|
Medicare CPT Rate Card
To find a code on this page hit Ctrl F on your keyboard
*For illustrative purposes only. All coding needs to verified by a
certified coder.
| ASC LIST EFFECTIVE JANUARY 1, 2007 |
| CPT |
Group |
Rate |
|
| 0176T |
9 |
$1,339.00 |
|
| 0177T |
9 |
$1,339.00 |
|
| 10121 |
2 |
$446.00 |
|
| 10180 |
2 |
$446.00 |
|
| 11010 |
2 |
$251.52 |
|
| 11011 |
2 |
$251.52 |
|
| 11012 |
2 |
$251.52 |
|
| 11042 |
2 |
$164.42 |
|
| 11043 |
2 |
$164.42 |
|
| 11044 |
2 |
$423.10 |
|
| 11404 |
1 |
$333.00 |
|
| 11406 |
2 |
$446.00 |
|
| 11424 |
2 |
$446.00 |
|
| 11426 |
2 |
$446.00 |
|
| 11444 |
1 |
$333.00 |
|
| 11446 |
2 |
$446.00 |
|
| 11450 |
2 |
$446.00 |
|
| 11451 |
2 |
$446.00 |
|
| 11462 |
2 |
$446.00 |
|
| 11463 |
2 |
$446.00 |
|
| 11470 |
2 |
$446.00 |
|
| 11471 |
2 |
$446.00 |
|
| 11604 |
2 |
$418.49 |
|
| 11606 |
2 |
$446.00 |
|
| 11624 |
2 |
$446.00 |
|
| 11626 |
2 |
$446.00 |
|
| 11644 |
2 |
$446.00 |
|
| 11646 |
2 |
$446.00 |
|
| 11770 |
3 |
$510.00 |
|
| 11771 |
3 |
$510.00 |
|
| 11772 |
3 |
$510.00 |
|
| 11960 |
2 |
$446.00 |
|
| 11970 |
3 |
$510.00 |
|
| 11971 |
1 |
$333.00 |
|
| 12005 |
2 |
$91.24 |
|
| 12006 |
2 |
$91.24 |
|
| 12007 |
2 |
$91.24 |
|
| 12016 |
2 |
$91.24 |
|
| 12017 |
2 |
$91.24 |
|
| 12018 |
2 |
$91.24 |
|
| 12020 |
1 |
$91.24 |
|
| 12021 |
1 |
$91.24 |
|
| 12034 |
2 |
$91.24 |
|
| 12035 |
2 |
$91.24 |
|
| 12036 |
2 |
$91.24 |
|
| 12037 |
2 |
$323.28 |
|
| 12044 |
2 |
$91.24 |
|
| 12045 |
2 |
$91.24 |
|
| 12046 |
2 |
$91.24 |
|
| 12047 |
2 |
$323.28 |
|
| 12054 |
2 |
$91.24 |
|
| 12055 |
2 |
$91.24 |
|
| 12056 |
2 |
$91.24 |
|
| 12057 |
2 |
$323.28 |
|
| CPT |
Group |
Rate |
|
| 13100 |
2 |
$323.28 |
|
| 13101 |
3 |
$323.28 |
|
| 13102 |
1 |
$91.24 |
|
| 13120 |
2 |
$91.24 |
|
| 13121 |
3 |
$91.24 |
|
| 13122 |
1 |
$91.24 |
|
| 13131 |
2 |
$91.24 |
|
| 13132 |
3 |
$91.24 |
|
| 13133 |
1 |
$91.24 |
|
| 13150 |
3 |
$323.28 |
|
| 13151 |
3 |
$323.28 |
|
| 13152 |
3 |
$323.28 |
|
| 13153 |
3 |
$91.24 |
|
| 13160 |
2 |
$446.00 |
|
| 14000 |
2 |
$446.00 |
|
| 14001 |
3 |
$510.00 |
|
| 14020 |
3 |
$510.00 |
|
| 14021 |
3 |
$510.00 |
|
| 14040 |
2 |
$446.00 |
|
| 14041 |
3 |
$510.00 |
|
| 14060 |
3 |
$510.00 |
|
| 14061 |
3 |
$510.00 |
|
| 14300 |
4 |
$630.00 |
|
| 14350 |
3 |
$510.00 |
|
| 15002 |
2 |
$323.28 |
|
| 15003 |
1 |
$323.28 |
|
| 15004 |
2 |
$323.28 |
|
| 15005 |
1 |
$323.28 |
|
| 15040 |
2 |
$91.24 |
|
| 15050 |
2 |
$323.28 |
|
| 15100 |
2 |
$446.00 |
|
| 15101 |
3 |
$510.00 |
|
| 15110 |
2 |
$446.00 |
|
| 15111 |
1 |
$333.00 |
|
| 15115 |
2 |
$446.00 |
|
| 15116 |
1 |
$333.00 |
|
| 15120 |
2 |
$446.00 |
|
| 15121 |
3 |
$510.00 |
|
| 15130 |
2 |
$446.00 |
|
| 15131 |
1 |
$333.00 |
|
| 15135 |
2 |
$446.00 |
|
| 15136 |
1 |
$333.00 |
|
| 15150 |
2 |
$446.00 |
|
| 15151 |
1 |
$333.00 |
|
| 15152 |
1 |
$333.00 |
|
| 15155 |
2 |
$446.00 |
|
| 15156 |
1 |
$333.00 |
|
| 15157 |
1 |
$333.00 |
|
| 15200 |
3 |
$510.00 |
|
| 15201 |
2 |
$323.28 |
|
| 15220 |
2 |
$446.00 |
|
| 15221 |
2 |
$323.28 |
|
| 15240 |
3 |
$510.00 |
|
| 15241 |
3 |
$323.28 |
|
| CPT |
Group |
Rate |
|
| 15260 |
2 |
$446.00 |
|
| 15261 |
2 |
$323.28 |
|
| 15300 |
2 |
$323.28 |
|
| 15301 |
1 |
$323.28 |
|
| 15320 |
2 |
$323.28 |
|
| 15321 |
1 |
$323.28 |
|
| 15330 |
2 |
$323.28 |
|
| 15331 |
1 |
$323.28 |
|
| 15335 |
2 |
$323.28 |
|
| 15336 |
1 |
$323.28 |
|
| 15400 |
2 |
$323.28 |
|
| 15401 |
2 |
$323.28 |
|
| 15420 |
2 |
$323.28 |
|
| 15421 |
1 |
$323.28 |
|
| 15430 |
2 |
$323.28 |
|
| 15431 |
1 |
$323.28 |
|
| 15570 |
3 |
$510.00 |
|
| 15572 |
3 |
$510.00 |
|
| 15574 |
3 |
$510.00 |
|
| 15576 |
3 |
$510.00 |
|
| 15600 |
3 |
$510.00 |
|
| 15610 |
3 |
$510.00 |
|
| 15620 |
4 |
$630.00 |
|
| 15630 |
3 |
$510.00 |
|
| 15650 |
5 |
$717.00 |
|
| 15731 |
3 |
$510.00 |
|
| 15732 |
3 |
$510.00 |
|
| 15734 |
3 |
$510.00 |
|
| 15736 |
3 |
$510.00 |
|
| 15738 |
3 |
$510.00 |
|
| 15740 |
2 |
$446.00 |
|
| 15750 |
2 |
$446.00 |
|
| 15760 |
2 |
$446.00 |
|
| 15770 |
3 |
$510.00 |
|
| 15775 |
3 |
$323.28 |
|
| 15776 |
3 |
$323.28 |
|
| 15820 |
3 |
$510.00 |
|
| 15821 |
3 |
$510.00 |
|
| 15822 |
3 |
$510.00 |
|
| 15823 |
5 |
$717.00 |
|
| 15824 |
3 |
$510.00 |
|
| 15825 |
3 |
$510.00 |
|
| 15826 |
3 |
$510.00 |
|
| 15828 |
3 |
$510.00 |
|
| 15829 |
5 |
$717.00 |
|
| 15830 |
3 |
$510.00 |
|
| 15832 |
3 |
$510.00 |
|
| 15833 |
3 |
$510.00 |
|
| 15834 |
3 |
$510.00 |
|
| 15835 |
3 |
$323.28 |
|
| 15836 |
3 |
$510.00 |
|
| 15839 |
3 |
$510.00 |
|
| 15840 |
4 |
$630.00 |
|
| 15841 |
4 |
$630.00 |
|
| CPT |
Group |
Rate |
|
| 15845 |
4 |
$630.00 |
|
| 15847 |
3 |
$510.00 |
|
| 15876 |
3 |
$510.00 |
|
| 15877 |
3 |
$510.00 |
|
| 15878 |
3 |
$510.00 |
|
| 15879 |
3 |
$510.00 |
|
| 15920 |
3 |
$251.52 |
|
| 15922 |
4 |
$630.00 |
|
| 15931 |
3 |
$510.00 |
|
| 15933 |
3 |
$510.00 |
|
| 15934 |
3 |
$510.00 |
|
| 15935 |
4 |
$630.00 |
|
| 15936 |
4 |
$630.00 |
|
| 15937 |
4 |
$630.00 |
|
| 15940 |
3 |
$510.00 |
|
| 15941 |
3 |
$510.00 |
|
| 15944 |
3 |
$510.00 |
|
| 15945 |
4 |
$630.00 |
|
| 15946 |
4 |
$630.00 |
|
| 15950 |
3 |
$510.00 |
|
| 15951 |
4 |
$630.00 |
|
| 15952 |
3 |
$510.00 |
|
| 15953 |
4 |
$630.00 |
|
| 15956 |
3 |
$510.00 |
|
| 15958 |
4 |
$630.00 |
|
| 16025 |
2 |
$67.11 |
|
| 16030 |
2 |
$99.83 |
|
| 19020 |
2 |
$446.00 |
|
| 19100 |
1 |
$240.00 |
|
| 19101 |
2 |
$446.00 |
|
| 19102 |
2 |
$240.00 |
|
| 19103 |
2 |
$395.77 |
|
| 19110 |
2 |
$446.00 |
|
| 19112 |
3 |
$510.00 |
|
| 19120 |
3 |
$510.00 |
|
| 19125 |
3 |
$510.00 |
|
| 19126 |
3 |
$510.00 |
|
| 19290 |
1 |
$333.00 |
|
| 19291 |
1 |
$333.00 |
|
| 19295 |
1 |
$106.76 |
|
| 19296 |
9 |
$1,339.00 |
|
| 19297 |
9 |
$1,339.00 |
|
| 19298 |
9 |
$1,339.00 |
|
| 19300 |
4 |
$630.00 |
|
| 19301 |
3 |
$510.00 |
|
| 19302 |
7 |
$995.00 |
|
| 19303 |
4 |
$630.00 |
|
| 19304 |
4 |
$630.00 |
|
| 19316 |
4 |
$630.00 |
|
| 19318 |
4 |
$630.00 |
|
| 19324 |
4 |
$630.00 |
|
| 19325 |
9 |
$1,339.00 |
|
| 19328 |
1 |
$333.00 |
|
| 19330 |
1 |
$333.00 |
|
| ASC
LIST EFFECTIVE JANUARY 1, 2007 |
| CPT |
Group |
Rate |
|
| 19340 |
2 |
$446.00 |
|
| 19342 |
3 |
$510.00 |
|
| 19350 |
4 |
$630.00 |
|
| 19355 |
4 |
$630.00 |
|
| 19357 |
5 |
$717.00 |
|
| 19366 |
5 |
$717.00 |
|
| 19370 |
4 |
$630.00 |
|
| 19371 |
4 |
$630.00 |
|
| 19380 |
5 |
$717.00 |
|
| 20005 |
2 |
$446.00 |
|
| 20200 |
2 |
$446.00 |
|
| 20205 |
3 |
$510.00 |
|
| 20206 |
1 |
$240.00 |
|
| 20220 |
1 |
$251.52 |
|
| 20225 |
2 |
$418.49 |
|
| 20240 |
2 |
$446.00 |
|
| 20245 |
3 |
$510.00 |
|
| 20250 |
3 |
$510.00 |
|
| 20251 |
3 |
$510.00 |
|
| 20525 |
3 |
$510.00 |
|
| 20650 |
3 |
$510.00 |
|
| 20670 |
1 |
$333.00 |
|
| 20680 |
3 |
$510.00 |
|
| 20690 |
2 |
$446.00 |
|
| 20692 |
3 |
$510.00 |
|
| 20693 |
3 |
$510.00 |
|
| 20694 |
1 |
$333.00 |
|
| 20900 |
3 |
$510.00 |
|
| 20902 |
4 |
$630.00 |
|
| 20910 |
3 |
$510.00 |
|
| 20912 |
3 |
$510.00 |
|
| 20920 |
4 |
$630.00 |
|
| 20922 |
3 |
$510.00 |
|
| 20924 |
4 |
$630.00 |
|
| 20926 |
4 |
$630.00 |
|
| 20975 |
2 |
$37.51 |
|
| 21010 |
2 |
$446.00 |
|
| 21015 |
3 |
$510.00 |
|
| 21025 |
2 |
$446.00 |
|
| 21026 |
2 |
$446.00 |
|
| 21029 |
2 |
$446.00 |
|
| 21034 |
3 |
$510.00 |
|
| 21040 |
2 |
$446.00 |
|
| 21044 |
2 |
$446.00 |
|
| 21046 |
2 |
$446.00 |
|
| 21047 |
2 |
$446.00 |
|
| 21050 |
3 |
$510.00 |
|
| 21060 |
2 |
$446.00 |
|
| 21070 |
3 |
$510.00 |
|
| 21100 |
2 |
$446.00 |
|
| 21120 |
7 |
$995.00 |
|
| 21121 |
7 |
$995.00 |
|
| 21122 |
7 |
$995.00 |
|
| 21123 |
7 |
$995.00 |
|
| CPT |
Group |
Rate |
|
| 21125 |
7 |
$995.00 |
|
| 21127 |
9 |
$1,339.00 |
|
| 21181 |
7 |
$995.00 |
|
| 21206 |
5 |
$717.00 |
|
| 21208 |
7 |
$995.00 |
|
| 21209 |
5 |
$717.00 |
|
| 21210 |
7 |
$995.00 |
|
| 21215 |
7 |
$995.00 |
|
| 21230 |
7 |
$995.00 |
|
| 21235 |
7 |
$995.00 |
|
| 21240 |
4 |
$630.00 |
|
| 21242 |
5 |
$717.00 |
|
| 21243 |
5 |
$717.00 |
|
| 21244 |
7 |
