[Federal Register: February 22, 2008 (Volume 73, Number 36)]
[Rules and Regulations]
[Page 9859-9933]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr22fe08-14]
[[Page 9859]]
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Part II
Department of Health and Human Services
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Centers for Medicare & Medicaid Services
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42 CFR Parts 410, 412, et al.
Medicare and Medicaid Programs; Correction; Final Rule
[[Page 9860]]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 410, 411, 412, 413, 414, 416, 419, 482, and 485
[(CMS-1392-CN), (CMS-1533-CN), and (CMS-1531-CN)]
RIN 0938-AO71, RIN 0938-AO70, and RIN 0938-AO35
Medicare Program; Changes to the Hospital Outpatient Prospective
Payment System and CY 2008 Payment Rates, the Ambulatory Surgical
Center Payment System and CY 2008 Payment Rates, the Hospital Inpatient
Prospective Payment System and FY 2008 Payment Rates; and Payments for
Graduate Medical Education for Affiliated Teaching Hospitals in Certain
Emergency Situations Medicare and Medicaid Programs: Hospital
Conditions of Participation; Necessary Provider Designations of
Critical Access Hospitals; Correction
AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS.
ACTION: Correction of final rule with comment period.
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SUMMARY: This document corrects technical errors that appeared in the
final rule with comment period published in the Federal Register (FR)
on November 27, 2007, entitled ``Changes to the Hospital Outpatient
Prospective Payment System and CY 2008 Payment Rates, the Ambulatory
Surgical Center Payment System and CY 2008 Payment Rates, the Hospital
Inpatient Prospective Payment System and FY 2008 Payment Rates; and
Payments for Graduate Medical Education for Affiliated Teaching
Hospitals in Certain Emergency Situations Medicare and Medicaid
Programs: Hospital Conditions of Participation; Necessary Provider
Designations of Critical Access Hospitals.''
DATES: Effective Date: January 1, 2008 except that the correction to
Sec. 485.610(e) is effective February 22, 2008.
FOR FURTHER INFORMATION CONTACT: Alberta Dwivedi, (410) 786-0378.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 07-5507 of November 27, 2007 (72 FR 66579), we have
identified a number of technical and typographical errors that we
describe in the ``Summary of Errors'' section and correct in the
``Correction of Errors'' section below. The provisions in this
correction notice are effective as if they had been included in the
document published on November 27, 2007. Accordingly, the corrections
are effective January 1, 2008.
II. Summary of Errors
On November 27, 2007, we published a final rule with comment period
entitled, ``Changes to the Hospital Outpatient Prospective Payment
System and CY 2008 Payment Rates, the Ambulatory Surgical Center
Payment System and CY 2008 Payment Rates, the Hospital Inpatient
Prospective Payment System and FY 2008 Payment Rates; and Payments for
Graduate Medical Education for Affiliated Teaching Hospitals in Certain
Emergency Situations Medicare and Medicaid Programs: Hospital
Conditions of Participation; Necessary Provider Designations of
Critical Access Hospitals,'' (hereinafter referred to as the OPPS/ASC
final rule with comment period). Included in that document were
technical and typographical errors.
We incorrectly stated that the application deadline for submitting
applications for a new class of new technology intraocular lenses in
the ``Dates'' section under Application Deadline--New Class of New
Technology Intraocular Lens was April 1, 2008. In the preamble to the
OPPS/ASC final rule with comment period (72 FR 66855), we stated the
correct application deadline date as March 14, 2008. We are changing
the application deadline in the ``Dates'' section to reflect the
correct date of March 14, 2008. We also stated that approximately 131
million final action claims were used for hospital outpatient
department services furnished on or after January 1, 2006 and before
January 1, 2007 for the purpose of recalibrating the OPPS relative
weights for CY 2008. The actual number of final action claims used was
141 million. In addition, we stated that we would provide further
instructions about reporting echocardiography procedures with and
without contrast in the January 2007 OPPS update. The correct reference
should have been to the January 2008 OPPS update and we are correcting
the statement. Furthermore, we are correcting the typographical errors
that mistakenly reversed the listings for the composite APC procedure
codes for APC 8001 and APC 8000.
We also inadvertently failed to address in the OPPS/ASC final rule
with comment period two timely public comments. This document includes
summaries of those public comments and our responses.
The OPPS/ASC final rule with comment period included several
addenda. We are adding three HCPCS codes (CPT codes 90650, 90681, and
90696) to Addendum B because they are new active CPT codes for CY 2008
that we omitted from the CY 2008 OPPS/ASC final rule with comment
period. In publishing Addenda A and B, we inadvertently published
incorrect minimum unadjusted copayment rates for several pass-through
drugs and biologicals. Additionally, for several HCPCS codes where
payment is based on mean costs from hospital claims, we inadvertently
published CY 2007 payment rates instead of CY 2008 payment rates. In
addition, in Addendum B, we inadvertently assigned status indicator
``L'' to new CPT codes 90661, 90662, and 90663 that indicated these
codes would be paid in CY 2008. These three CPT codes actually describe
vaccines where there are currently no FDA-approved products and,
therefore, these codes are noncovered by Medicare as of January 2008.
We are changing the status indicator to ``E'', to reflect the correct
status. Furthermore, we inadvertently assigned a payable status
indicator to HCPCS code G0377. We note that this is a noncovered
service under Medicare Part B in accordance with the statute as of
January 1, 2008. Also, in Addendum B, we incorrectly assigned status
indicator ``M'', indicating services not billable to the fiscal
intermediary, to new CY 2008 HCPCS code G9140, when this service may be
paid off another fee schedule by fiscal intermediaries.
In addition, we are republishing Addenda AA and BB to take into
account updated Medicare Physician Fee Schedule (MPFS) CY 2008
information. As required at 42 CFR Sec. 416.171(d), the revised ASC
payment system limits payment for office-based procedures and covered
ancillary radiology services to the lesser of the ASC rate or the
amount calculated by multiplying the nonfacility practice expense (PE)
relative value units (RVUs) for the service by the conversion factor
under the MPFS. However, the PE RVUs listed for many CPT codes in
Addendum B of the CY 2008 MPFS final rule (72 FR 66222) were incorrect
due to a methodological error and consequently, have been corrected in
a correction notice to that final rule (73 FR 2568). Since the ASC
payment amounts for office-based procedures and covered ancillary
services are determined using the amounts in the MPFS final rule, we
must correct the CY 2008 payment amounts for ASC procedures and
services using the
[[Page 9861]]
corrected MPFS amounts. The corrected payment amounts are reflected in
Addenda AA and BB to this correction notice. Lastly, we inadvertently
labeled two Addendum as Addendum DD2 and are correcting ``Addendum DD2-
OPPS Comment Indicators'' to read ``Addendum D2-OPPS Comment
Indicators.'' In Addendum M, we inadvertently assigned incorrect APCs
to HCPCS codes 90862, 96102, and M0064. The APC assignments of these
individual services were correct in Addendum B to the CY 2008 OPPS/ASC
final rule with comment period (72 FR 67096, 67103, and 67160) that
identified OPPS payment by HCPCS code. Therefore, we are correcting
their assignments in Addendum M that identified HCPCS codes that may be
paid through composite APCs to reflect their correct OPPS treatment if
they are paid through a single code APC.
III. Correction of Errors
In FR Doc. 07-5507 (72 FR 66579), we are making the following
corrections:
1. On page 66580, in the second column, line 6 of the paragraph
entitled, ``Application Deadline--New Class of New Technology
Intraocular Lens:'' in the ``Dates'' section, the application deadline
date ``April 1, 2008'' is corrected to read ``March 14, 2008''.
2. On page 66589, in the first column, in line 15, the number ``131
million'' is corrected to read ``141 million.''
3. On page 66644, in the third column, in lines 12 and 13, the date
``January 2007'' is corrected to read ``January 2008.''
4. On page 66669, in the third column, fourth full paragraph, the
paragraph is deleted and replaced in its entirety to read as follows:
We received one comment related to our proposal.
Comment: A commenter disagreed with the statement in the CY 2008
OPPS/ASC proposed rule that the circumstances in which total body
hypothermia would be provided to a Medicare beneficiary would be
extremely rare. The commenter stated that approximately 72 percent of
all U.S. hospitals do not have cardiac catheterization or open heart
surgery capabilities. The commenter also stated that it would be common
for many post-cardiac arrest patients who are treated in these
hospitals to be transferred to another facility that can provide the
necessary services. The commenter also disagreed that low-cost methods
to induce hypothermia, such as applying ice packs to the patient, are
viable alternatives to technologically advanced methods of inducing
hypothermia, specifically because the low-cost methods are ineffective
and inconvenient. According to the commenter, the small number of
claims (39 in CY 2006) and low median cost ($35) for CPT code 99816
(Hypothermia; total body) mean that a hospital receives no additional
payment when providing hypothermia. The commenter recommended that CMS
create a Level II HCPCS G-code for technologically advanced methods of
inducing hypothermia, and that CMS pay separately for this new code.
Response: We proposed to package payment for CPT code 99816 for CY
2008. We continue to believe that when a patient presents to one
hospital and then is cooled and transported to another hospital without
admission to the first hospital, payment for the hypothermia service
would be most appropriately packaged into payment for the many other
separately payable services that it most likely accompanied and that
would be paid to the first hospital under the OPPS. To the extent that
technologically advanced methods to induce hypothermia may become an
adopted standard of care by more hospitals over time based on the
evolution of clinical practice, the median cost for CPT code 99186 may
change to reflect contemporary utilization patterns. In general, if a
service is described by an existing CPT code, we do not create an
additional Level II HCPCS code for payment. Instead, the commenter may
wish to discuss the hypothermia service with the AMA's CPT Editorial
Panel in order to assess the need for any changes to CPT codes.
Therefore, we are finalizing our proposal to maintain the packaged
status of CPT code 99186 for CY 2008.
5. On page 66726, in the second column, first full paragraph, under
the heading ``b. Endovenous Ablation (APC 0092)'', the paragraph is
deleted and replaced in its entirety to read as follows:
``For CY 2008, we proposed to pay approximately $1,684 for CPT
codes 36476 (Endovenous ablation therapy of incompetent vein,
extremity, inclusive of all imaging guidance and monitoring,
percutaneous, radiofrequency; second and subsequent veins treated in a
single extremity, each through separate access sites) and 36478
(Endovenous ablation therapy of incompetent vein, extremity, inclusive
of all imaging guidance and monitoring, percutaneous, laser; first vein
treated) through their proposed assignment to APC 0092 (Level I
Vascular Ligation). In CY 2007, CPT code 36476 is assigned to APC 0091
(Level II Vascular Ligation), which has a proposed CY 2008 payment rate
of $2,781. The proposed APC assignment for CPT code 36478 is the same
as its CY 2007 APC assignment.
6. On page 66726, in the second column, second full paragraph,
under the heading ``b. Endovenous Ablation (APC 0092)'', the paragraph
is deleted and replaced in its entirety to read as follows:
``We received several public comments on the proposed CY 2008
payment for CPT codes 36476 and 36478. A summary of the public comments
and our response follow.''
