
                    (Thermachoice).                                      (Thermachoice).
                   UV monitor/meter........     5.0            $690.00  phototherapy UVB             10            $690.00  Other Equipment
                                                                         measuring device.
                   vacuum cart.............    10.0  .................  vacuum cart............      10
                   Other Equipment.........
E13615...........  vacuum dissector........    10.0            $635.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
E13627...........  vacuum evaporator.......     7.5         $15,000.00  Deleted (part of new     ......  .................  No Details
                                                                         system).
E13612...........  vacuum oven.............    10.0          $3,000.00  Deleted (part of new     ......  .................  No Details
                                                                         system).
E13624...........  vacuum pump.............    10.0          $1,455.00  vacuum pump............       7          $1,840.00  Laboratory
E92015...........  Vasopneumatic device....    10.0            $795.00  vasopneumatic                10            $632.48  Other Equipment
                                                                         compression system.
E91003...........  ventilator hood & blower    10.0            $602.55  hood, ventilator with        10          $1,612.50  Laboratory
                                                                         blower.

[[Page 47720]]

 
                   video add-on camera          5.0          $9,495.00  video add-on camera           5          $9,495.00  Scope
                    system w-monitor                                     system w-monitor
                    (endoscopy).                                         (endoscopy).
E13635...........  video camera............     5.0          $1,000.00  Deleted (part of new     ......  .................  No Details
                                                                         system).
E13635...........  video camera (combine        5.0          $1,000.00  video add-on camera           5          $9,495.00  Scope
                    with system).                                        system w-monitor
                                                                         (endoscopy).
E13635...........  video camera (combine        5.0          $1,000.00  video camera...........       5          $1,000.00  Documentation
                    with system).
                   video system, capsule     ......         $17,000.00  video system, capsule         5         $17,000.00  Scope
                    endoscopy (software,                                 endoscopy (software,
                    computer, monitor,                                   computer, monitor,
                    printer).                                            printer).
                   video system, capsule     ......          $2,500.00  video system, capsule         5          $2,500.00  Scope
                    endoscopy, booster                                   endoscopy, booster
                    drive w-accessories.                                 drive w-accessories.
                   video system, endoscopy      5.0         $33,233.00  video system, endoscopy       5         $33,232.50  Scope
                    (processor, digital                                  (processor, digital
                    capture, monitor,                                    capture, monitor,
                    printer, cart).                                      printer, cart).
                   video system, FEES           5.0         $21,675.00  video system, FEES            5         $21,675.00  Scope
                    (scope, camera, light                                (scope, camera, light
                    source, image capture,                               source, image capture,
                    monitor, printer, cart).                             monitor, printer,
                                                                         cart).
                   video system, FEESST         5.0         $29,550.00  video system, FEESST          5         $29,550.00  Scope
                    (scope, sensory                                      (scope, sensory
                    stimulator, camera,                                  stimulator, camera,
                    light source, image                                  light source, image
                    capture, monitor,                                    capture, monitor,
                    printer, cart).                                      printer, cart).
                   video system,                5.0         $25,310.00  video system,                 5         $25,310.00  Scope
                    stroboscopy (strobing                                stroboscopy (strobing
                    platform, camera,                                    platform, camera,
                    digital recorder,                                    digital recorder,
                    monitor, printer, cart).                             monitor, printer,
                                                                         cart).
E71033...........  visual response              7.0            $700.00  VRA-visual reinforcment       5          $1,550.00  Other Equipment
                    audiometry.                                          audiometry system.
E55023...........  VMax 229 (split/combine      8.0         $56,551.20  Vmax 229 (spirometry          8         $44,681.00  Other Equipment
                    systems).                                            testing equip,
                                                                         computer system).
E55023...........  VMax 229 (split/combine      8.0         $56,551.20  Vmax 29s (spirometry          8         $26,875.00  Other Equipment
                    systems).                                            testing equip,
                                                                         computer system).
                   Voice Pal Max...........     7.0            $555.00  augmentative                  7            $555.00  Other Equipment
                                                                         communication -
                                                                         VoicePal Max.
E13648...........  vortex mixer............     7.5            $500.00  Deleted (less than       ......  .................  No Details
                                                                         $500).
E54002...........  Voyager acquisition          7.0         $46,850.00  sleep screening system,       5         $22,000.00  Other Equipment
                    station.                                             attended (w-resp
                                                                         plethysmography).
                   water bath..............    10.0            $750.00  water bath, general           7            $726.45  Laboratory
                                                                         purpose (lab).
                   Water Bath Phantom with      5.0         $15,000.00  phantom, water,              10          $3,070.00  Radiology
                    Drivers.                                             includes remote motor
                                                                         drive.
                   water bath, general          5.0            $726.45  water bath, general           7            $726.45  Laboratory
                    purpose (lab).                                       purpose (lab).
                   Water Chiller...........     7.0         $28,000.00  water chiller                 7         $28,000.00  Radiology
                                                                         (radiation treatment).
E51026...........  Waterbath for                5.0            $750.00  water bath,                   7            $722.36  Radiology
                    Thermoplastic                                        thermoplastic softener
                    Immobilizer System.                                  (20in x 12in).
                   Waterbath, Medtech......     5.0          $1,150.00  water bath,                   7            $722.36  Radiology
                                                                         thermoplastic softener
                                                                         (20in x 12in).
E71008...........  Weeks dark adaptometer..     5.0         $16,100.00  Weeks dark adaptometer.       7          $2,950.00  Other Equipment
E51076...........  Well Counter............     5.0          $3,955.00  well counter...........       7          $3,955.00  Radiology
E51074...........  Well Ionization Chamber,     5.0          $4,641.00  Deleted through PEAC     ......  .................  No Details
                    Standard Imaging.                                    refinement..
E71108...........  wheatstone trainer......     7.5            $895.00  stereo trainer                7            $550.00  Other Equipment
                                                                         (wheatstone).
E92005...........  whirlpool...............    10.0          $3,700.00  whirlpool, lo-boy tank       10          $3,296.40  Furniture
                                                                         (whole body).
                   whitkit evaluation kit..     5.0          $1,400.00  augmentative                  7          $1,400.00  Other Equipment
                                                                         communication -
                                                                         WhitKit head support.
E53030...........  Whole Body or Dual Head      5.0        $575,000.00  Deleted through PEAC     ......  .................  No Details
                    Camera.                                              refinement..
                   WIT thermotherapy unit..     5.0         $18,500.00  WIT system (AquaTherm).       7         $16,400.00  Other Equipment
                   work bench, orthotic,       10.0            $750.00  cart-workbench,              10            $752.50  Furniture
                    mobile.                                              orthotic, mobile.
                   work station, post          10.0        $180,000.00  Deleted (part of new     ......  .................  No Details
                    processing for CT                                    system).
                    angiography.
E53022...........  Xenon Delivery System...     5.0          $5,450.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
                   xenon light source -         3.0
                    cable for endoscope.