$995.00 |
|
| 21245 |
7 |
$995.00 |
|
| 21246 |
7 |
$995.00 |
|
| 21248 |
7 |
$995.00 |
|
| 21249 |
7 |
$995.00 |
|
| 21267 |
7 |
$995.00 |
|
| 21270 |
5 |
$717.00 |
|
| 21275 |
7 |
$995.00 |
|
| 21280 |
5 |
$717.00 |
|
| 21282 |
5 |
$717.00 |
|
| 21295 |
1 |
$333.00 |
|
| 21296 |
1 |
$333.00 |
|
| 21310 |
2 |
$150.72 |
|
| 21315 |
2 |
$150.72 |
|
| 21320 |
2 |
$446.00 |
|
| 21325 |
4 |
$630.00 |
|
| 21330 |
5 |
$717.00 |
|
| 21335 |
7 |
$995.00 |
|
| 21336 |
4 |
$630.00 |
|
| 21337 |
2 |
$446.00 |
|
| 21338 |
4 |
$630.00 |
|
| 21339 |
5 |
$717.00 |
|
| 21340 |
4 |
$630.00 |
|
| 21345 |
7 |
$995.00 |
|
| 21355 |
3 |
$510.00 |
|
| 21356 |
3 |
$510.00 |
|
| 21400 |
2 |
$446.00 |
|
| 21401 |
3 |
$510.00 |
|
| 21421 |
4 |
$630.00 |
|
| 21445 |
4 |
$630.00 |
|
| 21450 |
3 |
$150.72 |
|
| 21451 |
4 |
$464.15 |
|
| 21452 |
2 |
$446.00 |
|
| 21453 |
3 |
$510.00 |
|
| 21454 |
5 |
$717.00 |
|
| 21461 |
4 |
$630.00 |
|
| 21462 |
5 |
$717.00 |
|
| 21465 |
4 |
$630.00 |
|
| 21480 |
1 |
$150.72 |
|
| 21485 |
2 |
$446.00 |
|
| 21490 |
3 |
$510.00 |
|
| CPT |
Group |
Rate |
|
| 21497 |
2 |
$446.00 |
|
| 21501 |
2 |
$446.00 |
|
| 21502 |
2 |
$446.00 |
|
| 21555 |
2 |
$446.00 |
|
| 21556 |
2 |
$446.00 |
|
| 21600 |
2 |
$446.00 |
|
| 21610 |
2 |
$446.00 |
|
| 21700 |
2 |
$446.00 |
|
| 21720 |
3 |
$510.00 |
|
| 21725 |
3 |
$88.46 |
|
| 21800 |
1 |
$103.62 |
|
| 21805 |
2 |
$446.00 |
|
| 21820 |
1 |
$103.62 |
|
| 21925 |
2 |
$446.00 |
|
| 21930 |
2 |
$446.00 |
|
| 21935 |
3 |
$510.00 |
|
| 22305 |
1 |
$103.62 |
|
| 22310 |
1 |
$103.62 |
|
| 22315 |
2 |
$103.62 |
|
| 22505 |
2 |
$446.00 |
|
| 22520 |
9 |
$1,339.00 |
|
| 22521 |
9 |
$1,339.00 |
|
| 22522 |
9 |
$1,339.00 |
|
| 22900 |
4 |
$630.00 |
|
| 23000 |
2 |
$446.00 |
|
| 23020 |
2 |
$446.00 |
|
| 23030 |
1 |
$333.00 |
|
| 23031 |
3 |
$510.00 |
|
| 23035 |
3 |
$510.00 |
|
| 23040 |
3 |
$510.00 |
|
| 23044 |
4 |
$630.00 |
|
| 23066 |
2 |
$446.00 |
|
| 23075 |
2 |
$446.00 |
|
| 23076 |
2 |
$446.00 |
|
| 23077 |
3 |
$510.00 |
|
| 23100 |
2 |
$446.00 |
|
| 23101 |
7 |
$995.00 |
|
| 23105 |
4 |
$630.00 |
|
| 23106 |
4 |
$630.00 |
|
| 23107 |
4 |
$630.00 |
|
| 23120 |
5 |
$717.00 |
|
| 23125 |
5 |
$717.00 |
|
| 23130 |
5 |
$717.00 |
|
| 23140 |
4 |
$630.00 |
|
| 23145 |
5 |
$717.00 |
|
| 23146 |
5 |
$717.00 |
|
| 23150 |
4 |
$630.00 |
|
| 23155 |
5 |
$717.00 |
|
| 23156 |
5 |
$717.00 |
|
| 23170 |
2 |
$446.00 |
|
| 23172 |
2 |
$446.00 |
|
| 23174 |
2 |
$446.00 |
|
| 23180 |
4 |
$630.00 |
|
| 23182 |
4 |
$630.00 |
|
| CPT |
Group |
Rate |
|
| 23184 |
4 |
$630.00 |
|
| 23190 |
4 |
$630.00 |
|
| 23195 |
5 |
$717.00 |
|
| 23330 |
1 |
$333.00 |
|
| 23331 |
1 |
$333.00 |
|
| 23395 |
5 |
$717.00 |
|
| 23397 |
7 |
$995.00 |
|
| 23400 |
7 |
$995.00 |
|
| 23405 |
2 |
$446.00 |
|
| 23406 |
2 |
$446.00 |
|
| 23410 |
5 |
$717.00 |
|
| 23412 |
7 |
$995.00 |
|
| 23415 |
5 |
$717.00 |
|
| 23420 |
7 |
$995.00 |
|
| 23430 |
4 |
$630.00 |
|
| 23440 |
4 |
$630.00 |
|
| 23450 |
5 |
$717.00 |
|
| 23455 |
7 |
$995.00 |
|
| 23460 |
5 |
$717.00 |
|
| 23462 |
7 |
$995.00 |
|
| 23465 |
5 |
$717.00 |
|
| 23466 |
7 |
$995.00 |
|
| 23480 |
4 |
$630.00 |
|
| 23485 |
7 |
$995.00 |
|
| 23490 |
3 |
$510.00 |
|
| 23491 |
3 |
$510.00 |
|
| 23500 |
1 |
$103.62 |
|
| 23505 |
1 |
$103.62 |
|
| 23515 |
3 |
$510.00 |
|
| 23520 |
1 |
$103.62 |
|
| 23525 |
1 |
$103.62 |
|
| 23530 |
3 |
$510.00 |
|
| 23532 |
4 |
$630.00 |
|
| 23540 |
1 |
$103.62 |
|
| 23545 |
1 |
$103.62 |
|
| 23550 |
3 |
$510.00 |
|
| 23552 |
4 |
$630.00 |
|
| 23570 |
1 |
$103.62 |
|
| 23575 |
1 |
$103.62 |
|
| 23585 |
3 |
$510.00 |
|
| 23605 |
2 |
$103.62 |
|
| 23615 |
4 |
$630.00 |
|
| 23616 |
4 |
$630.00 |
|
| 23625 |
2 |
$103.62 |
|
| 23630 |
5 |
$717.00 |
|
| 23650 |
1 |
$103.62 |
|
| 23655 |
1 |
$333.00 |
|
| 23660 |
3 |
$510.00 |
|
| 23665 |
2 |
$103.62 |
|
| 23670 |
3 |
$510.00 |
|
| 23675 |
2 |
$103.62 |
|
| 23680 |
3 |
$510.00 |
|
| 23700 |
1 |
$333.00 |
|
| 23800 |
4 |
$630.00 |
|
| ASC
LIST EFFECTIVE JANUARY 1, 2007 |
| CPT |
Group |
Rate |
|
| 23802 |
7 |
$995.00 |
|
| 23921 |
3 |
$323.28 |
|
| 23930 |
1 |
$333.00 |
|
| 23931 |
2 |
$446.00 |
|
| 23935 |
2 |
$446.00 |
|
| 24000 |
4 |
$630.00 |
|
| 24006 |
4 |
$630.00 |
|
| 24066 |
2 |
$446.00 |
|
| 24075 |
2 |
$446.00 |
|
| 24076 |
2 |
$446.00 |
|
| 24077 |
3 |
$510.00 |
|
| 24100 |
1 |
$333.00 |
|
| 24101 |
4 |
$630.00 |
|
| 24102 |
4 |
$630.00 |
|
| 24105 |
3 |
$510.00 |
|
| 24110 |
2 |
$446.00 |
|
| 24115 |
3 |
$510.00 |
|
| 24116 |
3 |
$510.00 |
|
| 24120 |
3 |
$510.00 |
|
| 24125 |
3 |
$510.00 |
|
| 24126 |
3 |
$510.00 |
|
| 24130 |
3 |
$510.00 |
|
| 24134 |
2 |
$446.00 |
|
| 24136 |
2 |
$446.00 |
|
| 24138 |
2 |
$446.00 |
|
| 24140 |
3 |
$510.00 |
|
| 24145 |
3 |
$510.00 |
|
| 24147 |
2 |
$446.00 |
|
| 24155 |
3 |
$510.00 |
|
| 24160 |
2 |
$446.00 |
|
| 24164 |
3 |
$510.00 |
|
| 24201 |
2 |
$446.00 |
|
| 24301 |
4 |
$630.00 |
|
| 24305 |
4 |
$630.00 |
|
| 24310 |
3 |
$510.00 |
|
| 24320 |
3 |
$510.00 |
|
| 24330 |
3 |
$510.00 |
|
| 24331 |
3 |
$510.00 |
|
| 24340 |
3 |
$510.00 |
|
| 24341 |
3 |
$510.00 |
|
| 24342 |
3 |
$510.00 |
|
| 24345 |
2 |
$446.00 |
|
| 24350 |
3 |
$510.00 |
|
| 24351 |
3 |
$510.00 |
|
| 24352 |
3 |
$510.00 |
|
| 24354 |
3 |
$510.00 |
|
| 24356 |
3 |
$510.00 |
|
| 24360 |
5 |
$717.00 |
|
| 24361 |
5 |
$717.00 |
|
| 24362 |
5 |
$717.00 |
|
| 24363 |
7 |
$995.00 |
|
| 24365 |
5 |
$717.00 |
|
| 24366 |
5 |
$717.00 |
|
| 24400 |
4 |
$630.00 |
|
| CPT |
Group |
Rate |
|
| 24410 |
4 |
$630.00 |
|
| 24420 |
3 |
$510.00 |
|
| 24430 |
3 |
$510.00 |
|
| 24435 |
4 |
$630.00 |
|
| 24470 |
3 |
$510.00 |
|
| 24495 |
2 |
$446.00 |
|
| 24498 |
3 |
$510.00 |
|
| 24500 |
1 |
$103.62 |
|
| 24505 |
1 |
$103.62 |
|
| 24515 |
4 |
$630.00 |
|
| 24516 |
4 |
$630.00 |
|
| 24530 |
1 |
$103.62 |
|
| 24535 |
1 |
$103.62 |
|
| 24538 |
2 |
$446.00 |
|
| 24545 |
4 |
$630.00 |
|
| 24546 |
5 |
$717.00 |
|
| 24560 |
1 |
$103.62 |
|
| 24565 |
2 |
$103.62 |
|
| 24566 |
2 |
$446.00 |
|
| 24575 |
3 |
$510.00 |
|
| 24576 |
1 |
$103.62 |
|
| 24577 |
1 |
$103.62 |
|
| 24579 |
3 |
$510.00 |
|
| 24582 |
2 |
$446.00 |
|
| 24586 |
4 |
$630.00 |
|
| 24587 |
5 |
$717.00 |
|
| 24600 |
1 |
$103.62 |
|
| 24605 |
2 |
$446.00 |
|
| 24615 |
3 |
$510.00 |
|
| 24620 |
2 |
$103.62 |
|
| 24635 |
3 |
$510.00 |
|
| 24655 |
1 |
$103.62 |
|
| 24665 |
4 |
$630.00 |
|
| 24666 |
4 |
$630.00 |
|
| 24670 |
1 |
$103.62 |
|
| 24675 |
1 |
$103.62 |
|
| 24685 |
3 |
$510.00 |
|
| 24800 |
4 |
$630.00 |
|
| 24802 |
5 |
$717.00 |
|
| 24925 |
3 |
$510.00 |
|
| 25000 |
3 |
$510.00 |
|
| 25020 |
3 |
$510.00 |
|
| 25023 |
3 |
$510.00 |
|
| 25024 |
3 |
$510.00 |
|
| 25025 |
3 |
$510.00 |
|
| 25028 |
1 |
$333.00 |
|
| 25031 |
2 |
$446.00 |
|
| 25035 |
2 |
$446.00 |
|
| 25040 |
5 |
$717.00 |
|
| 25066 |
2 |
$446.00 |
|
| 25075 |
2 |
$446.00 |
|
| 25076 |
3 |
$510.00 |
|
| 25077 |
3 |
$510.00 |
|
| 25085 |
3 |
$510.00 |
|
| CPT |
Group |
Rate |
|
| 25100 |
2 |
$446.00 |
|
| 25101 |
3 |
$510.00 |
|
| 25105 |
4 |
$630.00 |
|
| 25107 |
3 |
$510.00 |
|
| 25110 |
3 |
$510.00 |
|
| 25111 |
3 |
$510.00 |
|
| 25112 |
4 |
$630.00 |
|
| 25115 |
4 |
$630.00 |
|
| 25116 |
4 |
$630.00 |
|
| 25118 |
2 |
$446.00 |
|
| 25119 |
3 |
$510.00 |
|
| 25120 |
3 |
$510.00 |
|
| 25125 |
3 |
$510.00 |
|
| 25126 |
3 |
$510.00 |
|
| 25130 |
3 |
$510.00 |
|
| 25135 |
3 |
$510.00 |
|
| 25136 |
3 |
$510.00 |
|
| 25145 |
2 |
$446.00 |
|
| 25150 |
2 |
$446.00 |
|
| 25151 |
2 |
$446.00 |
|
| 25210 |
3 |
$510.00 |
|
| 25215 |
4 |
$630.00 |
|
| 25230 |
4 |
$630.00 |
|
| 25240 |
4 |
$630.00 |
|
| 25248 |
2 |
$446.00 |
|
| 25250 |
1 |
$333.00 |
|
| 25251 |
1 |
$333.00 |
|
| 25260 |
4 |
$630.00 |
|
| 25263 |
2 |
$446.00 |
|
| 25265 |
3 |
$510.00 |
|
| 25270 |
4 |
$630.00 |
|
| 25272 |
3 |
$510.00 |
|
| 25274 |
4 |
$630.00 |
|
| 25275 |
4 |
$630.00 |
|
| 25280 |
4 |
$630.00 |
|
| 25290 |