Comment: A commenter disagreed with our proposed reassignment of
add-on CPT code 36476 (Endovenous ablation therapy of incompetent vein,
extremity, inclusive of all imaging guidance and monitoring,
percutaneous, radiofrequency; second and subsequent veins treated in a
single extremity, each through separate access sites) from APC 0091
(Level II Vascular Ligation), with a proposed CY 2008 payment of
approximately $2,781, to APC 0092 (Level I Vascular Ligation), with a
proposed CY 2008 payment of approximately $1,684. According to the
commenter, CPT code 36476 should remain in APC 0091, the same APC to
which its associated primary CPT code, 36475 (Endovenous ablation
therapy of incompetent vein, extremity, inclusive of all imaging
guidance and monitoring, percutaneous, radiofrequency; first vein
treated), was proposed for assignment in CY 2008. The commenter
asserted that the procedures described by CPT codes 36475 and 36476 are
clinically similar and use comparable resources, and that the
application of the multiple procedure reduction to lower-paying APC
0092 would result in inaccurate payment for the CPT code 36476 add-on
procedure, which always must be performed in conjunction with the
primary procedure.
Response: We proposed to reassign 36476 from APC 0091 to APC 0092
because proposed rule claims data indicated that the costs associated
with CPT code 36476 are more similar to the costs of other procedures
assigned to APC 0092, taking into account the multiple surgical
procedure 50 percent payment reduction that would be applied in the
typical cases where CPT code 36476 was reported in conjunction with CPT
code 36475. Final rule claims data support this reassignment; the
median cost for CPT code 36476 is approximately $971, while the CY 2008
payment rate for APC 0092 is approximately $1,646, and the payment rate
for APC 0091 is approximately $2,714. The median cost for the first
vessel CPT code 36475 is much higher than that of CPT code 36476, at
approximately $2,396, which we believe
[[Page 9862]]
to be a reflection of the significantly higher relative cost of
furnishing the initial service described by CPT code 36475 compared to
the additional service described by CPT code 36476, likely due in part
to the radiofrequency catheter cost that is associated with the initial
service. We disagree with the commenter that CPT codes 36475 and 36476
are similar in terms of resource utilization based on this cost data.
The application of the multiple procedure reduction of 50 percent
to APC 0092 when CPT code 36476 is billed with another procedure with
status indicator ``T,'' such as CPT code 36475, would result in a
payment of approximately $823, a sum that is only slightly less than
the approximate $971 median cost of CPT code 36476. In contrast, if CPT
code 36476 were assigned to APC 0091, the payment with the multiple
procedure reduction would be approximately $1,357, a substantial
overpayment. Therefore, we disagree with the commenter that assignment
of CPT code 36476 to APC 0092 would result in inaccurate payment, even
with application of the multiple procedure reduction. While it is true
that the procedure described by CPT code 36476 is clinically similar to
the procedure described by CPT code 36475 which is assigned to APC 0091
as the commenter asserts, it also is clinically similar to other
procedures in APC 0092, which includes a variety of surgical procedures
involving veins.
In summary, we continue to believe that the procedure described by
CPT code 36476 is similar both clinically and in terms of resource
utilization to other procedures assigned to APC 0092, even with
application of the multiple procedure reduction. Therefore, after
review of the public comment received, we are finalizing our proposal,
without modification, to reassign CPT code 36476 to APC 0092 for CY
2008.
7. On page 66726, in the third column, the third full paragraph,
the paragraph is deleted and replaced in its entirety to read as
follows:
``After consideration of the public comments received, we are
finalizing our CY 2008 proposal, without modification, to assign CPT
codes 36476 and 36478 to APC 0092, with a median cost of about
$1,626''.
8. On page 66906, in the third column, in the first full
paragraph--
A. In line 16, the APC code ``8000'' is corrected to read ``8001.''
B. In line 24, the APC code, ``8001'' is corrected to read
``8000.''
Correction to Regulations Text
0
On page 66934, the introductory text of Sec. 485.610(e) is revised to
read as follows:
Sec. 485.610 Conditions of participation: Status and location.
* * * * *
(e) Standard: Off-campus and co-location requirements for CAHs. A
CAH may continue to meet the location requirements of paragraph (c) of
this section only if the CAH meets the following:
* * * * *
Corrections to Addenda
Addendum A.--OPPS APCS for CY 2008
0
1. On page 66939, for APC 0825, in line 74, in column 7, the minimum
unadjusted copayment ``$17.37'' is corrected to read ``$17.20.''
0
2. On page 66940, for APC 0911, in line 43--
0
A. In column 5, the payment rate ``$129.75'' is corrected to read
``$20.89.''
0
B. In column 7, the minimum unadjusted copayment ``25.95'' is corrected
to read ``$4.18.''
0
3. On page 66940, for APC 0951, in line 7 from the bottom of the page,
in column 7, the minimum unadjusted copayment ``$44.16'' is corrected
to read ``$43.74.''
0
4. On page 66941, for APC 0998, in line 11--
0
A. In column 5, the payment rate ``$88.15'' is corrected to read
``$12.24.''
0
B. In column 7, the minimum unadjusted copayment ``$17.63'' is
corrected to read ``$2.45.''
0
5. On page 66941, for APC 1041, in line 27--
0
A. In column 5, the payment rate ``$172.41'' is corrected to read
``$19.81.''
0
B. In column 7, the minimum unadjusted copayment ``$34.48'' is
corrected to read ``$3.96.''
0
6. On page 66941, for APC 1141, in line 36--
0
A. In column 5, the payment rate ``$67.96'' is corrected to read
``$42.24.''
0
B. In column 7, the minimum unadjusted copayment ``$13.59'' is
corrected to read ``$8.37.''
0
7. On page 66941, for APC 1168, in line 42, in column 7, the minimum
unadjusted copayment ``$9.68'' is corrected to read ``$9.59.''
0
8. On page 66941, for APC 1169, in line 43--
0
A. In column 5, the payment rate ``$482.56'' is corrected to read
``$407.56.''
0
B. In column 7, the minimum unadjusted copayment ``$96.51'' is
corrected to read ``$80.74.''
0
9. On page 66942, for APC 1606, in line 52--
0
A. In column 5, the payment rate ``$2,693.80'' is corrected to read
``$1,706.04.''
0
B. In column 7, the minimum unadjusted copayment ``$538.76'' is
corrected to read ``$341.21.''
0
10. On page 66943, for APC 2940, in line 37--
0
A. In column 5, the payment rate ``$168.90'' is corrected to read
``$42.69.''
0
B. In column 7, the minimum unadjusted copayment ``$33.78'' is
corrected to read ``$8.54.''
0
11. On page 66944, for APC 9051, in line 5--
0
A. In column 5, the payment rate ``$74.16'' is corrected to read
``$23.23.''
0
B. In column 7, the minimum unadjusted copayment ``$14.83'' is
corrected to read ``$4.65.''
0
12. On page 66944, for APC 9126, in line 17, in column 7, the minimum
unadjusted copayment ``$1.50'' is corrected to read ``$1.49.''
0
13. On page 66944, for APC 9140, in line 23--
0
A. In column 5, the payment rate ``$119.86'' is corrected to read
``$118.82.''
0
B. In column 7, the minimum unadjusted copayment ``$23.97'' is
corrected to read ``$23.76.''
0
14. On page 66944, for APC 9141, in line 24--
0
A. In column 5, the payment rate ``$45.53'' is corrected to read
``$66.38.''
0
B. In column 7, the minimum unadjusted copayment ``$9.11'' is corrected
to read ``$13.28.''
0
15. On page 66944, for APC 9167, in line 29--
0
A. In column 5, the payment rate ``$77.96'' is corrected to read
``$219.39.''
0
B. In column 7, the minimum unadjusted copayment ``$15.59'' is
corrected to read ``$43.88.''
0
16. On page 66944--
0
A. For APC 9227, in line 43, in column 7, the minimum unadjusted
copayment ``$0.29'' is corrected to read ``$0.28.''
0
B. For APC 9229, in line 45, in column 7, the minimum unadjusted
copayment ``$27.79'' is corrected to read ``$27.53.''
0
C. For APC 9230, in line 46, in column 7, the minimum unadjusted
copayment ``$3.74'' is corrected to read ``$3.70.''
0
D. For APC 9232, in line 48, in column 7, the minimum unadjusted
copayment ``$91.01'' is corrected to read ``$90.15.''
[[Page 9863]]
0
E. For APC 9233, in line 49, in column 7, the minimum unadjusted
copayment ``$406.05'' is corrected to read ``$402.22.''
0
F. For APC 9235, in line 51, in column 7, the minimum unadjusted
copayment ``$16.63'' is corrected to read ``$16.47.''
0
G. For APC 9236, in line 52, in column 7, the minimum unadjusted
copayment ``$35.28'' is corrected to read ``$34.94.''
0
17. On page 66944, for APC 9350, in line 55--
0
A. In column 5, the payment rate ``$482.56'' is corrected to read
``$496.87.''
0
B. In column 7, the minimum unadjusted copayment ``$96.51'' is
corrected to read ``$98.44.''
0
18. On page 66944, for APC 9351, in line 56--
0
A. In column 5, the payment rate ``$67.96'' is corrected to read
``$95.32.''
0
B. In column 7, the minimum unadjusted copayment ``$13.59'' is
corrected to read ``$18.88.''
ADDENDUM AA.--ASC COVERED SURGICAL PROCEDURES FOR CY 2008
We are republishing Addendum AA in its entirety. See attached
chart.
ADDENDUM B.--OPPS PAYMENT BY HCPCS CODE FOR CY 2008
0
1. On page 67095, the chart for HCPCS codes starting with HCPCS code
90649 through HCPCS code 90708 should read as follows:
--------------------------------------------------------------------------------------------------------------------------------------------------------
National Minimum
HCPCS code Short descriptor CI SI APC Relative Payment unadjusted unadjusted
weight rate copayment copayment
--------------------------------------------------------------------------------------------------------------------------------------------------------
90650.............. Hpv typ bival 3 dose, im.. NI................ E................. ........... ........... ........... ........... ...........
90655.............. Flu vaccine no preserv 6- .................. L................. ........... ........... ........... ........... ...........
35m.
90656.............. Flu vaccine no preserv 3 & .................. L................. ........... ........... ........... ........... ...........
>.
90657.............. Flu vaccine, 3 yrs, im.... .................. L................. ........... ........... ........... ........... ...........
90658.............. Flu vaccine, 3 yrs & >, im .................. L................. ........... ........... ........... ........... ...........
90660.............. Flu vaccine, nasal........ .................. L................. ........... ........... ........... ........... ...........
90661.............. Flu vacc cell cult prsv NI................ E................. ........... ........... ........... ........... ...........
free.
90662.............. Flu vacc prsv free inc NI................ E................. ........... ........... ........... ........... ...........
antig.
90663.............. Flu vacc pandemic......... NI................ E................. ........... ........... ........... ........... ...........
90665.............. Lyme disease vaccine, im.. .................. N................. ........... ........... ........... ........... ...........
90669.............. Pneumococcal vacc, ped <5. CH................ L................. ........... ........... ........... ........... ...........
90675.............. Rabies vaccine, im........ .................. K................. 9139 ........... $150.80 ........... $30.16
90676.............. Rabies vaccine, id........ .................. K................. 9140 ........... $118.82 ........... $23.76
90680.............. Rotavirus vacc 3 dose, .................. N................. ........... ........... ........... ........... ...........
oral.
90681.............. Rotavirus vacc 2 dose, NI................ E................. ........... ........... ........... ........... ...........
oral.
90690.............. Typhoid vaccine, oral..... .................. N................. ........... ........... ........... ........... ...........
90691.............. Typhoid vaccine, im....... .................. N................. ........... ........... ........... ........... ...........
90692.............. Typhoid vaccine, h-p, sc/ .................. N................. ........... ........... ........... ........... ...........
id.
90693.............. Typhoid vaccine, akd, sc.. .................. B................. ........... ........... ........... ........... ...........
