# Monday,

August 8, 2005



# Part II



# Department of Health and Human
Services

Centers for Medicare & Medicaid Services

42 CFR Part 405, et al. Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2006; Proposed Rule


## 45764 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

**DEPARTMENT OF HEALTH AND HUMAN SERVICES** 

**Centers for Medicare & Medicaid Services** 

**42 CFR Part 405, 410, 411, 413, 414, and 426** 

**[CMS–1502–P]**

**RIN 0938–AN84**



### Medicare Program; Revisions to **Payment Policies Under the Physician Fee Schedule for Calendar Year 2006** 

**AGENCY** 

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

**ACTION** 

### : Proposed rule.

**SUMMARY** 

### : This proposed rule would refine the resource-based practice expense relative value units (PE RVUs) and propose changes to payment based on supplemental survey data for practice expense and revisions to our methodology for calculating practice expense RVUs, as well as make other proposed changes to Medicare Part B payment policy. We are also proposing policy changes related to revisions to malpractice RVUs, in addition to revising the list of telehealth services. In this proposed rule, we also discuss multiple procedure payment reduction for diagnostic imaging, and several coding issues.

We are proposing these changes to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. This proposed rule also discusses geographic locality changes; payment for covered outpatient drugs and biologicals; supplemental payments to federally qualified health centers (FQHCs); payment for renal dialysis services; the national coverage decision (NCD) process; coverage of screening for glaucoma; private contracts; and physician referrals for nuclear medicine services and supplies to health care entities with which they have financial relationships.

In addition, we include discussions on payment for teaching anesthesiologists, the therapy cap, the chiropractic demonstration and the Sustainable Growth Rate (SGR).

**DATES** 

### : Comment Date: Comments will be considered if we receive them at one of the addresses provided below, no later than 5 p.m. on September 30, 2005.

**ADDRESSES** 

### : In commenting, please refer to file code CMS–1502–P. Because of staff and resource limitations, we cannot accept comments by facsimile (FAX)
transmission. You may submit comments in one of three ways (no duplicates, please):

1. Electronically. You may submit electronic comments on specific issues in this regulation to http:// www.cms.hhs.gov/regulations/

ecomments . (Attachments should be in Microsoft Word, WordPerfect, or Excel; however, we prefer Microsoft Word.)

2. By mail. You may mail written comments (one original and two copies) to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS–1502–P, P.O. Box 8017, Baltimore, MD 21244–8017.

Please allow sufficient time for mailed comments to be received before the close of the comment period.

3. By express or overnight mail. You may send written comments (one original and two copies) to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS–1502–P, Mail Stop C4–26–05, 7500 Security Boulevard, Baltimore, MD

21244–1850.

4. By hand or courier. If you prefer, you may deliver (by hand or courier) your written comments (one original and two copies) before the close of the comment period to one of the following addresses. If you intend to deliver your comments to the Baltimore address, please call telephone number (410) 786– 7197 in advance to schedule your arrival with one of our staff members. Room 445–G, Hubert H. Humphrey Building, 200 Independence Avenue, SW., Washington, DC 20201; or 7500 Security Boulevard, Baltimore, MD

21244–1850.

(Because access to the interior of the HHH Building is not readily available to persons without Federal Government identification, commenters are encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. A stamp-in clock is available for persons wishing to retain a proof of filing by stamping in and retaining an extra copy of the comments being filed.)

Comments mailed to the addresses indicated as appropriate for hand or courier delivery may be delayed and received after the comment period.

Submission of comments on paperwork requirements. You may submit comments on this document’s paperwork requirements by mailing your comments to the addresses provided at the end of the ‘‘Collection of Information Requirements’’ section in this document.

For information on viewing public comments, see the beginning of the

**SUPPLEMENTARY INFORMATION** 

### section. **FOR FURTHER INFORMATION CONTACT** 

### : Pam West (410) 786–2302 (for issues related to practice expense).

Rick Ensor (410) 786–5617 (for issues related to the non-physician workpool and supplemental survey data).

Stephanie Monroe (410) 786–6864 (for issues related to the geographic practice cost index).

Craig Dobyski (410) 786–4584 (for issues related to list of telehealth services).

Ken Marsalek (410) 786–4502 (for issues related to multiple procedure reduction for diagnostic imaging services and payment for teaching anesthesiologists).

Henry Richter (410) 786–4562 (for issues related to payments for end stage renal disease facilities).

Angela Mason (410) 786–7452 or Catherine Jansto (410) 786–7762 (for issues related to payment for covered outpatient drugs and biologicals).

Fred Grabau (410) 786–0206 (for issues related to private contracts and opt out provision).

David Worgo (410) 786–5919 (for issues related to Federally Qualified Health Centers).

Vadim Lubarsky (410) 786–0840 (for issues related National Coverage Decision timeframes).

Bill Larson (410) 786–7176 (for issues related to coverage of screening for glaucoma).

Diane Milstead (410) 786–3355 or Gaysha Brooks (410) 786–9649 (for all other issues).

**SUPPLEMENTARY INFORMATION** 

### :

Submitting Comments: We welcome comments from the public on all issues set forth in this rule to assist us in fully considering issues and developing policies. You can assist us by referencing the file code CMS–1502–P and the specific ‘‘issue identifier’’ that precedes the section on which you choose to comment.

Inspection of Public Comments: All comments received before the close of the comment period are available for viewing by the public, including any personally identifiable or confidential business information that is included in a comment. CMS posts all electronic comments received before the close of the comment period on its public website as soon as possible after they have been received. Hard copy comments received timely will be available for public inspection as they are received, generally beginning approximately 3 weeks after publication of a document, at the headquarters of the Centers for Medicare & Medicaid Services, 7500 Security Boulevard, Baltimore, Maryland 21244, Monday


## 45765 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

through Friday of each week from 8:30 a.m. to 4 p.m. To schedule an appointment to view public comments, phone 1

–800

– 743

– 3951.

This Federal Register document is also available from the Federal Register online database through GPO Access a service of the U.S. Government Printing Office. The Web site address is: http:// www.access.gpo.gov/nara/index.html

.

Information on the physician fee schedule can be found on the CMS homepage. You can access this data by using the following directions:

1. Go to the CMS homepage (http:// www.cms.hhs.gov ). 2. Place your cursor over the word

‘‘ Professionals ’’ in the blue areas near the top of the page. Select ‘‘ physicians ’’ from the drop-down menu.

3. Under ‘‘ Billing/Payment ’’ select

‘‘ Physician Fee Schedule ’’

.

To assist readers in referencing sections contained in this preamble, we are providing the following table of contents. Some of the issues discussed in this preamble affect the payment policies, but do not require changes to the regulations in the Code of Federal Regulations. Information on the regulation ’ s impact appears throughout the preamble and is not exclusively in
section VI.

Table of Contents I. Background

A. Introduction B. Development of the Relative Value

System C. Components of the Fee Schedule

Payment Amounts D. Most Recent Changes to the Fee

Schedule II. Provisions of the Proposed Rule

A. Resource-Based Practice Expense RVUs 1. Current Methodology 2. Practice Expense Proposals for Calendar

Year 2006 B. Geographic Practice Cost Indices C. Malpractice Relative Value Units (RVUs) D. Medicare Telehealth Services E. Contractor Pricing of Unlisted Therapy

Modalities and Procedures F. Payment for Teaching Anesthesiologists G. End Stage Renal Disease (ESRD) Related

Provisions 1. Revised Pricing Methodology for

Separately Billable Drugs and Biologicals Furnished by ESRD Facilities. 2. Adjustment to Account for Changes in

the Pricing of Separately Billable Drugs and Biologicals and the Estimated Increase in Expenditures for Drugs and Biologicals 3. Proposed Revisions to Geographic

Designations and Wage Indexes Applied to the End Stage Renal Disease Composite Payment Rate Wage Index 4. Proposed Revisions to § 413.170 (Scope)

and § 413.174 (Prospective rates for hospital-based and independent ESRD facilities) 5. Proposed Revisions to the Composite Payment Rate Exceptions Process H. Payment for Covered Outpatient Drugs

and Biologicals I. Private Contracts and Opt-out Provision J. Multiple Procedure Reduction for

Diagnostic Imaging K. Therapy Cap L. Chiropractic Services Demonstration M. Supplemental Payments to Federally

Qualified Health Centers (FQHCs) Subcontracting with Medicare Advantage Plans N. National Coverage Decisions

Timeframes O. Coverage of Screening for Glaucoma P. Physician Referrals for Nuclear

Medicine Services and Suppliers to Health Care Entities with Which They Have Financial Relationships Q. Sustainable Growth Rate III. Collection of Information Requirements IV. Response to Comments V. Regulatory Impact Analysis Regulation Text Addendum A

—Explanation and Use of

Addendum B Addendum B

— 2006 Relative Value Units

and Related Information Used in Determining Medicare Payments for 2006 Addendum C

—Codes for Which we Received

Practice Expense Review Committee (PERC) Recommendations on Practice Expense Direct Cost Inputs. Addendum D

— 2006 Geographic Practice

Cost Indices By Medicare Carrier and Locality Addendum E

—Proposed 2006 Geographic

Adjustment Factors (GAFs) Addendum F

—ESRD Facilities Metropolitan

Statistical Areas (MSA)/Core-Based Statistical Areas (CBSA) Crosswalk Addendum G

—List of CPT/HCPCS Codes

Used to Describe Nuclear Medicine Designated Health Services Under Section 1877 of the Social Security Act In addition, because of the many organizations and terms to which we refer by acronym in this proposed final rule, we are listing these acronyms and their corresponding terms in alphabetical order below: AADA American Academy of Dermatology

Association AAH American Association of Homecare ACC American College of Cardiology ACG American College of Gastroenterology ACR American College of Radiology AFROC Association of Freestanding

Radiation Oncology Centers AGA American Gastroenterological

Association AMA American Medical Association AMP Average manufacturer price ASA American Society of Anesthesiologists ASGE American Society of Gastrointestinal

Endoscopy ASP Average sales price ASTRO American Society for Therapeutic

Radiation Oncology ATA American Telemedicine Association AUA American Urological Association AWP Average wholesale price BBA Balanced Budget Act of 1997 BBRA Balanced Budget Refinement Act of

1999 BES (Bureau of the Census ’ ) Business Expenditure Survey BIPA Benefits Improvement and Protection

Act of 2000 BLS Bureau of Labor Statistics BMI Body mass index BNF Budget neutrality factor BSA Body surface area CAP College of American Pathologists CBSA Core-Based Statistical Area CF Conversion factor CFR Code of Federal Regulations CMA California Medical Association CMS Centers for Medicare & Medicaid

Services CNS Clinical nurse specialist CPEP Clinical Practice Expert Panel CPI Consumer Price Index CPO Care Plan Oversight CPT (Physicians ’ ) Current Procedural

Terminology (4th Edition, 2002, copyrighted by the American Medical Association) CRNA Certified Registered Nurse

Anesthetist CT Computed tomography CTA Computed tomographic angiography CY Calendar year DHS Designated health services DME Durable medical equipment DMERC Durable Medical Equipment

Regional Carrier DSMT Diabetes outpatient self-management

training services E&M Evaluation and management EPO Erythopoeitin ESRD End stage renal disease FAX Facsimile FI Fiscal intermediary FQHC Federally qualified healthcare center FR Federal Register GAF Geographic adjustment factor GAO General Accounting Office GPCI Geographic practice cost index HCPAC Health Care Professional Advisory

Committee HCPCS Healthcare Common Procedure

Coding System HHA Home health agency HHS (Department of) Health and Human

Services HOCM High Osmolar Contrast Media HPSA Health professional shortage area HRSA Health Resources Services

Administration (HHS) IDTFs Independent diagnostic testing

facilities IPF Inpatient psychiatric facility IPPS Inpatient prospective payment system IRF Inpatient rehabilitation facility ISO Insurance Services Office IVIG Intravenous immune globulin JCAAI Joint Council of Allergy, Asthma,

and Immunology JUA Joint underwriting association LCD Local coverage determination LTCH Long-term care hospital LOCM Low Osmolar Contrast Media MA Medicare Advantage MCAC Medicare Coverage Advisory

Committee MCG Medical College of Georgia MedPAC Medicare Payment Advisory

Commission MEI Medicare Economic Index


## 45766 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

MMA Medicare Prescription Drug,

Improvement, and Modernization Act of

2003 MNT Medical nutrition therapy MRA Magnetic resonance angiography MRI Magnetic resonance imaging MSA Metropolitan statistical area NCD National coverage determination NCQDIS National Coalition of Quality

Diagnostic Imaging Services NDC National drug code NECMA New England County Metropolitan

Area NECTA New England City and Town Area NP Nurse practitioner NPP Nonphysician practitioners OBRA Omnibus Budget Reconciliation Act OIG Office of Inspector General OMB Office of Management and Budget OPPS Outpatient prospective payment

system PA Physician assistant PC Professional component PE Practice Expense PEAC Practice Expense Advisory

Committee PERC Practice Expense Review Committee PET Positron emission tomography PFS Physician Fee Schedule PLI Professional liability insurance PPI Producer price index PPO Preferred provider organization PPS Prospective payment system PRA Paperwork Reduction Act PT Physical therapy RFA Regulatory Flexibility Act RIA Regulatory impact analysis RN Registered nurse RUC (AMA ’ s Specialty Society) Relative

(Value) Update Committee RVU Relative value unit SGR Sustainable growth rate SMS (AMA ’ s) Socioeconomic Monitoring

System SNF Skilled nursing facility SNM Society for Nuclear Medicine TA Technology assessment TC Technical component tPA Tissue-type plasminogen activator UAF Update adjustment factor WAC Wholesale acquisition cost WAMP Widely available market price


### I. Background [If you choose to comment on issues in this section, please include the caption

‘‘ BACKGROUND ’’ at the beginning of your comments.]

A. Introduction

Since January 1, 1992, Medicare has paid for physicians ’ services under section 1848 of the Social Security Act (the Act), ‘‘ Payment for Physicians ’
Services. ’’ The Act requires that payments under the physician fee schedule (PFS) be based on national uniform relative value units (RVUs) based on the resources used in furnishing a service. Section 1848(c) of the Act requires that national RVUs be established for physician work, practice expense (PE), and malpractice expense. Prior to the establishment of the resource-based relative value system, Medicare payment for physicians ’ services was based on reasonable charges.
B. Development of the Relative Value System

1. Work RVUs

The concepts and methodology underlying the PFS were enacted as part of the Omnibus Budget Reconciliation Act (OBRA) of 1989, Pub. L. 101

– 239, and OBRA 1990, (Pub. L. 101

– 508). The final rule, published November 25, 1991 (56 FR 59502), set forth the fee schedule for payment for physicians ’ services beginning January 1, 1992. Initially, only the physician work RVUs were resource-based, and the PE and malpractice RVUs were based on average allowable charges.

The physician work RVUs established for the implementation of the fee schedule in January 1992 were developed with extensive input from the physician community. A research team at the Harvard School of Public Health developed the original physician work RVUs for most codes in a cooperative agreement with the Department of Health and HumanServices. In constructing the codespecific vignettes for the original physician work RVUs, Harvard worked with panels of experts, both inside and outside the government and obtained input from numerous physician specialty groups.

Section 1848(b)(2)(A) of the Act specifies that the RVUs for radiology services are based on relative value scale we adopted under section 1834(b)(1)(A) of the Act, (the American College of Radiology (ACR) relative value scale), which we integrated into the overall PFS. Section 1848(b)(2)(B) of the Act specifies that the RVUs for anesthesia services are based on RVUs from a uniform relative value guide. We established a separate conversion factor (CF) for anesthesia services, and we continue to utilize time units as a factor in determining payment for these services. As a result, there is a separate payment methodology for anesthesia
services.

We establish physician work RVUs for new and revised codes based on recommendations received from the American Medical Association ’ s (AMA) Specialty Society Relative Value Update Committee (RUC).
2. Practice Expense Relative Value Units (PE RVUs)

Section 121 of the Social Security Act Amendments of 1994 (Pub. L. 103

–432), enacted on October 31, 1994, amended section 1848(c)(2)(C)(ii) of the Act and required us to develop resource-based PE RVUs for each physician ’ s service beginning in 1998. We were to consider general categories of expenses (such as office rent and wages of personnel, but excluding malpractice expenses) comprising practice expenses.

Section 4505(a) of the Balanced Budget Act of 1997 (BBA) (Pub. L. 105

– 33), amended section 1848(c)(2)(C)(ii) of the Act to delay implementation of the resource-based PE RVU system until January 1, 1999. In addition, section 4505(b) of the BBA provided for a 4-year transition period from charge-based PE RVUs to resource-based RVUs.

We established the resource-based PE RVUs for each physician ’ s service in a final rule, published November 2, 1998 (63 FR 58814), effective for services furnished in 1999. Based on therequirement to transition to a resourcebased system for PE over a 4-year period, resource-based PE RVUs did not become fully effective until 2002.

This resource-based system was based on two significant sources of actual PE data: The Clinical Practice Expert Panel (CPEP) data and the AMA ’ s Socioeconomic Monitoring System (SMS) data. The CPEP data were collected from panels of physicians, practice administrators, and nonphysicians (for example, registered nurses) nominated by physician specialty societies and other groups. The CPEP panels identified the direct inputs required for each physician ’ s service in both the office setting and out-of-office setting. The AMA ’ s SMSdata provided aggregate specialtyspecific information on hours worked and practice expenses.

Separate PE RVUs are established for procedures that can be performed in both a nonfacility setting, such as a physician ’ s office, and a facility setting, such as a hospital outpatient department. The difference between the facility and nonfacility RVUs reflects the fact that a facility receives separate payment from Medicare for its costs of providing the service, apart from payment under the PFS. The nonfacility RVUs reflect all of the direct and indirect practice expenses of providing a particular service.

Section 212 of the Balanced Budget Refinement Act of 1999 (BBRA) (Pub. L.

106

– 113) directed the Secretary to establish a process under which we accept and use, to the maximum extent practicable and consistent with sound data practices, data collected or developed by entities and organizations to supplement the data we normally collect in determining the PE component. On May 3, 2000, we


## 45767 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

published the interim final rule (65 FR 25664) that set forth the criteria for the submission of these supplemental PE survey data. The criteria were modified in response to comments received, and published in the Federal Register (65 FR 65376) as part of a November 1, 2000 final rule. The PFS final rules published in 2001 and 2003, respectively, (66 FR 55246 and 68 FR 63196) extended the period during which we would accept these supplemental data.
3. Resource-Based Malpractice RVUs

Section 4505(f) of the BBA amended section 1848(c) of the Act to require us to implement resource-based malpractice RVUs for services furnished on or after 2000. The resource-based malpractice RVUs were implemented in the PFS final rule published November 2, 1999 (64 FR 59380). The malpractice RVUs were based on malpractice insurance premium data collected from commercial and physician-owned insurers from all the States, the District of Columbia, and Puerto Rico.

4. Refinements to the RVUs

Section 1848(c)(2)(B)(i) of the Act requires that we review all RVUs no less often than every five years. The first 5- year review of the physician work RVUs went into effect in 1997, published on November 22, 1996 (61 FR 59489). The second 5-year review went into effect in 2002, published on November 1, 2001 (66 FR 55246). The next scheduled 5- year review is scheduled to go into effect in 2007.

In 1999, the AMA ’ s RUC established the Practice Expense Advisory Committee (PEAC) for the purpose of refining the direct PE inputs. Through March of 2004, the PEAC provided recommendations to CMS for over 7,600 codes (all but a few hundred of the codes currently listed in the AMA ’ s Current Procedural Terminology (CPT) codes).

In the November 15, 2004, PFS final rule (69 FR 66236), we implemented the first 5-year review of the malpractice RVUs (69 FR 66263).
5. Adjustments to RVUs are Budget Neutral

Section 1848(c)(2)(B)(ii)(II) of the Act provides that adjustments in RVUs for a year may not cause total PFS payments to differ by more than $20 million from what they would have been if the adjustments were not made. In accordance with section 1848(c)(2)(B)(ii)(II) of the Act, if adjustments to RVUs cause expenditures to change by more than $20 million, we make adjustments to ensure that expenditures do not increase or decrease by more than $20 million.
C. Components of the Fee Schedule Payment Amounts

To calculate the payment for every physician service, the components of the fee schedule (physician work, PE, and malpractice RVUs) are adjusted by a geographic practice cost index (GPCI). The GPCIs reflect the relative costs of physician work, practice expenses, and malpractice insurance in an area compared to the national average costs for each component.

Payments are converted to dollar amounts through the application of a CF, which is calculated by the Office of the Actuary and is updated annually for inflation.

The general formula for calculating the Medicare fee schedule amount for a given service and fee schedule area can be expressed as:

Payment = [(RVU work x GPCI work) + (RVU PE x GPCI PE) + (RVU malpractice x GPCI malpractice)] x CF.
D. Most Recent Changes to the Fee Schedule

In the November 15, 2004 PFS final rule (69 FR 66236), we refined the resource-based PE RVUs and made other changes to Medicare Part B payment policy. These policy changes included

—

• Supplemental survey data for PE;

• Updated GPCIs for physician work and PE;

• Updated malpractice RVUs;

• Revised requirements for supervision of therapy assistants;

• Revised payment rules for low osmolar contrast media;

• Payment policies for physicians and practitioners managing dialysis patients;

• Clarification of care plan oversight CPO) requirements;

• Requirements for supervision of diagnostic psychological testing services;

• Clarifications to the policies affecting therapy services provided incident to a physician ’ s service;

• Requirements for assignment of Medicare claims;

• Additions to the list of telehealth services;

• Changes to payments for drug administration services; and

• Several coding issues. The November 15, 2004, final rule also addressed the following provisions of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) (Pub. L. 108

– 173):

• Coverage of an initial preventive physical examination.

• Coverage of cardiovascular screening blood tests. • Coverage of diabetes screening tests.

• Incentive payment improvements for physicians in physician shortage

areas.

• Changes to payment for covered outpatient drugs and biologicals and drug administration services.

• Changes to payment for renal dialysis services.

• Coverage of routine costs associated with certain clinical trials of category A devices as defined by the Food and Drug Administration.

• Coverage of hospice consultation
service.

• Indexing the Part B deductible to inflation.

• Extension of coverage of intravenous immune globulin (IVIG) for the treatment in the home of primary immune deficiency diseases.

• Revisions to reassignment provisions.

• Payment for diagnostic

mammograms.

• Coverage of religious nonmedical health care institution items and services to the beneficiary ’ s home.

In addition, the November 15, 2004 PFS final rule finalized the calendar year (CY) 2004 interim RVUs for new and revised codes in effect during CY 2004 and issued interim RVUs for new and revised procedure codes for CY 2005; updated the codes subject to the physician self-referral prohibition; discussed payment for set-up of portable x-ray equipment; discussed the third 5- year refinement of work RVUs; and solicited comments on potentially misvalued work RVUs.

In accordance with section 1848(d)(1)(E) of the Act, we also announced that the PFS update for CY 2005 would be 1.5 percent; the initial estimate for the sustainable growth rate for CY 2005 is 4.3; and the CF for CY 2005 is $37.8975.
II. Provisions of the Proposed Rule

This proposed rule would affect the regulations set forth at Part 405, Federal Health Insurance for the Aged and Disabled; Part 410, Supplementary Medical Insurance (SMI) Benefits; Part 411, Exclusions from Medicare and Limitations on Medicare Payment; Part 413, Principles of Reasonable Cost Reimbursement, Payment for End-Stage Renal Disease Services, Prospectively Determined Payment Rates for Skilled Nursing Facilities; 414, Payment for Part B Medical and Other Health Services; Part 426, Review of National Coverage Determinations and Local Coverage
Determinations.


## 45768 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A. Resource-Based Practice Expense (PE) RVUs

Based on section 1848(c)(1)(B) of the Act practice expenses are the portion of the resources used in furnishing the service that reflects the general categories of physician and practitioner expenses (such as office rent and wages of personnel, but excluding malpractice expenses).

Section 121 of the Social Security Amendments of 1994 (Pub. L. 103

–432), enacted on October 31, 1994, required us to develop a methodology for a resource-based system for determining PE RVUs for each physician ’ s service. Up until this point, physicians ’ practice expenses were based on historical allowed charges. This legislation stated that the revised PE methodology must consider the staff, equipment, and supplies used in the provision of various medical and surgical services in various settings beginning in 1998. The Secretary has interpreted this to mean that Medicare payments for each service would be based on the relative PE resources typically involved with performing the service.

The initial implementation of resource-based PE RVUs was delayed until January 1, 1999, by section 4505(a) of the BBA 1997. In addition, section 4505(b) of the BBA 1997 required the new payment methodology be phased-in over 4 years, effective for services furnished in CY 1999, and fully effective in CY 2002. The first step toward implementation called for by the statute was to adjust the PE values for certain services for CY 1998. Section 4505(d) of BBA 1997 required that, in developing the resource-based PE RVUs, the Secretary must:

• Use, to the maximum extent possible, generally accepted cost accounting principles that recognize all staff, equipment, supplies, and expenses, not solely those that can be linked to specific procedures.

• Develop a refinement method to be used during the transition.

• Consider, in the course of notice and comment rulemaking, impact projections that compare new proposed payment amounts to data on actual physician PEs.

Beginning in CY 1999, Medicare began the four year transition to resource-based PE RVUs. In CY 2002, the resource-based PE RVUs were fully transitioned.
1. Current Methodology

The following sections discuss the current PE methodology. a. Data Sources There are two primary data sources used to calculate PEs. The American Medical Association ’ s (AMA) Socioeconomic Monitoring System (SMS) survey data are used to develop the PEs per hour for each specialty. The second source of data used to calculate PEs was originally developed by the Clinical Practice Expert Panels (CPEP). The CPEP data include the supplies, equipment and staff times specific to each procedure.

The AMA developed the SMS survey in 1981 and discontinued it in 1999. Beginning in 2002, we incorporated the 1999 SMS survey data into our calculation of the PE RVUs, using a 5- year average of SMS survey data. (SeeRevisions to Payment Policies and FiveYear Review of and Adjustments to the Relative Value Units Under the Physician Fee Schedule for Calendar Year 2002 final rule, published November 1, 2001 (66 FR 55246).) The SMS PE survey data are adjusted to a common year, 1995. The SMS data provide the following six categories of
PE costs:

• Clinical payroll expenses, which are payroll expenses (including fringe benefits) for nonphysician personnel.

• Administrative payroll expenses, which are payroll expenses (including fringe benefits) for nonphysician personnel involved in administrative, secretarial or clerical activities.

• Office expenses, which include expenses for rent, mortgage interest, depreciation on medical buildings, utilities and telephones.

• Medical material and supply expenses, which include expenses for drugs, x-ray films, and disposable medical products.

• Medical equipment expenses, which include expenses depreciation, leases, and rent of medical equipment used in the diagnosis or treatment of patients.

• All other expenses, which include expenses for legal services, accounting, office management, professional association memberships, and any professional expenses not mentioned above.

In accordance with section 212 of the BBRA, we established a process to supplement the SMS data for a specialty with data collected by entities and organizations other than the AMA (that is, the specialty itself). (See the Criteria for Submitting Supplemental Practice Expense Survey Data interim final rule with comment period, published on May 3, 2000 (65 FR 25664).) Originally, the deadline to submit supplementary survey data was through August 1, 2001. This deadline was extended in the November 1, 2001 final rule through August 1, 2003. (See the Revisions to Payment Policies and Five-Year Review of and Adjustments to the Relative Value Units Under the Physician Fee Schedule for Calendar Year 2002 final rule, published on November 1, 2001 (66 FR 55246).) Then, to ensure maximum opportunity for specialties to submit supplementary survey data, we extended the deadline to submit surveys until March 1, 2005. (See the Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2002 final rule, published on November 7, 2003 (68 FR 63196).)

The CPEPs consisted of panels of physicians, practice administrators, and nonphysicians (registered nurses (RNs), for example) who were nominated by physician specialty societies and other groups. There were 15 CPEPs consisting of 180 members from more than 61 specialties and subspecialties. Approximately 50 percent of the panelists were physicians.

The CPEPs identified specific inputs involved in each physician service provided in an office or facility setting. The inputs identified were the quantity and type of nonphysician labor, medical supplies, and medical equipment.

In 1999, the AMA ’ s RUC established the Practice Expense Advisory Committee (PEAC). Since 1999, anduntil March 2004, the PEAC, a multispecialty committee, reviewed the original CPEP inputs and provided us with recommendations for refining these direct PE inputs for existing CPT codes. Through its last meeting in March 2004, the PEAC provided recommendations which we have reviewed and accepted for over 7,600 codes. As a result of this scrutiny, the current CPEP inputs differ markedly from those originally recommended by the CPEPs. The PEAC has now been replaced by the Practice Expense Review Committee (PERC), which acts to assist the RUC in recommending PE inputs.
b. Allocation of Practice Expenses to
Services

In order to establish PE RVUs for specific services, it is necessary to establish the direct and indirect PE associated with each service. Our current approach allocates aggregate specialty practice costs to specific procedures and, thus, is often referred to

as a ‘‘ top-down ’’ approach. The specialty PEs are derived from the
AMA ’ s SMS survey and supplementary survey data. The PEs for a given specialty are allocated to the services performed by that specialty on the basis


## 45769 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

of the CPEP data and work RVUs assigned to each CPT code. The specific process is detailed as follows:
Step 1—Calculation of the SMS Cost Pool for Each Specialty

The six SMS cost categories can be described as either direct or indirect expenses. The three direct expense categories include clinical labor, medical supplies and medical equipment. Indirect expenses include administrative labor, office expense, and all other expenses. We combine these indirect expenses into a single category. The SMS cost pool for each specialty is calculated as follows:

• The specialty PE per hour (PE/HR) for each of the three direct and one indirect cost categories from the SMS is calculated by dividing the aggregate PE per specialty by the specialty ’ s total hours spent in patient care activities (also determined by the SMS survey). The PE/HR is divided by 60 seconds to obtain the PE per minute (PE/MIN). • Each specialty ’ s PE pools (for each of the three direct and one indirect cost categories) are created by multiplying the PE/MIN for the specialty by the total time the specialty spent treating Medicare patients for all procedures (determined using Medicare utilizationdata). Physician time on a procedurespecific level is available through RUC surveys of new or revised codes and through surveys conducted as part of the 5 year review process. For codes that the RUC has not yet reviewed, theoriginal data from the Harvard resourcebased RVU system survey is used. Physician time includes time spent on the case prior to, during, and after the procedure. The physician procedure time is multiplied by the frequency that each procedure is performed on Medicare patients by the specialty.

• The total specialty-specific SMS PE for each cost category is the sum, for each direct and indirect cost category, of all of the procedure-specific total PEs. Table 1 illustrates an example of the calculation of the total SMS cost pools for the three direct and one indirect cost categories discussed in step 1. For this specialty, PE/HR for clinical payroll expenses is $9.30 per hour. The hourly rate is divided by 60 minutes to obtain the clinical payroll per minute for the specialty.

The total clinical payroll for providing hypothetical procedure 00001 for this specialty of $3,633,465 is the result of taking the clinical payroll per minute of $0.16; multiplying this by the physician time for procedure 00001 (56 minutes); and multiplying the result by the number of times this procedure was provided to Medicare patients by this specialty (418,602). The total amount spent on clinical payroll in this specialty is $667,457,018. This amount is calculated by summing the clinical payroll expenses of procedure 00001 and all of the other services provided by this specialty.



### TABLE 1.—C ALCULATION OF 

### SMS C OST 

### P OOL

Standard methodology Clinical payroll

(A) Medical supplies

(B) Medical equipment (C) Indirect
expenses (D) Total * (E)

(a) PE/HR ................................................................... $9.30 $4.80 $7.40 $46.50 $68.00 (b) PE/Minute ............................................................. $0.16 $0.08 $0.12 $0.78 $1.13 (c) Physician Time—00001 ........................................ 56 56 56 56 56 (d) Number of Services .............................................. 418,602 418,602 418,602 418,602 418,602 (e) Subtotal ................................................................ $3,633,465 $1,875,337 $2,891,144 $18,167,327 $26,56 7,274 (f) All Other Services ................................................. $663,823,552 $342,618,608 $528,203,687 $3,319,117,762 $4 ,853,763,609 (g) Total—SMS Pool .................................................. $667,457,018 $344,493,945 $531,094,831 $3,337,285,089 $4,88 0,330,883

(b) = (a)/60 (e) = (b)*(c)*(d) (g) = (e)+(f) * Components may not add to totals due to rounding.



### Step 2—Calculation of CPEP Cost Pool

CPEP data provide expenditure amounts for the direct expense categories (clinical labor, supplies and equipment cost) at the procedure level. Multiplying the CPEP procedure-level PEs for each of these three categories by the number of times the specialty provided the procedure, produces a total category cost, per procedure, for that specialty. The sum of the total expenses from each procedure results in the total CPEP category cost for the specialty.

For example, in Table 2, using CPEP data, the clinical labor cost of procedure 00001 is $65.23. Under the methodology described above in this step, this is multiplied by the number of services for the specialty (418,602), to yield the total CPEP data clinical labor cost of the procedure: $27,305,408. In this example, the clinical labor cost for all other services performed by this specialty is $831,618,600. Therefore, the entire clinical labor CPEP expense pool for the specialty is $858,924,008. Step 2 is repeated to calculate the CPEP supply and equipment costs.



### TABLE 2.—C ALCULATION OF 

### CPEP C OST 

### P OOL

Standard methodology Clinical labor (A) Supplies (B) Equipment (C)

(a) CPT 00001 .................................................................................................................. ..... $65.23 $52.49 $1,556.86 (b) Allowed Services ........................................................................................................... ... 418,602 418,602 418,602 (c) Subtotal ................................................................................................................... ......... $27,305,408 $21,972,838 $651,704,875 (d) All Other Services ......................................................................................................... ... $831,618,600 $389,921,779 $5,277,570,148 (e) Total CPEP Pool ............................................................................................................ .. $858,924,008 $411,894,617 $5,929,275,023

(c) = (a)*(b) (e) = (c)+(d)


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Step 3

— Calculation and Application of Scaling Factors

This step ensures that the total of the CPEP costs across all procedures performed by the specialty equates with the total direct costs for the specialty as reflected by the SMS data. To accomplish this, the CPEP data are scaled to SMS data by means of a scaling factor so that the total CPEP costs for each specialty equals the total SMS cost for the specialty. (The scaling factor is calculated by dividing the specialty ’ s SMS pool by the specialty ’ s CPEP pool.)

The unscaled CPEP cost per procedure value, at the direct cost level, is then multiplied by the respective specialty scalar to yield the scaled CPEP procedure value. The sum of the scaled CPEP direct cost pool expenditures equals the total scaled direct expense for the specific procedure at the specialty level.

In the Step 3 example shown in Table 3, the SMS total clinical labor costs for the specialty is $667,457,018. This amount divided by the CPEP total clinical labor amount of $858,924,008 yields a scaling factor of 0.78. The CPEP clinical labor cost for hypothetical procedure 00001 is $65.23. Multiplying the 0.78 scaling factor for clinical labor costs by $65.23 yields the scaled clinical labor cost amount of $50.69. Individual scaling factors must also be calculated for supply and equipment expenses. The sum of the scaled direct cost values, $50.69, $43.90 and $139.45, respectively, equals the total scaled direct expense of $234.04.

Step 4

— Calculation of Indirect Expenses

Indirect PEs cannot be directly attributed to a specific service because they are incurred by the practice as a whole. Indirect costs include rent, utilities, office equipment and supplies, and accounting and legal fees. There is not a single, universally accepted approach for allocating indirect practice costs to individual procedure codes. Rather allocation involves judgment in identifying the base or bases that are the best measures of a practice ’ s indirect

costs. To allocate the indirect PEs to a specific service, we use the following methodology:

• The scaled direct expenses and the converted work RVU (the work RVU for the service is multiplied by $34.5030, the 1995 CF) are added together, and then multiplied by the number of services provided by the specialty to Medicare patients;

• The total indirect PEs per specialty are calculated by summing the indirect expenses for all other procedures provided by that specialty.

In the Table 4, the physician work RVU for procedure 00001 is 2.36. Multiplying the work RVU by the 1995 CF of $34.5030 equals $81.43. The physician work value is added to the scaled total direct expense from Step 3 ($234.04). The total of $314.47 is a proxy for the indirect PE for the specialty attributed to this procedure. The total indirect expenses are then multiplied by the number of services provided by the specialty (418,602), to calculate total indirect expenses for this procedure of $132,055,728. The process is repeated across all procedures performed by the specialty, and the indirect expenses for each service are summed to arrive at the total specialty indirect PE pool of $6,745,545,434.



### TABLE 

### 4.

—C ALCULATION OF 

### I NDIRECT 

### E XPENSE

Standard methodology Physician work* Total direct expense Total

(A) (B) (C)

(a) CPT 00001 .................................................................................................................. ..... $81.43 $234.04 $315.47 (b) Allowed Services ........................................................................................................... ... ........................ ........................ 418,602 (c) Subtotal ................................................................................................................... ......... ........................ ........................ $132,055,728 (d) All Other Services ......................................................................................................... ... ........................ ........................ $6,613,489,706 (e) Total Indirect Expense ..................................................................................................... ........................ ........................ $6,745,545,434

*Calculated by multiplying work RVU of 2.36 by 1995 conversion factor of $34.5030.


## 45771 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

Step 5

— Calculation and Application of Indirect Scaling Factors

Similar to the direct costs, the indirect costs are scaled to ensure that the total across all procedures performed by the specialty equates with the total indirect costs for the specialty as reflected by the SMS data. To accomplish this, the indirect costs calculated in Step 4 (Table 4) are scaled to SMS data. The calculation of the indirect scaling factors is as follows:

• The specialty ’ s total SMS indirect expense pool is divided by the specialty ’ s total indirect expense pool calculated in Step 4 (Table 4), to yield the indirect expense scaling factor.

• The unscaled indirect expense amount, at the procedure level, is multiplied by the specialty ’ s scaling factor to calculate the procedure ’ s scaled indirect expenses.

• The sum of the scaled indirect expense amount and the procedure ’ s direct expenses yields the total PEs for the specialty for this procedure.

In table 5, to calculate the indirect scaling factor for hypothetical procedure 00001, divide the total SMS indirect pool, $3,337,285,089 (calculated in Step

1

—Table 1), by the total indirect expense for the specialty across all procedures of $6,745,545,434. This results in a scaling factor of 0.49. Next, the unscaled indirect cost of $315.47 is multiplied by the 0.49 scaling factor, resulting in scaled indirect cost of $156.07. To calculate the total PEs for the specialty for procedure 00001, the scaled direct and indirect expenses are added, totaling $390.12.

Step 6

— Weighted Average of RVUs for Procedures Performed by More Than One Specialty

For codes that are performed by more than one specialty, a weighted average PE is calculated based on Medicare frequency data of all specialties performing the procedure as shown in Table 6.



### TABLE 

### 6.

—W EIGHT 

### AVERAGING FOR 

### A LL 

### S PECIALTIES

Standard Methodology Practice expense value Percent of total allowed

services

(A) (B)

(a) Specialty Total Practice Expense ........................................................................................... ........................... $390.12 83 (b) Weighted Avg.

—All Other Specialties .......................................................................................................... ..... $929.87 17 (c) Weighted Avg.

—All Specialties ................................................................................................................ .......... $481.70 100



### Step 7

—

Budget Neutrality and Final RVU Calculation

The total scaled direct and indirect inputs are then adjusted by a budget neutrality factor to calculate RVUs. Section 1848(c)(2)(B)(ii)(II) of the Act provides that adjustments in RVUs may not cause total PFS payments to differ by more than $20 million from what they would have been if the adjustments were not made. Budget neutrality for the upcoming year is determined relative to the sum of PE RVUs for the current year. Although the PE RVUs for anyparticular code may vary from year-toyear, the sum of PE RVUs across all codes is set equal to the current year. The budget neutrality factor (BNF) is equal to the sum of the current year ’ s PE RVUs, divided by the sum of the direct and indirect inputs across all codes for the upcoming year. The BNF is applied to (multiplied by) the scaled direct and indirect expenses for each code to set the PE RVU for the upcoming year.

In Table 7, the sum of the scaled direct and indirect expenses for hypothetical code 00001 ($481.70) is multiplied by the BNF (0.02 in this example) to yield a PE RVU of 10.60.


## 45772 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

TABLE 

### 7.

—C ALCULATE 

### PE RVU

Total scaleddirect and indirect inputs Budget neutrality factor Final PE RVU

(A) (B) (C)

(a) Code 00001 ................................................................................................................. ........... $481.70 0.02 10.60



### c. Other Methodological Issues: Nonphysician Work Pool (NPWP)

As an interim measure, until we couldfurther analyze the effect of the topdown methodology on the Medicare payment for services with no physician work (including the technical components (TCs) of radiation oncology, radiology and other diagnostic tests), we created a separate PE pool for these services. However, any specialty society could request that its services be removed from the nonphysician work pool. We have removed some services from the nonphysician work pool if we find that the requesting specialty provides the service the majority of the
time.

NPWP Step 1

— Calculation of the SMS Cost Pool for Each Specialty

This step parallels the calculations described above for the standard ‘‘ topdown ’’ PE allocation methodology. For codes in the nonphysician work pool, the direct and indirect SMS costs are set equal to the weighted average of the PE/ HR for the specialties that provide the services in the pool. Clinical staff time is substituted for physician time in the calculation. The clinical staff time for the code is from CPEP data. Otherwise, the calculation is similar to the method described previously for codes with physician time.

The following example in Table 8 illustrates this calculation for hypothetical code 00002. In this example, the average clinical payroll PE/HR for all specialties in the nonphysician work pool is $12.30 and the clinical staff time for code 00002 is
116 minutes.



### TABLE 

### 8.

—C ALCULATE 

### SMS C OST 

### P OOLS FOR 

### N ONPHYSICIAN 

### WORK 

### P OOL

Non-Physician work pool methodology (NPWP) Clinical payroll Medical supplies Medical equipment Indirect expenses Total*

(A) (B) (C) (D) (E)

(a) NPWP

— PE/HR .............................................................. $12.30 $7.40 $3.20 $46.30 $69.00 (b) NPWP

— PE/Minute ......................................................... 0.21 0.12 0.05 0.77 1.15 (c) Clinical Staff Time

—00002 ............................................. 116 116 116 116 116 (d) Number of Services ........................................................ 105,095 105,095 105,095 105,095 105,095 (e) Total

— NPWP ‘‘ SMS ’’ Pool ............................................. $2,499,159 $1,503,559 $650,188 $9,407,404 $14,019,673

(b) = (a)/60 (e) = (b)*(c)*(d) * Components may not add to totals due to rounding.



### NPWP Step 2

— Calculation of Chargebased PE RVU Cost Pool

The nonphysician work pool calculation uses the 1998 (charge-based) PE RVU value for the code, multiplied by the 1995 CF (25.74 × $34.503 = $888.11). The percentage of clinical labor, supplies and equipment are the percentage that each PE category represents for all physicians relative to the total PE for all physicians (calculated from the SMS data) as shown in Table 9.



### TABLE 

### 9.

—C ALCULATE 

### C HARGE 

### -B ASED 

### C OST 

### P OOLS FOR 

### N ONPHYSICIAN 

### WORK 

### P OOL

NPWP methodology Clinical Supplies Equipment

(A) (B) (C)

(a) CPT 00002

—Charge Based Value ........................................................................................ $888.11 $888.11 $888. 11 (b) Percent Clinical, Supplies, Equipment ................................................................................... 0.1 8 0.11 0.05 (c) CPT 00002 .................................................................................................................. ........... 158.08 95.03 41.74 (d) Number of

— NPWP ................................................................................................................ 105,095 105 ,095 105,095 (e) Total NPWP ‘‘ CPEP ’’ Pool ..................................................................................................... $16,613,742 $4,386,77 5 $9,986,912

(c) = (a)*(b) (e) = (c)*(d)



### NPWP Step 3

— Calculation and Application of Scaling Factors

After the total cost pools for each specialty and code performed by the specialty are calculated, the steps to ensure the total costs for all of the procedures performed by a specialty do not exceed the total costs for the specialty (scaling) are the same as those described previously for codes with physician work.

In Table 10 below, the SMS total clinical labor costs is $2,499,159. This amount divided by the charge-based total clinical labor amount of $16,613,742 yields a scaling factor of 0.15. The charge-based clinical labor cost for hypothetical procedure 00002 is $158.08 (from step 2

—Table 2). Multiplying the 0.15 scaling factor for clinical labor costs by $158.08 yields the


## 45773 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

scaled clinical labor cost amount of $23.78. Individual scaling factors must be calculated for both supply and equipment expenses. The sum of the scaled direct cost values, $23.78, $32.57 and $2.72, respectively, equals the total scaled direct expense of $59.07.

NPWP Step 4

— Calculation of Indirect Expenses

Because codes in the nonphysician work pool do not have work RVUs, indirect expenses are set equal to direct expenses (for codes with physician work, indirect expenses equal the sum of the scaled direct expenses and the converted work RVU). This amount is then multiplied by the number of times the procedure is performed.

In Table 11, the scaled total direct expense from Step 3 (Table 3) ($408.79) is also the proxy for the total indirect expense attributed to the procedure. The total indirect expense is multiplied by the number of services (105,095), to calculate total indirect cost for this procedure of $6,207,961.



### TABLE 

### 11.

—C ALCULATION OF 

### I NDIRECT 

### E XPENSES

NPWP methodology Physician work* Total direct expense Total

(A) (B) (C)

(a) CPT 00002 .................................................................................................................. ........... $ $59.07 $59.07 (b) Allowed Services

— NPWP ..................................................................................................... ...................... .. ........................ 105,095 (c) Total NPWP Indirect Expense ............................................................................................... . ....................... ........................ $6,207,961



### NPWP Step 5

— Calculation and Application of Indirect Scaling Factors

Similar to the direct costs, the indirect costs are scaled to ensure that the total of the charge-based PE RVU costs across all procedures equates with the total indirect costs as reflected by the SMS data for the NPWP. To accomplish this, the charge-based data are scaled to SMS data so the total charge-based costs equal the total SMS costs.

In Table 12, to calculate the indirect scaling factor for hypothetical procedure 00002, divide the total SMS indirect expense, $9,407,404 (from Step 1

— Table 1), by the total charge-based indirect expense of $6,207,961. This results in a scaling factor of 1.51. Next, the unscaled indirect charge-based cost for procedure 00002 of $59.07 (from step 4

—Table 4) is multiplied by the 1.51 scaling factor, resulting in scaled indirect costs for this procedure of $89.19.


## 45774 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

NPWP Step 6

— Budget Neutrality and Final RVU Calculation

Similar to the calculation for codes with physician work, the BNF is applied to (multiplied by) the scaled direct and indirect expenses for each code to set the PE RVU for the upcoming year.

In Table 13, the sum of the scaled direct and indirect expenses for hypothetical code 00002 ($148.26) is multiplied by the BNF (0.022 in this example) to yield a PE RVU of 3.26.



### TABLE 

### 13.

— B UDGET 

### N EUTRALITY AND 

### F INAL 

### RVU C ALCULATION

Totalscaled direct and indirect inputs Budget neutrality

factor Final PE RVU

Code

00002 $148.26 0.022 3.26



### d. Facility/Non-facility Costs

Procedures that can be performed in a physician ’ s office as well as in a hospital have two PE RVUs; facility and non-facility. The non-facility setting includes physicians ’ offices, patients ’ homes, freestanding imaging centers, and independent pathology labs. Facility settings include hospitals, ambulatory surgery centers, and skilled nursing facilities (SNFs). The methodology for calculating the PE RVUis the same for both facility and nonfacility RVUs, but is calculated independently to yield two separate PE RVUs. Because the PEs for services provided in a facility setting are generally included in the payment to the facility (rather than the payment to the physician under the fee schedule), the PE RVUs are generally lower for services provided in the facility setting. 2. PE Proposals for CY 2006
The following discussions outline the specific PE related proposals for CY

2006.
a. Supplemental PE Surveys

The following discussions outline the criteria for supplemental survey submission as well as information we have received for approval.
(1) Survey Criteria and Submission
Dates

In accordance with section 212 of the BBRA, we established criteria to evaluate survey data collected by organizations to supplement the SMS survey data normally used in the calculation of the PE component of the PFS. In the Payment Policies Under the Physician Fee Schedule for Calendar Year 2002 final rule, published November 7, 2003 (68 FR 63196), we provided that, beginning in 2004, supplemental survey data had to be submitted by March 1 to be considered for use in computing PE RVUs for the following year. This allows us to publish our decisions regarding survey data in the proposed rule and provides the opportunity for public comment on these results before implementation.

To continue to ensure the maximum opportunity for specialties to submit supplemental PE data, we extended until 2005 the period that we would accept survey data that meet the criteria set forth in the November 2000 PFS final rule. The deadline for submission of supplemental data to be considered in CY 2006 was March 1, 2005.
(2) Submission of Supplemental Survey
Data

The following discussion outlines the survey data submitted for CY 2004 and
CY 2005. • Surveys Submitted in 2004 As explained in the November 15, 2004 Physician Fee Schedule final rule (69 FR 66242), we received surveys by March 1, 2004 from the American College of Cardiology (ACC), the American College of Radiology (ACR), and the American Society for Therapeutic Radiation Oncology (ASTRO). The data submitted by the ACC and the ACR met our criteria. However, as requested by the ACC and the ACR, we deferred using their data until issues related to the nonphysician work pool could be addressed. We are proposing to use the ACC and ACR survey data in the calculation of PE RVUs for 2006, but only as specified in the proposals relating to a revised methodology for establishing direct PE RVUs, and a transition period for the revised methodology, as described below.

The survey data from ASTRO did not meet the precision criteria established for supplemental surveys, therefore, we did not use it in the calculation of PE RVUs for 2005.

• Surveys Submitted in 2005

This year we received surveys from the Association of Freestanding Radiation Oncology Centers (AFROC), the American Urological Association (AUA), the American Academy of Dermatology Association (AADA), the Joint Council of Allergy, Asthma, and Immunology (JCAAI), the National Coalition of Quality Diagnostic Imaging Services (NCQDIS) and a joint survey from the American Gastroenterological Association (AGA), the American Society of Gastrointestinal Endoscopy (ASGE) and the American College of Gastroenterology (ACG)

We contract with the Lewin Group to evaluate whether the supplemental


## 45775 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

survey data that are submitted meet our criteria and to make recommendations to us regarding their suitability for use in calculating PE RVUs. (The Lewin Group report on the 2005 submissions is available on the CMS Web site at http://www.cms.hhs.gov/physicians/pfs/ ). The report indicated that, except for the survey from NCQDIS, all met our criteria and we are proposing to accept these. The survey data submitted by the NCQDIS on independent diagnostic testing facilities (IDTFs) did not meet the precision criterion of a 90 percent confidence interval with a range of plus or minus 15 percent of the mean (that is, 1.645 times the standard error of the mean, divided by the mean, is equal to or less than 15 percent of the mean). For the NCQDIS survey, the precision level was calculated at 16.3 percent of the mean PE/HR (weighted by the number of physicians in the practice). However, the Lewin Group has recommended that we accept the data from NCQDIS. The Lewin Group points out that PE data for IDTFs do not currently exist, and suggests that the need for data for the specialty should be weighed against the precision requirement.

We are proposing not to accept the NCQDIS data to calculate the PE RVUs for services provided by IDTFs. As just noted, the NCQDIS data do not meet our precision requirements. We established the minimum precision standards because we believe it is necessary to ensure that the data used are valid and reliable, and the consistent application of the precision criteria is the best way to accomplish that objective.

Section 303(a)(1) of the MMA added section 1848(c)(2)(I) of the Act to require us to use survey data submitted by a specialty group where at least 40 percent of the specialty ’ s payments for Part B services are attributable to the administration of drugs in 2002 to adjust PE RVUs for drug administration services. The statute applies to surveys that include expenses for the administration of drugs and biologicals, and are received by March 1, 2005 for determining the CY 2006 PE RVUs. Section 303(a)(1) of the MMA also amended section 1848(c)(2)(B)(iv)(II) of the Act to provide an exemption from budget neutrality for any additional expenditures resulting from the use of these surveys. In the Changes to Medicare Payment for Drugs and Physician Fee Schedule Payments for Calendar Year 2004 interim final rule published January 7, 2004 (69 FR 1084), we stated that the specialty of urology meets the above criteria, along with gynecology and rheumatology (69 FR 1094). Because we are accepting new survey data from the AUA, we are required to exempt, from the budget neutrality adjustment any impacts of accepting these data for purposes of calculating PE RVUs for drug administration services.

In addition, Lewin recommended blending the radiation oncology data from this year ’ s AFROC survey data with last year ’ s ASTRO survey data to calculate the PE/HR. According to the Lewin Group, the goal of the AFROC survey was to represent the population of freestanding radiation oncology centers only. In order to develop an overall average for the radiation oncology PE pool, the Lewin Group recommended we use the AFROC survey for freestanding radiation oncology centers, and the hospital-based subset of last year ’ s ASTRO survey. We agree that this blending of the AFROC and ASTRO data is a reasonable way to calculate an average PE/HR that fully reflects the practice of radiation oncology in all settings. Therefore, we are proposing to use the new PE/HR calculated in this manner for radiation oncology.

We propose to use the following PE/ HR figures (deflated to 1995 values to be consistent with the SMS data):



### TABLE 14.

— P RACTICE 

### E XPENSE 

### P ER 

### H OUR 

### F IGURES

Specialty Clinical staff Admin. staff Office expense Medical supplies Medical equipment Other Total

Radiology ................................................. 14.8 18.6 16.5 6.5 13.1 26.8 96.3 Cardiology ................................................ 38.3 34.5 35.7 16.5 12.2 19.1 156.3 Radiation Oncology .................................. 35.6 18.9 28.5 4 20.1 21.2 128.3 Urology ..................................................... 18.4 27.9 35.3 16.7 7.5 15.9 121.7 Dermatology ............................................. 27.9 35.2 49.4 12.4 7.2 20 152.1 Allergy/Immunology .................................. 48.2 39.8 47 17.3 4.8 22.4 179.6 Gastroenterology ...................................... 15.4 23.2 26.8 4.8 3.3 11.5 85



### The deadline to submit supplemental PE surveys was March 1, 2005. As discussed in detail below, we are proposing to revise our methodology to calculate direct PE RVUs from the current top-down cost allocation methodology to a bottom-up methodology. Although we would continue to use the SMS data and the incorporated supplemental survey data for indirect PEs, we are not proposing to extend the deadline for submitting supplemental survey data at this time. Instead, we are inviting comment on the most appropriate way to proceed to ensure the indirect PEs per hour are accurate and consistent across specialties. (3) Revisions to the PE Methodology

Since 1997, when we first proposed a resource-based PE methodology, we have had several major goals for this payment system. One has been to encourage the maximum input from the medical community regarding our PE data and methodology. We have worked closely with the PEAC, PERC, RUC and the Health Care Professional Advisory Committee (HCPAC) which are all multi-specialty groups that allow the medical community to participate by making recommendations to us on the PE direct inputs. We also extended the deadline for the submission of supplementary PE surveys to ensure that specialties had the opportunity to submit new aggregate PE data. In addition, we have had scores of meetings with physician, practitioner and industry groups, and have made many modifications to our methodology in response to their comments and input. We look forward to continuing to work with the medical community as we strive to further improve our PE methodology.

We also have had three specific goals for the resource-based PE methodology itself. The following goals have also been supported in numerous comments we have received from the medical community:

• To ensure that the PE payments reflect, to the greatest extent possible, the actual relative resources required for each of the services on the PFS. This could only be accomplished by using


## 45776 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

the best available data to calculate the
PE RVUs.

• To develop a payment system for PE that is understandable and at least somewhat intuitive, so that specialties could generally predict the impacts of changes in the PE data.

• To stabilize the PE payments so that there are not large fluctuations in the payment for given procedures from year-to-year.

We believe that we have consistently made a good faith effort to ensure fairness in our PE payment system by using the best data available at any one time. The change from the originally proposed ‘‘ bottom-up ’’ to the ‘‘ topdown ’’ methodology came about because of a concern that the resource input data developed in 1995 by the CPEP were less reliable than the aggregate specialty cost data derived from the SMS process. The adoption of the top-down approach necessitated the creation of the nonphysician work pool. The nonphysician work pool is a separate pool created to allocate PEs for codes that have only a technical (rather than professional) component, or codes that are not performed by physicians. In the Physician Fee Schedule (CY 2000); Payment Policies and Relative Value Unit Adjustment final rule, published November 2, 1999 (64 FR 59379), we indicated that ‘‘ the purpose of this pool was only to protect the (TC) services from the substantial decreases * * * until further refinement could take place * * * ’’ (64 FR 59406).

However, the situation has now changed. The PEAC/PERC/RUC has completed the refinement of the original CPEP data and we believe that the refined PE inputs now, in general, accurately capture the relative direct costs of performing PFS services. On the other hand, although we have now accepted supplementary survey data from 13 specialties, we have not received updated aggregate cost data from most specialties. Thus, we believe that, in the aggregate, the refined CPEP data represent, more reliably, the relative direct costs PE inputs for physician services.

The major specialties comprising the nonphysician work pool (radiology, radiation oncology and cardiology) have submitted supplemental survey data that we are proposing to accept. (See the discussion on supplementary surveys above.) Now that we have representative aggregate PE data for these specialties, the continued necessity and equity of treating these technical services outside the PE methodology applied to other services is questionable.

We have also taken steps to make our complex top-down PE methodology more understandable. For example, we eliminated the somewhat arcane

‘‘ linking ’’ of direct cost input data when more than one CPEP panel reviewed a service and did away with the confusing and unhelpful distinction between procedure-specific and indirect equipment. However, we acknowledge that most in the medical community would find our current methodology, as described above, neither clear nor intuitive. For example, because of the need to scale the CPEP/RUC inputs to the SMS PEs under our top-down methodology, the PE RVUs for a procedure do not necessarily change proportionately with changes in the direct inputs. This raises the question as to what would now be the most straightforward and intuitive methodology for calculating the direct
PE RVUs.

Due to the ongoing refinement by the RUC of the direct PE inputs, we had expected that the PE RVUs would necessarily fluctuate from year-to-year, frustrating temporarily our efforts to reach the goal of stabilizing the PE portion of the PFS. At the same time, it became apparent that certain aspects of our methodology exacerbated the yearly fluctuations. For example, the need to scale the CPEP costs to equal the SMS costs meant that any changes in the direct PE inputs for one service often leads to unexpected results for other services where the inputs had not been altered. In addition, the services priced by the nonphysician work pool methodology have proved to be especially vulnerable to any change in the pool ’ s composition. We understand the need for stable PE RVUs, so that physicians and other practitioners can anticipate from year-to-year what the relative payments will be for the services they perform. Now, that the CPEP/RUC refinement of existing services is virtually complete, this appears to be an opportunity for us to propose a way to provide stability to the
PE RVUs.

Therefore, consistent with our goals of using the most appropriate data, simplifying our methodology, and increasing the stability of the payment system, we are proposing the following changes to our PE methodology:

• Use a Bottom-Up Methodology To Calculate Direct PE Costs

Instead of using the top-down approach to calculate the direct PE RVUs, where the aggregate CPEP/RUC costs for each specialty are scaled to match the aggregate SMS costs, we propose to adopt a bottom-up method of determining the relative direct costs for each service. Under this method, the direct costs would be determined by summing the costs of the resources

—the clinical staff, equipment and supplies

— typically required to provide the service. The costs of the resources, in turn, would be calculated from the refined CPEP/RUC inputs in our PE database.

• Eliminate the Nonphysician Work Pool

Now that we have new survey data for the major specialties that comprise the nonphysician work pool, we would eliminate the pool and calculate the PE RVUs for the services currently in the pool by the same methodology used for all other services. This would allow the use of the refined CPEP/RUC data to price the direct costs of individualservices, rather than utilizing the pre1998 charge-based PE RVUs.

• Utilize the Current Indirect PE RVUs, Except for Those Services Affected by the Accepted Supplementary Survey
Data

As described previously, the SMS and supplementary survey data are the source for the specialty-specific aggregate indirect costs used in our PE calculations. We then allocate to particular codes on the basis of the direct costs allocated to a code and the work RVUs. Although we now believe the CPEP/RUC data are preferable to the SMS data for determining direct costs, we have no information that would indicate that the current indirect PE methodology is inaccurate. We also are not aware of any alternative approaches or data sources that we could use to calculate more appropriately the indirect PE, other than the new supplementary survey data, which we propose to incorporate into our PE calculations. Therefore, we propose to use the current indirect PEs in our calculation incorporating the new survey data into the codes performed by the specialities submitting the surveys. We would welcome any suggestions that would assist us in further refinement of this indirect PE methodology. For example, we are considering whether we should continue to accept supplementary survey data or whether it would be preferable and feasible to have an SMS-type survey of only indirect costs for all specialties, or whether a more formula-based methodology independent of the SMS data should beadopted, perhaps using the specialtyspecific indirect-to-total cost percentage as a basis of the calculation. For a prior discussion of many of the issues associated with allocating indirect costs, we would refer the reader to the Physician Fee Schedule (CY 2000);


## 45777 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

Payment Policies and Relative Value Unit Adjustment proposed rule, published June 5, 1998 (63 FR 30823).

• Transition the Resulting Revised PE RVUs over a Four-Year Period

A complete analysis of the impacts of these changes is contained in the impact analysis in section V. of this proposed rule. We are concerned that, when combined with an expected negative update factor for CY 2006, the shifts in some of the PE RVUs resulting from our proposals could cause some measure of financial stress on medical practices. Therefore, we are proposing to transition the proposed PE changes over a 4-year period. This would also give ample opportunity for us, as well as the medical specialties and the RUC, to identify any anomalies in the PE data, to make any further appropriate revisions, and to collect additional data, as needed prior to the full implementation of the proposed PE changes.

During the transition period, the PE RVUs will be calculated on the basis of a blend of RVUs calculated using our proposed methodology described above (weighted by 25 percent during CY 2006, 50 percent during CY 2007, 75 percent during CY 2008, and 100 percent thereafter), and the current CY 2005 PE RVUs for each existing code.

We believe that implementing these proposed changes will meet our goals to produce a more accurate, more intuitive and more stable PE methodology.

Now that the direct PE inputs have been refined, we believe that the proposed CPEP/RUC direct input data are superior to the specialty-specific SMS PE/HR data for the purposes of determining the typical direct PE resources required to perform each service on the PFS. First, we have received recommendations on the procedure-specific inputs from the multi-specialty PEAC that were based on presentations from the relevant specialties after being closely scrutinized by the PEAC using standards and packages agreed to by all involved specialties. Second, the refined CPEP/RUC data are more current than the SMS data for the majority of specialties. Third, for direct costs, it appears more accurate to assume that the costs of the clinical staff, supplies and equipment are the same for a given service, regardless of the specialty that is performing it. This assumption does not hold true under the top-down directcost methodology, where the specialtyspecific scaling factors create widely differing costs for the same service.

We also would argue that the proposed methodology is less confusing and more intuitive than the current approach. First, the nonphysician work pool would be eliminated and all services would be priced using one methodology, eliminating the complicated calculations needed to price nonphysician work pool services. Second, the method for calculation of direct costs can now be described in sentences rather than paragraphs. Third, any revisions made to the direct inputs would now have predictable results. Changes in the direct practice inputs for a service would proportionately change the PE RVUs for that service without significantly affecting the PE RVUs for unrelated services.

The proposed methodology would also create a system that would besignificantly more stable from year-toyear than the current approach. Specialties should no longer experience the wide fluctuations in payment for a given service due to an aberrant direct cost scaling factor. Direct PEs should only change for a service if it is further refined or when prices are updated, while indirect PEs should change only when there are changes in the mix of specialties performing the service or with the use of any future new survey data for indirect costs.

We recognize that there are still some outstanding issues that need further consideration, as well as input from the medical community. For example, although we believe that the elimination of the nonphysician work pool would be, on the whole, a positive step, some practitioner services, such as audiology and medical nutrition therapy, would be significantly impacted by the proposed change. In addition, there are still services, such as the ESRD visit codes, for which we have no direct input information. Also, as mentioned above, we do not have current SMS or supplementary survey data to calculate the indirect costs for most specialties. Further, we do not yet have accurate utilization for the new drug administration codes that were created in response to the MMA provision on drug administration. Therefore, we are not proposing to change the RVU for these services at this time, but to include them under our proposed methodology in next year ’ s rule when we have appropriate data. The proposed transition period would give us the opportunity to work with the affected specialties to collect the needed survey or other data or to determine whether further revisions to our PE methodology are needed.

We, therefore, welcome all comments on these proposed changes, particularly those concerning additional modifications to the indirect PE methodology that might help us further our intended goals.