3 |
$510.00 |
|
| 25295 |
3 |
$510.00 |
|
| 25300 |
3 |
$510.00 |
|
| 25301 |
3 |
$510.00 |
|
| 25310 |
3 |
$510.00 |
|
| 25312 |
4 |
$630.00 |
|
| 25315 |
3 |
$510.00 |
|
| 25316 |
3 |
$510.00 |
|
| 25320 |
3 |
$510.00 |
|
| 25332 |
5 |
$717.00 |
|
| 25335 |
3 |
$510.00 |
|
| 25337 |
5 |
$717.00 |
|
| 25350 |
3 |
$510.00 |
|
| 25355 |
3 |
$510.00 |
|
| 25360 |
3 |
$510.00 |
|
| 25365 |
3 |
$510.00 |
|
| 25370 |
3 |
$510.00 |
|
| 25375 |
4 |
$630.00 |
|
| 25390 |
3 |
$510.00 |
|
| CPT |
Group |
Rate |
|
| 25391 |
4 |
$630.00 |
|
| 25392 |
3 |
$510.00 |
|
| 25393 |
4 |
$630.00 |
|
| 25400 |
3 |
$510.00 |
|
| 25405 |
4 |
$630.00 |
|
| 25415 |
3 |
$510.00 |
|
| 25420 |
4 |
$630.00 |
|
| 25425 |
3 |
$510.00 |
|
| 25426 |
4 |
$630.00 |
|
| 25440 |
4 |
$630.00 |
|
| 25441 |
5 |
$717.00 |
|
| 25442 |
5 |
$717.00 |
|
| 25443 |
5 |
$717.00 |
|
| 25444 |
5 |
$717.00 |
|
| 25445 |
5 |
$717.00 |
|
| 25446 |
7 |
$995.00 |
|
| 25447 |
5 |
$717.00 |
|
| 25449 |
5 |
$717.00 |
|
| 25450 |
3 |
$510.00 |
|
| 25455 |
3 |
$510.00 |
|
| 25490 |
3 |
$510.00 |
|
| 25491 |
3 |
$510.00 |
|
| 25492 |
3 |
$510.00 |
|
| 25505 |
1 |
$103.62 |
|
| 25515 |
3 |
$510.00 |
|
| 25520 |
1 |
$103.62 |
|
| 25525 |
4 |
$630.00 |
|
| 25526 |
5 |
$717.00 |
|
| 25535 |
1 |
$103.62 |
|
| 25545 |
3 |
$510.00 |
|
| 25565 |
2 |
$103.62 |
|
| 25574 |
3 |
$510.00 |
|
| 25575 |
3 |
$510.00 |
|
| 25605 |
3 |
$103.62 |
|
| 25606 |
3 |
$510.00 |
|
| 25607 |
5 |
$717.00 |
|
| 25608 |
5 |
$717.00 |
|
| 25609 |
5 |
$717.00 |
|
| 25624 |
2 |
$103.62 |
|
| 25628 |
3 |
$510.00 |
|
| 25635 |
1 |
$103.62 |
|
| 25645 |
3 |
$510.00 |
|
| 25660 |
1 |
$103.62 |
|
| 25670 |
3 |
$510.00 |
|
| 25671 |
1 |
$333.00 |
|
| 25675 |
1 |
$103.62 |
|
| 25676 |
2 |
$446.00 |
|
| 25680 |
2 |
$103.62 |
|
| 25685 |
3 |
$510.00 |
|
| 25690 |
1 |
$103.62 |
|
| 25695 |
2 |
$446.00 |
|
| 25800 |
4 |
$630.00 |
|
| 25805 |
5 |
$717.00 |
|
| 25810 |
5 |
$717.00 |
|
| ASC
LIST EFFECTIVE JANUARY 1, 2007 |
| CPT |
Group |
Rate |
|
| 25820 |
4 |
$630.00 |
|
| 25825 |
5 |
$717.00 |
|
| 25830 |
5 |
$717.00 |
|
| 25907 |
3 |
$510.00 |
|
| 25922 |
3 |
$510.00 |
|
| 25929 |
3 |
$510.00 |
|
| 26011 |
1 |
$333.00 |
|
| 26020 |
2 |
$446.00 |
|
| 26025 |
1 |
$333.00 |
|
| 26030 |
2 |
$446.00 |
|
| 26034 |
2 |
$446.00 |
|
| 26040 |
4 |
$630.00 |
|
| 26045 |
3 |
$510.00 |
|
| 26055 |
2 |
$446.00 |
|
| 26060 |
2 |
$446.00 |
|
| 26070 |
2 |
$446.00 |
|
| 26075 |
4 |
$630.00 |
|
| 26080 |
4 |
$630.00 |
|
| 26100 |
2 |
$446.00 |
|
| 26105 |
1 |
$333.00 |
|
| 26110 |
1 |
$333.00 |
|
| 26115 |
2 |
$446.00 |
|
| 26116 |
2 |
$446.00 |
|
| 26117 |
3 |
$510.00 |
|
| 26121 |
4 |
$630.00 |
|
| 26123 |
4 |
$630.00 |
|
| 26125 |
4 |
$630.00 |
|
| 26130 |
3 |
$510.00 |
|
| 26135 |
4 |
$630.00 |
|
| 26140 |
2 |
$446.00 |
|
| 26145 |
3 |
$510.00 |
|
| 26160 |
3 |
$510.00 |
|
| 26170 |
3 |
$510.00 |
|
| 26180 |
3 |
$510.00 |
|
| 26185 |
4 |
$630.00 |
|
| 26200 |
2 |
$446.00 |
|
| 26205 |
3 |
$510.00 |
|
| 26210 |
2 |
$446.00 |
|
| 26215 |
3 |
$510.00 |
|
| 26230 |
7 |
$992.95 |
|
| 26235 |
3 |
$510.00 |
|
| 26236 |
3 |
$510.00 |
|
| 26250 |
3 |
$510.00 |
|
| 26255 |
3 |
$510.00 |
|
| 26260 |
3 |
$510.00 |
|
| 26261 |
3 |
$510.00 |
|
| 26262 |
2 |
$446.00 |
|
| 26320 |
2 |
$446.00 |
|
| 26350 |
1 |
$333.00 |
|
| 26352 |
4 |
$630.00 |
|
| 26356 |
4 |
$630.00 |
|
| 26357 |
4 |
$630.00 |
|
| 26358 |
4 |
$630.00 |
|
| 26370 |
4 |
$630.00 |
|
| CPT |
Group |
Rate |
|
| 26372 |
4 |
$630.00 |
|
| 26373 |
3 |
$510.00 |
|
| 26390 |
4 |
$630.00 |
|
| 26392 |
3 |
$510.00 |
|
| 26410 |
3 |
$510.00 |
|
| 26412 |
3 |
$510.00 |
|
| 26415 |
4 |
$630.00 |
|
| 26416 |
3 |
$510.00 |
|
| 26418 |
4 |
$630.00 |
|
| 26420 |
4 |
$630.00 |
|
| 26426 |
3 |
$510.00 |
|
| 26428 |
3 |
$510.00 |
|
| 26432 |
3 |
$510.00 |
|
| 26433 |
3 |
$510.00 |
|
| 26434 |
3 |
$510.00 |
|
| 26437 |
3 |
$510.00 |
|
| 26440 |
3 |
$510.00 |
|
| 26442 |
3 |
$510.00 |
|
| 26445 |
3 |
$510.00 |
|
| 26449 |
3 |
$510.00 |
|
| 26450 |
3 |
$510.00 |
|
| 26455 |
3 |
$510.00 |
|
| 26460 |
3 |
$510.00 |
|
| 26471 |
2 |
$446.00 |
|
| 26474 |
2 |
$446.00 |
|
| 26476 |
1 |
$333.00 |
|
| 26477 |
1 |
$333.00 |
|
| 26478 |
1 |
$333.00 |
|
| 26479 |
1 |
$333.00 |
|
| 26480 |
3 |
$510.00 |
|
| 26483 |
3 |
$510.00 |
|
| 26485 |
2 |
$446.00 |
|
| 26489 |
3 |
$510.00 |
|
| 26490 |
3 |
$510.00 |
|
| 26492 |
3 |
$510.00 |
|
| 26494 |
3 |
$510.00 |
|
| 26496 |
3 |
$510.00 |
|
| 26497 |
3 |
$510.00 |
|
| 26498 |
4 |
$630.00 |
|
| 26499 |
3 |
$510.00 |
|
| 26500 |
4 |
$630.00 |
|
| 26502 |
4 |
$630.00 |
|
| 26508 |
3 |
$510.00 |
|
| 26510 |
3 |
$510.00 |
|
| 26516 |
1 |
$333.00 |
|
| 26517 |
3 |
$510.00 |
|
| 26518 |
3 |
$510.00 |
|
| 26520 |
3 |
$510.00 |
|
| 26525 |
3 |
$510.00 |
|
| 26530 |
3 |
$510.00 |
|
| 26531 |
7 |
$995.00 |
|
| 26535 |
5 |
$717.00 |
|
| 26536 |
5 |
$717.00 |
|
| 26540 |
4 |
$630.00 |
|
| CPT |
Group |
Rate |
|
| 26541 |
7 |
$995.00 |
|
| 26542 |
4 |
$630.00 |
|
| 26545 |
4 |
$630.00 |
|
| 26546 |
4 |
$630.00 |
|
| 26548 |
4 |
$630.00 |
|
| 26550 |
2 |
$446.00 |
|
| 26555 |
3 |
$510.00 |
|
| 26560 |
2 |
$446.00 |
|
| 26561 |
3 |
$510.00 |
|
| 26562 |
4 |
$630.00 |
|
| 26565 |
5 |
$717.00 |
|
| 26567 |
5 |
$717.00 |
|
| 26568 |
3 |
$510.00 |
|
| 26580 |
5 |
$717.00 |
|
| 26587 |
5 |
$717.00 |
|
| 26590 |
5 |
$717.00 |
|
| 26591 |
3 |
$510.00 |
|
| 26593 |
3 |
$510.00 |
|
| 26596 |
2 |
$446.00 |
|
| 26605 |
2 |
$103.62 |
|
| 26607 |
2 |
$103.62 |
|
| 26608 |
4 |
$630.00 |
|
| 26615 |
4 |
$630.00 |
|
| 26645 |
1 |
$103.62 |
|
| 26650 |
2 |
$446.00 |
|
| 26665 |
4 |
$630.00 |
|
| 26675 |
2 |
$103.62 |
|
| 26676 |
2 |
$446.00 |
|
| 26685 |
3 |
$510.00 |
|
| 26686 |
3 |
$510.00 |
|
| 26705 |
2 |
$103.62 |
|
| 26706 |
2 |
$103.62 |
|
| 26715 |
4 |
$630.00 |
|
| 26727 |
7 |
$995.00 |
|
| 26735 |
4 |
$630.00 |
|
| 26742 |
2 |
$103.62 |
|
| 26746 |
5 |
$717.00 |
|
| 26756 |
2 |
$446.00 |
|
| 26765 |
4 |
$630.00 |
|
| 26776 |
2 |
$446.00 |
|
| 26785 |
2 |
$446.00 |
|
| 26820 |
5 |
$717.00 |
|
| 26841 |
4 |
$630.00 |
|
| 26842 |
4 |
$630.00 |
|
| 26843 |
3 |
$510.00 |
|
| 26844 |
3 |
$510.00 |
|
| 26850 |
4 |
$630.00 |
|
| 26852 |
4 |
$630.00 |
|
| 26860 |
3 |
$510.00 |
|
| 26861 |
2 |
$446.00 |
|
| 26862 |
4 |
$630.00 |
|
| 26863 |
3 |
$510.00 |
|
| 26910 |
3 |
$510.00 |
|
| 26951 |
2 |
$446.00 |
|
| CPT |
Group |
Rate |
|
| 26952 |
4 |
$630.00 |
|
| 26990 |
1 |
$333.00 |
|
| 26991 |
1 |
$333.00 |
|
| 27000 |
2 |
$446.00 |
|
| 27001 |
3 |
$510.00 |
|
| 27003 |
3 |
$510.00 |
|
| 27033 |
3 |
$510.00 |
|
| 27035 |
4 |
$630.00 |
|
| 27040 |
1 |
$333.00 |
|
| 27041 |
2 |
$418.49 |
|
| 27047 |
2 |
$446.00 |
|
| 27048 |
3 |
$510.00 |
|
| 27049 |
3 |
$510.00 |
|
| 27050 |
3 |
$510.00 |
|
| 27052 |
3 |
$510.00 |
|
| 27060 |
5 |
$717.00 |
|
| 27062 |
5 |
$717.00 |
|
| 27065 |
5 |
$717.00 |
|
| 27066 |
5 |
$717.00 |
|
| 27067 |
5 |
$717.00 |
|
| 27080 |
2 |
$446.00 |
|
| 27086 |
1 |
$333.00 |
|
| 27087 |
3 |
$510.00 |
|
| 27097 |
3 |
$510.00 |
|
| 27098 |
3 |
$510.00 |
|
| 27100 |
4 |
$630.00 |
|
| 27105 |
4 |
$630.00 |
|
| 27110 |
4 |
$630.00 |
|
| 27111 |
4 |
$630.00 |
|
| 27193 |
1 |
$103.62 |
|
| 27194 |
2 |
$446.00 |
|
| 27202 |
2 |
$446.00 |
|
| 27230 |
1 |
$103.62 |
|
| 27238 |
1 |
$103.62 |
|
| 27246 |
1 |
$103.62 |
|
| 27250 |
1 |
$103.62 |
|
| 27252 |
2 |
$446.00 |
|
| 27257 |
3 |
$510.00 |
|
| 27265 |
1 |
$103.62 |
|
| 27266 |
2 |
$446.00 |
|
| 27275 |
2 |
$446.00 |
|
| 27301 |
3 |
$510.00 |
|
| 27305 |
2 |
$446.00 |
|
| 27306 |
3 |
$510.00 |
|
| 27307 |
3 |
$510.00 |
|
| 27310 |
4 |
$630.00 |
|
| 27323 |
1 |
$333.00 |
|
| 27324 |
1 |
$333.00 |
|
| 27325 |
2 |
$446.00 |
|
| 27326 |
2 |
$446.00 |
|
| 27327 |
2 |
$446.00 |
|
| 27328 |
3 |
$510.00 |
|
| 27329 |
4 |
$630.00 |
|
| 27330 |
4 |
$630.00 |
|
| ASC
LIST EFFECTIVE JANUARY 1, 2007 |
| CPT |
Group |
Rate |
|
| 27331 |
4 |