[[Page 47721]]

 
                   light source, xenon.....       5          $6,723.33  Other Equipment........
E53024...........  Xenon Monitor...........     5.0          $2,775.00  Deleted through PEAC     ......  .................  No Details
                                                                         refinement..
E51003...........  X-omat Film processor        8.0         $10,900.00  film processor, x-omat        8         $11,500.00  Documentation
                    M35A.                                                (Kodak 2000A).
E51002...........  X-omat film processor        8.0         $26,832.00  film processor, x-omat        8         $34,865.00  Documentation
                    M6B.                                                 (M6B).
E55032...........  x-ray lift..............     7.5            $800.00  lift, hydraulic, table       10          $1,111.00  Furniture
                                                                         assist.
E51001...........  X-ray View Box 4 panel..    15.0            $909.49  x-ray view box, 4 panel      10            $889.17  Radiology
E72000...........  YAG laser...............     5.0         $40,000.00  laser, YAG.............       5         $29,975.00  Other Equipment
E71009...........  Zeiss slit lamp camera..    10.0          $7,495.00  slit lamp (Haag-Streit)      10          $7,435.00  Other Equipment
                   zeiss visulas 690 PDT        5.0         $37,900.00  laser, photodynamic           5         $35,000.00  Other Equipment
                    laser.                                               therapy.
--------------------------------------------------------------------------------------------------------------------------------------------------------


[[Page 47722]]


   Addendum E.--Revised 2005 Office Rental Index Versus Current Office Rental Index by 2004 Fee Schedule Area
----------------------------------------------------------------------------------------------------------------
                       Loc.                                  Current    Revised 2005                 Percentage
     Carrier No.        No.          Locality name        rental index  rental index   Difference    difference
----------------------------------------------------------------------------------------------------------------
00510...............      00  ALABAMA...................         0.738         0.679        -0.059          -8.0
00831...............      01  ALASKA....................         1.249         1.141        -0.108          -8.6
31146...............      26  ANAHEIM/SANTA ANA, CA.....         1.422         1.586         0.164          11.5
00832...............      00  ARIZONA...................         1.000         1.034         0.034           3.4
00520...............      13  ARKANSAS..................         0.704         0.666        -0.038          -5.4
00511...............      01  ATLANTA, GA...............         1.136         1.271         0.135          11.9
00900...............      31  AUSTIN, TX................         1.111         1.243         0.132          11.9
00901...............      01  BALTIMORE/SURR. CNTYS, MD.         1.026         1.159         0.133          13.0
00900...............      20  BEAUMONT, TX..............         0.758         0.700        -0.058          -7.7
00900...............      09  BRAZORIA, TX..............         1.018         0.991        -0.027          -2.7
00952...............      16  CHICAGO, IL...............         1.216         1.274         0.058           4.8
00824...............      01  COLORADO..................         1.066         1.100         0.034           3.2
00591...............      00  CONNECTICUT...............         1.215         1.275         0.060           4.9
00900...............      11  DALLAS, TX................         1.196         1.167        -0.029          -2.4
00903...............      01  DC + MD/VA SUBURBS........         1.341         1.584         0.243          18.1
00902...............      01  DELAWARE..................         1.051         0.983        -0.068          -6.5
00953...............      01  DETROIT, MI...............         1.045         1.060         0.015           1.4
00952...............      12  EAST ST. LOUIS, IL........         0.792         0.912         0.120          15.2
00590...............      03  FORT LAUDERDALE, FL.......         1.090         1.041        -0.049          -4.5
00900...............      28  FORT WORTH, TX............         0.977         1.017         0.040           4.1
00900...............      15  GALVESTON, TX.............         0.924         0.901        -0.023          -2.5
00833...............      01  HAWAII/GUAM...............         1.389         1.186        -0.203         -14.6
00900...............      18  HOUSTON, TX...............         0.988         1.024         0.036           3.6
05130...............      00  IDAHO.....................         0.791         0.730        -0.061          -7.7
00630...............      00  INDIANA...................         0.847         0.789        -0.058          -6.8
00826...............      00  IOWA......................         0.785         0.737        -0.048          -6.1
00650...............      00  KANSAS*...................         0.793         0.765        -0.028          -3.5
00740...............      04  KANSAS*...................         0.793         0.765        -0.028          -3.5
00660...............      00  KENTUCKY..................         0.721         0.685        -0.036          -5.0
31146...............      18  LOS ANGELES, CA...........         1.223         1.328         0.105           8.6
00803...............      01  MANHATTAN, NY.............         1.744         1.676        -0.068          -3.9
31140...............      03  MARIN/NAPA/SOLANO, CA.....         1.647         1.886         0.239          14.5
31143...............      01  METROPOLITAN BOSTON.......         1.504         1.809         0.305          20.3
00740...............      02  METROPOLITAN KANSAS CITY,          0.916         0.962         0.046           5.0
                               MO.
00865...............      01  METROPOLITAN PHILADELPHIA,         1.178         1.196         0.018           1.5
                               PA.
00523...............      01  METROPOLITAN ST. LOUIS, MO         0.814         0.949         0.135          16.6
00590...............      04  MIAMI, FL.................         1.139         1.117        -0.022          -1.9
00954...............      00  MINNESOTA.................         0.940         0.997         0.057           6.1
00512...............      00  MISSISSIPPI...............         0.690         0.667        -0.023          -3.3
00751...............      01  MONTANA...................         0.794         0.738        -0.056          -7.1
00655...............      00  NEBRASKA..................         0.817         0.748        -0.069          -8.4
00834...............      00  NEVADA....................         1.117         1.110        -0.007          -0.6
31144...............      40  NEW HAMPSHIRE.............         1.089         1.123         0.034           3.1
00521...............      05  NEW MEXICO................         0.837         0.788        -0.049          -5.9
00528...............      01  NEW ORLEANS, LA...........         0.832         0.905         0.073           8.8
05535...............      00  NORTH CAROLINA............         0.869         0.826        -0.043          -4.9
00820...............      01  NORTH DAKOTA..............         0.800         0.751        -0.049          -6.1
00805...............      01  NORTHERN NJ...............         1.399         1.421         0.022           1.6
00803...............      02  NYC SUBURBS/LONG I., NY...         1.573         1.538        -0.035          -2.2
31140...............      07  OAKLAND/BERKELEY, CA......         1.470         1.886         0.416          28.3
00883...............      00  OHIO......................         0.863         0.838        -0.025          -2.9
00522...............      00  OKLAHOMA..................         0.725         0.717        -0.008          -1.1
00835...............      01  PORTLAND, OR..............         1.120         1.058        -0.062          -5.5
00803...............      03  POUGHKPSIE/N NYC SUBURBS,          1.254         1.201        -0.053          -4.2
                               NY.
00973...............      20  PUERTO RICO...............         0.688         0.631        -0.057          -8.3
14330...............      04  QUEENS, NY................         1.414         1.359        -0.055          -3.9
31146...............      99  REST OF CALIFORNIA*.......         1.050         1.110         0.060           5.7
31140...............      99  REST OF CALIFORNIA*.......         1.050         1.110         0.060           5.7
00590...............      99  REST OF FLORIDA...........         0.951         0.928        -0.023          -2.4
00511...............      99  REST OF GEORGIA...........         0.771         0.729        -0.042          -5.4
00952...............      99  REST OF ILLINOIS..........         0.797         0.741        -0.056          -7.0
00528...............      99  REST OF LOUISIANA.........         0.715         0.672        -0.043          -6.0
31142...............      99  REST OF MAINE.............         0.801         0.755        -0.046          -5.7
00901...............      99  REST OF MARYLAND..........         0.995         1.026         0.031           3.1
31143...............      99  REST OF MASSACHUSETTS.....         1.308         1.239        -0.069          -5.3
00953...............      99  REST OF MICHIGAN..........         0.848         0.799        -0.049          -5.8
00740...............      99  REST OF MISSOURI*.........         0.662         0.613        -0.049          -7.4
00523...............      99  REST OF MISSOURI*.........         0.662         0.613        -0.049          -7.4
00805...............      99  REST OF NEW JERSEY........         1.312         1.256        -0.056          -4.3
00801...............      99  REST OF NEW YORK..........         0.875         0.812        -0.063          -7.2