90696.............. Dtap-ipv vacc 4-6 yr, im.. NI................ E................. ........... ........... ........... ........... ...........
90698.............. Dtap-hib-ip vaccine, im... .................. N................. ........... ........... ........... ........... ...........
90700.............. Dtap vaccine, < 7 yrs, im. .................. N................. ........... ........... ........... ........... ...........
90701.............. Dtp vaccine, im........... .................. N................. ........... ........... ........... ........... ...........
90702.............. Dt vaccine < 7, im........ .................. N................. ........... ........... ........... ........... ...........
90703.............. Tetanus vaccine, im....... .................. N................. ........... ........... ........... ........... ...........
90704.............. Mumps vaccine, sc......... .................. N................. ........... ........... ........... ........... ...........
90705.............. Measles vaccine, sc....... .................. N................. ........... ........... ........... ........... ...........
90706.............. Rubella vaccine, sc....... .................. N................. ........... ........... ........... ........... ...........
90707.............. Mmr vaccine, sc........... .................. N................. ........... ........... ........... ........... ...........
90708.............. Measles-rubella vaccine, .................. K................. 9141 ........... $66.38 ........... $13.28
sc.
--------------------------------------------------------------------------------------------------------------------------------------------------------
0
2. On page 67118, for HCPCS code C9239, in line 25, in column 9, the
minimum unadjusted copayment ``$9.68'' is corrected to read ``$9.59.''
0
3. On page 67118, for HCPCS code C9352, in line 28--
0
A. In column 7, the payment rate ``$482.56'' is corrected to read
``$496.87.''
0
B. In column 9, the minimum unadjusted copayment ``$96.51'' is
corrected to read ``$98.44.''
0
4. On page 67118, for HCPCS code C9353, in line 29--
0
A. In column 7, the payment rate ``$482.56'' is corrected to read
``$407.56.''
0
B. In column 9, the minimum unadjusted copayment ``$96.51'' is
corrected to read ``$80.74.''
0
5. On page 67134, for HCPCS code G0377, in line 47--
0
A. In column 4, the SI code ``S'' is corrected to read ``E.''
0
B. In column 5, the APC code ``0437'' is removed.
0
C. In column 6, the relative weight number ``0.3945'' is removed.
0
D. In column 7, the payment rate ``$25.13'' is removed.
0
E. In column 9, the minimum unadjusted copayment ``$5.03'' is removed.
0
6. On page 67139, for HCPCS code G9140, in line 40, in column 4, the SI
code ``M'' is corrected to read ``A''.
0
7. On page 67139, for HCPCS code J0129, in line 43, in column 9, the
minimum unadjusted copayment ``$3.74'' is corrected to read ``$3.70.''
0
8. On page 67139, for HCPCS code J0190, in line 52--
0
A. In column 7, the payment rate ``$88.15'' is corrected to read
``$12.24.''
0
B. In column 9, the minimum unadjusted copayment ``$17.63'' is
corrected to read ``$2.45.''
0
9. On page 67139, for HCPCS code J0350, in line 74--
0
A. In column 7, the payment rate ``$2,693.80'' is corrected to read
``$1,706.04.''
0
B. In column 9, the minimum unadjusted copayment ``$538.76'' is
corrected to read ``$341.21.''
0
10. On page 67141, for HCPCS code J1300, in line 17, in column 9, the
minimum unadjusted copayment ``$35.28'' is corrected to read
``$34.94.''
0
11. On page 67142--
0
A. For HCPCS code J1740, in line 4, in column 9, the minimum unadjusted
copayment ``$27.79'' is corrected to read ``$27.53.''
0
B. For HCPCS code J1743, in line 6, in column 9, the minimum unadjusted
copayment ``$91.01'' is corrected to read ``$90.15.''
0
C. For HCPCS code J2248, in line 43, in column 9, the minimum
unadjusted copayment ``$0.29'' is corrected to read ``$0.28.''
0
D. For HCPCS code J2323, in line 57, in column 9, the minimum
unadjusted
[[Page 9864]]
copayment ``$1.50'' is corrected to read ``$1.49.''
0
12. On page 67143 for HCPCS code J2778, in line 21, in column 9, the
minimum unadjusted copayment ``$406.05'' is corrected to read
``$402.22.''
0
13. On page 67143, for HCPCS code J2940, in line 39--
0
A. In column 7, the payment rate ``$168.90'' is corrected to read
``$42.69.''
0
B. In column 9, the minimum unadjusted copayment ``$33.78'' is
corrected to read ``$8.54.''
0
14. On page 67143, for HCPCS code J2995, in line 43--
0
A. In column 7, the payment rate ``$129.75'' is corrected to read
``$20.89.''
0
B. In column 9, the minimum unadjusted copayment ``$25.95'' is
corrected to read ``$4.18.''
0
15. On page 67143, for HCPCS code J3350, in line 72--
0
A. In column 7, the payment rate ``$74.16'' is corrected to read
``$23.23.''
0
B. In column 9, the minimum unadjusted copayment ``$14.83'' is
corrected to read ``$4.65.''
0
16. On page 67144, for HCPCS code J3488, in line 15, in column 9, the
minimum unadjusted copayment ``$44.16'' is corrected to read
``$43.74.''
0
17. On page 67144, for HCPCS code J7348, in line 65--
0
A. In column 7, the payment rate ``$67.96'' is corrected to read
``$95.32,''
0
B. In column 9, the minimum unadjusted copayment ``$13.59'' is
corrected to read ``$18.88.''
0
18. On page 67144, for HCPCS code J7349, in line 66--
0
A. In column 7, the payment rate ``$67.96'' is corrected to read
``$42.24,''
0
B. In column 9, the minimum unadjusted copayment ``$13.59'' is
corrected to read ``$8.37.''
0
19. On page 67146, for HCPCS code J9261, in line 65, in column 9, the
minimum unadjusted copayment ``$17.37'' is corrected to read
``$17.20.''
0
20. On page 67146, for HCPCS code J9270, in line 71--
0
A. In column 7, the payment rate ``$172.41'' is corrected to read
``$19.81.''
0
B. In column 9, the minimum unadjusted copayment ``$34.48'' is
corrected to read ``$3.96.''
0
21. On page 67146, for HCPCS code J9303, in line 77, in column 9, the
minimum unadjusted copayment ``$16.63'' is corrected to read
``$16.47.''
0
22. On page 67147, for HCPCS code J9357, in line 4--
0
A. In column 7, the payment rate ``$77.96'' is corrected to read
``$219.39.''
0
B. In column 9, the minimum unadjusted copayment ``$15.59'' is
corrected to read ``$43.88.''
ADDENDUM BB.--ASC COVERED ANCILLARY SERVICES INTEGRAL TO COVERED
SURGICAL PROCEDURES FOR CY 2008
We are republishing Addendum BB in its entirety, see attached
chart.
ADDENDUM DD2.--OPPS COMMENT INDICATORS
0
On page 67190, in line 1, the header ``ADDENDUM DD2--OPPS COMMENT
INDICATORS'' is corrected to read ``ADDENDUM D2--OPPS COMMENT
INDICATORS.''
ADDENDUM M.--HCPCS CODES FOR ASSIGNMENT TO COMPOSITE APCS FOR CY 2008
0
On page 67225--
0
A. For HCPCS code 90862, in line 19, in column 5, the single code APC
assignment number ``0605'' is corrected to read ``0606.''
0
B. For HCPCS code 96102, in line 24, in column 5, the single code APC
assignment number ``0373'' is corrected to read ``0382.''
0
C. For HCPCS code M0064, in line 37, in column 5, the single code APC
assignment number ``0605'' is corrected to read ``0606.''
IV. Waiver of Proposed Rulemaking and Delay in Effective Date
We ordinarily publish a notice of proposed rulemaking in the
Federal Register to provide a period for public comment before the
provisions of a notice such as this takes effect in accordance with
section 553(b) of the Administrative Procedure Act (APA) (5 U.S.C.
553(b)). We also ordinarily provide a 30-day delay in the effective
date of the provisions of a notice in accordance with section 553(d) of
the APA (5 U.S.C. 553(d)). However, we can waive both the notice and
comment procedure and the 30-day delay in effective date if the
Secretary finds, for good cause, that it is impracticable, unnecessary
or contrary to the public interest, and incorporates a statement of the
finding and the reasons therefore in the notice. The policies and
payment methodology finalized in the CY 2008 OPPS/ASC final rule with
comment period have previously been subjected to notice and comment
procedures.
This correction notice merely provides technical corrections to the
CY 2008 OPPS/ASC final rule with comment period that was promulgated
through notice and comment rulemaking, and does not make substantive
changes to the policies or payment methodologies that were finalized in
the final rule with comment period. For example, in order to conform
the document to the final policies of the CY 2008 OPPS/ASC final rule
with comment period, this notice corrects typographical errors, makes
clarifications to the preamble text, and revises inaccurate tabular
data. Therefore, we find it unnecessary to undertake further notice and
comment procedures with respect to this correction notice. For the
reasons stated above, we find that both notice and comment and the 30-
day delay in effective date for this correction notice are unnecessary.
Therefore, we find there is good cause to waive notice and comment
procedures and the 30-day delay in effective date for this correction
notice.
(Catalog of Federal Domestic Assistance Program No. 93.774,
Medicare--Supplementary Medical Insurance Program)
Dated: February 5, 2008.
Ann Agnew,
Executive Secretary to the Department.
[[Page 9865]]
Addendum AA.--ASC Covered Surgical Procedures for CY 2008
[Including Surgical Procedures for Which Payment Is Packaged]
--------------------------------------------------------------------------------------------------------------------------------------------------------
CY 2008 CY 2008
Subject to CY 2007 ASC fully CY 2008 first
HCPCS code Short descriptor multiple Comment indicator Payment indicator payment implemented fully transition
procedure rate payment implemented year
discounting weight payment payment
--------------------------------------------------------------------------------------------------------------------------------------------------------
0016T............ Thermotx choroid vasc Y................ ................. R2............... ........... 4.1331 $171.11 $171.11
lesion.
0017T............ Photocoagulat macular Y................ ................. R2............... ........... 4.1331 $171.11 $171.11
drusen.
0027T............ Endoscopic epidural Y................ ................. G2............... ........... 18.0518 $747.36 $747.36
lysis.
0031T............ Speculoscopy............ N................ ................. N1............... ........... ........... ........... ...........
0032T............ Speculoscopy w/direct N................ ................. N1............... ........... ........... ........... ...........
sample.
0046T............ Cath lavage, mammary Y................ ................. R2............... ........... 16.1001 $666.56 $666.56
duct(s).
0047T............ Cath lavage, mammary Y................ ................. R2............... ........... 16.1001 $666.56 $666.56
duct(s).
0062T............ Rep intradisc annulus;1 Y................ ................. G2............... ........... 29.19 $1,208.50 $1,208.50
lev.
0063T............ Rep intradisc annulus; Y................ ................. G2............... ........... 29.19 $1,208.50 $1,208.50
>1 lev.
0084T............ Temp prostate urethral Y................ ................. G2............... ........... 2.0077 $83.12 $83.12
stent.
0088T............ Rf tongue base vol Y................ CH............... G2............... ........... 16.3288 $676.03 $676.03
reduxn.
0099T *.......... Implant corneal ring.... Y................ ................. R2............... ........... 16.171 $669.50 $669.50
0100T............ Prosth retina receive & Y................ ................. G2............... ........... 37.2078 $1,540.44 $1,540.44
gen.