$630.00 |
|
| 27332 |
4 |
$630.00 |
|
| 27333 |
4 |
$630.00 |
|
| 27334 |
4 |
$630.00 |
|
| 27335 |
4 |
$630.00 |
|
| 27340 |
3 |
$510.00 |
|
| 27345 |
4 |
$630.00 |
|
| 27347 |
4 |
$630.00 |
|
| 27350 |
4 |
$630.00 |
|
| 27355 |
3 |
$510.00 |
|
| 27356 |
4 |
$630.00 |
|
| 27357 |
5 |
$717.00 |
|
| 27358 |
5 |
$717.00 |
|
| 27360 |
5 |
$717.00 |
|
| 27372 |
7 |
$995.00 |
|
| 27380 |
1 |
$333.00 |
|
| 27381 |
3 |
$510.00 |
|
| 27385 |
3 |
$510.00 |
|
| 27386 |
3 |
$510.00 |
|
| 27390 |
1 |
$333.00 |
|
| 27391 |
2 |
$446.00 |
|
| 27392 |
3 |
$510.00 |
|
| 27393 |
2 |
$446.00 |
|
| 27394 |
3 |
$510.00 |
|
| 27395 |
3 |
$510.00 |
|
| 27396 |
3 |
$510.00 |
|
| 27397 |
3 |
$510.00 |
|
| 27400 |
3 |
$510.00 |
|
| 27403 |
4 |
$630.00 |
|
| 27405 |
4 |
$630.00 |
|
| 27407 |
4 |
$630.00 |
|
| 27409 |
4 |
$630.00 |
|
| 27418 |
3 |
$510.00 |
|
| 27420 |
3 |
$510.00 |
|
| 27422 |
7 |
$995.00 |
|
| 27424 |
3 |
$510.00 |
|
| 27425 |
7 |
$995.00 |
|
| 27427 |
3 |
$510.00 |
|
| 27428 |
4 |
$630.00 |
|
| 27429 |
4 |
$630.00 |
|
| 27430 |
4 |
$630.00 |
|
| 27435 |
4 |
$630.00 |
|
| 27437 |
4 |
$630.00 |
|
| 27438 |
5 |
$717.00 |
|
| 27441 |
5 |
$717.00 |
|
| 27442 |
5 |
$717.00 |
|
| 27443 |
5 |
$717.00 |
|
| 27496 |
5 |
$717.00 |
|
| 27497 |
3 |
$510.00 |
|
| 27498 |
3 |
$510.00 |
|
| 27499 |
3 |
$510.00 |
|
| 27500 |
1 |
$103.62 |
|
| 27501 |
2 |
$103.62 |
|
| 27502 |
2 |
$103.62 |
|
| CPT |
Group |
Rate |
|
| 27503 |
3 |
$103.62 |
|
| 27508 |
1 |
$103.62 |
|
| 27509 |
3 |
$510.00 |
|
| 27510 |
1 |
$103.62 |
|
| 27516 |
1 |
$103.62 |
|
| 27517 |
1 |
$103.62 |
|
| 27520 |
1 |
$103.62 |
|
| 27530 |
1 |
$103.62 |
|
| 27532 |
1 |
$103.62 |
|
| 27538 |
1 |
$103.62 |
|
| 27550 |
1 |
$103.62 |
|
| 27552 |
1 |
$333.00 |
|
| 27560 |
1 |
$103.62 |
|
| 27562 |
1 |
$333.00 |
|
| 27566 |
2 |
$446.00 |
|
| 27570 |
1 |
$333.00 |
|
| 27594 |
3 |
$510.00 |
|
| 27600 |
3 |
$510.00 |
|
| 27601 |
3 |
$510.00 |
|
| 27602 |
3 |
$510.00 |
|
| 27603 |
2 |
$446.00 |
|
| 27604 |
2 |
$446.00 |
|
| 27605 |
1 |
$333.00 |
|
| 27606 |
1 |
$333.00 |
|
| 27607 |
2 |
$446.00 |
|
| 27610 |
2 |
$446.00 |
|
| 27612 |
3 |
$510.00 |
|
| 27614 |
2 |
$446.00 |
|
| 27615 |
3 |
$510.00 |
|
| 27618 |
2 |
$446.00 |
|
| 27619 |
3 |
$510.00 |
|
| 27620 |
4 |
$630.00 |
|
| 27625 |
4 |
$630.00 |
|
| 27626 |
4 |
$630.00 |
|
| 27630 |
3 |
$510.00 |
|
| 27635 |
3 |
$510.00 |
|
| 27637 |
3 |
$510.00 |
|
| 27638 |
3 |
$510.00 |
|
| 27640 |
2 |
$446.00 |
|
| 27641 |
2 |
$446.00 |
|
| 27647 |
3 |
$510.00 |
|
| 27650 |
3 |
$510.00 |
|
| 27652 |
3 |
$510.00 |
|
| 27654 |
3 |
$510.00 |
|
| 27656 |
2 |
$446.00 |
|
| 27658 |
1 |
$333.00 |
|
| 27659 |
2 |
$446.00 |
|
| 27664 |
2 |
$446.00 |
|
| 27665 |
2 |
$446.00 |
|
| 27675 |
2 |
$446.00 |
|
| 27676 |
3 |
$510.00 |
|
| 27680 |
3 |
$510.00 |
|
| 27681 |
2 |
$446.00 |
|
| 27685 |
3 |
$510.00 |
|
| CPT |
Group |
Rate |
|
| 27686 |
3 |
$510.00 |
|
| 27687 |
3 |
$510.00 |
|
| 27690 |
4 |
$630.00 |
|
| 27691 |
4 |
$630.00 |
|
| 27692 |
3 |
$510.00 |
|
| 27695 |
2 |
$446.00 |
|
| 27696 |
2 |
$446.00 |
|
| 27698 |
2 |
$446.00 |
|
| 27700 |
5 |
$717.00 |
|
| 27704 |
2 |
$446.00 |
|
| 27705 |
2 |
$446.00 |
|
| 27707 |
2 |
$446.00 |
|
| 27709 |
2 |
$446.00 |
|
| 27730 |
2 |
$446.00 |
|
| 27732 |
2 |
$446.00 |
|
| 27734 |
2 |
$446.00 |
|
| 27740 |
2 |
$446.00 |
|
| 27742 |
2 |
$446.00 |
|
| 27745 |
3 |
$510.00 |
|
| 27750 |
1 |
$103.62 |
|
| 27752 |
1 |
$103.62 |
|
| 27756 |
3 |
$510.00 |
|
| 27758 |
4 |
$630.00 |
|
| 27759 |
4 |
$630.00 |
|
| 27760 |
1 |
$103.62 |
|
| 27762 |
1 |
$103.62 |
|
| 27766 |
3 |
$510.00 |
|
| 27780 |
1 |
$103.62 |
|
| 27781 |
1 |
$103.62 |
|
| 27784 |
3 |
$510.00 |
|
| 27786 |
1 |
$103.62 |
|
| 27788 |
1 |
$103.62 |
|
| 27792 |
3 |
$510.00 |
|
| 27808 |
1 |
$103.62 |
|
| 27810 |
1 |
$103.62 |
|
| 27814 |
3 |
$510.00 |
|
| 27816 |
1 |
$103.62 |
|
| 27818 |
1 |
$103.62 |
|
| 27822 |
3 |
$510.00 |
|
| 27823 |
3 |
$510.00 |
|
| 27824 |
1 |
$103.62 |
|
| 27825 |
2 |
$103.62 |
|
| 27826 |
3 |
$510.00 |
|
| 27827 |
3 |
$510.00 |
|
| 27828 |
4 |
$630.00 |
|
| 27829 |
2 |
$446.00 |
|
| 27830 |
1 |
$103.62 |
|
| 27831 |
1 |
$103.62 |
|
| 27832 |
2 |
$446.00 |
|
| 27840 |
1 |
$103.62 |
|
| 27842 |
1 |
$333.00 |
|
| 27846 |
3 |
$510.00 |
|
| 27848 |
3 |
$510.00 |
|
| 27860 |
1 |
$333.00 |
|
| CPT |
Group |
Rate |
|
| 27870 |
4 |
$630.00 |
|
| 27871 |
4 |
$630.00 |
|
| 27884 |
3 |
$510.00 |
|
| 27889 |
3 |
$510.00 |
|
| 27892 |
3 |
$510.00 |
|
| 27893 |
3 |
$510.00 |
|
| 27894 |
3 |
$510.00 |
|
| 28002 |
3 |
$510.00 |
|
| 28003 |
3 |
$510.00 |
|
| 28005 |
3 |
$510.00 |
|
| 28008 |
3 |
$510.00 |
|
| 28011 |
3 |
$510.00 |
|
| 28020 |
2 |
$446.00 |
|
| 28022 |
2 |
$446.00 |
|
| 28024 |
2 |
$446.00 |
|
| 28035 |
4 |
$630.00 |
|
| 28043 |
2 |
$446.00 |
|
| 28045 |
3 |
$510.00 |
|
| 28046 |
3 |
$510.00 |
|
| 28050 |
2 |
$446.00 |
|
| 28052 |
2 |
$446.00 |
|
| 28054 |
2 |
$446.00 |
|
| 28055 |
4 |
$630.00 |
|
| 28060 |
2 |
$446.00 |
|
| 28062 |
3 |
$510.00 |
|
| 28070 |
3 |
$510.00 |
|
| 28072 |
3 |
$510.00 |
|
| 28080 |
3 |
$510.00 |
|
| 28086 |
2 |
$446.00 |
|
| 28088 |
2 |
$446.00 |
|
| 28090 |
3 |
$510.00 |
|
| 28092 |
3 |
$510.00 |
|
| 28100 |
2 |
$446.00 |
|
| 28102 |
3 |
$510.00 |
|
| 28103 |
3 |
$510.00 |
|
| 28104 |
2 |
$446.00 |
|
| 28106 |
3 |
$510.00 |
|
| 28107 |
3 |
$510.00 |
|
| 28108 |
2 |
$446.00 |
|
| 28110 |
3 |
$510.00 |
|
| 28111 |
3 |
$510.00 |
|
| 28112 |
3 |
$510.00 |
|
| 28113 |
3 |
$510.00 |
|
| 28114 |
3 |
$510.00 |
|
| 28116 |
3 |
$510.00 |
|
| 28118 |
4 |
$630.00 |
|
| 28119 |
4 |
$630.00 |
|
| 28120 |
7 |
$995.00 |
|
| 28122 |
3 |
$510.00 |
|
| 28126 |
3 |
$510.00 |
|
| 28130 |
3 |
$510.00 |
|
| 28140 |
3 |
$510.00 |
|
| 28150 |
3 |
$510.00 |
|
| 28153 |
3 |
$510.00 |
|
| ASC
LIST EFFECTIVE JANUARY 1, 2007 |
| CPT |
Group |
Rate |
|
| 28160 |
3 |
$510.00 |
|
| 28171 |
3 |
$510.00 |
|
| 28173 |
3 |
$510.00 |
|
| 28175 |
3 |
$510.00 |
|
| 28192 |
2 |
$446.00 |
|
| 28193 |
4 |
$418.49 |
|
| 28200 |
3 |
$510.00 |
|
| 28202 |
3 |
$510.00 |
|
| 28208 |
3 |
$510.00 |
|
| 28210 |
3 |
$510.00 |
|
| 28222 |
1 |
$333.00 |
|
| 28225 |
1 |
$333.00 |
|
| 28226 |
1 |
$333.00 |
|
| 28234 |
2 |
$446.00 |
|
| 28238 |
3 |
$510.00 |
|
| 28240 |
2 |
$446.00 |
|
| 28250 |
3 |
$510.00 |
|
| 28260 |
3 |
$510.00 |
|
| 28261 |
3 |
$510.00 |
|
| 28262 |
4 |
$630.00 |
|
| 28264 |
1 |
$333.00 |
|
| 28270 |
3 |
$510.00 |
|
| 28280 |
2 |
$446.00 |
|
| 28285 |
3 |
$510.00 |
|
| 28286 |
4 |
$630.00 |
|
| 28288 |
3 |
$510.00 |
|
| 28289 |
3 |
$510.00 |
|
| 28290 |
2 |
$446.00 |
|
| 28292 |
2 |
$446.00 |
|
| 28293 |
3 |
$510.00 |
|
| 28294 |
3 |
$510.00 |
|
| 28296 |
3 |
$510.00 |
|
| 28297 |
3 |
$510.00 |
|
| 28298 |
3 |
$510.00 |
|
| 28299 |
5 |
$717.00 |
|
| 28300 |
2 |
$446.00 |
|
| 28302 |
2 |
$446.00 |
|
| 28304 |
2 |
$446.00 |
|
| 28305 |
3 |
$510.00 |
|
| 28306 |
4 |
$630.00 |
|
| 28307 |
4 |
$630.00 |
|
| 28308 |
2 |
$446.00 |
|
| 28309 |
4 |
$630.00 |
|
| 28310 |
3 |
$510.00 |
|
| 28312 |
3 |
$510.00 |
|
| 28313 |
2 |
$446.00 |
|
| 28315 |
4 |
$630.00 |
|
| 28320 |
4 |
$630.00 |
|
| 28322 |
4 |
$630.00 |
|
| 28340 |
4 |
$630.00 |
|
| 28341 |
4 |
$630.00 |
|
| 28344 |
4 |
$630.00 |
|
| 28345 |
4 |
$630.00 |
|
| 28400 |
1 |
$103.62 |
|
| CPT |
Group |
Rate |
|
| 28405 |
2 |
$103.62 |
|
| 28406 |
2 |
$446.00 |
|
| 28415 |
3 |
$510.00 |
|
| 28420 |
4 |
$630.00 |
|
| 28435 |
2 |
$103.62 |
|
| 28436 |
2 |
$446.00 |
|
| 28445 |
3 |
$510.00 |
|
| 28456 |
2 |
$446.00 |
|
| 28465 |
3 |
$510.00 |
|
| 28476 |
2 |
$446.00 |
|
| 28485 |
4 |
$630.00 |
|
| 28496 |
2 |
$446.00 |
|
| 28505 |
3 |
$510.00 |
|
| 28525 |
3 |
$510.00 |
|
| 28531 |
3 |
$510.00 |
|
| 28545 |
1 |
$333.00 |
|
| 28546 |
2 |
$446.00 |
|
| 28555 |
2 |
$446.00 |
|
| 28575 |
1 |
$103.62 |
|
| 28576 |
3 |
$510.00 |
|
| 28585 |
3 |
$510.00 |
|
| 28605 |
1 |
$103.62 |
|
| 28606 |
2 |