[[Page 47723]]

 
00835...............      99  REST OF OREGON............         0.901         0.837        -0.064          -7.1
00865...............      99  REST OF PENNSYLVANIA......         0.844         0.785        -0.059          -7.0
00900...............      99  REST OF TEXAS.............         0.795         0.759        -0.036          -4.5
00836...............      99  REST OF WASHINGTON........         0.958         0.915        -0.043          -4.5
00870...............      01  RHODE ISLAND..............         1.098         0.931        -0.167         -15.2
31140...............      05  SAN FRANCISCO, CA.........         2.174         2.356         0.182           8.4
31140...............      06  SAN MATEO, CA.............         2.174         2.356         0.182           8.4
31140...............      09  SANTA CLARA, CA...........         1.949         2.416         0.467          24.0
00836...............      02  SEATTLE (KING CNTY), WA...         1.232         1.234         0.002           0.2
00880...............      01  SOUTH CAROLINA............         0.825         0.763        -0.062          -7.5
00820...............      02  SOUTH DAKOTA..............         0.853         0.801        -0.052          -6.1
31142...............      03  SOUTHERN MAINE............         1.009         1.098         0.089           8.8
00952...............      15  SUBURBAN CHICAGO, IL......         1.216         1.274         0.058           4.8
05440...............      35  TENNESSEE.................         0.800         0.748        -0.052          -6.5
00910...............      09  UTAH......................         0.978         0.950        -0.028          -2.9
31146...............      17  VENTURA, CA...............         1.294         1.484         0.190          14.7
31145...............      50  VERMONT...................         1.004         0.997        -0.007          -0.7
00973...............      50  VIRGIN ISLANDS............         1.260         1.164        -0.096          -7.6
00904...............      00  VIRGINIA..................         0.892         0.933         0.041           4.6
00884...............      16  WEST VIRGINIA.............         0.685         0.634        -0.051          -7.4
00951...............      00  WISCONSIN.................         0.866         0.801        -0.065          -7.5
00825...............      21  WYOMING...................         0.799         0.751        -0.048         -6.0
----------------------------------------------------------------------------------------------------------------
Note: Revised Rental Indices Based Upon 2004 HUD FMR Data.


             Addendum F.--Current Geographic Practice Cost Indices by Medicare Carrier and Locality
----------------------------------------------------------------------------------------------------------------
                              Loc.
        Carrier No.            No.             Locality name              Work GPCI      PE GPCI       MP GPCI
----------------------------------------------------------------------------------------------------------------
00510......................      00  ALABAMA..........................         1.000         0.870         0.779
00831......................      01  ALASKA...........................         1.670         1.670         1.670
00832......................      00  ARIZONA..........................         1.000         0.978         1.090
00520......................      13  ARKANSAS.........................         1.000         0.847         0.389
31146......................      26  ANAHEIM/SANTA ANA, CA............         1.037         1.184         0.955
31146......................      18  LOS ANGELES, CA..................         1.056         1.139         0.955
31140......................      03  MARIN/NAPA/SOLANO, CA............         1.015         1.248         0.669
31140......................      07  OAKLAND/BERKELEY, CA.............         1.041         1.235         0.669
31140......................      05  SAN FRANCISCO, CA................         1.068         1.458         0.669
31140......................      06  SAN MATEO, CA....................         1.048         1.432         0.663
31140......................      09  SANTA CLARA, CA..................         1.063         1.380         0.622
31146......................      17  VENTURA, CA......................         1.028         1.125         0.763
31146......................      99  REST OF CALIFORNIA*..............         1.007         1.034         0.740
31140......................      99  REST OF CALIFORNIA*..............         1.007         1.034         0.740
00824......................      01  COLORADO.........................         1.000         0.992         0.821
00591......................      00  CONNECTICUT......................         1.050         1.156         0.933
00902......................      01  DELAWARE.........................         1.019         1.035         0.802
00903......................      01  DC + MD/VA SUBURBS...............         1.050         1.166         0.917
00590......................      03  FORT LAUDERDALE, FL..............         1.000         1.018         1.790
00590......................      04  MIAMI, FL........................         1.015         1.052         2.399
00590......................      99  REST OF FLORIDA..................         1.000         0.946         1.268
00511......................      01  ATLANTA, GA......................         1.006         1.059         0.951
00511......................      99  REST OF GEORGIA..................         1.000         0.892         0.951
00833......................      01  HAWAII/GUAM......................         1.000         1.124         0.817
05130......................      00  IDAHO............................         1.000         0.881         0.478
00952......................      16  CHICAGO, IL......................         1.028         1.092         1.832
00952......................      12  EAST ST. LOUIS, IL...............         1.000         0.924         1.720
00952......................      15  SUBURBAN CHICAGO, IL.............         1.006         1.071         1.648
00952......................      99  REST OF ILLINOIS.................         1.000         0.889         1.175
00630......................      00  INDIANA..........................         1.000         0.922         0.459
00826......................      00  IOWA.............................         1.000         0.876         0.593
00650......................      00  KANSAS*..........................         1.000         0.895         0.738
00740......................      04  KANSAS*..........................         1.000         0.895         0.738
00660......................      00  KENTUCKY.........................         1.000         0.866         0.875
00528......................      01  NEW ORLEANS, LA..................         1.000         0.945         1.240
00528......................      99  REST OF LOUISIANA................         1.000         0.870         1.066
31142......................      03  SOUTHERN MAINE...................         1.000         0.999         0.652
31142......................      99  REST OF MAINE....................         1.000         0.910         0.652
00901......................      01  BALTIMORE/SURR. CNTYS, MD........         1.021         1.038         0.931
00901......................      99  REST OF MARYLAND.................         1.000         0.972         0.767

[[Page 47724]]