(4) PE Recommendations on CPEP Inputs for CY 2006

Since 1999, the PEAC, an advisory committee of the AMA ’ s RUC, provided us with recommendations for refining the direct PE inputs (clinical staff, supplies, and equipment) for existing CPT codes. The PEAC held its last meeting in March 2004 and the AMA established a new committee, PERC, to assist the RUC in recommending PE inputs.

The PERC completed refinement of approximately 200 remaining codes at its meetings held in September 2004 and February 2005. (A list of these codes can be found in Addendum C of this proposed rule.)

We have reviewed the PERCsubmitted recommendations and propose to adopt nearly all of them. We have worked with the AMA staff to correct any typographical errors and to make certain that the recommendations are in line with previously accepted standards.

The complete PERC recommendations and the revised PE database can be found on our Web site. (See the

‘‘ Supplementary Information ’’ section of this proposed rule for directions on accessing our Web site.)

We disagreed with the PERC recommendation for clinical labor time for CPT code 36522, Extracorporeal Photophoresis. In last year ’ s Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2005 final rule, published November 15, 2004 (69 FR 66236) we assigned, on an interim basis, 223 minutes of total clinical labor for the service period based on the typical treatment time of approximately 4 hours. The PERC, however, recommended 122 minutes total clinical labor time for the service period, which allows for 90 minutes of nurse ‘‘ intra
service ’’ time for the performance of the procedure (the society originally proposed 180 minutes). We believe that 135 minutes is a more appropriate estimation of the clinical staff time actually needed for the intra time, as it more closely approximates the time assigned to the other procedures in this family of codes, including CPT codes 36514, 36515, and 36516. Therefore, we are proposing a total clinical labor time of 167 minutes for the service period.

The PERC/RUC also recommended that no inputs be assigned to several codes because the services were not performed in the office setting. However, our utilization data shows that four of these codes (CPT codes


## 45778 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

15852, 76975, 78350, and 86585) are currently priced in the office and are performed with sufficient frequency in the office to warrant this. Therefore, we are proposing not to accept the PERC/ RUC recommendations for these services at this time, but are requesting comments from the relevant specialties as to whether the recommendations should be accepted.
(5) Payment for Splint and Cast Supplies

In the Physician Fee Schedule (CY 2000); Payment Policies and Relative Value Unit Adjustment final rule, published November 2, 1999 (64 FR 59379) and the Physician Fee Schedule (CY 2002); Payment Policies and Relative Value Units Five-Year Review and Adjustments final rule, published November 1, 2000 (66 FR 55245), we removed cast and splint supplies from the PE database for the CPT codes for fracture management and cast/strapping application procedures. Because casting supplies could be separately billed using Healthcare Common Procedure Coding System (HCPCS) codes that were established for payment of these supplies under section 1861(s)(5) of the Act, we did not want to make duplicate payment under the PFS for these items.

However, in limiting payment of these supplies to the HCPCS codes Q4001 through Q4051, we unintentionally prohibited remuneration for these supplies when they are not used for reduction of a fracture or dislocation, but rather, are provided (and covered) as incident to a physician ’ s service under section 1861(s)(2)(A) of the Act.

Because these casting supplies are covered either through sections 1861(s)(5) of the Act or 1861(s)(2)(A) of the Act, we are proposing to eliminate the separate HCPCS codes for these casting supplies and to again include these supplies in the PE database. This will allow for payment for these supplies whether based on section 1861(s)(5) of the Act or section 1861(s)(2)(A) of the Act, while ensuring that no duplicate payments are made. In addition, by bundling the cost of the cast and splint supplies into the PE component of the applicable procedure codes under the PFS, physicians will no longer need to bill Q-codes in addition to the procedure codes to be paid for these materials.

Because these supplies were removed from the PE database prior to the refinement of these services by the PEAC, we are proposing to add back the original CPEP supply data for casts and splints to each applicable CPT code. For this reason, it is imperative that the relevant medical societies review the ‘‘ Direct Practice Expense Inputs ’’ on our Web site at http://www.cms.hhs.gov/ physicians/pfs (under the supporting documents for the 2006 proposed rule) and provide us with feedback regarding the appropriateness of the type and amount of casting and splinting supplies. We are also requesting specific information about the amount of casting supplies needed for the 10-day and 90- day global procedures, because these supplies may not be required at each follow-up visit; therefore, the number of follow-up visits may not reflect the typical number of cast changes required for each service.

The following cast and splint supplies have been reincorporated as direct inputs: fiberglass roll, 3 inch and 4 inch; cast padding, 4 inch; webril (now designated as cast padding, 3 inch); cast shoe; stockingnet/stockinette, 4 inch and 6 inch; dome paste bandage; cast sole; elastoplast roll; fiberglass splint; ace wrap, 6 inch; and kerlix (now designated as bandage, kerlix, sterile, 4.5 inch) and malleable arch bars. The cast and splint supplies have been added to the following CPT codes: 23500 through 23680, 24500 through 24685, 25500 through 25695, 26600 through 26785, 27500 through 27566, 27750 through 27848, 28400 through 28675, and 29000 through 29750.

Because we are proposing to pay for splint and cast through the PE component of the PFS, we would no longer make separate payment for these items using the HCPCS Q-codes.

(6) Miscellaneous PE Issues

In this section, we discuss our specific proposals related to PE inputs.

• Supply Items for CPT Code 95015

We are proposing to change the supply inputs for CPT code 95015, intracutaneous (intradermal) tests, sequential and incremental, with drugs, biologicals or venoms, immediate type reaction, specify number of tests, based on comments received from the JCAAI. The society reports that ‘‘ venom ’’ is the most typical test substance used when performing this service and that

‘‘ antigen ’’ , currently listed in the PE database, is never used. The JCAAI also suggests that the appropriate venom quantity should be 0.3 ml (instead of the 0.1 ml now listed) because of the necessity to use all five venoms (honey bee, yellow jacket, yellow hornet, white face hornet and wasp) to perform this sensitivity testing; that is, 1 ml of each venom type for a total of 5 ml of venom. The diluted venoms are sequentially administered until sensitivity is shown, beginning with the lowest concentration of venom and subsequently administering increasing concentrations of each venom. The JCAAI states that the typical number of tests per session is approximately 17, consistent with the RUC-approved vignette, which represents 0.3 ml of venom per test when divided into the total of 5 ml of venom needed to perform the entire service. We accept the specialty ’ s argument and propose to change the test substance in CPT code 95015 to venom, at $10.70(from single antigen, at $5.18) and the quantity to 0.3 ml (from 0.1 ml).

• Flow Cytometry Services

In the November 15, 2004 final rule (69 FR 66236), we solicited comments on the interim RVUs and PE inputs for new and revised codes, including flow cytometry services. Based on comments received and additional discussions with representatives from the society representing independent laboratories, we are proposing to revise the PE inputs for the flow cytometry CPT codes 88184 and 88185.

The specialty society indicated that a cytotechnologist is the typical clinical staff type to perform the intra portion of this service for both codes. They also provided us with a list of six additional equipment items, along with documented prices, and with the minutes in use for each service. All six equipment items are necessary to perform the flow cytometry services described in CPT code 88184, while only two (the computer and printer) are needed for CPT code 88185. For supplies, the society believes the antibody cost currently reflected in the PE database is too low, and so they provided us with an average antibody cost of $8.50, derived from a survey of laboratories performing these services. Using the vignette for the myeloid/ lymphoid panel to represent the typical service, this average cost was based on the cost of the total number of antibodies that are required to report the typical number of reported markers. Based on this information, we are proposing to change the following direct inputs used for PE:

+ Clinical Labor: Change the staff type in the service (intra)period in both CPT codes 88184 and 88185 to cytotechnologist, at $0.45 per minute (currently lab technician, at $0.33 per minute).

+ Supplies: Change the antibody cost for both CPT codes 88184 and 88185 to $8.50 (from $3.544).

+ Equipment: Add a computer, printer, slide strainer, biohazard hood, and FACS wash assistant to CPT code 88184. Add a computer and printer to the equipment for CPT code 88185.


## 45779 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

• Low Osmolar Contrast Media (LOCM) and High Osmolar Contrast Media (HOCM)

HOCM and LOCM are used to enhance images produced by various types of diagnostic radiological procedures. In the November 15, 2004 final rule (69 FR 66356), we eliminated the criteria for the payment of LOCM that had been included at § 414.38. Effective January 1, 2005, providers can be paid for either LOCM or HOCM when used with procedures requiring contrast media. Payment for LOCM is made through the use of separate Q-codes, while payment for HOCM is currently included as part of the PE component under the PFS. Effective January 1, 2006, we will no longer include payment for HOCM under the PFS. When HOCM is used, Q-codes that have been established specifically for HOCM will be used for payment.

We have reviewed the PE database and are proposing to remove the following two supply items which we have identified as HOCM from the PE database:

+ Conray inj. iothalamate 43 percent(supply item #SH026, deleted from 64 procedures).

+ Diatrizoate sodium 50 percent (supply item #SH0238, deleted from 74 procedures).

In reviewing the PE database we also identified 5 CPT codes (specifically CPT codes 42550, 70370, 93508, 93510 and 93526) that include omnipaque as a supply item. Since omnipaque is actually a type of LOCM that is separately billable, we are proposing to remove this supply item from these five CPT codes.

• Imaging Rooms

We include standardized ‘‘ rooms ’’ for certain services in our PE equipment database, rather than listing each item separately. We received pricing information from the ACR for the following rooms that are included in the database. We have accepted most of the proposed items that meet the $500 threshold for equipment and are proposing to include the items in each specific room, as follows:

+ Basic Radiology Room: $127,750 (xray machine @ $125,550 and camera @ $2,200). The recommended viewbox was not included because most codes assigned this room have also been assigned an alternator (automated film viewer) or a 4-panel viewbox.

+ Radiographic-Flouroscopic Room: $367,664 (Radiographic machine @ $365,464 and camera @ $2,200). The recommended viewbox was not included because most codes assigned this room have also been assigned an alternator (automated film viewer) or a 4-panel viewbox.

+ Mammography Room: $168,214 (mammography unit @ $124,900; reporting system @ $16,690; mammography phantom @ $674; densitometer @ $3,660; sensitometer @ $2,750; desktop PC for monitoring @ $1,840; and processor @ $17,700. Separately listed equipment items (densitometer, mammography reporting system, sensitometer, mammography phantom, desktop computer, and the film processor) that duplicated items included in the mammography room were removed from the codes assigned the room, eliminating the reporting system, sensitometer and phantom from the PE database.

+ Computed tomography (CT) Room: $1,284,000 (16-slice CT scanner with power injector and monitoring system)

+ Magnetic Resonance (MR) Room: $1,605,000 (1.5T MR scanner with power injector and monitoring system)

• Equipment Pricing for Select Services and Procedures from the November 15, 2004 final rule (69 FR 66236).

Equipment pricing for certain radiology services was received and supported with sufficient documentation from the ACR. We have accepted the following equipment prices as shown in table 15.



### TABLE 

### 15

CAD processor (CPT 76082

–83) $115,000 Collimator, cardiofocal set (CPT

78206

–07, 78647, 78803, 78807) ....................................... 8,543 Densitometer/DPA (CPT 78351) .. 150,000 Detector Probe (CPT 78455) ....... 19,995IVAC Injection Pump, single channel (CPT 78206

–07, 78647, 78803, 78807) ........................... 3,000Computer workstation/MRA includes: Includes 2 monitors, volume viewer, advanced x-ray analysis, data export, CD

– RW, DICOM Print, 2 GB RAM (CPT 71555, 72159, 72198, 73225, 73727, 74185) ........................... 122,000



### We accepted the documentation supplied from the American College of Obstetricians and Gynecologists (ACOG) to price the following equipment for which we assigned an average price from the three sources, as follows: Ultrasound color Doppler transducers

and vaginal probe (CPT 59070, 59074,

76818

– 19, 76825

– 28)

—$157,897 For CPT 36522, extracorporeal photopheresis, we received and accepted equipment pricing information specific to this procedure, as follows: Plasma pheresis machine with UV light source (CPT 36522)

—$65,000
We received comments from the American Academy of Ophthalmology that included documentation from two sources for the pricing of the EMG botox machine used in CPT code 92265 and we are proposing to accept $16,188 as the average price for this equipment.

• Supply Item for In Situ Hybridization Codes (CPT 88365, 88367, and 88368)

We received comments from the College of American Pathologists (CAP) regarding the number of DNA probes assigned to the in situ hybridization codes, CPT codes 88365, 88367, and 88368. Currently, CPT codes 88365 and 88368 have 1.5 probes assigned, while CPT code 88367 has only .75 of a probe assigned. CAP requested that we also assign 1.5 probes to CPT code 88367, and the comment provided justification for this request. We accept the CAP rationale and propose to change the probe quantity for CPT code 88367 to

1.5.

• Supply Item for Percutaneous Vertebroplasty Procedures (CPT codes 22520 and 22525)

The Society for Interventional Radiology provided us with documentation for the price of the vertebroplasty kit used in CPT codes 22520 and 22525. We propose to accept a new price of $696 for this supply, currently listed as $660.50, a placeholder price from last year ’ s final rule.

• Clinical Labor for G-codes Related to Home Health and Hospice Physician Supervision, Certification and Recertification

It has come to our attention that four G-codes related to home health and hospice physician supervision, certification and recertification, G0179, 180, 181, and 182, are incorrectly valued for clinical labor. These codes are cross-walked from CPT codes 99375 and 99378, which underwent PEAC refinement for the 2004 fee schedule. However, we did not apply the new refinements to these specific G-codes at that time, and are proposing to revise the PE database to reflect the new values.

• Programmers for Implantable Neurostimulators and Intrathecal Drug Infusion Pumps

We received comments from the neurological division of Medtronic Incorporated, the manufacturer of programmers for implantable neurostimulators and intrathecal drug infusion pumps, that the equipment


## 45780 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

costs for these programmers are not a direct expense for the physicians performing the programming of these devices. The manufacturer furnishes these devices without cost because the programming device is considered a

‘‘ necessary, ancillary item to the neurostimulator and drug pump and can only be used to program these devices. ’’ As such, we are proposing to remove the two programmers from the PE database: EQ208 for medication pump from 2 codes (CPT 62367 and 62368) and EQ209 for the neurostimulator from 8 codes (CPT 95970

–97979). We are asking for comments from the specialty societies performing these services to let us know if this proposal reflects typical practice.

• Pricing of New Supply and Equipment Items

As part of last year ’ s rulemaking process, we reviewed and updated the prices for equipment items in our PE database and assigned a unique identifier to each equipment item with the first two elements corresponding to one of seven categories. It has come to our attention that we have assigned the same category identifier (ELXXX) for both ‘‘ lanes/rooms ’’ as well as

‘‘ laboratory equipment ’’ . To correct this, we are assigning laboratory equipment items the new category identifier ‘‘ EPXXX ’’ , but the specific numbers associated with each item will remain the same. Supply items were reviewed and updated in the rulemaking process for the 2004 PFS. During subsequent meetings of both the PEAC (now referred to as the PERC) and the RUC, supply and equipment items were added that were not included in the pricing updates. The following two tables (Table 16: Proposed Practice Expense Supply Items and Table 17: Proposed Practice Expense Equipment Items) list the additional supply and equipment items for 2006 and the proposed associated prices that we will use in the PE calculation.



### TABLE 

### 16.

— P ROPOSED 

### P RACTICE 

### E XPENSE 

### S UPPLY 

### I TEM 

### A DDITIONS FOR 

### 2006

Supply code Supply description Unit Unit price *CPT code(s) associated with item Supply category

SJ071 ........... ACD

–A anticoagulant ......................................... item .... 6.58 36514, 36515, 36516 Pharmacy, NonRx. SL186 ........... Antibody, flow cytometry (each test) .................. item .... 8.5 88184, 88185 Lab. SL187 ........... Balance salt solution (BSS), sterile, 15cc .......... ml ....... 92265 Lab. SG093 .......... Bandage, Dome paste, 3in ................................. item .... 14.95 29580 Wound care, dressings. SJ072 ........... Brush, disposable applicator .............................. item .... 17360 Pharmacy, NonRx. SG094 .......... Cast, padding 3in x 4yd (Webril) ........................ item .... 1.22 18 codes Wound care, dressings. SG095 .......... Cast, sole ............................................................ item .... 14.74 29355, 29425, 29440 Wound ca re, dressings. SG096 .......... Casting tape, fiberglass 3in x 4 yds ................... item .... 9.2 29065, 29075, 29105, 29365, 29405, 29425 Wound care, dressings.

SD216 .......... Catheter, balloon, esophageal or rectal (graded distention test). item .... 217.00 91120, 91040 Accessory, Procedure.

SK102 .......... Communication book/treatment notebook .......... item .... 92510 Office supply, grocery. SB049 .......... Condom, Diapulse, Asepticap ............................ item .... 0.69 G0329 Gown, drape. SK103 .......... Cork sheet, 1cm x 1cm ...................................... item .... 88355 Office supply, grocery. SD217 .......... Diaphragm fitting set .......................................... item .... 57170 Accessory, Procedure. SJ073 ........... DMV remover ..................................................... item .... 92311, 92312, 92313, 92314, 92315, 92317, 92316, 92310 Pharmacy, NonRx.

SL188 ........... EM fixative, karnovsky ’ s ..................................... ml ....... 0.086 88355, 88356 Lab. SL189 ........... Ethanol, 100% .................................................... ml ....... 0.003 88365, 88367, 88368 Lab. SL190 ........... Ethanol, 70% ...................................................... ml ....... 0.003 88367, 88368, 88365 Lab. SL191 ........... Ethanol, 85% ...................................................... ml ....... 0.003 88368, 88367, 88365 Lab. SC088 .......... Fistula set, dialysis, 17g ..................................... item .... 36522 Hypodermic, IV. SK104 .......... Foil, aluminum, 10cm x 10cm ............................ item .... 88355 Office supply, grocery. SL192 ........... Formamide .......................................................... ml ....... 0.22 88368, 88365, 88367 Lab. SL193 ........... Glycolic acid, 20

–50% ........................................ ml ....... 17360 Lab. SL194 ........... Hemo-De ............................................................ ml ....... 0.008 88368, 88367, 88365 Lab. SA089 .......... Kit, boston original system ................................. kit ....... 4.5 92311, 92315, 92310, 92313, 92313, 92314, 92317, 92316 Kit, Pack, Tray.

SL195 ........... Kit, FISH paraffin pretreatment .......................... kit ....... 20.85 88367, 88368, 88365 Lab. SL196 ........... Kit, HER

–2/neu DNA Probe ............................... kit ....... 105.00 88367, 88368 Lab. SA090 .......... Kit, moulage (implantech) ................................... kit ....... 75.00 19396 Kit, Pack, Tray. SL197 ........... Label for blood tube ........................................... item .... 0.004 36516, 36515, 36514 Lab. SL198 ........... Label, vial ........................................................... item .... 0.003 88355 Lab. SJ074 ........... Lens cleaner ....................................................... ounce 92342, 92313, 92340, 92341 Pharmacy, No nRx. SL199 ........... Lithium carbonate, saturated .............................. ml ....... 88355, 88356 Lab SH092 .......... LMX 4% anesthetic cream ................................. gm ...... 1.6 96567 Pharmacy, Rx. SJ075 ........... Methoxsalen, 10ml vial ....................................... item .... 49.5 36522 Pharmacy, NonRx. SF044 .......... Micro air burr ...................................................... item .... 28755, 28750, 28740, 28760 Cutters, closures, cautery SC089 .......... Needle, Vacutainer ............................................. item .... 0.32 36514, 36515, 36516 Hypodermic, IV. SJ076 ........... Nose pads .......................................................... item .... 92370 Pharmacy, NonRx. SG092 .......... Packing, gauze, plain, 1 in (5 yd uou) ............... item .... 57180 Wound care, dressings. SJ077 ........... Screws, spectacles ............................................. item .... 0.14 92370 Pharmacy, NonRx. SL200 ........... Sodium bicarbonate spray, 8 oz ........................ item .... 17360 Lab. Splint, fiberglass, 4in x 15in ............................... item .... 16.5 29125 Wound care, dressings. SL201 ........... Stain, eosin ......................................................... ml ....... 0.044 88356, 88355 Lab. SJ078 ........... Temple tips ......................................................... pair ..... 1.00 92370 Pharmacy, NonRx. SL202 ........... Tissue conditioner, coesoft ................................. item .... 42280 Lab. SA091 .......... Tray, scoop, fast track system ........................... item .... 750.00 31730 Kit, Pack, Tray. SC090 .......... Tube, gastrostomy .............................................. item .... 43760 Hypodermic, IV. SC091 .......... Vacutainer ........................................................... item .... 5.9 36514, 36515, 36516 Hypodermic, IV.


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TABLE 

### 16.

— P ROPOSED 

### P RACTICE 

### E XPENSE 

### S UPPLY 

### I TEM 

### A DDITIONS FOR 

### 2006

—Continued

Supply code Supply description Unit Unit price *CPT code(s) associated with item Supply category

SL203 ........... Vial, 10 ml, plastic (

¥ 70 degree storage) ......... item .... 1.016 88355 Lab. SL204 ........... Vial, kimble sample, non sterile glass, 20 ml ..... item .... 0.708 88356, 88355 Lab.

*CPT codes and descriptions only are copyright 2004 American Medical Association. All Rights Reserved. Applicable FARS/DFARS ap ply.



### TABLE 

### 17.

— P ROPOSED 

### P RACTICE 

### E XPENSE 

### E QUIPMENT 

### I TEM 

### A DDITIONS FOR 

### 2006

Equip code Equipment description Life Unit price *CPT code(s) associated with item Equipment category

EQ269 .......... Blood pressure monitor, ambulatory ................ 5 3000 93786, 93784, 93788 OTHER EQUIP. EP044 .......... Centrifuge, cytospin ......................................... 7 7330 88184 LABORATORY. EP045 .......... Chamber, hybridization .................................... 7 7107 88368, 88365, 88367 LABORATORY. EP046 .......... Freezer, ultradeep (

¥ 70 degrees) .................. 10 16552 88355 LABORATORY. Light assembly, photophoresis ........................ 36522 OTHER EQUIP. EP047 .......... Loader, FACS .................................................. 7 22500 88184 LABORATORY. EP048 .......... Microfuge, benchtop ........................................ 7 2410 88368, 88367, 88365 LABORATORY. 0EQ270 ........ Plasma pheresis machine w/ UV light ............. 6 65000 36522 OTHER EQUIP. EP049 .......... Oven, isotemp (lab) ......................................... 10 2383 88368, 88367, 88365 LABORATORY. EQ271 .......... Radiuscope ...................................................... 7 92315, 92317, 92316, 92310, 92314, 92313, 92312, 92311 OTHER EQUIP.

EP050 .......... Scanner, AutoVysion ....................................... 5 135000 88367 LABORATORY. EQ272 .......... Sleep diagnostic system, attended .................. 5 46799 95805 OTHER EQUIP. EP051 .......... Slide warmer .................................................... 7 568 88368, 88365, 88367 LABORATORY. EP052 .......... Ultrasonic nebulizer ......................................... 10 1000 89220 LABORATORY. EP053 .......... Wash assistant, FACS ..................................... 7 38000 88184 LABORATORY. EP054 .......... Water bath, FISH procedures (lab) ................. 7 2111 88367, 88365 LABORATORY.

*CPT codes and descriptions only are copyright 2004 American medical Association. All Rights Reserved. Applicable FARS/DFARS ap ply.



### • Supply and Equipment Items Needing Specialty Input

We have identified certain supply and equipment items for which we were unable to verify the pricing information (see Table 18: Supply Items Needing Specialty Input for Pricing and Table 19: Equipment Items Needing Specialty Input for Pricing). During last year ’ s rulemaking, we listed both supply and equipment items for which pricing documentation was needed from the medical specialty societies and, for many of these items, we received sufficient documentation in the form of catalog listings, vendor websites, and invoices. We have accepted the documented prices for many of these items and have already incorporated them into the PE database. The items listed on Tables 18 and 19 represent the outstanding items from last year and new items added from the RUC recommendations. Therefore, we are requesting that commenters, particularly specialty organizations, provide pricing information on items in these tables along with documentation to support the recommended price.



### TABLE 

### 18.

—S UPPLY 

### I TEMS 

### N EEDING 

### S PECIALTY 

### I NPUT FOR 

### P RICING

Code 2005 Description Unit Unit Price Primary specialties associated with item *CPT code(s) associated with item Status of item

SK105 .......... Blood pressure recording form, average. Item .... 0.31 Cardiology ................... 93784, 93786, 93788 See Note A.

SJ072 ........... Brush, disposable applicator. Item .... Dermatology ................ 17360 See Note A.

SK102 .......... Communication book/
treatment notebook. Item .... Audiology, ENT ........... 92510 See Note A.

SK103 .......... Cork sheet, 1 cm x 1

cm. Item .... Pathology .................... 88355 See Note A.

SJ073 ........... DMV remover .............. Item .... Optometry, Opthalmology. 92310

–92317 See Note A.

SD217 .......... Diaphragm fitting set ... Item .... Ob-gyn ........................ 57170 See Note A. SD053 .......... Electrode, EEG, tin cup (12 pack uou). Item .... Neurology .................... 95812

– 13, 95816, 95819, 95822, 95950, 95954, 95956 See Note A.

SC088 .......... Fistula set, dialysis, 17g. Item .... Dermatology ................ 36522 See Note A

SK104 .......... Foil, aluminum, 10 cm
x 10 cm. Item .... Pathology .................... 88355 See Note A.

SL193 ........... Glycolic acid, 20

–50% ml ....... Dermatology ................ 17360 See Note A. SA090 .......... Kit, moulage (implantech). Item .... 75.00 Ob-Gyn ........................ 19396 See Note A.

SJ074 ........... Lens cleaner ............... oz ....... Optometry, Opthalmology. 92313, 92341, 92342 See Note A.


## 45782 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

TABLE 

### 18.

—S UPPLY 

### I TEMS 

### N EEDING 

### S PECIALTY 

### I NPUT FOR 

### P RICING



### —Continued

Code 2005 Description Unit Unit Price Primary specialties associated with item *CPT code(s) associated with item Status of item

SL199 ........... Lithium carbonate,
saturated. ml ....... Pathology .................... 88355, 88356 See Note A.

SF044 ........... Micro air burr ............... Item .... Podiatry, Orthopedics .. 28740, 28750, 28755, 28760 See Note A. SJ076 ........... Nose pads ................... Item .... Optometry ................... 92370 See Note A. SG092 .......... Packing, gauze, plain, 1 in (5yd uou). Item .... Ob-Gyn ........................ 57180 See Note A.

SH087 .......... Pentagastrin ................ ml ....... Gastroenterology ......... 91052 See Note A. SD140 .......... Pressure bag ............... Item .... 8.925 Cardiology ................... 93501, 93508, 93510, 93526 See Note A. SL119 ........... Sealant spray .............. oz ....... Radiation Oncology ..... 77333 See Note A. SL200 ........... Sodium bicarbonate spray, 8 oz. Item .... Dermatology ................ 17360 See Note A.

SL203 ........... Tissue conditioner, coesoft. Item .... Maxillofacial Surgery
ENT. 42280 See Note A.

SA091 .......... Tray, scoop, fast track system. Tray ... 750.00 ENT ............................. 31730 See Note A.

SD213 .......... Tubing, sterile, nonvented (fluid administration). Item .... 1.99 Cardiology ................... 93501, 93508, 93510, 93526 See Note A.

*CPT codes and descriptions only are copyright 2004 American Medical Association. All Rights Reserved. Applicable FARS/DFARS ap ply. Note A: Additional information required. Need detailed description (including kit contents), source, and current pricing inform ation (including pricing per specified unit of measure in database).



### TABLE 

### 19.

— E QUIPMENT 

### I TEMS 

### N EEDING 

### S PECIALTY 

### I NPUT FOR 

### P RICING AND 

### P ROPOSED 

### D ELETIONS

Code 2005 Description Price Primary specialties associated with item * CPT code(s) associated with item Status of item

EQ269 ......... Ambulatory blood pressure
monitor. 3,000.00 Cardiology ........................... 93784, 93786, 93788 See Note A.

EQ089 ......... cortical bipolar-biphasic stimulating equipment. ........................ Neurosurger, neurology ...... 95961, 95962 See Note A.

EQ091 ......... Cryo-thermal unit ................. ........................ Anesthesia ........................... 64620 See Notes A and C. ER025 .......... densitometry unit, whole body, SPA. 22,500.00 Radiology ............................ 78350 See Notes A and C. EQ100 ......... dialysis access flow monitor 10,000.00 Nephrology .......................... 90940 See Note A. EQ101 ......... diathermy, microwave ......... ........................ anesthesia, GP, podiatry ..... 97020 See Notes A and C.EQ008 ......... ECG signal averaging system. 8,250.00 Cardiology, IM ..................... 93278 See Note A.

EQ112 ......... electromagnetic therapy machine. 25,000.00 Physical therapy .................. G0329 See Note A.

EQ122 ......... fetal monitor software .......... 35,000.00 ob-gyn, radiology ................. 76818, 76819 See Note A. ER029 .......... film alternator (motorized film viewbox). 27,500.00 Radiology ............................ 329 codes See Notes A and
B. EQ124 ......... generator, constant current 950.00 Neurology, NP ..................... 95923 See Note A. EQ131 ......... hyperbaric chamber ............ 125,000.00 FP, IM, EM .......................... 99183 See Note A. ER036 .......... hyperthermia system, ultrasound, intracavitary. 250,000.00 radiation oncology ............... 77620 See Note A.

...................... Light assembly, photopheresis. ........................ Dermatology ........................ 36522 See Note A.

ER045 .......... orthovoltage radiotherapy system. 140,000.00 radiation oncology ............... 77401 See Note A.

ER008 .......... OSHA ventilated hood ........ 5,000.00 radiation oncology ............... 77334 See Notes A and
B. ...................... plasma pheresis machine w/ UV light source. 37,900.00 radiology, dermatology ........ 36481, G0341 See Note A.

EQ208 ......... Programmer, for implanted medication pump (spine). 1,975 anesthesiology, physical medicine. 62367 and 62368 See Note D.

EQ209 ......... Programmer, neurostimulator (w-printer). 1,975 neurology, neuro surgery, anesthesiology. 95970, 95971, 95972, 95973, 95974, 95975, 95978, 95979 See Note D.

EQ212 ......... pulse oxymetry recordingsoftware (prolonged monitoring). 3,660.00 Pulmonary disease, IM ....... 94762 See Note A.

EP055 .......... Slide Stainer ........................ 9,291.00 Pathology ............................ 88184 See Note A. EQ271 ......... Radiuscope ......................... ........................ ophthalmology, optometry ... 92310

—92317 See Note A. EQ220 ......... remote monitoring service (neurodiagnostics). 9,500.00 Neurology ............................ 95955 See Note A.

EQ221 ......... review master ...................... 23,500.00 pulmonary disease, neurology. 95805, 95807

– 11, 95816, 95822, 95955

–56 See Note A.


## 45783 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

TABLE 

### 19.

— E QUIPMENT 

### I TEMS 

### N EEDING 

### S PECIALTY 

### I NPUT FOR 

### P RICING AND 

### P ROPOSED 

### D ELETIONS



### —Continued

Code 2005 Description Price Primary specialties associated with item * CPT code(s) associated with item Status of item

EF022 .......... table, cystoscopy ................. ........................ Urology ................................ 52204

–24, 52265

–75,
52310

– 17, 52327

–32 See Note A.

EQ253 ......... ultrasound, echocardiography digital acquisition (Novo Microsonics, TomTec). 29,900.00 ob-gyn, cardiology, pediatrics. 76825

–28, 93303

– 12, 93314, 93320, 93325, 93350 See Note A.

EQ261 ......... vacuum cart ......................... ........................ anesthesia ........................... 64620 See Notes A and C EP054 .......... Wash assistant, FACS ........ 38,000.00 pathology ............................. 88184 See Note A.

* CPT codes and descriptions only are copyright 2004 American Medical Association. All Rights Reserved. Applicable FARS/DFARS app ly. Notes: A. Additional information required. Need detailed description (including system components as specified), source, and current p ricing information.

B. Proposed deletion as indirect expense. C. Item may no longer be available. D. Proposed deletion as supplied to physicians at no cost.



### B. Geographic Practice Cost Indices (GPCIs)
[If you choose to comment on issues in this section, please include the caption

‘‘ GPCIs ’’ at the beginning of your comments.]

Section 1848(e)(1)(A) of the Act requires us to develop separate GPCIs to measure resource cost differences among localities compared to the national average for each of the three fee schedule components. While requiring that the practice expense and malpractice GPCIs reflect the full relative cost differences, section 1848(e)(1)(A)(iii) of the Act requires that the physician work GPCIs reflect only one-quarter of the relative cost differences compared to the national

average.

Section 1848(1)(E) of the Act, as amended by section 412 of the MMA, established a floor of 1.0 for the work GPCI for any locality where the GPCI would otherwise fall below 1.0. This 1.0 work GPCI floor was used for purposes of payment for services furnished on or after January 1, 2004 and before January 1, 2007. This 1.0 floor will remain in effect in 2006.

Section 602 of the MMA added section 1848(e)(1)(G) of the Act, which sets a floor of 1.67 for the work, practice expense, and malpractice GPCIs for services furnished in Alaska between January 1, 2004 and December 31, 2005 for any locality where the GPCI would otherwise fall below 1.67. Effective January 1, 2006, this provision will end and the proposed 2006 GPCIs for Alaska will be 1.017 for physician work, 1.103 for PE, and 1.029 for malpractice.
Payment Localities

In the August 15, 2004 PFS rule proposed rule, we discussed the issue of changes to the GPCI payment localities (69 FR 47504). In that proposed rule, we noted that we look for the support of a State medical society as the impetus for changes to existing payment localities. Because the GPCIs for each locality are calculated using the average of the county-specific data from all of thecounties in the locality, removing highcost counties from a locality will result in lower GPCIs for the remaining counties. Therefore, because of this redistributive impact, we have refrained, in the past, from making changes to payment localities unless the State medical association provides evidence that any proposed change has statewide support.

In the November 15, 2004 PFS final rule, we discussed a ‘‘ placeholder ’’ proposal submitted to us in comments received from the California Medical Association (CMA) (69 FR 66263). The proposal described in CMA ’ s commentwould move any county with a countyspecific geographic adjustment factor (GAF) that is at least 5 percent greater than its locality GAF to its own individual county payment locality. (The GAF is the weighted average of the GPCIs for each locality. The GPCIs are weighted by the same weighting factors applied to physician work, practice expense, and malpractice in the Medicare Economic Index (MEI) used to update the CF.) However, in order to minimize reductions in the 2005 GAF of the Rest of California locality that would otherwise result from removal of the data for these high-cost counties, the CMA proposed maintaining Rest of California locality payments at the 2004 level by redistributing payments from the existing (and newly created) payment localities.

On October 21, 2004, the CMA Board of Trustees voted without objection to support the placeholder proposal with the amendment that the redistribution of payments designed to maintain 2004 levels of payment for the Rest of California payment locality would occur for two years only, in 2005 and 2006. However, we determined that we do not have the authority under section 1848(e) of the Act to modify the GPCIs of some localities in a State solely in order to offset higher payments to other localities.

After the publication of the November 15, 2004 PFS final rule, the CMA submitted a proposal for a demonstration project that was the same as its proposal discussed in that final rule. There were several aspects of the proposal that made implementation problematic for us under our demonstration authority. For example, physicians whose payments would decrease under the demonstration could challenge the validity of a new locality configuration established without providing them the opportunity to comment through the regulatory process (as is our normal process for making locality changes). In particular, physicians who are not members of county medical societies or the CMA did not agree to participate in the proposed demonstration, and some of them may have challenged its implementation.

Also, the Medicare PFS currently uses identical GPCIs to pay for services provided in an area by both physicians and nonphysician providers such as podiatrists, optometrists, physical therapists, and nurse practitioners (NPs). Changing the locality configuration for medical doctors and doctors of osteopathic medicine, but not for other professionals, would have some peculiar results that were not addressed in the CMA proposal. For example, in areas where the GPCIs would be reduced under the demonstration, some practitioners not


## 45784 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

participating under the demonstration (such as physical therapists) could be paid more than physicians in the same locality. Conversely, where the GPCIs would be increased under the demonstration, there would likely be complaints from the nonphysician practitioners (NPP) not included in the demonstration.

Nonetheless, we do recognize the potential impact of wide variations in the practice costs within a single payment locality. In last year ’ s PFS final rule, we noted that we received many comments from physicians and individuals in Santa Cruz County expressing the opinion that Santa Cruz County should be removed from the Rest of California payment locality and placed in its own payment locality. The county-specific GAF of Santa Cruz County is 10 percent higher than the Rest of California locality GAF. Santa Cruz County is adjacent to Santa Clara County and San Mateo County. Santa Clara and San Mateo Counties have two of the highest GAFs in the nation. The published 2006 GAF for the Rest of California payment locality is 24 percent less than the GAFs of Santa Clara and San Mateo.

Sonoma County is also part of the Rest of California payment locality. The county-specific GAF of Sonoma County is 8 percent higher than the Rest of California locality GAF. Sonoma County is bordered by Marin County and Napa County. Using published 2006 values, the payment locality that includes Marin and Napa counties has the fourth highest GAF in the nation, and is 13 percent higher than the GAF of the Rest of California payment locality.

We recognize that changing demographics over time may lead to payment disparities in particular circumstances. We rely upon State medical societies to identify and resolve these disparities because there are redistributive impacts within a State when new localities are created (or existing ones reconfigured). Yet we also recognize that CMS is ultimately responsible for establishing fee schedule areas. We have considered a number of alternative locality configurations including

—

• The CMA approach which calculates county-specific GAFs, and compares them to their locality GAF and designating any county with a GAF at least 5 percent higher than its locality GAF as a new locality;

• An approach that sorts counties by descending GAFs and compares the highest county to the second highest county. If the difference between these two counties is 5 percent or less, they are included in the same locality. The third highest county GAF is then compared to the highest county GAF and so on, until the next county GAP is not within 5 percent of the highest county GAF. At that point, the county GAF that is more than 5 percent lower than the highest county GAF becomes the comparison for the next lowest county GAF, to create a second locality. This process is repeated down throughout all of the counties;

• An approach that compares the county with the highest GAF to the statewide average, removing counties that are 5 percent or more than the statewide average; and

• An approach that uses Metropolitan Statistical Ares defined by the Office of Management and Budget.

However, because these reconfigurations would result in significant redistributions across most California counties, we are simply proposing that Santa Cruz and Sonoma Counties (the two counties with the most significant disparity between the assigned Rest of California GAF and the county-specific GAF) be removed from the Rest of California payment locality and that each would be its own payment locality. We invite comments regarding this proposal and possible alternative approaches to address this issue. We are particularly interested in whether the CMA supports this approach.

If implemented, our proposal would change the 2006 GPCIs and GAFs for Santa Cruz County, Sonoma County and the Rest of California. The Santa Cruz GAF would be 1.119, a value 10 percent above the 2005 Rest of California GAF. The Sonoma County GAF would be 1.098, a value 8 percent above the 2005 Rest of California GAF. The Rest of California GAF would be 1.011, a value 0.01 percent below the 2005 Rest of California GAF. We would note that the 2006 Rest of California GAF published in the November 15, 2004 PFS final rule (69 FR 66695) was 1.017. This represents the second year of the transition to the new GPCIs and GAFs incorporating updated data (69 FR 66260). The proposed 2006 Rest of California GAF of 1.011 fully reflects incorporating the updated data.

The issue of payment locality designation in light of changing economic and population trends will be of importance to us for the foreseeable future. We are interested in other solutions to the problem, and will work with anyone who presents an idea or makes a suggestion that will help resolve the problems associated with the designation and revision of payment localities. C. Malpractice Relative Value Units (RVUs) [If you choose to comment on issues in this section, please include the caption

‘‘ Malpractice RVUs ’’ at the beginning of your comments.]

As discussed in the Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2005 final rule, published November 15, 2004(69 FR 66236), we revised the resourcebased malpractice expense RVUs using specialty-specific malpractice premium data because those data represent the actual malpractice expense to the physician and are widely available. Based upon discussions with the medical community, we concluded that the primary determinants of malpractice liability costs are physician specialty, level of surgical involvement, and the physician ’ s malpractice history.

Malpractice premium data were collected for the 20 Medicare physician specialties with the largest share of malpractice RVUs. We collected data based on premiums for a $1 million/$3 million mature claims-made policy (a policy covering claims made, rather than services provided during the policy term). We collected premium data from all 50 States, Washington, DC, and Puerto Rico. Data were collected from commercial and physician-owned insurers and from joint underwriting associations (JUAs). The premium data collected represented at least 50 percent of total physician malpractice premiums paid in each State. For a more detailed description of the methodology utilized in the development of resource based malpractice RVUs, refer to the November 15, 2004 final rule.
1. Five Percent Specialty Threshold

As discussed in the November 15, 2004 final rule, we are concerned that the malpractice RVUs could be inappropriately inflated or deflated due to aberrant data based upon incorrectly reported specialty classifications. Therefore, we examined the impact of establishing a minimum percentage threshold for any procedure performed by any specialty before the risk factor of that specialty is included in the malpractice RVU calculation of a particular code.

We conducted an analysis excluding data for any specialty that performs less than 5 percent of a particular service or procedure from the malpractice RVU calculation for that service or procedure. The purpose of applying the minimum threshold was to identify and remove from the data specialties listed infrequently as performing a certain procedure. The assumption was that the


## 45785 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

infrequent instances of these specialties in our data represent aberrant occurrences and removing the associated risk factor from the malpractice RVU calculation would improve accuracy and stability of the
RVUs.

We excluded evaluation and management (E&M) services from the analysis. Medicare claims data show that E&M codes are performed by virtually all physician specialties. Therefore, in the case of E&M codes, it is likely that even the low relative percentages of performance by some specialties would accurately represent the provision of the service by those specialties.

For all services other than E&M services, we believe removing data attributable to specialties that occur in our data less than 5 percent of the time would most appropriately balance the objective to identify aberrant data (claims with a specialty identified that is highly unlikely to have performed a particular procedure) while including specialties that perform a procedure a small percentage of the time. We believe a higher threshold would result in the removal of data for specialties actually performing the procedure, while a lower threshold would likely fail to removesome aberrant data, particularly for lowvolume codes (fewer than 100 occurrences, where each claim represent 1 or more percentage points).

The overall impact of removing the risk factor for specialties that occur less than 5 percent of the time in our data for a procedure is minimal. There is no impact on the malpractice RVUs for over 5,280 codes, and there is an impact of less than 1 percent on the malpractice RVUs for over 1,300 additional codes. Only 16 codes decrease by at least 0.1 RVUs, with the biggest decrease being a negative 0.28 impact on the malpractice RVU for CPT code 17108, Destruction of skin lesions , from a current RVU of 0.82 to a proposed RVU of 0.54.

Conversely, there are 219 codes for which RVUs increase by at least 0.1, the largest increase being a positive 0.81 RVU increase for CPT code 61583, Craniofacial approach, skull , from a current RVU of 8.32 to a proposed RVU of 9.13. Among codes whose malpractice RVUs would increase under our proposal, 646 have increases of less than 1 percent. The impact analysis section of this proposed rule examines the effects of this proposed change by specialty.
2. Specialty Crosswalk Issues

Malpractice insurers generally use five-digit codes developed by the Insurance Services Office (ISO), an advisory body serving property and casualty insurers, to classify physician specialties into different risk classes for premium rating purposes. ISO codes classify physicians not only by specialty, but in many cases also by whether or not the specialty performs surgical procedures. A given specialty could thus have two ISO codes, one for use in rating a member of that specialty who performs surgical procedures and another for rating a member who does not perform surgery.

Medicare uses its own system of specialty classification for payment and data purposes. Therefore, to calculate the malpractice RVUs, it was necessary to map Medicare specialties to ISO codes and insurer risk classes. For some physician specialties, NPP, and other entities (for example, IDTFs) paid under the PFS, there was not a clear ISO assignment available. In these instances, we crosswalked these unassigned specialties to the most approximate existing ISO codes and risk classes based upon their relationship to those specialties for which we did have clear ISO crosswalks. The crosswalks we used to establish the 2005 malpractice RVUs were displayed in the November 15, 2004 PFS final rule (69 FR 66268). In most instances, when an appropriate crosswalk could not be identified we utilized the average for all physicians category, which is a weighted average of all specialty premium data.

Differences among specialties in malpractice premiums are a direct reflection of the malpractice risk associated with the services performed by a given specialty. The relative differences in national average premiums between various specialties can be expressed as a specialty risk factor. These risk factors are an index calculated by dividing the national average premium for each specialty by the national average premium for nephrology, which is the specialty with the lowest average premium among the 20 specialties for which data were collected.

We stated in the November 15, 2004 PFS final rule that we would continue to work with the AMA RUC ’ s Professional Liability Insurance (PLI) Workgroup to address any potential inconsistencies that may still exist in our methodology. Based upon this commitment, the RUC PLI Workgroup has forwarded various recommendations for our consideration. The RUC developed its recommendations based upon comments submitted to them by physician specialty organizations.

The RUC PLI Workgroup provided all specialty societies and the HCPAC with the opportunity to submit comments on the crosswalks listed in the November 15, 2004 final rule. Based on the comments, the Workgroup believes the risk factors assigned to certain professions overestimate the insurance premiums for these professions. We crosswalked clinical psychology, licensed clinical social work, and psychology to the nonsurgical risk factor for psychiatry (risk factor of 1.11). We crosswalked occupational therapy to occupational medicine (risk factor of 1.11). The PLI Workgroup recommends crosswalking these professions to allergy and immunology, with a risk factor of 1.00 (although the Workgroup suggests the actual risk factor for these professions may be below the risk factor for allergy and immunology and encourages the collection of malpractice premium data for these professions).

The Workgroup also believes that opticians and optometrists should be assigned this risk factor of 1.0, as opposed to being crosswalked to ophthalmology (nonsurgical risk factor of 1.24, surgical risk factor of 2.31). The Workgroup further suggests that it would be more appropriate to assign the risk factor of 1.0 to the chiropractic and physical therapy specialties rather than their current crosswalk to physical medicine and rehabilitation (nonsurgical and surgical risk factors of 1.26). The Workgroup felt that these specialties will not incur PLI premiums in excess of the current base premiums associated a risk factor of 1.0.

We examined the risk factors assigned to these professions, and agree that the PLI associated with them should reflect the lowest physician specialty risk factor (absent actual premium data for these professions). Therefore, we propose assigning these specialties a risk factor of 1.00. We invite comment from representatives of the affected specialties and others regarding the appropriateness of this proposal, as well as other specialty crosswalks and suggestions for reliable sources of actual malpractice premium data for nonphysician groups.

The RUC PLI Workgroup also felt that a number of professions that were assigned to the average for all physicians risk factor should be removed from the calculation of malpractice RVUs altogether. The PLI Workgroup believes that it would be more appropriate to exclude data from the following professions: Certified clinical nurse specialist (CNS), clinical laboratory, multispecialty clinic or group practice, NP, physician assistant (PA), and physiological laboratory (independent). In calculating the malpractice RVUs applicable for 2005,


## 45786 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

34 Medicare specialties were excluded from the calculation because they could not be otherwise assigned or crosswalked. The RUC recommends the above specialties and professions be similarly excluded. We agree and propose to establish malpractice RVUs based upon the mix of specialties exclusive of the above specialties and professions.

The PLI Workgroup also made the following recommendations that we are not accepting: Certified registered nurse anesthetists (CRNAs) should be crosswalked to anesthesiology which is 2.84 rather than to the ‘‘ all physicians ’’ which is 3.04; colorectal surgeons should be crosswalked to general surgery (the current risk factor is based on actual data); and gynecologists and oncologists (currently 5.63) should be crosswalked to surgical oncology (currently 6.13). We believe the current crosswalks we are using for these specialties appropriately reflect the types of services they provide. However, we would welcome comments on these proposals as well.

3. Cardiac Catheterization and Angioplasty Exception

In response to a comment received on our proposed methodology at the time, in the November 2, 1999 final rule (64 FR 59384), we applied surgical risk factors to the following cardiology catheterization and angioplasty codes: 92980 to 92998 and 93501 to 93536. This exception was established because these procedures are quite invasive and more akin to surgical than nonsurgical procedures.

In the November 15, 2004 final rule (69 FR 66275), we discussed changes in those codes that would fall under the exception. Based on a recommendation by the RUC, we revised the list of codes to which this exception applies. The
RUC ’ s PLI Workgroup requests that we correct a clerical error made by the RUC in identifying those codes that would fall under the exception. We agree with the RUC PLI Workgroup recommendation and propose that the following CPT codes be added to the existing list of codes under the exception: 92975; 92980 to 92998; and

93617 to 93641.
4. Dominant Specialty for Low-Volume Codes

The final recommendation from the PLI Workgroup is to use the dominant specialty approach for services or procedures with fewer than 100 occurrences. The Workgroup supplied a list of 1,844 services for our review and recommends that we utilize only the dominant specialty in calculating the final malpractice RVUs for these services. The PLI Workgroup worked in conjunction with various specialty organizations to identify the dominant specialty that performs each service.

We recognize and appreciate the efforts of the Workgroup to review these codes. We have considered the data that was presented to us and the argument for using the dominant specialty to establish the malpractice RVUs for these 1,844 codes.

We have previously registered our concerns with the dominant specialty approach. We believe that basing payment on all specialties that perform a particular service ensures that the actual PLI costs of all specialties are included in the calculation of the malpractice RVUs. Therefore, we do not believe it would appropriate, even for these low-volume services, to include only the dominant specialty if other specialties regularly provide the service.

However, as noted previously in our proposal to remove data for specialties that make up less than 5 percent of the total volume for that service, we also recognize the need to take steps to minimize the risk that aberrant data would inappropriately skew the malpractice RVU calculation. We believe that, for most services, the proposal to remove specialties making up less than 5 percent of the occurrences will ensure that aberrant data are removed. Yet for those services with especially low volumes, the malpractice RVUs may be especially susceptible to the influence of aberrant data in only a very few cases (but more than 5 percent, that is, 2 cases in a service with 20 occurrences). We will continue to evaluate ways to ensure these low-volume services are not skewed by a few occurrences of aberrant data, but we are concerned that including only the dominant specialty performing these services would exclude data from other specialties that are actually performing them.

We are not proposing to adopt this methodology at this time. We would note that low volume procedures or services are not necessarily performed by only one specialty. As noted above, we would distinguish between excluding data presumed to be erroneous from data reflecting utilization by specialties that perform a service but are not the dominant specialty. However, we acknowledge that there may be instances where aberrant data exist that would not be identified and removed by our proposed 5 percent threshold discussed previously. We will continue to work with the RUC PLI Workgroup examine this issue in the future. D. Medicare Telehealth Services [If you choose to comment on issues in this section, please include the caption

‘‘ TELEHEALTH ’’ at the beginning of your comments.]
1. Requests for Adding Services to the List of Medicare Telehealth Services

Section 1834(m) of the Act defines telehealth services as professional consultations, office and other outpatient visits, and office psychiatry services identified as of July 1, 2000 by CPT codes 99241 through 99275, 99201 through 99215, 90804 through 90809, and 90862. In addition, the statute requires us to establish a process for adding services to or deleting services from the list of telehealth services on an annual basis.

In the December 31, 2002 Federal Register (67 FR 79988), we established a process for adding or deleting services to the list of Medicare telehealth services. This process provides the public an ongoing opportunity to submit requests for adding services. We assign any request to make additions to the list of Medicare telehealth services to one of the following categories:

• Category #1: Services that are similar to office and other outpatient visits, consultation, and office psychiatry services. In reviewing these requests, we look for similarities between the proposed and existing telehealth services for the roles of, and interactions among, the beneficiary, the physician (or other practitioner) at the distant site and, if necessary, the telepresenter. We also look for similarities in the telecommunications system used to deliver the proposed service, for example, the use of interactive audio and video equipment.

• Category #2: Services that are not similar to the current list of telehealth services. Our review of these requests includes an assessment of whether the use of a telecommunications system to deliver the service produces similar diagnostic findings or therapeutic interventions as compared with the face-to-face ‘‘ hands on ’’ delivery of the same service. Requestors should submit evidence showing that the use of a telecommunications system does not affect the diagnosis or treatment plan as compared to a face-to-face delivery of the requested service.

Since establishing the process, we have added the psychiatric diagnostic interview examination and ESRD services with 2 to 3 visits per month and 4 or more visits per month to the list of Medicare telehealth services (although we require at least one visit a month by a physician, CNS, NP, or PA to examine the vascular access site).


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Requests for adding services to the list of Medicare telehealth services must be submitted and received no later than December 31st of each CY to be considered for the next proposed rule. For example, requests submitted before the end of CY 2004 are considered for the CY 2006 proposed rule. For more information on submitting a request for an addition to the list of Medicare telehealth services, visit our Web site at http://www.cms.hhs.gov/physicians/ telehealth

. 2. Submitted Requests for Addition to the List of Telehealth Services

We received the following public requests for additional approved services in CY 2004: (1) Diabetes outpatient self-management training services and medical nutritional therapy; and (2) modification of the definition of an interactive telecommunications system for purposes of furnishing a telehealth service. The following is a discussion of the requests submitted in CY 2004.
a. Medical Nutrition Therapy and Diabetes Self-Management Training

The American Telemedicine Association (ATA) and an individual practitioner submitted a request to add medical nutrition therapy (MNT) (as represented by HCPCS codes G0270, G0271 and 97802 through 97804) and diabetes outpatient self-management training services (DSMT) (as defined by HCPCS codes G0108 and G0109). The requestors believe that MNT and DSMT are similar to the services currently on the list of Medicare telehealth services and, therefore, should be added to the list of Medicare telehealth services.

CMS Review

Section 1861(s)(2) of the Act authorizes coverage and payment of MNT for certain beneficiaries who have diabetes or a renal disease. Individual MNT typically involves obtaining a nutrition history, counseling, the formulation of a treatment plan, implementation of a treatment plan through discussion with the patient, and follow-up with the patient. These components would be comparable to E&M office or other outpatient visits which are currently Medicare telehealth services. Additionally, the interactive dynamic of individual MNT is similar in nature to an E&M office visit because the nutrition professional is able to have a direct one-on-one discussion with the beneficiary and the beneficiary is able to ask immediate questions regarding his or role in following the treatment plan. Therefore, we propose to add individual MNT as represented by HCPCS codes G0270, 97802 and 97803 to the list of Medicare telehealth services.
Practitioners Who May Furnish Medical Nutrition Therapy Services

Section 1834(m) of the Act specifies that practitioners defined in section 1842(b)(18)(C) of the Act may receive payment for furnishing telehealth services at the distant site. Effective January 1, 2002, section 1842(b)(18)(C) of the Act includes a registered dietitian or nutrition professional as a Medicare practitioner. As a condition of Medicare Part B payment, the statute allows only a registered dietitian or nutrition professional to furnish medical nutrition therapy services (subject to referral made by the treating physician) for the purpose of managing diabetes or renal disease. Medicare practitioners who are not a licensed or certified registered dietitian or other nutrition professional, as defined in § 410.134, may not furnish and receive payment for MNT services.

We propose to revise § 410.78 and § 414.65 to include individual MNT as a Medicare telehealth service. Additionally, since a certified registered dietitian or other nutrition professional are the only practitioners permitted by law to furnish MNT, we propose to
revise § 410.78 to add a registered dietitian and nutrition professional as defined in § 410.134 to the list of practitioners that may furnish and receive payment for a telehealth service.
Group Medical Nutritional Therapy (MNT)

We believe that group counseling services have a different interactive dynamic between the physician or practitioner at the distant site and beneficiary at the originating site as compared to the current list of Medicare telehealth services. We do not currently have other group counseling services as telehealth services and do not believe that group MNT falls within the first category of requests. Category 1 requests must be similar to the current list of Medicare telehealth services in order to be added to the list.

For instance, office and other outpatient visits, consultation and the current office psychiatry services involve an individual professional encounter between the physician or practitioner and beneficiary. Through direct discussion with the beneficiary, the physician or practitioner provides patient counseling regarding diagnostic test results, recommendations for further studies, prognosis, treatment options, and other follow-up instructions. In this interactive dynamic, the patient is able to ask immediate questions and the physician or practitioner is able to discern whether the beneficiary understands his or her responsibilities in following the treatment plan. However, group therapy services do not allow for the same degree of direct patient interaction as compared with individual therapy
services.

As such, we were not able to conclude that the roles of and interaction among the physician or practitioner at the distant site and beneficiary at the originating site are similar to the existing Medicare telehealth services. Furthermore, the requestors did not submit comparative analyses illustrating that the use of a telecommunications system is an adequate substitute for the face-to-face delivery of group MNT services (which is a requirement for category 2). Therefore, we propose to not add group MNT (as described by HCPCS codes G0271 and 97804) to the list of Medicare telehealth services. However, we invite specific public comments on whether the use of an interactive telecommunications system is clinically adequate for furnishing group MNT. Additionally, if the requestors were to submit data showing that the use of a telecommunications system does not change the diagnosis ortreatment plan as compared to face-toface delivery, we would consider approving group MNT as a category 2
service.
Diabetes Outpatient Self-Management Training Services (DSMT)

The DSMT benefit, described at section 1861(qq) of the Act, is a comprehensive diabetes training program (one component of which is MNT). We consider DSMT as a category 2 request because the major portion of DSMT is furnished in the group setting and, as explained above, we believe group therapy has a different interactive dynamic than the current list of Medicare telehealth services. Additionally, the statute requires the training content for DSMT to include teaching beneficiaries the skills necessary for the self-administration of injectable drugs. We question the merits of providing beneficiary training to administer insulin injections via telehealth. For example, teaching a patient how to inject insulin requires consideration and instruction regarding factors such as the type of needle to be used, the anatomic location of the injection, the injection technique, and possible complications of the injection, all of which we believe, absent evidence to the contrary, require the physical presence of the teaching practitioner.


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These components are typically not part of the services currently on the list of telehealth services and the requestor did not provide any comparative analyses illustrating that the use of a telecommunications system is an adequate substitute for the in-person, collaborative, skill-based training required for DSMT services. Therefore, we propose to not add DSMT (as described by HCPCS codes G0108 and G0109) to the list of Medicare telehealth
services.

b. Definition of an Interactive Telecommunications System

The Medical College of Georgia (MCG) requested that we modify our definition of an interactive telecommunications system for purposes of furnishing a telehealth consultation. The MCG usesan interactive audio and one-way, realtime video telecommunications system, over an internet-based protocol, to furnish consultations for acute ischemic stroke patients. The physician at the distant site (typically a neurologist) can see the patient; however, the patient and physician (or practitioner) in the emergency room who is with the patient cannot see the neurologist. Under this model, the neurologist at the distant site examines the stroke patient in real-time video and reviews CT scans and other critical laboratory data to assess the stroke patient ’ s suitability for tissuetype plasminogen activator (tPA) treatment. The requestor noted that the use of tPA treatment is restricted to 3 hours after onset of stroke, and argued that rapid evaluation by a neurologist for stroke patients located in outlying rural hospitals is crucial. The requestor believes that the use of an interactive two-way video system does not provide added benefit to the consulting neurologist, would be unnecessarily cumbersome, and noted that the use of one-way video currently prohibits billing as a telehealth consultation.

CMS Review

As noted previously, consultations are included on the list of approved telehealth services. However, as a condition of payment, § 410.78 of the regulations requires the use of an interactive two-way audio and video telecommunications system to furnish atelehealth consultation. The use of oneway video does not meet the current interactive telecommunications system requirements for telehealth services and, therefore, the requestor cannot bill for a consultation service based on the model described above.

We have concerns with modifying our definition of an interactive telecommunications system to permit one-way video in place of an interactive two-way video system. The use of an interactive audio and video telecommunications system permitting two-way real-time interaction between the physician or practitioner at the distant site and the beneficiary and telepresenter (if necessary) at the originating site is a substitute for the face-to-face examination requirements of a consultation under Medicare.

We are concerned that the use of oneway video may not be clinically adequate for the evaluation of certain types of patients. Since telehealth services are intended as a substitute forservices that traditionally require a faceto-face interaction between a physician (or practitioner) and a patient, we believe that the use of a two-way video communication is much less of adeparture from this standard than a oneway video communication, because the face-to-face interaction between a physician and a patient allows two-way interactive communication, both verbally and physically. We are concerned that, without two-way video, communication of many subtle but important nuances of the interaction between the physician at the distant site and patient or clinical staff at the originating site would be lost, leading to reduced diagnostic accuracy and the possibility of unfavorable medical

outcomes.

However, we recognize that a timely neurological evaluation is critical for determining suitability for tPA treatment. Given the potential for adverse affects, such as the increased risk of bleeding, the decision to administer tPA (or not to administer) is crucial in determining the course of management for the stroke patient. Therefore, we are currently reviewing the definition of an interactive telecommunications system and request specific public comments regarding the added clinical value of two-wayinteractive video as compared to oneway video for the purpose of furnishing telehealth services. We are also interested in receiving comments as towhether an interactive audio and oneway video telecommunications system that permits the physician at the distant site to examine the patient in real-time is clinically adequate for a broad range of specialty consultations.
c. Definition of a Telehealth Originating
Site

Section 418 of the MMA required the Health Resources Services Administration (HRSA) within the Department of Health and Human Services (HHS), in consultation with CMS, to conduct an evaluation of demonstration projects under which SNFs, as defined in section 1819(a) of the Act, are treated as originating sites for Medicare telehealth services. The MMA also required HRSA to submit a report to the Congress that would include recommendations on

‘‘ mechanisms to ensure that permitting a SNF to serve as an originating site for the use of telehealth services or any other service delivered via a telecommunications system does not serve as a substitute for in-person visitsfurnished by a physician, or for inperson visits furnished by a PA, NP or CNS, as is otherwise required by the Secretary. ’’ This report is currently under development.

The MMA provides us with the authority to include a SNF as a Medicare telehealth originating site under section 1834(m) of the Act effective January 1, 2006, if the Secretary concludes in the report that it is advisable to do so and that mechanisms could be established to ensure that the use of a telecommunications system does not substitute for the required in-person physician or practitioner SNF visits. We will review and consider the recommendations of the report to determine whether to add SNFs to the list of approved originating sites. We are also soliciting public comments on this topic.
E. Contractor Pricing of Unlisted Therapy Modalities and Procedures
[If you choose to comment on issues in this section, please include the caption

‘‘ CODING

—CONTRACTOR PRICING ’’ at the beginning of your comments.]

We recognize that there may be services or procedures performed that have no specific CPT codes assigned. In these situations, it is appropriate to use one of the CPT codes designated for reporting unlisted procedures. These unlisted codes do not typically have RVUs assigned to them.

For services coded using these unlisted codes, the provider includes a description of specific procedures that were furnished. The contractor uses this information to determine an appropriate valuation.

Currently, there are two unlisted CPT codes with assigned RVUs, CPT 97039, Unlisted modality (specify and time if constant attendance) , and 97139 Unlisted therapeutic procedure . Given the variability of the services that could be provided using these nonspecific codes, use of assigned RVUs may not accurately reflect the resources actually associated with the provided services. This may result in an inappropriate


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payment (overpayment or underpayment) for the service provided.

Other unlisted services that are under the PFS are contractor priced. To make the pricing methodology consistent with our policy for other unlisted services, and to more appropriately match payments with the actual resources expended to deliver the services provided, we propose to have the contractors value CPT codes 97039 and

97139. F. Payment for Teaching Anesthesiologists [If you choose to comment on issues in this section, please include the caption

‘‘ TEACHING ANESTHESIOLOGISTS ’’ at the beginning of your comments.]

The following discussion summarizes the current policy for the payment for services provided by teaching anesthesiologists and solicits public comments on possible revisions to the current payment policy.
1. Payment for Anesthesia Services

Anesthesia services are paid under the PFS, but on a different basis than other physician services. Payments for anesthesia services are calculated using

a ‘‘ base unit ’’ that is specific to the anesthesia code plus the anesthesia time units. As noted in our regulations at § 414.46(a)(1), the base unit reflects all activities other than anesthesia time and includes the usual pre-operative and post-operative care. Anesthesia time units are computed (in 15 minute increments) from the actual elapsed time for the anesthesia procedure.

Anesthesia services may be personally performed by the anesthesiologist, or the anesthesiologist may medically direct qualified individuals involved in up to four concurrent anesthesia cases. Qualified individuals can include anesthesiologist assistants (AAs), certified registered nurse anesthetists (CRNAs), interns, or residents, and, under certain circumstances, student nurse anesthetists. When the anesthesiologist medically directs an anesthesia case, the payment for the physician ’ s medical direction service is 50 percent of the allowance otherwise recognized if the anesthesiologist personally performed the service. The physician would have to fulfill each of the medical direction criteria in § 415.110(a) to bill under the medical direction policy.
2. Teaching Physician Payment Policy

Under the teaching physician payment policy for complex surgery, the full fee schedule payment can be made for the services of the teaching physician as long as the teaching physician is present with the resident for the critical or key portions of the service. In order to bill for two overlapping surgeries, the teaching surgeon must be present during the key or critical portions of both operations.