$446.00 |
|
| 28615 |
3 |
$510.00 |
|
| 28635 |
1 |
$333.00 |
|
| 28636 |
3 |
$510.00 |
|
| 28645 |
3 |
$510.00 |
|
| 28665 |
1 |
$333.00 |
|
| 28666 |
3 |
$510.00 |
|
| 28675 |
3 |
$510.00 |
|
| 28705 |
4 |
$630.00 |
|
| 28715 |
4 |
$630.00 |
|
| 28725 |
4 |
$630.00 |
|
| 28730 |
4 |
$630.00 |
|
| 28735 |
4 |
$630.00 |
|
| 28737 |
5 |
$717.00 |
|
| 28740 |
4 |
$630.00 |
|
| 28750 |
4 |
$630.00 |
|
| 28755 |
4 |
$630.00 |
|
| 28760 |
4 |
$630.00 |
|
| 28810 |
2 |
$446.00 |
|
| 28820 |
2 |
$446.00 |
|
| 28825 |
2 |
$446.00 |
|
| 29800 |
3 |
$510.00 |
|
| 29804 |
3 |
$510.00 |
|
| 29805 |
3 |
$510.00 |
|
| 29806 |
3 |
$510.00 |
|
| 29807 |
3 |
$510.00 |
|
| 29819 |
3 |
$510.00 |
|
| 29820 |
3 |
$510.00 |
|
| 29821 |
3 |
$510.00 |
|
| 29822 |
3 |
$510.00 |
|
| 29823 |
3 |
$510.00 |
|
| 29824 |
5 |
$717.00 |
|
| CPT |
Group |
Rate |
|
| 29825 |
3 |
$510.00 |
|
| 29826 |
3 |
$510.00 |
|
| 29827 |
5 |
$717.00 |
|
| 29830 |
3 |
$510.00 |
|
| 29834 |
3 |
$510.00 |
|
| 29835 |
3 |
$510.00 |
|
| 29836 |
3 |
$510.00 |
|
| 29837 |
3 |
$510.00 |
|
| 29838 |
3 |
$510.00 |
|
| 29840 |
3 |
$510.00 |
|
| 29843 |
3 |
$510.00 |
|
| 29844 |
3 |
$510.00 |
|
| 29845 |
3 |
$510.00 |
|
| 29846 |
3 |
$510.00 |
|
| 29847 |
3 |
$510.00 |
|
| 29848 |
9 |
$1,339.00 |
|
| 29850 |
4 |
$630.00 |
|
| 29851 |
4 |
$630.00 |
|
| 29855 |
4 |
$630.00 |
|
| 29856 |
4 |
$630.00 |
|
| 29860 |
4 |
$630.00 |
|
| 29861 |
4 |
$630.00 |
|
| 29862 |
9 |
$1,339.00 |
|
| 29863 |
4 |
$630.00 |
|
| 29870 |
3 |
$510.00 |
|
| 29871 |
3 |
$510.00 |
|
| 29873 |
3 |
$510.00 |
|
| 29874 |
3 |
$510.00 |
|
| 29875 |
4 |
$630.00 |
|
| 29876 |
4 |
$630.00 |
|
| 29877 |
4 |
$630.00 |
|
| 29879 |
3 |
$510.00 |
|
| 29880 |
4 |
$630.00 |
|
| 29881 |
4 |
$630.00 |
|
| 29882 |
3 |
$510.00 |
|
| 29883 |
3 |
$510.00 |
|
| 29884 |
3 |
$510.00 |
|
| 29885 |
3 |
$510.00 |
|
| 29886 |
3 |
$510.00 |
|
| 29887 |
3 |
$510.00 |
|
| 29888 |
3 |
$510.00 |
|
| 29889 |
3 |
$510.00 |
|
| 29891 |
3 |
$510.00 |
|
| 29892 |
3 |
$510.00 |
|
| 29893 |
9 |
$1.00 |
255.56 |
| 29894 |
3 |
$510.00 |
|
| 29895 |
3 |
$510.00 |
|
| 29897 |
3 |
$510.00 |
|
| 29898 |
3 |
$510.00 |
|
| 29899 |
3 |
$510.00 |
|
| 29900 |
3 |
$510.00 |
|
| 29901 |
3 |
$510.00 |
|
| 29902 |
3 |
$510.00 |
|
| 30115 |
2 |
$446.00 |
|
| CPT |
Group |
Rate |
|
| 30117 |
3 |
$510.00 |
|
| 30118 |
3 |
$510.00 |
|
| 30120 |
1 |
$333.00 |
|
| 30125 |
2 |
$446.00 |
|
| 30130 |
3 |
$510.00 |
|
| 30140 |
2 |
$446.00 |
|
| 30150 |
3 |
$510.00 |
|
| 30160 |
4 |
$630.00 |
|
| 30220 |
3 |
$464.15 |
|
| 30310 |
1 |
$333.00 |
|
| 30320 |
2 |
$446.00 |
|
| 30400 |
4 |
$630.00 |
|
| 30410 |
5 |
$717.00 |
|
| 30420 |
5 |
$717.00 |
|
| 30430 |
3 |
$510.00 |
|
| 30435 |
5 |
$717.00 |
|
| 30450 |
7 |
$995.00 |
|
| 30460 |
7 |
$995.00 |
|
| 30462 |
9 |
$1,339.00 |
|
| 30465 |
9 |
$1,339.00 |
|
| 30520 |
4 |
$630.00 |
|
| 30540 |
5 |
$717.00 |
|
| 30545 |
5 |
$717.00 |
|
| 30560 |
2 |
$150.72 |
|
| 30580 |
4 |
$630.00 |
|
| 30600 |
4 |
$630.00 |
|
| 30620 |
7 |
$995.00 |
|
| 30630 |
7 |
$995.00 |
|
| 30801 |
1 |
$333.00 |
|
| 30802 |
1 |
$333.00 |
|
| 30903 |
1 |
$72.48 |
|
| 30905 |
1 |
$72.48 |
|
| 30906 |
1 |
$72.48 |
|
| 30915 |
2 |
$446.00 |
|
| 30920 |
3 |
$510.00 |
|
| 30930 |
4 |
$630.00 |
|
| 31020 |
2 |
$446.00 |
|
| 31030 |
3 |
$510.00 |
|
| 31032 |
4 |
$630.00 |
|
| 31050 |
2 |
$446.00 |
|
| 31051 |
4 |
$630.00 |
|
| 31070 |
2 |
$446.00 |
|
| 31075 |
4 |
$630.00 |
|
| 31080 |
4 |
$630.00 |
|
| 31081 |
4 |
$630.00 |
|
| 31084 |
4 |
$630.00 |
|
| 31085 |
4 |
$630.00 |
|
| 31086 |
4 |
$630.00 |
|
| 31087 |
4 |
$630.00 |
|
| 31090 |
5 |
$717.00 |
|
| 31200 |
2 |
$446.00 |
|
| 31201 |
5 |
$717.00 |
|
| 31205 |
3 |
$510.00 |
|
| 31233 |
2 |
$86.39 |
|
| ASC
LIST EFFECTIVE JANUARY 1, 2007 |
| CPT |
Group |
Rate |
|
| 31235 |
1 |
$333.00 |
|
| 31237 |
2 |
$446.00 |
|
| 31238 |
1 |
$333.00 |
|
| 31239 |
4 |
$630.00 |
|
| 31240 |
2 |
$446.00 |
|
| 31254 |
3 |
$510.00 |
|
| 31255 |
5 |
$717.00 |
|
| 31256 |
3 |
$510.00 |
|
| 31267 |
3 |
$510.00 |
|
| 31276 |
3 |
$510.00 |
|
| 31287 |
3 |
$510.00 |
|
| 31288 |
3 |
$510.00 |
|
| 31300 |
5 |
$717.00 |
|
| 31320 |
2 |
$446.00 |
|
| 31400 |
2 |
$446.00 |
|
| 31420 |
2 |
$446.00 |
|
| 31510 |
2 |
$446.00 |
|
| 31511 |
2 |
$86.39 |
|
| 31512 |
2 |
$446.00 |
|
| 31513 |
2 |
$86.39 |
|
| 31515 |
1 |
$333.00 |
|
| 31525 |
1 |
$333.00 |
|
| 31526 |
2 |
$446.00 |
|
| 31527 |
1 |
$333.00 |
|
| 31528 |
2 |
$446.00 |
|
| 31529 |
2 |
$446.00 |
|
| 31530 |
2 |
$446.00 |
|
| 31531 |
3 |
$510.00 |
|
| 31535 |
2 |
$446.00 |
|
| 31536 |
3 |
$510.00 |
|
| 31540 |
3 |
$510.00 |
|
| 31541 |
4 |
$630.00 |
|
| 31545 |
4 |
$630.00 |
|
| 31546 |
4 |
$630.00 |
|
| 31560 |
5 |
$717.00 |
|
| 31561 |
5 |
$717.00 |
|
| 31570 |
2 |
$446.00 |
|
| 31571 |
2 |
$446.00 |
|
| 31576 |
2 |
$446.00 |
|
| 31577 |
2 |
$236.42 |
|
| 31578 |
2 |
$446.00 |
|
| 31580 |
5 |
$717.00 |
|
| 31582 |
5 |
$717.00 |
|
| 31588 |
5 |
$717.00 |
|
| 31590 |
5 |
$717.00 |
|
| 31595 |
2 |
$446.00 |
|
| 31603 |
1 |
$333.00 |
|
| 31611 |
3 |
$510.00 |
|
| 31612 |
1 |
$333.00 |
|
| 31613 |
2 |
$446.00 |
|
| 31614 |
2 |
$446.00 |
|
| 31615 |
1 |
$333.00 |
|
| 31620 |
1 |
$333.00 |
|
| 31622 |
1 |
$333.00 |
|
| CPT |
Group |
Rate |
|
| 31623 |
2 |
$446.00 |
|
| 31624 |
2 |
$446.00 |
|
| 31625 |
2 |
$446.00 |
|
| 31628 |
2 |
$446.00 |
|
| 31629 |
2 |
$446.00 |
|
| 31630 |
2 |
$446.00 |
|
| 31631 |
2 |
$446.00 |
|
| 31635 |
2 |
$446.00 |
|
| 31636 |
2 |
$446.00 |
|
| 31637 |
1 |
$333.00 |
|
| 31638 |
2 |
$446.00 |
|
| 31640 |
2 |
$446.00 |
|
| 31641 |
2 |
$446.00 |
|
| 31643 |
2 |
$446.00 |
|
| 31645 |
1 |
$333.00 |
|
| 31646 |
1 |
$333.00 |
|
| 31656 |
1 |
$333.00 |
|
| 31717 |
1 |
$236.42 |
|
| 31720 |
1 |
$47.32 |
|
| 31730 |
1 |
$236.42 |
|
| 31750 |
5 |
$717.00 |
|
| 31755 |
2 |
$446.00 |
|
| 31820 |
1 |
$333.00 |
|
| 31825 |
2 |
$446.00 |
|
| 31830 |
2 |
$446.00 |
|
| 32000 |
1 |
$222.78 |
|
| 32400 |
1 |
$333.00 |
|
| 32405 |
1 |
$333.00 |
|
| 32420 |
1 |
$222.78 |
|
| 33010 |
2 |
$222.78 |
|
| 33011 |
2 |
$222.78 |
|
| 33212 |
3 |
$510.00 |
|
| 33213 |
3 |
$510.00 |
|
| 33222 |
2 |
$446.00 |
|
| 33223 |
2 |
$446.00 |
|
| 33233 |
2 |
$446.00 |
|
| 35188 |
4 |
$630.00 |
|
| 35207 |
4 |
$630.00 |
|
| 35875 |
9 |
$1,339.00 |
|
| 35876 |
9 |
$1,339.00 |
|
| 36260 |
3 |
$510.00 |
|
| 36261 |
2 |
$446.00 |
|
| 36262 |
1 |
$333.00 |
|
| 36475 |
9 |
$1,339.00 |
|
| 36476 |
9 |
$1,339.00 |
|
| 36478 |
9 |
$1,339.00 |
|
| 36479 |
9 |
$1,339.00 |
|
| 36555 |
1 |
$333.00 |
|
| 36556 |
1 |
$333.00 |
|
| 36557 |
2 |
$446.00 |
|
| 36558 |
2 |
$446.00 |
|
| 36560 |
3 |
$510.00 |
|
| 36561 |
3 |
$510.00 |
|
| 36563 |
3 |
$510.00 |
|
| CPT |
Group |
Rate |
|
| 36565 |
3 |
$510.00 |
|
| 36566 |
3 |
$510.00 |
|
| 36568 |
1 |
$333.00 |
|
| 36569 |
1 |
$333.00 |
|
| 36570 |
3 |
$510.00 |
|
| 36571 |
3 |
$510.00 |
|
| 36575 |
2 |
$446.00 |
|
| 36576 |
2 |
$446.00 |
|
| 36578 |
2 |
$446.00 |
|
| 36580 |
1 |
$333.00 |
|
| 36581 |
2 |
$446.00 |
|
| 36582 |
3 |
$510.00 |
|
| 36583 |
3 |
$510.00 |
|
| 36584 |
1 |
$333.00 |
|
| 36585 |
3 |
$510.00 |
|
| 36589 |
1 |
$333.00 |
|
| 36590 |
1 |
$333.00 |
|
| 36640 |
1 |
$333.00 |
|
| 36800 |
3 |
$510.00 |
|
| 36810 |
3 |
$510.00 |
|
| 36815 |
3 |
$510.00 |
|
| 36818 |
3 |
$510.00 |
|
| 36819 |
3 |
$510.00 |
|
| 36820 |
3 |
$510.00 |
|
| 36821 |
3 |
$510.00 |
|
| 36825 |
4 |
$630.00 |
|
| 36830 |
4 |
$630.00 |
|
| 36831 |
9 |
$1,339.00 |
|
| 36832 |
4 |
$630.00 |
|
| 36833 |
4 |
$630.00 |
|
| 36834 |
3 |
$510.00 |
|
| 36835 |
4 |
$630.00 |
|
| 36860 |
2 |
$127.40 |
|
| 36861 |
3 |
$510.00 |
|
| 36870 |
9 |
$1,339.00 |
|
| 37500 |
3 |
$510.00 |
|
| 37607 |
3 |
$510.00 |
|
| 37609 |
2 |
$446.00 |
|
| 37650 |
2 |
$446.00 |
|
| 37700 |
2 |
$446.00 |
|
| 37718 |
3 |
$510.00 |
|
| 37722 |
3 |
$510.00 |
|
| 37735 |
3 |
$510.00 |
|
| 37760 |
3 |