 
31143......................      01  METROPOLITAN BOSTON..............         1.041         1.239         0.803
31143......................      99  REST OF MASSACHUSETTS............         1.010         1.129         0.803
00953......................      01  DETROIT, MI......................         1.043         1.038         2.741
00953......................      99  REST OF MICHIGAN.................         1.000         0.938         1.545
00954......................      00  MINNESOTA........................         1.000         0.974         0.431
00512......................      00  MISSISSIPPI......................         1.000         0.837         0.750
00740......................      02  METROPOLITAN KANSAS CITY, MO.....         1.000         0.967         0.896
00523......................      01  METROPOLITAN ST. LOUIS, MO.......         1.000         0.938         0.893
00740......................      99  REST OF MISSOURI*................         1.000         0.825         0.842
00523......................      99  REST OF MISSOURI*................         1.000         0.825         0.842
00751......................      01  MONTANA..........................         1.000         0.876         0.815
00655......................      00  NEBRASKA.........................         1.000         0.877         0.442
00834......................      00  NEVADA...........................         1.005         1.039         1.138
31144......................      40  NEW HAMPSHIRE....................         1.000         1.030         0.883
00805......................      01  NORTHERN NJ......................         1.058         1.193         0.916
00805......................      99  REST OF NEW JERSEY...............         1.029         1.110         0.916
00521......................      05  NEW MEXICO.......................         1.000         0.900         0.898
00803......................      01  MANHATTAN, NY....................         1.094         1.351         1.586
00803......................      02  NYC SUBURBS/LONG I., NY..........         1.068         1.251         1.869
00803......................      03  POUGHKPSIE/N NYC SUBURBS, NY.....         1.011         1.075         1.221
14330......................      04  QUEENS, NY.......................         1.058         1.228         1.791
00801......................      99  REST OF NEW YORK.................         1.000         0.944         0.720
05535......................      00  NORTH CAROLINA...................         1.000         0.931         0.618
00820......................      01  NORTH DAKOTA.....................         1.000         0.880         0.630
00883......................      00  OHIO.............................         1.000         0.944         0.967
00522......................      00  OKLAHOMA.........................         1.000         0.876         0.413
00835......................      01  PORTLAND, OR.....................         1.000         1.049         0.438
00835......................      99  REST OF OREGON...................         1.000         0.933         0.438
00865......................      01  METROPOLITAN PHILADELPHIA, PA....         1.023         1.092         1.400
00865......................      99  REST OF PENNSYLVANIA.............         1.000         0.929         0.790
00973......................      20  PUERTO RICO......................         1.000         0.712         0.268
00870......................      01  RHODE ISLAND.....................         1.017         1.065         0.896
00880......................      01  SOUTH CAROLINA...................         1.000         0.904         0.336
00820......................      02  SOUTH DAKOTA.....................         1.000         0.878         0.385
05440......................      35  TENNESSEE........................         1.000         0.900         0.612
00900......................      31  AUSTIN, TX.......................         1.000         0.996         0.922
00900......................      20  BEAUMONT, TX.....................         1.000         0.890         1.318
00900......................      09  BRAZORIA, TX.....................         1.000         0.978         1.318
00900......................      11  DALLAS, TX.......................         1.010         1.065         0.996
00900......................      28  FORT WORTH, TX...................         1.000         0.981         0.996
00900......................      15  GALVESTON, TX....................         1.000         0.969         1.318
00900......................      18  HOUSTON, TX......................         1.020         1.007         1.316
00900......................      99  REST OF TEXAS....................         1.000         0.880         1.047
00910......................      09  UTAH.............................         1.000         0.941         0.653
31145......................      50  VERMONT..........................         1.000         0.986         0.527
00973......................      50  VIRGIN ISLANDS...................         1.000         1.023         1.003
00904......................      00  VIRGINIA.........................         1.000         0.938         0.540
00836......................      02  SEATTLE (KING CNTY), WA..........         1.005         1.100         0.803
00836......................      99  REST OF WASHINGTON...............         1.000         0.972         0.803
00884......................      16  WEST VIRGINIA....................         1.000         0.850         1.462
00951......................      00  WISCONSIN........................         1.000         0.929         0.865
00825......................      21  WYOMING..........................         1.000         0.895        0.970
----------------------------------------------------------------------------------------------------------------
Note: Work GPCI is the 1/4 work GPCI required by section 1848(e)(1)(A)(iii) of the Act. 1.0 Floor on Work GPCI,
  1.67 for all Alaska indices, set by MMA GPCIs are scaled by the following factors: Work= 0.9977, Practice
  Expense=0.9930, Malpractice Expense=1.0021.


          Addendum G.--Proposed 2005 Geographic Practice Cost Indices by Medicare Carrier and Locality
----------------------------------------------------------------------------------------------------------------
                              Loc.
        Carrier No.            No.             Locality name              Work GPCI      PE GPCI       MP GPCI
----------------------------------------------------------------------------------------------------------------
00510......................      00  ALABAMA..........................         1.000         0.860         0.779
00831......................      01  ALASKA...........................         1.670         1.670         1.670
00832......................      00  ARIZONA..........................         1.000         0.983         1.090
00520......................      13  ARKANSAS.........................         1.000         0.841         0.389
31146......................      26  ANAHEIM/SANTA ANA, CA............         1.036         1.203         0.955
31146......................      18  LOS ANGELES, CA..................         1.049         1.142         0.955
31140......................      03  MARIN/NAPA/SOLANO, CA............         1.026         1.292         0.669
31140......................      07  OAKLAND/BERKELEY, CA.............         1.049         1.301         0.669
31140......................      05  SAN FRANCISCO, CA................         1.066         1.498         0.669
31140......................      06  SAN MATEO, CA....................         1.062         1.482         0.663

[[Page 47725]]

 
31140......................      09  SANTA CLARA, CA..................         1.076         1.457         0.622
31146......................      17  VENTURA, CA......................         1.029         1.146         0.763
31146......................      99  REST OF CALIFORNIA*..............         1.007         1.039         0.740
31140......................      99  REST OF CALIFORNIA*..............         1.007         1.039         0.740
00824......................      01  COLORADO.........................         1.000         1.004         0.821
00591......................      00  CONNECTICUT......................         1.044         1.161         0.933
00902......................      01  DELAWARE.........................         1.016         1.027         0.802
00903......................      01  DC + MD/VA SUBURBS...............         1.051         1.202         0.917
00590......................      03  FORT LAUDERDALE, FL..............         1.000         1.005         1.790
00590......................      04  MIAMI, FL........................         1.007         1.036         2.399
00590......................      99  REST OF FLORIDA..................         1.000         0.941         1.268
00511......................      01  ATLANTA, GA......................         1.009         1.076         0.951
00511......................      99  REST OF GEORGIA..................         1.000         0.885         0.951
00833......................      01  HAWAII/GUAM......................         1.001         1.113         0.817
05130......................      00  IDAHO............................         1.000         0.874         0.478
00952......................      16  CHICAGO, IL......................         1.027         1.110         1.832
00952......................      12  EAST ST. LOUIS, IL...............         1.000         0.934         1.720
00952......................      15  SUBURBAN CHICAGO, IL.............         1.013         1.094         1.648
00952......................      99  REST OF ILLINOIS.................         1.000         0.883         1.175
00630......................      00  INDIANA..........................         1.000         0.916         0.459
00826......................      00  IOWA.............................         1.000         0.874         0.593
00650......................      00  KANSAS*..........................         1.000         0.889         0.738
00740......................      04  KANSAS*..........................         1.000         0.889         0.738
00660......................      00  KENTUCKY.........................         1.000         0.862         0.875
00528......................      01  NEW ORLEANS, LA..................         1.000         0.947         1.240
00528......................      99  REST OF LOUISIANA................         1.000         0.860         1.066
31142......................      03  SOUTHERN MAINE...................         1.000         1.006         0.652
31142......................      99  REST OF MAINE....................         1.000         0.899         0.652
00901......................      01  BALTIMORE/SURR. CNTYS, MD........         1.017         1.054         0.931
00901......................      99  REST OF MARYLAND.................         1.000         0.974         0.767
31143......................      01  METROPOLITAN BOSTON..............         1.036         1.277         0.803
31143......................      99  REST OF MASSACHUSETTS............         1.009         1.113         0.803
00953......................      01  DETROIT, MI......................         1.040         1.044         2.741
00953......................      99  REST OF MICHIGAN.................         1.000         0.930         1.545
00954......................      00  MINNESOTA........................         1.000         0.990         0.431
00512......................      00  MISSISSIPPI......................         1.000         0.840         0.750
00740......................      02  METROPOLITAN KANSAS CITY, MO.....         1.000         0.972         0.896
00523......................      01  METROPOLITAN ST. LOUIS, MO.......         1.000         0.949         0.893
00740......................      99  REST OF MISSOURI*................         1.000         0.815         0.842
00523......................      99  REST OF MISSOURI*................         1.000         0.815         0.842
00751......................      01  MONTANA..........................         1.000         0.861         0.815
00655......................      00  NEBRASKA.........................         1.000         0.878         0.442
00834......................      00  NEVADA...........................         1.004         1.039         1.138
31144......................      40  NEW HAMPSHIRE....................         1.000         1.027         0.883
00805......................      01  NORTHERN NJ......................         1.058         1.204         0.916
00805......................      99  REST OF NEW JERSEY...............         1.036         1.114         0.916
00521......................      05  NEW MEXICO.......................         1.000         0.895         0.898
00803......................      01  MANHATTAN, NY....................         1.080         1.346         1.586
00803......................      02  NYC SUBURBS/LONG I., NY..........         1.059         1.256         1.869
00803......................      03  POUGHKPSIE/N NYC SUBURBS, NY.....         1.012         1.072         1.221
14330......................      04  QUEENS, NY.......................         1.045         1.210         1.791
00801......................      99  REST OF NEW YORK.................         1.000         0.934         0.720
05535......................      00  NORTH CAROLINA...................         1.000         0.928         0.618
00820......................      01  NORTH DAKOTA.....................         1.000         0.871         0.630
00883......................      00  OHIO.............................         1.000         0.940         0.967
00522......................      00  OKLAHOMA.........................         1.000         0.867         0.413
00835......................      01  PORTLAND, OR.....................         1.000         1.052         0.438
00835......................      99  REST OF OREGON...................         1.000         0.929         0.438
00865......................      01  METROPOLITAN PHILADELPHIA, PA....         1.020         1.098         1.400
00865......................      99  REST OF PENNSYLVANIA.............         1.000         0.917         0.790
00973......................      20  PUERTO RICO......................         1.000         0.708         0.268
00870......................      01  RHODE ISLAND.....................         1.030         1.028         0.896
00880......................      01  SOUTH CAROLINA...................         1.000         0.901         0.336
00820......................      02  SOUTH DAKOTA.....................         1.000         0.878         0.385
05440......................      35  TENNESSEE........................         1.000         0.892         0.612
00900......................      31  AUSTIN, TX.......................         1.000         1.025         0.922
00900......................      20  BEAUMONT, TX.....................         1.000         0.877         1.318
00900......................      09  BRAZORIA, TX.....................         1.008         0.971         1.318
00900......................      11  DALLAS, TX.......................         1.011         1.064         0.996
00900......................      28  FORT WORTH, TX...................         1.000         0.985         0.996