Beginning in 1994, the teaching physician payment policy has been applied to anesthesiologists only when the teaching anesthesiologist is involved in one anesthesia case with a resident. If the teaching physician is involved with two concurrent cases, then the rules for ‘‘ medical direction ’’ of anesthesia apply.

In August 2002, we released a Medicare Carriers Manual transmittalrelating to the involvement of a nonmedically directed teaching CRNA with two student nurse anesthetists. The new policy allowed the teaching CRNA to be paid for his or her involvement with two concurrent cases with student nurse anesthetists, but not at the full fee level. If a teaching CRNA is involved with two concurrent cases with student nurse anesthetists, payment may be based on the base unit plus the time of each case that the teaching CRNA is present with the student nurse anesthetist. To bill the base unit, the teaching CRNA must be present with the student nurse anesthetist throughout the pre- and post-anesthesia care.

In the Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2004 final rule, published November 7, 2003 (68 FR 63196

–63395), we revised § 414.46 of our regulations to allow teaching anesthesiologists to bill in a similar manner to teaching CRNAs for the teaching anesthesiologist ’ s involvement in two concurrent cases involving residents. This policy took effect for services furnished on or after January 1, 2004. This was intended as an alternative to the ‘‘ medical direction ’’ payment policy applicable to concurrent cases involving teaching anesthesiologists and residents.

Under this policy, teaching anesthesiologists can bill and be paid the full fee schedule for the base unit portion of the payment if they arepresent with the resident during the preand post-anesthesia care included in the base units. Teaching anesthesiologists can also bill and be paid the full fee schedule amount for anesthesia time based on the amount of time the physician is present with the resident during each of the two concurrent cases. Payment to a teaching anesthesiologist for two concurrent cases involving residents under this policy would be greater than under the medical direction payment policy. However, if the teaching anesthesiologist is not present with the resident during the pre- and post-anesthesia care for both concurrent cases, the physician could only bill the

cases as ‘‘ medically directed. ’’

Despite the higher level of payment available under this policy, the American Society of Anesthesiologists (ASA) has informed us that it is not aware of any teaching anesthesia programs that have arranged their practices to meet the conditions necessary to bill under the revised policy. The ASA suggests that the teaching physician regulations for teaching anesthesiologists should be similar to those for teaching surgeons for overlapping complex surgery procedures. The ASA thinks that anesthesia is similar to complex surgery in terms of critical periods, overlap, and availability of teaching physicians. However, the critical portions of the teaching anesthesia service and the critical portions of the teaching surgeon service are not the same. The ASA believes that inadequate payment levels have contributed to the loss of teaching anesthesiologists and an inability to recruit new faculty.

We are requesting comments on a teaching physician policy for anesthesiologists that could build on the policy announced in the November 7, 2003 PFS final rule, but provide the appropriate revisions that would allow it to be more flexible for teaching anesthesia programs. We would also be interested in receiving data and studies relevant to this issue as well as any offsetting savings that could be made to account for any potential costs that could be incurred if there was a policy change.
G. End Stage Renal Disease (ESRD) Related Provisions

On November 15, 2004, we published the Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2005 final rule in the Federal Register (69 FR 66319), revising payments to ESRD facilities in accordance with provisions of the MMA. This final rule implemented section 1881(b) of the Act, as amended by section 623 of the MMA, which directed the Secretary to make a number of revisions to the composite rate payment system, as well as payment for separately billable drugs furnished by ESRD facilities. Changes that were implemented January 1, 2005 included a revision to payments for drugs billed separately by ESRD facilities whereby the top ten ESRD drugs are paid based on acquisition costs (as determined by the Office of Inspector General (OIG)) and other separately billed drugs are paid average sales price (ASP) +6 percent.


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Also, in accordance with section 623 of the MMA, an adjustment of 8.7 percent was made to the composite payment rate to account for the difference between previous payments for separately billed drugs and biologicals and the revised pricing that took effect January 1, 2005. As required by section 623 of the MMA, we are proposing to update this add-on adjustment to reflect changes in ESRD drug utilization. In addition, we are proposing to revise the add-on adjustment to reflect the methodology we will be using for ESRD drugs.

Section 623 of the MMA also required the establishment of basic case-mix adjustments to the composite payment rate for a limited number of patient characteristics. The November 15, 2004 final rule implemented three categories of patient characteristic adjustments (age, low body mass index (BMI), and body surface area (BSA)) that were implemented April 1, 2005. We are proposing to maintain these categories and patient characteristics as established in the November 15, 2004 final rule (69 FR 66238).

Also, section 1881(b)(12) of the Act as amended by section 623 of the MMA provided authority to revise the geographic adjustment applied to the composite payment rate. Accordingly, we are proposing to revise the geographic classifications and wage indexes currently in effect for adjusting composite rate payments. As required by section 623 of the MMA, these proposed changes will be phased in
over time.

In addition, we are proposing revisions to the regulations applicable to the composite rate exceptions process to reflect section 623 of the MMA provisions that restrict exceptions to pediatric facilities.
1. Revised Pricing Methodology for Separately Billable Drugs and Biologicals Furnished by ESRD Facilities [If you choose to comment on issues in this section, please include the caption

‘‘ ESRD-Pricing Methodology ’’ at the beginning of your comments.]

In the Revisions to Payment Policies under the Physician Fee Schedule for Calendar Year 2005 final rule, published on November 15, 2004, we determined that for CY 2005, payment for the top 10 separately billable ESRD drugs billed by freestanding facilities would be based on the acquisition cost of the drug, as determined by the OIG, updated by the Producer Price Index (PPI). The remaining separately billable ESRD drugs would be paid at the ASP +6 percent for freestanding facilities. We also determined that hospital-based facilities would continue cost reimbursement for all drugs with the exception of erythopoeitin (EPO) which would be paid the acquisition cost, as determined by the OIG, updated by the
PPI.

As discussed in section II.H. of this proposed rule, for CY 2006, we are proposing that payment for a drug furnished in connection with renal dialysis services and separately billed by freestanding renal dialysis facilities will be based on section 1874A of the Act. We are also proposing to update the payment allowances quarterly based on the ASP reported to us by drug manufacturers. For CY 2006, we are proposing to continue cost reimbursement for hospital-based facilities; while, proposing to pay for EPO in hospital-based facilities at the ASP +6 percent.
2. Adjustment to Account for Changes in the Pricing of Separately Billable Drugs and Biologicals, and the Estimated Increase in Expenditures for Drugs and Biologicals. [If you choose to comment on issues in this section, please include the caption

‘‘ ESRD

—Drugs and Biologicals ’’ at the beginning of your comments.]

Section 623(d) of the MMA, added section 1881(b)(12) of the Act which contains two provisions that describe how the drug add-on adjustment will be implemented in the ESRD payment system. First, that the add-on adjustment reflects the difference between payment methodology for separately billed drugs under the drug price in effect in CY 2004 and current drug pricing and, second, the aggregate payments for CY 2005 must equal aggregate payments absent this MMA provision.

In the November 15, 2004 final rule (69 FR 66322), we described in detail the methodology that we used for developing the drug add-on adjustment to the composite rate to account for the difference between estimated drug payments under the average wholesale price (AWP) payment system and the acquisition costs as determined by the OIG. This adjustment was developed so that aggregate spending for composite rate plus separately billed drugs would remain budget neutral for CY 2005.

Section 1881(b)(12) of the Act also contains two provisions related to adjustments to payments for drugs and biologicals for CY 2006. First, section 1881(b)(12)(C)(ii) of the Act provides that we recalculate the add-on adjustment to reflect the drug pricing methodology applied by the Secretary under section 1881(b)(13)(A)(iii) of the Act. That is, we must compute the drug add-on adjustment based on the difference between estimated payments using the AWP payment methodology and the proposed new payment methodology using ASP +6 percent.

In addition, section 1881(b)(12)(F) of the Act requires that, beginning in 2006, we establish an annual update adjustment to reflect estimated growth in expenditures for separately billable drugs and biologicals furnished by ESRD facilities. This update would be applied only to the drug add-on portion of the composite rate. In order to meet both requirements, we are proposing to develop the CY 2006 drug add-on adjustment in two steps.

First, we would recalculate the CY 2005 add-on adjustment to reflect the difference in drug payments using 95 percent AWP pricing and payments using ASP +6 pricing. This calculation would replace the current 8.7 percent adjustment and would be budget neutral to CY 2005 payments. The next step would be to develop a proposed annual update methodology that we would use in CY 2006 to reflect the estimated growth in drug expenditures each year. As mentioned above, this update would be applied only to the drug add-on portion of the composite payment rate. The following sections discuss the recomputation of the drug add-on adjustment followed by a discussion of the update of the adjustment for CY

2006.
a. Proposed Recalculation of the CY 2005 Drug Add-on Adjustment

For CY 2006, we are proposing to use the same method that we used to develop the drug add-on adjustment for CY 2005 to recalculate the adjustment to reflect the proposed revision to the ESRD drug payment methodology from acquisition costs to ASP +6 percent. That is, we propose to calculate the spread based on the difference in aggregate payments between estimated payment based on AWP pricing and estimated payment based on ASP +6 pricing. As discussed in detail below, we propose to use pricing data from the second quarter of CY 2005. All of thedata used to develop the proposed addon adjustment will be updated for the final rule, as more current data, including ASP data, will be available.
(1) Historical Drug Expenditure Data

To develop the drug add-on adjustment we used historical total aggregate payments for separately billed ESRD drugs for half of CY 2000 and all of CY 2001, CY 2002 and CY 2003. For EPO, these payments were broken down according to type of ESRD facility


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(hospital-based versus independent). We also used the number of dialysis treatments performed by these two types of facilities over the same period.

(2) ASP +6 Percent Prices

We obtained the ASP +6 percent prices, for the second quarter of CY 2005, as shown in the following table. For purposes of this proposed rule, we have used the latest ASP pricing available, which are second quarter prices. For the final rule, we will have prices for all 4 quarters of CY 2005 and plan to develop prices representing the average CY 2005 ASP payments for the drugs listed in Table 20 below.



### TABLE 20.

Drugs Second quarter ASP +6

percent

Epogen ................................... $9.25 Calcitriol .................................. $0.86 Doxercalciferol ........................ $2.78
Iron

_dextran ............................ $11.22
Iron

_sucrose ........................... $0.37 Levocarnitine .......................... $11.12 Paricalcitol .............................. $3.97 Sodium

_ferric

_glut .................. $4.73 Alteplase, Recombinant .......... $30.09 Vancomycin ............................ $3.19



### (3) Estimated Medicare Payments Using 95 Percent of AWP

In order to estimate AWP payments we used the first quarter 2005 AWP prices and updated them to the second quarter by applying, for drugs other than EPO, an estimated AWP quarterly growth of approximately 0.74 percent (annual growth factor of 3 percent). This growth factor is based on historical trends of AWP pricing (for all drugs) for the year 1997

– 2003. We did not increase the payment rate for Epogen since payment was maintained at $10.00 per thousand units prior to MMA. (See Table 21.)



### TABLE 21.

Drugs AWP ratesfor the second quarter

of 2005

Epogen ................................... $10.00 * Calcitriol .................................. $1.40 Doxercalciferol ........................ $3.11
Iron

_dextran ............................ $18.04 

### TABLE 21.

—Continued

Drugs AWP ratesfor the second quarter

of 2005

Iron

_sucrose ........................... $0.66 Levocarnitine .......................... $36.75 Paricalcitol .............................. $5.37
Sodium

_ferric

_glut .................. $8.23 Alteplase, Recombinant .......... $38.82 Vancomycin ............................ $5.55

* Statutory rate.


### (4) Dialysis Treatments

We updated the number of dialysis treatments by the actuarial projected growth in the number of ESRD beneficiaries. Since Medicare covers a maximum of three treatments per week, utilization growth is limited, and, therefore, any increase in the number of treatments should be due to beneficiary enrollment. In CY 2005, we estimate there will be a total of 34.5 million treatments performed. We note that this represents the most current actuarial projection and differs slightly from the projection published in the November, 15, 2004 final rule. (69 FR 66323)
(5) Drug Payments

We updated the total aggregate Epogen drug payments for both hospital-based and independent facilities by using historical trend factors. For CY 2004 and CY 2005, the CY 2003 payment level was increased each year by trend factor of 9.0 percent.

Using the 9 percent growth factor for Epogen, we updated the aggregate spending for separately billable drugs, other than EPO, for independent facilities. Aggregate payments in this category show extremely varied growth between 2000 and 2003, and, for this reason, we felt that trend analysis was not sufficient. Therefore, we believe it would be reasonable to correlate the growth of Epogen and separately billable drugs in an independent facility, since Epogen constitute the largest amount of drugs dispensed in an independent facility. Additionally, we deducted 50 cents for each administration of Epogen from the totalEpogen spending for both hospitalbased and independent facilities, to account for spending on syringes that were included in the EPO payments prior to the implementation of the MMA drug payment provisions. In CY 2005, we estimate payments for these syringeswill amount to $1.6 million for hospitalbased facilities and $26.8 million for independent facilities. For CY 2005, we estimate that total spending, after the deduction of payments for syringes, will reach $246 million for Epogen provided in hospital-based facilities, and $2.850 million for drugs provided in independent facilities ($1.960 million for Epogen and $890 million for other drugs). We note that all other drugs provided in hospital-based ESRD facilities continue to be paid at cost.

(6) Add-On Calculation and Budget Neutrality

For each of the top 10 drugs (as explained below), we calculated the percent by which ASP +6 percent is projected to be less than payment amounts under the 95 percent of AWP pricing system for CY 2005. For Epogen, this amount is 7.5 percent. We applied this 7.5 percent figure to the total aggregate drug payments for Epogen in hospital-based facilities, resulting in a difference of $18 million.

We then calculated a weighted average of the percentages by which ASP +6 percent would be below 95 percent of AWP payment prices, for the top 10 ESRD drugs for independent facilities. We weighted these percentages by using the CY 2005 estimated Medicare payment amounts for the top 10 drugs. This procedure resulted in a weighted average payment reduction of 12 percent. We note that in the previous calculation for the CY 2005 add-on adjustment, we had used CY 2002 values from the OIG. (See Table 22 for the calculated drug weights, and Table 23 for the percentage by which ASP prices are lower than AWP prices.) The CY 2003 data projected forward to CY 2005 indicated a significant drop in payments for drugs other than Epogen that are provided in an independent facility. This trend, which we expect will continue when we obtain CY 2004 historical data for the final rule, decreases the weights of the drugs, other than Epogen and increases the weight of Epogen. The overall effect is to lower the weighted average by several percentage points.


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TABLE 22.

Drugs CY 2005 estimated drug payments as a percentage of total drug expenditures

(percent) CY 2002 OIGdrug payments as a percentage oftotal drug expenditures (percent)

Epogen ......................................................................................................................... ................................................ 78.83 67.85 Calcitriol ..................................................................................................................... .................................................. 0.13 1.22 Doxercalciferol ................................................................................................................ ............................................. 1.74 1.28 Iron

_dextran ........................................................................................................................ ......................................... 0.38 0.65 Iron

_sucrose ........................................................................................................................ ........................................ 0.71 5.00 Levocarnitine .................................................................................................................. .............................................. 0.89 1.68 Paricalcitol ................................................................................................................... ................................................. 17.37 15.90 Sodium

_ferric

_glut ........................................................................................................................... ............................ 0.53 6.03 Alteplase, Recombinant ......................................................................................................... ...................................... 0.18 0.19 Vancomycin ..................................................................................................................... ............................................ 0.24 0.20

* Compared to the $10.00 statutory price.



### TABLE 23.

Drugs Percent by which ASP+6 percent rates are below 95

percent of AWP prices (except EPO)

(percent)

Epogen ................................... * 7.5 Calcitriol .................................. 38.7 Doxercalciferol ........................ 10.6
Iron

_dextran ............................ 37.8
Iron

_sucrose ........................... 45.1 Levocarnitine .......................... 69.7 Paricalcitol .............................. 26.0 Sodium

_ferric

_glut .................. 42.6 Alteplase, Recombinant .......... 22.5 Vancomycin ............................ 42.6

* Compared to the $10.00 statutory price. 

### We estimate that these ten drugs represent nearly 92 percent of total CY 2005 drug payments to independent facilities. To account for the drug spread related to the 8 percent of drug expenditures for which we do not have pricing data, we applied the weighted average to 100 percent of aggregate drug spending projections for independent facilities, producing a projected difference of $343 million. The weighted average is applied to 100 percent of drug spending projections for independent facilities to account for the drug spread related to the 8 percent of drugs expenditures for which we do not have pricing data.

We combined the CY 2005 figures of $18 million for the hospital-based facilities and $343 million for the independent facilities, for a total of $362 million. We distributed this over a total projected 34.5 million treatments resulting in a revised CY 2005 add-on to the per treatment composite rate of 8.1 percent. By making this adjustment to the composite rate, we estimate that the aggregate payments to both independent and hospital-based ESRD facilities would be budget neutral with respect to drug payments for CY 2005, as required by the MMA. We note that this 8.1 percent adjustment replaces the current 8.7 percent adjustment for CY 2005 in our calculations.
b. Calculation of the Proposed CY 2006 Update to the Drug Add-On Adjustment

This section describes the approach that we are proposing to use to update the drug add-on adjustment.
(1) Drug Payments and Dialysis
Treatments

Similar to the process discussed in the previous section, we updated the total aggregate Epogen drug payments for each hospital-based and independent facility using historical trend factors. For CY 2006, the payment level was increased from CY 2005 by a trend factor of 9.0 percent.

We also updated aggregate spending for separately billable drugs, other than EPO, for independent facilities using the 9 percent growth factor for Epogen. As discussed earlier, payments in this category have shown extremely varied growth in recent history and historical data between CY 2002 and CY 2003 showed a significant drop in aggregate spending. We felt it was reasonable to use trend analysis and correlate the growth of Epogen and other separately billable drugs. We expect that we will have further data for the final rule. This procedure resulted in projected expenditures of $268 million for Epogen provided in hospital-based facilities and $3.107 million for drugs provided in independent facilities ($2.137 million for Epogen and $970 million for other drugs). These numbers include an estimated reduction for the 50 cent payment for syringes of $1.6 million for hospital-based facilities and $27.5 million for independent facilities. We also updated the projected number of dialysis treatments using CMS actuarial enrollment projections. This resulted in a projected 35.4 million treatments for
CY 2006.
(2) Adjustment to Composite Rate AddOn

We then applied the 9 percent growth between projected CY 2005 and CY 2006 aggregate drug expenditures to the CY 2005 expected drug spread figures of $18 million for Epogen provided in hospital-based facilities and $343 million for drugs provided in independent facilities. This resulted in an incremental increase in the drug spread in CY 2006 of $2 million for Epogen provided in hospital-based facilities and $31 million for drugs provided in independent facilities. We distributed the combined $33 million over 35.4 million projected treatments, resulting in an additional 0.7 percent addition to the CY 2005 add-on of 8.1 percent.
(3) Proposed Drug Add-On Adjustment for CY 2006

With the recalculated CY 2005 add-on to the per treatment composite rate being 8.1 percent and with the additional increment for expenditures in CY 2006 being 0.7 percent, wecombine them to produce one drug addon adjustment for CY 2006 that would be 8.9 percent.
(4) Add-On for Spread for Drugs Furnished in Hospital-Based Facilities

In its June 2005 Report to Congress, MedPAC recommended that payment differences be eliminated for separately billed drugs furnished in independent and hospital-based facilities and that all these drugs be paid under the ASP +6 percent system. While we agree with MedPAC that paying the same rates in both settings would be the preferable


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policy, we have not proposed this policy because data on dosing units for drugs furnished by hospital-based facilities are not available. This data is needed to estimate the drug payments using ASP +6 percent pricing. That is a key component of the calculation of the drug add-on adjustment. In their report, MedPAC acknowledges these data issues and recommends that CMS take steps to collect data on acquisition costs and payment per unit for drugs provided in hospital-based ESRD facilities. We are currently examining approaches for obtaining these data. However, we seek comment about a potential method to estimate the drug add-on amount for drugs furnished in hospital-based facilities, and we seek comment about alternative estimation methodologies, data, or both.

One estimation approach could be an approach where the pricing spread for drugs other than EPO furnished in hospital based facilities would be assumed to be the same as for those drugs in independent facilities. This aggregate approach would assume that the add-on amount for drugs other than EPO furnished in hospital-based facilities results in the same relative amount of drugs furnished as for those drugs in independent facilities. Using aggregate ratios, the drug add-on amounts calculated for drugs other than EPO furnished in independent facilities might be extrapolated for drugs other than EPO furnished in hospital-based facilities.

Use of this approach could allow calculation of a reasonable estimate of aggregate drug add-on amount for drugsother than EPO furnished in hospitalbased facilities until the time that data becomes available to more accurately calculate the drug add-on adjustment. This approach would allow payment of all drugs furnished in hospital-based facilities under the ASP +6 percent payment methodology, achieve consistent payments for ESRD separately billed drugs regardless of setting, and provide a reasonable estimation of the drug add-on amount needed to adjust the composite rates for drugs other than EPO furnished in hospital-based facilities. We seek comment about this potential method to estimate spread for drugs furnished in hospital-based facilities, as well as alternative estimation methodologies, data, or both.
3. Proposed Revisions to Geographic Designations and Wage Indexes Applied to the ESRD Composite Payment Rate [If you choose to comment on issues in this section, please include the caption

‘‘ ESRD-Composite Payment Rate Wage Index ’’ at the beginning of your comments.]

Because of the significance of labor costs in determining the total cost of care, the prospective payment systems (PPSs) which we administer traditionally have used a wage index to account for differences in area wage levels. The labor-related shares of costs used to develop the composite rates were 36.78 percent for hospital-based facilities and 40.65 percent for independent facilities. The current composite payment rates are calculated using a blend of two wage indexes, one based on hospital wage data for fiscal years ending in CY 1982, and the other developed from CY 1980 data from the Bureau of Labor Statistics (BLS). The wage indexes are calculated for each urban and rural area based on 1980 U.S. Census definitions of metropolitan statistical areas (MSAs) or their equivalents, and areas outside of MSAs in each State, respectively. (51 FR 29411)

Section 4201(a)(2) of OBRA 1990 (Pub. L. 101

– 508) froze the composite payment rates, and the basis for their calculation, at the level in effect as of September 30, 1990 (except for subsequent statutory updates that did not affect the data used to calculate wage indexes). The OBRA 1990 restriction on revising the ESRD composite payment rates has had another effect. ESRD facilities located in counties classified as rural based on the 1980 Census, but which subsequently are classified as urban, are still considered rural for purposes of determining whether urban or rural composite payment rates apply. The rural rates are generally lower than those for urban ESRD facilities.

In addition, restrictions also apply to the wage index values used to compute the ESRD composite payment rates. Payments to facilities in areas where labor costs fall below 90 percent of the national average, or exceed 130 percent of that average, are not adjusted beyond the 90 percent or 130 percent level. (See the Prospective Reimbursement for Dialysis Services and Approval of Special Purpose Renal Dialysis Facilities final rule (48 FR 21254) and the Composite Rates and Methodology for Determining the Rates final notice (51 FR 29404)). This effectively means that ESRD facilities located in areas with wage index values less than 0.9000 are paid more than they would otherwise receive if we fully adjusted for area wage differences. Conversely, facilities in locales with wage index values greater than 1.3000 are paid less than they would receive if we fully adjusted the rates based on actual wage levels.

Section 1881(b)(12)(D) of the Act, as amended by section 623(d) of the MMA, gave the Secretary the discretionary authority to revise the current wage index. That provision also requires that any revised measure be phased-in over a multiyear period. In the November 15,2004 final rule establishing new casemix adjusted composite payment rates (69 FR 66332), we stated that we were deferring replacing the current wage index pending further assessment. We have completed our review, and believe that modernizing the current ESRD wage index is a matter of some urgency. After further analysis we are proposing
to use OMB ’ s revised geographic definitions announced in OMB Bulletin
No. 03

–04, issued June 6, 2003. Thesenew definitions are known as CoreBased Statistical Areas (CBSAs). In conjunction with the CBSAs, we are also proposing to recalculate the ESRD wage indexes based on acute care hospital wage and employment data for FY 2002, as reported to us in connection with the development of the wage index used in the inpatient hospital prospective payment system (IPPS). In addition, we are also proposing to update the labor portion of the ESRD composite rate to which the wage index is applied. The basis for our proposed revisions to the current ESRD composite rate wage index to reflect these changes is set forth in the following sections.

a. Current Urban and Rural Locales Based on MSAs

We currently adjust the labor-related share of the composite payment rates to account for differences in area wage levels using a wage index which is a blend of two wage index values, one based on hospital wage data from FY 1982, and the other developed from 1980 hospital data from the BLS. The hospital and BLS proportions of the blended wage index are 40 percent and 60 percent, respectively. The hospital and BLS wage index values used to compute the blended wage index were published in the Federal Register on August 15, 1986 (51 FR 29412).

The use of a blended wage index results from our effort to transition ESRD facilities from composite payment rates using a wage index based on BLS data, to one developed from hospital wage and employment data obtained from Medicare cost reports ( ‘‘ the hospital wage index ’’ ). A major limitation of the BLS wage index was its inability to distinguish area differences in the use of part-time hospital workers. In order to mitigate the impact of changes in facility payment rates as a


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result of our adoption of the newhospital wage index, we began a fiveyear phase-in of the new measure. During the phase-in period, we had intended to use a weighted wage index, under which the BLS portion would decrease 20 percent and the share represented by the hospital wage index would increase 20 percent each year. During the second year of the phase-in, for which the hospital and BLS portions of the wage index were 40 percent and 60 percent, respectively, the wage index was frozen as a result of the OBRA 1990 prohibition on composite payment rate
revisions.

The wage indexes are calculated for each urban and rural area. In general, an urban area is a MSA or New England County Metropolitan Area as defined by OMB based on 1980 U.S. Census definitions. A rural area consists of all counties within each State outside of an urban area. The counties which comprise the urban locales currently used to compute the wage index values incorporated in the urban composite payment rates were last published in the Federal Register on May 30, 1986 (51
FR 19738

– 19739). Although OMB has revised the definitions of the MSAs since that time, the composite payment rate urban/rural designations have not been changed due to the prohibition on revising the ESRD payment methodology established under section 4201(a)(2) of OBRA 1990. More current MSAs are used in connection with several other non-acute care Medicare PPSs that we administer, including those for SNFs, long-term care hospitals (LTCHs), inpatient psychiatric facilities (IPFs), home health agencies (HHAs), and inpatient rehabilitation facilities (IRFs).
b. Revision of Geographic Classifications

On June 6, 2003, OMB issued Bulletin

03

–04 that announced new geographic area designations based on the 2000 Census. The bulletin established revised definitions for the nation ’ s MSAs, designated county based Metropolitan Divisions within the MSAs that have a single core with a population of at least 2.5 million, created two new sets of statistical areas (Micropolitan Statistical Areas and Combined Statistical Areas), and defined New England City and Town Areas. The bulletin may be accessed on the Internet at: http:// www.whitehouse.gov/omb/bulletins/ bo3

–04.html.

Section 623 of the MMA gave the Secretary the authority to revise the geographic areas used to develop the wage indexes currently reflected in the composite payment rates, removing the OBRA 1990 restriction. Although we published revised composite payment rates in the November 15, 2004 final rule implementing MMA mandated revisions to those rates, we did not propose revising the wage indexes, or the geographic areas on which they are based at that time. For reasons discussed below, we are proposing to
use OMB ’ s list of geographic designations for purposes of adjusting the urban and rural composite payment rates. Facilities located in counties within MSAs or Metropolitan Divisions within CBSAs would be considered urban, while facilities located in micropolitan counties or other counties outside of the CBSAs would be classified as rural. We point out that these are the same urban and rural definitions used in connection with the Medicare IPPS, and are discussed in the August 11, 2004 final rule establishing the IPPS FY 2005 payment rates (69 FR 49026).

c. Core-Based Statistical Areas (CBSAs)

OMB reviews its metropolitan area definitions preceding each decennial census. As explained in the August 11, 2004 IPPS final rule (69 FR 49026), OMB chartered the Metropolitan Standards Review Committee to examine the metropolitan area standards and develop recommendations for possible changes to those standards. Three notices related to the review of the standards, providing an opportunity for public comment on the recommendations of the Committee, were published in the Federal Register on December 21, 1998 (63 FR 70526), October 20, 1999 (64 FR 56628), and August 22, 2000 (65 FR 51060).

In the December 27, 2000 Federal Register (65 FR 82228), OMB published a notice announcing its new standards. According to that notice, OMB defines a CBSA beginning in 2003 as ‘‘ a geographic entity associated with at least one core of 10,000 or more population, plus adjacent territory that has a high degree of social and economic integration with the core as measured by commuting ties. ’’ The standards designate and define two categories of CBSAs: MSAs and Micropolitan Statistical Areas (65 FR 82235).

According to OMB, MSAs are based on urbanized areas of 50,000 or more population, and Micropolitan Statistical Areas (referred to hereafter as Micropolitan Areas) are based on urban clusters with at least 10,000, but less than 50,000 population. Counties that do not fall within CBSAs are deemed

‘‘ Outside CBSAs ’’ . Previously OMB defined MSAs around areas with a minimum core population of 50,000, and smaller areas were ‘‘ Outside
MSAs ’’ . On June 6, 2003 OMB announced the new CBSAs, consisting of MSAs and the new Micropolitan Areas based on the results of the 2000
Census.
d. Adoption of MSAs as Urban Areas for Composite Payments

In its June 6, 2003 announcement, OMB cautioned that its new metropolitan area definitions ‘‘ should not be used to develop and implement Federal, State, and local nonstatistical programs and policies without full consideration of the effects of using these definitions for these purposes. These areas should not serve as a general purpose geographic framework for nonstatistical activities, and they may or may not be suitable for use in program funding formulas. ’’

We point out that Medicare ’ s PPSs, including the ESRD composite payment rate, historically have used the metropolitan area definitions developed by OMB. While the hospital IPPS is the most significant of these, the OMB geographic designations are also used to define labor market areas for purposes of recognizing area differences in labor costs under the SNF, inpatient rehabilitation, IPFs, and home health PPSs. In discussing the adoption of the OMB geographic designation for the IPPS area labor adjustment, the FY 1985 IPPS proposed rule published July 3, 1984 (49 FR 27426) noted as follows:

[i]n administering a national payment system, we must have a national classification system built on clear, objective standards. Otherwise the program becomes increasingly difficult to administer because the distinction between rural and urban hospitals is blurred. We believe that the MSA system (developed by OMB) is the only one that currently meets the requirements for use as a classification system in a national payment program. The MSA classification system is a statistical standard developed for use by Federal agencies in the production, analysis, and publication of data on metropolitan areas. The standards have been developed with the aim of producing definitions that will be as consistent as possible for all MSAs nationwide.



### The logic represented in the statement above still applies today. The process used by OMB to develop the geographic designations resulted in the creation of geographic locales that we believe also reflect the characteristics of unified labor market areas. The CBSAs contain a core population plus adjacent areas that reflect a high degree of social and economic integration. This integration is measured by commuting patterns, thus demonstrating that the areas likely draw workers from the same general locale. In


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addition, the CBSAs reflect the most upto-date information, based on the 2000 Census. OMB reviews its metropolitan area definitions preceding each decennial census to ensure consideration of the most recent population changes. Finally, in the context of the IPPS, we have reviewed alternative methods for determining geographic areas for purposes of the wage index. In each case, we have concluded that it was preferable to retain the independently developed OMB designations rather than replace them with alternatives. ( See the August 11, 2004 final IPPS rule at 69 FR 49027

– 49028.)

Aside from the long established precedent of using OMB geographic designations to adjust for differing area wage levels in the PPSs that we administer, we also point out that the Congress has recognized the propriety of the OMB definitions in distinguishing among geographic areas for making Medicare payments. For example, section 1886(d)(2)(D) of the Act defines

an ‘‘ urban area ’’ as ‘‘ an area within a MSA (as defined by the OMB) or within a similar area as the Secretary has recognized. ’’ Similarly, in the sections of the Act governing the guidelines to be used by the Medicare Geographic Classification Review Board for hospital reclassification, the Congress directed the Secretary to create guidelines for

‘‘ determining whether the county in which the hospital is located should be treated as being a part of a particular [MSA] ’’ . (See sections 1886(d)(10)(A) and (D)(i)(II) of the Act.) The Congress has accepted the use of MSAs as a reasonable basis for dividing the nation into labor market areas for purposes of Medicare payments. Accordingly, we are proposing to revise the ESRD composite payment system labor market areas based on OMB ’ s geographic designations. Facilities located in counties within MSAs (including those in the MSA category of CBSA) would be classified as urban. We are proposing that facilities located in Micropolitan Areas (the other category of CBSA) or in other counties outside of CBSAs in each State, would be considered rural.
e. Revised OMB Geographic Areas

In the following sections we discuss the classification of facilities located in New England MSAs, within Metropolitan Divisions of MSAs, and our proposed treatment of the CBSA classification of Micropolitan Areas.
(1) New England MSAs

Under the current composite payment system, urban areas in New England reflect county-based locales known as New England County Metropolitan Areas (NECMAs), rather than MSAs. We use NECMAs in New England to provide consistency in labor market definitions compared to the MSAs used in the rest of the country, which are also based on counties. Under the new CBSAs, OMB has defined MSAs and Micropolitan Areas in New England on the basis of counties. OMB has also established a new classification, New England City and Town Areas (NECTAs), which are similar to the previous New England MSAs, but which are not used in the geographic area revisions proposed in this proposed rule.

In the interest of consistency among all urban labor market areas, we are proposing to use the county-based definitions for all MSAs in the nation. As a result of the 2000 Census, we now have county-based MSAs in New England. We believe that adopting county-based definitions for all urban areas in the country provides consistency and stability, and minimizes administrative complexity in the Medicare program. We point out that our use of MSAs in New England comports with the implementation of the CBSA designations under the IPPS for New England urban locales. ( See the August 11, 2004 Federal Register, 69 FR 49208.) Accordingly, under the revised composite payment rates discussed in this proposed rule, we are proposing to use New England MSAs along with MSAs in the rest of the nation to define urban areas. As a result, urban locales in New England would no longer be based on NECMAs.
(2) Metropolitan Divisions

Under OMB ’ s new CBSA designations, a Metropolitan Division is a county or group of counties within a CBSA that contains a core population of at least 2.5 million, representing an employment center, plus adjacent counties associated with the main county or counties through commuting ties. A county qualifies as a main county if 65 percent or more of its employed residents work within the county, and the ratio of the number of jobs located in the county to the number of employed residents is at least 75 percent. A county qualifies as a secondary county if at least 50 percent, but less than 65 percent, of its employed residents work within the county, and the ratio of the number of jobs located in the county to the number of employed residents is at least 75 percent. After all the main and secondary counties are identified and grouped, each additional county that already has qualified for inclusion in the MSA falls within the Metropolitan Division associated with the main or secondary county or counties with which the county at issue has the highest employment interchange measure. Counties in a Metropolitan Division must be contiguous ( See the December 27, 2000 Federal Register, Standards for Defining Metropolitan and Micropolitan Statistical Areas, (65 FR 82236)).

Under the CBSA definitions, there are 11 MSAs containing Metropolitan Divisions: Boston; Chicago; Dallas; Detroit; Los Angeles; Miami; New York; Philadelphia; San Francisco; Seattle; and Washington, DC. We believe that these MSAs may be too large to accurately reflect the local labor costs prevailing within each of these areas.For example, the Chicago-NapervilleJoliet IL-IN-WI MSA consists of 14 counties classified among 3Metropolitan Divisions: ChicagoNaperville-Joliet IL (8 counties); Lake County-Kenosha County IL-WI (2 counties); and Gary IN (4 counties). Similarly, the New York-Newark-Edison NY-NJ-PA MSA consists of 23 counties classified among 4 Metropolitan Divisions: New York-Wayne-WhitePlains NY-NJ (11 counties); NewarkUnion NJ-PA (6 counties); Edison NJ (4 counties); and Suffolk County-Nassau County NY (2 counties). Accordingly, for the 11 MSAs with Metropolitan Divisions, we are proposing to use the Metropolitan Division as the urban area for purposes of constructing the wage index and applying revised composite payment rates.

We believe that the proposed use of Metropolitan Divisions would result in a more accurate adjustment accounting for local variation in labor costs within each of the 11 MSAs with those Divisions. We are proposing to recognize each county-based Metropolitan Division within the 11 affected MSAs as a separate urban area for purposes of applying revised composite payment rates. Each Metropolitan Division would have its own wage index and its own urban composite payment rate. This proposed methodology is consistent with the new CBSA-based labor market definitions under the IPPS. (See the August 11,

2004 Federal Register, 69 FR 49029.)
(3) Micropolitan Statistical Areas

In its June 6, 2003 bulletin, OMB also designated another classification of metropolitan area, Micropolitan Statistical Areas, which we will refer to as Micropolitan Areas. That bulletin listed 565 Micropolitan Areas. Of the 3142 counties in the United States, 1090 are in MSAs and 674 are in


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Micropolitan Areas, with the remaining 1378 outside of either classification. As discussed in greater detail in the August 11, 2004 IPPS final rule (69 FR 49029

– 49032), the way that Micropolitan Area counties are classified in connection with developing revised wage indexes has a substantial impact on the wage index adjustment. Specifically, whether or not Micropolitan Areas are included in computing the statewide rural wage indexes has a significant effect on the rural wage index in any State that contains these locales. Consistent with the IPPS final rule, we are proposing that each Micropolitan Area county continue to be considered part of each
State ’ s rural labor market area. That is, we would continue to classify all Micropolitan counties as rural.

To facilitate an understanding of our proposed policies relating to the revisions to the ESRD facility labor market areas discussed in this proposed rule, we have provided addendum F in the Addendum section to this proposed rule. Addendum F is a crosswalk table that contains a listing of each SSA State and county location code; state and county name; existing 1980 MSA based labor market area designation; and CBSA-based labor market area. Addendum F also contains the new wage indexes for each urban and rural

area. f. Proposed Revisions to the Labor Component of the Composite Rate

The current labor-related portions of the hospital-based and independent composite payment rates (in other words, the portion adjusted by each facility ’ s area wage index) are 36.78 percent and 40.65 percent, respectively. These labor-related shares have not been revised since the inception of the ESRD composite payment system in 1983.

When the composite rates were established in 1983, we developed the labor-related share of the rate based on 1978 and 1979 cost data collected from 110 ESRD facilities; 40 independent and 70 hospital-based. For other PPSs administered by us, the labor-related shares are determined based on the labor components established in the relevant market baskets for each provider type.

The basis for determining the current labor shares is based on outdated data from very few facilities relative to the current number of ESRD facilities (110 versus approximately 4300 facilities). We are proposing to establish a single labor-related share applicable to allESRD facilities based on the laborrelated categories included in the ESRD composite rate market basket. This change will bring the methodology for the ESRD composite rate labor-related share more in line with that for determining the labor-related shares for other Medicare PPSs.
(1) ESRD Composite Rate Market Basket

In the following sections, we present a brief background on market baskets, provide a reference to the detailed methodology used to develop the ESRD composite rate market basket, and outline the methodology used to determine the proposed ESRD labor share.

As required by section 422(b) of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA), Pub. L. 106

– 554, we developed an ESRD composite rate market basket. Each of the PPSs that we administer utilizes a market basket that reflects each type of provider ’ s production patterns used to furnish patient care. The market baskets capture the rate of price inflation for a fixed quantity of inputs (both goods and services used to provide medical services) relative to a base year. Each of the PPS market baskets distinguishes between labor-related and non-labor costs. Similar to other PPSs, we believe the ESRD composite rate market basket index is an appropriate measure for revising the labor-related portion of the composite payment rate. The detailed methodology used to develop the ESRD composite rate market basket, including data sources, cost categories, and price proxies, is set forth in the Secretary ’ s May 2003 report to the Congress, Toward a Bundled Outpatient Medicare ESRD Prospective Payment System. That report is available on the Internet

at http://qa.cms.hhs.gov/providers/esrd and we recommend it to interested readers. We used CY 1997 as the base year for the development of the ESRD composite rate market basket cost categories. Source data included CY 1997 Medicare cost reports (Form CMS

– 265

–94), supplemented with 1997 data from the U.S. Department of Commerce, Bureau of the Census ’ Business Expenditure Survey (BES). Analysis of Medicare cost reports for CYs 1996, 1997, 1998, and 1999 showed little difference in cost weights compared to CY 1997. Medicare cost reports from independent ESRD facilities were used to construct the market basket because data from independent ESRD facilities tend to reflect the actual cost structure faced by the ESRD facility itself, and are not influenced by the allocation of overhead over the entire institution as in hospital-based facilities. This approach is consistent with our standard methodology used in the development of other market baskets, particularly those used for updating the SNF and home health PPSs. We expectthat the cost structure in both hospitalbased and independent ESRD facilities and units would be similar. Therefore,we are proposing to base the laborrelated share of the composite payment rates on data from freestanding facilities only.

In Table 24, we have reproduced Table 2 from the May 2003 report to the Congress containing the ESRD composite rate market basket cost categories, weights, and price proxies in this proposed rule. This table lists all of the expenditure categories in the ESRD composite rate market basket.



### TABLE 

### 24.

— ESRD C OMPOSITE 

### RATE 

### M ARKET 

### B ASKET 

### C OST 

### C ATEGORIES 

### , W EIGHTS



### , AND 

### P RICE 

### P ROXIES

Cost category Price/wage variable Base-year: CY 1997weights (percent)

Total ............................................................................................. ............................. ........................................................................ 100.000 Compensation .............................................................................. ..................................... ................................................................ 47.388 Wages and Salaries .............................................................. ECI

— Health Care Workers ......................................................... 38.808 Employee Benefits ................................................................ ECI

— Benefits Health Care Workers .......................................... 8.580
Professional Fees ........................................................................ ECI

—Compensation Prof. & Tech. (Priv.) .................................. 0.903
Utilities .......................................................................................... ............................ ......................................................................... 1.524 Electricity ............................................................................... WPI

—Commercial Electric Power .............................................. 0.818
Natural Gas ........................................................................... WPI

—Commercial Natural Gas .................................................. 0.113 Water and Sewerage ............................................................ CPI

—Water & Sewage ............................................................... 0.593
All Other ....................................................................................... ............................... ...................................................................... 36.156


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TABLE 

### 24.

— ESRD C OMPOSITE 

### RATE 

### M ARKET 

### B ASKET 

### C OST 

### C ATEGORIES 

### , W EIGHTS



### , AND 

### P RICE 

### P ROXIES

Cost category Price/wage variable Base-year: CY 1997weights (percent)

Pharmaceuticals .................................................................... WPI

— Prescription Drugs ............................................................ 0.967 Supplies ................................................................................ PPI

—Surgical, Medical and Dental* ........................................... 17.748
Labs ...................................................................................... PPI

— Medical Labs ..................................................................... 0.433 Telephone ............................................................................. CPI

—Telephone Services ........................................................... 0.875 Housekeeping and Operations ............................................. PPI

— Building, cleaning, and maintenance ................................ 1.247 Administrative and Other Costs ............................................ CPI

—All items less food and energy .......................................... 14.886 Capital Costs ................................................................................ .................................. ................................................................... 14.029 Capital Related

— Building and Equipment ........................... CPI

— Residential Rent ................................................................ 9.071 Capital Related

— Machinery ................................................. PPI

— Electrical Machinery and Equipment ................................. 4.957



### The labor-related share of a market basket is determined by identifying the national average proportion of operating costs that are related to, influenced by, or vary with the local labor market. The labor-related share is typically the sum of wages and salaries, fringe benefits, professional fees, labor-intensive services, and a portion of the capital share from the appropriate market basket.

We used the 1997-based ESRD composite rate market basket costs to determine the proposed labor-related share for ESRD facilities. The proposed labor-related share for ESRD facilities is 53.711, as shown in Table 25. It is the sum of wages and salaries, employee benefits, professional fees, housekeeping and operations, and 46 percent of the weight for capital-related building and equipment (the portion of capital that we have determined to be influenced by local labor markets). The following section describes each of the categories that make up the proposed labor-related share for the ESRD composite rate payment system and how they were derived.



### TABLE 

### 25.

— P ROPOSED 

### ESRD C OM



### POSITE 

### RATE 

### LABOR 

### -R ELATED 

### S HARE

Cost category Proposed CY 1997-basedESRD composite rate labor share

(percent)

Wages and salaries ................ 38.808 Employee benefits .................. 8.580
Professional fees .................... 0.903 Housekeeping and operations 1.247

SUBTOTAL ...................... 49.538

Labor-related share of capital

costs .................................... 4.173

Total ................................. 53.711 

### (2) Wage and Salaries

The wages and salaries weight for the ESRD composite rate labor-related share includes salaries for both direct and indirect patient care. We computed a weight for wages and salaries for direct patient care from Worksheet B of the Medicare cost report. However, Worksheet B only includes direct patient care salaries. We had to derive an estimate for non-direct patient care salaries in order to calculate the market basket weight. We first computed the ratio of salaries to total cost in each cost center from the trial balance of the cost report (Worksheet A). We applied these ratios to the costs reported on Worksheet B for the corresponding cost centers to obtain the total wages and salaries for each composite rate cost center. These salaries were then summed and added to the direct patient care salary amount that is reported separately. When divided by total composite rate costs, the result is a cost weight for total salaries. This increased the expenditure weight from 34.154 percent for direct patient care salaries to 38.808 percent for total salaries.
(3) Employee Benefits

The benefits weight was derived from the BES since a benefit share for all employees is not available for the ESRD Medicare cost reports. The cost reports only reflect benefits for direct patient care. We applied the benefits proportion of wages and salaries for kidney dialysis centers from the BES to the salary amount calculated from the cost reports as described above. This resulted in a benefit weight that was 1.758 percentage points larger (8.850 versus 6.822) than the benefits for direct patient care calculated from the cost reports. To avoid double counting and to ensure all of the market basket weights still totaled 100 percent, we removed this additional 1.758 percentage points for benefits from pharmaceuticals, administrative and general, supplies, laboratory services, housekeeping and operations, and the capital components. This calculation reapportions the benefits expense for each of these categories using a method similar to the method used for distributing non-direct patient care salaries as described above. This method approximates the proportion of each cost center ’ s costs that are benefits using available salary expenditure data.

(4) Professional Fees

Professional fees include accounting, bookkeeping, and legal expenses. We derived the weight for professional fees from the BES since the Medicare cost reports do not include this level of detail. We first calculated the ratio of BES professional fees for kidney dialysis centers to total BES wages and salaries for kidney dialysis centers. We applied this ratio to the total wages and salaries share calculated from the cost reports to estimate the proportion of ESRD facility professional fees. The resulting weight was 0.903 percent. To avoid double counting, this proportion was deducted from the calculated weight for the administrative and other expenditure category, where the fees would have been reported on the Medicare cost reports.
(5) Housekeeping and Operations

The housekeeping and operations cost category includes expenses such as janitorial and building services costs. We developed a market basket weight for this category using data from both Worksheets A and B of the cost reports.Worksheet B combines the capitalrelated costs for buildings and fixtures with the operation and maintenance of plant (operations) and housekeeping cost centers, so we were unable to calculate a weight directly from Worksheet B. Accordingly, we computed the proportion of housekeeping and operations costs, to the combination of total capital-related costs for buildings and fixtures and housekeeping and operations costs


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using Worksheet A because these categories are individually reported on this worksheet. We then subtracted this share from the proportion of Worksheet B total capital-related costs to yield a weight for housekeeping and operations. To avoid double counting, we subtracted utilities expenditures (which are included in the utilities weight shown in Table 24) from the housekeeping and operations weight, as well as the non-direct patient care salaries and benefits share associated with the operations and housekeeping cost centers from Worksheet A. The resulting market basket weight for housekeeping and operations was 1.247 percent. (6) Labor-Related Share for CapitalRelated Expenses

The labor-related share for capitalrelated expenses (46 percent of ESRD facilities ’ adjusted capital-related building and equipment expenses) reflects the proportion of ESRD facilities ’ capital-related building and equipment expenses that we believe varies with local area wages.

Capital-related expenses are affected in some proportion by local area labor costs (such as construction worker wages) that are reflected in the price of the capital asset. However, many other inputs that determine capital costs are not related to local area wage costs, such as interest rates. Thus, it is appropriate that capital-related expenses would vary less with local wages than would the operating expenses for ESRD facilities. The 46 percent figure is based on regressions run for the Prospective Payment System for Inpatient Hospital Capital-Related Costs in 1991 (56 FR 43375).

We use a similar methodology to calculate capital-related expenses for the labor-related shares for rehabilitation facilities, psychiatric facilities, long-term care facilities, and SNFs. (See Rehabilitation Facility Prospective Payment System for FY 2006, Part II (70 FR 30233) and Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities-Update (66 FR 39585)).

Table 26 provides a comparison of the current and proposed labor/nonlabor portions of the ESRD base composite

rate.



### TABLE 26.

—C OMPARISON OF THE 

### C URRENT AND 

### P ROPOSED 

### LABOR

### /N ONLABOR 

### P ORTIONS OF THE 

### ESRD B ASE 

### C OMPOSITE 

### RATE

Hospitalbased Independent

Base Composite Rate ............................................................................................................ ...................................... $132.41 $128.35
Current Labor Share ............................................................................................................ ........................................ 48.70 52.17 Current NonLabor Share ......................................................................................................... .................................... 83.71 76.18

Proposed Labor Share (53.711 percent) .......................................................................................... ........................... 71.12 68.94 Proposed NonLabor Share ........................................................................................................ .................................. 61.29 59.41



### As indicated earlier in this discussion, the ESRD market basket was derived from CY 1997 data. As with other payment systems, we would propose updating the labor share of the composite payment when the components of the ESRD market basket are rebased to reflect more recent data.
g. Implementation of Revised Composite Wage Indexes

In the section below, we explain how each ESRD facility ’ s new composite payment rate would be determined to reflect the proposed 2 year transition, based on section 623(d)(1) of the MMA ’ s requirement that the application of any revised geographic index be phased in over a multi-year period.
(1) Hospital Data Used

In this proposed rule, for purposes of adjusting the labor-related portion of the ESRD composite rate beginning January 1, 2006, we propose to use acute care hospital inpatient wage index data. This data was generated from cost reporting periods beginning FY 2002, and is the most recent complete data available.

To determine the applicable ESRD wage index values, we are proposing to use the acute care hospital inpatient wage data without regard to any approved geographic reclassification under section 1886(d)(8) or (d)(10) of the Act, which only applies to hospitals that are paid under the IPPS. We note this policy is consistent with the areawage adjustments used in all other nonacute care facility PPSs (such as, SNFs, IPPSs, HHAs, and IRFs).

The proposed wage index values that would be applicable to the ESRD composite rate for services furnished on or after January 1, 2006, are shown in Tables 27 and 28 in this proposed rule.

(2) Labor Market Areas With No Hospital Wage Data

In adopting OMB ’ s CBSA designations, we identified a small number of ESRD facilities in both urban and rural geographic areas where there were no hospitals, and, thus, no hospital wage index data on which to base the calculations of the FY 2006 ESRD wage index. The first situation is rural Massachusetts. Because there is no reasonable proxy for rural data within Massachusetts, we are proposing to use last year ’ s acute care hospital wage index value for rural Massachusetts.

The second situation involves ESRD facilities in urban areas in Hinesville, GA (CBSA 25980) and Mansfield, OH (CBSA 31900). We propose to use a wage index based on the wage indexes in all of the other urban areas within the state to serve as a reasonable proxy for the urban areas without hospital wage index data. Specifically, we are proposing to use the average wage index for all urban areas within the State as the urban wage index value for purposes of the ESRD wage index for these areas. We solicit comments on these approaches to calculating the wage index values for areas without hospitals (and, thus, without hospital wage data) for FY 2006 and subsequent years.

(3) Use of Floor/Ceiling Values

As discussed in this preamble, the current wage index values applied to the labor share of the ESRD composite payment rate are restricted at the high and low ends with a floor of 0.9000 and a cap of 1.3000. The effects of these restrictions have been to overpay facilities in low wage areas and underpay facilities in high wage areas. The floor and cap were originally intended to remain in effect only until the transition from use of BLS wage date to hospital wage data ended. However, since the transition was never completed because of the statutory restrictions discussed above in this


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preamble, the floor and cap have remained in effect since 1983.

The basis for the 1.3000 wage index cap was to ensure that we did not pay any more than the allowable reasonable charge per treatment that was in effect before the composite payment rate system was implemented. Since the allowable reasonable charge screen no longer has any relevance to the current composite rate, and because of the effect it has had on restricting payment in high cost wage areas, we are proposing to eliminate the wage index cap.

However, because of the potential adverse impact that removing the wage index floor could have on access to dialysis for ESRD beneficiaries, we are proposing to maintain a wage index floor at this time. We note that when we established the 0.9000 floor beginning in 1983, it was intended that the floor would be phased out by the end of the transition. Because the floor has been in place for so long, we are concerned that eliminating the floor entirely could decrease payments to facilities in some areas significantly. However, we believe that a floor of 0.9000 may be too high under the proposed revision to the labor market areas, since a substantial number of wage areas (172 out of 481 wage areas) have wage index values less than 0.9000. The current wage areas used for adjusting composite rate payments have only 83 areas with wage index values below 0.9000.

Given that the distribution of wage index values has changed so significantly, we are proposing to reduce the floor to 0.8500 for CY 2006 and to 0.8000 for CY 2007 as we transition to the new geographic areas and wage indexes. This would result in application of the wage index floor to 17.7 percent of facilities that would otherwise have been subject to the current 0.9000 floor in CY 2006 and to 10.0 percent of facilities in CY 2007. It would also protect 86 geographic areas at a floor of 0.8500 in CY 2006 and 36 geographic areas at a floor of 0.8000 in
CY 2007.

Although we are proposing to maintain a wage index floor through CY 2007, our goal is to eliminate the wage index floor in the future. Therefore, for CY 2008 we would re-evaluate the need for continuing the floor. We are soliciting comment on this issue, especially in light of the fact the any wage index changes must be budget neutral for aggregate payments to facilities.

(4) Transition Period

Section 623(d) of MMA added section 1881(b)(12)(D) of the Act which requires that any revisions to the geographic adjustments applied to the composite payment rate must be phased-in over a multiyear period. In determining the best approach to phasing-in the proposed new wage index adjustments, we considered not only the immediate impact on payments from revising the wage index values, but also the impact on payments over time because of our inability to update the wage index. Facilities in areas where wages have increased at a higher rate than the national average may have been disadvantaged by the continued use of outdated wage data and geographic designations to adjust the composite payment rate.

With both of these considerations in mind, we are proposing a two-year transition under which facilities wouldbe paid the higher of the new wageadjusted composite rate, or a 50

– 50 blend of the current wage adjustedcomposite rate and the new wageadjusted composite rate. This proposed transition would allow facilities that may have been disadvantaged under the current wage index adjustment to move immediately to the new wage adjustment. It also provides for a reasonable transition period for other facilities. Given the age of the current wage index adjustments, we believe it is appropriate to move as quickly as possible to the revised updated wage adjustments. Since we are proposing to maintain the wage index floor during the transition period, we believe the overall impact to facilities will be mitigated. Also, as discussed in the following section, the proposed budget neutrality adjustment will ensure that the level of aggregate payments to ESRD facilities is maintained. We note that our proposal to allow some facilities to move directly to the new wage-adjusted composite rate will have some impact on the level of the budget neutrality adjustment. However, we estimate that the overall effect on total payments to facilities would not be significant. For example, the impact on aggregate payments to rural facilities would be a decrease of about 0.2 percent and an increase of about 0.1 percent for urban facilities. This occurs because all of the facilities that are currently subject to the 1.300 wage index cap are located in urban areas.

We also considered alternative approaches for transitioning facilities to the proposed updated wage adjustments. Another approach would be to apply the proposed 50

– 50 transition to all facilities, whether or not they do better using the updated wage index adjustment. This approach would treat all facilities equally for transition purposes, but would mean that those facilities that are currently underpaid because of the current outdated wage index adjustment would have to wait until the transition was completed to receive the higher payment to which they are entitled.

An alternative to the proposed twoyear transition would be to adopt a three-year transition. This would allow facilities that would receive lower payments using the revised wage adjustment to have an additional year to adapt to the lower payment amount. This approach, if coupled with allowing facilities that do better to move immediately to the new wage index, would have a more significant impact on the budget neutrality adjustment required by MMA. (See budget neutrality discussion below.).

We are specifically seeking comments on the proposed transition or any of the alternative approaches mentioned above.
(5) ESRD Wage Index Budget Neutrality

Section 623(d) of MMA amended section 1881(b)(12)(E)(i) of the Act which requires that any revisions to the ESRD composite rate payment system as a result of the MMA provision (including the geographic adjustment) be made in a budget neutral manner. This means that aggregate payments to ESRD facilities in CY 2006 should be the same as aggregate payments would have been if we had not made any changes to the geographic adjusters. In order to achieve budget neutrality, we are proposing to apply a budget neutrality adjustment factor directly to the revised ESRD wage index values, rather than applying the adjustment to the base composite payment rates. For payment purposes, we believe this is the simplest approach since it allows us to maintain a base composite rate for hospital-based facilities and one for independent facilities during the transition from the current wage adjustments to the revised wage adjustments.

In order to compute the proposed wage index budget neutrality adjustment factor, we used treatment counts from the CY 2004 billing data and facility-specific 2005 composite payment rates. We note that this file is currently only about 85 percent complete. For the final rule, we expect to use the most complete CY 2004 file available. Using the CY 2004 billing data, we first computed the estimated total dollar amount that ESRD facilities would have received in CY 2006 had there been no changes to the ESRD wage index. This amount becomes the estimated target amount of expenditures for all ESRD facilities. Then we


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computed the estimated dollar amount that would be paid to the same ESRD facilities using the revised ESRD wage index. After comparing these two dollar amounts, we calculate an adjustment factor to the ESRD wage index as the factor that when multiplied by the revised ESRD wage index will result in the target amount of expenditures for all ESRD facilities. Since the revised wage index values are only applied to the labor-related portion of the composite payment rate, we computed the adjustment based on that proportion (that is, 53.711 percent). We applied the estimated budget neutrality adjustment factor to the revised wage index values and then simulated payments for CY 2006 to ensure that estimated aggregate payments to ESRD facilities would remain budget neutral. This proposed adjustment factor would be 1.023024.

Each ESRD wage index value has been adjusted by this factor to establish the budget neutral wage index values that we propose to use to adjust the labor portion of the composite payment rate beginning January 1, 2006. (See Tables 27 and 28.) By using these adjusted ESRD wage index values, the estimated aggregate payments to ESRD facilities will meet the estimated target expenditure amount.

This calculation becomes more complex because of our proposed transition policy. Under that policy an ESRD facility that would receive a higher composite rate payment using the new geographic adjustment would receive 100 percent of that rate in the first year of transition. However, if an ESRD facility ’ s composite rate using the new geographic adjustment is less than its current rate, then that facility will receive 50 percent of the composite rate payment it would have received using the current wage index and 50 percent of the composite rate using the revised wage index. To account for the differential payments, we compare the target amount of expenditures for all ESRD facilities in an iterative fashion until the time that the ESRD wage index adjustment factor would result in the target amount of expenditures for all ESRD facilities. This is shown in column 4 of Table 37 in section V. (Regulatory Impact Analysis) of this proposed rule. In aggregate the change to all ESRD facilities would be 0.0 percent. The distributive effect of the revised ESRD wage index can be seen in the various impact table groupings in column 4 of Table 37 in section V. of this proposed rule.

Another element of the proposed transition policy would be a proposed wage index floor of 0.8500. Using the method described above to compute the budget neutrality factor, makes it necessary to apply the budget neutrality factor to this floor which would result in a proposed adjusted floor of 0.8696.
(6) Transition Examples

In the following examples, we show the application of revised wage adjusted composite payment rates during the proposed two year transition period:

• Example 1

—Neighborhood Dialysis Center is an independent dialysis facility located in Baltimore County, Maryland. As the Crosswalk Table (see addendum F) reveals, Baltimore County was previously classified as part of the Baltimore MSA, and is still classified as an urban county under the new CBSAclassification system. The current wageadjusted composite payment rate for Neighborhood Dialysis Center is $134.93.

Because Neighborhood DialysisCenter is located within the BaltimoreTowson MD CBSA (code 12580), its new wage index, which has been adjusted for budget neutrality, is 1.0135. Applying the wage index of 1.0135 to the revised labor-related component of the base composite rate for independent facilities shown in Table 26, yields a labor adjusted payment rate of $129.28. ($68.94 × 1.0135) + $59.41 = $129.28

This labor adjusted payment rate of $129.28 is less than the wage-adjusted composite rate of $134.93 currently applicable to Neighborhood Dialysis Center. In accordance with our proposed two year transition, this facility would receive a wage-adjusted composite payment rate beginning January 1, 2006 equal to 50 percent of its current wage-adjusted rate plus 50 percent of its new wage-adjusted rate. The CY 2006 blended wage-adjusted rate for this facility would be $132.11. ($0.50 × $134.93) + (0.50 × $129.28) =

$132.11 The 8.9 percent drug add-on adjustment and relevant case-mix adjustments (related to the budget neutrality adjustment) would be applied to this blended rate.

• Example 2

— Serve U Well is a hospital-based dialysis facility located in Morrow County, Ohio. The Crosswalk table (see Addendum F) reveals that Morrow County was previously classified as rural, but is now classified urban as part of the Columbus, OH CBSA, code 18140. The new CBSA wage index applicable to Serve U Well, adjusted for budget neutrality, is 1.0077. Applying the wage index of 1.0077 to the revised labor related component ofthe base composite rate for hospitalbased facilities shown in Table 26 yields a wage-adjusted composite rate of $132.96.

($71.12 × 1.0077) + $61.29 = $132.96

Serve U Well ’ s current rural Ohio wage-adjusted composite payment rateis $128.66. Because the revised wageadjusted composite payment rate of $132.96 is greater than $128.66, Serve U Well would receive 100 percent of its new wage-adjusted composite payment rate of $132.96 beginning January 1,

2006.

As in the previous example, the 8.9 percent drug add-on adjustment and relevant case-mix adjustments (related to the budget neutrality adjustment)would be applied to this new wageadjusted composite rate.

(7) Frequency of Update

Section 623(d)(1) of the MMA provides that any revised wage index used in connection with the composite payment rates must be phased-in over a multiyear period. We are proposing a two-year transition period to the new wage indexes based on CBSAs. An issue remains as to how frequently the new wage index values should be updated to reflect changes in area wage levels. These changes would be detected through our receipt of hospital wage and employment data obtained from the Medicare hospital cost reports subsequent to FY 2005. In order to keeppayments to ESRD facilities as up-todate as possible, we propose to update the wage index on an annual basis, as part of the overall ESRD payment update.

(8) Wage Index Table

The following two tables show the proposed ESRD wage index for urban areas (Table 27) and rural areas (Table 28).

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TABLE 

### 28.

— P ROPOSED 

### ESRD WAGE 

### I NDEX FOR 

### R URAL 

### A REAS 

### B ASED ON 

### CBSA LABOR 

### M ARKET 

### A REAS

CBSA code Nonurban

area Wage index

1 ........ Alabama ............................ 0.8696 2 ........ Alaska ............................... 1.2266 3 ........ Arizona .............................. 0.8979 4 ........ Arkansas ........................... 0.8696 5 ........ California ........................... 1.1107 6 ........ Colorado ............................ 0.9605 7 ........ Connecticut ....................... 1.2066
8 ........ Delaware ........................... 0.9827 10 ...... Florida ............................... 0.8796 11 ...... Georgia ............................. 0.8696
12 ...... Hawaii ............................... 1.0805 13 ...... Idaho ................................. 0.8696 14 ...... Illinois ................................ 0.8696 15 ...... Indiana .............................. 0.8829 16 ...... Iowa ................................... 0.8698 17 ...... Kansas .............................. 0.8696 18 ...... Kentucky ........................... 0.8696 19 ...... Louisiana ........................... 0.8696 20 ...... Maine ................................ 0.9056 21 ...... Maryland ........................... 0.9304 22 ...... Massachusetts .................. 1.0451 23 ...... Michigan ............................ 0.9074 24 ...... Minnesota .......................... 0.9394 25 ...... Mississippi ......................... 0.8696 26 ...... Missouri ............................. 0.8696 27 ...... Montana ............................ 0.9036 28 ...... Nebraska ........................... 0.8865 29 ...... Nevada .............................. 0.9283 30 ...... New Hampshire ................ 1.0923 32 ...... New Mexico ...................... 0.8843 33 ...... New York .......................... 0.8696 34 ...... North Carolina ................... 0.8764
35 ...... North Dakota ..................... 0.8696 36 ...... Ohio ................................... 0.8988 37 ...... Oklahoma .......................... 0.8696 38 ...... Oregon .............................. 1.0056 39 ...... Pennsylvania ..................... 0.8696 42 ...... South Carolina .................. 0.8840 43 ...... South Dakota .................... 0.8696
44 ...... Tennessee ........................ 0.8696 45 ...... Texas ................................ 0.8696 46 ...... Utah ................................... 0.8696 47 ...... Vermont ............................. 1.0067 48 ...... Virginia .............................. 0.8696 49 ...... Washington ....................... 1.0699 50 ...... West Virginia ..................... 0.8696 51 ...... Wisconsin .......................... 0.9698 52 ...... Wyoming ........................... 0.9426



### (9) Crosswalk Table

The crosswalk table for the MSA and CBSA can be found in Addendum F to this proposed rule.
4. Proposed Revisions to § 413.170 (Scope) and § 413.174 (Prospective Rates for Hospital-Based and Independent ESRD Facilities)

Under section 623 of the MMA, we propose to revise § 413.170(b) to specify that this subpart provides procedures and criteria under which only a pediatric facility may receive an exception.