0101T............ Extracorp shockwv tx,hi Y................ ................. G2............... ........... 29.19 $1,208.50 $1,208.50
enrg.
0102T............ Extracorp shockwv Y................ ................. G2............... ........... 29.19 $1,208.50 $1,208.50
tx,anesth.
0123T............ Scleral fistulization... Y................ ................. G2............... ........... 23.1758 $959.50 $959.50
0124T *.......... Conjunctival drug Y................ ................. R2............... ........... 5.1169 $211.84 $211.84
placement.
0137T............ Prostate saturation Y................ CH............... G2............... ........... 11.0338 $456.81 $456.81
sampling.
0170T............ Anorectal fistula plug Y................ CH............... G2............... ........... 30.1606 $1,248.68 $1,248.68
rpr.
0176T............ Aqu canal dilat w/o Y................ ................. A2............... $1,339.00 39.7101 $1,644.04 $1,415.26
retent.
0177T............ Aqu canal dilat w retent Y................ ................. A2............... $1,339.00 39.7101 $1,644.04 $1,415.26
0186T............ Suprachoroidal drug Y................ NI............... G2............... ........... 18.235 $754.95 $754.95
delivery.
10021............ Fna w/o image........... Y................ ................. P2............... ........... 1.1097 $45.94 $45.94
10022............ Fna w/image............. Y................ ................. G2............... ........... 4.327 $179.14 $179.14
10040............ Acne surgery............ Y................ ................. P2............... ........... 0.793 $32.83 $32.83
10060............ Drainage of skin abscess Y................ ................. P3............... ........... 1.1191 $46.33 $46.33
10061............ Drainage of skin abscess Y................ ................. P2............... ........... 1.4066 $58.23 $58.23
10080............ Drainage of pilonidal Y................ ................. P2............... ........... 1.4066 $58.23 $58.23
cyst.
10081............ Drainage of pilonidal Y................ ................. P3............... ........... 3.1106 $128.78 $128.78
cyst.
10120............ Remove foreign body..... Y................ ................. P2............... ........... 1.4066 $58.23 $58.23
10121............ Remove foreign body..... Y................ ................. A2............... $446.00 16.1001 $666.56 $501.14
10140............ Drainage of hematoma/ Y................ ................. P3............... ........... 1.6623 $68.82 $68.82
fluid.
10160............ Puncture drainage of Y................ ................. P2............... ........... 1.4066 $58.23 $58.23
lesion.
10180............ Complex drainage, wound. Y................ ................. A2............... $446.00 18.3197 $758.45 $524.11
11000............ Debride infected skin... Y................ ................. P3............... ........... 0.5348 $22.14 $22.14
11001............ Debride infected skin Y................ ................. P3............... ........... 0.1894 $7.84 $7.84
add-on.
11010............ Debride skin, fx........ Y................ ................. A2............... $251.52 4.3039 $178.19 $233.19
11011............ Debride skin/muscle, fx. Y................ ................. A2............... $251.52 4.3039 $178.19 $233.19
11012............ Debride skin/muscle/ Y................ ................. A2............... $251.52 4.3039 $178.19 $233.19
bone, fx.
11040............ Debride skin, partial... Y................ ................. P3............... ........... 0.4937 $20.44 $20.44
11041............ Debride skin, full...... Y................ ................. P3............... ........... 0.5679 $23.51 $23.51
11042............ Debride skin/tissue..... Y................ ................. A2............... $164.42 2.6604 $110.14 $150.85
11043............ Debride tissue/muscle... Y................ ................. A2............... $164.42 2.6604 $110.14 $150.85
11044............ Debride tissue/muscle/ Y................ ................. A2............... $423.10 6.8816 $284.91 $388.55
bone.
11055............ Trim skin lesion........ Y................ ................. P3............... ........... 0.5596 $23.17 $23.17
11056............ Trim skin lesions, 2 to Y................ ................. P3............... ........... 0.6253 $25.89 $25.89
4.
11057............ Trim skin lesions, over Y................ ................. P3............... ........... 0.7077 $29.30 $29.30
4.
11100............ Biopsy, skin lesion..... Y................ ................. P2............... ........... 0.793 $32.83 $32.83
11101............ Biopsy, skin add-on..... Y................ ................. P3............... ........... 0.3046 $12.61 $12.61
11200............ Removal of skin tags.... Y................ CH............... P2............... ........... 0.793 $32.83 $32.83
11201............ Remove skin tags add-on. Y................ ................. P3............... ........... 0.1316 $5.45 $5.45
11300............ Shave skin lesion....... Y................ ................. P2............... ........... 0.793 $32.83 $32.83
11301............ Shave skin lesion....... Y................ ................. P2............... ........... 0.793 $32.83 $32.83
11302............ Shave skin lesion....... Y................ ................. P2............... ........... 0.793 $32.83 $32.83
11303............ Shave skin lesion....... Y................ ................. P2............... ........... 1.4595 $60.42 $60.42
11305............ Shave skin lesion....... Y................ ................. P3............... ........... 0.7901 $32.71 $32.71
11306............ Shave skin lesion....... Y................ CH............... P2............... ........... 0.793 $32.83 $32.83
11307............ Shave skin lesion....... Y................ ................. P2............... ........... 0.793 $32.83 $32.83
11308............ Shave skin lesion....... Y................ ................. P2............... ........... 0.793 $32.83 $32.83
11310............ Shave skin lesion....... Y................ CH............... P2............... ........... 0.793 $32.83 $32.83
11311............ Shave skin lesion....... Y................ ................. P2............... ........... 0.793 $32.83 $32.83
11312............ Shave skin lesion....... Y................ ................. P2............... ........... 0.793 $32.83 $32.83
11313............ Shave skin lesion....... Y................ CH............... P2............... ........... 0.793 $32.83 $32.83
11400............ Exc tr-ext b9+marg 0.5 < Y................ ................. P3............... ........... 1.5963 $66.09 $66.09
cm.
11401............ Exc tr-ext b9+marg 0.6-1 Y................ ................. P3............... ........... 1.7444 $72.22 $72.22
cm.
11402............ Exc tr-ext b9+marg 1.1-2 Y................ ................. P3............... ........... 1.9009 $78.70 $78.70
cm.
11403............ Exc tr-ext b9+marg 2.1-3 Y................ ................. P3............... ........... 2.0408 $84.49 $84.49
cm.
11404............ Exc tr-ext b9+marg 3.1-4 Y................ ................. A2............... $333.00 16.1001 $666.56 $416.39
cm.
11406............ Exc tr-ext b9+marg > 4.0 Y................ ................. A2............... $446.00 16.1001 $666.56 $501.14
cm.
11420............ Exc h-f-nk-sp b9+marg Y................ ................. P3............... ........... 1.4811 $61.32 $61.32
0.5 <.
11421............ Exc h-f-nk-sp b9+marg Y................ ................. P3............... ........... 1.7611 $72.91 $72.91
0.6-1.
11422............ Exc h-f-nk-sp b9+marg Y................ ................. P3............... ........... 1.9338 $80.06 $80.06
1.1-2.
11423............ Exc h-f-nk-sp b9+marg Y................ ................. P3............... ........... 2.1642 $89.60 $89.60
2.1-3.
11424............ Exc h-f-nk-sp b9+marg Y................ ................. A2............... $446.00 16.1001 $666.56 $501.14
3.1-4.
11426............ Exc h-f-nk-sp b9+marg > Y................ ................. A2............... $446.00 21.1098 $873.97 $552.99
4 cm.
11440............ Exc face-mm b9+marg 0.5 Y................ ................. P3............... ........... 1.728 $71.54 $71.54
< cm.
11441............ Exc face-mm b9+marg 0.6- Y................ ................. P3............... ........... 1.942 $80.40 $80.40
1 cm.
[[Page 9866]]
11442............ Exc face-mm b9+marg 1.1- Y................ ................. P3............... ........... 2.1313 $88.24 $88.24
2 cm.
11443............ Exc face-mm b9+marg 2.1- Y................ ................. P3............... ........... 2.3864 $98.80 $98.80
3 cm.
11444............ Exc face-mm b9+marg 3.1- Y................ ................. A2............... $333.00 8.685 $359.57 $339.64
4 cm.
11446............ Exc face-mm b9+marg > 4 Y................ ................. A2............... $446.00 21.1098 $873.97 $552.99
cm.
11450............ Removal, sweat gland Y................ ................. A2............... $446.00 21.1098 $873.97 $552.99
lesion.
11451............ Removal, sweat gland Y................ ................. A2............... $446.00 21.1098 $873.97 $552.99
lesion.
11462............ Removal, sweat gland Y................ ................. A2............... $446.00 21.1098 $873.97 $552.99
lesion.
11463............ Removal, sweat gland Y................ ................. A2............... $446.00 21.1098 $873.97 $552.99
lesion.
11470............ Removal, sweat gland Y................ ................. A2............... $446.00 21.1098 $873.97 $552.99
lesion.
11471............ Removal, sweat gland Y................ ................. A2............... $446.00 21.1098 $873.97 $552.99
lesion.
11600............ Exc tr-ext mlg+marg 0.5 Y................ ................. P3............... ........... 2.2135 $91.64 $91.64
< cm.
11601............ Exc tr-ext mlg+marg 0.6- Y................ ................. P3............... ........... 2.5263 $104.59 $104.59
1 cm.
11602............ Exc tr-ext mlg+marg 1.1- Y................ ................. P3............... ........... 2.7485 $113.79 $113.79
2 cm.
11603............ Exc tr-ext mlg+marg 2.1- Y................ ................. P3............... ........... 2.9294 $121.28 $121.28
3 cm.
11604............ Exc tr-ext mlg+marg 3.1- Y................ ................. A2............... $418.49 8.685 $359.57 $403.76
4 cm.
11606............ Exc tr-ext mlg+marg > 4 Y................ ................. A2............... $446.00 16.1001 $666.56 $501.14
cm.
11620............ Exc h-f-nk-sp mlg+marg Y................ ................. P3............... ........... 2.2384 $92.67 $92.67
0.5 <.
11621............ Exc h-f-nk-sp mlg+marg Y................ ................. P3............... ........... 2.5509 $105.61 $105.61
0.6-1.
11622............ Exc h-f-nk-sp mlg+marg Y................ ................. P3............... ........... 2.8224 $116.85 $116.85
1.1-2.
11623............ Exc h-f-nk-sp mlg+marg Y................ ................. P3............... ........... 3.0692 $127.07 $127.07
2.1-3.
11624............ Exc h-f-nk-sp mlg+marg Y................ ................. A2............... $446.00 16.1001 $666.56 $501.14
3.1-4.
11626............ Exc h-f-nk-sp mlg+mar > Y................ ................. A2............... $446.00 21.1098 $873.97 $552.99
4 cm.
11640............ Exc face-mm malig+marg Y................ ................. P3............... ........... 2.3536 $97.44 $97.44
0.5 <.
11641............ Exc face-mm malig+marg Y................ ................. P3............... ........... 2.7403 $113.45 $113.45
0.6-1.
11642............ Exc face-mm malig+marg Y................ ................. P3............... ........... 3.061 $126.73 $126.73
1.1-2.
11643............ Exc face-mm malig+marg Y................ ................. P3............... ........... 3.3246 $137.64 $137.64
2.1-3.
11644............ Exc face-mm malig+marg Y................ ................. A2............... $446.00 16.1001 $666.56 $501.14
3.1-4.
11646............ Exc face-mm mlg+marg > 4 Y................ ................. A2............... $446.00 21.1098 $873.97 $552.99
cm.