[[Page 47726]]

 
00900......................      15  GALVESTON, TX....................         1.000         0.962         1.318
00900......................      18  HOUSTON, TX......................         1.020         1.012         1.316
00900......................      99  REST OF TEXAS....................         1.000         0.874         1.047
00910......................      09  UTAH.............................         1.000         0.940         0.653
31145......................      50  VERMONT..........................         1.000         0.979         0.527
00973......................      50  VIRGIN ISLANDS...................         1.000         1.008         1.003
00904......................      00  VIRGINIA.........................         1.000         0.941         0.540
00836......................      02  SEATTLE (KING CNTY), WA..........         1.011         1.115         0.803
00836......................      99  REST OF WASHINGTON...............         1.000         0.975         0.803
00884......................      16  WEST VIRGINIA....................         1.000         0.836         1.462
00951......................      00  WISCONSIN........................         1.000         0.925         0.865
00825......................      21  WYOMING..........................         1.000         0.875        0.970
----------------------------------------------------------------------------------------------------------------
Note: Work GPCI is the 1/4 work GPCI required by section 1848(e)(1)(A)(iii) of the Act. 1.0 Floor on Work GPCI,
  1.67 for all Alaska indices, set by MMAMMA GPCIs are scaled by the following factors: Work= 0.9977, Practice
  Expense=0.9930, Malpractice Expense=1.0021.


          Addendum H.--Proposed 2006 Geographic Practice Cost Indices by Medicare Carrier and Locality
----------------------------------------------------------------------------------------------------------------
                              Loc.
        Carrier No.            No.             Locality name              Work GPCI      PE GPCI       MP GPCI
----------------------------------------------------------------------------------------------------------------
00510......................      00  ALABAMA..........................         1.000         0.850         0.752
00831......................      01  ALASKA...........................         1.670         1.670         1.670
00832......................      00  ARIZONA..........................         1.000         0.988         1.069
00520......................      13  ARKANSAS.........................         1.000         0.835         0.438
31146......................      26  ANAHEIM/SANTA ANA, CA............         1.036         1.223         0.954
31146......................      18  LOS ANGELES, CA..................         1.043         1.144         0.954
31140......................      03  MARIN/NAPA/SOLANO, CA............         1.037         1.336         0.651
31140......................      07  OAKLAND/BERKELEY, CA.............         1.058         1.366         0.651
31140......................      05  SAN FRANCISCO, CA................         1.064         1.539         0.651
31140......................      06  SAN MATEO, CA....................         1.076         1.531         0.639
31140......................      09  SANTA CLARA, CA..................         1.088         1.534         0.604
31146......................      17  VENTURA, CA......................         1.031         1.167         0.744
31146......................      99  REST OF CALIFORNIA*..............         1.007         1.044         0.733
31140......................      99  REST OF CALIFORNIA*..............         1.007         1.044         0.733
00824......................      01  COLORADO.........................         1.000         1.016         0.803
00591......................      00  CONNECTICUT......................         1.039         1.167         0.900
00902......................      01  DELAWARE.........................         1.013         1.020         0.892
00903......................      01  DC + MD/VA SUBURBS...............         1.052         1.238         0.926
00590......................      03  FORT LAUDERDALE, FL..............         1.000         0.992         1.703
00590......................      04  MIAMI, FL........................         1.000         1.020         2.269
00590......................      99  REST OF FLORIDA..................         1.000         0.936         1.272
00511......................      01  ATLANTA, GA......................         1.012         1.093         0.966
00511......................      99  REST OF GEORGIA..................         1.000         0.877         0.966
00833......................      01  HAWAII/GUAM......................         1.006         1.101         0.800
05130......................      00  IDAHO............................         1.000         0.868         0.459
00952......................      16  CHICAGO, IL......................         1.027         1.128         1.867
00952......................      12  EAST ST. LOUIS, IL...............         1.000         0.944         1.750
00952......................      15  SUBURBAN CHICAGO, IL.............         1.021         1.117         1.652
00952......................      99  REST OF ILLINOIS.................         1.000         0.877         1.193
00630......................      00  INDIANA..........................         1.000         0.910         0.436
00826......................      00  IOWA.............................         1.000         0.872         0.589
00650......................      00  KANSAS*..........................         1.000         0.882         0.721
00740......................      04  KANSAS*..........................         1.000         0.882         0.721
00660......................      00  KENTUCKY.........................         1.000         0.858         0.873
00528......................      01  NEW ORLEANS, LA..................         1.000         0.950         1.197
00528......................      99  REST OF LOUISIANA................         1.000         0.849         1.058
31142......................      03  SOUTHERN MAINE...................         1.000         1.013         0.637
31142......................      99  REST OF MAINE....................         1.000         0.888         0.637
00901......................      01  BALTIMORE/SURR. CNTYS, MD........         1.014         1.070         0.947
00901......................      99  REST OF MARYLAND.................         1.000         0.977         0.760
31143......................      01  METROPOLITAN BOSTON..............         1.032         1.314         0.823
31143......................      99  REST OF MASSACHUSETTS............         1.008         1.097         0.823
00953......................      01  DETROIT, MI......................         1.038         1.050         2.744
00953......................      99  REST OF MICHIGAN.................         1.000         0.923         1.518
00954......................      00  MINNESOTA........................         1.000         1.005         0.410
00512......................      00  MISSISSIPPI......................         1.000         0.843         0.722
00740......................      02  METROPOLITAN KANSAS CITY, MO.....         1.000         0.978         0.946
00523......................      01  METROPOLITAN ST. LOUIS, MO.......         1.000         0.961         0.941
00740......................      99  REST OF MISSOURI*................         1.000         0.805         0.892