Also under section 623 of the MMA, we propose to revise § 413.174 to reflect the changes in the additional payment for separately billable drugs.
5. Proposed Revisions to the Composite Payment Rate Exceptions Process [If you choose to comment on issues in this section, please include the caption

‘‘ ESRD-Exceptions Process ’’ at the beginning of your comments.]

The current regulations at § 413.180 through § 413.192 contain the procedures for requesting exceptions to ESRD facility composite payment rates, and establish five criteria for approval of exception requests. The five criteria are as follows:

• Atypical service intensity ( § 413.184).

• Isolated essential facility ( § 413.186).

• Extraordinary circumstances ( § 413.188).

• Self-dialysis training costs ( § 413.190).

• Frequency of dialysis ( § 413.192). Under section 1881(b)(7) of the Act, when a facility ’ s costs were higher than the prospectively determined composite rate, we could, under certain conditions, grant the facility an exception to its composite payment rate and set a higher prospective rate. The facility had to show, on the basis of projected cost and utilization trends, that it would have an allowable cost per treatment higher than its prospective composite payment rate and that any excess costs were attributable to one or more of the specific exception criteria.

As explained further below, ESRD facility exception rates in effect on December 31, 2000, or those that were subsequently approved based on an application under section 422(a)(2)(B) of BIPA, (collectively hereinafter termed

‘‘ existing exception rates ’’ ), will remain in effect under section 422(a)(2)(C) of BIPA as long as the exception rate exceeds the facility ’ s updated composite payment rate.

Section 623 of the MMA amended BIPA to provide that the prohibition on exceptions to the ESRD composite rate does not apply to pediatric facilities that do not have an exception rate in effect on October 1, 2002. As a result, only pediatric facilities can now qualify for exception rates. We do not intend for the proposed regulation changes detailed below to limit the exception criteria under which a pediatric facility may qualify. However, we believe that pediatric facilities would not qualify for an exception under most of the existing exception criteria because of the uniqueness of their pediatric patient population (at least 50 percent) and, in the past, ESRD facilities with high percentages of pediatric patients only qualified for exceptions under the

‘‘ atypical patient mix ’’ criterion. Therefore, we are proposing to revise the regulations by eliminating the other exception criteria (Isolated essential facilities, Extraordinary circumstances, and Frequency of dialysis) specified in § 413.182(b), (c), and (e). However, we are proposing to retain the exception criterion for self-dialysis training costs under § 413.182(d) because some pediatric facilities may qualify for an exception on that basis.
a. Statutory Changes

Section 422 of BIPA 2000, prohibited us from providing for any further composite rate exceptions on or after December 31, 2000; allowed one final opportunity for ESRD facilities that did not apply for an exception during 2000 to apply for one by July 1, 2001; and provided for approved exceptions (either those in effect or those that were approved based on subsequent applications) to continue in effect as long as the rate exceeds the updated composite rate.

By prohibiting future exceptions to the composite rate for ESRD facilities, we believe the Congress intended to make the ESRD composite rate payment system more compatible with other Medicare PPSs that do not allow exceptions to their payment rates. By providing for the continuation of existing exception rates as long as those rates exceed the updated case-mix adjusted composite rate, we believe the Congress intended, in effect, to provide for the transition of most ESRD facilities to payment under the composite rate payment system.

In response to ESRD facility concerns about the current composite rate payment methodology, the Congress enacted section 623 of the MMA, which revised ESRD facility prospective composite payment rates. As a result, effective January 1, 2005, ESRD facility prospective composite payment rates were increased 1.6 percent and include a drug add-on of 8.7 percent. These increases were implemented in the PFS final rule published on November 15, 2004 (69 FR 66319

–66320). Section 623 also amended section 422(a)(2) of BIPA to provide that the prohibition on exceptions to the ESRD composite rates does not apply as of October 1, 2002, to pediatric facilities that do not have an exception rate in effect on October 1,

2002

—in effect restoring the exception process for pediatric facilities. Pediatric facilities are defined as ‘‘ renal facilities at least 50 percent of whose patients are individuals under 18 years of age. ’’

Existing exception rates are protected under section 422(a)(2)(C) of BIPA 2000.


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The ‘‘ protection ’’ clause for existing exception rates provides that exception rates in effect on December 1, 2000 (or approved based on an application by July 1, 2001) shall remain in effect as long as the facility ’ s exception rate is higher than the updated composite rate. Pediatric ESRD facility exception rates granted under the provisions of section 623 of the MMA are not subject to the

‘‘ protection ’’ clause for existing exception rates.
b. Summary of Proposed Changes to Part 413, Subpart H

As a result of the statutory changes discussed above, we are proposing to revise both the content and the organization of the existing regulations at 42 CFR part 413, subpart H (Payment for ESRD Services and Organ Procurement Costs) by limiting certain qualifications and clarifying the regulations. Currently, all of the Medicare rules for requesting exceptions to composite rate payments for covered outpatient maintenance dialysis treatments can be found at § 413.180 through § 413.192. We propose to revise the current regulations at part 413, subpart H by

—

• Adding a definition of a ‘‘ pediatric facility ’’ (in accordance with section 422(a)(2)of BIPA 2000, as amended by section 623(b) of the MMA) to mean a renal facility at least 50 percent of whose patients are individuals under 18 years of age;

• Removing existing exception criteria that are no longer applicable; and

• Adjudicating future exception requests in accordance with the proposed revised exception criteria.
(1) Proposed Revisions to § 413.180 (Procedures for Requesting Exceptions to Payment Rates)

In response to the changes made by section 422 of BIPA 2000 and section 623 of MMA, we are proposing significant changes to the existing regulations at § 413.180 through § 413.192 regarding ESRD exception criteria and application procedures. Under our current regulations, existing exception rates that were approved prior to December 31, 2000 (or those approved during the window that closed on July 1, 2001) would remain in effect as long as the conditions under which the exception was granted have not changed and as long as the facility files a request to retain the exception rate with its fiscal intermediary during the 30-day period before the opening of an exception cycle (and the request is approved by the fiscal intermediary.) Even though pediatric exceptions are not subject to the ‘‘ protection ’’ clause under section 422(a)(2)(C) of BIPA, we propose to continue all exception rates in effect on the same basis. Since section 422(a)(2)(B) of BIPA allows existing exception rates to continue in effect as long as the exception rate exceeds the facility ’ s updated composite payment rate, we expect that the facilities will compare their existing exception rates to their basic case-mix adjusted composite rates to determine which is the best payment rate for their facility. We expect that each ESRD facility would choose to be paid at the higher of its existing exception rate or its basic case-mix composite rate (which includes all the payment adjustments required under section 623 of the MMA). If the facility retains its exception rate, the rate is not subject to any of the adjustments specified in section 623 of the MMA. We believe the determination as to whether an ESRD facility ’ s exception rate per treatment will exceed its average case-mix adjusted composite rate per treatment is best left to the affected entity. An ESRD facility that has an existing exception rate may give up that rate if it determines that it should be paid instead under the case-mix adjusted composite rate methodology.

In § 413.180, we propose to revise our regulations to provide that each ESRD facility must notify its fiscal intermediary (in writing) if it wishes to give up its exception rate. The facility would be paid based on its case-mix adjusted composite payment rate beginning thirty days after the intermediary ’ s receipt of written notification that the facility wishes to give up its exception rate. Once a facility notifies its fiscal intermediary that it wishes to give up its exception rate, that decision could not be subsequently rescinded or reversed. We also propose to revise paragraph (b) of this section to provide that ESRD facilities that retain their existing exception rates do not need to notify their intermediaries. Therefore, we propose to remove the last sentence from paragraph (b) that states,

‘‘ However, a facility may only request an exception or seek to retain its previously approved exception rate when authorized under the conditions specified in paragraphs (d) and (e) of this section. ’’

In the past, an ESRD facility could request an exception to its prospective composite payment rate within 180 days of the effective date of its new composite rate(s) or the date on which we opened a specific exception window. Because only pediatric facilities can now file for exceptions, we expect to receive a minimal number of exception applications. In this section, we propose to revise paragraph (d) to remove the requirement that an application for an exception be filed within the 180-day window because we believe the small volume of applications will make it administratively feasible for us to accept applications on a rolling basis. Further, we are proposing to revise paragraph (d) to state that a pediatric ESRD facility may request an exception to its composite payment rate at any time after it is in operation for at least 12 consecutive months.

We are proposing to permit pediatric ESRD facilities to file exception requests at any time. We also propose to change our regulations to continue pediatric facility exception rates granted under section 623 of the MMA (hereinafter referred to as ‘‘ pediatric facility exception rates ’’ ) in the same way as existing exception rates. Specifically, we are proposing that pediatric facility exception rates would remain in effect until the facility notifies its fiscal intermediary that it wishes to give up its rate because its case-mix adjusted composite rate is higher. Therefore, we propose to eliminate paragraph (e) of this section, entitled ‘‘ Criteria for retaining a previously approved exception request ’’ and replace it with paragraph (f) (Completion of requirements and criteria) of this section. We are proposing to eliminate paragraph (e) because ESRD facilities that have an approved exception rate (either an existing exception rate or a pediatric facility exception rate) and elect to retain it do not need to notify their intermediaries. Current paragraph (f), entitled, ‘‘ Documentation for a payment rate exception request ’’ , would be redesignated as proposed paragraph (e). We are proposing to clarify existing regulations by indicating that the applicant must include in its documentation a copy of the most recent cost report filed in accordance with § 413.198. As a result of these proposed changes to this section, we propose to revise the remaining paragraphs as follows:

• Current paragraph (g) would be redesignated as proposed paragraph (f).

• Current paragraph (h) would be redesignated as proposed paragraph (g).

• Current paragraph (i) would be redesignated as proposed paragraph (h).

• Current paragraph (j) provides the period of an exception approval. We would redesignate paragraph (j) as proposed paragraph (i). We propose to revise the redesignated paragraph to state that an approved exception payment rate applies for the period from the date the complete exception request


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was filed with the facility ’ s fiscal intermediary until thirty days after the intermediary ’ s receipt of the facility ’ s letter notifying the intermediary of the facility ’ s request to give up its exception rate and become subject to the current composite payment rate methodology. Once a facility decides not to retain its current exception rate (and puts that decision in writing), that decision cannot be subsequently rescinded or reversed.

• Current paragraph (k) would be removed.

• Current paragraph (l) would be redesignated as proposed paragraph (j).

• Current paragraph (m) would be redesignated as proposed paragraph (k). In the past, a pediatric facility denied an exception rate would have to wait until a subsequent exception window opened to file a new request. We are proposing to revise redesignated paragraph (m) to state that a pediatric ESRD facility that has been denied an exception rate may immediately file another exception request. Any subsequent exception request would be required to address and document the issues cited in our denial letter.

(2) Proposed Revisions to § 413.182 (Criteria for Approval of Exception Requests)

We propose to revise this section to state that CMS may approve exceptions to a pediatric ESRD facility ’ s prospective payment rate if the pediatric facility did not have an approved exception rate as of October 1, 2002. The proposed revised section would also state that the pediatric facility would be required to demonstrate, by convincing objective evidence, that its total per treatment costs are reasonable and allowable under the relevant cost reimbursement principles of part 413 and that its per treatment costs in excess of its payment rate would be directly attributable to any of the following
criteria:

• Pediatric patient mix, as specified
in § 413.184.

• Self-dialysis training costs in pediatric facilities, as specified in § 413.186.

In the future, pediatric facilities would file for an exception under the proposed revised exception criteria in revised § 413.184 (Payment exception: Pediatric patient mix) and redesignated § 413.190 (Payment exception: Selfdialysis training costs in pediatric facilities). (We are proposing to revise § 413.190 and redesignate it as § 413.186, see discussion below.). (3) Proposed Revisions to § 413.184 (Payment Exception: Atypical Service Intensity (Patient Mix))

Because only pediatric ESRD facilities (those with at least a 50 percent patient mix) may qualify for an exception rate, we are proposing to rename § 413.184 to read, ‘‘ Payment exception: Pediatric patient mix ’’ . We also propose to revise paragraph (a) of this section to specify that to qualify for an exception to its prospective payment rate based on its pediatric patient mix, a facility would be required to demonstrate that

—

• At least 50 percent of its patients are individuals under 18 years of age;

• Its nursing personnel costs are allocated properly between each mode of care;

• The additional nursing hours per treatment are not the result of an excess number of employees;

• Its pediatric patients require a significantly higher staff-to-patient ratio than typical adult patients; and

• These services, procedures, or supplies and its per treatment costs are clearly prudent and reasonable when compared to those of pediatric facilities with a similar patient mix.

The ‘‘ Atypical service intensity ’’ criterion is the one under which exceptions for facilities that treated a high proportion of pediatric patients were granted in the past. In order to receive approval for an exception rate, pediatric facilities would still need to meet many of the same criteria previously required under § 413.184 for

‘‘ Atypical service intensity. ’’

To better match the patient listing documentation requirements to the characteristics of pediatric ESRD facilities, we are proposing to eliminate five categories currently required in § 413.184(b) (Documentation) and replace those items with a revised list. Under the proposed revised paragraph, a facility would be required to submit a listing of all outpatient dialysis patients (including all home patients) treated during its most recently completed and filed cost report (cost reporting requirements under § 413.198) showing

—

• Age of patients, and the percentage of patients under the age of 18;

• Individual patient diagnosis;

• Home patients and ages;

• In-facility patients, staff assisted, or self-dialysis;

• Diabetic patients; and

• Patients isolated because of contagious disease. (4) Proposed Removal of § 413.186 (Payment Exception: Isolated Essential Facility)

Since pediatric facilities are the only ESRD facilities that can now apply for exceptions, we are proposing to remove § 413.186 to conform with the elimination of § 413.182(b), (c) and (e) as discussed above and redesignate § 413.190 as the new § 413.186. We would also rename the section to read,

‘‘ Payment exception: Self-dialysis training costs in pediatric facilities ’’ . No further changes are proposed to § 413.186.
(5) Proposed Removal of § 413.188 (Payment Exception: Extraordinary Circumstances)

We are proposing to remove this § 413.188 to conform with the elimination of elimination of § 413.182(b), (c) and (e) as discussed above.
(6) Proposed Redesignation of § 413.190 (Payment Exception: Self-Dialysis Training Costs)

We propose to continue to recognize exceptions for self-dialysis training costs under § 413.190 only for pediatric facilities, and to rename this section,

‘‘ Payment exception: Self-dialysis training costs in pediatric facilities. ’’ We are proposing to change the name to conform with the current statute that prohibits exceptions for facilities other than pediatric ESRD facilities. We are also proposing to redesignate this
section as § 413.186. (As discussed above, we are proposing to remove existing § 413.186.) The current regulatory language in § 413.190 (proposed to be redesignated as § 413.186) would remain unchanged.
(7) Proposed Removal of § 413.192 (Payment Exception: Frequency of Dialysis)

We are proposing to remove this section to conform with the elimination of § 413.182(b), (c) and (e) as discussed above.
H. Payment for Covered Outpatient Drugs and Biologicals
[If you choose to comment on issues in this section, please include the caption

‘‘ Payment for Covered Outpatient Drugs and Biologicals ’’ at the beginning of your comments.]

Medicare Part B covers a limited number of prescription drugs and biologicals. For the purposes of this proposed rule, the term ‘‘ drugs ’’ will hereafter refer to both drugs and biologicals. Medicare Part B covered drugs not paid on a cost or prospective


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payment basis generally fall into three categories:

• Drugs furnished incident to a physician ’ s service.

• DME drugs.

• Drugs specifically covered by statute (immunosuppressive drugs, for example).

Beginning in CY 2005, the vast majority of Medicare Part B drugs not paid on a cost or prospective payment basis are paid under the ASP methodology. The ASP methodology is based on data submitted to us quarterly by manufacturers. In addition to the payment for the drug, Medicare currently pays a dispensing fee for inhalation drugs, a furnishing fee for blood clotting factors, and a supplying fee for certain Part B drugs.

This section of the preamble discusses proposed changes and issues related to the determination of the payment amounts for covered Part B drugs and the separate payments allowable for dispensing inhalation drugs, furnishing blood clotting factor, and supplying certain other Part B drugs. This section of the preamble also discusses proposed changes in how manufacturers calculate and report ASP data to us.

1. ASP Issues [If you choose to comment on issues in this section, please include the caption

‘‘ ASP Issues ’’ at the beginning of your comments.]

Section 303(c) of the MMA amended Title XVIII of the Act by adding new section 1847A. This new section establishes the use of the ASP methodology for payment for most drugs and biologicals not paid on a cost or prospective payment basis furnished on or after January 1, 2005. The ASP reporting requirements are set forth in section 1927(b) of the Act. Manufacturers must submit ASP data to us quarterly. The manufacturers ’ submissions are due to us not later than 30 days after the last day of each calendar quarter. The methodology for developing Medicare drug payment allowances based on the manufacturers ’ submitted ASP data is specified in the regulations in part 414, subpart K. Based on the data we receive, we update the Part B drug payment amounts quarterly.

In this section of the preamble, we discuss issues and propose changes related to the methodology manufacturers use to apply the estimate of lagged price concessions in the ASP calculation. We also discuss the submission of ASP data, including WAC, and our intent to propose, in a separate notice, the collection of additional information from manufacturers, using a revised reporting format, to ensure more accurate calculation of the Medicare payment

amounts.

Also, included in this section is a discussion of the weighting methodology we follow to establish the Medicare payment amounts using the ASP data.
a. Estimation Methodology for Lagged
Price Concessions

Section 1847A(c)(5)(A) of the Act states that the ASP is to be calculated by the manufacturer on a quarterly basis. As a part of that calculation, manufacturers are to take into account price concessions such as

—

• Volume discounts.

• Prompt pay discounts.

• Cash discounts.

• Free goods that are contingent on any purchase requirement.

• Chargebacks.

• Rebates (other than rebates under the Medicaid drug rebate programs).

If the data on these price concessions are lagged, then the manufacturer is required to estimate costs attributable to these price concessions. Specifically, the manufacturer sums the price concessions for the most recent 12- month period available associated with all sales subject to the ASP reporting requirements. The manufacturer then calculates a percentage using this summed amount as the numerator and the corresponding total sales data as the denominator. This results in a 12-month rolling average price concession percentage that is applied to the total in dollars for the sales subject to the ASP reporting requirement for the quarter being submitted to determine the price concession estimate for the quarter. The methodology is specified in § 414.804(a)(3) and was published in the Manufacturer Submission of Manufacturer ’ s ASP Data for Medicare Part B Drugs and Biologicals final rule published on September 16, 2004 (69 FR 55763).

Our goal is to ensure that the ASP data submitted by manufacturers reflects an appropriate estimate of lagged price concessions. Since publication of the September 16, 2004 final rule, we have identified a refinement of the ASP calculation and lagged price concession estimation methodology related to chargebacks that we believe will improve the accuracy of the estimate. As a result, we are proposing to clarify the ASP calculation in this proposed rule.

b. Price Concessions: Wholesaler Chargebacks

Wholesaler chargebacks are a type of price concession, generally paid on a lagged basis, that apply to sales to customers (for example, physicians) via a wholesaler (or distributor). Wholesaler chargeback arrangements may vary in scope and complexity. However, simply put, the wholesaler administers contract prices negotiated between the manufacturer and end purchasers (for example, physician or other health care providers), or otherwise implements pricing terms established by the manufacturer (for example, pricing that varies by type of purchaser or class of trade). The wholesaler charges the customer a certain price and charges back the manufacturer an agreed upon amount for the purposes of making up the difference between the wholesaler ’ s price (for example, WAC) and the

customer ’ s price.

Under the current estimation methodology for lagged price concessions, total lagged price concessions, including lagged wholesaler chargebacks, for the 12- month period are divided by total sales for that same period to determine a ratio that is applied to the total sales for the reporting period. The ratio of lagged price concessions to sales is calculated over all sales, both indirect sales (sales to wholesalers and distributors and other similar entities that sells to others in the distribution chain) and direct sales (sales directly from manufacturer to providers, such as hospitals or HMOs). To the extent that the relationship between total dollars for indirect sales and total dollars for all sales is different for the reporting quarter and the 12-month period used, the current ratio methodology for estimating lagged price concessions may overstate or understate wholesaler chargebacks expected for the reporting period. A more accurate estimation of lagged price concessions would minimize the effect of quarter to quarter variations in the relationship between indirect sales and all sales.

As a result, we propose to revise § 414.804 to require manufacturers to calculate the ASP for direct sales independently from the ASP for all other sales subject to the ASP reporting requirement (indirect sales). Then, the manufacturer would calculate a weighted average of the direct sales ASP and the indirect sales ASP to submit to us. For example, for a National Drug Code (NDC), the manufacturer has 100 direct sales and 200 indirect sales. Taking into account applicable price concessions for direct sales and those for indirect sales, including use of the ratio methodology for estimating lagged price concessions, the direct sales ASP is $25, and the indirect sales ASP is $27.


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The weighted average of the ASPs would be as shown in this example.



### 100 25 200 27

100 200 33 × 

# ( ) + × 

# ( )

+ = $26.

We believe the weighted average of direct sales ASP and indirect sales ASP improves the overall accuracy of the ASP calculation, particularly for NDCs with significant fluctuations in the percentage of sales that are direct sales.

We are proposing conforming changes

to § 414.804 for the methodology for calculating the lagged price concessions percentage. We are also proposing to revise the regulation text to clarify that the estimation ratio methodology relates to lagged price concessions. We also are proposing to define direct sales and indirect sales in § 414.802, and seek to develop definitions for these terms so that all sales subject to the ASP reporting requirement are included under these two definitions.

We seek comments about the advisability of requiring manufacturers to calculate the ASP for direct sales, including price concessions, independently from the ASP for indirect sales and then calculating a weighted average of these ASPs to submit to CMS. We also seek comments about the potential affects of this approach on the ASP as well as our proposed definitions of direct sales and indirect sales (that is, that direct sales are from manufacturer to provider or supplier, and indirect sales are the remaining sales subject to the ASP reporting requirement).
c. Determining the Payment Amount Based on ASP Data

We have received inquiries related to the formula we use to calculate the payment amount for each billing code. We posted a Frequently Asked Question on this subject on our Web site (http://www.questions.cms.hhs.gov ) earlier this year. We are including this section in this preamble to ensure greater public access to this information. Our approach to calculating the payment amounts is as follows:

• For each billing code, we calculate a weighted ASP using the ASP data submitted by manufacturers.

• Manufacturers submit ASP data at the 11-digit NDC level.

• Manufacturers submit the number of units of the 11-digit NDC sold and the ASP for those units.

• We convert the manufacturers ’ ASP for each NDC into the ASP per billing unit by dividing the manufacturer ’ s ASP for that NDC by the number of billing units in that NDC. For example, a manufacturer sells a box of 4 vials of a drug. Each vial contains 20 milligrams (mg). The billing code is per 10 mg. The conversion formula is: Manufacturer ’ s ASP/[(4 vials × 20 mg)/10 mg = 8 billable units per NDC].

• Then, the ASP per billing unit and the number of units (11-digit NDCs) sold for each NDC assigned to the billing code are used to calculate a weighted ASP for the billing code. We sum the ASP per billing unit times the number of 11-digit NDCs sold for each NDC assigned to the billing code, and then divide by the total number of NDCs sold. The ASP per billing unit for each NDC is weighted equally regardless of package size.
d. Reporting WAC

In response to manufacturer ’ s questions about reporting WAC, we posted a Frequently Asked Question on this subject on our Web site (http:// www.questions.cms.hhs.gov ) last year. In the posting on the Web site, we state that manufacturers must report the WAC for a single source drug or biological if it is less than the ASP for a quarter and in cases where the ASP during the first quarter of sales is unavailable. Upon further review, we have determined that the WAC must be reported each quarter if required for payment to be made under section 1847A of the Act, in addition to the ASP, if available.

Section 1927(b)(3)(A)(iii) of the Act specifies the ASP data manufacturers must report. Section 1927(b)(3)(A)(iii)(II) of the Act specifies that the manufacturer must report the WAC, if it is required in order for payment to be made under section 1847A of the Act. Under section 1847A of the Act, the payment is based on WAC (as opposed to ASP) in the following cases:

• For a single source drug or biological, when the WAC-based calculated payment is less than the ASP-based calculated payment for all NDCs assigned to such drug or biological product. (See section 1847A(b)(4) of the Act.)

• During an initial period in which data on the prices for sales for the drug or biological is not sufficiently available from the manufacturer to compute an ASP. (See section 1847A(c)(4) of the Act.)

In these instances, we must make the determination of whether the payment amount is based on ASP or WAC. Therefore, WAC is required for payment in all of these instances.

On April 6, 2004, we published the ASP reporting regulations in the Manufacturer Submission of Manufacturer ’ s ASP Data for Medicare Part B Drugs and Biologicals interim final rule with comment (66 FR 17935

– 17941). In that interim final rule, we specified that manufacturers must report the ASP data to us using the template provided in Addendum A of that interim final rule. That template included the manufacturer ’ s name, NDC, manufacturer ’ s ASP, and number of units. The WAC was not included in the template. Therefore, in order to report the WAC, manufacturers have used several approaches. Some manufacturers have appended the WAC to the template; others have noted it in their written cover letters to their submissions. Still others have sent the WAC to us using electronic mail. Because a place for the WAC was not included in the template, it is possible that manufacturers may not have submitted the WAC even though it was required. On a few occasions, we have contacted the manufacturer to obtain the WAC when it was needed to determine the payment amount. Therefore, because of the requirement to submit the WAC and the confusion manufacturers have experienced in submitting the WAC data we will propose, in a separate information collection notice, to revise the reporting template to include a place to report WAC. See the discussion in section e. below for further details about potential changes to the reporting format.

To clarify the instances when manufacturers are required to report the WAC, in this proposed rule we are clarifying that manufacturers are required to report quarterly both the ASP and the WAC for NDCs assigned to a single source drug or biological billing code. Manufacturers are also required to report the WAC for use in determining the payment during the initial period under section 1847A(c)(4) of the Act. That is, the WAC is reported for the reporting period prior to reporting the ASP based on a full quarter of sales.

Because the WAC could change during a reporting period, we are proposing that in reporting the WAC, manufacturers would be required to report the WAC in effect on the last day of the reporting period.
e. Revised Format for Submitting ASP
Data

As specified in the April 6, 2004 interim final rule, manufacturers are required to report the ASP data to us in Microsoft Excel using the specified template. As discussed above, the current template does not provide adequate instructions for manufacturers to report both the ASP and the WAC. Therefore, in a separate information collection notice that will be published at or about the same time as this


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proposed rule, we will propose to revise the ASP reporting format to accommodate submission of both the ASP and the WAC. We will also propose to collect the following additional information:

• Drug name.

• Package size (strength of product, volume per item, and number of items per NDC).

• Expiration date for last lot manufactured.

• Date the NDC was first marketed (for products first marketed on or after October 1, 2005).

• Date of first sale for products first sold on or after October 1, 2005.

We are mentioning the separate information collection notice in this proposed rule in order to broaden public awareness of the separate notice. The separate notice will be posted at http://www.cms.hhs.gov/regulations/ pra/. The current reporting format is an approved information collection. The OMB control number is 0938

–0921.

f. Limitations on ASP

Section 1847A(d)(1) of the Act states that ‘‘ the Inspector General of the Department of Health and Human Services shall conduct studies, which may include surveys to determine the widely available market prices of drugs and biologicals to which this section applies, as the Inspector General, in consultation with the Secretary determines to be appropriate. ’’ Section 1847A(d)(2) of the Act states that

‘‘ Based upon such studies and other data for drugs and biologicals, the Inspector General shall compare the ASP under this section for drugs and biologicals with

—

• The widely available market price for such drugs and biologicals (if any); and

• The average manufacturer price (as determined under section 1927(k)(1) for such drugs and biologicals. ’’

Section 1847A(d)(3)(A) of the Act states that ‘‘ The Secretary may disregard the ASP for a drug or biological that exceeds the widely available market price or the average manufacturer price for such drug or biological by the applicable threshold percentage (as defined in subparagraph (B)). ’’ The applicable threshold is specified as 5 percent for CY 2005. For CY 2006 and subsequent years, section 1847A(d)(3)(B)of the Act establishes that the applicable threshold is ‘‘ the percentage applied under this subparagraph subject to such adjustment as the Secretary may specify for the widely available market price or the average manufacturer price, or both. ’’

For CY 2006, we propose to specify an applicable threshold percentage of 5 percent for both the widely available market price (WAMP) and average manufacturer price (AMP). The OIG is conducting its first review. However, we did not receive the OIG ’ s final report in time for consideration before developing this proposed rule. Thus, we believe that continuing the CY 2005 threshold percentage applicable to both the WAMP and AMP is most appropriate.
2. Payment for Drugs Furnished During CY 2006 in Connection With the Furnishing of Renal Dialysis Services if Separately Billed by Renal Dialysis Facilities [If you choose to comment on issues in this section, please include the caption

‘‘ Payment for ESRD Drugs ’’ at the beginning of your comments.]

Section 1881(b)(13)(A)(iii) of the Act indicates that payment for a drug furnished during CY 2006 and subsequent years in connection with the furnishing of renal dialysis services, if separately billed by renal dialysis facilities, will be based on the acquisition cost of the drug as determined by the OIG report to the Secretary as required by section 623(c) of the MMA or, the amount determined under section 1847A of the Act for the drug, as the Secretary may specify. In the report entitled, ‘‘ Medicare Reimbursement for Existing End Stage Renal Disease Drugs, ’’ the OIG obtained the drug acquisition costs for the top 10 ESRD drugs for the 4 largest ESRD chains as well as a sampling of the remaining independent facilities. Based on the information obtained from this report, for CY 2005, payment for the top 10 ESRD drugs billed by freestanding facilities and payment for EPO billed by hospital-based facilities was based on acquisition costs as determined by the OIG. Due to the lag in the data obtained by the OIG, we updated the acquisition costs for the top 10 ESRD drugs to 2005 by the PPI. The separately billable ESRD drugs not contained in the OIG report were paid at the ASP +6 percent for freestanding facilities. The payment allowances for these remaining drugs were updated on a quarterly basis during 2005.

Section 1881(b)(13)(A)(iii) of the Act gives the Secretary the authority to establish the payment amounts for separately billable ESRD drugs beginning in 2006 based on acquisition costs or the amount determined under section 1847A of the Act. For reasons discussed below, we do not believe that it is appropriate to continue to use 2002 acquisition costs updated by the PPI for another year as the basis for payment. The acquisition costs are based on 2002 data which, despite updates by the PPI, do not necessarily reflect current market conditions. As discussed below, the chances increase that Medicare payments will either overpay or underpay for drugs, thus, resulting in payments that are inconsistent with the goal of making accurate payments for drugs. We also considered whether actual acquisition cost data could be periodically updated. However, we do not believe that it would be feasible to base Medicare payments over the long term on continually acquiring data on actual acquisition costs from ESRD facilities. This approach would provide incentives for manufacturers and facilities to increase acquisition costs without constraint. It also would not necessarily provide data regarding current market rates. Therefore, we believe it is appropriate for the payment methodology for all ESRD drugs when separately billed by freestanding ESRD facilities during CY 2006 to be paid the amount determined under section 1847A of the Act. This payment amount is the ASP +6 percent rate.

In reaching the conclusion about establishing payment using the amount determined under section 1847A of the Act rather than actual acquisition costs, we analyzed the ASP +6 percent payment rates for all separately billable ESRD drugs, including the top 10, for both the first and second quarters of CY 2005. (We note that the ASP payment rates are updated quarterly. The new rates are made available each quarter at the following Web site: http:// www.cms.hhs.gov/providers/drugs/

asp.asp. ). Additionally, we analyzed the CY 2005 payment rates, based on OIG data, updated by the PPI to reflect inflation as well as the potential CY 2006 payment rates, based on the OIG data, also updated by the PPI to reflect inflation for the top 10 separately billable ESRD drugs. As indicated in the

‘‘ Top 10 Separately Billable ESRD Drugs ’’ chart, the payment rates for the top 10 separately billable ESRD drugs based on the acquisition costs (as determined by the OIG), updated by the PPI would increase by 7 percent for CY 2006. In contrast, the percentage change in the ASP +6 percent payment rates for the top 10 separately billable ESRD drugs based on the first and secondquarters of CY 2005 varied on a drugby-drug basis.


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TOP 

### 10 S EPARATELY 

### B ILLABLE 

### ESRD D RUGS

Drug name 2005 Payment rate Estimated 2006 payment rate based on

OIG data(2003 data inflated 16.2% to 2006 by the estimated PPI) Estimated 2006 payment rate based on ASP+6 (2nd quarter 2005 rates) Percent change in ASP

+6 rates between 1st quarter and 2nd quarter 2005 (percent)

Epoetin alpha ................................................................................................... $9.760 $10.440 $9.250

¥ 1% Paricalcitol ........................................................................................................ $4.000 $4.2 70 $3.971

¥ 1 Sodium Ferric Gluconate ................................................................................. $4.950 $5.290 $4.726

¥ 2 Iron Sucrose .................................................................................................... $0.370 $0.390 $ 0.365 1 Levocarnitine .................................................................................................... $13.630 $14.56 0 $11.122

¥ 24 Doxercalciferol ................................................................................................. $2.600 $2.780 $ 2.784

¥ 0.5 Calcitriol ........................................................................................................... $0.960 $1. 030 $0.859 21 Iron Dextran ..................................................................................................... $10.940 $11.70 0 $11.218 1 Vancomycin ..................................................................................................... $2.980 $3.190 $3 .188 32 Alteplase, Recombinant ................................................................................... $31.740 $33.920 $30.08 9 0



### However, the percentage increases or decreases in the ASP +6 percent payment rates are relatively minimal. For example, the payment allowance for Alteplase, recombinant, J2997, decreased from first quarter 2005 to second quarter 2005 by less than 1 percent. Based on an analysis of the 2002 acquisition costs for the top 10 separately billable ESRD drugs, when updated by the PPI for CY 2006, it is our contention that relying on 2002 acquisition cost data updated for a number of years as would be necessary to establish a payment amount for 2006 is not the most appropriate option for determining Medicare payment rates when other drug-specific pricing is available. Further, we contend that relying on the ASP +6 percent as the payment rate for all separately billable ESRD drugs when billed by freestanding ESRD facilities for CY 2006 is a more reliable indicator of the market transaction prices for these drugs. The ASP is reflective of manufacturer sales for specific drug products and is more indicative of market and sales trends for those specific products than the 2002 OIG acquisition cost data.

We also note MedPAC ’ s recommendation in its June 2005 report that the ASP be the basis of payment for all separately billable ESRD drugs provided by both freestanding and hospital-based facilities in CY 2006 (MedPAC, ‘‘ Report to the Congress: Issues in a Modernized Medicare Program, ’’ June 2005). In making this recommendation, MedPAC states that the ASP data are more current (updated quarterly), and, thus, more likely to reflect actual transaction prices, compared with acquisition cost data which are not regularly collected by the OIG or CMS. Furthermore, the report indicated that utilizing the same payment policy for both freestanding and hospital-based facilities would ensure uniformity across the various settings irrespective of the site of care. In addition, MedPAC recommends in its report that we obtain, ‘‘ * * * data to estimate hospitals ’ costs and Medicare ’ s payment per unit for these drugs. No published source identifies the unit payment for these drugs because Medicare pays hospitals their reasonable costs. ’’ MedPAC further

states: ‘‘ We attempted to calculate the unit payment from 2003 claims data, but the accuracy of the data fields we needed to make this calculation was unclear, particularly the number of units furnished and Medicare ’ s payment to the hospital. ’’ MedPAC also recommends that CMS and/or OIG collect acquisition cost data periodically in the future to gauge the appropriate percentage of ASP for the payment

amount.

While we acknowledge MedPAC ’ s recommendations, we are proposing to make payment using the ASP +6 percent methodology for all separately billed ESRD drugs furnished in freestanding facilities and for EPO furnished in hospital-based facilities. Paying for EPO furnished in hospital-based facilities using the ASP +6 percent methodology is consistent with past practices where we have paid for EPO in hospital-based facilities consistent with freestanding facilities. That is, in 2005, we paid for EPO in hospital-based facilities based on acquisition costs consistent with freestanding facilities. While we are not proposing to pay for drugs other than EPO furnished in hospital-based facilities under the ASP +6 percent methodology at this time, we are interested in moving to this approach. We believe that it is more appropriate to pay for separately billed drugs furnished in hospital-based facilities under the ASP +6 percent methodology rather than on a reasonable cost basis, as we believe that there should be consistency across sites in payment for the same item or service. However, we have not made this proposal due to the lack of data regarding drug costs andexpenditures associated with hospitalbased ESRD payments. We have discussed a potential approach to making estimates of these costs and units. We seek comments about the estimation method discussed in section II.G. of this proposed rule or other methods or data that could be used.

Therefore, for CY 2006, we propose that payment for a drug furnished in connection with renal dialysis services and separately billed by freestanding renal dialysis facilities and EPO billed by hospital-based facilities be based on section 1847A of the Act. We propose to update the payment allowances quarterly based on the ASP reported to us by drug manufacturers. We seek comment on our proposed decision to revise the payment methodology for separately billable ESRD drugs. Whilewe have not proposed to pay hospitalbased facilities under the ASP +6 percent methodology for 2006, we seek comments about the potential method we have discussed to accomplish this policy. We also seek comment on how this proposed decision could affect beneficiaries or providers access to these drugs.
3. Clotting Factor Furnishing Fee [If you choose to comment on issues in this section, please include the caption

‘‘ Clotting Factor ’’ at the beginning of your comments.]

Section 303(e)(1) of the MMA added section 1842(o)(5) of the Act which requires the Secretary, beginning in CY 2005 to pay a furnishing fee, in an amount the Secretary determines to be appropriate, to hemophilia treatment


## 45847 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

1 GAO, ‘‘ Medicare Payment for Covered Outpatient Drugs Exceed Providers ’ Costs, ’’ September 2001. OIG, ‘‘ Excessive Medicare Reimbursement for Albuterol, ’’ March 2002. OIG,

‘‘ Excessive Medicare Reimbursement for Ipratropium Bromide, ’’ March 2002.

2 For more details see the Interim Final Rule regarding Changes to Medicare Payment for Drugs and Physician Fee Schedule Payments for Calendar Year 2004 published in the Federal Register on January 7, 2004. 3 GAO, ‘‘ Appropirate Dispensing Fee Needed for Suppliers of Inhalation Therapy Drugs, ’’ GAO

–05

– 72, October 2004. 

### centers and homecare companies for the items and services associated with the furnishing of blood clotting factor. In the Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2005 final rule, published November 15, 2004 (69 FR 66236) we established a furnishing fee of $0.14 per unit of clotting factor for CY 2005. Section 1842(o)(5) of the Act specifies that the furnishing fee for clotting factor for years after CY 2005 will be equal to the fee for the previous year increased by the percentage increase in the consumer price index (CPI) for medical care for the 12-month period ending with June of the previous year. The CPI data for the 12-month period ending in June 2005 is not yet available. As a point of reference, we note that the percent change in the CPI for medical care for the 12-month period ending June 2004 was 5.1 percent. In the final rule, we will include the actual figure for the percent change in the CPI medical care for the 12-month period ending June 2005, and the updated furnishing fee for CY 2006 calculated based on that figure.
4. Payment for Inhalation Drugs and Dispensing Fee [If you choose to comment on issues in this section, please include the caption

‘‘ Inhalation Drugs and Dispensing Fee ’’ at the beginning of your comments.]

Medicare Part B pays for inhalation drugs administered via a nebulizer, a covered item of DME. Medicare Part B pays for DME and associated supplies, including inhalations drugs that are necessary for the operation of the nebulizer. Metered-dose inhalers (MDIs) are another mode of delivery for inhalation drugs. MDIs are considered disposable medical equipment (for which there is no current Medicare Part B benefit category), and consequently are not currently covered under Part B. Beginning in CY 2006, coverage for MDIs will generally be available through the Medicare Part D benefit. This represents an important expansion in the options available to beneficiaries for inhalation drug coverage under Medicare. With Medicare coverage of both delivery methods available, we anticipate that physicians will choose the option that best suits a patient ’ s particular needs consistent with the applicable standards of medical practice. We expect that both modes of inhalation drug delivery will play an important role in the Medicare program in the years to come.

Prior to CY 2004, most Medicare Part B covered drugs, including inhalation drugs, were paid at 95 percent of the AWP. Numerous studies by the OIG and General Accounting Office (GAO) indicated that 95 percent of AWP substantially exceeded suppliers ’ acquisition costs for Medicare Part B drugs, particularly for the high volume nebulizer drugs, albuterol and ipratropium bromide. 1 

### For example, supplier ’ s acquisition costs were estimated to be 34 percent of AWP for ipratropium bromide and 17 percent of AWP for albuterol based on averaging results from a GAO and an OIG study. 2 

### The MMA changed the Medicare payment methodology for many Part B covered drugs. As an interim step, in CY 2004, Medicare paid a reduced percentage of AWP, 80 percent of AWP in the case of albuterol and ipratropium bromide. Beginning with CY 2005, Medicare paid for nebulizer drugs at 106 percent of the ASP. The move to the ASP system represented a substantial reduction in reimbursement for the high volume nebulizer drugs.

In addition to paying for the cost of the drug itself, Medicare has paid a dispensing fee for inhalation drugs. Prior to CY 2005, Medicare paid a monthly $5 dispensing fee for each covered nebulizer drug or combination of drugs used. In the Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2005 proposed rule, published August 5, 2004, we proposed to continue to pay a dispensing fee for these drugs. In that proposed rule, we sought comment on an appropriate dispensing fee level to cover the shipping, handling, compounding, and other pharmacy activities required to get these medications to beneficiaries.

In response to last year ’ s proposed rule, we received a number of comments that varied substantially in terms of the dispensing fee amount that commenters thought was adequate. We received comments from a retail pharmacy that indicated that a dispensing fee of five to six times the prior $5 fee was necessary to cover costs. Another retail pharmacy indicated that a dispensing fee of $25 would be an adequate amount and would be profitable.

We also received several comments that asserted that a substantially higher fee was needed and that the dispensing fee should cover a variety of services. A number of commenters referenced an August 2004 report prepared for the American Association of Homecare (AAH) by a consultant that surveyed 104 home care agencies, which indicated that in order to maintain the CY 2004 levels of service to Medicare beneficiaries and provide an operating margin of 7 percent, Medicare would have to pay a dispensing fee of $68.10 per service encounter (service encounters they estimate occur on average every 42 days). The survey included costs for a wide range of activities including activities associated with getting the drug to the beneficiary, as well as other additional services. More specifically, the AAH data included the following cost categories:

• Clinical intake.

• Establishing and revising the plan of care.

• Care coordination.

• Patient education.

• Caregiver training.

• Compliance monitoring/refill calls.

• In-home visits.

• Delivery of services.

• Billing/collections.

• Other costs (not specified by AAH). As an example, the AAH data indicated that inhalation drug suppliers spent on average about 29 minutes per new patient on patient education and caregiver training and continued to spend on average about 17 minutes per month for each established patient on patient education and caregiver training. The data also indicated that suppliers spent on average about 23 minutes per patient each month on in-home visits, with there being substantial variation in the provision of this service. A number of commenters asserted that these and other services included in the AAH data were important to the provision of inhalation drugs, and should be paid for by Medicare.

Between publication of the August 5, 2004 proposed rule and the November 15, 2004 final rule, the GAO released a report based on a survey of 12 inhalation therapy companies, representing 42 percent of the market, which indicated wide variation across companies in the patient monthly cost of dispensing inhalation drugs from a low of $7 to a high of $204. 3 

### The GAO report indicated that the wide variation in supplier costs is due, in part, to variation in the services suppliers offer and that some of the costs incurred by suppliers may not be necessary to dispense inhalation drugs, for example,


## 45848 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

marketing, overnight shipping, and 24- hour hotlines.

In light of the substantial changes occurring in inhalation drug reimbursement in 2005, we viewed 2005 as a transitional year. With the wide variation in the reported costs and services provided by inhalation drug suppliers suggested by the comments and the GAO study, we stated in last

year ’ s final rule that we would establish an interim dispensing fee for inhalation drugs applicable for CY 2005 and reconsider the issue for CY 2006. The 2005 dispensing fee for a 30-day supply of inhalation drugs was based on the industry recommended $68 fee from AAH study, excluding certain costs that Medicare generally does not reimburse regardless of the scope of the Medicare benefit (that is, sales and marketing, bad debt, and an explicit profit margin). The resulting fee established for a 30-day supply of inhalation drugs was $57 for CY 2005. This CY 2005 fee substantially exceeded some providers ’ costs as reflected in a few comments on last

year ’ s proposed rule and the GAO study. For example, as noted previously, we received comments from two retail pharmacy companies indicating that a fee of $25 or a fee of five to six times the prior $5 fee was adequate to cover costs. Because the AAH study did not include cost data for a 90-day supply, we applied the methodology used in the GAO report to convert the 30-day fee to a 90-day fee. The 2005 fee established for a 90-day supply was $80. In using the AAH data to establish an interim fee for dispensing for CY 2005, we indicated in last year ’ s final rule that we were concerned that some of the services included in the AAH study may be outside the scope of a dispensing fee and that we would consider this issue further in order to establish an appropriate dispensing fee for CY 2006.

Authority for a dispensing fee for inhalation drugs is based on section 1842(o)(2) of the Act. This section of the Act stipulates that if payment is made to a licensed pharmacy for a drug or biological under Medicare Part B, the Secretary may pay a dispensing fee (less the applicable deductible and coinsurance) to the pharmacy. The statute does not define ‘‘ dispensing fee. ’’ As noted above, the AAH data on which the 2005 dispensing fee is based includes a wide range of cost categories. The cost categories include basic pharmacy services such as delivery of drugs, as well as other services such as in-home visits. We are soliciting comments on what services appropriately fall within the scope of a dispensing fee, the cost of providing those services, and whether any of the services being provided by inhalation drug suppliers may be covered through another part of the Medicare program, such as the physician fee schedule or the DME benefit. We intend to establish a dispensing fee amount for 2006 that is adequate to cover the costs of those services that appropriately fall within the scope of a dispensing fee, and we think that it is likely that this fee amount will be lower than the 2005 level. As discussed previously, we believe that 2005 was a transition year. Payment for inhalation drugs in 2005 was reduced from a percentage of AWP to 106 percent of ASP and the 2005 dispensing fee was set at a much higher level than previously paid based on the limited information available and taking into account the transition. Additional changes will occur in 2006 because the implementation of the Medicare prescription drug benefit will expand coverage options for inhalation drugs to include metered dose inhalers under Medicare Part D. As noted above, we expect that physicians will choose the treatment option that best suits a particular beneficiary ’ s needs and that both nebulizers and metered-dose inhalers will play an important role in the Medicare program. We do not know what the effect will be of this upcoming expansion of inhalation drug coverage options, but we believe it is important that this second transitional year be as smooth as possible. We are seeking comments on an appropriate dispensing fee level for 2006. We also seek data and information on the various services inhalation drug suppliers are currently providing to Medicare beneficiaries and the associated costs. Furthermore, we are also soliciting comments on how inhalation drug suppliers have utilized the newly available 90-day scripts in order to reduce unit shipping costs and any reasons as to why 90-day supplies may not have been utilized. We also seek information on how revised guidelines regarding the time frame for delivery of refills has affected the need for overnight delivery services. We are interested in comments that detail the extent to which suppliers have shifted their shipping to ground services.

CMS takes quality of care seriously and we have been implementing a number of quality initiatives such as the chronic care improvement program. We expect that Medicare beneficiaries receive high quality care, and we seek data and information on any efforts by inhalation drug suppliers to measure patient outcomes. Furthermore, we seek comments and additional information about what are typical dispensing costs for an efficient, high-quality supplier. Finally, we seek comment on the potential impact on beneficiaries and providers of possible changes to the inhalation drug dispensing fee in 2006, as well as the impact of the new drug benefit on inhalation drug access.
5. Supplying Fee

[If you choose to comment on issues in this section, please include the caption ‘‘ Supplying Fee ’’ at the beginning of your comments.]

Section 303(e)(2) of the MMA added section 1842(o)(6) of the Act that requires the Secretary to pay a supplying fee (less applicable deductible and coinsurance) to pharmacies for certain Medicare Part B drugs and biologicals, as determined appropriate by the Secretary. The types of Medicare Part B drugs and biologicals eligible for a supplying fee are immunosuppressive drugs described in section 1861(s)(2)(J) of the Act, oral anticancer chemotherapeutic drugs described in section 1861(s)(2)(Q) of the Act, and oral anti-emetic drugs used as part of an anticancer chemotherapeutic regimen described in section 1861(s)(2)(T) of the Act.

Beginning with CY 2005, we established a supplying fee of $24 per prescription for these categories of drugs, with a higher fee of $50 for the initial oral immunosuppressive prescription supplied in the first month after a transplant. When multiple drugs are supplied to a beneficiary, a separate supplying fee is paid for each prescription, except when different strengths of the same drug are supplied on a single day. In the November 15, 2004 final rule, we indicated that we were establishing a supplying fee that was higher than that of other payers due to the lack of on-line claims adjudication for Medicare Part B oral drugs. Other than the cost of billing Medicare Part B, we indicated that we did not believe there were any other significant cost differences between Medicare and other payers that justified a higher Medicare supplying fee for these drugs. We noted in last year ’ s final rule that many other payers with online adjudication have dispensing fees in the range of $5 to $10 per prescription. We also indicated that we had received comments that the average cost to a pharmacy to dispense a non-Medicaid third party or cash prescription for those drugs ranges anywhere from $7.50 to $8.00.

When multiple drugs are supplied to a beneficiary on the same day or in the same month, current policy is to pay a full supplying fee for each additional drug. As mentioned previously, we established a supplying fee higher than


## 45849 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

that of other payers to compensate for the added costs associated with our lack of online claims adjudication. However, in situations where multiple drugs are supplied to a beneficiary during the same month, many of which are likely to be supplied on the same day, we are concerned that we are overpaying for the costs associated with our lack of online claims adjudication. We believe that there are likely to be substantial economies of scale and that the burden associated with our lack of online claims adjudication would be relatively similar whether one prescription or multiple prescriptions were supplied during the same month.

Consequently, in § 414.1001 (Basis of payment), we are proposing changes to the supplying fee for multiple prescriptions supplied during the same month. We would continue paying $24 for the first prescription supplied during a month (or $50 for the first oral immunosuppressive prescription supplied in the first month after a transplant). We believe that this $24 supplying fee for the first prescription would adequately compensate a supplier for the billing costs associated with the lack of on-line claims adjudication, and that the cost of supplying additional prescriptions in the same month should be comparable to that of other payers. Therefore, in that same section, we are proposing to pay a supplier an $8 supplying fee per prescription for any prescription, after the first one, that that supplier provided to a beneficiary during a month. If a beneficiary obtained prescriptions attwo separate pharmacies during a onemonth period, each pharmacy would be paid a $24 fee for the first drug it supplied and an $8 fee per prescription for any subsequent prescriptions during the month.

We are also proposing to expand the circumstances under which we pay supplying fees for multiple prescriptions filled on the same day. Currently, we pay a supplying fee for each prescription supplied on the same day as long as the prescriptions are for different drugs. We are now proposing to pay a supplying fee for each prescription, even if the prescriptions are for different strengths of the same drug. This change is intended to recognize the costs involved in filling separate prescriptions for different strengths of a drug. For example, if two prescriptions were supplied on a single day and they were for different strengths of the same drug, we are proposing to pay a supplying fee of $24 for the first prescription and a supplying fee of $8 for the second prescription. Our goal is to ensure that each beneficiary who needs covered oral drugs has access to those medications while maintaining our fiduciary responsibility to pay appropriately for Medicare covered services. We seek comments about the appropriateness of our proposed supplying fee for multiple prescriptions supplied during a single month. We also seek data and information about the incremental costs of supplying additional prescriptions to a Medicare beneficiary during a single month, as well as data and information about how pharmacy costs and reimbursement for supplying oral drugs under Medicare compares to that of other payers.
I. Private Contracts and Opt-Out
Provision [If you choose to comment on issues in this section, please include the caption

‘‘ PRIVATE CONTRACTS AND OP

– OUT ’’ at the beginning of your comments.]

Section 4507 of the BBA of 1997 amended section 1802 of the Act to permit certain physicians and practitioners to opt-out of Medicare if certain conditions were met, and to provide through private contracts services that would otherwise be covered by Medicare. Under these private contracts, the mandatory claims submission and limiting charge rules of section 1848(g) of the Act would not apply. The amendments to section 1802 of the Act, which were effective on January 1, 1998, made the provisions of the Medicare statute that would ordinarily preclude physicians and practitioners from contracting privately with Medicare beneficiaries to pay without regard to Medicare limits inapplicable if the conditions necessary for an effective ‘‘ opt-out ’’ are met.

When a physician or practitioner fails to maintain the conditions necessary for opt-out and does not take good faith efforts to correct his or her failure to maintain opt-out, current regulations at § 405.435(b) specify the consequences to that physician or practitioner for the remainder of that physician ’ s or practitioner ’ s 2-year opt-out period. However, § 405.435(b) describes a situation where the Medicare carrier notifies the physician or practitioner that he or she is violating the regulations and the statute. The current regulations do not address the consequences to physicians and practitioners in situations when a condition resulting in failure to maintain opt-out occurs during the 2- year opt-out period, but a Medicare carrier does not discover or give notice of a physician ’ s or practitioner ’ s failure to maintain opt-out during the 2-year opt-out period. Therefore, we are proposing to amend § 405.435 in order to clarify that the consequences specified in § 405.435(b) for the failure on the part of a physician or practitioner to maintain opt-out will apply regardless of whether or when a carrier notifies a physician or practitioner of the failure to maintain opt-out. We are also proposing to add a new paragraph (d) to clarify that in situations where a violation of § 405.435(a) is not discovered by the carrier during the 2- year opt-out period when the violation actually occurred, then the requirements of § 405.435(b)(1) through (b)(8) would be applicable from the date that the first violation of § 405.435(a) occurred until the end of the opt-out period during which the violation occurred (unless the physician or practitioner takes good faith efforts to restore opt-out conditions, for example, by refunding the amounts in excess of the charge limits to beneficiaries with whom he or she did not sign a private contract). These good faith efforts must be made within 45 days of any notice by the carrier that the physician or practitioner has failed to maintain opt-out (where the carrier discovers the failure after the two-year opt-out period has expired), or within 45 days after the physician or practitioner has discovered the failure to maintain opt-out, whichever is earlier.
J. Multiple Procedure Reduction for Diagnostic Imaging [If you choose to comment on issues in this section, please include the caption

‘‘ MULTIPLE PROCEDURE
REDUCTION ’’ at the beginning of your comments.]

Medicare has a longstanding policy of reducing payment for multiple surgical procedures performed on the same patient, by the same physician, on the same day. In those cases, full payment is made for the highest priced procedure and each subsequent procedure is paid at 50 percent. Effective January 1, 1995, the multiple procedure policy, with the same reductions, was extended to nuclear medicine diagnostic procedures (CPT codes 78306, 78320, 78802, 78803, 78806 and 78807). In the Medicare Program Physician Fee Schedule for Calendar Year 1995 final rule, published on December 8, 1994 (59 FR 63410), we indicated that we would consider applying the policy to other diagnostic tests in the future.

Under the PFS, diagnostic imaging procedures are priced in the following three ways:

• The professional component (PC) represents the physician work, that is, the interpretation.


## 45850 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

• The TC represents practice expense, that is, clinical staff, supplies, and equipment.

• The global service represents both PC and TC. Generally, diagnostic imaging procedures even those performed on contiguous body parts are paid at 100 percent for each procedure. For example, the TC payment is approximately $978 for a magnetic resonance imaging (MRI) of the abdomen (without and with dye), and $529 for an MRI of the pelvis (with dye) (CPT codes 74183 and 72196, respectively), even when both procedures are performed in a single
session.

Under the resource-based PE methodology, specific PE inputs of clinical labor, supplies and equipment are used to calculate PE RVUs for each individual service. We do not believe these same inputs are needed to perform subsequent procedures. When multiple images are acquired in a single session, most of the clinical labor activities and most supplies are not performed or furnished twice. Specifically, we consider that the following clinical labor activities are not duplicated for subsequent procedures:

• Greeting the patient.

• Positioning and escorting the patient.

• Providing education and obtaining

consent.

• Retrieving prior exams.

• Setting up the IV.

• Preparing and cleaning the room. In addition, we consider that supplies, with the exception of film, are not duplicated for subsequent procedures. Equipment time and indirect costs are allocated based on clinical labor time; therefore, these inputs should be reduced accordingly. Excluding the above practice expense inputs, along with the corresponding portion of equipment time and indirect costs, supports a 50 percent reduction in the payment for the TC of subsequent procedures. Applying this reduction to the two procedures indicated above would result in a full payment of $978 for the highest priced procedure, and a reduced payment of $264.50 (50 percent

× $529) for the second procedure. This same calculation is currently used for the multiple procedure payment reduction for surgery. We are not proposing to apply a multiple procedure reduction to PC services at this time because we believe physician work is not significantly affected for multiple procedures.

The global service payment equals the combined PC and TC components. When the global service code is billed for these procedures, the TC would be reduced the same as above, but the PC would be paid in full at $117 and $90 for codes 74183 and 72196, respectively.

In our view, duplicate payment is currently being made for the TC of multiple diagnostic imaging services, particularly when contiguous body parts are viewed in a single session. The Medicare Payment Advisory Commission (MedPAC) supports this reduction in its March 2005 Report to the Congress on Medicare Payment Policy.

We have identified 11 families of imaging procedures by imaging modality (ultrasound, CT and computed tomographic angiography (CTA), MRI and magnetic resonance angiography (MRA) and contiguous body area (for example, CT and CTA of Chest/Thorax/ Abdomen/Pelvis). MedPAC pointed out that Medicare ’ s payment rates are based on each service being provided independently and that the rates do not account for efficiencies that may be gained when multiple studies using the same imaging modality are performed in the same session. Those efficiencies are more likely when contiguous body areas are the focus of the imaging because the patient and equipment have already been prepared for the second and subsequent procedures, potentially yielding resource savings in areas such as clerical time, technical preparation, and supplies. Using billing data, we identified a number of contiguous body areas for which imaging is performed during the same session. Next, because our proposed discounting policies are based on the expectation that facilities will achieve savings by not having to expend more than once, many of the resources associated with performance of a second, and any subsequent procedures, we organized the families by imaging modality.

We propose extending the multiple procedure payment reduction to TC only services and the TC portion of global services for the procedures in Table 29, below. At this time, we propose applying the reduction only to procedures involving contiguous body parts within a family of codes, not across families. For example, the reduction would not apply to an MRI of the brain (CPT 70552) in code family 5, when performed in the same session as an MRI of the neck and spine (CPT 72142) in code family 6. When multiple procedures within the same family are performed in the same session, we propose making full payment for the TC of the highest priced procedure and payment at 50 percent of the TC for each additional procedure. The following is an example of the current and proposed payments:

74183 72196 Total current payment Total proposed payment Payment calculation

PC ..................................................................... $117.00 $90.00 $207.00 $207.00 no reduction. TC ..................................................................... $978.00 $530.00 $1,507.00 $1,243 $978 + (.5 × $530) Global ................................................................ $1,095.00 $620.00 $1,714.00 $1,450 $207 + $978 + (.5 × $530)



### TABLE 

### 29.

— D IAGNOSTIC 

### I MAGING 

### S ERVICES

**Family 1 Ultrasound (Chest/Abdomen/**
**Pelvis**

**— Non-Obstetrical** 

76604 ............. Ultrasound exam, chest, bscan 76645 ............. Ultrasound exam, breast(s) 76700 ............. Ultrasound exam, abdom, complete
76705 ............. Echo exam of abdomen
76770 ............. Ultrasound exam abdo back wall, comp 

### TABLE 

### 29.

— D IAGNOSTIC 

### I MAGING 

### S ERVICES



### —Continued

76775 ............. Ultrasound exam abdo back wall, lim 76778 ............. Ultrasound exam kidney transplant 76830 ............. Transvaginal Ultrasound, non-ob 76831 ............. Echo exam, uterus 76856 ............. Ultrasound exam, pelvic, complete76857 ............. Ultrasound exam, pelvic, limited 

### TABLE 

### 29.

— D IAGNOSTIC 

### I MAGING 

### S ERVICES



### —Continued

**Family 2 CT and CTA (Chest/Thorax/Abd/ Pelvis)** 

71250 ............. CT thorax w/o dye 71260 ............. CT thorax w/ dye 71270 ............. CT thorax w/o & w/ dye 71275 ............. CTA, chest 72191 ............. CTA, pelv w/o & w/ dye 72192 ............. CT pelvis w/o dye 72193 ............. CT pelvis w/ dye 72194 ............. CT pelvis w/o & w/ dye 74150 ............. CT abdomen w/o dye 74160 ............. CT abdomen w/ dye


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TABLE 

### 29.

— D IAGNOSTIC 

### I MAGING 

### S ERVICES



### —Continued

74170 ............. CT abdomen w/o & w/ dye 74175 ............. CTA, abdom w/o & w/ dye 75635 ............. CTA abdominal arteries 0067T ............. CT colonography; dx

**Family 3 CT and CTA (Head/Brain/Orbit/ Maxillofacial/Neck)** 

70450 ............. CT head/brain w/o dye 70460 ............. CT head/brain w/ dye 70470 ............. CT head/brain w/o & w/ dye 70480 ............. CT orbit/ear/fossa w/o dye 70481 ............. CT orbit/ear/fossa w/ dye 70482 ............. CT orbit/ear/fossa w/o & w/ dye 70486 ............. CT maxillofacial w/o dye 70487 ............. CT maxillofacial w/ dye 70488 ............. CT maxillofacial w/o & w/ dye 70490 ............. CT soft tissue neck w/o dye 70491 ............. CT soft tissue neck w/ dye 70492 ............. CT soft tissue neck w/o & w/ dye 70496 ............. CTA, head 70498 ............. CTA, neck

**Family 4 MRI and MRA (Chest/Abd/Pelvis)**

71550 ............. MRI chest w/o dye 71551 ............. MRI chest w/ dye 71552 ............. MRI chest w/o & w/ dye 71555 ............. MRI angio chest w/ or w/o dye 72195 ............. MRI pelvis w/o dye 72196 ............. MRI pelvis w/ dye 72197 ............. MRI pelvis w/o &w/ dye 72198 ............. MRI angio pelvis w/ or w/o dye 74181 ............. MRI abdomen w/o dye 74182 ............. MRI abdomen w/ dye 74183 ............. MRI abdomen w/o and w/ dye 74185 ............. MRI angio, abdom w/ or w/o dye

**Family 5 MRI and MRA (Head/Brain/Neck)**

70540 ............. MRI orbit/face/neck w/o dye 70542 ............. MRI orbit/face/neck w/ dye 70543 ............. MRI orbit/face/neck w/o & w/ dye 70544 ............. MRA head w/o dye 70545 ............. MRA head w/dye 70546 ............. MRA head w/o & w/dye 70547 ............. MRA neck w/o dye 70548 ............. MRA neck w/dye 70549 ............. MRA neck w/o & w/dye 70551 ............. MRI brain w/o dye 70552 ............. MRI brain w/dye 70553 ............. MRI brain w/o & w/dye

**Family 6 MRI and MRA (spine)**

72141 ............. MRI neck spine w/o dye 72142 ............. MRI neck spine w/dye 72146 ............. MRI chest spine w/o dye 72147 ............. MRI chest spine w/dye 72148 ............. MRI lumbar spine w/o dye 72149 ............. MRI lumbar spine w/dye 72156 ............. MRI neck spine w/o & w/dye 72157 ............. MRI chest spine w/o & w/ dye 

### TABLE 

### 29.

— D IAGNOSTIC 

### I MAGING 

### S ERVICES



### —Continued

72158 ............. MRI lumbar spine w/o & w/ dye

**Family 7 CT (spine)**

72125 ............. CT neck spine w/o dye 72126 ............. CT neck spine w/dye 72127 ............. CT neck spine w/o & w/dye 72128 ............. CT chest spine w/o dye 72129 ............. CT chest spine w/dye 72130 ............. CT chest spine w/o & w/dye 72131 ............. CT lumbar spine w/o dye 72132 ............. CT lumbar spine w/dye 72133 ............. CT lumbar spine w/o & w/ dye

**Family 8 MRI and MRA (lower extremities)**

73718 ............. MRI lower extremity w/o dye 73719 ............. MRI lower extremity w/dye 73720 ............. MRI lower ext w/ & w/o dye 73721 ............. MRI joint of lwr extre w/o dye 73722 ............. MRI joint of lwr extr w/dye 73723 ............. MRI joint of lwr extr w/o & w/ dye 73725 ............. MRA lower ext w or w/o dye

**Family 9 CT and CTA (lower extremities)**

73700 ............. CT lower extremity w/o dye 73701 ............. CT lower extremity w/dye 73702 ............. CT lower extremity w/o & w/ dye 73706 ............. CTA lower ext w/o & w/dye

**Family 10 Mr and MRI (upper extremities and joints)** 

73218 ............. MRI upper extr w/o dye 73219 ............. MRI upper extr w/dye 73220 ............. MRI upper extremity w/o & w/dye 73221 ............. MRI joint upper extr w/o dye 73222 ............. MRI joint upper extr w/dye 73223 ............. MRI joint upper extr w/o & w/dye

**Family 11 CT and CTA (upper extremities)**

73200 ............. CT upper extremity w/o dye 73201 ............. CT upper extremity w/dye 73202 ............. CT upper extremity w/o & w/ dye 73206 ............. CTA upper extr w/o & w/dye



### K. Therapy Cap [If you choose to comment on issues in this section, please include the caption

‘‘ THERAPY CAP ’’ at the beginning of your comments.]