11719............ Trim nail(s)............ Y................ ................. P3............... ........... 0.2551 $10.56 $10.56
11720............ Debride nail, 1-5....... Y................ ................. P3............... ........... 0.3292 $13.63 $13.63
11721............ Debride nail, 6 or more. Y................ ................. P3............... ........... 0.4031 $16.69 $16.69
11730............ Removal of nail plate... Y................ CH............... P2............... ........... 0.793 $32.83 $32.83
11732............ Remove nail plate, add- Y................ ................. P3............... ........... 0.4031 $16.69 $16.69
on.
11740............ Drain blood from under Y................ CH............... P2............... ........... 0.2963 $12.27 $12.27
nail.
11750............ Removal of nail bed..... Y................ ................. P3............... ........... 2.1065 $87.21 $87.21
11752............ Remove nail bed/finger Y................ ................. P3............... ........... 2.9048 $120.26 $120.26
tip.
11755............ Biopsy, nail unit....... Y................ ................. P3............... ........... 1.4811 $61.32 $61.32
11760............ Repair of nail bed...... Y................ ................. G2............... ........... 2.1051 $87.15 $87.15
11762............ Reconstruction of nail Y................ CH............... P3............... ........... 2.7072 $112.08 $112.08
bed.
11765............ Excision of nail fold, Y................ ................. P2............... ........... 1.4595 $60.42 $60.42
toe.
11770............ Removal of pilonidal Y................ ................. A2............... $510.00 21.1098 $873.97 $600.99
lesion.
11771............ Removal of pilonidal Y................ ................. A2............... $510.00 21.1098 $873.97 $600.99
lesion.
11772............ Removal of pilonidal Y................ ................. A2............... $510.00 21.1098 $873.97 $600.99
lesion.
11900............ Injection into skin Y................ ................. P3............... ........... 0.6418 $26.57 $26.57
lesions.
11901............ Added skin lesions Y................ ................. P3............... ........... 0.6831 $28.28 $28.28
injection.
11920............ Correct skin color Y................ ................. P2............... ........... 2.1051 $87.15 $87.15
defects.
11921............ Correct skin color Y................ ................. P2............... ........... 2.1051 $87.15 $87.15
defects.
11922............ Correct skin color Y................ ................. P3............... ........... 0.8476 $35.09 $35.09
defects.
11950............ Therapy for contour Y................ ................. P3............... ........... 0.8311 $34.41 $34.41
defects.
11951............ Therapy for contour Y................ ................. P3............... ........... 0.9874 $40.88 $40.88
defects.
11952............ Therapy for contour Y................ CH............... P2............... ........... 1.2792 $52.96 $52.96
defects.
11954............ Therapy for contour Y................ ................. P2............... ........... 1.2792 $52.96 $52.96
defects.
11960............ Insert tissue Y................ ................. A2............... $446.00 20.2069 $836.59 $543.65
expander(s).
11970............ Replace tissue expander. Y................ ................. A2............... $510.00 42.985 $1,779.62 $827.41
11971............ Remove tissue Y................ ................. A2............... $333.00 21.1098 $873.97 $468.24
expander(s).
11976............ Removal of contraceptive Y................ ................. P3............... ........... 1.4154 $58.60 $58.60
cap.
11980............ Implant hormone N................ ................. P2............... ........... 0.631 $26.12 $26.12
pellet(s).
11981............ Insert drug implant N................ ................. P2............... ........... 0.631 $26.12 $26.12
device.
11982............ Remove drug implant N................ ................. P2............... ........... 0.631 $26.12 $26.12
device.
11983............ Remove/insert drug N................ ................. P2............... ........... 0.631 $26.12 $26.12
implant.
12001............ Repair superficial Y................ ................. P2............... ........... 1.2792 $52.96 $52.96
wound(s).
12002............ Repair superficial Y................ ................. P2............... ........... 1.2792 $52.96 $52.96
wound(s).
12004............ Repair superficial Y................ ................. P2............... ........... 1.2792 $52.96 $52.96
wound(s).
12005............ Repair superficial Y................ ................. A2............... $91.24 1.2792 $52.96 $81.67
wound(s).
12006............ Repair superficial Y................ ................. A2............... $91.24 1.2792 $52.96 $81.67
wound(s).
12007............ Repair superficial Y................ ................. A2............... $91.24 1.2792 $52.96 $81.67
wound(s).
12011............ Repair superficial Y................ ................. P2............... ........... 1.2792 $52.96 $52.96
wound(s).
12013............ Repair superficial Y................ ................. P2............... ........... 1.2792 $52.96 $52.96
wound(s).
12014............ Repair superficial Y................ ................. P2............... ........... 1.2792 $52.96 $52.96
wound(s).
12015............ Repair superficial Y................ ................. G2............... ........... 1.2792 $52.96 $52.96
wound(s).
12016............ Repair superficial Y................ ................. A2............... $91.24 1.2792 $52.96 $81.67
wound(s).
12017............ Repair superficial Y................ ................. A2............... $91.24 1.2792 $52.96 $81.67
wound(s).
12018............ Repair superficial Y................ ................. A2............... $91.24 1.2792 $52.96 $81.67
wound(s).
12020............ Closure of split wound.. Y................ ................. A2............... $91.24 4.5263 $187.39 $115.28
12021............ Closure of split wound.. Y................ ................. A2............... $91.24 4.5263 $187.39 $115.28
12031............ Layer closure of Y................ ................. P2............... ........... 2.1051 $87.15 $87.15
wound(s).
12032............ Layer closure of Y................ ................. P2............... ........... 2.1051 $87.15 $87.15
wound(s).
[[Page 9867]]
12034............ Layer closure of Y................ ................. A2............... $91.24 2.1051 $87.15 $90.22
wound(s).
12035............ Layer closure of Y................ ................. A2............... $91.24 2.1051 $87.15 $90.22
wound(s).
12036............ Layer closure of Y................ ................. A2............... $91.24 2.1051 $87.15 $90.22
wound(s).
12037............ Layer closure of Y................ ................. A2............... $323.28 2.1051 $87.15 $264.25
wound(s).
12041............ Layer closure of Y................ ................. P2............... ........... 2.1051 $87.15 $87.15
wound(s).
12042............ Layer closure of Y................ ................. P2............... ........... 2.1051 $87.15 $87.15
wound(s).
12044............ Layer closure of Y................ ................. A2............... $91.24 2.1051 $87.15 $90.22
wound(s).
12045............ Layer closure of Y................ ................. A2............... $91.24 2.1051 $87.15 $90.22
wound(s).
12046............ Layer closure of Y................ ................. A2............... $91.24 2.1051 $87.15 $90.22
wound(s).
12047............ Layer closure of Y................ ................. A2............... $323.28 2.1051 $87.15 $264.25
wound(s).
12051............ Layer closure of Y................ ................. P2............... ........... 2.1051 $87.15 $87.15
wound(s).
12052............ Layer closure of Y................ ................. P2............... ........... 2.1051 $87.15 $87.15
wound(s).
12053............ Layer closure of Y................ ................. P2............... ........... 2.1051 $87.15 $87.15
wound(s).
12054............ Layer closure of Y................ ................. A2............... $91.24 2.1051 $87.15 $90.22
wound(s).
12055............ Layer closure of Y................ ................. A2............... $91.24 2.1051 $87.15 $90.22
wound(s).
12056............ Layer closure of Y................ ................. A2............... $91.24 2.1051 $87.15 $90.22
wound(s).
12057............ Layer closure of Y................ ................. A2............... $323.28 2.1051 $87.15 $264.25
wound(s).
13100............ Repair of wound or Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
lesion.
13101............ Repair of wound or Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
lesion.
13102............ Repair wound/lesion add- Y................ ................. A2............... $91.24 4.5263 $187.39 $115.28
on.
13120............ Repair of wound or Y................ ................. A2............... $91.24 2.1051 $87.15 $90.22
lesion.
13121............ Repair of wound or Y................ ................. A2............... $91.24 4.5263 $187.39 $115.28
lesion.
13122............ Repair wound/lesion add- Y................ ................. A2............... $91.24 2.1051 $87.15 $90.22
on.
13131............ Repair of wound or Y................ ................. A2............... $91.24 4.5263 $187.39 $115.28
lesion.
13132............ Repair of wound or Y................ ................. A2............... $91.24 4.5263 $187.39 $115.28
lesion.
13133............ Repair wound/lesion add- Y................ ................. A2............... $91.24 4.5263 $187.39 $115.28
on.
13150............ Repair of wound or Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
lesion.
13151............ Repair of wound or Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
lesion.
13152............ Repair of wound or Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
lesion.
13153............ Repair wound/lesion add- Y................ ................. A2............... $91.24 2.1051 $87.15 $90.22
on.
13160............ Late closure of wound... Y................ ................. A2............... $446.00 20.2069 $836.59 $543.65
14000............ Skin tissue Y................ ................. A2............... $446.00 15.0458 $622.91 $490.23
rearrangement.
14001............ Skin tissue Y................ ................. A2............... $510.00 15.0458 $622.91 $538.23
rearrangement.
14020............ Skin tissue Y................ ................. A2............... $510.00 15.0458 $622.91 $538.23
rearrangement.
14021............ Skin tissue Y................ ................. A2............... $510.00 15.0458 $622.91 $538.23
rearrangement.
14040............ Skin tissue Y................ ................. A2............... $446.00 15.0458 $622.91 $490.23
rearrangement.
14041............ Skin tissue Y................ ................. A2............... $510.00 15.0458 $622.91 $538.23
rearrangement.
14060............ Skin tissue Y................ ................. A2............... $510.00 15.0458 $622.91 $538.23
rearrangement.
14061............ Skin tissue Y................ ................. A2............... $510.00 15.0458 $622.91 $538.23
rearrangement.
14300............ Skin tissue Y................ ................. A2............... $630.00 20.2069 $836.59 $681.65
rearrangement.
14350............ Skin tissue Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
rearrangement.
15002............ Wnd prep, ch/inf, trk/ Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
arm/lg.
15003............ Wnd prep, ch/inf addl Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
100 cm.
15004............ Wnd prep ch/inf, f/n/hf/ Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
g.
15005............ Wnd prep, f/n/hf/g, addl Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
cm.
15040............ Harvest cultured skin Y................ ................. A2............... $91.24 2.1051 $87.15 $90.22
graft.
15050............ Skin pinch graft........ Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
15100............ Skin splt grft, trnk/arm/ Y................ ................. A2............... $446.00 20.2069 $836.59 $543.65
leg.
15101............ Skin splt grft t/a/l, Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
add-on.
15110............ Epidrm autogrft trnk/arm/ Y................ ................. A2............... $446.00 4.5263 $187.39 $381.35
leg.
15111............ Epidrm autogrft t/a/l Y................ ................. A2............... $333.00 4.5263 $187.39 $296.60
add-on.
15115............ Epidrm a-grft face/nck/ Y................ ................. A2............... $446.00 4.5263 $187.39 $381.35
hf/g.
15116............ Epidrm a-grft f/n/hf/g Y................ ................. A2............... $333.00 4.5263 $187.39 $296.60
addl.
15120............ Skn splt a-grft fac/nck/ Y................ ................. A2............... $446.00 20.2069 $836.59 $543.65
hf/g.
15121............ Skn splt a-grft f/n/hf/g Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
add.
15130............ Derm autograft, trnk/arm/ Y................ ................. A2............... $446.00 15.0458 $622.91 $490.23
leg.
15131............ Derm autograft t/a/l add- Y................ ................. A2............... $333.00 15.0458 $622.91 $405.48
on.