[[Page 47727]]

 
00523......................      99  REST OF MISSOURI*................         1.000         0.805         0.892
00751......................      01  MONTANA..........................         1.000         0.845         0.904
00655......................      00  NEBRASKA.........................         1.000         0.879         0.454
00834......................      00  NEVADA...........................         1.003         1.039         1.068
31144......................      40  NEW HAMPSHIRE....................         1.000         1.023         0.942
00805......................      01  NORTHERN NJ......................         1.059         1.215         0.973
00805......................      99  REST OF NEW JERSEY...............         1.043         1.117         0.973
00521......................      05  NEW MEXICO.......................         1.000         0.890         0.895
00803......................      01  MANHATTAN, NY....................         1.067         1.341         1.504
00803......................      02  NYC SUBURBS/LONG I., NY..........         1.051         1.260         1.785
00803......................      03  POUGHKPSIE/N NYC SUBURBS, NY.....         1.013         1.070         1.167
14330......................      04  QUEENS, NY.......................         1.032         1.192         1.710
00801......................      99  REST OF NEW YORK.................         1.000         0.923         0.677
05535......................      00  NORTH CAROLINA...................         1.000         0.926         0.640
00820......................      01  NORTH DAKOTA.....................         1.000         0.862         0.602
00883......................      00  OHIO.............................         1.000         0.937         0.976
00522......................      00  OKLAHOMA.........................         1.000         0.858         0.382
00835......................      01  PORTLAND, OR.....................         1.004         1.055         0.441
00835......................      99  REST OF OREGON...................         1.000         0.926         0.441
00865......................      01  METROPOLITAN PHILADELPHIA, PA....         1.018         1.105         1.386
00865......................      99  REST OF PENNSYLVANIA.............         1.000         0.906         0.806
00973......................      20  PUERTO RICO......................         1.000         0.705         0.261
00870......................      01  RHODE ISLAND.....................         1.044         0.992         0.909
00880......................      01  SOUTH CAROLINA...................         1.000         0.897         0.394
00820......................      02  SOUTH DAKOTA.....................         1.000         0.879         0.365
05440......................      35  TENNESSEE........................         1.000         0.884         0.631
00900......................      31  AUSTIN, TX.......................         1.000         1.053         0.986
00900......................      20  BEAUMONT, TX.....................         1.000         0.864         1.298
00900......................      09  BRAZORIA, TX.....................         1.025         0.964         1.298
00900......................      11  DALLAS, TX.......................         1.013         1.063         1.061
00900......................      28  FORT WORTH, TX...................         1.000         0.989         1.061
00900......................      15  GALVESTON, TX....................         1.000         0.956         1.298
00900......................      18  HOUSTON, TX......................         1.020         1.017         1.297
00900......................      99  REST OF TEXAS....................         1.000         0.868         1.138
00910......................      09  UTAH.............................         1.000         0.939         0.662
31145......................      50  VERMONT..........................         1.000         0.972         0.514
00973......................      50  VIRGIN ISLANDS...................         1.000         0.993         1.003
00904......................      00  VIRGINIA.........................         1.000         0.944         0.579
00836......................      02  SEATTLE (KING CNTY), WA..........         1.018         1.131         0.819
00836......................      99  REST OF WASHINGTON...............         1.000         0.979         0.819
00884......................      16  WEST VIRGINIA....................         1.000         0.822         1.547
00951......................      00  WISCONSIN........................         1.000         0.921         0.790
00825......................      21  WYOMING..........................         1.000         0.856        0.935
----------------------------------------------------------------------------------------------------------------
Note: Work GPCI is the 1/4 work GPCI required by section 1848(e)(1)(A)(iii) of the Act. 1.0 Floor on Work GPCI,
  1.67 for all Alaska indices, set by MMA GPCIs are scaled by the following factors: Work= 0.9977, Practice
  Expense=0.9930, Malpractice Expense=1.0021.


                        Addendum I.--Comparison of Current 2004 GAFs to Proposed 2005GAFs
                                       [In descending order of difference]
----------------------------------------------------------------------------------------------------------------
                       Loc.                               Current 2004    Proposed                     Percent
     Carrier No.        No.          Locality name             GAF        2005 GAF     Difference    difference
----------------------------------------------------------------------------------------------------------------
31140...............      09  SANTA CLARA, CA...........         1.184         1.225         0.040          3.41
31140...............      07  OAKLAND/BERKELEY, CA......         1.111         1.144         0.033          2.96
31140...............      06  SAN MATEO, CA.............         1.201         1.230         0.029          2.44
31140...............      03  MARIN/NAPA/SOLANO, CA.....         1.104         1.128         0.025          2.25
31140...............      05  SAN FRANCISCO, CA.........         1.223         1.239         0.017          1.36
00903...............      01  DC + MD/VA SUBURBS........         1.095         1.112         0.016          1.49
31143...............      01  METROPOLITAN BOSTON.......         1.118         1.132         0.014          1.24
00952...............      15  SUBURBAN CHICAGO, IL......         1.059         1.073         0.014          1.31
00900...............      31  AUSTIN, TX................         0.995         1.008         0.013          1.26
00836...............      02  SEATTLE (KING CNTY), WA...         1.038         1.048         0.010          0.96
31146...............      17  VENTURA, CA...............         1.060         1.070         0.010          0.91
00511...............      01  ATLANTA, GA...............         1.027         1.036         0.009          0.88
31146...............      26  ANAHEIM/SANTA ANA, CA.....         1.098         1.106         0.008          0.72
00952...............      16  CHICAGO, IL...............         1.087         1.094         0.008          0.70
00954...............      00  MINNESOTA.................         0.967         0.974         0.007          0.70
00805...............      99  REST OF NEW JERSEY........         1.060         1.065         0.005          0.50
00824...............      01  COLORADO..................         0.990         0.995         0.005          0.51

[[Page 47728]]