Section 1833(g)(1) of the Act applies an annual, per beneficiary combined cap on outpatient physical therapy (PT) and speech-language pathology services, and a similar separate cap on outpatient occupational therapy services under Medicare Part B. This cap was added by section 4541 of the BBA 1997, Pub. L.

105

– 33. However, the application of the caps was suspended from CY 2000 through CY 2002 under section 1833(g)(4) of the Act by section 221 of the of BBRA 1999, Pub. L. 106

– 113, and extended by section 421 of BIPA 2000, Pub. L. 105

– 551. The caps were implemented from September 1, 2003 through December 7, 2003. Section 624 of the MMA reinstated the moratorium on the application of these caps from December 8, 2003 through December 31, 2005. Thus, the caps will again become effective beginning January 1, 2006.

Section 1883(g)(2) of the Act provides that, for 1999 through 2001, the caps were both $1500, and for years after 2001, the caps are equal to the preceding year ’ s cap increased by the percentage increase in the MEI (except that if an increase for a year is not a multiple of $10, it is rounded to the nearest multiple of $10). We will publish the dollar amount for therapy caps in the final rule, when the MEI is available. Based on the April 4, 2005 MEI estimate, the estimated value of therapy caps for 2006 would be $1,750.
L. Chiropractic Services Demonstration [If you choose to comment on issues in this section, please include the caption

‘‘ CHIROPRACTIC SERVICES ’’ at the beginning of your comments.]

Section 1861(r)(5) of the Act limits current Medicare coverage for chiropractic treatment by means of the manual manipulation of the spine for the purpose of correcting a subluxation, defined generally as a malfunction of the spine. Specifically, Medicare covers three CPT Codes provided by chiropractors: 98940 (manipulative
treatment, 1

– 2 regions of the spine), 98941 (manipulative treatment, 3

–4 regions of the spine), and 98942 (manipulative treatment, 5 regions of the spine). Treatment must be provided for an active subluxation only, and not for prevention or maintenance. Additionally, treatment of the subluxation must be related to a neuromusculoskeletal condition where there is a reasonable expectation of recovery or functional improvement.

Section 651 of the MMA provides for a 2-year demonstration to evaluate the feasibility and advisability of covering chiropractic services under Medicare. These services extend beyond the current coverage for manipulation to care for neuromusculoskeletal conditions typical among eligible beneficiaries, and will cover diagnostic and other services that a chiropractor is legally authorized to perform by the State or jurisdiction in which the treatment is provided. Physician approval will not be required for these services. The demonstration must be budget neutral and will be conducted in


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four sites, two rural and two urban. One site of each area type must be a health professional shortage area (HPSA).

On January 28, 2005, we published a notice in the Federal Register (70 FR 4130) describing the covered services and site selection for this demonstration. As recognized in the notice, the statute requires the Secretary to ensure that aggregate payments made under the Medicare program do not exceed the amount that would have been paid under the Medicare program in the absence of this demonstration.

Ensuring budget neutrality requires that the Secretary develop a strategy for recouping funds should the demonstration result in costs higher than would occur in the absence of the demonstration. In this case, we stated we would make adjustments in the national chiropractor fee schedule to recover the costs of the demonstration in excess of the amount estimated to yield budget neutrality. We indicated that we will assess budget neutrality by determining the change in costs based on a pre/post comparison of costs and the rate of change for specific diagnoses that are treated by chiropractors and physicians in the demonstration sites and control sites. We will not limit our analysis to reviewing only chiropractor claims, because the costs of the expanded chiropractor services may have an impact on other Medicare costs.

We anticipate that any necessary reduction will be made in the 2010 and 2011 fee schedules because it will take approximately 2 years to complete the claims analysis. If we determine that the adjustment for budget neutrality is greater than 2 percent of spending for the chiropractor fee schedule codes (comprised of the 3 currently covered CPT codes 98940, 98941 and 98942), we will implement the adjustment over a 2- year period. However, if the adjustment is less than 2 percent of spending under the chiropractor fee schedule codes, we will implement the adjustment over a 1- year period. We will include the detailed analysis of budget neutrality and the proposed offset in the 2009 Federal Register publication of the PFS.

PT services that are performed by chiropractors under the demonstration will be included under the PT cap described in section J above. We are including these services under the cap because chiropractors are subject to the same rules as medical doctors for therapy services under the demonstration. Therefore these services should be included under the therapy cap. See our Web site http:// www.cms.hhs.gov/researchers/demos/ eccs/ for additional information concerning the chiropractic services demonstration.
M. Supplemental Payments to Federally Qualified Health Centers (FQHCs) Subcontracting With Medicare Advantage Plans [If you choose to comment on issues in this section, please include the caption

‘‘ SUPPLEMENTAL PAYMENTS

— FQHCS ’’ at the beginning of your comments.]

Title II of the MMA established the Medicare Advantage (MA) program. The MA program replaces the Medicare+Choice (M+C) program established under Part C of the Act. Although the MA program retains many key features of the M+C program, it includes several new features, such as the availability of a regional MA plan option. Regional MA plans must be preferred provider organization (PPO) plans.

Section 237 of the MMA amended section 1833(a)(3) of the Act to provide supplemental payments to FQHCs that contract with MA organizations to, in general, cover the difference, if any, between the payment received by the health center for treating enrollees in MA plans offered by the MA organization and the payment that the FQHC is entitled to receive under the cost-based all-inclusive payment rate as set forth in part 405, subpart X. This new supplemental payment for covered Medicare FQHC services furnished to MA enrollees augments the direct payments made by MA Plans to FQHCs for covered Medicare FQHC services. Medicare ’ s obligation to provide supplemental payments to FQHCs applies to centers with direct or indirect subcontract arrangements following a written agreement with MA organizations.

Centers eligible for supplemental payments under section 1833(a)(3) of the Act, as revised by Section 237 of the MMA, include any facility qualified to furnish FQHC services described in section 1832(a)(2)(D) of the Act. Only the following entities are qualified to furnish FQHC services: (1) entities receiving a grant under section 330 (other than subsection (h)) of Public Health Services Act or receiving funding from this grant under a contract with its recipient and meets the requirements to receive this grant; (2) entities determined by the Secretary to meet the requirements for receiving this grant; (3) entities treated by the Secretary, for purposes of Part B, as a comprehensive Federally funded health center as of January 1, 1990; or (4) an outpatient health program or facility operated by a tribe or tribal organization receiving funds under title V of Indian Health Care Improvement Act.

In order to implement this new payment provision, CMS mustdetermine whether the Medicare costbased payments that the FQHC would be entitled to exceed the amount of payments received by the center from the MA organization and, if so, pay the difference to the FQHC at least quarterly. In determining the supplemental payment, the statute also excludes in the calculation of the supplemental payments any financial incentives provided to FQHCs under their MA arrangements, such as risk pool payments, bonuses, or withholds.

Managed care organizations frequently use financial incentives in their contracts with providers to reduce unnecessary utilization of services. These incentives may be negative, such as withholding a portion of the capitation payments, if utilization goals are not satisfied. Incentives may also be positive, such as a bonus payment if utilization outcomes are achieved. In both cases, these incentives (whether positive or negative) are separate from the MA organization ’ s payment for services provided under its direct or indirect contract with the FQHC and are prohibited by statute from being included in our calculation of supplemental payments due to the Medicare FQHC. In other words, in determining the difference between payments from the MA organization to the FQHC and what the FQHC will receive on a cost basis, we are precluded from using the incentive payments in the calculation of the FQHC supplemental payment. Only capitatedper month per beneficiary or fee-forservice payments from the MA plan for services furnished to MA enrollees are included in the calculations of the rate differential.

Under original Medicare, each center is paid an all-inclusive per visit rate based on its reasonable costs as reported in the FQHC cost report. The payment is calculated, in general, by dividing the

center ’ s total allowable cost by the total number of visits for FQHC services. At the beginning of the rate year, the Medicare Fiscal Intermediary (FI) calculates an interim rate based on estimated allowable costs and visits from the center if it is new to the FQHC program or actual costs and visits from the previous cost reporting period for existing FQHCs. The center ’ s interim rate is reconciled to actual reasonable costs at the end of the cost reporting period.


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Proposed Payment Methodology

We are proposing a supplemental payment method based on a per visit calculation subject to an annual reconciliation. The supplemental payment for FQHC covered services rendered to MA enrollees is equal to the difference between 100 percent of the FQHC ’ s all-inclusive cost-based per visit rate and the average per visit rate received by the center from the MA plan in which the enrollee is enrolled, less any amount the FQHC may charge as described in section 1857(e)(3)(B) of the Act. Each center will be required to submit (for the first rate year) to the intermediary an estimate of the average MA payment per visit for covered FQHC services. Every eligible center will be required to submit a detailed estimate of its average per visit payment for enrollees in each MA plan offered by the MA organization and any other information as may be required to enable the intermediary to accurately establish an interim supplemental payment, which will be the difference between the estimated MA per visit payment rate and the center ’ s interim all-inclusive cost-based per visit rate. Expected payments from the MA plan will only be used until actual MA revenue and visits can be collected on the center ’ s FQHC cost report. The interim and final supplemental payment amount will vary by center depending on its current Medicare reimbursement rates and its contractual arrangements with MA plans.

Effective January 1, 2006, eligible FQHCs will report actual revenue received from the MA plan and visits on their cost reports. At the end of the cost reporting period the FI would use actual MA revenue and visit data along with the FQHCs ’ final all-inclusive payment rate, to determine the center ’ s final actual supplemental per visit payment for enrollees in the relevant MA plan. This will serve as the interim rate for the subsequent rate year. Actual aggregated supplemental payments will then be reconciled with aggregated interim supplemental payments, and any underpayment or overpayment thereon will then be accounted for in determining final Medicare FQHC program liability at cost settlement. Necessary changes will be made to the FQHC cost report to effectuate the calculation of the supplemental rate.

A supplemental payment will be made every time a face-to-face encounter occurs between a MA enrollee and any one of the following FQHC covered core practitioners: physicians, NPs, PAs, clinical nurse midwives, clinical psychologists, or clinical social workers. The supplemental payment is made directly to each qualified center through the Medicare FI. Each center is responsible for submitting Medicare claims with the proper codes for these visits. Necessary changes will be made to the instructions for the FQHC claim form to effectuate the billing and payment of supplemental payments.

To conform our regulations to the statute, we are proposing to add § 405.2469 to specify the per visit payment methodology for making supplemental payments to FQHCs under contract (directly or indirectly) with MA organizations.
N. National Coverage Decisions Timeframes [If you choose to comment on issues in this section, please include the caption

‘‘ NCD TIMEFRAMES ’’ at the beginning of your comments.]

We have established requirements concerning the administrative review of local coverage determinations (LCDs) and National Coverage Determinations (NCDs) at 42 CFR part 426, with subpart C specifically addressing the general provisions for the review of LCDs and NCDs. Under our existing regulations in part 426, subpart C, the Departmental Appeals Board may stay the adjudicatory proceedings in certain circumstances to allow CMS to consider significant new evidence that is submitted in the context of a challenge to an NCD. Our previous regulations at § 426.340(e), permitted a brief stay of the adjudicatory proceedings (not more than 90 days), for CMS to complete its reconsideration of the NCD. Those time frames, although short, were consistent with the previous process for making NCDs that did not require publication of a proposed decision memorandum and an opportunity for public comment on the proposed decision memorandum.

Section 731 of the MMA of 2003 modifies certain timeframes in the NCD review process. Specifically, the MMA amended section 1862(l) of the Act to specify that for NCD requests not requiring an external technology assessment (TA) or Medicare Coverage Advisory Committee (MCAC) review, the decision on the request shall be made not later than 6 months after the date the request is received. For those NCD requests requiring either an external TA or MCAC review, where a clinical trial is not requested, the decision on the request must be made not later than 9 months after the date the request is received.

Furthermore, section 731 of the MMA stipulates that not later than the end of the 6 or 9 month period described above, a draft of the proposed decision must be made available on the CMS website (or other appropriate means) for public comment. This comment period will last 30 days. Comments will be reviewed and a final decision will be issued not later than 60 days after the conclusion of the comment period. A summary of the public comments received and responses to the comments will continue to be included in the final
NCD.

In light of the procedural change made by section 731 of the MMA that requires a public comment period before we can issue a final determination for NCDs, we are proposing to amend § 426.340 to reflect the new timeframes in the MMA. The regulation is amended to state that if the CMS informs the Board that a revision or reconsideration was or will be initiated, then the Board will stay the proceedings and set appropriate timeframes by which the revision or reconsideration will be completed, that reflects sufficient time for the publication of a proposed determination, a thirty day public comment period, and time for CMS to prepare a final determination that responds to public comments as specified in section 1862(l) of the Act. Subsequently, the reference to the 90 day reconsideration period in § 426.340(e)(3) will be eliminated for NCD appeals to reflect the new timeframes in the MMA. The LCD timeframes will not be affected by this change.
O. Coverage of Screening for Glaucoma [If you choose to comment on issues in this section, please include the caption

‘‘ COVERAGE OF SCREENING

— GLAUCOMA ’’ at the beginning of your comments.]

On January 1, 2002, we implemented regulations at § 410.23(a)(2), Conditions for and limitations on coverage of screening for glaucoma, requiring that the term ‘‘ eligible beneficiary ’’ be defined to include individuals in the following high risk categories: (i) Individual with diabetes mellitus; (ii) Individual with a family history of glaucoma; or (iii) African-Americans age 50 and over. Based on our review of the current medical literature, we believe that there are other beneficiaries who are at risk for glaucoma and should be included in the definition of eligible beneficiary for purposes of the glaucoma screening benefit.

The Eye Diseases Prevalence Research Group recently reviewed the literature on the prevalence of glaucoma in adults in the United States (Arch Ophthalmol
2004; 122:532

– 538) and provided separate data for Hispanic persons. They


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reported that Hispanic subjects had a marked higher prevalence in the oldest age group. After controlling for age and gender, rates of open angle glaucoma in Hispanic persons did not differ significantly from that among whites, except for those age 65 years and older. The prevalence of open angle glaucoma in Hispanic persons age 65 years and older was significantly higher than among whites. Overall, Hispanic subjects had a significantly lower prevalence of open angle glaucoma than African-Americans. One notable limitation of this review article is that the data on Hispanic persons came from a single study of mostly Mexican-born Hispanics from Arizona (Quigley HA et al. The prevalence of glaucoma in a population based study of Hispanic subjects: proyecto VER. Ann Ophthalmol 2001; 119:1819

– 1825). We believe the evidence is adequate to conclude that Hispanic persons age 65 and older are at high risk and could benefit from glaucoma screening.

Therefore in § 410.23(a)(2), we are proposing to revise the definition of an eligible beneficiary to include Hispanic Americans age 65 and over. If this proposal is adopted in the final rule, effective January 1, 2006, Hispanic Americans age 65 and older would qualify for Medicare coverage and payment for glaucoma screening services, if the applicable condition and limitations on coverage of screening for glaucoma specified in § 410.23(b) and (c) are met.

In view of the possibility that it may be appropriate to include other individuals in the statutory definition of those at ‘‘ high risk ’’ for glaucoma, we are requesting comments on this issue. Specifically, we request that anyone providing us with specific recommendations on this issue provide documentation in support of them from the peer-reviewed medical literature.
P. Physician Referrals for Nuclear Medicine Services and Supplies to Health Care Entities With Which They Have Financial Relationships [If you choose to comment on issues in this section, please include the caption

‘‘ NUCLEAR MEDICINE SERVICES ’’ at the beginning of your comments.]
1. Background

Under section 1877 of the Act, a physician may not refer a Medicare patient for certain designated health services (DHS) to an entity with which the physician (or an immediate family member of the physician) has a financial relationship, unless an exception applies. Section 1877 of the Act also prohibits the DHS entity from submitting claims to Medicare or billing the beneficiary or any other entity for Medicare DHS that are furnished as a result of a prohibited referral. Sections 1877(h)(6)(D) and (E) of the Act define DHS to include ‘‘ [r]adiology services, including magnetic resonance imaging, computerized axial tomography and ultrasound services ’’ and ‘‘ [r]adiation therapy services and supplies. ’’ This proposed rule would include diagnostic and therapeutic nuclear medicine procedures under the DHS categories for radiology and certain other imaging services and radiation therapy services and supplies, respectively.

On January 9, 1998, we published a proposed rule (63 FR 1659) that, among other things, proposed regulatory definitions for the various DHS categories listed in the statute. In that proposed rule, we proposed to include nuclear medicine services in the definition of radiology services. In the January 4, 2001 physician self-referral Phase I final rule (66 FR 856), we defined ‘‘ radiology and certain other imaging services ’’ and ‘‘ radiation therapy services and supplies ’’ at § 411.351. We did not include nuclear medicine services in either definition because, at that time, we believed that diagnostic nuclear medicine services were not commonly considered to be radiology services and that therapeutic nuclear medicine services were not commonly considered to be radiation therapy services. We received one comment urging us to include nuclear medicine services in the definition of radiology services. In the Phase II final rule, published on March 26, 2004 (69 FR 16054), we indicated that we were concerned with the issues raised by the commenter and that we might revisit the issue of nuclear medicine in a proposed rule.
2. Proposal To Include Nuclear Medicine

Our knowledge of nuclear medicine, which is based in part on our awareness of the health care community ’ s view of nuclear medicine, has changed significantly since we published the Phase I final rule. As a result, we have reconsidered the question of whether nuclear medicine services should be considered a DHS. We are proposing to amend § 411.351 to include diagnostic nuclear medicine services in the definition of ‘‘ radiology and certain other imaging services ’’ and to include therapeutic nuclear medicine services in the definition of ‘‘ radiation therapy services and supplies. ’’ We believe this change is needed in light of the statute ’ s inclusion of radiology and radiation therapy as DHS. We also believe this change is appropriate, given the current manner in which these services are covered and paid under the Medicare program. As noted in the Phase I final rule (66 FR 860) and the Phase II finalrule (69 FR 16071), we interpret the selfreferral prohibition in a manner that is consistent with existing Medicare coverage and payment rules. In addition, we believe nuclear medicine services (both diagnostic and therapeutic services and supplies) pose the same risk of abuse that the Congress intended to eliminate for other types of radiology, imaging, and radiation therapy services and supplies. In § 411.351 (Definitions), we would revise the definition of ‘‘ Radiation therapy services and supplies ’’ to remove the language that excluded therapeutic nuclear medicine services and supplies from the definition. We would also revise the definition of ‘‘ Radiology and certain other imaging services ’’ to remove the language that excluded diagnostic nuclear medicine services from the definition. In addition, we would revise the list of radiology services on our website and in annual updates to include CPT and HCPCS codes that include the diagnostic uses of nuclear medicine, and the list of radiation therapy services and supplies to include the therapeutic use of nuclear medicine. For purposes of this proposed rule, we have attached Addendum G, which contains the codes for all diagnostic nuclear medicine procedures, all therapeutic nuclear medicine procedures, and the nuclear medicine radiopharmaceuticals. In the final rule, we intend to include the diagnostic nuclear medicine services in the list of codes for ‘‘ Radiology and Certain Other Imaging Services ’’ and the therapeutic nuclear medicine services in the list of

‘‘ Radiation Therapy Services and Supplies. ’’ Each radiopharmaceutical would be included in each category in which it is used, that is, some may be included in both categories. We welcome comment on whether the list is accurate and complete.

Section 1877(h)(6)(D) of the Act provides that ‘‘ radiology services, including magnetic resonance imaging, computerized axial tomography scans, and ultrasound services ’’ are DHS. We believe it is appropriate to include nuclear diagnostic services as radiology services within the meaning of this

statute.

Dorland ’ s Illustrated Medical Dictionary, 29th Edition, 2000, at 1512, defines radiology as ‘‘ that branch of the health sciences dealing with radioactive substances and radiant energy and with the diagnosis and treatment of disease by means of both ionizing (that is,


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4 The Encyclopaedia Britannica online explains that radiology is a branch of medicine using radiation for the diagnosis and treatment of disease. It states that ‘‘ Radiology originally involved the use of X rays in the diagnosis of disease and the use of X rays, gamma rays, and other forms of ionizing radiation in the treatment of disease. In more recent years radiology has come also to embrace diagnosis by a method of organ scanning with the use of radioactive isotopes and also with non-ionizing radiation, such as ultrasound waves and nuclear magnetic resonance. Similarly, the scope of radiotherapy has extended to include, in the treatment of cancer, such agents as hormones and chemotherapeutic drugs. ’’ ( ‘‘ radiology. ’’ Encyclopaedia Britannica, 2005, Encyclopaedia Britannica Online 3 June 2005 http:// search.ed.com/eb/article?tocid=9062423. ) 

### x-rays) and non-ionizing (that is, ultrasound) radiations. ’’ 4 

### Nuclear medicine uses very small amounts of radioactive materials (radiopharmaceuticals) to diagnose and treat disease. In nuclear imaging, the radiopharmaceuticals are detected by special types of cameras that work with computers to provide very precise pictures about the area of the body being imaged. In treatment or therapy, the radiopharmaceuticals go directly to the organ being treated. The amount of radiation in a typical nuclear imaging procedure is comparable to that received during a diagnostic x-ray. The Society for Nuclear Medicine (SNM) states that the science of nuclear medicine, particularly nuclear medicine imaging, provides physicians with information about both structure and function of certain internal body organs. SNM further states that ‘‘ unlike a diagnostic X-ray where radiation is passed through the body, nuclear medicine tracers are taken internally; external detectors measure the radiation that they emit. ’’ (http://www.snm.org ) The ACR, in its March 26, 2004 letter to us, stated that nuclear medicine is considered a part of the specialty of radiology. It noted that the American Board of Radiology certifies diagnostic radiologists through an examination process that includes nuclear medicine in both the written and oral exams. The AMA also recognizes nuclear medicine as a subspecialty of radiology. The
AMA ’ s ‘‘ Current Procedural Terminology CPT 2005 ’’ , (2004), identifies its ‘‘ Radiology Guidelines (including Nuclear Medicine and Diagnostic Ultrasound) ’’ as CPT codes in the 70000

– 79999 series. In its radiology section, at 273

– 302, the AMA includes both diagnostic imaging procedures (including diagnostic nuclear medicine), and therapeutic procedures. The radiology subsections are as follows: Diagnostic Radiology (Diagnostic Imaging) is comprised of CPT codes 70010

– 76499. Diagnostic Ultrasound is comprised of CPT codes 76506

– 76999. Radiation Oncology is comprised of CPT codes 77261

– 77799. Nuclear Medicine (Diagnostic) is comprised of CPT codes 78000

– 78999, and Nuclear Medicine (Therapeutic) is comprised of CPT codes 79005

– 79999.

We also note that the Medicare statute places diagnostic nuclear medicine in the same category as diagnostic radiology for coverage and payment purposes. That is, we cover diagnostic nuclear medicine under our authority in section 1861(s)(3) of the Act, the same statutory section that authorizes coverage for diagnostic X-rays, CT scans, MRIs, and ultrasound services. In addition, section 1833(t) of the Act sets forth Medicare payment for ‘‘ outpatient hospital radiology services (including diagnostic and therapeutic radiology, nuclear medicine and CAT scan procedures, magnetic resonance imaging, and ultrasound and other imaging services, but excluding screening mammography) ’’ as described in section 1833(a)(2)(E)(i) of the Act.

For these reasons, we believe that the Congress intended ‘‘ radiology services ’’ in section 1877(h)(6) of the Act to include diagnostic and therapeutic nuclear medicine. While we believe that diagnostic nuclear medicine is a subset of radiology, even if it is not, it is an imaging service covered by 1861(s)(3) of the Act, and of the type that the Congress intended to prohibit.

Similarly, we believe it is proper to interpret the DHS category described in section 1877(h)(6)(E) of the Act,

‘‘ radiation therapy services and supplies ’’ to include therapeutic nuclear medicine services. Radiation therapy is the treatment of disease (especially cancer) by exposure to radiation from a radioactive substance. Therapeutic nuclear medicine employs radioactive substances known as radionuclides. Medicare covers therapeutic nuclear medicine services and other forms of radiation therapy under section 1861(s)(4) of the Act, which authorizes coverage and payment for ‘‘ X-ray, radium, and radioactive isotope therapy. ’’

Although our proposal to include as DHS diagnostic nuclear medicine services and therapeutic nuclear medicine services and supplies is based primarily on our view that nuclear medicine services are radiology and radiation therapy within the meaning of section 1877(h)(6) of the Act, we would resolve any doubt on the matter in favor of our proposal because of the risk of abuse and anti-competitive behavior inherent in physician self-referrals for nuclear medicine services. The risk of abuse and anti-competitiveness is exacerbated by the greater affordability of nuclear medicine equipment, by our expansive coverage of nuclear medicine services, and by the setting in which mostly diagnostic and some therapeutic nuclear medicine services now are primarily performed.

At the time we were preparing the Phase I final rule, the vast majority of nuclear medicine procedures werealready subject to the physician selfreferral prohibition because they were primarily performed in hospitalfacilities rather than in physicianowned freestanding facilities. Thus, they were performed as inpatient or outpatient hospital services and were therefore DHS subject to the self-referral prohibition in accordance with section 1877(h)(6)(K) of the Act. Since publication of the Phase I final rule, however, many more nuclear medicine procedures have been performed in physician offices or in physician-owned freestanding facilities. This has occurred for several reasons. First, positron emission tomography (PET) scanners may be used outside of a hospital setting. Second, there have been significant technological advances; an entity does not have to own a particle accelerator to produce the radioactive tracer necessary for a PET scan because a small network of pharmacies now distribute radioactive tracer. Third, our coverage of PET scans has increased dramatically. We began covering PET scans in December 2000. This initial, limited, coverage was for only a few types of cancers. Since December 2001, we have significantly expanded our coverage to include an increased number of cancers and other conditions. In his March 17, 2005 testimony before the Congress concerning imaging services, the Executive Director of the MedPAC noted that diagnostic imaging services paid under Medicare ’ s PFS grew more rapidly than any other type of physician service between 1999 and 2003. Whereas physician services grew 22 percent in those years, imaging services grew twice as fast, by 45 percent. This measure is the growth in the volume and intensity of services per beneficiary. However, not all imaging services grew at that rate, and some grew even faster. Nuclear medicine grew 85 percent between those years (1999 and 2003).

Under Medicare, almost all imaging services have two distinct parts: (1) The performance of the test; and (2) the interpretation of the results by a physician. If the study is performed in a physician office, the physician submits a TC claim and the interpreting physician submits a PC claim. Tests performed in a hospital result in a facility payment rather than a TC claim.


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Thus, if more imaging services are performed in physician offices, TC claims will increase as a share of all fee schedule imagining claims. An increase in TC claims occurred between 1999 and 2002, which indicates that imaging procedures shifted to physician offices. Because the TC of an imaging service generally is assigned a higher payment rate than the PC, growth of TC claims as a share of all imaging claims leads to additional payments under the PFS. These additional payments accounted for about 20 percent of the growth in the volume and intensity of imaging services between 1999 and 2002 (MedPAC 2004).

Recent studies and articles indicate that risk of abuse for radiology services (and diagnostic nuclear medicine) will continue if not specifically prohibited. The Journal of Radiology reported what happened after a managed care organization halted reimbursement to non-radiologists for some forms of imaging (other than CT scans, MRIs, sonography or nuclear medicine) but left the physicians free to refer their patients to radiologists if they believe the imaging they had been conducting on their patients was needed. The following specialties were not allowed to perform any imaging services: Gastroenterologists, general surgeons, nephrologists, neurosurgeons, oncologists, pediatric surgeons, and physiatrists. The study found that imaging declined 20 to 25 percent from what was expected given the previous trend of imaging growth, and an absolute decline of 6 percent. Prior to these prohibitions, non-radiologists were performing 39 percent of outpatient radiographs. The 20 to 25 percent decline from the trend was roughly half of this 39 percent initial share. That is, the research showed that approximately half of the imaging performed by self-referrers ceased when these self-referrers lost their financial interest in the services. (The Effect of Imaging Guidelines on the Number and Quality of Outpatient Radiographic
Examinations. AJR 2000; 175:9

– 15. Harold Moskowitz, Jonathan Sunshine, Donald Grossman, Leslie Adams, Lynn Gelinas. See also Recent Rapid Increase in Utilization of Radionuclide Myocardial Perfusion Imaging and Related Procedures; 1996

– 1998 Practice
Patterns. Radiology 2002; 222:144

– 148. David C. Levin, MD, Laurence Parker, PhD, Charles M. Intenzo, MD, Jonathan H. Sunshine, PhD.) (Growth in utilization of Radionuclide Myocardial Perfusion Imaging (MPI) between 1996 and 1998 was almost 10 times higher among cardiologists than radiologists). Although the Moskowitz study did not include nuclear imaging, we do not see a basis for assuming that physician behavior would be different for nuclear imaging than it is for other imaging services. To the contrary, we believe financial relationships related to diagnostic and therapeutic nuclear medicine, including joint ventures and leases, pose a risk of anti-competitive behavior and risk of abuse comparable to that associated with investment interests in CT, MRI, ultrasound, other radiology ventures, and radiation therapy facilities.

Thus, we believe our proposal to include nuclear medicine as a DHS is consistent with the intent of the Congress to prevent over-utilization of health care services covered by Medicare and to prohibit physicians from selecting treatment modalities based on financial incentives.

We have been told that consultants and others have been actively encouraging physicians to participate in joint ventures to purchase diagnostic nuclear medicine machines for investment because Phase I did not include nuclear medicine services. We have received many inquiries from physicians and attorneys asking whether physician ownership of, and referral to, nuclear medicine facilities complies with the physician self-referral provisions. We are mindful that our previous guidance, particularly that provided in the Phase I final rule, may have encouraged physician investment in nuclear medicine equipment and ventures, particularly PET scanners, which are very expensive and often require a substantial financialinvestment on the part of physicianowners. We are aware that including nuclear medicine services as DHS will require that physician-investors in nuclear medicine equipment (including PET scanners) divest their ownership or investment interests or be precluded from submitting claims to Medicare or billing the beneficiary or any entity for the nuclear medicine DHS referred by physician-owners and performed with the physician-owned equipment (unless the arrangement falls within an exception to section 1877 of the Act).

We are soliciting comments as to whether, or how, to minimize the impact on physicians who are currently parties to arrangements that involve nuclear medicine services and supplies (that is, by specifying a delayed effective date or by grandfathering certain arrangements).

Q. Sustainable Growth Rate [If you choose to comment on issues in this section, please include the caption ‘‘ SGR ’’ at the beginning of your comments.]

1. Current Estimate

Sections 1848(d) and (f) of the Act require the Secretary to set the physician fee schedule update under the SGR system. We are currently forecasting an update of

¥ 4.3 percent for 2006, and anticipate further negative updates in later years. As in the past, we will include a complete discussion of our methodology for calculating the SGR in the final rule.

Underlying the projected rate reductions is substantial growth in Medicare spending. The vast majority of spending growth in 2004 is attributable to the following five areas:

• An increase in spending for office visits, with a shift toward longer and
more intense visits.

• Greater utilization of minor procedures, including physical therapy and drug administration.

• More patients receiving more frequent and more complex imaging services, such as MRIs and echocardiograms.

• More laboratory and other physician-ordered tests.

• Higher utilization of physicianadministered prescription drugs.

We would like to understand these trends further, including which changes in utilization are likely to be associated with important health improvements and which ones may have more questionable health benefits. Consequently, we have had discussions on these topics with numerous physician and nonphysician groups, as well as other Medicare stakeholders such as the Congress and the Medicare Payment Advisory Commission (MedPAC).

The AMA has provided us with several illustrations of recent trends in medical practice that it believes contribute to the overall growth in spending on physicians ’ services. For example, the AMA points out that some payers are encouraging physicians to determine the left ventricular valve function of their patients with congestive heart failure using an echocardiogram. Also, five years ago, statin therapy to lower cholesterol levels was only recommended for patients as old as 79. Now, patients as old as 86 may receive statin therapy, resulting in additional laboratory tests.

The AMA provided many other examples, and we are evaluating them to better understand their impact on physician spending. With regard to the specific examples mentioned above, we agree the utilization of these services has increased. However, in the case of


## 45857 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

echocardiograms, the 19 percent rate of increase from 2003 to 2004 is similar to the increase observed for all imaging services. There was also a 17 percent rate of increase in laboratory tests (lipid panels) consistent with more patients receiving statin therapy (new prescriptions require more frequent visits and more lab tests). However, total spending for the service was only $42 million.

2. Ongoing Issues

In addition to providing adequate payments, Medicare ’ s physician payment system should encourage physicians to provide quality care and prevent avoidable health care costs. We support MedPAC ’ s recommendation for the development of measures related to the quality and efficiency of care furnished by physicians. Physicians ’ decisions are central to the health care their patients receive, and there are substantial variations across geographic areas and among similar specialties in the use of services, including those accounting for most of the spending growth. We want to work with physicians in this effort to better understand the consequences of these differences in the use of follow-up visits, imaging procedures, laboratory testing, minor therapeutic procedures, and physician-administered drugs for the health of beneficiaries, and to identify ways to provide better support for utilization decisions that clearly increase the quality of care while avoiding unnecessary costs for beneficiaries and the Medicare program.

We are already engaged with the physician community in developing useful quality measures, and we expect to intensify these efforts given the rapid growth in spending. As an early step in using such measures to improve care, we are now exploring means of sharing information related to quality of care and use of resources with individual physicians. We anticipate that only data showing the quality of care and resource use in the aggregate would be released to the public. Some measures can be derived from claims data with little or no collection burden (for example, information on the frequency and complexity of minor therapy procedures, imaging procedures, lab test, and visits for their patients with chronic illnesses.) We believe that by providing feedback to physicians individually and by working with physician groups to understand and respond to the overall trends, we can provide more useful information and support physicians ’ efforts to run more efficient practices. Finally, we continue to work closely with the medical community, Congress, MedPAC, and others toward a long-term approach ensuring adequate physician payments in the future while also ensuring Medicare ’ s payments are made only for care that is necessary and beneficial. We are particularly interested in comments that build on recent progress on payment reforms to promote higher quality and avoid unnecessary costs, and that are consistent with the President ’ s budgetary goal of paying for better value in Medicare without increasing overall Medicare costs. For example, we areinterested in ways to promote higherquality ambulatory care that can achieve offsetting savings by avoiding complications or unnecessary services. In addition, it has been suggested that we have the authority to make certain administrative adjustments in the SGR methodology, such as removing Part B drug payments from the calculation of both projected and actual expenditures (retroactive to 1996) that are used to set the spending target. We encourage comments regarding possible changes to the SGR methodology, including the legal theories that support them. We are particularly interested in comments on steps to promote physician payment adequacy without increasing overall Medicare costs.

III. Collection of Information Requirements

Under the Paperwork Reduction Act of 1995, we are required to provide 60- day notice in the Federal Register and solicit public comment before a collection of information requirement is submitted to the Office of Management and Budget (OMB) for review and approval. In order to fairly evaluate whether an information collection should be approved by OMB, section 3506(c)(2)(A) of the Paperwork Reduction Act of 1995 requires that we solicit comment on the following issues:

• The need for the information collection and its usefulness in carrying out the proper functions of our agency.

• The accuracy of our estimate of the information collection burden.

• The quality, utility, and clarity of the information to be collected.

• Recommendations to minimize the information collection burden on the affected public, including automated collection techniques.

We are soliciting public comment on each of these issues for the following sections of this document that contain information collection requirements: Section 413.180 Procedures for Requesting Exceptions to Payment Rates

Paragraph (b) specifies the criteria for a pediatric ESRD facility requesting an exception to payment rates.

Paragraph (e) outlines the documentation that a pediatric ESRD facility must submit to CMS when requesting an exception to its payment rates. Paragraph (i) discusses the period of approval for payment exception requests. A prospective exception payment rate approved by CMS applies for the period from the date the complete exception request was filed with its intermediary until thirty days after the intermediary ’ s receipt of the facility ’ s letter notifying the intermediary of the facility ’ s request to give up its exception rate.

The burden associated with the requirements in paragraph (e) is the time and effort required by the facility to prepare and submit the exception request to CMS. The burden associated with the requirement in paragraph (i) is the time and effort required by the facility to draft and mail the letter that notifies the intermediary of the facilities request to give up its exception rate.

The collection requirement in this section has not changed. While this requirement is subject to the PRA, this requirement is currently approved in
OMB No. 0938

–0296.
Section 413.184 Payment Exception: Pediatric Patient Mix

Paragraph (b) specifies the documentation requirements that a pediatric ESRD facility must meet in order to qualify for an exception to its prospective payment rate based on its pediatric patient mix. In addition to the other qualifications specified in this section, this section states that a facility must submit a listing of all outpatient dialysis patients (including all home patients) treated during the most recently completed and filed cost report.

The burden associated with this requirement is the time and effort for the facility to submit a listing of all outpatient dialysis patients (including all home patients) treated during the most recently completed and filed cost report.

The collection requirement in this section has not changed. While this requirement is subject to the PRA, this requirement is currently approved in
OMB No. 0938

–0296.
Section 413.186 Payment Exception: Self-Dialysis Training Costs in Pediatric Facilities

In summary, this section outlines the requirements a pediatric ESRD facility


## 45858 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

must meet to qualify for an exception to the prospective payment rate based on self-dialysis training costs. Paragraph (e) states that a facility must provide specific information to support its exception request. Paragraph (f) states that in addition to the other qualifications outlined in this section, pediatric ESRD facility must submit with its exception request a list of patients, by modality, trained during the most recent cost report period, in order to justify its accelerated training exception request.

The burden associated with these requirements is the time and effort for the facility to prepare and submit the required information to support its exception request, and the time and effort for the pediatric ESRD facility to prepare and submit with its exception request a list of patients, by modality, trained during the most recent cost report period.

The collection requirements in this section have not changed. While these requirements are subject to the PRA, they are currently approved in OMB No.

0938

–0296. Section 414.804 Basis of Payment

In summary, this section requires manufacturers to report ASP data to CMS. This section details the process a manufacturer must follow to calculate the ASP. The ASP reporting requirements are discussed in further detail in the interim final rule with comment, Medicare Program; Manufacturer Submission of Manufacturer ’ s Average Sales Price (ASP) Data for Medicare Part B Drugs and Biologicals, that published on April 2, 2004 in the Federal Register (69FR17935

– 17941).

The burden associated with these requirements is the time and effort required by manufacturers of Medicare Part B Drugs and biologicals to prepare and submit to the required ASP data to
CMS.

While these requirements are subject to the PRA, the requirements are currently approved in OMB No. 0938

– 0921, with a current expiration date of September 30, 2007.

We intend to revise this information collection to include adequate instructions for manufacturers to report the ASP, the WAC, and other data elements. These revisions will be addressed in detail in a revised information collection request in accordance with the Paperwork Reduction Act of 1995.

We have submitted a copy of this proposed rule to OMB for its review of the information collection requirements described above. These requirements are not effective until they have been approved by OMB.

If you comment on these information collection and recordkeeping requirements, please mail copies directly to the following:

Centers for Medicare & Medicaid Services, Office of Strategic Operations and Regulatory Affairs, Regulations Development Group, Attn: Jim Wickliffe, [CMS

– 1502

–P], Room C4

– 26

– 05, 7500 Security Boulevard, Baltimore,
MD 21244

– 1850; and

Office of Information and Regulatory Affairs, Office of Management and Budget, Room 10235, New Executive Office Building, Washington, DC 20503, Attn: Christopher Martin, CMS Desk Officer, CMS

– 1502

–P, Christopher

_Martin@omb.eop.gov. Fax (202) 395

–6974.
IV. Response to Comments

Because of the large number of public comments we normally receive on Federal Register documents, we are not able to acknowledge or respond to them individually. We will consider all comments we receive by the date and time specified in the **DATES** 

### section of this preamble, and, when we proceed with a subsequent document, we will respond to the comments in the preamble to that document.
V. Regulatory Impact Analysis [If you choose to comment on issues in this section, please include the caption

‘‘ IMPACT ’’ at the beginning of your comments.]

We have examined the impact of this rule as required by Executive Order 12866 (September 1993, Regulatory Planning and Review), the Regulatory Flexibility Act (RFA) (September 16, 1980 Pub. L. 96

– 354), section 1102(b) of the Social Security Act, the Unfunded Mandates Reform Act of 1995 (Pub. L.

104

–4), and Executive Order 13132.

Executive Order 12866 (as amended by Executive Order 13258, which merely reassigns responsibilities of duties) directs agencies to assess all costs and benefits of available regulatory alternatives and, when regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects, distributive impacts, and equity). A regulatory impact analysis must be prepared for proposed rules with economically significant effects (that is, a proposed rule that would have an annual effect on the economy of $100 million or more in any one year, or would adversely affect in a material way the economy, a sector of the economy, productivity, competition, jobs, the environment, public health or safety, or State, local, or tribal governments or communities). As indicated in more detail below, we estimate that the PFS provisions included in this proposed rule will redistribute more than $100 million in one year. We are considering this proposed rule to be economically significant because its provisions are estimated to result in an increase, decrease or aggregate redistribution of Medicare spending that will exceed $100 million. Therefore, this proposed rule is a major rule and we have prepared a regulatory impact analysis.

The RFA requires that we analyze regulatory options for small businesses and other entities. We prepare a regulatory flexibility analysis unless we certify that a rule would not have a significant economic impact on a substantial number of small entities. The analysis must include a justification concerning the reason action is being taken, the kinds and number of small entities the rule affects, and an explanation of any meaningful options that achieve the objectives with less significant adverse economic impact on the small entities.

Section 1102(b) of the Act requires us to prepare a regulatory impact analysis for any proposed rule that may have a significant impact on the operations of a substantial number of small rural hospitals. This analysis must conform to the provisions of section 603 of the RFA. For purposes of section 1102(b) of the Act, we define a small rural hospital as a hospital that is located outside a Metropolitan Statistical Area and has fewer than 100 beds. We have determined that this proposed rule would have minimal impact on small hospitals located in rural areas. Of 213 hospital-based ESRD facilities located in rural areas, only 40 are affiliated with hospitals with fewer than 100 beds.

For purposes of the RFA, physicians, nonphysician practitioners, and suppliers are considered small businesses if they generate revenues of $6 million or less. Approximately 95 percent of physicians are considered to be small entities. There are about 875,000 physicians, other practitioners and medical suppliers that receive Medicare payment under the PFS.

For purposes of the RFA, approximately 90 percent of suppliers of durable medical equipment (DME) and prosthetic devices are considered small businesses according to the Small Business Administration ’ s (SBA) size standards. We estimate that 106,000 entities bill Medicare for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) each year. Total annual estimated Medicare


## 45859 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

revenues for DME suppliers exceed approximately $8.5 billion in 2004. Of this amount, approximately $1.4 billion were for nebulizer drugs in 2004. The vast majority, 95 percent, of retail pharmacy companies are small businesses as measured by the SBA size standard. Approximately, 16,000 pharmacies billed Medicare for immunosuppressive, oral anti-cancer, or oral anti-emetic drugs in 2004. Pharmacies received Medicare revenues for those drugs of approximately $350 million in 2004.

In addition, most ESRD facilities are considered small entities, either based on nonprofit status or by having revenues of $29 million or less in any year. We consider a substantial number of entities to be affected if the proposed rule is estimated to impact more than 5 percent of the total number of small entities. Based on our analysis of the 896 nonprofit ESRD facilities considered small entities in accordance with the above definitions, we estimate that the combined impact of the proposed changes to payment for renal dialysis services included in this proposed rule would have a 1.3 percent increase in overall payments relative to current overall payments.

The analysis and discussion provided in this section, as well as elsewhere in this proposed rule, complies with the RFA requirements.

Section 202 of the Unfunded Mandates Reform Act of 1995 also requires that agencies assess anticipated costs and benefits before issuing any rule that may result in expenditures in any year by State, local, or tribal governments, in the aggregate, or by the private sector, of $110 million. Medicare beneficiaries are considered to be part of the private sector for this purpose.

We have examined this proposed rule in accordance with Executive Order 13132 and have determined that this regulation would not have any significant impact on the rights, roles, or responsibilities of State, local, or tribal governments. A discussion concerning the impact of this rule on beneficiaries is found later in this section.

We have prepared the following analysis, which, together with the information provided in the rest of this preamble, meets all assessment requirements. It explains the rationale for and purposes of the rule; details the costs and benefits of the rule; analyzes alternatives; and presents the measures we propose to use to minimize the burden on small entities. As indicated elsewhere in this proposed rule, we propose to change our methodology for calculating resource-based practice expense RVUs and make a variety of other changes to our regulations, payments, or payment policies to ensure that our payment systems reflect changes in medical practice and the relative value of services. We provide information for each of the policy changes in the relevant sections of this proposed rule. We are unaware of any relevant Federal rules that duplicate, overlap or conflict with this proposed rule. The relevant sections of this proposed rule contain a description of significant alternatives if applicable.

A. Resource-Based PE RVUs

Table 30 below shows the specialty level impact on payment of changes to the PE methodology being proposed for CY 2006. The columns in the table demonstrate the estimated impacts on payments (relative to estimated 2006 payments, absent any adjustment for inflation or utilization) during each year of the transition. For example, the first column displays the impact of blending 25 percent of the PE RVUs calculated using the methodology we are proposing with current PE RVUs. The percent of the RVUs based on the proposed method increase until the transition is complete in 2009.

Our estimates of changes in physician Medicare revenues for PFS services compare payment rates for CY 2006 with payment rates for CY 2005 using CY 2004 Medicare utilization for both years. In general, updating the utilization data has little or no impact on total payments to a specialty, but the practice expense values for a new code may change because we did not initially have Medicare utilization data to determine the specialty mix for the service. In these cases, we either assigned the code to a particular specialty ’ s practice expense pool based on the specialty most likely to provide the service, or we used the ‘‘ all physician ’’ practice expense pool to determine the code ’ s practice expense RVUs. While we try to minimize instability in the practice expense RVUs for new services by assigning the specialty that is most likely to perform the service until such time as we have actual utilization data, the addition of actual utilization data may still result in some change to the practice expense RVUs during the first few years a code
is in existence.

The estimated payment impacts reflect the averages for each specialty based on Medicare utilization. To the extent that there are year-to-year changes in the volume and mix of services provided by a specialty, the actual impact on total Medicare revenues may be different than those shown here. Also, the payment impact for an individual physician may be different from the specialty average impact, based on the mix of services the physician provides. Because physicians, practitioners and suppliers, furnishservices to both Medicare and nonMedicare patients and they may receive substantial Medicare revenues for services that are not paid under the PFS, the average change in total revenues for any specialty, practitioner or supplier, would be less than the impacts displayed here. For instance, independent laboratories receive approximately 80 percent of their Medicare revenues from clinical laboratory services that are not paid under the PFS. The table shows only the payment impacts on PFS services.

We modeled the impact of the proposed changes to the practice expense methodology and illustrated the effect in Table 30 below.



### TABLE 

### 30.

— I MPACT OF 

### P RACTICE 

### E XPENSE 

### C HANGES ON 

### TOTAL 

### M EDICARE 

### A LLOWED 

### C HARGES BY 

### P HYSICIAN



### , P RACTITIONER AND 

### S UPPLIER 

### S UBCATEGORY

Specialty 2006 (25% Blend) 2007 (50% Blend) 2008 (75% Blend) 2009 (100% Blend)

Physicians: Allergy/Immunology .................................................................................. 0.6% 1.1% 1.7% 2.3% Anesthesiology .........................................................................................

¥ 0.7%

¥ 1.5%

¥ 2.2%

¥ 2.9% Cardiac Surgery ........................................................................................

¥ 1.0%

¥ 2.0%

¥ 2.9%

¥ 3.9% Cardiology .................................................................................................

¥ 0.5%

¥ 1.1%

¥ 1.6%

¥ 2.1% Colon and Rectal Surgery ........................................................................ 0.7% 1.5% 2.2% 3.0%
Critical Care ..............................................................................................

¥ 0.3%

¥ 0.5%

¥ 0.8%

¥ 1.0% Dermatology ............................................................................................. 4.1% 8.4% 12.8% 17.5%


## 45860 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

TABLE 

### 30.

— I MPACT OF 

### P RACTICE 

### E XPENSE 

### C HANGES ON 

### TOTAL 

### M EDICARE 

### A LLOWED 

### C HARGES BY 

### P HYSICIAN



### , P RACTITIONER AND 

### S UPPLIER 

### S UBCATEGORY



### —Continued

Specialty 2006 (25% Blend) 2007 (50% Blend) 2008 (75% Blend) 2009 (100% Blend)

Emergency Medicine ................................................................................

¥ 0.4%

¥ 0.8%

¥ 1.3%

¥ 1.7% Endocrinology ...........................................................................................

¥ 0.5%

¥ 1.0%

¥ 1.5%

¥ 1.9% Family Practice ......................................................................................... 0.1% 0.1% 0.2% 0.2% Gastroenterology ...................................................................................... 1.4% 2.8% 4.3% 5.7% General Practice ....................................................................................... 0.2% 0.3% 0.5% 0.7% General Surgery ....................................................................................... 0.2% 0.3% 0.5% 0.6% Geriatrics ..................................................................................................

¥ 0.2%

¥ 0.5%

¥ 0.7%

¥ 1.0% Hand Surgery ...........................................................................................

¥ 0.5%

¥ 1.0%

¥ 1.5%

¥ 1.9% Hematology/Oncology .............................................................................. 0.4% 0.7% 1.1% 1.4% Infectious Disease ....................................................................................

¥ 0.1%

¥ 0.2%

¥ 0.2%

¥ 0.3% Internal Medicine ......................................................................................

¥ 0.1%

¥ 0.3%

¥ 0.4%

¥ 0.6% Interventional Radiology ........................................................................... 0.2% 0.5% 0.7% 0.9% Nephrology ...............................................................................................

¥ 0.2%

¥ 0.4%

¥ 0.6%

¥ 0.8% Neurology .................................................................................................

¥ 0.6%

¥ 1.1%

¥ 1.7%

¥ 2.2% Neurosurgery ............................................................................................

¥ 0.7%

¥ 1.4%

¥ 2.0%

¥ 2.7% Nuclear Medicine ......................................................................................

¥ 0.3%

¥ 0.5%

¥ 0.8%

¥ 1.0% Obstetrics/Gynecology .............................................................................. 0.0% 0.1% 0.1% 0.2% Ophthalmology ..........................................................................................

¥ 1.1%

¥ 2.2%

¥ 3.3%

¥ 4.4% Orthopedic Surgery ..................................................................................

¥ 0.4%

¥ 0.7%

¥ 1.1%

¥ 1.5% Otolaryngology ..........................................................................................

¥ 0.6%

¥ 1.1%

¥ 1.7%

¥ 2.2% Pathology .................................................................................................. 1.3% 2.6% 3.9% 5.3% Pediatrics .................................................................................................. 0.1% 0.2% 0.3% 0.5% Physical Medicine .....................................................................................

¥ 0.5%

¥ 1.1%

¥ 1.6%

¥ 2.1% Plastic Surgery ......................................................................................... 0.1% 0.1% 0.2% 0.3% Psychiatry ................................................................................................. 0.0% 0.1% 0.1% 0.1% Pulmonary Disease ..................................................................................

¥ 0.2%

¥ 0.4%

¥ 0.6%

¥ 0.7% Radiation Oncology .................................................................................. 1.9% 3.9% 5.8% 7.9% Radiology .................................................................................................. 0.4% 0.8% 1.2% 1.7% Rheumatology ...........................................................................................

¥ 0.9%

¥ 1.8%

¥ 2.7%

¥ 3.6% Thoracic Surgery ......................................................................................

¥ 0.8%

¥ 1.5%

¥ 2.3%

¥ 3.0% Urology ..................................................................................................... 1.8% 3.6% 5.5% 7.3% Vascular Surgery ...................................................................................... 0.5% 0.9% 1.4% 1.9%
Practitioners: Audiologist ................................................................................................

¥ 5.8%

¥ 11.3%

¥ 16.5%

¥ 21.3% Chiropractor ..............................................................................................

¥ 1.3%

¥ 2.7%

¥ 4.0%

¥ 5.3% Clinical Psychologist .................................................................................

¥ 0.6%

¥ 1.1%

¥ 1.7%

¥ 2.2% Clinical Social Worker ...............................................................................

¥ 0.6%

¥ 1.2%

¥ 1.8%

¥ 2.4% Nurse Anesthetist .....................................................................................

¥ 0.4%

¥ 0.8%

¥ 1.2%

¥ 1.6% Nurse Practitioner ..................................................................................... 0.1% 0.1% 0.2% 0.2% Optometry .................................................................................................

¥ 0.8%

¥ 1.6%

¥ 2.4%

¥ 3.1% Oral/Maxillofacial Surgery ......................................................................... 0.8% 1.6% 2.4% 3.2% Physical/Occupational Therapy ................................................................ 1.5% 2.9% 4.4% 6.0% Physician Assistants ................................................................................. 0.0% 0.1% 0.1% 0.2% Podiatry ..................................................................................................... 1.3% 2.6% 3.9% 5.3% Suppliers: Diagnostic Testing Facility ........................................................................

¥ 2.4%

¥ 4.7%

¥ 7.0%

¥ 9.2% Independent Laboratory ........................................................................... 6.4% 13.1% 20.3% 28.0% Portable X-Ray Supplier ........................................................................... 0.4% 0.8% 1.1% 1.5%



### The table shows the effect of the proposed refinements to the PE methodology. As described in section II.A.2. in the preamble of this proposed rule, we are proposing to use the updated practice expense per hour data from the accepted supplementary surveys only in the calculation of indirect PE, and to utilize a ‘‘ bottomup ’’ methodology to calculate direct PE.

Even if no other changes were made to our PE calculation methodology, a significant redistribution of PE RVUs would still be produced by the acceptance of the supplementary PE surveys from seven specialties and the corresponding increases in the direct and indirect PE per hour for these specialties. As noted in the preamble discussion regarding our proposal to change the PE methodology, the nonphysician work pool was created to protect codes without physician work components until further refinement could occur. Removing these codes from the nonphysician work pool generally has a negative impact on these codes (although we note that we have consistently indicated this methodology was an interim approach until we had better data available). In addition, the limited number of codes remaining in the nonphysician work pool would also experience significant impacts. Eliminating the nonphysician work pool would generally negatively impact these codes remaining in the pool (for example, certain codes used by audiology and portable x-ray suppliers). We believe that much of this impact is due to the change in the scaling of the inputs when codes move from the nonphysician work pool to the individual specialty pool.

We believe that, in addition to the increased accuracy and simplicity that result from using a ‘‘ bottom-up ’’ approach for direct costs, this proposed approach also helps mitigate some of the potentially inequitable redistribution of practice expense RVUs


## 45861 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

resulting from the acceptance of new specialty-specific survey data. However, several of the impacts that are shown require further consideration.

Audiology is clearly negatively impacted when its services are removed from the nonphysician work pool, though the impact is cut nearly in half when the ‘‘ bottom-up ’’ approach is used for the direct costs. This impact is in large part driven by the decrease in the PE RVUs for audiology CPT codes 92557, 92567 and 92588, which we believe may now be more appropriately priced in our proposal than they were in the nonphysician work pool that uses historic charge-based RVUs to determine the direct practice expense for a service. However, we would welcome discussions with audiologists regarding this impact, so that we can ensure that the relative costs are reflected appropriately.

Despite submitting a supplementary survey that showed higher PE costs per hour, cardiology is shown to have an impact of

¥ 2.1 percent in the last column of Table 30. This is largely due to the decrease in direct PE for several high-volume services resulting from the adoption of the ‘‘ bottom up ’’ approach. For example, the RVUs for the complete electrocardiogram service, CPT code 93000, decline by 43 percent. The RVUs for multiple 3-D heart imaging, CPT Code 78465, decline by 32 percent. However, it should be noted that, if the new survey data had not been used to calculate indirect PE, cardiology would have had a significantly larger (11 percent) negative impact. Both physical/occupational therapy and independent laboratory show significant positive impacts in the last column of 6.0 and 28.0 percent, respectively. For therapy services, we had previously applied an adjustment that assigned all therapy services the therapy practice expense per hour, even when billed by specialties with higher costs. Under the top-down methodology, this adjustment was applied to both direct and indirect costs. However, under our proposed methodology, the practice expense per hour data would not be used to calculate direct expenses and this would eliminate the adjustment for direct practice expense costs.

The total CPEP/RUC dollars for supplies and equipment for the services performed by independent laboratories are significantly higher than the aggregate dollars shown by the recent supplementary survey for these costpools. Therefore, under the current topdown methodology, the CPEP/RUC dollars are scaled down to equal the survey dollars, and the practice expense RVUs are consequently reduced. Under our proposed methodology, the direct costs would no longer be scaled, resulting in higher practice expense RVUs for these services. (This also results in a positive 5.2 percent impact for pathologists, who also perform these services.) Although, as discussed above, we generally believe the refined CPEP/ RUC data to be more accurate for calculating direct costs than the SMS or supplementary survey data, we are concerned that there is such a discrepancy between the refined direct cost inputs and a recent survey. We will want to discuss this issue with both the specialty and the RUC to ensure that the refined CPEP/RUC data accurately reflect the typical resources needed for these services. However, as we indicated above, independent laboratories receive only approximately 20 percent of their total Medicare revenues from PFS services, and there should not be significant impact on other specialties from this increase for independent laboratory services.

As discussed in section II.C. of this proposed rule, we are proposing technical changes to the calculation of the malpractice RVUs. We are proposing to remove the malpractice data for specialties that occur less than 5 percent of the time in our data for a procedure code. In addition, the RUC practice liability workgroup has written to us recommending several changes to the crosswalks used to assign risk factors to specialties for which we did not have data otherwise. We are proposing to accept these recommendations, and, as also recommended, we are proposing to use the lowest risk factor of 1.00 for specialties such as clinical psychology, licensed clinical social work, chiropractors, and physical therapists. We are also proposing to add cardiology catheterization and angioplasty codes to the list of codes for which we apply surgical rather than nonsurgical risk adjustment factors. Table 31 below shows the impacts of these proposed changes. Because the malpractice RVUs account for less than 4 percent of total payments, the overall impacts on any particular specialty are negligible.



### TABLE 31.

—S PECIALTY 

### I MPACT OF 

### M ALPRACTICE 

### RVU C HANGES

Speciality Impact of removing aberrant malpractice data

(percent) Impact of crosswalkchanges (percent) Combined impacts * (percent)

Physicians: Allergy/Immunology ............................................................................................................. . 0.0 0.0 0.0 Anesthesiology ................................................................................................................. .... 0.0 0.0

¥ 0.1 Cardiac Surgery ................................................................................................................ .... 0.2 0.1 0.2 Cardiology ..................................................................................................................... ........ 0.0 0.1 0.1 Colon and Rectal Surgery .................................................................................................... 0.00.0 0.0 Critical Care .................................................................................................................. ........ 0.0 0.0 0.0 Dermatology ....................................................................................................................

..... ¥ 0.1 0.0

¥ 0.1 Emergency Medicine ............................................................................................................ 0 .0 0.0 0.0 Endocrinology .................................................................................................................. ..... 0.0 0.0 0.0 Family Practice ................................................................................................................ ..... 0.0 0.0 0.0 Gastroenterology ............................................................................................................... ... 0.0 0.0 0.0 General Practice ............................................................................................................... .... 0.0 0.0 0.0 General Surgery ................................................................................................................ ... 0.0 0.0 0.1 Geriatrics ..................................................................................................................... ......... 0.0 0.0 0.0 Hand Surgery ................................................................................................................... .... 0.1 0.0 0.1 Hematology/Oncology .......................................................................................................... 0. 0 0.0 0.0 Infectious Disease ............................................................................................................. ... 0.0 0.0 0.0
Internal Medicine .............................................................................................................. .... 0.0 0.0 0.0 Interventional Radiology .......................................................................................................

¥ 0.1 0.0

¥ 0.1


## 45862 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

TABLE 31.

—S PECIALTY 

### I MPACT OF 

### M ALPRACTICE 

### RVU C HANGES



### —Continued

Speciality Impact of removing aberrant malpractice data

(percent) Impact of crosswalkchanges (percent) Combined impacts * (percent)

Nephrology ..................................................................................................................... ...... 0.0 0.0 0.0 Neurology ...................................................................................................................... ....... 0.0 0.0 0.0 Neurosurgery ................................................................................................................... ..... 0.2 0.1 0.2 Nuclear Medicine ...............................................................................................................

... ¥ 0.1 0.0

¥ 0.1 Obstetrics/Gynecology .......................................................................................................... 0.0 0.0 0.0 Ophthalmology .................................................................................................................. .... 0.0 0.0 0.0 Orthopedic Surgery ............................................................................................................. . 0.1 0.0 0.1 Otolaryngology ................................................................................................................. ..... 0.0 0.0 0.0 Pathology ...................................................................................................................... ........ 0.0 0.0 0.0 Pediatrics ..................................................................................................................... ......... 0.0 0.0 0.0 Physical Medicine .............................................................................................................. ... 0.0 0.0

¥ 0.1 Plastic Surgery ................................................................................................................ ..... 0.0 0.0 0.0 Psychiatry ..................................................................................................................... ........ 0.0

¥ 0.1

¥ 0.1 Pulmonary Disease .............................................................................................................. 0.0 0.0 0.0 Radiation Oncology ............................................................................................................. . 0.0 0.0 0.0 Radiology ...................................................................................................................... ........ 0.0 0.0 0.0 Rheumatology ................................................................................................................... .... 0.0 0.0 0.0 Thoracic Surgery ............................................................................................................... ... 0.2 0.0 0.2 Urology ........................................................................................................................ ......... 0.0 0.0 0.0 Vascular Surgery ............................................................................................................... ... 0.0 0.0 0.0 Practitioners: Audiologist .................................................................................................................... ........ 0.0 0.0 0.0 Chiropractor ................................................................................................................... ....... 0.0

¥ 0.5

¥ 0.6 Clinical Psychologist .......................................................................................................... ... 0.0 0.0

¥ 0.3 Clinical Social Worker ......................................................................................................... . 0.0 0.0

¥ 0.4 Nurse Anesthetist .............................................................................................................. ... 0.0

¥ 0.2 0.0 Nurse Practitioner ............................................................................................................. .... 0.0 0.0 0.0 Optometry ...................................................................................................................... ....... 0.0

¥ 0.1 0.0 Oral/Maxillofacial Surgery ..................................................................................................... 0.0 0.0 0.0 Physical/Occupational Therapy ............................................................................................ 0.0 0. 0

¥ 0.5 Physician Assistants ........................................................................................................... .. 0.0 0.0 0.0 Podiatry ....................................................................................................................... .......... 0.2 0.0 0.0 Suppliers: Diagnostic Testing Facility .................................................................................................... 0.0 0.0 0.0 Independent Laboratory ....................................................................................................... 0. 0 0.0 0.0 Portable X-Ray Supplier ....................................................................................................... 0 .0 0.0 0.0

*Sum of the columns may be different due to rounding.