15135............ Derm autograft face/nck/ Y................ ................. A2............... $446.00 15.0458 $622.91 $490.23
hf/g.
15136............ Derm autograft, f/n/hf/g Y................ ................. A2............... $333.00 15.0458 $622.91 $405.48
add.
15150............ Cult epiderm grft t/arm/ Y................ ................. A2............... $446.00 4.5263 $187.39 $381.35
leg.
15151............ Cult epiderm grft t/a/l Y................ ................. A2............... $333.00 4.5263 $187.39 $296.60
addl.
15152............ Cult epiderm graft t/a/l Y................ ................. A2............... $333.00 4.5263 $187.39 $296.60
+%.
15155............ Cult epiderm graft, f/n/ Y................ ................. A2............... $446.00 4.5263 $187.39 $381.35
hf/g.
15156............ Cult epidrm grft f/n/hfg Y................ ................. A2............... $333.00 4.5263 $187.39 $296.60
add.
15157............ Cult epiderm grft f/n/ Y................ ................. A2............... $333.00 4.5263 $187.39 $296.60
hfg +%.
15200............ Skin full graft, trunk.. Y................ ................. A2............... $510.00 15.0458 $622.91 $538.23
15201............ Skin full graft trunk Y................ ................. A2............... $323.28 15.0458 $622.91 $398.19
add-on.
15220............ Skin full graft sclp/arm/ Y................ ................. A2............... $446.00 15.0458 $622.91 $490.23
leg.
15221............ Skin full graft add-on.. Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
15240............ Skin full grft face/ Y................ ................. A2............... $510.00 15.0458 $622.91 $538.23
genit/hf.
15241............ Skin full graft add-on.. Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
15260............ Skin full graft een & Y................ ................. A2............... $446.00 15.0458 $622.91 $490.23
lips.
15261............ Skin full graft add-on.. Y................ ................. A2............... $323.28 15.0458 $622.91 $398.19
15300............ Apply skinallogrft, t/ Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
arm/lg.
15301............ Apply sknallogrft t/a/l Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
addl.
15320............ Apply skin allogrft f/n/ Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
hf/g.
15321............ Aply sknallogrft f/n/hfg Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
add.
[[Page 9868]]
15330............ Aply acell alogrft t/arm/ Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
leg.
15331............ Aply acell grft t/a/l Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
add-on.
15335............ Apply acell graft, f/n/ Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
hf/g.
15336............ Aply acell grft f/n/hf/g Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
add.
15340............ Apply cult skin Y................ CH............... G2............... ........... 2.1051 $87.15 $87.15
substitute.
15341............ Apply cult skin sub add- Y................ ................. G2............... ........... 2.1051 $87.15 $87.15
on.
15360............ Apply cult derm sub, t/a/ Y................ ................. G2............... ........... 2.1051 $87.15 $87.15
l.
15361............ Aply cult derm sub t/a/l Y................ ................. G2............... ........... 2.1051 $87.15 $87.15
add.
15365............ Apply cult derm sub f/n/ Y................ ................. G2............... ........... 2.1051 $87.15 $87.15
hf/g.
15366............ Apply cult derm f/hf/g Y................ ................. G2............... ........... 2.1051 $87.15 $87.15
add.
15400............ Apply skin xenograft, t/ Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
a/l.
15401............ Apply skn xenogrft t/a/l Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
add.
15420............ Apply skin xgraft, f/n/ Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
hf/g.
15421............ Apply skn xgrft f/n/hf/g Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
add.
15430............ Apply acellular Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
xenograft.
15431............ Apply acellular xgraft Y................ ................. A2............... $323.28 4.5263 $187.39 $289.31
add.
15570............ Form skin pedicle flap.. Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
15572............ Form skin pedicle flap.. Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
15574............ Form skin pedicle flap.. Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
15576............ Form skin pedicle flap.. Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
15600............ Skin graft.............. Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
15610............ Skin graft.............. Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
15620............ Skin graft.............. Y................ ................. A2............... $630.00 20.2069 $836.59 $681.65
15630............ Skin graft.............. Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
15650............ Transfer skin pedicle Y................ ................. A2............... $717.00 20.2069 $836.59 $746.90
flap.
15731............ Forehead flap w/vasc Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
pedicle.
15732............ Muscle-skin graft, head/ Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
neck.
15734............ Muscle-skin graft, trunk Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
15736............ Muscle-skin graft, arm.. Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
15738............ Muscle-skin graft, leg.. Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
15740............ Island pedicle flap Y................ ................. A2............... $446.00 15.0458 $622.91 $490.23
graft.
15750............ Neurovascular pedicle Y................ ................. A2............... $446.00 20.2069 $836.59 $543.65
graft.
15760............ Composite skin graft.... Y................ ................. A2............... $446.00 20.2069 $836.59 $543.65
15770............ Derma-fat-fascia graft.. Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
15775............ Hair transplant punch Y................ ................. A2............... $323.28 1.2792 $52.96 $255.70
grafts.
15776............ Hair transplant punch Y................ ................. A2............... $323.28 1.2792 $52.96 $255.70
grafts.
15780............ Abrasion treatment of Y................ ................. P3............... ........... 9.3645 $387.70 $387.70
skin.
15781............ Abrasion treatment of Y................ ................. P2............... ........... 4.3039 $178.19 $178.19
skin.
15782............ Abrasion treatment of Y................ ................. P2............... ........... 4.3039 $178.19 $178.19
skin.
15783............ Abrasion treatment of Y................ ................. P2............... ........... 2.6604 $110.14 $110.14
skin.
15786............ Abrasion, lesion, single Y................ ................. P2............... ........... 0.793 $32.83 $32.83
15787............ Abrasion, lesions, add- Y................ ................. P3............... ........... 0.7901 $32.71 $32.71
on.
15788............ Chemical peel, face, Y................ ................. P2............... ........... 0.793 $32.83 $32.83
epiderm.
15789............ Chemical peel, face, Y................ ................. P2............... ........... 1.4595 $60.42 $60.42
dermal.
15792............ Chemical peel, nonfacial Y................ ................. P2............... ........... 1.4595 $60.42 $60.42
15793............ Chemical peel, nonfacial Y................ ................. P2............... ........... 0.793 $32.83 $32.83
15819............ Plastic surgery, neck... Y................ ................. G2............... ........... 2.1051 $87.15 $87.15
15820............ Revision of lower eyelid Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
15821............ Revision of lower eyelid Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
15822............ Revision of upper eyelid Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
15823............ Revision of upper eyelid Y................ ................. A2............... $717.00 20.2069 $836.59 $746.90
15824............ Removal of forehead Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
wrinkles.
15825............ Removal of neck wrinkles Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
15826............ Removal of brow wrinkles Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
15828............ Removal of face wrinkles Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
15829............ Removal of skin wrinkles Y................ ................. A2............... $717.00 20.2069 $836.59 $746.90
15830............ Exc skin abd............ Y................ ................. A2............... $510.00 21.1098 $873.97 $600.99
15832............ Excise excessive skin Y................ ................. A2............... $510.00 21.1098 $873.97 $600.99
tissue.
15833............ Excise excessive skin Y................ ................. A2............... $510.00 21.1098 $873.97 $600.99
tissue.
15834............ Excise excessive skin Y................ ................. A2............... $510.00 21.1098 $873.97 $600.99
tissue.
15835............ Excise excessive skin Y................ ................. A2............... $323.28 21.1098 $873.97 $460.95
tissue.
15836............ Excise excessive skin Y................ ................. A2............... $510.00 16.1001 $666.56 $549.14
tissue.
15837............ Excise excessive skin Y................ ................. G2............... ........... 16.1001 $666.56 $666.56
tissue.
15838............ Excise excessive skin Y................ ................. G2............... ........... 16.1001 $666.56 $666.56
tissue.
15839............ Excise excessive skin Y................ ................. A2............... $510.00 16.1001 $666.56 $549.14
tissue.
15840............ Graft for face nerve Y................ ................. A2............... $630.00 20.2069 $836.59 $681.65
palsy.
15841............ Graft for face nerve Y................ ................. A2............... $630.00 20.2069 $836.59 $681.65
palsy.
15842............ Flap for face nerve Y................ ................. G2............... ........... 20.2069 $836.59 $836.59
palsy.
15845............ Skin and muscle repair, Y................ ................. A2............... $630.00 20.2069 $836.59 $681.65
face.
15847............ Exc skin abd add-on..... Y................ ................. A2............... $510.00 21.1098 $873.97 $600.99
15850............ Removal of sutures...... Y................ ................. G2............... ........... 2.6604 $110.14 $110.14
15851............ Removal of sutures...... Y................ ................. P3............... ........... 1.2425 $51.44 $51.44
15852............ Dressing change not for N................ ................. G2............... ........... 0.631 $26.12 $26.12
burn.
15860............ Test for blood flow in N................ ................. G2............... ........... 0.631 $26.12 $26.12
graft.
15876............ Suction assisted Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
lipectomy.
15877............ Suction assisted Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
lipectomy.
15878............ Suction assisted Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
lipectomy.
[[Page 9869]]
15879............ Suction assisted Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
lipectomy.
15920............ Removal of tail bone Y................ ................. A2............... $251.52 4.3039 $178.19 $233.19
ulcer.
15922............ Removal of tail bone Y................ ................. A2............... $630.00 20.2069 $836.59 $681.65
ulcer.
15931............ Remove sacrum pressure Y................ ................. A2............... $510.00 21.1098 $873.97 $600.99
sore.
15933............ Remove sacrum pressure Y................ ................. A2............... $510.00 21.1098 $873.97 $600.99
sore.
15934............ Remove sacrum pressure Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
sore.
15935............ Remove sacrum pressure Y................ ................. A2............... $630.00 20.2069 $836.59 $681.65
sore.
15936............ Remove sacrum pressure Y................ ................. A2............... $630.00 15.0458 $622.91 $628.23
sore.
15937............ Remove sacrum pressure Y................ ................. A2............... $630.00 20.2069 $836.59 $681.65
sore.
15940............ Remove hip pressure sore Y................ ................. A2............... $510.00 21.1098 $873.97 $600.99
15941............ Remove hip pressure sore Y................ ................. A2............... $510.00 21.1098 $873.97 $600.99
15944............ Remove hip pressure sore Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
15945............ Remove hip pressure sore Y................ ................. A2............... $630.00 20.2069 $836.59 $681.65
15946............ Remove hip pressure sore Y................ ................. A2............... $630.00 20.2069 $836.59 $681.65
15950............ Remove thigh pressure Y................ ................. A2............... $510.00 21.1098 $873.97 $600.99
sore.
15951............ Remove thigh pressure Y................ ................. A2............... $630.00 21.1098 $873.97 $690.99
sore.
15952............ Remove thigh pressure Y................ ................. A2............... $510.00 15.0458 $622.91 $538.23
sore.
15953............ Remove thigh pressure Y................ ................. A2............... $630.00 15.0458 $622.91 $628.23
sore.
15956............ Remove thigh pressure Y................ ................. A2............... $510.00 15.0458 $622.91 $538.23
sore.
15958............ Remove thigh pressure Y................ ................. A2............... $630.00 15.0458 $622.91 $628.23
sore.
16000............ Initial treatment of Y................ ................. P3............... ........... 0.65 $26.91 $26.91
burn(s).
16020............ Dress/debrid p-thick Y................ ................. P3............... ........... 0.9874 $40.88 $40.88
burn, s.
16025............ Dress/debrid p-thick Y................ ................. A2............... $67.11 2.6604 $110.14 $77.87
burn, m.
16030............ Dress/debrid p-thick Y................ ................. A2............... $99.83 2.6604 $110.14 $102.41
burn, l.