 
00805...............      01  NORTHERN NJ...............         1.111         1.116         0.005          0.45
00901...............      01  BALTIMORE/SURR. CNTYS, MD.         1.025         1.030         0.005          0.48
00523...............      01  METROPOLITAN ST. LOUIS, MO         0.969         0.974         0.005          0.51
00952...............      12  EAST ST. LOUIS, IL........         0.995         0.999         0.004          0.44
31142...............      03  SOUTHERN MAINE............         0.986         0.989         0.003          0.31
00740...............      02  METROPOLITAN KANSAS CITY,          0.981         0.984         0.002          0.24
                               MO.
31146...............      99  REST OF CALIFORNIA*.......         1.008         1.011         0.002          0.22
31140...............      99  REST OF CALIFORNIA*.......         1.008         1.011         0.002          0.22
00900...............      18  HOUSTON, TX...............         1.026         1.028         0.002          0.21
00832...............      00  ARIZONA...................         0.994         0.996         0.002          0.20
00900...............      28  FORT WORTH, TX............         0.992         0.993         0.002          0.16
00836...............      99  REST OF WASHINGTON........         0.980         0.981         0.002          0.16
00512...............      00  MISSISSIPPI...............         0.919         0.920         0.002          0.16
00835...............      01  PORTLAND, OR..............         1.000         1.001         0.001          0.13
00904...............      00  VIRGINIA..................         0.955         0.956         0.001          0.14
00865...............      01  METROPOLITAN PHILADELPHIA,         1.067         1.069         0.001          0.12
                               PA.
00953...............      01  DETROIT, MI...............         1.106         1.107         0.001          0.10
00901...............      99  REST OF MARYLAND..........         0.979         0.980         0.001          0.11
00528...............      01  NEW ORLEANS, LA...........         0.985         0.986         0.001          0.10
00900...............      09  BRAZORIA, TX..............         1.003         1.004         0.001          0.09
00655...............      00  NEBRASKA..................         0.925         0.925         0.000          0.04
00900...............      11  DALLAS, TX................         1.033         1.034         0.000          0.02
00831...............      01  ALASKA....................         1.670         1.670         0.000          0.00
00820...............      02  SOUTH DAKOTA..............         0.923         0.923         0.000         -0.01
00910...............      09  UTAH......................         0.961         0.960         0.000         -0.03
00834...............      00  NEVADA....................         1.025         1.024        -0.001         -0.05
00803...............      03  POUGHKPSIE/N NYC SUBURBS,          1.047         1.046        -0.001         -0.06
                               NY.
00591...............      00  CONNECTICUT...............         1.092         1.091        -0.001         -0.08
00826...............      00  IOWA......................         0.930         0.929        -0.001         -0.11
05535...............      00  NORTH CAROLINA............         0.955         0.954        -0.001         -0.13
00880...............      01  SOUTH CAROLINA............         0.932         0.931        -0.001         -0.14
31144...............      40  NEW HAMPSHIRE.............         1.009         1.007        -0.001         -0.13
00883...............      00  OHIO......................         0.974         0.973        -0.002         -0.17
00835...............      99  REST OF OREGON............         0.949         0.947        -0.002         -0.18
00951...............      00  WISCONSIN.................         0.964         0.962        -0.002         -0.17
00973...............      20  PUERTO RICO...............         0.846         0.844        -0.002         -0.21
00660...............      00  KENTUCKY..................         0.937         0.935        -0.002         -0.20
00590...............      99  REST OF FLORIDA...........         0.987         0.985        -0.002         -0.21
00521...............      05  NEW MEXICO................         0.952         0.950        -0.002         -0.23
31146...............      18  LOS ANGELES, CA...........         1.088         1.086        -0.002         -0.22
00630...............      00  INDIANA...................         0.945         0.942        -0.003         -0.27
00803...............      02  NYC SUBURBS/LONG I., NY...         1.179         1.176        -0.003         -0.22
00650...............      00  KANSAS*...................         0.944         0.941        -0.003         -0.28
00740...............      04  KANSAS*...................         0.944         0.941        -0.003         -0.28
00952...............      99  REST OF ILLINOIS..........         0.958         0.956        -0.003         -0.28
00900...............      99  REST OF TEXAS.............         0.950         0.947        -0.003         -0.29
00520...............      13  ARKANSAS..................         0.910         0.907        -0.003         -0.31
00900...............      15  GALVESTON, TX.............         0.999         0.996        -0.003         -0.29
00511...............      99  REST OF GEORGIA...........         0.951         0.948        -0.003         -0.33
05130...............      00  IDAHO.....................         0.928         0.925        -0.003         -0.34
31145...............      50  VERMONT...................         0.976         0.973        -0.003         -0.33
00953...............      99  REST OF MICHIGAN..........         0.994         0.990        -0.003         -0.34
05440...............      35  TENNESSEE.................         0.941         0.938        -0.004         -0.37
00820...............      01  NORTH DAKOTA..............         0.933         0.929        -0.004         -0.43
00522...............      00  OKLAHOMA..................         0.923         0.919        -0.004         -0.44
00740...............      99  REST OF MISSOURI*.........         0.917         0.913        -0.004         -0.46
00523...............      99  REST OF MISSOURI*.........         0.917         0.913        -0.004         -0.46
00801...............      99  REST OF NEW YORK..........         0.965         0.960        -0.004         -0.44
00833...............      01  HAWAII/GUAM...............         1.047         1.043        -0.004         -0.42
00510...............      00  ALABAMA...................         0.935         0.930        -0.004         -0.48
00528...............      99  REST OF LOUISIANA.........         0.946         0.941        -0.004         -0.48
31142...............      99  REST OF MAINE.............         0.947         0.942        -0.005         -0.51
00902...............      01  DELAWARE..................         1.018         1.013        -0.005         -0.49
00865...............      99  REST OF PENNSYLVANIA......         0.961         0.956        -0.005         -0.54
00900...............      20  BEAUMONT, TX..............         0.964         0.959        -0.006         -0.59
00590...............      03  FORT LAUDERDALE, FL.......         1.038         1.033        -0.006         -0.55
00884...............      16  WEST VIRGINIA.............         0.953         0.946        -0.006         -0.66
00973...............      50  VIRGIN ISLANDS............         1.010         1.004        -0.007         -0.65
00751...............      01  MONTANA...................         0.939         0.932        -0.007         -0.71
31143...............      99  REST OF MASSACHUSETTS.....         1.054         1.046        -0.008         -0.72

[[Page 47729]]

 
00825...............      21  WYOMING...................         0.953         0.944        -0.009         -0.92
00803...............      01  MANHATTAN, NY.............         1.225         1.216        -0.009         -0.75
00870...............      01  RHODE ISLAND..............         1.033         1.024        -0.009         -0.89
00590...............      04  MIAMI, FL.................         1.085         1.073        -0.011         -1.02
14330...............      04  QUEENS, NY................         1.161         1.146        -0.015        -1.26
----------------------------------------------------------------------------------------------------------------
Note: GAFs based upon revised MEI weights as published in November 7, 2003 final rule; Work GPCI=52.466,
  Practice Expense GPCI=43.669, Malpractice GPCI=3.865