$510.00 |
|
| 37780 |
3 |
$510.00 |
|
| 37785 |
3 |
$510.00 |
|
| 37790 |
3 |
$510.00 |
|
| 38300 |
1 |
$333.00 |
|
| 38305 |
2 |
$446.00 |
|
| 38308 |
2 |
$446.00 |
|
| 38500 |
2 |
$446.00 |
|
| 38505 |
1 |
$240.00 |
|
| 38510 |
2 |
$446.00 |
|
| 38520 |
2 |
$446.00 |
|
| CPT |
Group |
Rate |
|
| 38525 |
2 |
$446.00 |
|
| 38530 |
2 |
$446.00 |
|
| 38542 |
2 |
$446.00 |
|
| 38550 |
3 |
$510.00 |
|
| 38555 |
4 |
$630.00 |
|
| 38570 |
9 |
$1,339.00 |
|
| 38571 |
9 |
$1,339.00 |
|
| 38572 |
9 |
$1,339.00 |
|
| 38740 |
2 |
$446.00 |
|
| 38745 |
4 |
$630.00 |
|
| 38760 |
2 |
$446.00 |
|
| 40500 |
2 |
$446.00 |
|
| 40510 |
2 |
$446.00 |
|
| 40520 |
2 |
$446.00 |
|
| 40525 |
2 |
$446.00 |
|
| 40527 |
2 |
$446.00 |
|
| 40530 |
2 |
$446.00 |
|
| 40650 |
3 |
$464.15 |
|
| 40652 |
3 |
$464.15 |
|
| 40654 |
3 |
$464.15 |
|
| 40700 |
7 |
$995.00 |
|
| 40701 |
7 |
$995.00 |
|
| 40720 |
7 |
$995.00 |
|
| 40761 |
3 |
$510.00 |
|
| 40801 |
2 |
$446.00 |
|
| 40814 |
2 |
$446.00 |
|
| 40816 |
2 |
$446.00 |
|
| 40818 |
1 |
$150.72 |
|
| 40819 |
1 |
$333.00 |
|
| 40831 |
1 |
$333.00 |
|
| 40840 |
2 |
$446.00 |
|
| 40842 |
3 |
$510.00 |
|
| 40843 |
3 |
$510.00 |
|
| 40844 |
5 |
$717.00 |
|
| 40845 |
5 |
$717.00 |
|
| 41005 |
1 |
$150.72 |
|
| 41006 |
1 |
$333.00 |
|
| 41007 |
1 |
$333.00 |
|
| 41008 |
1 |
$333.00 |
|
| 41009 |
1 |
$150.72 |
|
| 41010 |
1 |
$333.00 |
|
| 41015 |
1 |
$150.72 |
|
| 41016 |
1 |
$333.00 |
|
| 41017 |
1 |
$333.00 |
|
| 41018 |
1 |
$333.00 |
|
| 41112 |
2 |
$446.00 |
|
| 41113 |
2 |
$446.00 |
|
| 41114 |
2 |
$446.00 |
|
| 41116 |
1 |
$333.00 |
|
| 41120 |
5 |
$717.00 |
|
| 41250 |
2 |
$150.72 |
|
| 41251 |
2 |
$150.72 |
|
| 41252 |
2 |
$446.00 |
|
| 41500 |
1 |
$333.00 |
|
| ASC
LIST EFFECTIVE JANUARY 1, 2007 |
| CPT |
Group |
Rate |
|
| 41510 |
1 |
$333.00 |
|
| 41520 |
2 |
$446.00 |
|
| 41800 |
1 |
$88.46 |
|
| 41827 |
2 |
$446.00 |
|
| 42000 |
2 |
$150.72 |
|
| 42107 |
2 |
$446.00 |
|
| 42120 |
4 |
$630.00 |
|
| 42140 |
2 |
$446.00 |
|
| 42145 |
5 |
$717.00 |
|
| 42180 |
1 |
$150.72 |
|
| 42182 |
2 |
$446.00 |
|
| 42200 |
5 |
$717.00 |
|
| 42205 |
5 |
$717.00 |
|
| 42210 |
5 |
$717.00 |
|
| 42215 |
7 |
$995.00 |
|
| 42220 |
5 |
$717.00 |
|
| 42226 |
5 |
$717.00 |
|
| 42235 |
5 |
$717.00 |
|
| 42260 |
4 |
$630.00 |
|
| 42300 |
1 |
$333.00 |
|
| 42305 |
2 |
$446.00 |
|
| 42310 |
1 |
$150.72 |
|
| 42320 |
1 |
$150.72 |
|
| 42340 |
2 |
$446.00 |
|
| 42405 |
2 |
$446.00 |
|
| 42408 |
3 |
$510.00 |
|
| 42409 |
3 |
$510.00 |
|
| 42410 |
3 |
$510.00 |
|
| 42415 |
7 |
$995.00 |
|
| 42420 |
7 |
$995.00 |
|
| 42425 |
7 |
$995.00 |
|
| 42440 |
3 |
$510.00 |
|
| 42450 |
2 |
$446.00 |
|
| 42500 |
3 |
$510.00 |
|
| 42505 |
4 |
$630.00 |
|
| 42507 |
3 |
$510.00 |
|
| 42508 |
4 |
$630.00 |
|
| 42509 |
4 |
$630.00 |
|
| 42510 |
4 |
$630.00 |
|
| 42600 |
1 |
$333.00 |
|
| 42665 |
7 |
$995.00 |
|
| 42700 |
1 |
$150.72 |
|
| 42720 |
1 |
$333.00 |
|
| 42725 |
2 |
$446.00 |
|
| 42802 |
1 |
$333.00 |
|
| 42804 |
1 |
$333.00 |
|
| 42806 |
2 |
$446.00 |
|
| 42808 |
2 |
$446.00 |
|
| 42810 |
3 |
$510.00 |
|
| 42815 |
5 |
$717.00 |
|
| 42820 |
3 |
$510.00 |
|
| 42821 |
5 |
$717.00 |
|
| 42825 |
4 |
$630.00 |
|
| 42826 |
4 |
$630.00 |
|
| CPT |
Group |
Rate |
|
| 42830 |
4 |
$630.00 |
|
| 42831 |
4 |
$630.00 |
|
| 42835 |
4 |
$630.00 |
|
| 42836 |
4 |
$630.00 |
|
| 42860 |
3 |
$510.00 |
|
| 42870 |
3 |
$510.00 |
|
| 42890 |
7 |
$995.00 |
|
| 42892 |
7 |
$995.00 |
|
| 42900 |
1 |
$333.00 |
|
| 42950 |
2 |
$446.00 |
|
| 42955 |
2 |
$446.00 |
|
| 42960 |
1 |
$72.48 |
|
| 42962 |
2 |
$446.00 |
|
| 42972 |
3 |
$510.00 |
|
| 43200 |
1 |
$333.00 |
|
| 43201 |
1 |
$333.00 |
|
| 43202 |
1 |
$333.00 |
|
| 43204 |
1 |
$333.00 |
|
| 43205 |
1 |
$333.00 |
|
| 43215 |
1 |
$333.00 |
|
| 43216 |
1 |
$333.00 |
|
| 43217 |
1 |
$333.00 |
|
| 43219 |
1 |
$333.00 |
|
| 43220 |
1 |
$333.00 |
|
| 43226 |
1 |
$333.00 |
|
| 43227 |
2 |
$446.00 |
|
| 43228 |
2 |
$446.00 |
|
| 43231 |
2 |
$446.00 |
|
| 43232 |
2 |
$446.00 |
|
| 43234 |
1 |
$333.00 |
|
| 43235 |
1 |
$333.00 |
|
| 43236 |
2 |
$446.00 |
|
| 43237 |
2 |
$446.00 |
|
| 43238 |
2 |
$446.00 |
|
| 43239 |
2 |
$446.00 |
|
| 43240 |
2 |
$446.00 |
|
| 43241 |
2 |
$446.00 |
|
| 43242 |
2 |
$446.00 |
|
| 43243 |
2 |
$446.00 |
|
| 43244 |
2 |
$446.00 |
|
| 43245 |
2 |
$446.00 |
|
| 43246 |
2 |
$446.00 |
|
| 43247 |
2 |
$446.00 |
|
| 43248 |
2 |
$446.00 |
|
| 43249 |
2 |
$446.00 |
|
| 43250 |
2 |
$446.00 |
|
| 43251 |
2 |
$446.00 |
|
| 43255 |
2 |
$446.00 |
|
| 43256 |
3 |
$510.00 |
|
| 43257 |
3 |
$510.00 |
|
| 43258 |
3 |
$510.00 |
|
| 43259 |
3 |
$510.00 |
|
| 43260 |
2 |
$446.00 |
|
| 43261 |
2 |
$446.00 |
|
| CPT |
Group |
Rate |
|
| 43262 |
2 |
$446.00 |
|
| 43263 |
2 |
$446.00 |
|
| 43264 |
2 |
$446.00 |
|
| 43265 |
2 |
$446.00 |
|
| 43267 |
2 |
$446.00 |
|
| 43268 |
2 |
$446.00 |
|
| 43269 |
2 |
$446.00 |
|
| 43271 |
2 |
$446.00 |
|
| 43272 |
2 |
$446.00 |
|
| 43450 |
1 |
$333.00 |
|
| 43453 |
1 |
$333.00 |
|
| 43456 |
2 |
$335.41 |
|
| 43458 |
2 |
$335.41 |
|
| 43600 |
1 |
$333.00 |
|
| 43653 |
9 |
$1,339.00 |
|
| 43750 |
2 |
$446.00 |
|
| 43760 |
1 |
$144.98 |
|
| 43761 |
1 |
$333.00 |
|
| 43870 |
1 |
$333.00 |
|
| 44100 |
1 |
$333.00 |
|
| 44312 |
1 |
$333.00 |
|
| 44340 |
3 |
$510.00 |
|
| 44360 |
2 |
$446.00 |
|
| 44361 |
2 |
$446.00 |
|
| 44363 |
2 |
$446.00 |
|
| 44364 |
2 |
$446.00 |
|
| 44365 |
2 |
$446.00 |
|
| 44366 |
2 |
$446.00 |
|
| 44369 |
2 |
$446.00 |
|
| 44370 |
9 |
$1,339.00 |
|
| 44372 |
2 |
$446.00 |
|
| 44373 |
2 |
$446.00 |
|
| 44376 |
2 |
$446.00 |
|
| 44377 |
2 |
$446.00 |
|
| 44378 |
2 |
$446.00 |
|
| 44379 |
9 |
$1,339.00 |
|
| 44380 |
1 |
$333.00 |
|
| 44382 |
1 |
$333.00 |
|
| 44383 |
9 |
$1,339.00 |
|
| 44385 |
1 |
$333.00 |
|
| 44386 |
1 |
$333.00 |
|
| 44388 |
1 |
$333.00 |
|
| 44389 |
1 |
$333.00 |
|
| 44390 |
1 |
$333.00 |
|
| 44391 |
1 |
$333.00 |
|
| 44392 |
1 |
$333.00 |
|
| 44393 |
1 |
$333.00 |
|
| 44394 |
1 |
$333.00 |
|
| 44397 |
1 |
$333.00 |
|
| 45000 |
1 |
$312.07 |
|
| 45005 |
2 |
$446.00 |
|
| 45020 |
2 |
$446.00 |
|
| 45100 |
1 |
$333.00 |
|
| 45108 |
2 |
$446.00 |
|
| CPT |
Group |
Rate |
|
| 45150 |
2 |
$446.00 |
|
| 45160 |
2 |
$446.00 |
|
| 45170 |
2 |
$446.00 |
|
| 45190 |
9 |
$1,339.00 |
|
| 45305 |
1 |
$333.00 |
|
| 45307 |
1 |
$333.00 |
|
| 45308 |
1 |
$333.00 |
|
| 45309 |
1 |
$333.00 |
|
| 45315 |
1 |
$333.00 |
|
| 45317 |
1 |
$333.00 |
|
| 45320 |
1 |
$333.00 |
|
| 45321 |
1 |
$333.00 |
|
| 45327 |
1 |
$333.00 |
|
| 45331 |
1 |
$299.24 |
|
| 45332 |
1 |
$299.24 |
|
| 45333 |
1 |
$333.00 |
|
| 45334 |
1 |
$333.00 |
|
| 45335 |
1 |
$299.24 |
|
| 45337 |
1 |
$299.24 |
|
| 45338 |
1 |
$333.00 |
|
| 45339 |
1 |
$333.00 |
|
| 45340 |
1 |
$333.00 |
|
| 45341 |
1 |
$333.00 |
|
| 45342 |
1 |
$333.00 |
|
| 45345 |
1 |
$333.00 |
|
| 45355 |
1 |
$333.00 |
|
| 45378 |
2 |
$446.00 |
|
| 45379 |
2 |
$446.00 |
|
| 45380 |
2 |
$446.00 |
|
| 45381 |
2 |
$446.00 |
|
| 45382 |
2 |
$446.00 |
|
| 45383 |
2 |
$446.00 |
|
| 45384 |
2 |
$446.00 |
|
| 45385 |
2 |
$446.00 |
|
| 45386 |
2 |
$446.00 |
|
| 45387 |
1 |
$333.00 |
|
| 45391 |
2 |
$446.00 |
|
| 45392 |
2 |
$446.00 |
|
| 45500 |
2 |
$446.00 |
|
| 45505 |
2 |
$446.00 |
|
| 45560 |
2 |
$446.00 |
|
| 45900 |
1 |
$312.07 |
|
| 45905 |
1 |
$333.00 |
|
| 45910 |
1 |
$333.00 |
|
| 45915 |
1 |
$312.07 |
|
| 45990 |
2 |
$312.07 |
|
| 46020 |
3 |
$510.00 |
|
| 46030 |
1 |
$312.07 |
|
| 46040 |
3 |
$510.00 |
|
| 46045 |
2 |
$446.00 |
|
| 46050 |
1 |
$312.07 |
|
| 46060 |
2 |
$446.00 |
|
| 46080 |
3 |
$510.00 |
|
| 46200 |
2 |
$446.00 |
|
| ASC
LIST EFFECTIVE JANUARY 1, 2007 |
| CPT |
Group |
Rate |
|
| 46210 |
2 |
$446.00 |
|
| 46211 |
2 |
$446.00 |
|
| 46220 |
1 |
$333.00 |
|
| 46230 |
1 |
$333.00 |
|
| 46250 |
3 |
$510.00 |
|
| 46255 |
3 |
$510.00 |
|
| 46257 |
3 |
$510.00 |
|
| 46258 |
3 |
$510.00 |
|
| 46260 |
3 |