16035............ Incision of burn scab, Y................ ................. G2............... ........... 2.6604 $110.14 $110.14
initi.
17000............ Destruct premalg lesion. Y................ ................. P2............... ........... 0.793 $32.83 $32.83
17003............ Destruct premalg les, 2- Y................ ................. P3............... ........... 0.0906 $3.75 $3.75
14.
17004............ Destroy premlg lesions Y................ ................. P3............... ........... 1.9502 $80.74 $80.74
15+.
17106............ Destruction of skin Y................ ................. P2............... ........... 2.6604 $110.14 $110.14
lesions.
17107............ Destruction of skin Y................ ................. P2............... ........... 2.6604 $110.14 $110.14
lesions.
17108............ Destruction of skin Y................ ................. P2............... ........... 2.6604 $110.14 $110.14
lesions.
17110............ Destruct b9 lesion, 1-14 Y................ ................. P2............... ........... 0.793 $32.83 $32.83
17111............ Destruct lesion, 15 or Y................ ................. P2............... ........... 1.4595 $60.42 $60.42
more.
17250............ Chemical cautery, tissue Y................ ................. P3............... ........... 1.0451 $43.27 $43.27
17260............ Destruction of skin Y................ ................. P3............... ........... 1.1026 $45.65 $45.65
lesions.
17261............ Destruction of skin Y................ ................. P2............... ........... 1.4595 $60.42 $60.42
lesions.
17262............ Destruction of skin Y................ ................. P2............... ........... 1.4595 $60.42 $60.42
lesions.
17263............ Destruction of skin Y................ ................. P2............... ........... 1.4595 $60.42 $60.42
lesions.
17264............ Destruction of skin Y................ ................. P2............... ........... 1.4595 $60.42 $60.42
lesions.
17266............ Destruction of skin Y................ ................. P3............... ........... 2.4685 $102.20 $102.20
lesions.
17270............ Destruction of skin Y................ ................. P2............... ........... 1.4595 $60.42 $60.42
lesions.
17271............ Destruction of skin Y................ ................. P2............... ........... 1.4595 $60.42 $60.42
lesions.
17272............ Destruction of skin Y................ ................. P2............... ........... 1.4595 $60.42 $60.42
lesions.
17273............ Destruction of skin Y................ CH............... P3............... ........... 2.2299 $92.32 $92.32
lesions.
17274............ Destruction of skin Y................ ................. P3............... ........... 2.5427 $105.27 $105.27
lesions.
17276............ Destruction of skin Y................ ................. P2............... ........... 2.6604 $110.14 $110.14
lesions.
17280............ Destruction of skin Y................ CH............... P2............... ........... 1.4595 $60.42 $60.42
lesions.
17281............ Destruction of skin Y................ CH............... P3............... ........... 1.9091 $79.04 $79.04
lesions.
17282............ Destruction of skin Y................ CH............... P3............... ........... 2.1806 $90.28 $90.28
lesions.
17283............ Destruction of skin Y................ CH............... P3............... ........... 2.5098 $103.91 $103.91
lesions.
17284............ Destruction of skin Y................ ................. P2............... ........... 2.6604 $110.14 $110.14
lesions.
17286............ Destruction of skin Y................ ................. P2............... ........... 2.6604 $110.14 $110.14
lesions.
17311............ Mohs, 1 stage, h/n/hf/g. Y................ ................. P2............... ........... 3.6321 $150.37 $150.37
17312............ Mohs addl stage......... Y................ ................. P2............... ........... 3.6321 $150.37 $150.37
17313............ Mohs, 1 stage, t/a/l.... Y................ ................. P2............... ........... 3.6321 $150.37 $150.37
17314............ Mohs, addl stage, t/a/l. Y................ ................. P2............... ........... 3.6321 $150.37 $150.37
17315............ Mohs surg, addl block... Y................ ................. P3............... ........... 0.9381 $38.84 $38.84
17340............ Cryotherapy of skin..... Y................ ................. P3............... ........... 0.2961 $12.26 $12.26
17360............ Skin peel therapy....... Y................ ................. P2............... ........... 0.793 $32.83 $32.83
17380............ Hair removal by Y................ ................. R2............... ........... 0.793 $32.83 $32.83
electrolysis.
19000............ Drainage of breast Y................ ................. P3............... ........... 1.6046 $66.43 $66.43
lesion.
19001............ Drain breast lesion add- Y................ ................. P3............... ........... 0.2058 $8.52 $8.52
on.
19020............ Incision of breast Y................ ................. A2............... $446.00 18.3197 $758.45 $524.11
lesion.
19030............ Injection for breast x- N................ ................. N1............... ........... ........... ........... ...........
ray.
19100............ Bx breast percut w/o Y................ ................. A2............... $240.00 4.327 $179.14 $224.79
image.
19101............ Biopsy of breast, open.. Y................ ................. A2............... $446.00 20.6417 $854.59 $548.15
19102............ Bx breast percut w/image Y................ ................. A2............... $240.00 7.1147 $294.56 $253.64
19103............ Bx breast percut w/ Y................ ................. A2............... $395.77 13.5764 $562.08 $437.35
device.
19105............ Cryosurg ablate fa, each Y................ ................. G2............... ........... 31.7134 $1,312.97 $1,312.97
19110............ Nipple exploration...... Y................ ................. A2............... $446.00 20.6417 $854.59 $548.15
19112............ Excise breast duct Y................ ................. A2............... $510.00 20.6417 $854.59 $596.15
fistula.
19120............ Removal of breast lesion Y................ ................. A2............... $510.00 20.6417 $854.59 $596.15
19125............ Excision, breast lesion. Y................ ................. A2............... $510.00 20.6417 $854.59 $596.15
19126............ Excision, addl breast Y................ ................. A2............... $510.00 20.6417 $854.59 $596.15
lesion.
19290............ Place needle wire, N................ ................. N1............... ........... ........... ........... ...........
breast.
19291............ Place needle wire, N................ ................. N1............... ........... ........... ........... ...........
breast.
19295............ Place breast clip, N................ CH............... N1............... ........... ........... ........... ...........
percut.
[[Page 9870]]
19296............ Place po breast cath for Y................ ................. A2............... $1,339.00 56.5774 $2,342.36 $1,589.84
rad.
19297............ Place breast cath for Y................ ................. A2............... $1,339.00 56.5774 $2,342.36 $1,589.84
rad.
19298............ Place breast rad tube/ Y................ ................. A2............... $1,339.00 56.5774 $2,342.36 $1,589.84
caths.
19300............ Removal of breast tissue Y................ ................. A2............... $630.00 20.6417 $854.59 $686.15
19301............ Partical mastectomy..... Y................ ................. A2............... $510.00 20.6417 $854.59 $596.15
19302............ P-mastectomy w/ln Y................ ................. A2............... $995.00 39.8191 $1,648.55 $1,158.39
removal.
19303............ Mast, simple, complete.. Y................ ................. A2............... $630.00 31.7134 $1,312.97 $800.74
19304............ Mast, subq.............. Y................ ................. A2............... $630.00 31.7134 $1,312.97 $800.74
19316............ Suspension of breast.... Y................ ................. A2............... $630.00 31.7134 $1,312.97 $800.74
19318............ Reduction of large Y................ ................. A2............... $630.00 39.8191 $1,648.55 $884.64
breast.
19324............ Enlarge breast.......... Y................ ................. A2............... $630.00 39.8191 $1,648.55 $884.64
19325............ Enlarge breast with Y................ ................. A2............... $1,339.00 56.5774 $2,342.36 $1,589.84
implant.
19328............ Removal of breast Y................ ................. A2............... $333.00 31.7134 $1,312.97 $577.99
implant.
19330............ Removal of implant Y................ ................. A2............... $333.00 31.7134 $1,312.97 $577.99
material.
19340............ Immediate breast Y................ ................. A2............... $446.00 39.8191 $1,648.55 $746.64
prosthesis.
19342............ Delayed breast Y................ ................. A2............... $510.00 56.5774 $2,342.36 $968.09
prosthesis.
19350............ Breast reconstruction... Y................ ................. A2............... $630.00 20.6417 $854.59 $686.15
19355............ Correct inverted Y................ ................. A2............... $630.00 31.7134 $1,312.97 $800.74
nipple(s).
19357............ Breast reconstruction... Y................ ................. A2............... $717.00 56.5774 $2,342.36 $1,123.34
19366............ Breast reconstruction... Y................ ................. A2............... $717.00 31.7134 $1,312.97 $865.99
19370............ Surgery of breast Y................ ................. A2............... $630.00 31.7134 $1,312.97 $800.74
capsule.
19371............ Removal of breast Y................ ................. A2............... $630.00 31.7134 $1,312.97 $800.74
capsule.
19380............ Revise breast Y................ ................. A2............... $717.00 39.8191 $1,648.55 $949.89
reconstruction.
19396............ Design custom breast Y................ ................. G2............... ........... 31.7134 $1,312.97 $1,312.97
implant.
20000............ Incision of abscess..... Y................ ................. P2............... ........... 1.4066 $58.23 $58.23
20005............ Incision of deep abscess Y................ ................. A2............... $446.00 21.2689 $880.55 $554.64
20103............ Explore wound, extremity Y................ ................. G2............... ........... 9.6341 $398.86 $398.86
20150............ Excise epiphyseal bar... Y................ ................. G2............... ........... 42.985 $1,779.62 $1,779.62
20200............ Muscle biopsy........... Y................ ................. A2............... $446.00 16.1001 $666.56 $501.14
20205............ Deep muscle biopsy...... Y................ ................. A2............... $510.00 16.1001 $666.56 $549.14
20206............ Needle biopsy, muscle... Y................ ................. A2............... $240.00 7.1147 $294.56 $253.64
20220............ Bone biopsy, trocar/ Y................ ................. A2............... $251.52 8.685 $359.57 $278.53
needle.
20225............ Bone biopsy, trocar/ Y................ ................. A2............... $418.49 8.685 $359.57 $403.76
needle.
20240............ Bone biopsy, excisional. Y................ ................. A2............... $446.00 21.1098 $873.97 $552.99
20245............ Bone biopsy, excisional. Y................ ................. A2............... $510.00 21.1098 $873.97 $600.99
20250............ Open bone biopsy........ Y................ ................. A2............... $510.00 21.2689 $880.55 $602.64
20251............ Open bone biopsy........ Y................ ................. A2............... $510.00 21.2689 $880.55 $602.64
20500............ Injection of sinus tract Y................ ................. P3............... ........... 1.4811 $61.32 $61.32
20501............ Inject sinus tract for x- N................ ................. N1............... ........... ........... ........... ...........
ray.
20520............ Removal of foreign body. Y................ ................. P3............... ........... 2.2712 $94.03 $94.03
20525............ Removal of foreign body. Y................ ................. A2............... $510.00 21.1098 $873.97 $600.99
20526............ Ther injection, carp Y................ ................. P3............... ........... 0.7323 $30.32 $30.32
tunnel.
20550............ Inj tendon sheath/ Y................ ................. P3............... ........... 0.5514 $22.83 $22.83
ligament.
20551............ Inj tendon origin/ Y................ ................. P3............... ........... 0.5432 $22.49 $22.49
insertion.
20552............ Inj trigger point, 1/2 Y................ ................. P3............... ........... 0.5348 $22.14 $22.14
muscl.
20553............ Inject trigger points, =/ Y................ ................. P3............... ........... 0.6007 $24.87 $24.87
> 3.
20555............ Place ndl musc/tis for Y................ NI............... G2............... ........... 29.19 $1,208.50 $1,208.50
rt.