### As discussed in section II.J. of this proposed rule, we are proposing to reduce payments for technical components of certain multiple imaging procedures performed in the same session within the same imaging families. In order to calculate the impact of this proposed change, we examined 2004 PFS carrier claims processed through March 31, 2005. We extracted all claims that were billed on the same day, for the same beneficiary, at the same provider, for multiple diagnostic imaging procedures within the same family of codes. For each subset of claims, the procedures were arrayed based on the pricing of the technical component of these services. We simulated the effect of the multiple procedure payment reduction by accounting for 100 percent of the highest priced technical component, and 50 percent of all other technical components. Note that if the procedure was billed globally, the professional component was always calculated at 100 percent of the professional component (modifier

– 26) value.

The simulated total allowed charges for each family of codes includes all global, technical, and professional utilization for the family of codes (for example, the sum of claims where the multiple procedure payment reduction would have been in effect, in addition to claims that would not have been subject to the multiple procedure payment reduction). These simulated totals were then compared to the actual allowed charges for each family of codes within the same time period to calculate the impacts of the proposed change.

Table 32 below shows the actual 2004 allowed charges by family of imaging procedures and lists the percentage impact by family if this proposed policy had been in effect. Family 2 has the largest (

¥ 18.9 percent) impact, while Family 11 has the smallest (

¥ 1.3 percent) impact.



### TABLE 

### 32.

— I MPACT OF 

### M ULTIPLE 

### P ROCEDURE 

### R EDUCTION FOR 

### D IAGNOSTIC 

### I MAGING BY 

### FAMILY OF 

### I MAGING 

### S ERVICES

Family Description of family of imaging procedures 2004 Medicare allowed

charges ($ in millions) Percentage impact (percent)

01 ........... Ultrasound (Chest/Abdomen/Pelvis

— Non-Obstetrical ............................................................................ $138

¥ 6.8


## 45863 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

TABLE 

### 32.

— I MPACT OF 

### M ULTIPLE 

### P ROCEDURE 

### R EDUCTION FOR 

### D IAGNOSTIC 

### I MAGING BY 

### FAMILY OF 

### I MAGING 

### S ERVICES



### — Continued

Family Description of family of imaging procedures 2004 Medicare allowed

charges ($ in millions) Percentage impact (percent)

02 ........... CT and CTA (Chest/Thorax/Abd/Pelvis) .............................................................................. ................... 563

¥ 18.9 03 ........... CT and CTA (Head/Brain/Orbit/Maxillofacial/Neck) .................................................................. .............. 97

¥ 2.6 04 ........... MRI and MRA (Chest/Abd/Pelvis) .................................................................................... ...................... 105

¥ 4.7 05 ........... MRI and MRA (Head/Brain/Neck) ..................................................................................... ...................... 532

¥ 6.2 06 ........... MRI and MRA (spine) ............................................................................................... .............................. 540

¥ 4.3 07 ........... CT (spine) ........................................................................................................ ....................................... 24

¥ 4.1 08 ........... MRI and MRA (lower extremities) ................................................................................... ........................ 166

¥ 3.2 09 ........... CT and CTA (lower extremities) .................................................................................... ......................... 5

¥ 2.0 10 ........... MR and MRI (upper extremities and joints) ......................................................................... ................... 107

¥ 2.7 11 ........... CT and CTA (upper extremities) .................................................................................... ......................... 2

¥ 1.3

Total for all procedures subject to multiple imaging reductions ............................................................. 2,2 76

¥ 8.3



### Using the same data, we also summarized the dollar value of thereductions by specialty. Specialtyspecific percentage impacts were calculated by comparing each specialty ’ s 2004 allowed charges for all Medicare allowed services to the reduced allowed charges that would have occurred had this proposal been in effect. As expected, the most significant impacts occur among radiologists, who would experience a

¥ 2.1 percent impact. Diagnostic testing facilities experience a

¥ 2.9 percent impact. Most other specialties experience a 0.2 percent payment increase as a result of the budget neutrality adjustment. (Because this multiple procedure reduction adjustment would otherwise reduce overall payments by 0.2 percent, it is necessary to include a budget neutrality adjustment to the RVUs, resulting in positive impacts for most specialties.) Table 33 below shows the percentage impact by specialty in combination with other proposed changes.

Table 33 below shows the estimated change in average payments by specialty, nonphysician practitioner, and supplier, resulting from proposed changes to the calculation of practice expense and malpractice RVUs, and the multiple imaging procedure discount. The first column displays Medicare allowed charges during 2004 for each specialty, practitioner, and supplier. The practice expense changes shown in the second column represent the first year impact of a 4-year transition resulting from all practice expense revisions including the adoption of the bottom-up approach and the elimination of the nonphysician work pool. The impact shown is identical to the first column of Table 30. The malpractice impacts shown in the third column are identical to those displayed above in Table 31. The fourth column in Table 33 below demonstrates the impacts for each specialty of the proposed multiple imaging procedure discount. The fifth column shows the combined impact of all proposed changes by specialty.

The largest impacts in this column are attributable to the proposed changes to the PE methodology. The final column includes the current estimate of the 2006 PFS update factor of

¥ 4.3 percent. It also combines the impacts of the previous three columns. In addition, this column reflects the expiration of the transitional adjustment required by section 303 of the MMA for drug administration services. This adjustment was set at 32 percent for 2004 and 3 percent for 2005.

Section 1848(d) and (f) of the Act requires the Secretary to set the PFS update under the SGR system. We are currently forecasting a negative update of

¥ 4.3 percent for 2006 and negative updates for the next few years. As in the past, we will include a complete discussion of our methodology for calculating the SGR in the final rule.



### TABLE 

### 33.

— I MPACT OF 

### P RACTICE 

### E XPENSE 

### , M ALPRACTICE 

### RVU S 

### , M ULTIPLE 

### I MAGING 

### D ISCOUNT



### , AND 

### P HYSICIAN 

### F EE 

### S CHEDULE 

### U PDATE ON 

### TOTAL 

### M EDICARE 

### A LLOWED 

### C HARGES BY 

### P HYSICIAN 

### , P RACTITIONER



### , AND 

### S UPPLIER 

### S UB



### CATEGORY

Specialty Medicare allowed charges for2004 ($ in millions) Impact of PE RVU changes

(percent) Impact of malpractice RVU changes

(percent) Impact ofmultiple imaging discount

(percent) Impact of all proposed changes (percent) Combinedimpact: includes update

and drug admin. trans.

(percent)

Physicians: Allergy\Immunology .......................... $165 0.6 0.0 0.2 0.8

¥ 3.5 Anesthesiology .................................. 1,486

¥ 0.7

¥ 0.1 0.2

¥ 0.6

¥ 4.9 Cardiac Surgery ................................ 385

¥ 1.0 0.2 0.2

¥ 0.5

¥ 4.8 Cardiology ......................................... 7,219

¥ 0.5 0.1 0.2

¥ 0.2

¥ 4.5 Colon and Rectal Surgery ................ 118 0.7 0.0 0.2 1.0

¥ 3.3 Critical Care ...................................... 147

¥ 0.3 0.0 0.2

¥ 0.1

¥ 4.4 Dermatology ...................................... 2,033 4.1

¥ 0.1 0.2 4.2

¥ 0.1 Emergency Medicine ........................ 1,841

¥ 0.4 0.0 0.2

¥ 0.2

¥ 4.5 Endocrinology ................................... 301

¥ 0.5 0.0 0.2

¥ 0.3

¥ 4.6 Family Practice ................................. 4,683 0.1 0.0 0.1 0.2

¥ 4.1 Gastroenterology .............................. 1,710 1.4 0.0 0.1 1.5

¥ 2.8


## 45864 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

TABLE 

### 33.

— I MPACT OF 

### P RACTICE 

### E XPENSE 

### , M ALPRACTICE 

### RVU S 

### , M ULTIPLE 

### I MAGING 

### D ISCOUNT



### , AND 

### P HYSICIAN 

### F EE 

### S CHEDULE 

### U PDATE ON 

### TOTAL 

### M EDICARE 

### A LLOWED 

### C HARGES BY 

### P HYSICIAN 

### , P RACTITIONER



### , AND 

### S UPPLIER 

### S UB



### CATEGORY



### —Continued

Specialty Medicare allowed charges for2004 ($ in millions) Impact of PE RVU changes

(percent) Impact of malpractice RVU changes

(percent) Impact ofmultiple imaging discount

(percent) Impact of all proposed changes (percent) Combinedimpact: includes update

and drug admin. trans.

(percent)

General Practice ............................... 1,023 0.2 0.0 0.1 0.2

¥ 4.1 General Surgery ............................... 2,319 0.2 0.1 0.2 0.4

¥ 3.9 Geriatrics ........................................... 123

¥ 0.2 0.0 0.2

¥ 0.1

¥ 4.4 Hand Surgery .................................... 68

¥ 0.5 0.1 0.2

¥ 0.2

¥ 4.5 Hematology\Oncology ....................... 985 0.4 0.0 0.1 0.5

¥ 5.2 Infectious Disease ............................ 410

¥ 0.1 0.0 0.2 0.1

¥ 4.3 Internal Medicine .............................. 9,257

¥ 0.1 0.0 0.2 0.1

¥ 4.2 Interventional Radiology ................... 209 0.2

¥ 0.1

¥ 0.9

¥ 0.8

¥ 5.1 Nephrology ........................................ 1,507

¥ 0.2 0.0 0.2 0.0

¥ 4.3 Neurology .......................................... 1,284

¥ 0.6 0.0 0.0

¥ 0.6

¥ 4.9 Neurosurgery .................................... 538

¥ 0.7 0.2 0.1

¥ 0.3

¥ 4.6 Nuclear Medicine .............................. 87

¥ 0.3

¥ 0.1

¥ 0.2

¥ 0.5

¥ 4.8 Obstetrics\Gynecology ...................... 599 0.0 0.0 0.1 0.2

¥ 4.2 Ophthalmology .................................. 4,739

¥ 1.1 0.0 0.2

¥ 1.0

¥ 5.3 Orthopedic Surgery ........................... 3,145

¥ 0.4 0.1 0.2

¥ 0.1

¥ 4.4 Otolaryngology .................................. 871

¥ 0.6 0.0 0.2

¥ 0.4

¥ 4.7 Pathology .......................................... 915 1.3 0.0 0.2 1.5

¥ 2.8 Pediatrics .......................................... 66 0.1 0.0 0.2 0.3

¥ 4.1 Physical Medicine ............................. 750

¥ 0.5

¥ 0.1 0.2

¥ 0.4

¥ 4.7 Plastic Surgery .................................. 279 0.1 0.0 0.2 0.3

¥ 4.0 Psychiatry ......................................... 1,127 0.0

¥ 0.1 0.2 0.1

¥ 4.2 Pulmonary Disease ........................... 1,521

¥ 0.2 0.0 0.2 0.0

¥ 4.3 Radiation Oncology .......................... 1,308 1.9 0.0 0.1 2.0

¥ 2.3 Radiology .......................................... 5,154 0.4 0.0

¥ 2.1

¥ 1.7

¥ 6.0 Rheumatology ................................... 400

¥ 0.9 0.0 0.1

¥ 0.8

¥ 5.4 Thoracic Surgery .............................. 464

¥ 0.8 0.2 0.2

¥ 0.4

¥ 4.7 Urology .............................................. 1,782 1.8 0.0 0.0 1.8

¥ 2.6 Vascular Surgery .............................. 560 0.5 0.0 0.2 0.7

¥ 3.6 Practitioners: Audiologist ........................................ 31

¥ 5.8 0.0 0.2

¥ 5.6

¥ 9.9 Chiropractor ...................................... 720

¥ 1.3

¥ 0.6 0.2

¥ 1.8

¥ 6.1 Clinical Psychologist ......................... 527

¥ 0.6

¥ 0.3 0.2

¥ 0.6

¥ 4.9 Clinical Social Worker ....................... 345

¥ 0.6

¥ 0.4 0.2

¥ 0.8

¥ 5.1 Nurse Anesthetist ............................. 523

¥ 0.4 0.0 0.2

¥ 0.2

¥ 4.5 Nurse Practitioner ............................. 617 0.1 0.0 0.2 0.2

¥ 4.1 Optometry ......................................... 720

¥ 0.8 0.0 0.2

¥ 0.6

¥ 4.9 Oral\Maxillofacial Surgery ................. 37 0.8 0.0 0.2 1.0

¥ 3.3 Physical\Occupational Therapy ........ 1,283 1.5

¥ 0.5 0.2 1.2

¥ 3.1 Physicians Assistant ......................... 472 0.0 0.0 0.2 0.3

¥ 4.0 Podiatry ............................................. 1,487 1.3 0.0 0.2 1.5

¥ 2.8 Suppliers: Diagnostic Testing Facility ................ 1,087

¥ 2.4 0.0

¥ 2.9

¥ 5.3

¥ 9.6 Independent Laboratory .................... 631 6.4 0.0 0.2 6.6 2.3 Portable X-Ray Supplier ................... 96 0.4 0.0 0.1 0.5

¥ 3.8



### Table 34 below shows the impact on total payments for selected high-volume procedures of all of the changes previously discussed. We selected these procedures because they are the most commonly provided by a broad spectrum of physician specialties. There are separate columns that show the change in the facility rates and the nonfacility rates. For an explanation of facility and nonfacility practice expense refer to section II.A. in the preamble of this proposed rule. If we change any of the proposed provisions following the consideration of public comments, these figures may change.



### TABLE 

### 34.

— I MPACT OF 

### P ROPOSED 

### R ULE ON 

### P AYMENT FOR 

### S ELECTED 

### P ROCEDURES

HCPCS MOD Description Non-facility Facility

Old New Percent change Old New Percent change

11721 ......... ................ Debride nail, 6 or more .............................. $39.79 $38.77

¥ 3 $31.08 $29.60

¥ 5 17000 ......... ................ Destroy benign/premlg lesion ..................... 60.64 62.54 3 44.34 44.39 0 27130 ......... ................ Total hip arthroplasty .................................. N/A N/A N/A 1,396.14 1,321.88

¥ 5


## 45865 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

TABLE 

### 34.

— I MPACT OF 

### P ROPOSED 

### R ULE ON 

### P AYMENT FOR 

### S ELECTED 

### P ROCEDURES



### —Continued

HCPCS MOD Description Non-facility Facility

Old New Percent change Old New Percent change

27244 ......... ................ Treat thigh fracture ..................................... N/A N/A N/A 1,134.65 1,073.62

¥ 5 27447 ......... ................ Total knee arthroplasty ............................... N/A N/A N/A 1,507.94 1,427.92

¥ 5 33533 ......... ................ CABG, arterial, single ................................. N/A N/A N/A 1,923.30 1,813.54

¥ 6 35301 ......... ................ Rechanneling of artery ............................... N/A N/A N/A 1,128.59 1,072.23

¥ 5 43239 ......... ................ Upper GI endoscopy, biopsy ...................... 333.50 336.27 1 162.20 159.18

¥ 2 66821 ......... ................ After cataract laser surgery ........................ 248.23 233.25

¥ 6 230.42 216.83

¥ 6 66984 ......... ................ Cataract surg w/iol, 1 stage ....................... N/A N/A N/A 684.05 649.50

¥ 5 67210 ......... ................ Treatment of retinal lesion .......................... 599.54 568.15

¥ 5 573.39 544.48

¥ 5 71010 ......... ................ Chest x-ray ................................................. 28.04 25.68

¥ 8 N/A N/A N/A 71010 ......... 26 Chest x-ray ................................................. 9.47 9.17

¥ 3 9.47 9.17

¥ 3 76091 ......... ................ Mammogram, both breasts ........................ 97.40 101.39 4 N/A N/A N/A 76091 ......... 26 Mammogram, both breasts ........................ 45.10 43.77

¥ 3 45.10 43.77

¥ 3 76092 ......... ................ Mammogram, screening ............................. 85.65 83.77

¥ 2 N/A N/A N/A 76092 ......... 26 Mammogram, screening ............................. 36.38 35.33

¥ 3 36.38 35.33

¥ 3 77427 ......... ................ Radiation tx management, x5 .................... 172.05 168.64

¥ 2 172.05 166.10

¥ 3 78465 ......... 26 Heart image (3d), multiple .......................... 77.31 74.92

¥ 3 77.31 74.92

¥ 3 88305 ......... 26 Tissue exam by pathologist ........................ 42.07 40.14

¥ 5 42.07 40.14

¥ 5 90801 ......... ................ Psy dx interview ......................................... 153.11 147.29

¥ 4 144.01 137.12

¥ 5 90862 ......... ................ Medication management ............................ 51.92 50.31

¥ 3 48.89 46.77

¥ 4 90935 ......... ................ Hemodialysis, one evaluation ..................... N/A N/A N/A 73.14 69.37

¥ 5 92012 ......... ................ Eye exam established pat .......................... 65.18 61.63

¥ 5 37.14 35.32

¥ 5 92014 ......... ................ Eye exam & treatment ................................ 96.26 91.31

¥ 5 60.64 57.66

¥ 5 92980 ......... ................ Insert intracoronary stent ............................ N/A N/A N/A 809.11 786.38

¥ 3 93000 ......... ................ Electrocardiogram, complete ...................... 26.91 24.23

¥ 10 N/A N/A N/A 93010 ......... ................ Electrocardiogram report ............................ 9.10 8.81

¥ 3 9.10 8.81

¥ 3 93015 ......... ................ Cardiovascular stress test .......................... 108.01 107.55 0 N/A N/A N/A 93307 ......... 26 Echo exam of heart .................................... 49.27 47.67

¥ 3 49.27 47.67

¥ 3 93510 ......... 26 Left heart catheterization ............................ 257.32 252.61

¥ 2 257.32 252.61

¥ 2 98941 ......... ................ Chiropractic manipulation ........................... 36.76 34.78

¥ 5 31.83 30.42

¥ 4 99203 ......... ................ Office/outpatient visit, new ......................... 97.02 93.33

¥ 4 72.38 69.11

¥ 5 99213 ......... ................ Office/outpatient visit, est ........................... 52.68 50.65

¥ 4 35.62 33.96

¥ 5 99214 ......... ................ Office/outpatient visit, est ........................... 82.62 79.62

¥ 4 59.12 56.30

¥ 5 99222 ......... ................ Initial hospital care ...................................... N/A N/A N/A 112.93 107.79

¥ 5 99223 ......... ................ Initial hospital care ...................................... N/A N/A N/A 157.27 150.29

¥ 4 99231 ......... ................ Subsequent hospital care ........................... N/A N/A N/A 34.11 32.60

¥ 4 99232 ......... ................ Subsequent hospital care ........................... N/A N/A N/A 55.71 53.31

¥ 4 99233 ......... ................ Subsequent hospital care ........................... N/A N/A N/A 79.21 75.74

¥ 4 99236 ......... ................ Observ/hosp same date ............................. N/A N/A N/A 223.22 213.40

¥ 4 99239 ......... ................ Hospital discharge day ............................... N/A N/A N/A 96.64 92.53

¥ 4 99243 ......... ................ Office consultation ...................................... 122.79 118.66

¥ 3 93.99 90.08

¥ 4 99244 ......... ................ Office consultation ...................................... 172.81 166.69

¥ 4 138.70 133.04

¥ 4 99253 ......... ................ Initial inpatient consult ................................ N/A N/A N/A 98.91 94.99

¥ 4 99254 ......... ................ Initial inpatient consult ................................ N/A N/A N/A 142.12 136.30

¥ 4 99261 ......... ................ Follow-up inpatient consult ......................... N/A N/A N/A 22.36 21.43

¥ 4 99262 ......... ................ Follow-up inpatient consult ......................... N/A N/A N/A 45.48 43.50

¥ 4 99263 ......... ................ Follow-up inpatient consult ......................... N/A N/A N/A 67.46 64.57

¥ 4 99283 ......... ................ Emergency dept visit .................................. N/A N/A N/A 62.15 59.30

¥ 5 99284 ......... ................ Emergency dept visit .................................. N/A N/A N/A 97.02 92.54

¥ 5 99291 ......... ................ Critical care, first hour ................................ 256.57 243.87

¥ 5 207.68 198.33

¥ 4 99292 ......... ................ Critical care, addï ’ l 30 min .................. 113.69 108.60

¥ 4 103.84 99.17

¥ 4 99302 ......... ................ Nursing facility care .................................... 87.92 84.00

¥ 4 87.92 84.00

¥ 4 99303 ......... ................ Nursing facility care .................................... 108.39 103.43

¥ 5 108.39 103.43

¥ 5 99312 ......... ................ Nursing fac care, subseq ........................... 56.47 54.03

¥ 4 56.47 54.03

¥ 4 99313 ......... ................ Nursing fac care, subseq ........................... 79.58 76.18

¥ 4 79.58 76.18

¥ 4 99348 ......... ................ Home visit, est patient ................................ 72.01 68.65

¥ 5 N/A N/A N/A 99350 ......... ................ Home visit, est patient ................................ 164.48 156.46

¥ 5 N/A N/A N/A G0008 ......... ................ Immunization admin ................................... 18.57 17.88

¥ 4 N/A N/A N/A G0317 ......... ................ ESRD related svs 4+mo 20+yrs ................. 307.73 294.91

¥ 4 307.73 294.91

¥ 4 G0344 ......... ................ Initial preventive exam ................................ 97.40 93.69

¥ 4 72.76 69.47

¥ 5 G0366 ......... ................ EKG for initial prevent exam ...................... 26.91 24.23

¥ 10 N/A N/A N/A G0367 ......... ................ EKG tracing for initial prev ......................... 17.81 15.42

¥ 13 N/A N/A N/A G0368 ......... ................ EKG interpret & report preve ..................... 9.10 8.81

¥ 3 9.10 8.81

¥ 3



### In the November 15, 2004 PFS final rule, we showed the combined impact of PFS and drug payment changes on the total revenues for specialties that perform a significant volume of drug administration services. (69 FR 66406) Although we have not performed a similar combined impact analysis this year for all of the specialties considered


## 45866 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

last year, we have undertaken a similar analysis of hematology/oncology. In last

year ’ s final rule, we announced a oneyear demonstration to collect information about symptoms for cancer patients receiving chemotherapy (69 FR 66308). Although this demonstration was implemented through the Secretary ’ s authority under sections 402(a)(1)(B) and 402(a)(2) of the Social Security Act Amendments of 1967 (Pub.
L. 90

– 248) and not through administrative rulemaking, we discussed the impacts of the additional payments from this demonstration in last year ’ s final rule impact analysis. Therefore, we are also including an analysis of the impact on payments to hematology/oncology as this demonstration project ends. As indicated in Table 35 below, PFS services account for approximately 28 percent of Medicare revenues for hematology/oncology. Medicare payments for all PFS services provided by the specialties of hematology/ oncology are projected to decrease by 5.2 percent for 2006. We estimate the impact of the one-year demonstration was 15 percent higher payments relative to PFS payments during 2005. We estimate that approximately 69 percent of total Medicare revenues for hematology/oncology are attributed to drugs, and, for purposes of this analysis, we are assuming no change in the payment levels for Part B drugs during 2006. Assuming no changes in utilization for 2006, we project total Medicare revenues to oncologists would decline by 5.6 percent. However, if the volume of drugs and PFS services increased at historical rates, total Medicare revenues for hematology/ oncology would increase by 8.1 percent between 2005 and 2006.



### TABLE 

### 35

— I MPACT OF 

### D RUG AND 

### P HYSICIAN 

### F EE 

### S CHEDULE 

### P AYMENT 

### C HANGES

Physician Fee Schedule Drugs All Revenues

Specialty Percent of total medicare revenues from fee schedule

(percent) Change medicare physician fee schedule

revenues (percent) Change oneyear demonstration project (percent) Percent of total medicare revenues from drugs Change medicare drug revenues (percent) Combined percent change all medicare

revenues* Combined percent change all medicare revenues with

utilization increase**

Hematology/Oncology .. 28

¥ 5.2

¥ 15 69 0

¥ 5.6 8.1%

*Note: Reflects changes in total Medicare revenues assuming no changes in utilization. Calculation reflects average changes in fee schedule payments and for drugs weighted by percent of Medicare revenues.

** Note: We estimate that Medicare payments to oncologists would increase by 8% between 2005 and 2006 if growth in the volume of drugs and physician fee schedule services were to grow at historical rates, despite the effect of the end of the one-year demonstrati on project.



### B. Geographic Practice Cost Indices (GPCI)

— Payment Localities

As discussed in section II.B. of the preamble to this proposed rule, we are proposing two changes to the California GPCI payment localities. We are proposing to remove both Santa Cruz County and Sonoma County from the Rest of California payment locality, and make both of those counties separate payment localities.

In the November 15, 2004 final rule, we published 2005 and 2006 GPCI and GAF values reflecting the 2 year phasein of the updated GPCI data. For the Rest of California payment locality that included Santa Cruz and Sonoma counties, the 2005 GAF is 1.012, and the 2006 GAF published at that time was 1.017. After removing Santa Cruz County from the Rest of California locality, its proposed 2006 GAF increases to 1.119. Removing Sonoma County from the Rest of California locality results in a proposed 2006 GAF of 1.098 for the new Sonoma County payment locality. The Rest of California proposed 2006 GAF is 1.011. Table 36 below shows the impacts of the proposed changes in the GPCIs and GAFs. Although only Santa Cruz and Sonoma Counties and the Rest of California locality are specifically impacted by the proposed change, in Table 36, we are showing the GPCIs and GAFs for all California payment localities (the changes from the 2005 to 2006 GAFs for these counties represent the second year of the transition to updated GPCIs).


## 45867 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed RulesTABLE36.—IMPACTS ONCALIFORNIAPAYMENTLOCALITIESLocality name CountyWorkGPCI2005 GPCIGAF2006 Proposed GPCI Percentchangefrom2005GAFsPE GPCI MP GPCIWorkGPCIPE GPCI MP GPCI GAFAnaheim\Santa Ana ........................................ Orange ................................... 1.036 1.21 0.954 1.109 1.034 1.236 0.954 1.119 0.9Los Angeles .................................................... Los Angeles ........................... 1.049 1.147 0.954 1.088 1.041 1.156 0.954 1.088 0.0Marin\Napa\Solano ......................................... Marin, Napa, Solano .............. 1.025 1.294 0.651 1.128 1.035 1.34 0.651 1.154 2.3Oakland\Berkley .............................................. Alameda, Contra Costa ......... 1.048 1.303 0.651 1.144 1.054 1.3710.651 1.177 2.9San Francisco ................................................. San Francisco ........................ 1.064 1.501 0.651 1.239 1.061.543 0.651 1.256 1.4San Mateo ....................................................... San Mateo ............................. 1.061 1.484 0.639 1.23 1.073 1.536 0.639 1.259 2.4Santa Clara ..................................................... Santa Clara ............................ 1.073 1.46 0.604 1.224 1.083 1.54 0.604 1.265 3.3Santa Cruz ...................................................... Santa Cruz ............................. 1.007 1.043 0.733 1.0121.014 1.218 0.717 1.119 10.6Sonoma ........................................................... Sonoma .................................. 1.007 1.043 0.733 1.012 1.017 1.23 0.717 1.098 8.5Ventura ............................................................ Ventura .................................. 1.028 1.152 0.744 1.072 1.028 1.179 0.744 1.083 1.0Rest of California* ........................................... ........................................... 1.007 1.043 0.733 1.012 1.007 1.042 0.717 1.011¥0.1%*Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, El Dorado, Fresno, Glenn, Humboldt, Imperial, Inyo, Kern, Kings, Lake, Lassen, Madera, Mariposa, Mendocino, Merced, Modoc,Mono, Monterey, Nevada, Placer, Plumas, Riverside, Sacramento, San Benito, San Bernardino, San Joaquin, San Diego, San Luis Obispo, Santa Barbara, Shasta, Sierra, Siskiyou,Stanislaus, Sutter, Tehama, Trinity, Tulare, Tuolumne, Yolo, Yuba


## 45868 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

C. Medicare Telehealth Services

In section II.D. of this proposed rule, we are proposing to add individual medical nutrition therapy, as represented by HCPCS codes G0270, 97802, and 97803, to the list of telehealth services. We believe that this change will have little effect on Medicare expenditures.

D. Contractor Pricing of CPT Codes 97039 and 97139

As discussed earlier in the preamble of this proposed rule (section II.E.), we are proposing to have the contractors value CPT codes 97039 and 97139. This will make the pricing methodology for these services consistent with our policy for other unlisted services and we believe it will have no significant impact on Medicare expenditures. E. ESRD

–

MMA Related Provisions The ESRD related provisions in this proposed rule are discussed in section II.G. In order to understand the impact of the proposed changes affecting payments to different categories of ESRD facilities, it is necessary to compare estimated payments under the current payment system (current payments) to estimated payments under the proposed revisions to the composite rate payment system as set forth in this proposed rule (proposed payments). To estimate the impact among various classes of ESRD facilities, it is imperative that the estimates of current payments and proposed payments contain similar inputs. Therefore, we simulated payments only for those ESRD facilities for which we are able to calculate both current 2005 payments and proposed 2006 payments. Due to data limitations, we are unable to estimate current and proposed payments for 77 facilities that bill for ESRD dialysis treatments. ESRD providers were grouped into the categories based on characteristics provided in the Online Survey and Certification and Reporting (OSCAR) file and the most recent cost report data from the Healthcare Cost Report Information System (HCRIS). We also used the December 2004 update of CY 2004 Standard Analytical File (SAF) claims as a basis for Medicare dialysis treatments and separately billable drugs and biologicals. While the December 2004 update of the 2004 SAF file is not complete, we wanted to use the most recent data available, and plan to use an updated version of the 2004 SAF file for the final rule.



### TABLE 

### 37

— I MPACT OF 

### P ROPOSED 

### C HANGES IN 

### P AYMENTS TO 

### H OSPITAL 

### B ASED AND 

### I NDEPENDENT 

### ESRD FACILITIES 

### (I NCLUDES 

### D RUG AND 

### C OMPOSITE 

### RATE 

### P AYMENTS 

### )

[Percent change in total payments to ESRD facilities (both program and beneficiaries)]

Number of

facilities Number of Dialysis treatments (in millions) Effect of changes in wage index 1 Effect of changes indrug payments 2 Overall effect 3

All ......................................................................................... 4,293 29.5 0.0 1.2 0.5 Independent ......................................................................... 3,716 26.1

¥ 0.1 1.2 0.4 Hospital Based ..................................................................... 577 3.3 1.3 1.0 1.2 Size: Small < than 5000 treatments per year ....................... 1,714 4.9

¥ 0.5 1.1 0.1 Medium 5000 to 9999 treatments per year .................. 1,724 12.4 0.1 1.3 0.6 Large > than 10000 treatments per year ..................... 855 12.1 0.2 1.2 0.6 Type of Ownership: Profit .............................................................................. 3,388 23.8

¥ 0.2 1.2 0.4 Nonprofit ....................................................................... 896 5.6 1.0 1.1 1.0 Rural ............................................................................. 1,189 6.0

¥ 0.6 1.1 0.1 Urban ............................................................................ 3,104 23.5 0.2 1.2 0.6 Region: New England ................................................................ 143 1.1 3.7 1.6 2.9 Middle Atlantic .............................................................. 521 3.9 2.1 1.5 1.9 East North Central ........................................................ 651 4.6

¥ 1.9 0.9

¥ 0.8 West North Central ....................................................... 333 1.6

¥ 0.9 1.0

¥ 0.2 South Atlantic ................................................................ 975 6.8

¥ 0.3 1.2 0.4 East South Central ....................................................... 342 2.2

¥ 1.6 1.1

¥ 0.4 West South Central ...................................................... 585 4.1

¥ 1.3 1.1

¥ 0.3 Mountain ....................................................................... 226 1.3

¥ 0.6 1.1 0.0 Pacific ........................................................................... 486 3.7 2.6 1.5 2.2
Puerto Rico ................................................................... 31 0.3

¥ 1.6 0.7

¥ 0.7

1 This column shows the effect of wage changes to composite rate payments to ESRD providers. Composite rate payments computed usi ng the current wage index are compared to composite rate payments using the proposed wage index changes.

2 This column shows the effect of the changes in drug payments to ESRD providers. These include proposed changes In payment for s eparately billable drugs (2006 ASP+6) and the 8.9% drug add-on compared to current payment for separately billable drugs (2005 AAP ) and the current 8.7 percent drug add-on.

3 This column shows the percent change between proposed and current payments to ESRD facilities. The proposed payments include th e wage adjusted composite rate, and the 8.9% drug add-on times treatments plus proposed payment for separately billable drugs. Th e current payment to ESRD facilities includes the current wage adjusted composite rate times treatments plus current drug payments for separately billable drugs.



### Table 37 above shows the impact of this year ’ s proposed changes to payments to hospital based and independent ESRD facilities. We have included both composite rate payments as well as payments for separately billable drugs and biologicals because both are affected by the proposed changes. The first column of Table 37 identifies the type of ESRD provider, the second column indicates the number of ESRD facilities for each type, and the third column indicates the number of dialysis treatments.

The fourth column shows the effect of proposed changes to the ESRD wage index as it affects the composite rate payments to ESRD facilities. The fourth


## 45869 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

column compares aggregate wage adjusted composite rate payments using the proposed ESRD wage index compared to the current ESRD wage adjusted composite rate payments. The overall effect to all ESRD providers in aggregate is zero because the proposed ESRD wage index has been multiplied by a budget neutrality factor to comply with the statutory requirement that any wage index revisions be done in a manner that results in the same aggregate amount of expenditures as would have been made without any changes in the wage index. The percent changes shown in the fifth and sixth columns are the result of the increase to the drug add-on and the changes in drug prices which are explained in section G below.

The fifth column shows the effect of the proposed changes in drug payments to ESRD providers. Current payments for drugs represent 2005 Medicare reimbursement using AAP prices for the top ten drugs (as discussed earlier in this preamble). Current Medicare spending for the top ten drugs is estimated using 2005 AAP prices times actual drug utilization from 2004 claims. (EPO units are estimated using payments because the units field on bills represents the number of EPO administrations rather than the number of EPO units). Spending under the proposed change is 2005 ASP +6 percent for the top ten drugs times actual drug utilization from 2004 claims. The proposed prices for these top ten drugs are discussed earlier in this preamble. In order to simulate what ASP +6 percent pricing will be in 2006 we inflated the 2005 first quarter ASP +6 prices by a forecast of the PPI for prescription drugs (5.7 percent annual growth from 2005 to 2006).

Proposed payment for drugs in 2006also includes the 8.9 percent drug addon to the composite rate. This amount is computed by multiplying the wage adjusted composite rate for each provider times dialysis treatments from 2004 claims. Column 5 is computed by comparing spending under the proposed payment for drugs (ASP +6 percent inflated to 2006) including the 8.9 percent drug add-on amount to spending under current payments for drugs with the current drug add-on of 8.7 percent. In order to make column 5 comparable with rest of Table 38, current composite rate payments to ESRD facilities were included in both current and proposed spending calculations.

We did not simulate any case mix in this impact table because 2004 claims data do not include the new data fields (height and weight) that are needed to calculate case mix. These data fields were not required be reported by providers until January 1, 2005. However, we have not proposed any changes to case mix for calendar year

2006.

Column 6 shows the overall effect of all changes in drug and composite rate payments to ESRD providers. The overall effect is measured as the difference between proposed payment with all MMA changes as proposed in this rule and current payment. Proposed payment is computed by multiplying the composite rate for each provider (with both the proposed wage index and the 8.9 percent drug add-on) times dialysis treatments from 2004. In addition, the proposed payment includes payments for separately billable drugs under the ASP +6 drug pricing inflated to 2006 levels. Current payment is the current wage adjusted composite rate for each provider times dialysis treatments from 2004 claims plus current AAP priced drug payments for separately billable drugs with the current 8.7 percent drug add-on.

The overall impact to ESRD providers in aggregate is 0.5 percent. Among the two separately shown effects, the effect of changes to the wage index has the most variation among provider type but is budget neutral in aggregate. The effect of change in drug payments contributes most to the overall effect, but varies little among provider types.

We also note that the proposed revisions to the composite rate exceptions process will have no impact on payments to ESRD providers since we have only proposed changes in process and these changes do not affect which providers will be eligible for exceptions nor the amount of the exception.
F. Payment for Covered Outpatient Drugs and Biologicals

As discussed in section II.H. of this proposed rule, the proposal to pay a reduced supplying fee for each Medicare Part B oral drug prescription, after the first one, supplied to a beneficiary during a month is estimated to reduce total Federal expenditures by $8 million in 2006, and $30 million over the five-year period, CY 2006 to 2010. The preamble seeks comment on an appropriate inhalation drug dispensing fee amount for 2006. The effect on Federal expenditures of a potential change to the inhalation drug dispensing fee would depend on the dispensing fee amount established. G. Private Contracts and Opt-Out
Provision

The changes discussed in section II.I. of this proposed rule, with respect to private contracts and the opt-out provision, are currently estimated to have no significant impact on Medicare expenditures. However, we believe the changes will clarify that the consequences for the failure to maintain opt-out will apply regardless of whether the physician or practitioner was notified by the carrier.
H. FQHC Supplemental Payment
Provision

Section 237 of the MMA amended section 1833(a)(3) of Act to provide supplemental payments to FQHCs that contract with Medicare Advantage (MA) organizations to cover the difference, if any, between the payment received by the health center for treating MA enrollees and the payment to which the FQHC would be entitled to receive under its cost-based all-inclusive payment rate. We estimate that this new MMA payment provision for FQHC services will not increase Medicare payments. In other words, this MMA provision would have no budgetary impact on the Medicare trust fund due to the fact that a supplemental payment would only be made when the MA payment to the health center is less than its original FQHC cost based rate. Consequently, no additional Medicare expenditures would be needed to pay the center up to what it would have received under original Medicare.
I. National Coverage Decisions Timeframes

The proposed changes to § 426.340 discussed in section II.N. of this proposed rule, are made in order to conform certain timeframes in the regulation to meet legislative changes made by the MMA of 2003. These changes to the regulation will meet Congressional intent in the development of NCDs, and will conform the regulation to the overall NCD process. There will be no budget implications as a result of these changes.
J. Coverage of Screening for Glaucoma

As discussed in section II.O. of the preamble to this proposed rule, we would expand the definition of an eligible beneficiary under the glaucoma screening benefit to include Hispanic Americans age 65 and over, effective January 1, 2006, subject to certain frequency and other limitations on coverage. At present, § 410.23(a)(2) (Conditions for and limitations on coverage of screening for glaucoma) defines the term ‘‘ eligible beneficiary ’’


## 45870 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

to include individuals in the following high risk categories:

• Individual with diabetes mellitus.

• Individual with a family history of glaucoma.

• African-Americans age 50 and over. Based on the projected utilization of these screening services and related medically necessary follow-up tests and treatment that may be required for the additional beneficiaries screened, we estimate that this expanded benefit will result in an increase in Medicare payments to ophthalmologists or optometrists who will provide these screening tests and related follow-up tests and treatment. However, this is not expected to have a significant cost impact on the Medicare program.
K. Physician Referral for Nuclear Medicine Services

This proposal, which is discussed in section II.P. of this proposed rule, would primarily affect physicians and health care entities that furnish items and services to Medicare beneficiaries. We have attempted to minimize its effect by interpreting the law in a practical and realistic manner. We are unable to quantify the number of physicians who have either an ownership or an investment interest in entities that furnish nuclear medicine services and/or supplies. Even if we assume that a substantial number of physicians have ownership or investment interests in these types of entities, we believe that, in general, the economic impact on these physicians would not necessarily be substantial, for the reasons stated below.

Physician owners/investors of entities that furnish nuclear medicine services and supplies in a manner that satisfies the requirements of the in-office ancillary services exception would not be affected by this proposed rule. In addition, physician ownership of or investment in entities that furnish nuclear medicine services and supplies to residents of rural areas would not be affected by this requirement.

If a physician ’ s ownership or investment interest would lead to a prohibition on his or her referrals to that entity, the physician has two options. First, he or she can stop making referrals to that entity and make referrals to another entity. Second, the physician can divest himself or herself of the interest. While the impact on an individual physician may be significant, we do not believe that physicians, in general, will be significantly affected if they have to stop making referrals to an entity in which they have an ownership interest. We have come to this conclusion because we assume that the majority of physicians receive most of their income from the services they personally furnish, not from nuclear medicine services performed by entities that they own. In addition, we assume that, unless the physician established the entity to serve only his or her patients, the entity receives referrals from other physicians. Thus, the physician may still receive a return on the ownership or investment. We do not believe that the second option (divestiture of the ownership interest) would necessarily have a significant economic effect. However, we assume, that, at least from an economic standpoint, most physicians invest in entities because they are income producing. If an investment is successful, a physician may have little difficulty finding new investors willing to take over the physician ’ s investment. The physician, in turn, can then invest the monies received in some other investment. We believe the cost of divestiture will vary from situation to
situation.

We also do not believe that beneficiary access to medically necessary nuclear medicine services would be threatened simply because most physician ownership of entities that furnish nuclear medicine services would be prohibited. As indicated above, we see no reason why medically necessary nuclear medicine services could not be furnished by entities owned by those not in a position to refer such services.

We expect that this proposed rule may result in savings to both the Medicare and Medicaid programs by minimizing anti-competitive business arrangements as well as financialincentives that encourage overutilization of costly nuclear medicine services. ( See David Armstrong, ‘‘ MRI and CT Centers Offer Doctors Way to Profit on Scans, ’’ Wall Street Journal, May 2, 2005, et al. ) We cannot gauge with any certainty the extent of these savings to either program at this time.

L. Alternatives Considered

This proposed rule contains a range of policies, including some proposals related to specific MMA provisions. The preamble provides descriptions of the statutory provisions that are addressed, identifies those policies when discretion has been exercised, presents rationale for our decisions and, where relevant, alternatives that were considered.
M. Impact on Beneficiaries

There are a number of changes made in this proposed rule that would have an effect on beneficiaries. In general, we believe these changes will improve beneficiary access to services that are currently covered or will expand the Medicare benefit package to include new services. As explained in more detail below, the regulatory provisions may affect beneficiary liability in some cases. Any changes in aggregate beneficiary liability from a particular provision will be a function of the coinsurance (20 percent if applicable for the particular provision after the beneficiary has met the deductible) and the effect of the aggregate cost (savings) of the provision on the calculation of the Medicare Part B premium rate (generally 25 percent of the provision ’ s cost or savings).

To illustrate this point, as shown in Table 34, the 2005 national payment amount in the nonfacility setting for CPT code 99203 (Office/outpatient visit, new), is $97.02 which means that currently a beneficiary is responsible for 20 percent of this amount, or $19.40. Under this proposed rule the 2006 national payment amount in the nonfacility setting for CPT code 99203, as shown in Table 34, is $93.33 which means that, in 2006, the beneficiary coinsurance for this service would be $18.66.

Very few of the changes we are proposing impact overall payments and therefore will affect Medicare beneficiaries ’ coinsurance liability. Proposals discussed above that do affect overall spending would similarly impact beneficiaries ’ coinsurance.

For example, we have tried to ensure that the proposal concerning physician self-referral for nuclear medicine services would not adversely impact the medical care of Medicare or Medicaid patients. While we recognize that these proposed revisions may have an impact on current arrangements under which patients are receiving medical care, there are other ways to structure these arrangements so that patients may continue to receive medically necessary nuclear medicine services. In almost all cases, we believe this proposal concerning physician referral for nuclear medicine services should not require substantial changes in delivery arrangements and would help minimize anti-competitive behavior that can affect where a beneficiary receives health care services and possibly the quality of the services furnished. We also believe it will minimize the number of medically unnecessary nuclear medicine procedures billed to the Medicare and Medicaid programs.

N. Accounting Statement

As required by OMB Circular A

–4 (available at http://www.whitehouse. gov/omb/circulars/a004/a

–4.pdf ), in


## 45871 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

Table 38 below, we have prepared an accounting statement showing the classification of the expenditures associated with the provisions of this proposed rule. This table includes the impact of the proposed changes in this rule on providers and suppliers and encompasses the anticipated negative update to the physician fee schedule based on the statutory SGR formula.

Expenditures are classified as transfers to Medicare providers/or suppliers (that is, ESRD facilities and physicians, other practitioners and medical suppliers that receive payment under the physician fee schedule or Medicare Part B).



### TABLE 38.

—ACCOUNTING 

### S TATEMENT 

### : C LASSIFICATION OF 

### E STIMATED 

### E XPENDITURES 

### , F ROM 

### CY 2005 TO THE 

### CY
2006

[in millions]

Category Transfers

Annualized Monetized Transfers ........................ Negative transfer-Estimated decrease in expenditures ($1,860). From Whom To Whom? ..................................... Federal Government To ESRD Medicare Providers; physicians, other practit ioners and suppliers who receive payment under the Medicare Physician Fee Schedule; and Medicare Suppliers billing for Part B drugs.



### In accordance with the provisions of Executive Order 12866, this final rule was reviewed by the Office of Management and Budget.

List of Subjects

42 CFR Part 405

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

42 CFR Part 410

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

42 CFR Part 411

Kidney diseases, Medicare, Physician Referral, Reporting and recordkeeping requirements.

42 CFR Part 413

Health facilities, Kidney diseases, Medicare, Reporting and recordkeeping requirements.

42 CFR Part 414

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

42 CFR Part 426

Administrative practice and procedure, Medicare, Reporting and recordkeeping requirements.

For the reasons set forth in the preamble, the Centers for Medicare & Medicaid Services proposes to amend 42 CFR chapter IV as set forth below: **PART 405**

**— FEDERAL HEALTH**  **INSURANCE FOR THE AGED AND DISABLED** 

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

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



### Subpart D

**— Private Contracts** 

2. Section 405.435 is amended by

— A. Revising introductory text in paragraph (b).

B. Adding paragraph (d). The revision and addition read as follows:

**§ 405.435 Failure to maintain opt-out.** 



### * * * * *

(b) If a physician or practitioner fails to maintain opt-out in accordance with paragraph (a) of this section, then, for the remainder of the opt-out period, except as provided by paragraph (d) of this section

— * * * * *

(d) If a physician or practitioner demonstrates that he or she has taken good faith efforts to maintain opt-out (including by refunding amounts in excess of the charge limits to beneficiaries with whom he or she did not sign a private contract) within 45 days of a notice from the carrier of a violation of paragraph (a) of this section, then the requirements of paragraphs (b)(1) through (b)(8) of this section are not applicable. In situations where a violation of paragraph (a) of this section is not discovered by the carrier during the 2-year opt-out period when the violation actually occurred, then the requirements of paragraphs (b)(1) through (b)(8) of this section are applicable from the date that the first violation of paragraph (a) of this section occurred until the end of the opt-out period during which the violation occurred (unless the physician or practitioner takes good faith efforts, within 45 days of any notice from the carrier that the physician or practitioner failed to maintain opt-out, or the physician ’ s or practitioner ’ s discovery of the failure to maintain opt-out, whichever is earlier, to correct his or her violations of paragraph (a) of this section, for example, by refunding the amounts in excess of the charge limits to beneficiaries with whom he or she did not sign a private contract).

* * * * *

**Subpart X**

**— Rural Health Clinic and**  **Federally Qualified Health Center Services** 

3. Add § 405.2469 to read as follows:

**§ 405.2469 Federally Qualified Health**  **Centers supplemental payments.**



### Federally Qualified Health Centers under contract (directly or indirectly) with Medicare Advantage plans are eligible for supplemental payments for covered Federally Qualified Health Center services furnished to enrollees in Medicare Advantage plans offered by the Medicare Advantage organization to cover the difference, if any, between their payments from the Medicare Advantage plan and what they would receive under the cost-based Federally Qualified Health Center payment system.

(a) Calculation of supplemental payment. (1) The supplemental payment for Federally Qualified Health Center covered services provided to Medicare patients enrolled in Medicare Advantage plans is based on

—

(i) The difference between payments received by the center from the Medicare Advantage plan as determined on a per visit basis;


## 45872 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

(ii) The Federally Qualified Health
Center ’ s all-inclusive cost-based per visit rate as set forth in this subpart;

(iii) Less any amount the FQHC may charge as described in section 1857(e)(3)(B) of the Act.

(2) Any financial incentives provided to Federally Qualified Health Centers under their Medicare Advantage contracts, such as risk pool payments, bonuses, or withholds, are prohibited from being included in the calculation of supplemental payments due to the Federally Qualified Health Center.

(b) Per visit supplemental payment. A supplemental payment required under this section is made to the Federally Qualified Health Center when a covered face-to-face encounter occurs between a Medicare Advantage enrollee and a practitioner as set forth in § 405.4563.

**PART 410**

**— SUPPLEMENTARY**  **MEDICAL INSURANCE (SMI) BENEFITS** 

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

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



### Subpart B

**— Medical and Other Health**  **Services**

5. Section 410.23 is amended by revising paragraph (a)(2)(i) through (iv) to read as follows:

**§ 410.23 Screening for glaucoma:**  **Conditions for and limitations on coverage.**



### (a) * * * (2) * * * (i) Individual with diabetes mellitus. (ii) Individual with a family history of glaucoma.

(iii) African-Americans age 50 and

over.

(iv) Hispanic-Americans age 65 and

over.
* * * * *

6. Section 410.78 is amended by

— A. Revising paragraph (b) introductory text.

B. Adding paragraph (b)(2)(viii). The revision and addition read as follows:

**§ 410.78 Telehealth services** 



### * * * * *

(b) General rule. Medicare Part B pays for office and other outpatient visits, professional consultation, psychiatric diagnostic interview examination, individual psychotherapy, pharmacologic management, end stage renal disease related services included in the monthly capitation payment (except for one visit per month to examine the access site), and individual medical nutrition therapy furnished by an interactive telecommunications system if the following conditions are

met:

(2) * * * (viii) A registered dietician or nutrition professional as described in § 410.134.

* * * * *

**PART 411**

**— EXCLUSIONS FROM**  **MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT** 

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

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



### Subpart J

**— Financial Relationships**  **Between Physicians and Entities Furnishing Designated Health Services** 

8. Section 411.351 is amended by

— A. Revising the definition ‘‘ Radiation therapy services and supplies ’’

.

B. Revising the definition ‘‘ Radiology and certain other imaging services ’’

.

The revisions read as follows:

**§ 411.351 Definitions.** 



### * * * * *

Radiation therapy services and supplies means those particular services and supplies so identified on the List of CPT/HCPCS Codes. All services and supplies identified on the List of CPT/ HCPCS Codes are radiation therapy services and supplies for purposes of this subpart. Any service or supply not specifically identified as radiation therapy services or supplies on the List of CPT/HCPCS Codes is not a radiation therapy service or supply for purposes of this subpart. The list of codes identifying radiation therapy services and supplies are those covered under section 1861(s)(4) of the Act and § 410.35 of this chapter.

Radiation and certain other imaging
services means those particular services so identified on the List of CPT/HCPCS Codes. All services so identified on the List of CPT/HCPCS Codes are radiology and certain other imaging services for purposes of this subpart. Any service not specifically identified as radiology and certain other imaging services on the List of CPT/HCPCS Codes, is not a radiology or certain other imaging service for purposes of this subpart. The list of codes identifying radiology and certain other imaging services includes the professional and technical components of any diagnostic test or procedure using x-rays, ultrasound, or other imaging services, computerized axial tomography, or magnetic resonance imaging, or diagnostic nuclear medicine, as covered under section 1861(s)(3) of the Act and § 410.32 and § 410.34 of this chapter, but does not include

—

(1) X-ray, fluoroscopy, or ultrasound procedures that require the insertion of a needle, catheter, tube, or probe through the skin or into a body orifice.

(2) Radiology procedures that areintegral to the performance of a nonradiological medical procedure and performed

—

(i) During the nonradiological medical procedure; or

(ii) Immediately following the nonradiological medical procedure where necessary to confirm placement of an item placed during the nonradiological medical procedure.

* * * * *

**PART 413**

**— PRINCIPLES OF**  **REASONABLE COST REIMBURSEMENT; PAYMENT FOR**  **END-STAGE RENAL DISEASE SERVICES; PROSPECTIVELY**  **DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES** 

9. The authority citation for part 413 continues to read as follows:

Authority: Secs. 1102, 1812(d), 1814(b), 1815, 1833(a), (i), and (n), 1871, 1881, 1883, and 1886 of the Social Security Act (42 U.S.C. 1302, 1395D(D), 1395f(b), 1395g, 13951(a), (i), and (n), 1395hh, 1395rr, 1395tt, and 1395ww).



### Subpart H

**— Payment for End-Stage**  **Renal Disease (ESRD) Services and Organ Procurement Costs** 

10. Section 413.170 is amended by revising paragraph (b) to read as follows:

**§ 413.170 Scope.** 



### * * * * *

(b) Providing procedures and criteria under which a pediatric ESRD facility (an ESRD facility with at least a 50 percent pediatric patient mix) may receive an exception to the prospective payment rates; and

* * * * *

11. Section 413.174 is amended by

— A. Revising paragraph (f). B. Removing paragraph (g). The revisions read as follows:

**§ 413.174 Prospective rates for hospital**  **based and independent ESRD facilities.**



### * * * * *

(f) Additional payment for separately billable drugs. CMS makes an additional payment for certain drugs furnished to ESRD patients by a Medicare-approved ESRD facility. CMS makes this payment directly to the ESRD facility. Payment for these drugs is made

—

(1) Only on an assignment basis, directly to the facility which must


## 45873 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

accept, as payment in full, the amount that CMS determines;

(2) Subject to the Part B deductible and coinsurance;

(3) To hospital-based facilities in accordance with the cost reimbursement rules set forth in this part, except for erythropoietin/epogen (commonly called EPO), which is paid the same amount as independent facilities; and

(4) To independent facilities in accordance with the methodology set forth in § 405.517 of this chapter.

12. Section 413.180 is amended by

— A. Revising paragraphs (b) and (d) B. Removing paragraphs (e) and (k). C. Redesignating paragraphs (f) through (j) as paragraphs (e) through (i).

D. Redesignating paragraphs (l) and (m) as paragraphs (j) and (k).

The amendment reads as follows:

**§ 413.180 Procedures for requesting**  **exceptions to payment rates.**



### * * * * *

(b) Criteria for requesting an exception. If a pediatric ESRD facility projects on the basis of prior year costs and utilization trends that it has an allowable cost per treatment higher than its prospective rate set under § 413.174, and if these excess costs are attributable to one or more of the factors in § 413.182, the facility may request, in accordance with paragraph (e) of this section, that CMS approve an exception to that rate and set a higher prospective payment rate.

* * * * *

(d) Payment rate exception request. Effective October 1, 2002, CMS may approve exceptions to a pediatric ESRD facility ’ s updated prospective payment rate, if the pediatric ESRD facility did not have an approved exception rate as of October 1, 2002. A pediatric ESRD facility may request an exception to its payment rate at any time after it is in operation for at least 12 consecutive months.

* * * * *

13. Section 413.182 is revised to read as follows:

**§ 413.182 Criteria for approval of**  **exception requests.**



### (a) CMS may approve exceptions to a pediatric ESRD facility ’ s prospective payment rate if the pediatric ESRD facility did not have an approved exception rate as of October 1, 2002.

(b) The pediatric ESRD facility must demonstrate, by convincing objective evidence, that its total per treatment costs are reasonable and allowable under the relevant cost reimbursement principles of part 413 and that its per treatment costs in excess of its payment rate are directly attributable to any of the following criteria: (1) Pediatric patient mix, as specified
in § 413.184.

(2) Self-dialysis training costs in pediatric facilities, as specified in § 413.186

14. Section 413.184 is amended by revising paragraphs (a) and (b)(1) to read as follows:

**§ 413.184 Payment exception: Pediatric**  **patient mix.**



### (a) Qualifications. To qualify for an exception to its prospective payment rate based on its pediatric patient mix a facility must demonstrate that

—

(1) At least 50 percent of its patients are individuals under 18 years of age;

(2) Its nursing personnel costs are allocated properly between each mode of care;

(3) The additional nursing hours per treatment are not the result of an excess number of employees;

(4) Its pediatric patients require a significantly higher staff-to-patient ratio than typical adult patients; and

(5) These services, procedures, or supplies and its per treatment costs are clearly prudent and reasonable when compared to those of pediatric facilities with a similar patient mix.

(b) Documentation. (1) A pediatric ESRD facility must submit a listing of all outpatient dialysis patients (including all home patients) treated during the most recently completed and filed cost report (in accordance with cost reporting requirements under § 413.198) showing

—

(i) Age of patients and percentage of patients under the age of 18;

(ii) Individual patient diagnosis; (iii) Home patients and ages; (iv) In-facility patients, staff-assisted, or self-dialysis;

(v) Diabetic patients; and (vi) Patients isolated because of contagious disease.

* * * * *

**§ 413.186 [Removed]** 



### 15. Section 413.186 is removed.

**§ 413.188 [Removed]** 



### 16. Section 413.188 is removed. 17. Redesignate § 413.190 as § 413.186 and revise the newly designated § 413.186 to read as follows:

**§ 413.186 Payment exception: Self-dialysis**  **training costs in pediatric facilities.**



### (a) Qualification. To qualify for an exception to the prospective payment rate based on self-dialysis training costs, the pediatric ESRD facility must establish that it incurs per treatment costs for furnishing self-dialysis and home dialysis training that exceed the facility ’ s payment rate for the training
sessions. (b) Justification. To justify its exception request, a facility must

—

(1) Separately identify those elements contributing to its costs in excess of the composite training rate; and

(2) Demonstrate that its per treatment costs are reasonable and allowable.

(c) Criteria for determining proper cost reporting. CMS considers the pediatric ESRD facility ’ s total costs, cost finding and apportionment, including its allocation of costs, to determine if costs are properly reported by treatment modality.

(d) Limitation of exception requests. Exception requests for a higher training rate are limited to those cost components relating to training such as technical staff, medical supplies, and the special costs of education (manuals and education materials). These requests may include overhead and other indirect costs to the extent that these costs are directly attributable to the additional training costs.

(e) Documentation. The pediatric ESRD facility must provide the following information to support its exception request:

(1) A copy of the facility ’ s training

program.

(2) Computation of the facility ’ s cost per treatment for maintenance sessions and training sessions including an explanation of the cost difference between the two modalities.

(3) Class size and patients ’ training schedules.

(4) Number of training sessions required, by treatment modality, to train patients.

(5) Number of patients trained for the current year and the prior 2 years on a monthly basis.

(6) Projection for the next 12 months of future training candidates.

(7) The number and qualifications of staff at training sessions.

(f) Accelerated training exception. (1) A pediatric ESRD facility may bill Medicare for a dialysis training session only when a patient receives a dialysis treatment (normally three times a week for hemodialysis). Continuous cycling peritoneal dialysis (CCPD) and continuous ambulatory peritoneal dialysis (CAPD) are daily treatment modalities; ESRD facilities are paid the equivalent of three hemodialysis treatments for each week that CCPD and CAPD treatments are provided.

(2) If a pediatric ESRD facility elects to train all its patients using a particular treatment modality more often than during each dialysis treatment and, as a result, the number of billable training dialysis sessions is less than the number of actual training sessions, the facility


## 45874 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

may request a composite rate exception, limited to the lesser of the

—

(i) Facility ’ s projected training cost per treatment; or

(ii) Cost per treatment the facility receives in training a patient if it had trained patients only during a dialysis treatment, that is, three times per week.

(3) An ESRD facility may bill a maximum of 25 training sessions per patient for hemodialysis training and 15 sessions for CCPD and CAPD training.

(4) In computing the payment amount under an accelerated training exception, CMS uses a minimum number of training sessions per patient (15 for hemodialysis and 5 for CAPD and CCPD) when the facility actually provides fewer than the minimum number of training sessions.

(5) To justify an accelerated training exception request, an ESRD facility must document that a significant number of training sessions for a particular modality are provided during a shorter but more condensed period.

(6) The facility must submit with the exception request a list of patients, by modality, trained during the most recent cost report period. The list must include each beneficiary ’ s

—

(i) Name; (ii) Age; and (iii) Training status (completed, not completed, being retrained, or in the process of being trained).

(7) The total treatments from the patient list must be the same as the total treatments reported on the cost report filed with the request.

**§ 413.192 [Removed]** 



### 18. Section 413.192 is removed.

**PART 414**

**— PAYMENT FOR PART B**  **MEDICAL AND OTHER HEALTH SERVICES** 

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

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



### Subpart B

**— Physicians and Other**  **Practitioners**

20. Section 414.65 is amended by revising paragraph (a)(1) to read as follows:.

**§ 414.65 Payment for telehealth services** 



### (a) * * * (1) The Medicare payment amount for office or other outpatient visits, consultation, individual psychotherapy, psychiatric diagnostic interview examination, pharmacologic management, end stage renal disease related services included in the monthly capitation payment (except for one visit per month to examine the access site), and individual medical nutrition therapy furnished via an interactive telecommunications system is equal to the current fee schedule amount applicable for the service of the physician or practitioner.

* * * * *

21. Section 414.802 is amended by adding definitions of ‘‘ direct sales ’’ and

‘‘ indirect sales ’’ to read as follows:

**§ 414.802 Definitions** 



### * * * * *

Direct Sales means sales directly from the manufacturer to the provider (for example, physician or other health care provider) or supplier.

* * * * *

Indirect Sales means from the manufacturer to a wholesaler, distributor, or similar entity that sells to others in the distribution chain. Indirect sales also include any sale subject to the average sales price reporting requirement that is not a direct sale.

* * * * *

22. Section 414.804(a) is amended by: A. Redesignating paragraphs (a)(3), (a)(4), (a)(5), and (a)(6), as paragraphs (a)(4), (a)(5), (a)(6), and (a)(7).

B. Adding a new paragraph (a)(3). C. Revising newly redesignated paragraph (a)(4).

The redesignations and revisions read as follows:

**§ 414.804 Basis of payment.** 



### (a) * * * (3) In calculating the manufacturer ’ s average sales price, a manufacturer

must

—

(i) Calculate the average sales price for direct sales;

(ii) Calculate the average sales price for indirect sales; and

(iii) Calculate the weighted average of the results from paragraphs (a)(3)(i) and (a)(3)(ii). Example. [(ASP for direct sales

× direct sales units) + (ASP for indirect sales × indirect sales units)]/(direct sales units + indirect units sales units).

(4) To the extent that data on price concessions, as described in paragraph (a)(2) of this section, are available on a lagged basis, the manufacturer must estimate this amount in accordance with the methodology described in paragraphs (a)(4)(i) through (a)(4)(iv) of this section, for each of the amounts calculated under paragraphs (a)(3)(i) and (a)(3)(ii) of this section, before calculating the weighted average described in paragraph (a)(3)(iii) of this
section.

(i) For each National Drug Code, the manufacturer calculates a percentage equal to the sum of the price concessions for the most recent 12- month period available associated with sales subject to the average sales price reporting requirement divided by the total in dollars for the sales subject to the average sales price reporting requirement for the same 12-month period.

(ii) The manufacturer then multiplies the percentage described in paragraph (a)(4)(i) of this section by the total in dollars for the sales subject to the average sales price reporting requirement for the quarter being submitted. (The manufacturer must carry a sufficient number of decimal places in the calculation of the price concessions percentage in order to round accurately the net total sales amount for the quarter to the nearest whole dollar.) The result of this multiplication is then subtracted from the total in dollars for the sales subject to the average sales price reporting requirement for the quarter being submitted.

(iii) The manufacturer then uses the result of the calculation described in paragraph (a)(4)(ii) of this section as the numerator and the number of units sold in the quarter as the denominator to calculate the manufacturer ’ s average sales price for the National Drug Code in the quarter being submitted.

(iv) Example. The total lagged price concessions (discounts, rebates, etc.) over the most recent 12-month period available associated with direct sales for National Drug Code 12345

–6789

–01 subject to the ASP reporting requirement equal $200,000. The total in dollars for the direct sales subject to the average sales price reporting requirement for the same period equals $600,000. The lagged price concessions percentage for this period equals 200,000/600,000 = .33333. The total in dollars for the direct sales subject to the average sales price reporting requirement for the quarter being reported equals $50,000 for 10,000 direct sales units sold. Assuming no non-lagged price concessions apply, the manufacturer ’ s average sales price calculation for direct sales for this National Drug Code for this quarter is: $50,000

— (0.33333 × $50,000) = $33,334 (net total direct sales amount); $33,334/ 10,000 = $3.33 (average sales price for direct sales). The average sales price for indirect sales is calculated independently.