$510.00 |
|
| 46261 |
4 |
$630.00 |
|
| 46262 |
4 |
$630.00 |
|
| 46270 |
3 |
$510.00 |
|
| 46275 |
3 |
$510.00 |
|
| 46280 |
4 |
$630.00 |
|
| 46285 |
1 |
$333.00 |
|
| 46288 |
4 |
$630.00 |
|
| 46608 |
1 |
$333.00 |
|
| 46610 |
1 |
$333.00 |
|
| 46611 |
1 |
$333.00 |
|
| 46612 |
1 |
$333.00 |
|
| 46615 |
2 |
$446.00 |
|
| 46700 |
3 |
$510.00 |
|
| 46706 |
1 |
$333.00 |
|
| 46750 |
3 |
$510.00 |
|
| 46753 |
3 |
$510.00 |
|
| 46754 |
2 |
$446.00 |
|
| 46760 |
2 |
$446.00 |
|
| 46761 |
3 |
$510.00 |
|
| 46762 |
7 |
$995.00 |
|
| 46917 |
1 |
$333.00 |
|
| 46922 |
1 |
$333.00 |
|
| 46924 |
1 |
$333.00 |
|
| 46937 |
2 |
$446.00 |
|
| 46938 |
2 |
$446.00 |
|
| 46946 |
1 |
$333.00 |
|
| 46947 |
7 |
$995.00 |
|
| 47000 |
1 |
$333.00 |
|
| 47510 |
2 |
$446.00 |
|
| 47511 |
9 |
$1,245.85 |
|
| 47525 |
1 |
$333.00 |
|
| 47530 |
1 |
$333.00 |
|
| 47552 |
2 |
$446.00 |
|
| 47553 |
3 |
$510.00 |
|
| 47554 |
3 |
$510.00 |
|
| 47555 |
3 |
$510.00 |
|
| 47556 |
9 |
$1,245.85 |
|
| 47560 |
3 |
$510.00 |
|
| 47561 |
3 |
$510.00 |
|
| 47630 |
3 |
$510.00 |
|
| 48102 |
1 |
$333.00 |
|
| 49080 |
2 |
$222.78 |
|
| 49081 |
2 |
$222.78 |
|
| 49180 |
1 |
$333.00 |
|
| 49250 |
4 |
$630.00 |
|
| CPT |
Group |
Rate |
|
| 49320 |
3 |
$510.00 |
|
| 49321 |
4 |
$630.00 |
|
| 49322 |
4 |
$630.00 |
|
| 49402 |
2 |
$446.00 |
|
| 49419 |
1 |
$333.00 |
|
| 49420 |
1 |
$333.00 |
|
| 49421 |
1 |
$333.00 |
|
| 49422 |
1 |
$333.00 |
|
| 49426 |
2 |
$446.00 |
|
| 49495 |
4 |
$630.00 |
|
| 49496 |
4 |
$630.00 |
|
| 49500 |
4 |
$630.00 |
|
| 49501 |
9 |
$1,339.00 |
|
| 49505 |
4 |
$630.00 |
|
| 49507 |
9 |
$1,339.00 |
|
| 49520 |
7 |
$995.00 |
|
| 49521 |
9 |
$1,339.00 |
|
| 49525 |
4 |
$630.00 |
|
| 49540 |
2 |
$446.00 |
|
| 49550 |
5 |
$717.00 |
|
| 49553 |
9 |
$1,339.00 |
|
| 49555 |
5 |
$717.00 |
|
| 49557 |
9 |
$1,339.00 |
|
| 49560 |
4 |
$630.00 |
|
| 49561 |
9 |
$1,339.00 |
|
| 49565 |
4 |
$630.00 |
|
| 49566 |
9 |
$1,339.00 |
|
| 49568 |
7 |
$995.00 |
|
| 49570 |
4 |
$630.00 |
|
| 49572 |
9 |
$1,339.00 |
|
| 49580 |
4 |
$630.00 |
|
| 49582 |
9 |
$1,339.00 |
|
| 49585 |
4 |
$630.00 |
|
| 49587 |
9 |
$1,339.00 |
|
| 49590 |
3 |
$510.00 |
|
| 49600 |
4 |
$630.00 |
|
| 49650 |
4 |
$630.00 |
|
| 49651 |
7 |
$995.00 |
|
| 50200 |
1 |
$333.00 |
|
| 50390 |
1 |
$333.00 |
|
| 50392 |
1 |
$333.00 |
|
| 50393 |
1 |
$333.00 |
|
| 50395 |
1 |
$333.00 |
|
| 50396 |
1 |
$131.50 |
|
| 50398 |
1 |
$333.00 |
|
| 50551 |
1 |
$333.00 |
|
| 50553 |
1 |
$333.00 |
|
| 50555 |
1 |
$333.00 |
|
| 50557 |
1 |
$333.00 |
|
| 50561 |
1 |
$333.00 |
|
| 50688 |
1 |
$333.00 |
|
| 50947 |
9 |
$1,339.00 |
|
| 50948 |
9 |
$1,339.00 |
|
| 50951 |
1 |
$333.00 |
|
| CPT |
Group |
Rate |
|
| 50953 |
1 |
$333.00 |
|
| 50955 |
1 |
$333.00 |
|
| 50957 |
1 |
$333.00 |
|
| 50961 |
1 |
$333.00 |
|
| 50970 |
1 |
$333.00 |
|
| 50972 |
1 |
$333.00 |
|
| 50974 |
1 |
$333.00 |
|
| 50976 |
1 |
$333.00 |
|
| 50980 |
1 |
$333.00 |
|
| 51010 |
1 |
$333.00 |
|
| 51020 |
4 |
$630.00 |
|
| 51030 |
4 |
$630.00 |
|
| 51040 |
4 |
$630.00 |
|
| 51045 |
4 |
$399.24 |
|
| 51050 |
4 |
$630.00 |
|
| 51065 |
4 |
$630.00 |
|
| 51080 |
1 |
$333.00 |
|
| 51500 |
4 |
$630.00 |
|
| 51520 |
4 |
$630.00 |
|
| 51710 |
1 |
$333.00 |
|
| 51715 |
3 |
$510.00 |
|
| 51726 |
1 |
$209.48 |
|
| 51772 |
1 |
$131.50 |
|
| 51785 |
1 |
$66.92 |
|
| 51880 |
1 |
$333.00 |
|
| 51992 |
5 |
$717.00 |
|
| 52000 |
1 |
$333.00 |
|
| 52001 |
2 |
$399.24 |
|
| 52005 |
2 |
$446.00 |
|
| 52007 |
2 |
$446.00 |
|
| 52010 |
2 |
$399.24 |
|
| 52204 |
2 |
$446.00 |
|
| 52214 |
2 |
$446.00 |
|
| 52224 |
2 |
$446.00 |
|
| 52234 |
2 |
$446.00 |
|
| 52235 |
3 |
$510.00 |
|
| 52240 |
3 |
$510.00 |
|
| 52250 |
4 |
$630.00 |
|
| 52260 |
2 |
$446.00 |
|
| 52270 |
2 |
$446.00 |
|
| 52275 |
2 |
$446.00 |
|
| 52276 |
3 |
$510.00 |
|
| 52277 |
2 |
$446.00 |
|
| 52281 |
2 |
$446.00 |
|
| 52282 |
9 |
$1,339.00 |
|
| 52283 |
2 |
$446.00 |
|
| 52285 |
2 |
$446.00 |
|
| 52290 |
2 |
$446.00 |
|
| 52300 |
2 |
$446.00 |
|
| 52301 |
3 |
$510.00 |
|
| 52305 |
2 |
$446.00 |
|
| 52310 |
2 |
$399.24 |
|
| 52315 |
2 |
$446.00 |
|
| 52317 |
1 |
$333.00 |
|
| CPT |
Group |
Rate |
|
| 52318 |
2 |
$446.00 |
|
| 52320 |
5 |
$717.00 |
|
| 52325 |
4 |
$630.00 |
|
| 52327 |
2 |
$446.00 |
|
| 52330 |
2 |
$446.00 |
|
| 52332 |
2 |
$446.00 |
|
| 52334 |
3 |
$510.00 |
|
| 52341 |
3 |
$510.00 |
|
| 52342 |
3 |
$510.00 |
|
| 52343 |
3 |
$510.00 |
|
| 52344 |
3 |
$510.00 |
|
| 52345 |
3 |
$510.00 |
|
| 52346 |
3 |
$510.00 |
|
| 52351 |
3 |
$510.00 |
|
| 52352 |
4 |
$630.00 |
|
| 52353 |
4 |
$630.00 |
|
| 52354 |
4 |
$630.00 |
|
| 52355 |
4 |
$630.00 |
|
| 52400 |
3 |
$510.00 |
|
| 52402 |
3 |
$510.00 |
|
| 52450 |
3 |
$510.00 |
|
| 52500 |
3 |
$510.00 |
|
| 52510 |
3 |
$510.00 |
|
| 52601 |
4 |
$630.00 |
|
| 52606 |
1 |
$333.00 |
|
| 52612 |
2 |
$446.00 |
|
| 52614 |
1 |
$333.00 |
|
| 52620 |
1 |
$333.00 |
|
| 52630 |
2 |
$446.00 |
|
| 52640 |
2 |
$446.00 |
|
| 52647 |
9 |
$1,339.00 |
|
| 52648 |
9 |
$1,339.00 |
|
| 52700 |
2 |
$446.00 |
|
| 53000 |
1 |
$333.00 |
|
| 53010 |
1 |
$333.00 |
|
| 53020 |
1 |
$333.00 |
|
| 53040 |
2 |
$446.00 |
|
| 53080 |
3 |
$510.00 |
|
| 53200 |
1 |
$333.00 |
|
| 53210 |
5 |
$717.00 |
|
| 53215 |
5 |
$717.00 |
|
| 53220 |
2 |
$446.00 |
|
| 53230 |
2 |
$446.00 |
|
| 53235 |
3 |
$510.00 |
|
| 53240 |
2 |
$446.00 |
|
| 53250 |
2 |
$446.00 |
|
| 53260 |
2 |
$446.00 |
|
| 53265 |
2 |
$446.00 |
|
| 53270 |
2 |
$446.00 |
|
| 53275 |
2 |
$446.00 |
|
| 53400 |
3 |
$510.00 |
|
| 53405 |
2 |
$446.00 |
|
| 53410 |
2 |
$446.00 |
|
| 53420 |
3 |
$510.00 |
|
| ASC
LIST EFFECTIVE JANUARY 1, 2007 |
| CPT |
Group |
Rate |
|
| 53425 |
2 |
$446.00 |
|
| 53430 |
2 |
$446.00 |
|
| 53431 |
2 |
$446.00 |
|
| 53440 |
2 |
$446.00 |
|
| 53442 |
1 |
$333.00 |
|
| 53444 |
2 |
$446.00 |
|
| 53445 |
1 |
$333.00 |
|
| 53446 |
1 |
$333.00 |
|
| 53447 |
1 |
$333.00 |
|
| 53449 |
1 |
$333.00 |
|
| 53450 |
1 |
$333.00 |
|
| 53460 |
1 |
$333.00 |
|
| 53502 |
2 |
$446.00 |
|
| 53505 |
2 |
$446.00 |
|
| 53510 |
2 |
$446.00 |
|
| 53515 |
2 |
$446.00 |
|
| 53520 |
2 |
$446.00 |
|
| 53605 |
2 |
$446.00 |
|
| 53665 |
1 |
$333.00 |
|
| 54000 |
2 |
$446.00 |
|
| 54001 |
2 |
$446.00 |
|
| 54015 |
4 |
$630.00 |
|
| 54057 |
1 |
$333.00 |
|
| 54060 |
1 |
$333.00 |
|
| 54065 |
1 |
$333.00 |
|
| 54100 |
1 |
$333.00 |
|
| 54105 |
1 |
$333.00 |
|
| 54110 |
2 |
$446.00 |
|
| 54111 |
2 |
$446.00 |
|
| 54112 |
2 |
$446.00 |
|
| 54115 |
1 |
$333.00 |
|
| 54120 |
2 |
$446.00 |
|
| 54150 |
1 |
$333.00 |
|
| 54152 |
1 |
$333.00 |
|
| 54160 |
2 |
$446.00 |
|
| 54161 |
2 |
$446.00 |
|
| 54162 |
2 |
$446.00 |
|
| 54163 |
2 |
$446.00 |
|
| 54164 |
2 |
$446.00 |
|
| 54205 |
4 |
$630.00 |
|
| 54220 |
1 |
$131.50 |
|
| 54300 |
3 |
$510.00 |
|
| 54304 |
3 |
$510.00 |
|
| 54308 |
3 |
$510.00 |
|
| 54312 |
3 |
$510.00 |
|
| 54316 |
3 |
$510.00 |
|
| 54318 |
3 |
$510.00 |
|
| 54322 |
3 |
$510.00 |
|
| 54324 |
3 |
$510.00 |
|
| 54326 |
3 |
$510.00 |
|
| 54328 |
3 |
$510.00 |
|
| 54340 |
3 |
$510.00 |
|
| 54344 |
3 |
$510.00 |
|
| 54348 |
3 |
$510.00 |
|
| CPT |
Group |
Rate |
|
| 54352 |
3 |
$510.00 |
|
| 54360 |
3 |
$510.00 |
|
| 54380 |
3 |
$510.00 |
|
| 54385 |
3 |
$510.00 |
|
| 54400 |
3 |
$510.00 |
|
| 54401 |
3 |
$510.00 |
|
| 54405 |
3 |
$510.00 |
|
| 54406 |
3 |
$510.00 |
|
| 54408 |
3 |
$510.00 |
|
| 54410 |
3 |
$510.00 |
|
| 54415 |
3 |
$510.00 |
|
| 54416 |
3 |
$510.00 |
|
| 54420 |
4 |
$630.00 |
|
| 54435 |
4 |
$630.00 |
|
| 54440 |
4 |
$630.00 |
|
| 54450 |
1 |
$209.48 |
|
| 54500 |
1 |
$333.00 |
|
| 54505 |
1 |
$333.00 |
|
| 54512 |
2 |
$446.00 |
|
| 54520 |
3 |
$510.00 |
|
| 54522 |
3 |
$510.00 |
|
| 54530 |
4 |
$630.00 |
|
| 54550 |
4 |
$630.00 |
|
| 54600 |
4 |
$630.00 |
|
| 54620 |
3 |
$510.00 |
|
| 54640 |
4 |
$630.00 |
|
| 54660 |
2 |
$446.00 |
|
| 54670 |
3 |
$510.00 |
|
| 54680 |
3 |
$510.00 |
|