20600............ Drain/inject, joint/ Y................ ................. P3............... ........... 0.5432 $22.49 $22.49
bursa.
20605............ Drain/inject, joint/ Y................ ................. P3............... ........... 0.6171 $25.55 $25.55
bursa.
20610............ Drain/inject, joint/ Y................ ................. P3............... ........... 0.8311 $34.41 $34.41
bursa.
20612............ Aspirate/inj ganglion Y................ ................. P3............... ........... 0.5761 $23.85 $23.85
cyst.
20615............ Treatment of bone cyst.. Y................ CH............... P3............... ........... 2.5591 $105.95 $105.95
20650............ Insert and remove bone Y................ ................. A2............... $510.00 21.2689 $880.55 $602.64
pin.
20662............ Application of pelvis Y................ ................. R2............... ........... 21.2689 $880.55 $880.55
brace.
20663............ Application of thigh Y................ ................. R2............... ........... 21.2689 $880.55 $880.55
brace.
20665............ Removal of fixation N................ ................. G2............... ........... 0.631 $26.12 $26.12
device.
20670............ Removal of support Y................ ................. A2............... $333.00 16.1001 $666.56 $416.39
implant.
20680............ Removal of support Y................ ................. A2............... $510.00 21.1098 $873.97 $600.99
implant.
20690............ Apply bone fixation Y................ ................. A2............... $446.00 29.19 $1,208.50 $636.63
device.
20692............ Apply bone fixation Y................ ................. A2............... $510.00 29.19 $1,208.50 $684.63
device.
20693............ Adjust bone fixation Y................ ................. A2............... $510.00 21.2689 $880.55 $602.64
device.
20694............ Remove bone fixation Y................ ................. A2............... $333.00 21.2689 $880.55 $469.89
device.
20822............ Replantation digit, Y................ ................. G2............... ........... 26.3105 $1,089.28 $1,089.28
complete.
20900............ Removal of bone for Y................ ................. A2............... $510.00 29.19 $1,208.50 $684.63
graft.
20902............ Removal of bone for Y................ ................. A2............... $630.00 29.19 $1,208.50 $774.63
graft.
20910............ Remove cartilage for Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
graft.
20912............ Remove cartilage for Y................ ................. A2............... $510.00 20.2069 $836.59 $591.65
graft.
20920............ Removal of fascia for Y................ ................. A2............... $630.00 15.0458 $622.91 $628.23
graft.
20922............ Removal of fascia for Y................ ................. A2............... $510.00 15.0458 $622.91 $538.23
graft.
20924............ Removal of tendon for Y................ ................. A2............... $630.00 29.19 $1,208.50 $774.63
graft.
20926............ Removal of tissue for Y................ ................. A2............... $630.00 4.5263 $187.39 $519.35
graft.
20950............ Fluid pressure, muscle.. Y................ ................. G2............... ........... 1.4066 $58.23 $58.23
20972............ Bone/skin graft, Y................ ................. G2............... ........... 44.2687 $1,832.77 $1,832.77
metatarsal.
20973............ Bone/skin graft, great Y................ ................. R2............... ........... 44.2687 $1,832.77 $1,832.77
toe.
20975............ Electrical bone N................ CH............... N1............... ........... ........... ........... ...........
stimulation.
20979............ Us bone stimulation..... N................ ................. P3............... ........... 0.5843 $24.19 $24.19
20982............ Ablate, bone tumor(s) Y................ ................. G2............... ........... 42.985 $1,779.62 $1,779.62
perq.
[[Page 9871]]
20985............ Cptr-asst dir ms px..... N................ NI............... N1............... ........... ........... ........... ...........
20986............ Cptr-asst dir ms px io N................ NI............... N1............... ........... ........... ........... ...........
img.
20987............ Cptr-asst dir ms px pre N................ NI............... N1............... ........... ........... ........... ...........
img.
21010............ Incision of jaw joint... Y................ ................. A2............... $446.00 23.9765 $992.65 $582.66
21015............ Resection of facial Y................ ................. A2............... $510.00 16.3288 $676.03 $551.51
tumor.
21025............ Excision of bone, lower Y................ ................. A2............... $446.00 39.8776 $1,650.97 $747.24
jaw.
21026............ Excision of facial Y................ ................. A2............... $446.00 39.8776 $1,650.97 $747.24
bone(s).
21029............ Contour of face bone Y................ ................. A2............... $446.00 39.8776 $1,650.97 $747.24
lesion.
21030............ Excise max/zygoma b9 Y................ ................. P3............... ........... 5.5627 $230.30 $230.30
tumor.
21031............ Remove exostosis, Y................ ................. P3............... ........... 4.5588 $188.74 $188.74
mandible.
21032............ Remove exostosis, Y................ ................. P3............... ........... 4.6905 $194.19 $194.19
maxilla.
21034............ Excise max/zygoma mlg Y................ ................. A2............... $510.00 39.8776 $1,650.97 $795.24
tumor.
21040............ Excise mandible lesion.. Y................ ................. A2............... $446.00 23.9765 $992.65 $582.66
21044............ Removal of jaw bone Y................ ................. A2............... $446.00 39.8776 $1,650.97 $747.24
lesion.
21046............ Remove mandible cyst Y................ ................. A2............... $446.00 39.8776 $1,650.97 $747.24
complex.
21047............ Excise lwr jaw cyst w/ Y................ ................. A2............... $446.00 39.8776 $1,650.97 $747.24
repair.
21048............ Remove maxilla cyst Y................ ................. R2............... ........... 39.8776 $1,650.97 $1,650.97
complex.
21050............ Removal of jaw joint.... Y................ ................. A2............... $510.00 39.8776 $1,650.97 $795.24
21060............ Remove jaw joint Y................ ................. A2............... $446.00 39.8776 $1,650.97 $747.24
cartilage.
21070............ Remove coronoid process. Y................ ................. A2............... $510.00 39.8776 $1,650.97 $795.24
21073 *.......... Mnpj of tmj w/anesth.... Y................ NI............... P3............... ........... 4.526 $187.38 $187.38
21076............ Prepare face/oral Y................ ................. P3............... ........... 8.3851 $347.15 $347.15
prosthesis.
21077............ Prepare face/oral Y................ ................. P3............... ........... 20.4816 $847.96 $847.96
prosthesis.
21079............ Prepare face/oral Y................ ................. P3............... ........... 14.598 $604.37 $604.37
prosthesis.
21080............ Prepare face/oral Y................ ................. P3............... ........... 16.7293 $692.61 $692.61
prosthesis.
21081............ Prepare face/oral Y................ ................. P3............... ........... 15.3632 $636.05 $636.05
prosthesis.
21082............ Prepare face/oral Y................ ................. P3............... ........... 14.096 $583.59 $583.59
prosthesis.
21083............ Prepare face/oral Y................ ................. P3............... ........... 13.8738 $574.39 $574.39
prosthesis.
21084............ Prepare face/oral Y................ ................. P3............... ........... 16.1697 $669.44 $669.44
prosthesis.
21085............ Prepare face/oral Y................ ................. P3............... ........... 6.2622 $259.26 $259.26
prosthesis.
21086............ Prepare face/oral Y................ ................. P3............... ........... 15.0917 $624.81 $624.81
prosthesis.
21087............ Prepare face/oral Y................ ................. P3............... ........... 14.9518 $619.02 $619.02
prosthesis.
21088............ Prepare face/oral Y................ ................. R2............... ........... 39.8776 $1,650.97 $1,650.97
prosthesis.
21100............ Maxillofacial fixation.. Y................ ................. A2............... $446.00 39.8776 $1,650.97 $747.24
21110............ Interdental fixation.... Y................ ................. P2............... ........... 7.4474 $308.33 $308.33
21116............ Injection, jaw joint x- N................ ................. N1............... ........... ........... ........... ...........
ray.
21120............ Reconstruction of chin.. Y................ ................. A2............... $995.00 23.9765 $992.65 $994.41
21121............ Reconstruction of chin.. Y................ ................. A2............... $995.00 23.9765 $992.65 $994.41
21122............ Reconstruction of chin.. Y................ ................. A2............... $995.00 23.9765 $992.65 $994.41
21123............ Reconstruction of chin.. Y................ ................. A2............... $995.00 23.9765 $992.65 $994.41
21125............ Augmentation, lower jaw Y................ ................. A2............... $995.00 23.9765 $992.65 $994.41
bone.
21127............ Augmentation, lower jaw Y................ ................. A2............... $1,339.00 39.8776 $1,650.97 $1,416.99
bone.
21137............ Reduction of forehead... Y................ ................. G2............... ........... 23.9765 $992.65 $992.65
21138............ Reduction of forehead... Y................ ................. G2............... ........... 39.8776 $1,650.97 $1,650.97
21139............ Reduction of forehead... Y................ ................. G2............... ........... 39.8776 $1,650.97 $1,650.97
21150............ Reconstruct midface, Y................ ................. G2............... ........... 39.8776 $1,650.97 $1,650.97
lefort.
21181............ Contour cranial bone Y................ ................. A2............... $995.00 23.9765 $992.65 $994.41
lesion.
21198............ Reconstr lwr jaw segment Y................ ................. G2............... ........... 39.8776 $1,650.97 $1,650.97
21199............ Reconstr lwr jaw w/ Y................ ................. G2............... ........... 39.8776 $1,650.97 $1,650.97
advance.
21206............ Reconstruct upper jaw Y................ ................. A2............... $717.00 39.8776 $1,650.97 $950.49
bone.
21208............ Augmentation of facial Y................ ................. A2............... $995.00 39.8776 $1,650.97 $1,158.99
bones.
21209............ Reduction of facial Y................ ................. A2............... $717.00 39.8776 $1,650.97 $950.49
bones.
21210............ Face bone graft......... Y................ ................. A2............... $995.00 39.8776 $1,650.97 $1,158.99
21215............ Lower jaw bone graft.... Y................ ................. A2............... $995.00 39.8776 $1,650.97 $1,158.99
21230............ Rib cartilage graft..... Y................ ................. A2............... $995.00 39.8776 $1,650.97 $1,158.99
21235............ Ear cartilage graft..... Y................ ................. A2............... $995.00 23.9765 $992.65 $994.41
21240............ Reconstruction of jaw Y................ ................. A2............... $630.00 39.8776 $1,650.97 $885.24
joint.
21242............ Reconstruction of jaw Y................ ................. A2............... $717.00 39.8776 $1,650.97 $950.49
joint.
21243............ Reconstruction of jaw Y................ ................. A2............... $717.00 39.8776 $1,650.97 $950.49
joint.
21244............ Reconstruction of lower Y................ ................. A2............... $995.00 39.8776 $1,650.97 $1,158.99
jaw.
21245............ Reconstruction of jaw... Y................ ................. A2............... $995.00 39.8776 $1,650.97 $1,158.99
21246............ Reconstruction of jaw... Y................ ................. A2............... $995.00 39.8776 $1,650.97 $1,158.99
21248............ Reconstruction of jaw... Y................ ................. A2............... $995.00 39.8776 $1,650.97 $1,158.99
21249............ Reconstruction of jaw... Y................ ................. A2............... $995.00 39.8776 $1,650.97 $1,158.99
21260............ Revise eye sockets...... Y................ ................. G2............... ........... 39.8776 $1,650.97 $1,650.97
21267............ Revise eye sockets...... Y................ ................. A2............... $995.00 39.8776 $1,650.97 $1,158.99
21270............ Augmentation, cheek bone Y................ ................. A2............... $717.00