* * * * *


## 45875 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

**Subpart L**

**— Supplying and Dispensing**  **Fees**

23. Section 414.1001 is amended by revising paragraph (a) as follows:

**§ 414.1001 Basis of payment.** 



### (a) A supplying fee of $24 is paid to a supplier for the first prescription of drugs and biologicals described in sections 1861(s)(2)(J), 1861(s)(2)(Q), and 1861(s)(2)(T) of the Act that that supplier provided to a beneficiary during a month. A supplying fee of $8 is paid to a supplier for each prescription of drugs and biologicals described in sections 1861(s)(2)(J), 1861(s)(2)(Q), and 1861(s)(2)(T) of the Act, after the first one, that that supplier provided to a beneficiary during a month.

* * * * *

**PART 426**

**— REVIEW OF NATIONAL**  **COVERAGE DETERMINATIONS AND LOCAL COVERAGE**  **DETERMINATIONS**

24. The authority citation for part 426 continues to read as follows: Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh).



### 25. The heading for part 426 is revised to read as set forth above.

**Subpart C**

**— General Provisions for the**  **Review of LCDs and NCDs**

26. Section 426.340 is amended by

— A. Revising paragraph (e)(2). B. Adding paragraph (e)(3). C. Revising paragraph (f)(2). D. Adding paragraph (f)(3). The revisions and additions read as follows:

**§ 426.340 Procedures for review of new**  **evidence.**



### * * * * *

(e) * * * (2) For LCDs, sets a reasonable timeframe, not more than 90 days, by which the contractor completes the reconsideration.

(3) For NCDs, sets a reasonable timeframe, in compliance with the timeframes specified in section 1862(1) of the Act, by which CMS completes the reconsideration. (f) * * * (2) For LCDs, the 90-day reconsideration timeframe is not met.

(3) For NCDs, the reconsideration timeframe as specified by the Board, in compliance with section 1862(1) of the Act, is not met.

* * * * *
(Catalog of Federal Domestic Assistance Program No. 93.778, Medical Assistance Program).
(Catalog of Federal Domestic Assistance Program No. 93.773, Medicare

—Hospital Insurance; and Program No. 93.774,
Medicare

— Supplementary Medical Insurance Program).

Dated: July 12, 2005.
Mark B. McClellan, Administrator, Centers for Medicare &
Medicaid Services.

Approved: July 18, 2005.
Michael O. Leavitt,
Secretary.


## 45876 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

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



### Addendum A—Explanation and Use of Addenda B

The addenda on the following pages provide various data pertaining to the Medicare fee schedule for physicians ’ services furnished in 2006. AddendumB contains the RVUs for work, nonfacility practice expense, facility practice expense, and malpractice expense, and other information for all services included in the physician fee schedule.

In previous years, we have listed many services in Addendum B that are not paid under the physician fee schedule. To avoid publishing as many pages of codes for these services, we are not including clinical laboratory codes and most alpha-numeric codes (Healthcare Common Procedure Coding System (HCPCS) codes not included in CPT) in Addendum B.

Addendum B—2006 Relative Value Units and Related Information Used in Determining Medicare Payments For

2006

This addendum contains the following information for each CPT code and alphanumeric HCPCS code, except for alphanumeric codes beginning with B (enteral and parenteral therapy), E (durable medical equipment), K (temporary codes for nonphysicians ’ services or items), or L (orthotics), and codes for anesthesiology.

1. CPT/HCPCS code. This is the CPT or alphanumeric HCPCS number for the service. Alphanumeric HCPCS codes are included at the end of this addendum.

2. Modifier. A modifier is shown if there is a technical component (modifier TC) and a professional component (PC) (modifier

– 26) for the service. If there is a PC and a TC for the service, Addendum B contains three entries for the code: One for the global values (both professional and technical); one for modifier

– 26 (PC); and one for modifier TC. The global service is not designated by a modifier, and physicians must bill using the code without a modifier if the physician furnishes both the PC and the TC of the service.

Modifier

– 53 is shown for a discontinued procedure. There will be RVUs for the code (CPT code 45378) with this modifier.

3. Status indicator. This indicator shows whether the CPT/HCPCS code is in the physician fee schedule and whether it is separately payable if the service is covered.

A = Active code. These codes are separately payable under the fee schedule if covered. There will be RVUs for codes with this status. The presence of an ‘‘ A ’’ indicator does not mean that Medicare has made a national coverage determination regarding the coverage of the service. Carriers remain responsible for coverage decisions in the absence of a national Medicare policy.

B = Bundled code. Payment for covered services is always bundled into payment for other services not specified. If RVUs are shown, they are not used for Medicare payment. If these services are covered, payment for them is subsumed by the payment for the services to which they are incident. (An example is a telephone call from a hospital nurse regarding care of a patient.)

C = Carrier-priced code. Carriers will establish RVUs and payment amountsfor these services, generally on a caseby-case basis following review of documentation, such as an operative report.

D = Deleted/discontinued code. These codes are deleted effective with the beginning of the calendar year.

E = Excluded from physician fee schedule by regulation. These codes are for items or services that CMS chose to exclude from the physician fee schedule payment by regulation. No RVUs are shown, and no payment may be made under the physician fee schedule for these codes. Payment for them, if they are covered, continues under reasonable charge or other payment procedures.

F = Deleted/discontinued codes. (Code not subject to a 90-day grace period.) These codes are deleted effective with the beginning of the year and are never subject to a grace period. This indicator is no longer effective with the 2006 physician fee schedule as of January 1, 2006.

G = Code not valid for Medicare purposes. Medicare does not recognize codes assigned this status. Medicare uses another code for reporting of, and payment for, these services. (Code subject to a 90 day grace period.) This indicator is no longer effective with the 2006 physician fee schedule as of January 1, 2006.

H = Deleted modifier. For 2000 and later years, either the TC or PC component shown for the code has been deleted and the deleted component is shown in the data base with the H status indicator.

I = Not valid for Medicare purposes. Medicare uses another code for the reporting of, and the payment for these services. (Code NOT subject to a 90-day grace period.)

N = Noncovered service. These codes are noncovered services. Medicare payment may not be made for these codes. If RVUs are shown, they are not used for Medicare payment.

P = Bundled or excluded code. There are no RVUs for these services. No separate payment is made for them under the physician fee schedule.

—If the item or service is covered as

incident to a physician ’ s service and is furnished on the same day as a physician ’ s service, payment for it is bundled into the payment for the physician ’ s service to which it is incident (an example is an elastic bandage furnished by a physician incident to a physician ’ s service).

—If the item or service is covered as

other than incident to a physician ’ s service, it is excluded from the physician fee schedule (for example, colostomy supplies) and is paid under the other payment provisions of the
Act. R = Restricted coverage. Special coverage instructions apply. If the service is covered and no RVUs are shown, it is carrier-priced.

T = Injections. There are RVUs for these services, but they are only paid if there are no other services payable under the physician fee schedule billed on the same date by the same provider. If any other services payable under the physician fee schedule are billed on the same date by the same provider, these services are bundled into the service(s) for which payment is made.

X = Exclusion by law. These codes represent an item or service that is not within the definition of ‘‘ physicians ’
services ’’ for physician fee schedule payment purposes. No RVUs are shown for these codes, and no payment may be made under the physician fee schedule. (Examples are ambulance services and clinical diagnostic laboratory services.)

4. Description of code. This is an abbreviated version of the narrative description of the code.

5. Physician work RVUs. These are the RVUs for the physician work for this service in 2005. Codes that are not used for Medicare payment are identified with a ‘‘ +. ’’

6. Non-facility practice expense
RVUs. These are the fully implemented resource-based practice expense RVUs for non-facility settings.

7. Facility practice expense RVUs. These are the fully implemented resource-based practice expense RVUs for facility settings.

8. Malpractice expense RVUs. These are the RVUs for the malpractice expense for the service for 2005.

9. Facility total. This is the sum of the work, fully implemented facility practice expense, and malpractice expense RVUs.


## 45877 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

10. Non-facility total. This is the sumof the work, fully implemented nonfacility practice expense, and malpractice expense RVUs.

11. Global period. This indicator shows the number of days in the global period for the code (0, 10, or 90 days). An explanation of the alpha codes follows: MMM = The code describes a service furnished in uncomplicated maternity cases including antepartum care, delivery, and postpartum care. The usual global surgical concept does not apply. See the 1999 Physicians ’ Current Procedural Terminology for specific definitions.

XXX = The global concept does not apply. YYY = The global period is to be set by the carrier (for example, unlisted surgery codes).

ZZZ = Code related to another service that is always included in the global period of the other service. (Note: Physician work and practice expense are associated with intra service time and in some instances the post service time.)


## 45878

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

0003T ......... ............ C Cervicography ............................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0008T ......... ............ C Upper gi endoscopy w/suture ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0010T ......... ............ C Tb test, gamma interferon ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0016T ......... ............ C Thermotx choroid vasc lesion ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0017T ......... ............ C Photocoagulat macular drusen ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0018T ......... ............ C Transcranial magnetic stimul ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0019T ......... ............ I Extracorp shock wave tx, ms ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0020T ......... ............ C Extracorp shock wave tx, ft ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0021T ......... ............ C Fetal oximetry, trnsvag/cerv ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0023T ......... ............ C Phenotype drug test, hiv 1 .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0024T ......... ............ C Transcath cardiac reduction ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0026T ......... ............ C Measure remnant lipoproteins ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0027T ......... ............ C Endoscopic epidural lysis ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0028T ......... ............ C Dexa body composition study ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0029T ......... ............ C Magnetic tx for incontinence ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0030T ......... ............ C Antiprothrombin antibody ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0031T ......... ............ C Speculoscopy .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0032T ......... ............ C Speculoscopy w/direct sample .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0033T ......... ............ C Endovasc taa repr incl subcl ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0034T ......... ............ C Endovasc taa repr w/o subcl ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0035T ......... ............ C Insert endovasc prosth, taa ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0036T ......... ............ C Endovasc prosth, taa, add-on ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0037T ......... ............ C Artery transpose/endovas taa ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0038T ......... ............ C Rad endovasc taa rpr w/cover .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0039T ......... ............ C Rad s/i, endovasc taa repair ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0040T ......... ............ C Rad s/i, endovasc taa prosth ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0041T ......... ............ C Detect ur infect agnt w/cpas ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0042T ......... ............ C Ct perfusion w/contrast, cbf ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0043T ......... ............ C Co expired gas analysis .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0044T ......... ............ C Whole body photography ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0045T ......... ............ C Whole body photography ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0046T ......... ............ C Cath lavage, mammary duct(s .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0047T ......... ............ C Cath lavage, mammary duct(s) ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0048T ......... ............ C Implant ventricular device ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0049T ......... ............ C External circulation assist ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0050T ......... ............ C Removal circulation assist ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0051T ......... ............ C Implant total heart system ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0052T ......... ............ C Replace component heart syst ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0053T ......... ............ C Replace component heart syst ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0054T ......... ............ C Bone surgery using computer ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0055T ......... ............ C Bone surgery using computer ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0056T ......... ............ C Bone surgery using computer ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0058T ......... ............ C Cryopreservation, ovary tiss ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0059T ......... ............ C Cryopreservation, oocyte ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0060T ......... ............ C Electrical impedance scan .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0061T ......... ............ C Destruction of tumor, breast ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0062T ......... ............ C Rep intradisc annulus;1 lev ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0063T ......... ............ C Rep intradisc annulus;>1lev ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0064T ......... ............ C Spectroscop eval expired gas ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0065T ......... ............ C Ocular photoscreen bilat ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0066T ......... ............ N Ct colonography;screen .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0066T ......... 26 ....... N Ct colonography;screen .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0066T ......... TC ...... N Ct colonography;screen .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0067T ......... ............ C Ct colonography;dx ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0067T ......... 26 ....... C Ct colonography;dx ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0067T ......... TC ...... C Ct colonography;dx ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0068T ......... ............ C Interp/rept heart sound ................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0069T ......... ............ C Analysis only heart sound ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0070T ......... ............ C Interp only heart sound ............................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0071T ......... ............ C U/s leiomyomata ablate <200 ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0072T ......... ............ C U/s leiomyomata ablate >200 ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0073T ......... ............ A Delivery, comp imrt ..................................... 0.00 16.71 NA 0.13 16.84 NA XXX 0074T ......... ............ N Online physician e/m ................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0075T ......... ............ C Perq stent/chest vert art .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0075T ......... 26 ....... C Perq stent/chest vert art .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0075T ......... TC ...... C Perq stent/chest vert art .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0076T ......... ............ C S&i stent/chest vert art ................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0076T ......... 26 ....... C S&i stent/chest vert art ................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0076T ......... TC ...... C S&i stent/chest vert art ................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0077T ......... ............ C Cereb therm perfusion probe ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0078T ......... ............ C Endovasc aort repr w/device ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0079T ......... ............ C Endovasc visc extnsn repr .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0080T ......... ............ C Endovasc aort repr rad s&i ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0081T ......... ............ C Endovasc visc extnsn s&i ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX


## 45879

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

0082T ......... ............ C Stereotactic rad delivery .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0083T ......... ............ C Stereotactic rad tx mngmt ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0084T ......... ............ C Temp prostate urethral stent ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0085T ......... ............ C Breath test heart reject ................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0086T ......... ............ C L ventricle fill pressure ................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0087T ......... ............ C Sperm eval hyaluronan ............................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0088T ......... ............ C Rf tongue base vol reduxn .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0500F ......... ............ I Initial prenatal care visit .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0501F ......... ............ I Prenatal flow sheet ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0502F ......... ............ I Subsequent prenatal care ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0503F ......... ............ I Postpartum care visit ................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 1000F ......... ............ I Tobacco use, smoking, assess ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 1001F ......... ............ I Tobacco use, non-smoking ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 10021 .......... ............ A Fna w/o image ............................................. 1.27 2.11 0.53 0.10 3.48 1.90 XXX 10022 .......... ............ A Fna w/image ................................................ 1.27 2.51 0.44 0.08 3.86 1.79 XXX 1002F ......... ............ I Assess anginal symptom/level .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 10040 .......... ............ A Acne surgery ............................................... 1.18 1.12 0.84 0.05 2.35 2.07 010 10060 .......... ............ A Drainage of skin abscess ............................ 1.17 1.27 0.94 0.12 2.56 2.24 010 10061 .......... ............ A Drainage of skin abscess ............................ 2.40 1.90 1.49 0.26 4.56 4.15 010 10080 .......... ............ A Drainage of pilonidal cyst ............................ 1.17 2.98 1.07 0.11 4.27 2.36 010 10081 .......... ............ A Drainage of pilonidal cyst ............................ 2.45 3.91 1.48 0.24 6.60 4.17 010 10120 .......... ............ A Remove foreign body .................................. 1.22 2.14 0.94 0.12 3.49 2.28 010 10121 .......... ............ A Remove foreign body .................................. 2.70 3.47 1.75 0.33 6.49 4.77 010 10140 .......... ............ A Drainage of hematoma/fluid ........................ 1.53 1.83 1.29 0.19 3.56 3.01 010 10160 .......... ............ A Puncture drainage of lesion ........................ 1.20 1.62 1.08 0.14 2.96 2.43 010 10180 .......... ............ A Complex drainage, wound .......................... 2.25 2.95 1.93 0.35 5.55 4.53 010 11000 .......... ............ A Debride infected skin ................................... 0.60 0.61 0.21 0.07 1.28 0.88 000 11001 .......... ............ A Debride infected skin add-on ...................... 0.30 0.24 0.11 0.04 0.58 0.45 ZZZ 11004 .......... ............ A Debride genitalia & perineum ...................... 10.33 NA 3.80 0.67 NA 14.80 000 11005 .......... ............ A Debride abdom wall .................................... 13.78 NA 5.42 0.96 NA 20.16 000 11006 .......... ............ A Debride genit/per/abdom wall ..................... 12.64 NA 4.73 1.28 NA 18.64 000 11008 .......... ............ A Remove mesh from abd wall ...................... 5.01 NA 1.97 0.61 NA 7.59 ZZZ 11010 .......... ............ A Debride skin, fx ........................................... 4.20 6.68 2.57 0.66 11.54 7.43 010 11011 .......... ............ A Debride skin/muscle, fx ............................... 4.95 7.80 2.29 0.74 13.49 7.98 000 11012 .......... ............ A Debride skin/muscle/bone, fx ...................... 6.88 11.37 3.73 1.16 19.41 11.78 000 11040 .......... ............ A Debride skin, partial .................................... 0.50 0.55 0.21 0.06 1.11 0.77 000 11041 .......... ............ A Debride skin, full .......................................... 0.82 0.68 0.32 0.10 1.60 1.24 000 11042 .......... ............ A Debride skin/tissue ...................................... 1.12 0.98 0.43 0.13 2.23 1.68 000 11043 .......... ............ A Debride tissue/muscle ................................. 2.38 3.33 2.54 0.32 6.03 5.25 010 11044 .......... ............ A Debride tissue/muscle/bone ........................ 3.07 4.38 3.65 0.43 7.88 7.15 010
11055 .......... ............ R Trim skin lesion ........................................... 0.43 0.60 0.17 0.05 1.08 0.65 000 11056 .......... ............ R Trim skin lesions, 2 to 4 .............................. 0.61 0.68 0.23 0.07 1.36 0.91 000 11057 .......... ............ R Trim skin lesions, over 4 ............................. 0.79 0.78 0.29 0.10 1.68 1.18 000 11100 .......... ............ A Biopsy, skin lesion ....................................... 0.81 1.38 0.39 0.03 2.22 1.23 000 11101 .......... ............ A Biopsy, skin add-on ..................................... 0.41 0.37 0.20 0.02 0.80 0.63 ZZZ 11200 .......... ............ A Removal of skin tags ................................... 0.77 1.11 0.78 0.04 1.92 1.59 010 11201 .......... ............ A Remove skin tags add-on ........................... 0.29 0.17 0.12 0.02 0.48 0.43 ZZZ 11300 .......... ............ A Shave skin lesion ........................................ 0.51 1.05 0.21 0.03 1.59 0.75 000 11301 .......... ............ A Shave skin lesion ........................................ 0.85 1.22 0.39 0.04 2.11 1.28 000 11302 .......... ............ A Shave skin lesion ........................................ 1.05 1.43 0.46 0.05 2.53 1.57 000 11303 .......... ............ A Shave skin lesion ........................................ 1.24 1.73 0.52 0.07 3.04 1.83 000 11305 .......... ............ A Shave skin lesion ........................................ 0.67 0.91 0.27 0.07 1.65 1.01 000 11306 .......... ............ A Shave skin lesion ........................................ 0.99 1.20 0.42 0.07 2.27 1.48 000 11307 .......... ............ A Shave skin lesion ........................................ 1.14 1.41 0.49 0.07 2.63 1.70 000 11308 .......... ............ A Shave skin lesion ........................................ 1.41 1.56 0.58 0.13 3.10 2.13 000 11310 .......... ............ A Shave skin lesion ........................................ 0.73 1.19 0.32 0.04 1.96 1.09 000 11311 .......... ............ A Shave skin lesion ........................................ 1.05 1.35 0.49 0.05 2.45 1.59 000 11312 .......... ............ A Shave skin lesion ........................................ 1.20 1.57 0.55 0.06 2.83 1.81 000 11313 .......... ............ A Shave skin lesion ........................................ 1.62 1.95 0.71 0.10 3.67 2.43 000 11400 .......... ............ A Exc tr-ext b9+marg 0.5 < cm ...................... 0.85 1.98 0.88 0.06 2.89 1.79 010 11401 .......... ............ A Exc tr-ext b9+marg 0.6-1 cm ...................... 1.23 2.08 1.01 0.10 3.42 2.35 010 11402 .......... ............ A Exc tr-ext b9+marg 1.1-2 cm ...................... 1.51 2.26 1.07 0.13 3.91 2.72 010 11403 .......... ............ A Exc tr-ext b9+marg 2.1-3 cm ...................... 1.79 2.43 1.32 0.17 4.39 3.28 010 11404 .......... ............ A Exc tr-ext b9+marg 3.1-4 cm ...................... 2.06 2.74 1.40 0.21 5.01 3.67 010 11406 .......... ............ A Exc tr-ext b9+marg > 4.0 cm ...................... 2.77 3.08 1.64 0.32 6.16 4.73 010 11420 .......... ............ A Exc h-f-nk-sp b9+marg 0.5 < ...................... 0.98 1.79 0.93 0.09 2.86 2.00 010 11421 .......... ............ A Exc h-f-nk-sp b9+marg 0.6-1 ...................... 1.42 2.11 1.10 0.13 3.66 2.66 010 11422 .......... ............ A Exc h-f-nk-sp b9+marg 1.1-2 ...................... 1.63 2.30 1.33 0.16 4.09 3.12 010 11423 .......... ............ A Exc h-f-nk-sp b9+marg 2.1-3 ...................... 2.01 2.61 1.45 0.20 4.83 3.66 010 11424 .......... ............ A Exc h-f-nk-sp b9+marg 3.1-4 ...................... 2.43 2.87 1.60 0.25 5.55 4.28 010 11426 .......... ............ A Exc h-f-nk-sp b9+marg > 4 cm ................... 3.78 3.50 2.09 0.44 7.72 6.30 010 11440 .......... ............ A Exc face-mm b9+marg 0.5 < cm ................ 1.06 2.19 1.29 0.08 3.33 2.43 010 11441 .......... ............ A Exc face-mm b9+marg 0.6-1 cm ................. 1.48 2.35 1.47 0.13 3.97 3.08 010 11442 .......... ............ A Exc face-mm b9+marg 1.1-2 cm ................. 1.72 2.59 1.55 0.16 4.47 3.43 010


## 45880

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

11443 .......... ............ A Exc face-mm b9+marg 2.1-3 cm ................. 2.29 2.96 1.78 0.22 5.48 4.30 010 11444 .......... ............ A Exc face-mm b9+marg 3.1-4 cm ................. 3.15 3.52 2.14 0.30 6.97 5.59 010 11446 .......... ............ A Exc face-mm b9+marg > 4 cm ................... 4.49 4.17 2.71 0.43 9.09 7.63 010 11450 .......... ............ A Removal, sweat gland lesion ...................... 2.74 4.91 2.02 0.34 7.99 5.10 090 11451 .......... ............ A Removal, sweat gland lesion ...................... 3.95 6.43 2.52 0.53 10.90 7.00 090 11462 .......... ............ A Removal, sweat gland lesion ...................... 2.52 5.04 2.03 0.32 7.88 4.86 090 11463 .......... ............ A Removal, sweat gland lesion ...................... 3.95 6.59 2.67 0.54 11.08 7.16 090 11470 .......... ............ A Removal, sweat gland lesion ...................... 3.26 4.98 2.28 0.40 8.64 5.93 090 11471 .......... ............ A Removal, sweat gland lesion ...................... 4.41 6.48 2.76 0.58 11.47 7.75 090 11600 .......... ............ A Exc tr-ext mlg+marg 0.5 < cm .................... 1.31 2.68 0.96 0.10 4.09 2.38 010 11601 .......... ............ A Exc tr-ext mlg+marg 0.6-1 cm ..................... 1.80 2.86 1.21 0.12 4.78 3.14 010 11602 .......... ............ A Exc tr-ext mlg+marg 1.1-2 cm ..................... 1.95 3.00 1.25 0.12 5.07 3.32 010 11603 .......... ............ A Exc tr-ext mlg+marg 2.1-3 cm ..................... 2.19 3.22 1.31 0.16 5.58 3.66 010 11604 .......... ............ A Exc tr-ext mlg+marg 3.1-4 cm ..................... 2.40 3.52 1.37 0.20 6.13 3.98 010 11606 .......... ............ A Exc tr-ext mlg+marg > 4 cm ....................... 3.43 4.22 1.70 0.36 8.01 5.49 010 11620 .......... ............ A Exc h-f-nk-sp mlg+marg 0.5 < .................... 1.19 2.65 0.94 0.09 3.93 2.22 010 11621 .......... ............ A Exc h-f-nk-sp mlg+marg 0.6-1 ..................... 1.76 2.86 1.22 0.12 4.74 3.11 010 11622 .......... ............ A Exc h-f-nk-sp mlg+marg 1.1-2 ..................... 2.09 3.14 1.37 0.14 5.38 3.60 010 11623 .......... ............ A Exc h-f-nk-sp mlg+marg 2.1-3 ..................... 2.62 3.49 1.55 0.20 6.30 4.36 010 11624 .......... ............ A Exc h-f-nk-sp mlg+marg 3.1-4 ..................... 3.07 3.90 1.74 0.27 7.23 5.07 010 11626 .......... ............ A Exc h-f-nk-sp mlg+mar > 4 cm ................... 4.30 4.79 2.34 0.45 9.54 7.09 010 11640 .......... ............ A Exc face-mm malig+marg 0.5 < .................. 1.35 2.74 1.09 0.11 4.20 2.55 010 11641 .......... ............ A Exc face-mm malig+marg 0.6-1 .................. 2.16 3.19 1.50 0.16 5.52 3.82 010 11642 .......... ............ A Exc face-mm malig+marg 1.1-2 .................. 2.60 3.59 1.67 0.19 6.38 4.45 010 11643 .......... ............ A Exc face-mm malig+marg 2.1-3 .................. 3.11 3.98 1.91 0.26 7.34 5.28 010 11644 .......... ............ A Exc face-mm malig+marg 3.1-4 .................. 4.03 4.87 2.39 0.37 9.27 6.79 010 11646 .......... ............ A Exc face-mm mlg+marg > 4 cm .................. 5.95 5.96 3.38 0.61 12.53 9.94 010 11719 .......... ............ R Trim nail(s) .................................................. 0.17 0.27 0.07 0.02 0.46 0.26 000 11720 .......... ............ A Debride nail, 1-5 .......................................... 0.32 0.36 0.12 0.04 0.72 0.48 000 11721 .......... ............ A Debride nail, 6 or more ............................... 0.54 0.46 0.21 0.07 1.07 0.82 000 11730 .......... ............ A Removal of nail plate .................................. 1.13 1.08 0.42 0.14 2.36 1.69 000 11732 .......... ............ A Remove nail plate, add-on .......................... 0.57 0.46 0.22 0.07 1.10 0.86 ZZZ 11740 .......... ............ A Drain blood from under nail ........................ 0.37 0.59 0.36 0.04 1.00 0.77 000 11750 .......... ............ A Removal of nail bed .................................... 1.86 2.27 1.76 0.22 4.35 3.85 010 11752 .......... ............ A Remove nail bed/finger tip .......................... 2.68 3.09 2.95 0.35 6.12 5.98 010 11755 .......... ............ A Biopsy, nail unit ........................................... 1.31 1.70 0.78 0.14 3.15 2.23 000 11760 .......... ............ A Repair of nail bed ........................................ 1.58 2.68 1.71 0.21 4.47 3.50 010 11762 .......... ............ A Reconstruction of nail bed .......................... 2.90 3.00 2.27 0.36 6.26 5.53 010 11765 .......... ............ A Excision of nail fold, toe .............................. 0.69 1.91 0.80 0.08 2.68 1.57 010 11770 .......... ............ A Removal of pilonidal lesion ......................... 2.62 3.43 1.49 0.33 6.37 4.44 010 11771 .......... ............ A Removal of pilonidal lesion ......................... 5.74 5.69 3.32 0.74 12.18 9.80 090 11772 .......... ............ A Removal of pilonidal lesion ......................... 6.98 7.42 5.05 0.89 15.29 12.92 090 11900 .......... ............ A Injection into skin lesions ............................ 0.52 0.72 0.22 0.02 1.26 0.76 000 11901 .......... ............ A Added skin lesions injection ........................ 0.80 0.76 0.38 0.03 1.59 1.21 000 11920 .......... ............ R Correct skin color defects ........................... 1.61 3.44 1.08 0.24 5.30 2.93 000 11921 .......... ............ R Correct skin color defects ........................... 1.93 3.70 1.24 0.29 5.92 3.47 000 11922 .......... ............ R Correct skin color defects ........................... 0.49 1.08 0.24 0.07 1.65 0.80 ZZZ 11950 .......... ............ R Therapy for contour defects ........................ 0.84 1.13 0.41 0.06 2.03 1.31 000 11951 .......... ............ R Therapy for contour defects ........................ 1.19 1.47 0.51 0.11 2.77 1.82 000 11952 .......... ............ R Therapy for contour defects ........................ 1.69 1.81 0.67 0.16 3.66 2.52 000 11954 .......... ............ R Therapy for contour defects ........................ 1.85 2.32 0.89 0.25 4.42 3.00 000 11960 .......... ............ A Insert tissue expander(s) ............................. 9.09 NA 10.12 1.31 NA 20.51 090 11970 .......... ............ A Replace tissue expander ............................. 7.06 NA 5.95 1.05 NA 14.07 090 11971 .......... ............ A Remove tissue expander(s) ........................ 2.13 8.65 3.67 0.32 11.10 6.12 090 11975 .......... ............ N Insert contraceptive cap .............................. 1.48 1.50 0.57 0.17 3.15 2.22 XXX 11976 .......... ............ R Removal of contraceptive cap ..................... 1.78 1.75 0.66 0.21 3.74 2.66 000 11977 .......... ............ N Removal/reinsert contra cap ....................... 3.31 2.31 1.25 0.37 5.99 4.93 XXX 11980 .......... ............ A Implant hormone pellet(s) ........................... 1.48 1.12 0.58 0.13 2.73 2.19 000 11981 .......... ............ A Insert drug implant device ........................... 1.48 1.82 0.67 0.12 3.43 2.28 XXX 11982 .......... ............ A Remove drug implant device ...................... 1.78 2.03 0.82 0.17 3.98 2.78 XXX 11983 .......... ............ A Remove/insert drug implant ........................ 3.31 2.51 1.51 0.23 6.05 5.04 XXX 12001 .......... ............ A Repair superficial wound(s) ......................... 1.70 1.91 0.75 0.15 3.76 2.60 010 12002 .......... ............ A Repair superficial wound(s) ......................... 1.86 1.97 0.87 0.17 4.00 2.90 010 12004 .......... ............ A Repair superficial wound(s) ......................... 2.24 2.24 0.98 0.21 4.70 3.43 010 12005 .......... ............ A Repair superficial wound(s) ......................... 2.87 2.73 1.16 0.27 5.87 4.30 010 12006 .......... ............ A Repair superficial wound(s) ......................... 3.67 3.28 1.47 0.35 7.29 5.49 010 12007 .......... ............ A Repair superficial wound(s) ......................... 4.12 3.69 1.76 0.45 8.26 6.33 010 12011 .......... ............ A Repair superficial wound(s) ......................... 1.76 2.06 0.76 0.16 3.99 2.68 010 12013 .......... ............ A Repair superficial wound(s) ......................... 1.99 2.20 0.90 0.18 4.37 3.07 010 12014 .......... ............ A Repair superficial wound(s) ......................... 2.46 2.49 1.02 0.23 5.19 3.72 010 12015 .......... ............ A Repair superficial wound(s) ......................... 3.20 3.03 1.21 0.29 6.52 4.70 010 12016 .......... ............ A Repair superficial wound(s) ......................... 3.93 3.45 1.48 0.37 7.74 5.78 010 12017 .......... ............ A Repair superficial wound(s) ......................... 4.71 NA 1.84 0.47 NA 7.02 010 12018 .......... ............ A Repair superficial wound(s) ......................... 5.53 NA 2.19 0.64 NA 8.37 010


## 45881

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

12020 .......... ............ A Closure of split wound ................................. 2.63 3.78 1.88 0.30 6.71 4.80 010 12021 .......... ............ A Closure of split wound ................................. 1.84 1.82 1.40 0.24 3.90 3.48 010 12031 .......... ............ A Layer closure of wound(s) ........................... 2.15 2.69 1.06 0.17 5.01 3.39 010 12032 .......... ............ A Layer closure of wound(s) ........................... 2.47 4.16 1.76 0.16 6.80 4.39 010 12034 .......... ............ A Layer closure of wound(s) ........................... 2.93 3.55 1.47 0.25 6.73 4.64 010 12035 .......... ............ A Layer closure of wound(s) ........................... 3.43 5.25 2.09 0.39 9.07 5.91 010 12036 .......... ............ A Layer closure of wound(s) ........................... 4.05 5.50 2.47 0.55 10.10 7.07 010 12037 .......... ............ A Layer closure of wound(s) ........................... 4.67 6.07 2.88 0.66 11.40 8.21 010 12041 .......... ............ A Layer closure of wound(s) ........................... 2.37 2.89 1.20 0.19 5.46 3.77 010 12042 .......... ............ A Layer closure of wound(s) ........................... 2.75 3.58 1.49 0.17 6.50 4.41 010 12044 .......... ............ A Layer closure of wound(s) ........................... 3.15 3.70 1.61 0.27 7.12 5.03 010 12045 .......... ............ A Layer closure of wound(s) ........................... 3.64 5.20 2.22 0.41 9.25 6.27 010 12046 .......... ............ A Layer closure of wound(s) ........................... 4.25 6.30 2.68 0.54 11.09 7.47 010 12047 .......... ............ A Layer closure of wound(s) ........................... 4.65 6.42 2.99 0.58 11.64 8.22 010 12051 .......... ............ A Layer closure of wound(s) ........................... 2.47 3.52 1.47 0.20 6.19 4.15 010 12052 .......... ............ A Layer closure of wound(s) ........................... 2.78 3.56 1.46 0.17 6.50 4.40 010 12053 .......... ............ A Layer closure of wound(s) ........................... 3.13 3.83 1.55 0.23 7.18 4.91 010 12054 .......... ............ A Layer closure of wound(s) ........................... 3.46 4.13 1.64 0.30 7.89 5.40 010 12055 .......... ............ A Layer closure of wound(s) ........................... 4.43 5.03 2.12 0.45 9.91 7.00 010 12056 .......... ............ A Layer closure of wound(s) ........................... 5.24 6.86 2.95 0.59 12.69 8.78 010 12057 .......... ............ A Layer closure of wound(s) ........................... 5.96 6.58 3.62 0.56 13.11 10.15 010 13100 .......... ............ A Repair of wound or lesion ........................... 3.13 4.22 2.26 0.26 7.60 5.64 010 13101 .......... ............ A Repair of wound or lesion ........................... 3.92 5.05 2.65 0.26 9.23 6.82 010 13102 .......... ............ A Repair wound/lesion add-on ....................... 1.24 1.27 0.56 0.13 2.64 1.93 ZZZ 13120 .......... ............ A Repair of wound or lesion ........................... 3.31 4.29 2.29 0.26 7.85 5.86 010 13121 .......... ............ A Repair of wound or lesion ........................... 4.33 5.26 2.75 0.25 9.84 7.32 010 13122 .......... ............ A Repair wound/lesion add-on ....................... 1.44 1.54 0.62 0.15 3.13 2.21 ZZZ 13131 .......... ............ A Repair of wound or lesion ........................... 3.79 4.58 2.63 0.26 8.63 6.68 010 13132 .......... ............ A Repair of wound or lesion ........................... 5.95 6.47 4.16 0.32 12.74 10.43 010 13133 .......... ............ A Repair wound/lesion add-on ....................... 2.19 1.80 1.02 0.18 4.18 3.39 ZZZ 13150 .......... ............ A Repair of wound or lesion ........................... 3.81 4.92 2.70 0.34 9.06 6.85 010 13151 .......... ............ A Repair of wound or lesion ........................... 4.45 5.08 3.10 0.31 9.83 7.86 010 13152 .......... ............ A Repair of wound or lesion ........................... 6.33 6.56 3.96 0.40 13.30 10.69 010 13153 .......... ............ A Repair wound/lesion add-on ....................... 2.38 2.07 1.11 0.24 4.69 3.74 ZZZ 13160 .......... ............ A Late closure of wound ................................. 10.48 NA 7.03 1.54 NA 19.05 090 14000 .......... ............ A Skin tissue rearrangement .......................... 5.89 8.20 5.35 0.59 14.68 11.83 090 14001 .......... ............ A Skin tissue rearrangement .......................... 8.48 10.09 6.90 0.82 19.39 16.20 090 14020 .......... ............ A Skin tissue rearrangement .......................... 6.59 9.07 6.37 0.64 16.30 13.61 090 14021 .......... ............ A Skin tissue rearrangement .......................... 10.06 10.93 8.08 0.81 21.80 18.95 090 14040 .......... ............ A Skin tissue rearrangement .......................... 7.88 9.46 7.06 0.62 17.95 15.55 090 14041 .......... ............ A Skin tissue rearrangement .......................... 11.49 11.70 8.59 0.73 23.92 20.81 090 14060 .......... ............ A Skin tissue rearrangement .......................... 8.51 9.39 7.32 0.68 18.58 16.51 090 14061 .......... ............ A Skin tissue rearrangement .......................... 12.29 12.73 9.39 0.76 25.78 22.44 090 14300 .......... ............ A Skin tissue rearrangement .......................... 11.76 12.16 8.95 1.16 25.09 21.87 090 14350 .......... ............ A Skin tissue rearrangement .......................... 9.62 NA 7.01 1.34 NA 17.97 090 15000 .......... ............ A Skin graft ..................................................... 4.00 3.98 2.14 0.54 8.52 6.68 000 15001 .......... ............ A Skin graft add-on ......................................... 1.00 1.32 0.40 0.14 2.46 1.54 ZZZ 15050 .......... ............ A Skin pinch graft ........................................... 4.30 6.91 4.97 0.57 11.78 9.84 090 15100 .......... ............ A Skin split graft .............................................. 9.06 12.29 7.58 1.28 22.63 17.91 090 15101 .......... ............ A Skin split graft add-on ................................. 1.72 3.48 1.11 0.24 5.45 3.08 ZZZ 15120 .......... ............ A Skin split graft .............................................. 9.84 11.33 7.57 1.16 22.32 18.57 090 15121 .......... ............ A Skin split graft add-on ................................. 2.68 4.31 1.75 0.36 7.34 4.79 ZZZ 15200 .......... ............ A Skin full graft ............................................... 8.04 9.81 6.07 0.98 18.82 15.09 090 15201 .......... ............ A Skin full graft add-on ................................... 1.32 2.51 0.60 0.19 4.02 2.12 ZZZ 15220 .......... ............ A Skin full graft ............................................... 7.88 9.79 6.51 0.84 18.51 15.23 090 15221 .......... ............ A Skin full graft add-on ................................... 1.19 2.30 0.55 0.16 3.65 1.90 ZZZ 15240 .......... ............ A Skin full graft ............................................... 9.05 10.88 7.76 0.92 20.85 17.72 090 15241 .......... ............ A Skin full graft add-on ................................... 1.86 2.54 0.89 0.23 4.63 2.98 ZZZ 15260 .......... ............ A Skin full graft ............................................... 10.06 11.18 8.47 0.69 21.93 19.22 090 15261 .......... ............ A Skin full graft add-on ................................... 2.23 2.85 1.36 0.21 5.29 3.80 ZZZ 15342 .......... ............ A Cultured skin graft, 25 cm ........................... 1.00 1.86 0.54 0.12 2.98 1.66 010 15343 .......... ............ A Culture skn graft addl 25 cm ....................... 0.25 0.09 0.09 0.03 0.37 0.37 ZZZ 15350 .......... ............ A Skin homograft ............................................ 4.00 6.20 3.75 0.51 10.71 8.26 090 15351 .......... ............ A Skin homograft add-on ................................ 1.00 NA 0.36 0.14 NA 1.50 ZZZ 15400 .......... ............ A Skin heterograft ........................................... 4.00 4.14 3.97 0.47 8.61 8.43 090 15401 .......... ............ A Skin heterograft add-on ............................... 1.00 1.79 0.43 0.14 2.93 1.57 ZZZ 15570 .......... ............ A Form skin pedicle flap ................................. 9.22 10.97 6.57 1.34 21.53 17.13 090 15572 .......... ............ A Form skin pedicle flap ................................. 9.28 9.50 6.27 1.20 19.98 16.75 090 15574 .......... ............ A Form skin pedicle flap ................................. 9.89 10.88 7.59 1.20 21.97 18.68 090 15576 .......... ............ A Form skin pedicle flap ................................. 8.70 9.94 6.72 0.87 19.51 16.29 090 15600 .......... ............ A Skin graft ..................................................... 1.91 7.11 2.95 0.27 9.29 5.13 090 15610 .......... ............ A Skin graft ..................................................... 2.42 4.58 3.30 0.35 7.36 6.07 090 15620 .......... ............ A Skin graft ..................................................... 2.95 7.48 3.77 0.35 10.77 7.07 090 15630 .......... ............ A Skin graft ..................................................... 3.28 7.06 4.05 0.34 10.68 7.66 090


## 45882

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

15650 .......... ............ A Transfer skin pedicle flap ............................ 3.97 7.20 4.12 0.42 11.59 8.50 090 15732 .......... ............ A Muscle-skin graft, head/neck ...................... 17.85 17.55 11.84 1.99 37.38 31.67 090 15734 .......... ............ A Muscle-skin graft, trunk ............................... 17.80 17.23 11.96 2.61 37.64 32.36 090 15736 .......... ............ A Muscle-skin graft, arm ................................. 16.28 17.29 10.85 2.45 36.03 29.58 090 15738 .......... ............ A Muscle-skin graft, leg .................................. 17.93 17.10 11.35 2.65 37.68 31.92 090 15740 .......... ............ A Island pedicle flap graft ............................... 10.25 11.22 8.29 0.63 22.11 19.17 090 15750 .......... ............ A Neurovascular pedicle graft ........................ 11.41 NA 8.81 1.42 NA 21.65 090 15756 .......... ............ A Free myo/skin flap microvasc ..................... 35.25 NA 19.96 4.61 NA 59.82 090 15757 .......... ............ A Free skin flap, microvasc ............................ 35.25 NA 20.93 3.89 NA 60.07 090 15758 .......... ............ A Free fascial flap, microvasc ........................ 35.12 NA 20.93 4.23 NA 60.28 090 15760 .......... ............ A Composite skin graft ................................... 8.75 10.37 7.07 0.85 19.97 16.66 090 15770 .......... ............ A Derma-fat-fascia graft .................................. 7.53 NA 6.55 1.05 NA 15.13 090 15775 .......... ............ R Hair transplant punch grafts ........................ 3.96 4.40 1.34 0.52 8.88 5.82 000 15776 .......... ............ R Hair transplant punch grafts ........................ 5.54 5.71 2.82 0.72 11.97 9.08 000 15780 .......... ............ A Abrasion treatment of skin .......................... 7.29 11.64 8.13 0.67 19.61 16.09 090 15781 .......... ............ A Abrasion treatment of skin .......................... 4.85 7.37 5.36 0.34 12.56 10.55 090 15782 .......... ............ A Abrasion treatment of skin .......................... 4.32 9.54 6.31 0.34 14.20 10.96 090 15783 .......... ............ A Abrasion treatment of skin .......................... 4.29 7.10 4.35 0.28 11.67 8.92 090 15786 .......... ............ A Abrasion, lesion, single ............................... 2.03 3.43 1.39 0.11 5.58 3.54 010 15787 .......... ............ A Abrasion, lesions, add-on ............................ 0.33 1.02 0.16 0.04 1.40 0.53 ZZZ 15788 .......... ............ R Chemical peel, face, epiderm ..................... 2.09 7.25 3.43 0.11 9.46 5.63 090 15789 .......... ............ R Chemical peel, face, dermal ....................... 4.92 8.43 5.00 0.20 13.55 10.12 090 15792 .......... ............ R Chemical peel, nonfacial ............................. 1.86 7.34 4.59 0.13 9.33 6.59 090 15793 .......... ............ A Chemical peel, nonfacial ............................. 3.74 6.85 4.57 0.19 10.78 8.50 090 15810 .......... ............ A Salabrasion .................................................. 4.74 0.00 3.74 0.51 5.25 8.99 090 15811 .......... ............ A Salabrasion .................................................. 5.39 5.30 4.65 0.80 11.49 10.84 090 15819 .......... ............ A Plastic surgery, neck ................................... 9.39 NA 7.02 0.97 NA 17.38 090 15820 .......... ............ A Revision of lower eyelid .............................. 5.15 6.76 5.38 0.40 12.31 10.93 090 15821 .......... ............ A Revision of lower eyelid .............................. 5.72 7.13 5.55 0.45 13.30 11.72 090 15822 .......... ............ A Revision of upper eyelid .............................. 4.45 5.66 4.37 0.37 10.48 9.19 090 15823 .......... ............ A Revision of upper eyelid .............................. 7.05 7.64 6.27 0.50 15.20 13.82 090 15824 .......... ............ R Removal of forehead wrinkles ..................... 0.00 0.00 0.00 0.00 0.00 0.00 000 15825 .......... ............ R Removal of neck wrinkles ........................... 0.00 0.00 0.00 0.00 0.00 0.00 000 15826 .......... ............ R Removal of brow wrinkles ........................... 0.00 0.00 0.00 0.00 0.00 0.00 000 15828 .......... ............ R Removal of face wrinkles ............................ 0.00 0.00 0.00 0.00 0.00 0.00 000 15829 .......... ............ R Removal of skin wrinkles ............................ 0.00 0.00 0.00 0.00 0.00 0.00 000
15831 .......... ............ A Excise excessive skin tissue ....................... 12.40 NA 7.99 1.75 NA 22.14 090 15832 .......... ............ A Excise excessive skin tissue ....................... 11.59 NA 8.13 1.66 NA 21.39 090 15833 .......... ............ A Excise excessive skin tissue ....................... 10.64 NA 7.89 1.49 NA 20.02 090 15834 .......... ............ A Excise excessive skin tissue ....................... 10.85 NA 7.50 1.61 NA 19.96 090 15835 .......... ............ A Excise excessive skin tissue ....................... 11.67 NA 7.42 1.60 NA 20.69 090 15836 .......... ............ A Excise excessive skin tissue ....................... 9.35 NA 6.64 1.34 NA 17.33 090 15837 .......... ............ A Excise excessive skin tissue ....................... 8.44 8.28 7.16 1.18 17.90 16.78 090 15838 .......... ............ A Excise excessive skin tissue ....................... 7.13 NA 5.93 0.58 NA 13.64 090 15839 .......... ............ A Excise excessive skin tissue ....................... 9.39 8.67 6.28 1.22 19.28 16.89 090 15840 .......... ............ A Graft for face nerve palsy ........................... 13.27 NA 9.70 1.32 NA 24.28 090 15841 .......... ............ A Graft for face nerve palsy ........................... 23.28 NA 14.69 2.54 NA 40.51 090 15842 .......... ............ A Flap for face nerve palsy ............................ 37.98 NA 22.25 4.93 NA 65.16 090 15845 .......... ............ A Skin and muscle repair, face ...................... 12.58 NA 9.08 0.81 NA 22.47 090 15850 .......... ............ B Removal of sutures ..................................... 0.78 1.53 0.30 0.05 2.36 1.13 XXX 15851 .......... ............ A Removal of sutures ..................................... 0.86 1.62 0.30 0.06 2.54 1.22 000 15852 .......... ............ A Dressing change not for burn ..................... 0.86 1.77 0.32 0.09 2.72 1.27 000 15860 .......... ............ A Test for blood flow in graft .......................... 1.95 NA 0.77 0.27 NA 2.99 000 15876 .......... ............ R Suction assisted lipectomy .......................... 0.00 0.00 0.00 0.00 0.00 0.00 000 15877 .......... ............ R Suction assisted lipectomy .......................... 0.00 0.00 0.00 0.00 0.00 0.00 000 15878 .......... ............ R Suction assisted lipectomy .......................... 0.00 0.00 0.00 0.00 0.00 0.00 000 15879 .......... ............ R Suction assisted lipectomy .......................... 0.00 0.00 0.00 0.00 0.00 0.00 000
15920 .......... ............ A Removal of tail bone ulcer .......................... 7.96 NA 5.45 1.04 NA 14.44 090 15922 .......... ............ A Removal of tail bone ulcer .......................... 9.91 NA 7.03 1.42 NA 18.36 090 15931 .......... ............ A Remove sacrum pressure sore ................... 9.25 NA 5.58 1.25 NA 16.08 090 15933 .......... ............ A Remove sacrum pressure sore ................... 10.85 NA 7.66 1.52 NA 20.03 090 15934 .......... ............ A Remove sacrum pressure sore ................... 12.70 NA 7.84 1.78 NA 22.32 090 15935 .......... ............ A Remove sacrum pressure sore ................... 14.58 NA 10.04 2.09 NA 26.71 090 15936 .......... ............ A Remove sacrum pressure sore ................... 12.38 NA 7.99 1.76 NA 22.14 090 15937 .......... ............ A Remove sacrum pressure sore ................... 14.22 NA 9.53 2.06 NA 25.81 090 15940 .......... ............ A Remove hip pressure sore .......................... 9.35 NA 6.02 1.31 NA 16.68 090 15941 .......... ............ A Remove hip pressure sore .......................... 11.43 NA 9.13 1.66 NA 22.23 090 15944 .......... ............ A Remove hip pressure sore .......................... 11.46 NA 8.36 1.65 NA 21.47 090 15945 .......... ............ A Remove hip pressure sore .......................... 12.70 NA 9.36 1.84 NA 23.90 090 15946 .......... ............ A Remove hip pressure sore .......................... 21.58 NA 13.97 3.16 NA 38.71 090 15950 .......... ............ A Remove thigh pressure sore ....................... 7.55 NA 5.30 1.04 NA 13.88 090 15951 .......... ............ A Remove thigh pressure sore ....................... 10.72 NA 7.67 1.49 NA 19.88 090 15952 .......... ............ A Remove thigh pressure sore ....................... 11.39 NA 7.57 1.60 NA 20.56 090 15953 .......... ............ A Remove thigh pressure sore ....................... 12.64 NA 8.75 1.79 NA 23.18 090


## 45883

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

15956 .......... ............ A Remove thigh pressure sore ....................... 15.53 NA 10.47 2.21 NA 28.21 090 15958 .......... ............ A Remove thigh pressure sore ....................... 15.49 NA 10.73 2.25 NA 28.47 090 15999 .......... ............ C Removal of pressure sore ........................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 16000 .......... ............ A Initial treatment of burn(s) ........................... 0.89 0.84 0.25 0.08 1.81 1.22 000 16010 .......... ............ A Treatment of burn(s) ................................... 0.87 NA 0.61 0.09 NA 1.58 000 16015 .......... ............ A Treatment of burn(s) ................................... 2.35 NA 1.13 0.32 NA 3.81 000 16020 .......... ............ A Treatment of burn(s) ................................... 0.80 1.24 0.57 0.08 2.13 1.45 000 16025 .......... ............ A Treatment of burn(s) ................................... 1.85 1.71 0.94 0.19 3.75 2.99 000 16030 .......... ............ A Treatment of burn(s) ................................... 2.08 2.09 1.10 0.24 4.41 3.43 000 16035 .......... ............ A Incision of burn scab, initi ........................... 3.75 NA 1.59 0.46 NA 5.80 090 16036 .......... ............ A Escharotomy; add ’ l incision ......................... 1.50 NA 0.59 0.20 NA 2.29 ZZZ 17000 .......... ............ A Destroy benign/premlg lesion ...................... 0.60 1.09 0.59 0.03 1.73 1.22 010 17003 .......... ............ A Destroy lesions, 2-14 .................................. 0.15 0.12 0.08 0.01 0.28 0.24 ZZZ 17004 .......... ............ A Destroy lesions, 15 or more ........................ 2.80 2.58 1.71 0.11 5.49 4.62 010 17106 .......... ............ A Destruction of skin lesions .......................... 4.59 4.81 3.35 0.35 9.75 8.29 090 17107 .......... ............ A Destruction of skin lesions .......................... 9.17 7.66 5.50 0.63 17.46 15.30 090 17108 .......... ............ A Destruction of skin lesions .......................... 13.21 9.87 7.77 0.54 23.62 21.52 090 17110 .......... ............ A Destruct lesion, 1-14 ................................... 0.65 1.65 0.75 0.05 2.35 1.45 010 17111 .......... ............ A Destruct lesion, 15 or more ......................... 0.92 1.79 0.87 0.05 2.76 1.84 010 17250 .......... ............ A Chemical cautery, tissue ............................. 0.50 1.23 0.34 0.06 1.79 0.90 000 17260 .......... ............ A Destruction of skin lesions .......................... 0.91 1.33 0.69 0.04 2.28 1.64 010 17261 .......... ............ A Destruction of skin lesions .......................... 1.17 1.83 0.91 0.05 3.05 2.13 010 17262 .......... ............ A Destruction of skin lesions .......................... 1.58 2.13 1.11 0.06 3.78 2.76 010 17263 .......... ............ A Destruction of skin lesions .......................... 1.79 2.32 1.18 0.07 4.19 3.04 010 17264 .......... ............ A Destruction of skin lesions .......................... 1.94 2.51 1.19 0.08 4.53 3.22 010 17266 .......... ............ A Destruction of skin lesions .......................... 2.34 2.79 1.26 0.09 5.23 3.69 010 17270 .......... ............ A Destruction of skin lesions .......................... 1.32 1.89 0.94 0.05 3.27 2.31 010 17271 .......... ............ A Destruction of skin lesions .......................... 1.49 2.01 1.07 0.06 3.56 2.63 010 17272 .......... ............ A Destruction of skin lesions .......................... 1.77 2.25 1.21 0.07 4.10 3.06 010 17273 .......... ............ A Destruction of skin lesions .......................... 2.05 2.48 1.31 0.08 4.62 3.44 010 17274 .......... ............ A Destruction of skin lesions .......................... 2.60 2.87 1.53 0.10 5.56 4.23 010 17276 .......... ............ A Destruction of skin lesions .......................... 3.21 3.26 1.72 0.16 6.63 5.08 010 17280 .......... ............ A Destruction of skin lesions .......................... 1.17 1.80 0.87 0.05 3.03 2.09 010 17281 .......... ............ A Destruction of skin lesions .......................... 1.72 2.15 1.18 0.07 3.94 2.98 010 17282 .......... ............ A Destruction of skin lesions .......................... 2.04 2.43 1.35 0.08 4.55 3.47 010 17283 .......... ............ A Destruction of skin lesions .......................... 2.65 2.86 1.58 0.11 5.61 4.34 010 17284 .......... ............ A Destruction of skin lesions .......................... 3.22 3.26 1.82 0.13 6.60 5.17 010 17286 .......... ............ A Destruction of skin lesions .......................... 4.44 4.01 2.44 0.23 8.68 7.11 010 17304 .......... ............ A 1 stage mohs, up to 5 spec ........................ 7.61 9.35 3.85 0.30 17.26 11.76 000 17305 .......... ............ A 2 stage mohs, up to 5 spec ........................ 2.86 4.64 1.46 0.11 7.61 4.42 000 17306 .......... ............ A 3 stage mohs, up to 5 spec ........................ 2.86 4.79 1.47 0.11 7.76 4.44 000 17307 .......... ............ A Mohs addl stage up to 5 spec .................... 2.86 4.39 1.49 0.11 7.36 4.45 000 17310 .......... ............ A Mohs any stage > 5 spec each ................... 0.95 1.74 0.51 0.03 2.72 1.49 ZZZ 17340 .......... ............ A Cryotherapy of skin ..................................... 0.76 0.38 0.36 0.05 1.19 1.17 010 17360 .......... ............ A Skin peel therapy ........................................ 1.43 1.51 0.96 0.06 3.00 2.46 010 17380 .......... ............ R Hair removal by electrolysis ........................ 0.00 0.00 0.00 0.00 0.00 0.00 000 17999 .......... ............ C Skin tissue procedure .................................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY 19000 .......... ............ A Drainage of breast lesion ............................ 0.84 1.97 0.32 0.08 2.89 1.24 000
19001 .......... ............ A Drain breast lesion add-on .......................... 0.42 0.25 0.15 0.04 0.71 0.61 ZZZ 19020 .......... ............ A Incision of breast lesion .............................. 3.57 6.18 2.67 0.45 10.20 6.68 090 19030 .......... ............ A Injection for breast x-ray ............................. 1.53 3.03 0.53 0.09 4.65 2.15 000 19100 .......... ............ A Bx breast percut w/o image ........................ 1.27 2.06 0.43 0.16 3.50 1.86 000 19101 .......... ............ A Biopsy of breast, open ................................ 3.19 4.65 1.98 0.39 8.23 5.56 010 19102 .......... ............ A Bx breast percut w/image ........................... 2.00 3.99 0.68 0.14 6.13 2.83 000 19103 .......... ............ A Bx breast percut w/device ........................... 3.70 11.81 1.26 0.30 15.81 5.25 000 19110 .......... ............ A Nipple exploration ........................................ 4.30 5.75 2.87 0.57 10.62 7.74 090 19112 .......... ............ A Excise breast duct fistula ............................ 3.67 5.89 2.69 0.48 10.04 6.84 090 19120 .......... ............ A Removal of breast lesion ............................ 5.56 4.56 3.06 0.73 10.85 9.35 090 19125 .......... ............ A Excision, breast lesion ................................ 6.06 4.77 3.28 0.80 11.63 10.14 090 19126 .......... ............ A Excision, addl breast lesion ........................ 2.94 NA 0.98 0.38 NA 4.29 ZZZ 19140 .......... ............ A Removal of breast tissue ............................ 5.14 7.05 3.39 0.69 12.88 9.22 090 19160 .......... ............ A Partial mastectomy ...................................... 5.99 NA 3.41 0.79 NA 10.19 090 19162 .......... ............ A P-mastectomy w/ln removal ........................ 13.54 NA 6.26 1.79 NA 21.59 090
19180 .......... ............ A Removal of breast ....................................... 8.81 NA 5.00 1.18 NA 14.99 090 19182 .......... ............ A Removal of breast ....................................... 7.74 NA 4.72 1.04 NA 13.50 090 19200 .......... ............ A Removal of breast ....................................... 15.50 NA 7.87 1.92 NA 25.29 090 19220 .......... ............ A Removal of breast ....................................... 15.73 NA 8.17 2.07 NA 25.98 090 19240 .......... ............ A Removal of breast ....................................... 16.01 NA 8.15 2.12 NA 26.28 090 19260 .......... ............ A Removal of chest wall lesion ...................... 15.45 NA 10.76 2.13 NA 28.34 090 19271 .......... ............ A Revision of chest wall ................................. 18.91 NA 17.32 2.62 NA 38.84 090 19272 .......... ............ A Extensive chest wall surgery ....................... 21.56 NA 18.30 2.99 NA 42.85 090 19290 .......... ............ A Place needle wire, breast ............................ 1.27 3.01 0.44 0.07 4.36 1.78 000 19291 .......... ............ A Place needle wire, breast ............................ 0.63 1.27 0.22 0.04 1.94 0.89 ZZZ 19295 .......... ............ A Place breast clip, percut .............................. 0.00 2.74 NA 0.01 2.75 NA ZZZ


## 45884

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

19296 .......... ............ A Place po breast cath for rad ....................... 3.64 117.96 1.50 0.36 121.96 5.49 000 19297 .......... ............ A Place breast cath for rad ............................. 1.72 NA 0.62 0.17 NA 2.52 ZZZ 19298 .......... ............ A Place breast rad tube/caths ........................ 6.01 39.56 2.35 0.43 46.00 8.79 000 19316 .......... ............ A Suspension of breast .................................. 10.69 NA 7.30 1.64 NA 19.63 090 19318 .......... ............ A Reduction of large breast ............................ 15.63 NA 10.79 2.92 NA 29.34 090 19324 .......... ............ A Enlarge breast ............................................. 5.85 NA 4.79 0.84 NA 11.48 090 19325 .......... ............ A Enlarge breast with implant ......................... 8.46 NA 6.33 1.33 NA 16.11 090 19328 .......... ............ A Removal of breast implant .......................... 5.68 NA 4.88 0.91 NA 11.47 090 19330 .......... ............ A Removal of implant material ....................... 7.60 NA 5.88 1.26 NA 14.74 090 19340 .......... ............ A Immediate breast prosthesis ....................... 6.33 NA 3.03 1.06 NA 10.42 ZZZ 19342 .......... ............ A Delayed breast prosthesis ........................... 11.20 NA 8.67 1.83 NA 21.70 090 19350 .......... ............ A Breast reconstruction .................................. 8.93 13.03 6.95 1.41 23.37 17.28 090 19355 .......... ............ A Correct inverted nipple(s) ............................ 7.58 9.85 4.63 0.92 18.34 13.12 090
19357 .......... ............ A Breast reconstruction .................................. 18.17 NA 15.13 2.93 NA 36.23 090 19361 .......... ............ A Breast reconstruction .................................. 19.27 NA 12.09 2.92 NA 34.28 090 19364 .......... ............ A Breast reconstruction .................................. 41.02 NA 22.83 6.22 NA 70.07 090 19366 .......... ............ A Breast reconstruction .................................. 21.29 NA 11.31 3.24 NA 35.84 090 19367 .......... ............ A Breast reconstruction .................................. 25.74 NA 16.16 4.03 NA 45.93 090 19368 .......... ............ A Breast reconstruction .................................. 32.43 NA 18.34 5.52 NA 56.30 090 19369 .......... ............ A Breast reconstruction .................................. 29.84 NA 17.81 4.50 NA 52.15 090 19370 .......... ............ A Surgery of breast capsule ........................... 8.06 NA 6.70 1.29 NA 16.05 090 19371 .......... ............ A Removal of breast capsule ......................... 9.36 NA 7.60 1.62 NA 18.57 090
19380 .......... ............ A Revise breast reconstruction ....................... 9.15 NA 7.48 1.44 NA 18.07 090 19396 .......... ............ A Design custom breast implant ..................... 2.17 2.17 1.02 0.30 4.65 3.50 000 19499 .......... ............ C Breast surgery procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 20000 .......... ............ A Incision of abscess ...................................... 2.12 2.70 1.73 0.25 5.07 4.10 010 20005 .......... ............ A Incision of deep abscess ............................. 3.42 3.50 2.23 0.46 7.37 6.10 010 2000F ......... ............ I Blood pressure, measured .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 20100 .......... ............ A Explore wound, neck ................................... 10.08 NA 4.35 1.21 NA 15.64 010 20101 .......... ............ A Explore wound, chest .................................. 3.23 5.85 1.57 0.44 9.52 5.24 010 20102 .......... ............ A Explore wound, abdomen ........................... 3.94 7.18 1.88 0.49 11.61 6.31 010 20103 .......... ............ A Explore wound, extremity ............................ 5.30 8.22 3.29 0.75 14.27 9.34 010 20150 .......... ............ A Excise epiphyseal bar ................................. 13.70 NA 7.00 2.03 NA 22.73 090 20200 .......... ............ A Muscle biopsy .............................................. 1.46 2.95 0.74 0.23 4.64 2.44 000 20205 .......... ............ A Deep muscle biopsy .................................... 2.35 3.79 1.17 0.33 6.47 3.86 000 20206 .......... ............ A Needle biopsy, muscle ................................ 0.99 6.34 0.66 0.07 7.40 1.72 000 20220 .......... ............ A Bone biopsy, trocar/needle ......................... 1.27 4.29 0.79 0.08 5.65 2.15 000 20225 .......... ............ A Bone biopsy, trocar/needle ......................... 1.87 22.84 1.17 0.22 24.94 3.27 000 20240 .......... ............ A Bone biopsy, excisional ............................... 3.24 NA 2.48 0.44 NA 6.16 010 20245 .......... ............ A Bone biopsy, excisional ............................... 7.79 NA 6.39 1.31 NA 15.48 010 20250 .......... ............ A Open bone biopsy ....................................... 5.03 NA 3.45 1.02 NA 9.50 010 20251 .......... ............ A Open bone biopsy ....................................... 5.56 NA 4.09 1.15 NA 10.80 010 20500 .......... ............ A Injection of sinus tract ................................. 1.23 2.10 1.46 0.12 3.46 2.81 010 20501 .......... ............ A Inject sinus tract for x-ray ............................ 0.76 2.87 0.26 0.04 3.67 1.06 000 20520 .......... ............ A Removal of foreign body ............................. 1.85 2.81 1.70 0.21 4.88 3.77 010 20525 .......... ............ A Removal of foreign body ............................. 3.50 8.59 2.55 0.51 12.60 6.55 010 20526 .......... ............ A Ther injection, carp tunnel ........................... 0.94 0.94 0.51 0.13 2.01 1.58 000 20550 .......... ............ A Inj tendon sheath/ligament .......................... 0.75 0.69 0.23 0.09 1.54 1.07 000 20551 .......... ............ A Inj tendon origin/insertion ............................ 0.75 0.67 0.32 0.08 1.50 1.15 000 20552 .......... ............ A Inj trigger point, 1/2 muscl ........................... 0.66 0.70 0.20 0.05 1.41 0.91 000 20553 .......... ............ A Inject trigger points, =/> 3 ........................... 0.75 0.79 0.21 0.04 1.58 1.00 000 20600 .......... ............ A Drain/inject, joint/bursa ................................ 0.66 0.66 0.35 0.08 1.40 1.09 000 20605 .......... ............ A Drain/inject, joint/bursa ................................ 0.68 0.75 0.35 0.08 1.52 1.11 000 20610 .......... ............ A Drain/inject, joint/bursa ................................ 0.79 0.92 0.41 0.11 1.83 1.31 000 20612 .......... ............ A Aspirate/inj ganglion cyst ............................ 0.70 0.70 0.35 0.10 1.50 1.15 000 20615 .......... ............ A Treatment of bone cyst ............................... 2.28 3.38 1.82 0.20 5.87 4.31 010 20650 .......... ............ A Insert and remove bone pin ........................ 2.23 2.35 1.54 0.31 4.90 4.09 010 20660 .......... ............ A Apply, rem fixation device ........................... 2.52 2.95 1.58 0.59 6.05 4.68 000 20661 .......... ............ A Application of head brace ........................... 4.89 NA 4.82 1.14 NA 10.85 090 20662 .......... ............ A Application of pelvis brace .......................... 6.07 NA 5.39 0.56 NA 12.02 090 20663 .......... ............ A Application of thigh brace ............................ 5.43 NA 4.71 0.94 NA 11.08 090 20664 .......... ............ A Halo brace application ................................. 8.07 NA 6.89 1.74 NA 16.70 090 20665 .......... ............ A Removal of fixation device .......................... 1.31 2.06 1.32 0.19 3.57 2.82 010 20670 .......... ............ A Removal of support implant ........................ 1.74 10.66 2.02 0.28 12.68 4.04 010 20680 .......... ............ A Removal of support implant ........................ 3.35 8.36 3.59 0.56 12.27 7.50 090 20690 .......... ............ A Apply bone fixation device .......................... 3.52 NA 2.45 0.59 NA 6.56 090 20692 .......... ............ A Apply bone fixation device .......................... 6.41 NA 3.67 1.05 NA 11.14 090 20693 .......... ............ A Adjust bone fixation device ......................... 5.86 NA 5.26 0.98 NA 12.10 090 20694 .......... ............ A Remove bone fixation device ...................... 4.16 6.78 3.93 0.71 11.65 8.80 090 20802 .......... ............ A Replantation, arm, complete ....................... 41.17 NA 20.55 3.81 NA 65.53 090 20805 .......... ............ A Replant forearm, complete .......................... 50.03 NA 32.77 4.84 NA 87.64 090 20808 .......... ............ A Replantation hand, complete ...................... 61.68 NA 40.74 6.86 NA 109.28 090 20816 .......... ............ A Replantation digit, complete ........................ 30.95 NA 35.39 4.52 NA 70.86 090 20822 .......... ............ A Replantation digit, complete ........................ 25.60 NA 32.40 4.18 NA 62.18 090