| 54690 |
9 |
$1,339.00 |
|
| 54700 |
2 |
$446.00 |
|
| 54800 |
1 |
$127.16 |
|
| 54830 |
3 |
$510.00 |
|
| 54840 |
4 |
$630.00 |
|
| 54860 |
3 |
$510.00 |
|
| 54861 |
4 |
$630.00 |
|
| 54865 |
1 |
$333.00 |
|
| 54900 |
4 |
$630.00 |
|
| 54901 |
4 |
$630.00 |
|
| 55040 |
3 |
$510.00 |
|
| 55041 |
5 |
$717.00 |
|
| 55060 |
4 |
$630.00 |
|
| 55100 |
1 |
$333.00 |
|
| 55110 |
2 |
$446.00 |
|
| 55120 |
2 |
$446.00 |
|
| 55150 |
1 |
$333.00 |
|
| 55175 |
1 |
$333.00 |
|
| 55180 |
2 |
$446.00 |
|
| 55200 |
2 |
$446.00 |
|
| 55250 |
2 |
$446.00 |
|
| 55400 |
1 |
$333.00 |
|
| 55500 |
3 |
$510.00 |
|
| 55520 |
4 |
$630.00 |
|
| 55530 |
4 |
$630.00 |
|
| CPT |
Group |
Rate |
|
| 55535 |
4 |
$630.00 |
|
| 55540 |
5 |
$717.00 |
|
| 55550 |
9 |
$1,339.00 |
|
| 55680 |
1 |
$333.00 |
|
| 55700 |
2 |
$345.83 |
|
| 55705 |
2 |
$345.83 |
|
| 55720 |
1 |
$333.00 |
|
| 55725 |
2 |
$446.00 |
|
| 55873 |
9 |
$1,339.00 |
|
| 55875 |
9 |
$1,339.00 |
|
| 56440 |
2 |
$446.00 |
|
| 56441 |
1 |
$333.00 |
|
| 56442 |
1 |
$333.00 |
|
| 56515 |
3 |
$510.00 |
|
| 56620 |
5 |
$717.00 |
|
| 56625 |
7 |
$995.00 |
|
| 56700 |
1 |
$333.00 |
|
| 56740 |
3 |
$510.00 |
|
| 56800 |
3 |
$510.00 |
|
| 56810 |
5 |
$717.00 |
|
| 57000 |
1 |
$333.00 |
|
| 57010 |
2 |
$446.00 |
|
| 57020 |
2 |
$409.33 |
|
| 57023 |
1 |
$333.00 |
|
| 57065 |
1 |
$333.00 |
|
| 57105 |
2 |
$446.00 |
|
| 57130 |
2 |
$446.00 |
|
| 57135 |
2 |
$446.00 |
|
| 57155 |
2 |
$409.33 |
|
| 57180 |
1 |
$178.05 |
|
| 57200 |
1 |
$333.00 |
|
| 57210 |
2 |
$446.00 |
|
| 57220 |
3 |
$510.00 |
|
| 57230 |
3 |
$510.00 |
|
| 57240 |
5 |
$717.00 |
|
| 57250 |
5 |
$717.00 |
|
| 57260 |
5 |
$717.00 |
|
| 57265 |
7 |
$995.00 |
|
| 57267 |
7 |
$995.00 |
|
| 57268 |
3 |
$510.00 |
|
| 57288 |
5 |
$717.00 |
|
| 57289 |
5 |
$717.00 |
|
| 57291 |
5 |
$717.00 |
|
| 57300 |
3 |
$510.00 |
|
| 57400 |
2 |
$446.00 |
|
| 57410 |
2 |
$446.00 |
|
| 57415 |
2 |
$446.00 |
|
| 57513 |
2 |
$446.00 |
|
| 57520 |
2 |
$446.00 |
|
| 57522 |
2 |
$446.00 |
|
| 57530 |
3 |
$510.00 |
|
| 57550 |
3 |
$510.00 |
|
| 57556 |
5 |
$717.00 |
|
| 57558 |
3 |
$510.00 |
|
| CPT |
Group |
Rate |
|
| 57700 |
1 |
$333.00 |
|
| 57720 |
3 |
$510.00 |
|
| 58120 |
2 |
$446.00 |
|
| 58145 |
5 |
$717.00 |
|
| 58346 |
2 |
$446.00 |
|
| 58350 |
3 |
$510.00 |
|
| 58353 |
7 |
$995.00 |
|
| 58545 |
9 |
$1,339.00 |
|
| 58546 |
9 |
$1,339.00 |
|
| 58550 |
9 |
$1,339.00 |
|
| 58555 |
1 |
$333.00 |
|
| 58558 |
3 |
$510.00 |
|
| 58559 |
2 |
$446.00 |
|
| 58560 |
3 |
$510.00 |
|
| 58561 |
3 |
$510.00 |
|
| 58562 |
3 |
$510.00 |
|
| 58563 |
9 |
$1,339.00 |
|
| 58565 |
9 |
$1,339.00 |
|
| 58660 |
5 |
$717.00 |
|
| 58661 |
5 |
$717.00 |
|
| 58662 |
5 |
$717.00 |
|
| 58670 |
3 |
$510.00 |
|
| 58671 |
3 |
$510.00 |
|
| 58672 |
5 |
$717.00 |
|
| 58673 |
5 |
$717.00 |
|
| 58800 |
3 |
$510.00 |
|
| 58820 |
3 |
$510.00 |
|
| 58900 |
3 |
$510.00 |
|
| 58970 |
1 |
$245.92 |
|
| 58974 |
1 |
$245.92 |
|
| 58976 |
1 |
$245.92 |
|
| 59160 |
3 |
$510.00 |
|
| 59320 |
1 |
$333.00 |
|
| 59812 |
5 |
$717.00 |
|
| 59820 |
5 |
$717.00 |
|
| 59821 |
5 |
$717.00 |
|
| 59840 |
5 |
$717.00 |
|
| 59841 |
5 |
$717.00 |
|
| 59870 |
5 |
$717.00 |
|
| 59871 |
5 |
$717.00 |
|
| 60000 |
1 |
$333.00 |
|
| 60200 |
2 |
$446.00 |
|
| 60280 |
4 |
$630.00 |
|
| 60281 |
4 |
$630.00 |
|
| 61020 |
1 |
$183.83 |
|
| 61026 |
1 |
$183.83 |
|
| 61050 |
1 |
$183.83 |
|
| 61055 |
1 |
$183.83 |
|
| 61070 |
1 |
$183.83 |
|
| 61215 |
3 |
$510.00 |
|
| 61790 |
3 |
$510.00 |
|
| 61791 |
3 |
$351.92 |
|
| 61795 |
1 |
$302.04 |
|
| 61885 |
2 |
$446.00 |
|
| ASC
LIST EFFECTIVE JANUARY 1, 2007 |
| CPT |
Group |
Rate |
|
| 61886 |
3 |
$510.00 |
|
| 61888 |
1 |
$333.00 |
|
| 62194 |
1 |
$333.00 |
|
| 62225 |
1 |
$333.00 |
|
| 62230 |
2 |
$446.00 |
|
| 62263 |
1 |
$333.00 |
|
| 62264 |
1 |
$333.00 |
|
| 62268 |
1 |
$183.83 |
|
| 62269 |
1 |
$333.00 |
|
| 62270 |
1 |
$139.00 |
|
| 62272 |
1 |
$139.00 |
|
| 62273 |
1 |
$333.00 |
|
| 62280 |
1 |
$333.00 |
|
| 62281 |
1 |
$333.00 |
|
| 62282 |
1 |
$333.00 |
|
| 62287 |
9 |
$1,339.00 |
|
| 62294 |
3 |
$183.83 |
|
| 62310 |
1 |
$333.00 |
|
| 62311 |
1 |
$333.00 |
|
| 62318 |
1 |
$333.00 |
|
| 62319 |
1 |
$333.00 |
|
| 62350 |
2 |
$446.00 |
|
| 62355 |
2 |
$446.00 |
|
| 62360 |
2 |
$446.00 |
|
| 62361 |
2 |
$446.00 |
|
| 62362 |
2 |
$446.00 |
|
| 62365 |
2 |
$446.00 |
|
| 63600 |
2 |
$446.00 |
|
| 63610 |
1 |
$333.00 |
|
| 63650 |
2 |
$446.00 |
|
| 63660 |
1 |
$333.00 |
|
| 63685 |
2 |
$446.00 |
|
| 63688 |
1 |
$333.00 |
|
| 63744 |
3 |
$510.00 |
|
| 63746 |
2 |
$446.00 |
|
| 64410 |
1 |
$333.00 |
|
| 64415 |
1 |
$139.00 |
|
| 64417 |
1 |
$139.00 |
|
| 64420 |
1 |
$139.00 |
|
| 64421 |
1 |
$333.00 |
|
| 64430 |
1 |
$139.00 |
|
| 64470 |
1 |
$333.00 |
|
| 64472 |
1 |
$333.00 |
|
| 64475 |
1 |
$333.00 |
|
| 64476 |
1 |
$333.00 |
|
| 64479 |
1 |
$333.00 |
|
| 64480 |
1 |
$333.00 |
|
| 64483 |
1 |
$333.00 |
|
| 64484 |
1 |
$333.00 |
|
| 64510 |
1 |
$333.00 |
|
| 64517 |
2 |
$139.00 |
|
| 64520 |
1 |
$333.00 |
|
| 64530 |
1 |
$333.00 |
|
| 64553 |
1 |
$333.00 |
|
| CPT |
Group |
Rate |
|
| 64561 |
3 |
$510.00 |
|
| 64573 |
1 |
$333.00 |
|
| 64575 |
1 |
$333.00 |
|
| 64577 |
1 |
$333.00 |
|
| 64580 |
1 |
$333.00 |
|
| 64581 |
3 |
$510.00 |
|
| 64585 |
1 |
$333.00 |
|
| 64590 |
2 |
$446.00 |
|
| 64595 |
1 |
$333.00 |
|
| 64600 |
1 |
$333.00 |
|
| 64605 |
1 |
$333.00 |
|
| 64610 |
1 |
$333.00 |
|
| 64620 |
1 |
$333.00 |
|
| 64622 |
1 |
$333.00 |
|
| 64623 |
1 |
$333.00 |
|
| 64626 |
1 |
$333.00 |
|
| 64627 |
1 |
$333.00 |
|
| 64630 |
2 |
$351.92 |
|
| 64680 |
2 |
$390.95 |
|
| 64681 |
2 |
$446.00 |
|
| 64702 |
1 |
$333.00 |
|
| 64704 |
1 |
$333.00 |
|
| 64708 |
2 |
$446.00 |
|
| 64712 |
2 |
$446.00 |
|
| 64713 |
2 |
$446.00 |
|
| 64714 |
2 |
$446.00 |
|
| 64716 |
3 |
$510.00 |
|
| 64718 |
2 |
$446.00 |
|
| 64719 |
2 |
$446.00 |
|
| 64721 |
2 |
$446.00 |
|
| 64722 |
1 |
$333.00 |
|
| 64726 |
1 |
$333.00 |
|
| 64727 |
1 |
$333.00 |
|
| 64732 |
2 |
$446.00 |
|
| 64734 |
2 |
$446.00 |
|
| 64736 |
2 |
$446.00 |
|
| 64738 |
2 |
$446.00 |
|
| 64740 |
2 |
$446.00 |
|
| 64742 |
2 |
$446.00 |
|
| 64744 |
2 |
$446.00 |
|
| 64746 |
2 |
$446.00 |
|
| 64771 |
2 |
$446.00 |
|
| 64772 |
2 |
$446.00 |
|
| 64774 |
2 |
$446.00 |
|
| 64776 |
3 |
$510.00 |
|
| 64778 |
2 |
$446.00 |
|
| 64782 |
3 |
$510.00 |
|
| 64783 |
2 |
$446.00 |
|
| 64784 |
3 |
$510.00 |
|
| 64786 |
3 |
$510.00 |
|
| 64787 |
2 |
$446.00 |
|
| 64788 |
3 |
$510.00 |
|
| 64790 |
3 |
$510.00 |
|
| 64792 |
3 |
$510.00 |
|
| CPT |
Group |
Rate |
|
| 64795 |
2 |
$446.00 |
|
| 64802 |
2 |
$446.00 |
|
| 64821 |
4 |
$630.00 |
|
| 64831 |
4 |
$630.00 |
|
| 64832 |
1 |
$333.00 |
|
| 64834 |
2 |
$446.00 |
|
| 64835 |
3 |
$510.00 |
|
| 64836 |
3 |
$510.00 |
|
| 64837 |
1 |
$333.00 |
|
| 64840 |
2 |
$446.00 |
|
| 64856 |
2 |
$446.00 |
|
| 64857 |
2 |
$446.00 |
|
| 64858 |
2 |
$446.00 |
|
| 64859 |
1 |
$333.00 |
|
| 64861 |
3 |
$510.00 |
|
| 64862 |
3 |
$510.00 |
|
| 64864 |
3 |
$510.00 |
|
| 64865 |
4 |
$630.00 |
|
| 64870 |
4 |
$630.00 |
|
| 64872 |
2 |
$446.00 |
|
| 64874 |
3 |
$510.00 |
|
| 64876 |
3 |
$510.00 |
|
| 64885 |
2 |
$446.00 |
|
| 64886 |
2 |
$446.00 |
|
| 64890 |
2 |
$446.00 |
|
| 64891 |
2 |
$446.00 |
|
| 64892 |
2 |
$446.00 |
|
| 64893 |
2 |
$446.00 |
|
| 64895 |
3 |
$510.00 |
|
| 64896 |
3 |
$510.00 |
|
| 64897 |
3 |
$510.00 |
|
| 64898 |
3 |
$510.00 |
|
| 64901 |
2 |
$446.00 |
|
| 64902 |
2 |
$446.00 |
|
| 64905 |
2 |
$446.00 |
|
| 64907 |
1 |
$333.00 |
|
| 65091 |
3 |
$510.00 |
|
| 65093 |
3 |
$510.00 |
|
| 65101 |
3 |
$510.00 |
|
| 65103 |
3 |
$510.00 |
|
| 65105 |
4 |
$630.00 |
|
| 65110 |
5 |
$717.00 |
|
| 65112 |
7 |
$995.00 |
|
| 65114 |
7 |
$995.00 |
|
| 65130 |
3 |
$510.00 |
|
| 65135 |
2 |
$446.00 |
|
| 65140 |
3 |
$510.00 |
|
| 65150 |
2 |
$446.00 |
|
| 65155 |
3 |
$510.00 |
|
| 65175 |
1 |
|
2007 CPT Rates 