                       Addendum J.--Comparison of Current 2004 GAFs to Proposed 2006 GAFs
                                       [in descending order of difference]
----------------------------------------------------------------------------------------------------------------
                       Loc.                               Current 2004    Proposed                     Percent
     Carrier No.        No.          Locality name             GAF        2006 GAF     Difference    difference
----------------------------------------------------------------------------------------------------------------
31140...............      09  SANTA CLARA, CA...........         1.184         1.264         0.080          6.72
31140...............      07  OAKLAND/BERKELEY, CA......         1.111         1.177         0.065          5.87
31140...............      06  SAN MATEO, CA.............         1.201         1.258         0.057          4.76
31140...............      03  MARIN/NAPA/SOLANO, CA.....         1.104         1.153         0.049          4.45
00903...............      01  DC + MD/VA SUBURBS........         1.095         1.128         0.033          3.01
31140...............      05  SAN FRANCISCO, CA.........         1.223         1.255         0.033          2.68
31143...............      01  METROPOLITAN BOSTON.......         1.118         1.147         0.029          2.56
00952...............      15  SUBURBAN CHICAGO, IL......         1.059         1.087         0.028          2.67
00900...............      31  AUSTIN, TX................         0.995         1.023         0.027          2.74
00836...............      02  SEATTLE (KING CNTY), WA...         1.038         1.060         0.021          2.04
31146...............      17  VENTURA, CA...............         1.060         1.079         0.019          1.80
00511...............      01  ATLANTA, GA...............         1.027         1.046         0.019          1.82
00952...............      16  CHICAGO, IL...............         1.087         1.104         0.017          1.54
31146...............      26  ANAHEIM/SANTA ANA, CA.....         1.098         1.114         0.017          1.51
00805...............      01  NORTHERN NJ...............         1.111         1.124         0.013          1.13
00954...............      00  MINNESOTA.................         0.967         0.979         0.013          1.29
00805...............      99  REST OF NEW JERSEY........         1.060         1.073         0.012          1.18
00523...............      01  METROPOLITAN ST. LOUIS, MO         0.969         0.981         0.012          1.24
00901...............      01  BALTIMORE/SURR. CNTYS, MD.         1.025         1.036         0.011          1.07
00952...............      12  EAST ST. LOUIS, IL........         0.995         1.005         0.010          1.00
00824...............      01  COLORADO..................         0.990         0.999         0.010          0.97
00740...............      02  METROPOLITAN KANSAS CITY,          0.981         0.988         0.007          0.71
                               MO.
00900...............      09  BRAZORIA, TX..............         1.003         1.009         0.006          0.60
00900...............      28  FORT WORTH, TX............         0.992         0.998         0.006          0.59
31142...............      03  SOUTHERN MAINE............         0.986         0.992         0.006          0.56
00835...............      01  PORTLAND, OR..............         1.000         1.005         0.005          0.49
00904...............      00  VIRGINIA..................         0.955         0.959         0.004          0.43
31146...............      99  REST OF CALIFORNIA*.......         1.008         1.013         0.004          0.41
31140...............      99  REST OF CALIFORNIA*.......         1.008         1.013         0.004          0.41
00836...............      99  REST OF WASHINGTON........         0.980         0.984         0.004          0.40
00900...............      18  HOUSTON, TX...............         1.026         1.029         0.004          0.35
00832...............      00  ARIZONA...................         0.994         0.997         0.003          0.34
00900...............      11  DALLAS, TX................         1.033         1.037         0.003          0.32
00953...............      01  DETROIT, MI...............         1.106         1.109         0.003          0.25
00865...............      01  METROPOLITAN PHILADELPHIA,         1.067         1.070         0.003          0.26
                               PA.
00901...............      99  REST OF MARYLAND..........         0.979         0.981         0.002          0.22
00512...............      00  MISSISSIPPI...............         0.919         0.921         0.002          0.19
00655...............      00  NEBRASKA..................         0.925         0.926         0.001          0.13
00528...............      01  NEW ORLEANS, LA...........         0.985         0.986         0.001          0.07
00831...............      01  ALASKA....................         1.670         1.670         0.000          0.00
00910...............      09  UTAH......................         0.961         0.960         0.000         -0.04
00820...............      02  SOUTH DAKOTA..............         0.923         0.923         0.000         -0.05
31144...............      40  NEW HAMPSHIRE.............         1.009         1.008        -0.001         -0.08
00880...............      01  SOUTH CAROLINA............         0.932         0.932        -0.001         -0.09
05535...............      00  NORTH CAROLINA............         0.955         0.954        -0.001         -0.13
00900...............      99  REST OF TEXAS.............         0.950         0.948        -0.002         -0.19
00826...............      00  IOWA......................         0.930         0.928        -0.002         -0.22
00591...............      00  CONNECTICUT...............         1.092         1.090        -0.002         -0.20
00883...............      00  OHIO......................         0.974         0.972        -0.003         -0.27
00835...............      99  REST OF OREGON............         0.949         0.946        -0.003         -0.30
00803...............      03  POUGHKPSIE/N NYC SUBURBS,          1.047         1.044        -0.003         -0.29
                               NY.
00973...............      20  PUERTO RICO...............         0.846         0.843        -0.003         -0.39
00520...............      13  ARKANSAS..................         0.910         0.906        -0.004         -0.39
00660...............      00  KENTUCKY..................         0.937         0.933        -0.004         -0.40
00834...............      00  NEVADA....................         1.025         1.021        -0.004         -0.36

[[Page 47730]]

 
00590...............      99  REST OF FLORIDA...........         0.987         0.983        -0.004         -0.41
00521...............      05  NEW MEXICO................         0.952         0.948        -0.005         -0.47
00952...............      99  REST OF ILLINOIS..........         0.958         0.954        -0.005         -0.48
31146...............      18  LOS ANGELES, CA...........         1.088         1.084        -0.005         -0.43
00511...............      99  REST OF GEORGIA...........         0.951         0.945        -0.006         -0.63
00630...............      00  INDIANA...................         0.945         0.939        -0.006         -0.64
00902...............      01  DELAWARE..................         1.018         1.011        -0.006         -0.61
00900...............      15  GALVESTON, TX.............         0.999         0.992        -0.006         -0.63
05440...............      35  TENNESSEE.................         0.941         0.935        -0.006         -0.67
00951...............      00  WISCONSIN.................         0.964         0.957        -0.006         -0.66
00650...............      00  KANSAS*...................         0.944         0.938        -0.006         -0.68
00740...............      04  KANSAS*...................         0.944         0.938        -0.006         -0.68
05130...............      00  IDAHO.....................         0.928         0.921        -0.007         -0.70
00740...............      99  REST OF MISSOURI*.........         0.917         0.911        -0.007         -0.72
00523...............      99  REST OF MISSOURI*.........         0.917         0.911        -0.007         -0.72
31145...............      50  VERMONT...................         0.976         0.969        -0.007         -0.70
00953...............      99  REST OF MICHIGAN..........         0.994         0.986        -0.007         -0.75
00833...............      01  HAWAII/GUAM...............         1.047         1.040        -0.008         -0.74
00803...............      02  NYC SUBURBS/LONG I., NY...         1.179         1.171        -0.008         -0.70
00820...............      01  NORTH DAKOTA..............         0.933         0.924        -0.009         -0.97
00884...............      16  WEST VIRGINIA.............         0.953         0.943        -0.009         -0.96
00522...............      00  OKLAHOMA..................         0.923         0.914        -0.009         -0.99
00865...............      99  REST OF PENNSYLVANIA......         0.961         0.951        -0.009         -0.97
00528...............      99  REST OF LOUISIANA.........         0.946         0.936        -0.010         -1.02
00510...............      00  ALABAMA...................         0.935         0.925        -0.010         -1.06
31142...............      99  REST OF MAINE.............         0.947         0.937        -0.010         -1.07
00751...............      01  MONTANA...................         0.939         0.929        -0.010         -1.09
00801...............      99  REST OF NEW YORK..........         0.965         0.954        -0.011         -1.11
00900...............      20  BEAUMONT, TX..............         0.964         0.952        -0.012         -1.26
00973...............      50  VIRGIN ISLANDS............         1.010         0.997        -0.013         -1.30
31143...............      99  REST OF MASSACHUSETTS.....         1.054         1.040        -0.014         -1.36
00590...............      03  FORT LAUDERDALE, FL.......         1.038         1.024        -0.015         -1.42
00870...............      01  RHODE ISLAND..............         1.033         1.016        -0.017         -1.65
00825...............      21  WYOMING...................         0.953         0.935        -0.018         -1.93
00803...............      01  MANHATTAN, NY.............         1.225         1.204        -0.021         -1.74
00590...............      04  MIAMI, FL.................         1.085         1.058        -0.027         -2.47
14330...............      04  QUEENS, NY................         1.161         1.128        -0.032        -2.80
----------------------------------------------------------------------------------------------------------------
Note: GAFs based upon revised MEI weights as published in November 7, 2003 final rule; Work GPCI=52.466,
  Practice Expense GPCI=43.669, Malpractice GPCI=3.865

[FR Doc. 04-17312 Filed 7-27-04; 8:45 am]
BILLING CODE 4120-01-P