## 45885

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

20824 .......... ............ A Replantation thumb, complete .................... 30.95 NA 34.30 4.61 NA 69.86 090 20827 .......... ............ A Replantation thumb, complete .................... 26.42 NA 34.08 3.66 NA 64.16 090 20838 .......... ............ A Replantation foot, complete ........................ 41.43 NA 21.78 1.12 NA 64.34 090 20900 .......... ............ A Removal of bone for graft ........................... 5.58 8.42 5.50 0.94 14.95 12.02 090 20902 .......... ............ A Removal of bone for graft ........................... 7.56 NA 6.66 1.30 NA 15.52 090 20910 .......... ............ A Remove cartilage for graft ........................... 5.34 NA 5.04 0.71 NA 11.09 090 20912 .......... ............ A Remove cartilage for graft ........................... 6.35 NA 5.63 0.69 NA 12.67 090 20920 .......... ............ A Removal of fascia for graft .......................... 5.31 NA 4.26 0.66 NA 10.23 090 20922 .......... ............ A Removal of fascia for graft .......................... 6.61 7.41 4.87 0.70 14.72 12.18 090 20924 .......... ............ A Removal of tendon for graft ........................ 6.48 NA 5.69 1.04 NA 13.22 090 20926 .......... ............ A Removal of tissue for graft .......................... 5.53 NA 4.66 0.87 NA 11.06 090 20930 .......... ............ B Spinal bone allograft ................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 20931 .......... ............ A Spinal bone allograft ................................... 1.81 NA 0.90 0.43 NA 3.15 ZZZ 20936 .......... ............ B Spinal bone autograft .................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 20937 .......... ............ A Spinal bone autograft .................................. 2.80 NA 1.41 0.54 NA 4.74 ZZZ 20938 .......... ............ A Spinal bone autograft .................................. 3.03 NA 1.52 0.64 NA 5.18 ZZZ 20950 .......... ............ A Fluid pressure, muscle ................................ 1.26 6.35 0.97 0.20 7.81 2.43 000 20955 .......... ............ A Fibula bone graft, microvasc ....................... 39.23 NA 23.52 4.89 NA 67.64 090 20956 .......... ............ A Iliac bone graft, microvasc .......................... 39.29 NA 24.03 7.01 NA 70.33 090 20957 .......... ............ A Mt bone graft, microvasc ............................. 40.67 NA 18.69 7.05 NA 66.42 090 20962 .......... ............ A Other bone graft, microvasc ........................ 39.29 NA 25.76 6.55 NA 71.60 090 20969 .......... ............ A Bone/skin graft, microvasc .......................... 43.94 NA 25.78 4.79 NA 74.51 090 20970 .......... ............ A Bone/skin graft, iliac crest ........................... 43.09 NA 24.61 6.60 NA 74.30 090 20972 .......... ............ A Bone/skin graft, metatarsal ......................... 43.02 NA 20.22 5.30 NA 68.54 090 20973 .......... ............ A Bone/skin graft, great toe ............................ 45.78 NA 24.42 5.54 NA 75.74 090
20974 .......... ............ A Electrical bone stimulation .......................... 0.62 0.71 0.53 0.11 1.44 1.26 000 20975 .......... ............ A Electrical bone stimulation .......................... 2.61 NA 1.67 0.51 NA 4.78 000 20979 .......... ............ A Us bone stimulation ..................................... 0.62 0.77 0.33 0.09 1.49 1.04 000 20982 .......... ............ A Ablate, bone tumor(s) perq ......................... 7.28 105.12 12.41 0.69 113.09 20.38 000 20999 .......... ............ C Musculoskeletal surgery .............................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21010 .......... ............ A Incision of jaw joint ...................................... 10.14 NA 7.28 1.11 NA 18.53 090 21015 .......... ............ A Resection of facial tumor ............................ 5.29 NA 4.86 0.70 NA 10.86 090 21025 .......... ............ A Excision of bone, lower jaw ........................ 10.06 12.30 9.24 1.32 23.68 20.62 090 21026 .......... ............ A Excision of facial bone(s) ............................ 4.85 7.94 6.20 0.60 13.39 11.65 090 21029 .......... ............ A Contour of face bone lesion ........................ 7.72 9.32 6.85 0.94 17.98 15.50 090 21030 .......... ............ A Excise max/zygoma b9 tumor ..................... 4.50 6.45 4.96 0.54 11.49 10.00 090 21031 .......... ............ A Remove exostosis, mandible ...................... 3.25 5.29 3.62 0.48 9.01 7.35 090 21032 .......... ............ A Remove exostosis, maxilla .......................... 3.25 5.45 3.51 0.47 9.16 7.23 090 21034 .......... ............ A Excise max/zygoma mlg tumor ................... 16.18 15.67 12.29 1.71 33.56 30.19 090
21040 .......... ............ A Excise mandible lesion ................................ 4.50 6.51 4.70 0.54 11.55 9.74 090 21044 .......... ............ A Removal of jaw bone lesion ........................ 11.86 NA 9.18 1.12 NA 22.17 090 21045 .......... ............ A Extensive jaw surgery ................................. 16.18 NA 12.08 1.52 NA 29.79 090 21046 .......... ............ A Remove mandible cyst complex ................. 13.01 NA 11.91 1.85 NA 26.77 090 21047 .......... ............ A Excise lwr jaw cyst w/repair ........................ 18.76 NA 13.17 2.12 NA 34.05 090 21048 .......... ............ A Remove maxilla cyst complex ..................... 13.51 NA 12.13 1.76 NA 27.40 090 21049 .......... ............ A Excis uppr jaw cyst w/repair ....................... 18.01 NA 12.78 1.59 NA 32.37 090 21050 .......... ............ A Removal of jaw joint .................................... 10.77 NA 9.31 1.47 NA 21.56 090 21060 .......... ............ A Remove jaw joint cartilage .......................... 10.23 NA 8.51 1.38 NA 20.12 090 21070 .......... ............ A Remove coronoid process .......................... 8.21 NA 7.03 1.27 NA 16.50 090 21076 .......... ............ A Prepare face/oral prosthesis ....................... 13.43 12.00 9.44 1.99 27.42 24.85 010 21077 .......... ............ A Prepare face/oral prosthesis ....................... 33.77 29.60 24.40 4.55 67.91 62.72 090 21079 .......... ............ A Prepare face/oral prosthesis ....................... 22.35 20.43 16.13 3.15 45.94 41.63 090 21080 .......... ............ A Prepare face/oral prosthesis ....................... 25.11 23.16 18.23 3.74 52.01 47.08 090 21081 .......... ............ A Prepare face/oral prosthesis ....................... 22.90 21.14 16.42 3.20 47.24 42.52 090 21082 .......... ............ A Prepare face/oral prosthesis ....................... 20.88 18.48 14.83 3.11 42.47 38.82 090 21083 .......... ............ A Prepare face/oral prosthesis ....................... 19.31 17.90 13.57 2.88 40.09 35.76 090 21084 .......... ............ A Prepare face/oral prosthesis ....................... 22.52 21.12 16.44 2.18 45.82 41.15 090 21085 .......... ............ A Prepare face/oral prosthesis ....................... 9.01 8.28 6.79 1.27 18.56 17.07 010 21086 .......... ............ A Prepare face/oral prosthesis ....................... 24.93 22.34 18.15 3.71 50.98 46.79 090 21087 .......... ............ A Prepare face/oral prosthesis ....................... 24.93 22.11 18.05 3.44 50.48 46.42 090 21088 .......... ............ C Prepare face/oral prosthesis ....................... 0.00 0.00 0.00 0.00 0.00 0.00 090 21089 .......... ............ C Prepare face/oral prosthesis ....................... 0.00 0.00 0.00 0.00 0.00 0.00 090
21100 .......... ............ A Maxillofacial fixation .................................... 4.22 11.76 4.79 0.34 16.32 9.35 090 21110 .......... ............ A Interdental fixation ....................................... 5.21 10.08 8.54 0.72 16.01 14.47 090 21116 .......... ............ A Injection, jaw joint x-ray ............................... 0.81 4.08 0.34 0.06 4.95 1.21 000 21120 .......... ............ A Reconstruction of chin ................................. 4.93 10.42 7.29 0.60 15.95 12.82 090 21121 .......... ............ A Reconstruction of chin ................................. 7.65 9.92 7.81 0.90 18.47 16.36 090 21122 .......... ............ A Reconstruction of chin ................................. 8.53 NA 8.55 1.07 NA 18.15 090 21123 .......... ............ A Reconstruction of chin ................................. 11.16 NA 10.59 1.40 NA 23.15 090 21125 .......... ............ A Augmentation, lower jaw bone .................... 10.62 55.80 8.18 0.79 67.21 19.59 090 21127 .......... ............ A Augmentation, lower jaw bone .................... 11.12 48.12 9.27 1.52 60.76 21.91 090 21137 .......... ............ A Reduction of forehead ................................. 9.83 NA 7.48 1.32 NA 18.63 090 21138 .......... ............ A Reduction of forehead ................................. 12.19 NA 9.25 1.74 NA 23.18 090 21139 .......... ............ A Reduction of forehead ................................. 14.62 NA 11.13 1.18 NA 26.93 090


## 45886

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

21141 .......... ............ A Reconstruct midface, lefort ......................... 18.11 NA 13.41 2.35 NA 33.87 090 21142 .......... ............ A Reconstruct midface, lefort ......................... 18.82 NA 12.75 2.38 NA 33.95 090 21143 .......... ............ A Reconstruct midface, lefort ......................... 19.59 NA 14.37 1.66 NA 35.62 090 21145 .......... ............ A Reconstruct midface, lefort ......................... 19.95 NA 13.66 2.84 NA 36.45 090 21146 .......... ............ A Reconstruct midface, lefort ......................... 20.72 NA 15.04 3.09 NA 38.85 090 21147 .......... ............ A Reconstruct midface, lefort ......................... 21.78 NA 14.88 1.84 NA 38.51 090 21150 .......... ............ A Reconstruct midface, lefort ......................... 25.25 NA 16.60 2.55 NA 44.40 090 21151 .......... ............ A Reconstruct midface, lefort ......................... 28.32 NA 21.89 2.30 NA 52.51 090 21154 .......... ............ A Reconstruct midface, lefort ......................... 30.53 NA 22.45 2.48 NA 55.46 090 21155 .......... ............ A Reconstruct midface, lefort ......................... 34.47 NA 23.33 6.64 NA 64.44 090 21159 .......... ............ A Reconstruct midface, lefort ......................... 42.40 NA 27.95 8.18 NA 78.53 090 21160 .......... ............ A Reconstruct midface, lefort ......................... 46.46 NA 27.92 4.13 NA 78.51 090 21172 .......... ............ A Reconstruct orbit/forehead .......................... 27.82 NA 13.53 3.55 NA 44.90 090 21175 .......... ............ A Reconstruct orbit/forehead .......................... 33.19 NA 17.38 4.83 NA 55.40 090 21179 .......... ............ A Reconstruct entire forehead ........................ 22.26 NA 13.72 2.80 NA 38.78 090 21180 .......... ............ A Reconstruct entire forehead ........................ 25.20 NA 14.96 3.48 NA 43.65 090 21181 .......... ............ A Contour cranial bone lesion ........................ 9.91 NA 7.23 1.32 NA 18.46 090
21182 .......... ............ A Reconstruct cranial bone ............................ 32.20 NA 18.55 2.80 NA 53.56 090 21183 .......... ............ A Reconstruct cranial bone ............................ 35.33 NA 20.24 4.47 NA 60.04 090 21184 .......... ............ A Reconstruct cranial bone ............................ 38.26 NA 21.33 5.70 NA 65.29 090 21188 .......... ............ A Reconstruction of midface ........................... 22.47 NA 18.35 1.69 NA 42.52 090 21193 .......... ............ A Reconst lwr jaw w/o graft ............................ 17.15 NA 12.42 2.23 NA 31.81 090 21194 .......... ............ A Reconst lwr jaw w/graft ............................... 19.85 NA 13.45 2.02 NA 35.32 090 21195 .......... ............ A Reconst lwr jaw w/o fixation ........................ 17.24 NA 14.61 1.64 NA 33.50 090 21196 .......... ............ A Reconst lwr jaw w/fixation ........................... 18.92 NA 15.41 2.07 NA 36.40 090 21198 .......... ............ A Reconstr lwr jaw segment ........................... 14.17 NA 12.46 1.44 NA 28.07 090 21199 .......... ............ A Reconstr lwr jaw w/advance ....................... 16.01 NA 8.90 1.39 NA 26.30 090 21206 .......... ............ A Reconstruct upper jaw bone ....................... 14.11 NA 12.46 1.33 NA 27.90 090 21208 .......... ............ A Augmentation of facial bones ...................... 10.23 23.47 9.29 1.09 34.79 20.61 090 21209 .......... ............ A Reduction of facial bones ............................ 6.72 10.88 7.90 0.90 18.50 15.52 090 21210 .......... ............ A Face bone graft ........................................... 10.23 27.25 9.15 1.30 38.78 20.68 090 21215 .......... ............ A Lower jaw bone graft ................................... 10.77 47.37 9.24 1.53 59.67 21.54 090 21230 .......... ............ A Rib cartilage graft ........................................ 10.77 NA 7.79 1.29 NA 19.85 090 21235 .......... ............ A Ear cartilage graft ........................................ 6.72 10.18 6.28 0.61 17.52 13.62 090 21240 .......... ............ A Reconstruction of jaw joint .......................... 14.06 NA 11.95 2.24 NA 28.25 090 21242 .......... ............ A Reconstruction of jaw joint .......................... 12.96 NA 11.42 1.78 NA 26.15 090 21243 .......... ............ A Reconstruction of jaw joint .......................... 20.80 NA 17.27 3.25 NA 41.33 090 21244 .......... ............ A Reconstruction of lower jaw ........................ 11.86 NA 11.91 1.25 NA 25.02 090 21245 .......... ............ A Reconstruction of jaw .................................. 11.86 14.32 9.62 1.19 27.37 22.67 090 21246 .......... ............ A Reconstruction of jaw .................................. 12.47 NA 8.83 1.35 NA 22.65 090 21247 .......... ............ A Reconstruct lower jaw bone ........................ 22.65 NA 17.07 2.83 NA 42.54 090 21248 .......... ............ A Reconstruction of jaw .................................. 11.48 12.29 9.24 1.55 25.32 22.28 090 21249 .......... ............ A Reconstruction of jaw .................................. 17.52 16.75 12.47 2.48 36.76 32.47 090 21255 .......... ............ A Reconstruct lower jaw bone ........................ 16.72 NA 15.70 2.38 NA 34.80 090 21256 .......... ............ A Reconstruction of orbit ................................ 16.20 NA 11.48 1.50 NA 29.18 090 21260 .......... ............ A Revise eye sockets ..................................... 16.53 NA 13.26 0.97 NA 30.76 090 21261 .......... ............ A Revise eye sockets ..................................... 31.50 NA 23.50 3.42 NA 58.42 090 21263 .......... ............ A Revise eye sockets ..................................... 28.44 NA 19.87 2.62 NA 50.93 090 21267 .......... ............ A Revise eye sockets ..................................... 18.91 NA 18.95 1.70 NA 39.56 090 21268 .......... ............ A Revise eye sockets ..................................... 24.49 NA 19.69 3.65 NA 47.83 090 21270 .......... ............ A Augmentation, cheek bone ......................... 10.23 11.66 7.09 0.72 22.61 18.04 090 21275 .......... ............ A Revision, orbitofacial bones ........................ 11.24 NA 7.91 1.29 NA 20.45 090 21280 .......... ............ A Revision of eyelid ........................................ 6.03 NA 5.78 0.42 NA 12.23 090 21282 .......... ............ A Revision of eyelid ........................................ 3.49 NA 4.35 0.26 NA 8.10 090 21295 .......... ............ A Revision of jaw muscle/bone ...................... 1.53 NA 2.51 0.16 NA 4.20 090 21296 .......... ............ A Revision of jaw muscle/bone ...................... 4.25 NA 4.95 0.34 NA 9.54 090 21299 .......... ............ C Cranio/maxillofacial surgery ........................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY
21300 .......... ............ A Treatment of skull fracture .......................... 0.72 2.00 0.26 0.13 2.85 1.11 000 21310 .......... ............ A Treatment of nose fracture .......................... 0.58 2.16 0.15 0.05 2.79 0.78 000 21315 .......... ............ A Treatment of nose fracture .......................... 1.51 4.19 1.81 0.14 5.84 3.46 010 21320 .......... ............ A Treatment of nose fracture .......................... 1.85 3.89 1.58 0.18 5.92 3.61 010 21325 .......... ............ A Treatment of nose fracture .......................... 3.77 NA 8.21 0.31 NA 12.29 090 21330 .......... ............ A Treatment of nose fracture .......................... 5.38 NA 9.26 0.56 NA 15.20 090 21335 .......... ............ A Treatment of nose fracture .......................... 8.62 NA 9.38 0.74 NA 18.74 090 21336 .......... ............ A Treat nasal septal fracture .......................... 5.72 NA 9.31 0.55 NA 15.59 090 21337 .......... ............ A Treat nasal septal fracture .......................... 2.71 5.96 3.49 0.28 8.95 6.48 090 21338 .......... ............ A Treat nasoethmoid fracture ......................... 6.46 NA 13.21 0.82 NA 20.49 090 21339 .......... ............ A Treat nasoethmoid fracture ......................... 8.10 NA 13.20 0.96 NA 22.26 090 21340 .......... ............ A Treatment of nose fracture .......................... 10.77 NA 8.17 1.15 NA 20.09 090 21343 .......... ............ A Treatment of sinus fracture ......................... 12.96 NA 14.86 1.47 NA 29.28 090 21344 .......... ............ A Treatment of sinus fracture ......................... 19.73 NA 15.85 2.43 NA 38.01 090 21345 .......... ............ A Treat nose/jaw fracture ............................... 8.17 9.82 7.04 0.92 18.91 16.13 090 21346 .......... ............ A Treat nose/jaw fracture ............................... 10.61 NA 11.91 1.21 NA 23.73 090 21347 .......... ............ A Treat nose/jaw fracture ............................... 12.70 NA 15.39 1.47 NA 29.55 090


## 45887

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

21348 .......... ............ A Treat nose/jaw fracture ............................... 16.69 NA 10.81 2.48 NA 29.98 090 21355 .......... ............ A Treat cheek bone fracture ........................... 3.77 6.07 3.42 0.34 10.18 7.52 010 21356 .......... ............ A Treat cheek bone fracture ........................... 4.15 6.99 4.41 0.46 11.60 9.02 010 21360 .......... ............ A Treat cheek bone fracture ........................... 6.46 NA 5.80 0.74 NA 13.00 090 21365 .......... ............ A Treat cheek bone fracture ........................... 14.96 NA 10.51 1.69 NA 27.16 090 21366 .......... ............ A Treat cheek bone fracture ........................... 17.78 NA 11.02 2.49 NA 31.29 090 21385 .......... ............ A Treat eye socket fracture ............................ 9.17 NA 8.06 0.97 NA 18.20 090 21386 .......... ............ A Treat eye socket fracture ............................ 9.17 NA 6.88 0.97 NA 17.01 090 21387 .......... ............ A Treat eye socket fracture ............................ 9.71 NA 8.67 1.08 NA 19.46 090 21390 .......... ............ A Treat eye socket fracture ............................ 10.13 NA 7.58 0.90 NA 18.61 090 21395 .......... ............ A Treat eye socket fracture ............................ 12.69 NA 8.75 1.44 NA 22.88 090 21400 .......... ............ A Treat eye socket fracture ............................ 1.40 2.60 1.82 0.15 4.15 3.37 090 21401 .......... ............ A Treat eye socket fracture ............................ 3.27 7.77 3.44 0.38 11.41 7.09 090 21406 .......... ............ A Treat eye socket fracture ............................ 7.01 NA 5.92 0.73 NA 13.67 090 21407 .......... ............ A Treat eye socket fracture ............................ 8.62 NA 6.66 0.94 NA 16.22 090 21408 .......... ............ A Treat eye socket fracture ............................ 12.38 NA 8.63 1.44 NA 22.45 090 21421 .......... ............ A Treat mouth roof fracture ............................ 5.14 9.62 8.32 0.73 15.49 14.19 090 21422 .......... ............ A Treat mouth roof fracture ............................ 8.33 NA 7.89 0.99 NA 17.20 090 21423 .......... ............ A Treat mouth roof fracture ............................ 10.40 NA 9.02 1.27 NA 20.69 090 21431 .......... ............ A Treat craniofacial fracture ........................... 7.05 NA 9.40 0.70 NA 17.15 090 21432 .......... ............ A Treat craniofacial fracture ........................... 8.62 NA 7.96 0.81 NA 17.39 090 21433 .......... ............ A Treat craniofacial fracture ........................... 25.36 NA 15.91 2.78 NA 44.05 090 21435 .......... ............ A Treat craniofacial fracture ........................... 17.25 NA 12.37 1.98 NA 31.60 090 21436 .......... ............ A Treat craniofacial fracture ........................... 28.06 NA 17.82 3.09 NA 48.96 090 21440 .......... ............ A Treat dental ridge fracture ........................... 2.71 7.43 6.26 0.38 10.52 9.34 090 21445 .......... ............ A Treat dental ridge fracture ........................... 5.38 10.05 8.32 0.78 16.21 14.48 090 21450 .......... ............ A Treat lower jaw fracture .............................. 2.98 7.70 6.71 0.33 11.01 10.02 090 21451 .......... ............ A Treat lower jaw fracture .............................. 4.87 9.77 8.44 0.63 15.27 13.94 090 21452 .......... ............ A Treat lower jaw fracture .............................. 1.98 12.37 4.74 0.27 14.62 7.00 090 21453 .......... ............ A Treat lower jaw fracture .............................. 5.54 11.18 10.71 0.74 17.46 16.99 090 21454 .......... ............ A Treat lower jaw fracture .............................. 6.46 NA 6.17 0.82 NA 13.46 090 21461 .......... ............ A Treat lower jaw fracture .............................. 8.10 26.43 12.53 0.98 35.51 21.60 090 21462 .......... ............ A Treat lower jaw fracture .............................. 9.80 29.34 12.71 1.27 40.41 23.78 090 21465 .......... ............ A Treat lower jaw fracture .............................. 11.91 NA 9.63 1.50 NA 23.05 090 21470 .......... ............ A Treat lower jaw fracture .............................. 15.35 NA 11.78 1.96 NA 29.09 090 21480 .......... ............ A Reset dislocated jaw ................................... 0.61 1.72 0.19 0.06 2.39 0.86 000 21485 .......... ............ A Reset dislocated jaw ................................... 3.99 8.73 7.76 0.51 13.23 12.25 090 21490 .......... ............ A Repair dislocated jaw .................................. 11.86 NA 9.55 1.96 NA 23.37 090 21493 .......... ............ A Treat hyoid bone fracture ............................ 1.27 NA 0.53 0.12 NA 1.92 090 21494 .......... ............ A Treat hyoid bone fracture ............................ 6.28 NA 3.42 0.57 NA 10.27 090 21495 .......... ............ A Treat hyoid bone fracture ............................ 5.69 NA 8.55 0.46 NA 14.70 090 21497 .......... ............ A Interdental wiring ......................................... 3.86 8.88 7.77 0.50 13.24 12.12 090 21499 .......... ............ C Head surgery procedure ............................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21501 .......... ............ A Drain neck/chest lesion ............................... 3.81 6.31 3.73 0.43 10.55 7.97 090
21502 .......... ............ A Drain chest lesion ........................................ 7.12 NA 5.42 0.97 NA 13.52 090 21510 .......... ............ A Drainage of bone lesion .............................. 5.74 NA 5.42 0.80 NA 11.96 090 21550 .......... ............ A Biopsy of neck/chest ................................... 2.06 3.85 1.74 0.16 6.08 3.96 010 21555 .......... ............ A Remove lesion, neck/chest ......................... 4.35 5.54 3.17 0.56 10.45 8.08 090 21556 .......... ............ A Remove lesion, neck/chest ......................... 5.57 NA 4.05 0.65 NA 10.27 090 21557 .......... ............ A Remove tumor, neck/chest ......................... 8.89 NA 5.23 1.08 NA 15.19 090 21600 .......... ............ A Partial removal of rib ................................... 6.89 NA 5.68 0.99 NA 13.57 090 21610 .......... ............ A Partial removal of rib ................................... 14.62 NA 8.68 3.07 NA 26.37 090 21615 .......... ............ A Removal of rib ............................................. 9.88 NA 6.42 1.45 NA 17.75 090 21616 .......... ............ A Removal of rib and nerves .......................... 12.04 NA 7.95 1.86 NA 21.85 090 21620 .......... ............ A Partial removal of sternum .......................... 6.79 NA 5.72 0.98 NA 13.50 090 21627 .......... ............ A Sternal debridement .................................... 6.81 NA 6.17 1.02 NA 14.00 090 21630 .......... ............ A Extensive sternum surgery .......................... 17.38 NA 11.45 2.58 NA 31.42 090 21632 .......... ............ A Extensive sternum surgery .......................... 18.15 NA 10.81 2.65 NA 31.60 090 21685 .......... ............ A Hyoid myotomy & suspension ..................... 13.01 NA 9.82 1.06 NA 23.89 090 21700 .......... ............ A Revision of neck muscle ............................. 6.19 NA 4.74 0.32 NA 11.26 090 21705 .......... ............ A Revision of neck muscle/rib ........................ 9.61 NA 5.43 1.43 NA 16.47 090
21720 .......... ............ A Revision of neck muscle ............................. 5.68 NA 2.87 0.91 NA 9.46 090 21725 .......... ............ A Revision of neck muscle ............................. 6.99 NA 5.31 1.21 NA 13.51 090 21740 .......... ............ A Reconstruction of sternum .......................... 16.51 NA 8.37 2.36 NA 27.24 090 21742 .......... ............ C Repair stern/nuss w/o scope ....................... 0.00 0.00 0.00 0.00 0.00 0.00 090 21743 .......... ............ C Repair sternum/nuss w/scope ..................... 0.00 0.00 0.00 0.00 0.00 0.00 090 21750 .......... ............ A Repair of sternum separation ...................... 10.77 NA 5.94 1.63 NA 18.35 090 21800 .......... ............ A Treatment of rib fracture ............................. 0.96 0.00 1.31 0.09 1.05 2.36 090 21805 .......... ............ A Treatment of rib fracture ............................. 2.76 NA 3.20 0.38 NA 6.34 090 21810 .......... ............ A Treatment of rib fracture(s) ......................... 6.86 NA 4.93 0.94 NA 12.74 090
21820 .......... ............ A Treat sternum fracture ................................. 1.28 1.78 1.70 0.16 3.22 3.15 090 21825 .......... ............ A Treat sternum fracture ................................. 7.41 NA 6.25 1.11 NA 14.78 090 21899 .......... ............ C Neck/chest surgery procedure .................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21920 .......... ............ A Biopsy soft tissue of back ........................... 2.06 3.54 1.48 0.14 5.74 3.68 010


## 45888

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

21925 .......... ............ A Biopsy soft tissue of back ........................... 4.49 5.12 3.24 0.60 10.20 8.33 090 21930 .......... ............ A Remove lesion, back or flank ...................... 5.00 5.82 3.39 0.66 11.48 9.05 090 21935 .......... ............ A Remove tumor, back ................................... 17.97 NA 9.46 2.47 NA 29.90 090 22100 .......... ............ A Remove part of neck vertebra .................... 9.74 NA 7.39 2.13 NA 19.26 090 22101 .......... ............ A Remove part, thorax vertebra ..................... 9.82 NA 7.57 1.90 NA 19.28 090 22102 .......... ............ A Remove part, lumbar vertebra .................... 9.82 NA 7.89 1.87 NA 19.58 090 22103 .......... ............ A Remove extra spine segment ..................... 2.34 NA 1.17 0.44 NA 3.96 ZZZ 22110 .......... ............ A Remove part of neck vertebra .................... 12.75 NA 8.96 2.76 NA 24.47 090 22112 .......... ............ A Remove part, thorax vertebra ..................... 12.82 NA 9.03 2.52 NA 24.36 090 22114 .......... ............ A Remove part, lumbar vertebra .................... 12.82 NA 9.02 2.63 NA 24.46 090 22116 .......... ............ A Remove extra spine segment ..................... 2.32 NA 1.14 0.50 NA 3.96 ZZZ 22210 .......... ............ A Revision of neck spine ................................ 23.83 NA 15.05 5.44 NA 44.31 090 22212 .......... ............ A Revision of thorax spine .............................. 19.43 NA 12.99 3.90 NA 36.32 090 22214 .......... ............ A Revision of lumbar spine ............................. 19.46 NA 13.43 3.91 NA 36.80 090 22216 .......... ............ A Revise, extra spine segment ....................... 6.04 NA 3.04 1.29 NA 10.37 ZZZ 22220 .......... ............ A Revision of neck spine ................................ 21.38 NA 13.33 5.06 NA 39.78 090 22222 .......... ............ A Revision of thorax spine .............................. 21.53 NA 11.12 4.12 NA 36.78 090 22224 .......... ............ A Revision of lumbar spine ............................. 21.53 NA 13.85 4.18 NA 39.56 090 22226 .......... ............ A Revise, extra spine segment ....................... 6.04 NA 3.00 1.29 NA 10.34 ZZZ 22305 .......... ............ A Treat spine process fracture ....................... 2.05 2.25 1.86 0.39 4.69 4.31 090 22310 .......... ............ A Treat spine fracture ..................................... 2.62 2.72 2.28 0.50 5.84 5.40 090 22315 .......... ............ A Treat spine fracture ..................................... 8.85 9.37 7.16 1.85 20.07 17.86 090 22318 .......... ............ A Treat odontoid fx w/o graft .......................... 21.51 NA 13.09 5.28 NA 39.89 090 22319 .......... ............ A Treat odontoid fx w/graft ............................. 24.01 NA 14.38 6.03 NA 44.41 090 22325 .......... ............ A Treat spine fracture ..................................... 18.31 NA 11.94 3.87 NA 34.12 090 22326 .......... ............ A Treat neck spine fracture ............................ 19.60 NA 12.41 4.42 NA 36.43 090 22327 .......... ............ A Treat thorax spine fracture .......................... 19.21 NA 12.28 3.98 NA 35.47 090 22328 .......... ............ A Treat each add spine fx .............................. 4.61 NA 2.21 0.94 NA 7.76 ZZZ 22505 .......... ............ A Manipulation of spine .................................. 1.87 NA 0.92 0.36 NA 3.15 010 22520 .......... ............ A Percut vertebroplasty thor ........................... 8.92 60.09 5.24 1.71 70.72 15.87 010 22521 .......... ............ A Percut vertebroplasty lumb ......................... 8.35 54.29 5.08 1.60 64.24 15.03 010 22522 .......... ............ A Percut vertebroplasty add ’ l .......................... 4.31 NA 1.70 0.82 NA 6.83 ZZZ 22532 .......... ............ A Lat thorax spine fusion ................................ 24.01 NA 14.47 4.34 NA 42.82 090 22533 .......... ............ A Lat lumbar spine fusion ............................... 23.14 NA 13.34 3.15 NA 39.63 090 22534 .......... ............ A Lat thor/lumb, add ’ l seg ............................... 6.00 NA 2.95 1.25 NA 10.20 ZZZ 22548 .......... ............ A Neck spine fusion ........................................ 25.83 NA 15.46 5.59 NA 46.88 090 22554 .......... ............ A Neck spine fusion ........................................ 18.63 NA 12.07 4.45 NA 35.15 090 22556 .......... ............ A Thorax spine fusion ..................................... 23.47 NA 14.33 4.34 NA 42.14 090 22558 .......... ............ A Lumbar spine fusion .................................... 22.29 NA 12.94 3.15 NA 38.39 090 22585 .......... ............ A Additional spinal fusion ............................... 5.53 NA 2.72 1.25 NA 9.50 ZZZ 22590 .......... ............ A Spine & skull spinal fusion .......................... 20.52 NA 13.02 4.78 NA 38.32 090 22595 .......... ............ A Neck spinal fusion ....................................... 19.40 NA 12.54 4.40 NA 36.34 090 22600 .......... ............ A Neck spine fusion ........................................ 16.15 NA 10.93 3.72 NA 30.80 090 22610 .......... ............ A Thorax spine fusion ..................................... 16.03 NA 11.12 3.52 NA 30.67 090 22612 .......... ............ A Lumbar spine fusion .................................... 21.01 NA 13.81 4.46 NA 39.28 090 22614 .......... ............ A Spine fusion, extra segment ....................... 6.44 NA 3.25 1.38 NA 11.08 ZZZ 22630 .......... ............ A Lumbar spine fusion .................................... 20.85 NA 13.27 4.72 NA 38.84 090 22632 .......... ............ A Spine fusion, extra segment ....................... 5.23 NA 2.59 1.16 NA 8.98 ZZZ 22800 .......... ............ A Fusion of spine ............................................ 18.26 NA 12.40 3.75 NA 34.41 090 22802 .......... ............ A Fusion of spine ............................................ 30.89 NA 19.00 6.15 NA 56.04 090 22804 .......... ............ A Fusion of spine ............................................ 36.29 NA 22.00 6.98 NA 65.27 090 22808 .......... ............ A Fusion of spine ............................................ 26.28 NA 15.86 4.92 NA 47.07 090 22810 .......... ............ A Fusion of spine ............................................ 30.28 NA 17.84 5.13 NA 53.25 090 22812 .......... ............ A Fusion of spine ............................................ 32.72 NA 19.47 5.28 NA 57.46 090 22818 .......... ............ A Kyphectomy, 1-2 segments ......................... 31.84 NA 18.38 6.45 NA 56.67 090 22819 .......... ............ A Kyphectomy, 3 or more ............................... 36.46 NA 19.51 7.65 NA 63.63 090 22830 .......... ............ A Exploration of spinal fusion ......................... 10.85 NA 7.73 2.29 NA 20.87 090 22840 .......... ............ A Insert spine fixation device .......................... 12.55 NA 6.31 2.78 NA 21.63 ZZZ 22841 .......... ............ B Insert spine fixation device .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 22842 .......... ............ A Insert spine fixation device .......................... 12.59 NA 6.32 2.74 NA 21.64 ZZZ 22843 .......... ............ A Insert spine fixation device .......................... 13.47 NA 6.41 2.85 NA 22.73 ZZZ 22844 .......... ............ A Insert spine fixation device .......................... 16.45 NA 8.49 3.18 NA 28.12 ZZZ 22845 .......... ............ A Insert spine fixation device .......................... 11.96 NA 5.91 2.85 NA 20.72 ZZZ 22846 .......... ............ A Insert spine fixation device .......................... 12.42 NA 6.16 2.95 NA 21.53 ZZZ 22847 .......... ............ A Insert spine fixation device .......................... 13.81 NA 6.82 2.99 NA 23.62 ZZZ 22848 .......... ............ A Insert pelv fixation device ............................ 6.00 NA 3.09 1.15 NA 10.24 ZZZ 22849 .......... ............ A Reinsert spinal fixation ................................ 18.52 NA 11.40 3.89 NA 33.80 090 22850 .......... ............ A Remove spine fixation device ..................... 9.53 NA 6.80 2.04 NA 18.37 090 22851 .......... ............ A Apply spine prosth device ........................... 6.71 NA 3.27 1.49 NA 11.47 ZZZ 22852 .......... ............ A Remove spine fixation device ..................... 9.02 NA 6.60 1.89 NA 17.50 090 22855 .......... ............ A Remove spine fixation device ..................... 15.14 NA 9.43 3.51 NA 28.08 090 22899 .......... ............ C Spine surgery procedure ............................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
22900 .......... ............ A Remove abdominal wall lesion ................... 5.80 NA 3.22 0.76 NA 9.78 090 22999 .......... ............ C Abdomen surgery procedure ....................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY


## 45889

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

23000 .......... ............ A Removal of calcium deposits ...................... 4.36 8.16 4.28 0.68 13.20 9.32 090 23020 .......... ............ A Release shoulder joint ................................. 8.94 NA 7.31 1.54 NA 17.79 090 23030 .......... ............ A Drain shoulder lesion .................................. 3.43 7.02 2.81 0.57 11.01 6.81 010 23031 .......... ............ A Drain shoulder bursa ................................... 2.75 7.33 2.62 0.46 10.54 5.83 010 23035 .......... ............ A Drain shoulder bone lesion ......................... 8.62 NA 7.93 1.47 NA 18.02 090 23040 .......... ............ A Exploratory shoulder surgery ...................... 9.21 NA 7.61 1.60 NA 18.42 090 23044 .......... ............ A Exploratory shoulder surgery ...................... 7.12 NA 6.22 1.24 NA 14.58 090 23065 .......... ............ A Biopsy shoulder tissues .............................. 2.27 2.71 1.60 0.20 5.18 4.08 010 23066 .......... ............ A Biopsy shoulder tissues .............................. 4.16 7.54 3.89 0.63 12.33 8.68 090 23075 .......... ............ A Removal of shoulder lesion ......................... 2.39 3.59 1.75 0.34 6.33 4.49 010 23076 .......... ............ A Removal of shoulder lesion ......................... 7.64 NA 5.45 1.13 NA 14.21 090 23077 .......... ............ A Remove tumor of shoulder .......................... 16.10 NA 9.99 2.33 NA 28.42 090 23100 .......... ............ A Biopsy of shoulder joint ............................... 6.03 NA 5.48 1.04 NA 12.55 090 23101 .......... ............ A Shoulder joint surgery ................................. 5.58 NA 5.15 0.96 NA 11.69 090 23105 .......... ............ A Remove shoulder joint lining ....................... 8.24 NA 6.90 1.42 NA 16.56 090 23106 .......... ............ A Incision of collarbone joint ........................... 5.96 NA 5.51 0.99 NA 12.46 090 23107 .......... ............ A Explore treat shoulder joint ......................... 8.63 NA 7.15 1.49 NA 17.27 090 23120 .......... ............ A Partial removal, collar bone ........................ 7.11 NA 6.24 1.23 NA 14.59 090 23125 .......... ............ A Removal of collar bone ............................... 9.40 NA 7.32 1.62 NA 18.34 090 23130 .......... ............ A Remove shoulder bone, part ....................... 7.56 NA 6.89 1.30 NA 15.75 090 23140 .......... ............ A Removal of bone lesion .............................. 6.89 NA 5.09 1.08 NA 13.07 090 23145 .......... ............ A Removal of bone lesion .............................. 9.10 NA 7.23 1.49 NA 17.82 090 23146 .......... ............ A Removal of bone lesion .............................. 7.84 NA 6.88 1.35 NA 16.06 090 23150 .......... ............ A Removal of humerus lesion ........................ 8.49 NA 6.70 1.32 NA 16.51 090 23155 .......... ............ A Removal of humerus lesion ........................ 10.35 NA 8.07 1.80 NA 20.22 090 23156 .......... ............ A Removal of humerus lesion ........................ 8.69 NA 7.14 1.50 NA 17.33 090
23170 .......... ............ A Remove collar bone lesion .......................... 6.86 NA 5.82 1.12 NA 13.80 090 23172 .......... ............ A Remove shoulder blade lesion .................... 6.90 NA 6.08 1.01 NA 13.99 090 23174 .......... ............ A Remove humerus lesion ............................. 9.52 NA 8.10 1.65 NA 19.27 090 23180 .......... ............ A Remove collar bone lesion .......................... 8.54 NA 8.60 1.47 NA 18.61 090 23182 .......... ............ A Remove shoulder blade lesion .................... 8.16 NA 8.18 1.37 NA 17.71 090 23184 .......... ............ A Remove humerus lesion ............................. 9.39 NA 8.92 1.63 NA 19.94 090 23190 .......... ............ A Partial removal of scapula ........................... 7.24 NA 5.98 1.17 NA 14.40 090 23195 .......... ............ A Removal of head of humerus ...................... 9.82 NA 7.48 1.70 NA 19.00 090 23200 .......... ............ A Removal of collar bone ............................... 12.08 NA 8.44 1.93 NA 22.46 090 23210 .......... ............ A Removal of shoulder blade ......................... 12.49 NA 8.72 2.02 NA 23.24 090 23220 .......... ............ A Partial removal of humerus ......................... 14.57 NA 10.48 2.48 NA 27.53 090 23221 .......... ............ A Partial removal of humerus ......................... 17.75 NA 11.47 3.05 NA 32.26 090 23222 .......... ............ A Partial removal of humerus ......................... 23.93 NA 15.31 3.94 NA 43.17 090 23330 .......... ............ A Remove shoulder foreign body ................... 1.85 3.54 1.81 0.24 5.64 3.90 010 23331 .......... ............ A Remove shoulder foreign body ................... 7.38 NA 6.57 1.27 NA 15.23 090 23332 .......... ............ A Remove shoulder foreign body ................... 11.62 NA 9.02 2.02 NA 22.66 090 23350 .......... ............ A Injection for shoulder x-ray .......................... 1.00 3.39 0.35 0.06 4.45 1.41 000 23395 .......... ............ A Muscle transfer,shoulder/arm ...................... 16.85 NA 12.46 2.93 NA 32.25 090 23397 .......... ............ A Muscle transfers .......................................... 16.14 NA 11.05 2.73 NA 29.92 090 23400 .......... ............ A Fixation of shoulder blade ........................... 13.55 NA 9.73 2.29 NA 25.57 090 23405 .......... ............ A Incision of tendon & muscle ........................ 8.38 NA 6.69 1.45 NA 16.51 090 23406 .......... ............ A Incise tendon(s) & muscle(s) ...................... 10.79 NA 8.07 1.87 NA 20.74 090 23410 .......... ............ A Repair rotator cuff, acute ............................ 12.45 NA 9.10 2.16 NA 23.72 090 23412 .......... ............ A Repair rotator cuff, chronic .......................... 13.32 NA 9.58 2.31 NA 25.20 090 23415 .......... ............ A Release of shoulder ligament ..................... 9.98 NA 7.73 1.73 NA 19.44 090 23420 .......... ............ A Repair of shoulder ....................................... 13.31 NA 10.51 2.31 NA 26.12 090 23430 .......... ............ A Repair biceps tendon .................................. 9.99 NA 7.84 1.73 NA 19.56 090 23440 .......... ............ A Remove/transplant tendon .......................... 10.48 NA 7.99 1.82 NA 20.29 090 23450 .......... ............ A Repair shoulder capsule ............................. 13.41 NA 9.53 2.32 NA 25.26 090 23455 .......... ............ A Repair shoulder capsule ............................. 14.38 NA 10.11 2.49 NA 26.98 090 23460 .......... ............ A Repair shoulder capsule ............................. 15.38 NA 11.01 2.66 NA 29.05 090 23462 .......... ............ A Repair shoulder capsule ............................. 15.31 NA 10.42 2.59 NA 28.32 090 23465 .......... ............ A Repair shoulder capsule ............................. 15.86 NA 10.83 2.76 NA 29.46 090 23466 .......... ............ A Repair shoulder capsule ............................. 14.23 NA 11.02 2.46 NA 27.71 090 23470 .......... ............ A Reconstruct shoulder joint ........................... 17.15 NA 11.86 2.98 NA 32.00 090 23472 .......... ............ A Reconstruct shoulder joint ........................... 21.11 NA 13.97 3.66 NA 38.74 090 23480 .......... ............ A Revision of collar bone ................................ 11.18 NA 8.49 1.94 NA 21.61 090 23485 .......... ............ A Revision of collar bone ................................ 13.44 NA 9.57 2.33 NA 25.34 090 23490 .......... ............ A Reinforce clavicle ........................................ 11.86 NA 8.43 1.47 NA 21.76 090 23491 .......... ............ A Reinforce shoulder bones ........................... 14.22 NA 10.37 2.46 NA 27.05 090 23500 .......... ............ A Treat clavicle fracture .................................. 2.08 2.79 2.44 0.30 5.17 4.82 090 23505 .......... ............ A Treat clavicle fracture .................................. 3.69 4.29 3.74 0.61 8.59 8.04 090 23515 .......... ............ A Treat clavicle fracture .................................. 7.41 NA 6.34 1.28 NA 15.03 090
23520 .......... ............ A Treat clavicle dislocation ............................. 2.16 2.77 2.67 0.34 5.28 5.17 090
23525 .......... ............ A Treat clavicle dislocation ............................. 3.60 4.40 3.83 0.46 8.46 7.88 090
23530 .......... ............ A Treat clavicle dislocation ............................. 7.31 NA 5.75 1.20 NA 14.27 090
23532 .......... ............ A Treat clavicle dislocation ............................. 8.02 NA 6.76 1.38 NA 16.15 090
23540 .......... ............ A Treat clavicle dislocation ............................. 2.23 2.79 2.28 0.29 5.31 4.81 090


## 45890

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

23545 .......... ............ A Treat clavicle dislocation ............................. 3.26 4.10 3.29 0.35 7.71 6.90 090 23550 .......... ............ A Treat clavicle dislocation ............................. 7.24 NA 6.18 1.25 NA 14.67 090 23552 .......... ............ A Treat clavicle dislocation ............................. 8.46 NA 7.08 1.46 NA 17.00 090 23570 .......... ............ A Treat shoulder blade fx ............................... 2.23 2.92 2.81 0.36 5.52 5.40 090 23575 .......... ............ A Treat shoulder blade fx ............................... 4.06 4.75 4.19 0.59 9.40 8.84 090 23585 .......... ............ A Treat scapula fracture ................................. 8.97 NA 7.39 1.54 NA 17.90 090 23600 .......... ............ A Treat humerus fracture ................................ 2.94 4.40 3.44 0.48 7.81 6.86 090 23605 .......... ............ A Treat humerus fracture ................................ 4.87 5.95 4.97 0.84 11.66 10.68 090 23615 .......... ............ A Treat humerus fracture ................................ 9.36 NA 8.56 1.62 NA 19.54 090 23616 .......... ............ A Treat humerus fracture ................................ 21.28 NA 13.70 3.69 NA 38.67 090 23620 .......... ............ A Treat humerus fracture ................................ 2.40 3.51 2.89 0.40 6.31 5.69 090 23625 .......... ............ A Treat humerus fracture ................................ 3.93 4.80 4.16 0.67 9.40 8.76 090 23630 .......... ............ A Treat humerus fracture ................................ 7.35 NA 6.41 1.27 NA 15.04 090
23650 .......... ............ A Treat shoulder dislocation ........................... 3.39 3.68 2.67 0.30 7.36 6.35 090 23655 .......... ............ A Treat shoulder dislocation ........................... 4.57 NA 4.04 0.69 NA 9.30 090 23660 .......... ............ A Treat shoulder dislocation ........................... 7.49 NA 6.18 1.29 NA 14.96 090 23665 .......... ............ A Treat dislocation/fracture ............................. 4.47 5.18 4.59 0.71 10.36 9.77 090 23670 .......... ............ A Treat dislocation/fracture ............................. 7.91 NA 6.61 1.36 NA 15.88 090 23675 .......... ............ A Treat dislocation/fracture ............................. 6.05 6.63 5.66 1.01 13.70 12.73 090 23680 .......... ............ A Treat dislocation/fracture ............................. 10.06 NA 7.86 1.75 NA 19.67 090 23700 .......... ............ A Fixation of shoulder ..................................... 2.53 NA 2.11 0.44 NA 5.08 010 23800 .......... ............ A Fusion of shoulder joint ............................... 14.17 NA 10.10 2.35 NA 26.62 090 23802 .......... ............ A Fusion of shoulder joint ............................... 16.61 NA 9.87 2.70 NA 29.19 090 23900 .......... ............ A Amputation of arm & girdle ......................... 19.73 NA 11.40 3.18 NA 34.31 090 23920 .......... ............ A Amputation at shoulder joint ....................... 14.62 NA 9.65 2.46 NA 26.73 090 23921 .......... ............ A Amputation follow-up surgery ...................... 5.49 NA 4.93 0.78 NA 11.20 090 23929 .......... ............ C Shoulder surgery procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 23930 .......... ............ A Drainage of arm lesion ................................ 2.95 5.96 2.24 0.43 9.34 5.62 010 23931 .......... ............ A Drainage of arm bursa ................................ 1.79 5.52 2.09 0.28 7.60 4.16 010 23935 .......... ............ A Drain arm/elbow bone lesion ...................... 6.09 NA 5.72 1.05 NA 12.86 090 24000 .......... ............ A Exploratory elbow surgery ........................... 5.82 NA 5.24 0.97 NA 12.03 090 24006 .......... ............ A Release elbow joint ..................................... 9.32 NA 7.51 1.50 NA 18.33 090 24065 .......... ............ A Biopsy arm/elbow soft tissue ...................... 2.08 3.47 1.72 0.17 5.73 3.97 010 24066 .......... ............ A Biopsy arm/elbow soft tissue ...................... 5.21 8.65 4.03 0.80 14.66 10.04 090 24075 .......... ............ A Remove arm/elbow lesion ........................... 3.92 7.23 3.34 0.56 11.71 7.81 090 24076 .......... ............ A Remove arm/elbow lesion ........................... 6.30 NA 4.75 0.95 NA 12.01 090 24077 .......... ............ A Remove tumor of arm/elbow ....................... 11.76 NA 7.55 1.72 NA 21.04 090 24100 .......... ............ A Biopsy elbow joint lining .............................. 4.93 NA 4.39 0.85 NA 10.17 090 24101 .......... ............ A Explore/treat elbow joint .............................. 6.13 NA 5.73 1.03 NA 12.90 090 24102 .......... ............ A Remove elbow joint lining ........................... 8.04 NA 6.64 1.33 NA 16.01 090 24105 .......... ............ A Removal of elbow bursa ............................. 3.61 NA 4.25 0.61 NA 8.47 090
24110 .......... ............ A Remove humerus lesion ............................. 7.39 NA 6.46 1.28 NA 15.13 090 24115 .......... ............ A Remove/graft bone lesion ........................... 9.64 NA 7.02 1.67 NA 18.33 090 24116 .......... ............ A Remove/graft bone lesion ........................... 11.81 NA 8.78 2.05 NA 22.65 090
24120 .......... ............ A Remove elbow lesion .................................. 6.65 NA 5.74 1.10 NA 13.49 090 24125 .......... ............ A Remove/graft bone lesion ........................... 7.90 NA 6.05 1.06 NA 15.01 090 24126 .......... ............ A Remove/graft bone lesion ........................... 8.32 NA 6.82 1.16 NA 16.30 090 24130 .......... ............ A Removal of head of radius .......................... 6.25 NA 5.82 1.04 NA 13.11 090 24134 .......... ............ A Removal of arm bone lesion ....................... 9.74 NA 8.50 1.64 NA 19.88 090
24136 .......... ............ A Remove radius bone lesion ........................ 8.00 NA 7.04 1.38 NA 16.42 090 24138 .......... ............ A Remove elbow bone lesion ......................... 8.06 NA 7.53 1.34 NA 16.92 090 24140 .......... ............ A Partial removal of arm bone ........................ 9.19 NA 8.71 1.51 NA 19.41 090 24145 .......... ............ A Partial removal of radius ............................. 7.59 NA 7.71 1.25 NA 16.54 090 24147 .......... ............ A Partial removal of elbow .............................. 7.55 NA 8.23 1.30 NA 17.08 090 24149 .......... ............ A Radical resection of elbow .......................... 14.21 NA 11.28 2.34 NA 27.82 090 24150 .......... ............ A Extensive humerus surgery ......................... 13.28 NA 9.69 2.32 NA 25.28 090 24151 .......... ............ A Extensive humerus surgery ......................... 15.59 NA 11.17 2.59 NA 29.36 090 24152 .......... ............ A Extensive radius surgery ............................. 10.06 NA 7.49 1.48 NA 19.04 090 24153 .......... ............ A Extensive radius surgery ............................. 11.54 NA 5.91 0.74 NA 18.20 090 24155 .......... ............ A Removal of elbow joint ................................ 11.73 NA 8.15 1.92 NA 21.80 090 24160 .......... ............ A Remove elbow joint implant ........................ 7.84 NA 6.68 1.30 NA 15.82 090 24164 .......... ............ A Remove radius head implant ...................... 6.23 NA 5.58 1.03 NA 12.84 090 24200 .......... ............ A Removal of arm foreign body ...................... 1.76 3.26 1.59 0.20 5.22 3.55 010 24201 .......... ............ A Removal of arm foreign body ...................... 4.56 9.27 4.11 0.72 14.55 9.38 090 24220 .......... ............ A Injection for elbow x-ray .............................. 1.31 3.46 0.46 0.08 4.85 1.85 000 24300 .......... ............ A Manipulate elbow w/anesth ......................... 3.75 NA 5.52 0.65 NA 9.92 090 24301 .......... ............ A Muscle/tendon transfer ................................ 10.20 NA 7.93 1.66 NA 19.79 090 24305 .......... ............ A Arm tendon lengthening .............................. 7.45 NA 6.49 1.15 NA 15.10 090 24310 .......... ............ A Revision of arm tendon ............................... 5.98 NA 5.40 0.96 NA 12.34 090 24320 .......... ............ A Repair of arm tendon .................................. 10.56 NA 7.54 1.73 NA 19.83 090 24330 .......... ............ A Revision of arm muscles ............................. 9.61 NA 7.63 1.60 NA 18.84 090 24331 .......... ............ A Revision of arm muscles ............................. 10.65 NA 8.40 1.77 NA 20.82 090 24332 .......... ............ A Tenolysis, triceps ......................................... 7.45 NA 6.56 1.23 NA 15.24 090 24340 .......... ............ A Repair of biceps tendon .............................. 7.90 NA 6.76 1.36 NA 16.01 090


## 45891

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

24341 .......... ............ A Repair arm tendon/muscle .......................... 7.91 NA 7.68 1.36 NA 16.94 090 24342 .......... ............ A Repair of ruptured tendon ........................... 10.62 NA 8.25 1.85 NA 20.72 090 24343 .......... ............ A Repr elbow lat ligmnt w/tiss ........................ 8.66 NA 7.89 1.43 NA 17.98 090 24344 .......... ............ A Reconstruct elbow lat ligmnt ....................... 14.01 NA 11.16 2.36 NA 27.53 090 24345 .......... ............ A Repr elbw med ligmnt w/tissu ..................... 8.66 NA 7.78 1.44 NA 17.87 090 24346 .......... ............ A Reconstruct elbow med ligmnt .................... 14.01 NA 11.00 2.33 NA 27.34 090 24350 .......... ............ A Repair of tennis elbow ................................ 5.25 NA 5.40 0.87 NA 11.52 090 24351 .......... ............ A Repair of tennis elbow ................................ 5.91 NA 5.72 1.02 NA 12.65 090 24352 .......... ............ A Repair of tennis elbow ................................ 6.43 NA 5.97 1.10 NA 13.50 090 24354 .......... ............ A Repair of tennis elbow ................................ 6.48 NA 5.95 1.07 NA 13.50 090 24356 .......... ............ A Revision of tennis elbow ............................. 6.68 NA 6.10 1.11 NA 13.90 090 24360 .......... ............ A Reconstruct elbow joint ............................... 12.34 NA 9.17 2.05 NA 23.56 090 24361 .......... ............ A Reconstruct elbow joint ............................... 14.09 NA 10.24 2.18 NA 26.51 090 24362 .......... ............ A Reconstruct elbow joint ............................... 15.00 NA 9.75 2.60 NA 27.35 090 24363 .......... ............ A Replace elbow joint ..................................... 18.50 NA 13.29 3.01 NA 34.80 090 24365 .......... ............ A Reconstruct head of radius ......................... 8.40 NA 6.97 1.41 NA 16.78 090 24366 .......... ............ A Reconstruct head of radius ......................... 9.14 NA 7.29 1.52 NA 17.95 090 24400 .......... ............ A Revision of humerus ................................... 11.06 NA 8.58 1.92 NA 21.56 090 24410 .......... ............ A Revision of humerus ................................... 14.83 NA 10.10 2.57 NA 27.49 090 24420 .......... ............ A Revision of humerus ................................... 13.45 NA 10.21 2.17 NA 25.83 090 24430 .......... ............ A Repair of humerus ....................................... 12.82 NA 9.43 2.21 NA 24.45 090 24435 .......... ............ A Repair humerus with graft ........................... 13.18 NA 10.55 2.27 NA 25.99 090 24470 .......... ............ A Revision of elbow joint ................................ 8.75 NA 7.46 1.48 NA 17.69 090 24495 .......... ............ A Decompression of forearm .......................... 8.13 NA 8.34 1.18 NA 17.65 090 24498 .......... ............ A Reinforce humerus ...................................... 11.92 NA 8.97 2.06 NA 22.95 090 24500 .......... ............ A Treat humerus fracture ................................ 3.22 4.99 3.57 0.50 8.71 7.29 090 24505 .......... ............ A Treat humerus fracture ................................ 5.17 6.69 5.24 0.89 12.75 11.30 090 24515 .......... ............ A Treat humerus fracture ................................ 11.65 NA 9.09 2.02 NA 22.76 090 24516 .......... ............ A Treat humerus fracture ................................ 11.65 NA 8.82 2.02 NA 22.49 090 24530 .......... ............ A Treat humerus fracture ................................ 3.50 5.33 3.92 0.57 9.40 7.99 090 24535 .......... ............ A Treat humerus fracture ................................ 6.87 7.89 6.43 1.18 15.94 14.48 090 24538 .......... ............ A Treat humerus fracture ................................ 9.44 NA 8.42 1.64 NA 19.50 090 24545 .......... ............ A Treat humerus fracture ................................ 10.46 NA 8.18 1.82 NA 20.46 090 24546 .......... ............ A Treat humerus fracture ................................ 15.70 NA 10.96 2.73 NA 29.39 090 24560 .......... ............ A Treat humerus fracture ................................ 2.81 4.64 3.09 0.44 7.88 6.33 090 24565 .......... ............ A Treat humerus fracture ................................ 5.56 6.71 5.37 0.93 13.20 11.86 090 24566 .......... ............ A Treat humerus fracture ................................ 7.80 NA 7.86 1.30 NA 16.96 090 24575 .......... ............ A Treat humerus fracture ................................ 10.66 NA 8.14 1.86 NA 20.66 090 24576 .......... ............ A Treat humerus fracture ................................ 2.87 4.90 3.60 0.46 8.23 6.93 090 24577 .......... ............ A Treat humerus fracture ................................ 5.79 7.01 5.67 0.95 13.75 12.41 090 24579 .......... ............ A Treat humerus fracture ................................ 11.60 NA 8.55 2.02 NA 22.17 090 24582 .......... ............ A Treat humerus fracture ................................ 8.56 NA 8.78 1.48 NA 18.82 090 24586 .......... ............ A Treat elbow fracture .................................... 15.22 NA 10.87 2.64 NA 28.73 090 24587 .......... ............ A Treat elbow fracture .................................... 15.17 NA 10.68 2.52 NA 28.37 090
24600 .......... ............ A Treat elbow dislocation ............................... 4.23 4.99 3.39 0.50 9.72 8.12 090 24605 .......... ............ A Treat elbow dislocation ............................... 5.42 NA 5.20 0.89 NA 11.51 090 24615 .......... ............ A Treat elbow dislocation ............................... 9.43 NA 7.57 1.60 NA 18.59 090 24620 .......... ............ A Treat elbow fracture .................................... 6.98 NA 6.08 1.07 NA 14.13 090 24635 .......... ............ A Treat elbow fracture .................................... 13.20 NA 13.92 2.28 NA 29.40 090
24640 .......... ............ A Treat elbow dislocation ............................... 1.20 2.03 0.77 0.12 3.35 2.10 010 24650 .......... ............ A Treat radius fracture .................................... 2.16 4.11 2.66 0.35 6.62 5.18 090 24655 .......... ............ A Treat radius fracture .................................... 4.40 6.05 4.65 0.70 11.15 9.75 090 24665 .......... ............ A Treat radius fracture .................................... 8.15 NA 7.26 1.41 NA 16.81 090 24666 .......... ............ A Treat radius fracture .................................... 9.50 NA 7.80 1.62 NA 18.92 090 24670 .......... ............ A Treat ulnar fracture ...................................... 2.55 4.27 2.98 0.41 7.23 5.93 090 24675 .......... ............ A Treat ulnar fracture ...................................... 4.72 6.10 4.83 0.81 11.63 10.36 090 24685 .......... ............ A Treat ulnar fracture ...................................... 8.81 NA 7.27 1.52 NA 17.60 090 24800 .......... ............ A Fusion of elbow joint ................................... 11.20 NA 8.49 1.63 NA 21.33 090 24802 .......... ............ A Fusion/graft of elbow joint ........................... 13.70 NA 10.04 2.37 NA 26.11 090 24900 .......... ............ A Amputation of upper arm ............................ 9.61 NA 6.91 1.53 NA 18.05 090 24920 .......... ............ A Amputation of upper arm ............................ 9.55 NA 6.77 1.61 NA 17.93 090 24925 .......... ............ A Amputation follow-up surgery ...................... 7.07 NA 5.91 1.14 NA 14.12 090 24930 .......... ............ A Amputation follow-up surgery ...................... 10.25 NA 7.05 1.67 NA 18.97 090 24931 .......... ............ A Amputate upper arm & implant ................... 12.73 NA 5.68 1.89 NA 20.30 090 24935 .......... ............ A Revision of amputation ................................ 15.57 NA 7.92 2.13 NA 25.62 090 24940 .......... ............ C Revision of upper arm ................................. 0.00 0.00 0.00 0.00 0.00 0.00 090 24999 .......... ............ C Upper arm/elbow surgery ............................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY
25000 .......... ............ A Incision of tendon sheath ............................ 3.38 NA 6.49 0.55 NA 10.41 090 25001 .......... ............ A Incise flexor carpi radialis ............................ 3.38 NA 4.10 0.55 NA 8.03 090 25020 .......... ............ A Decompress forearm 1 space ..................... 5.92 NA 9.00 0.93 NA 15.85 090 25023 .......... ............ A Decompress forearm 1 space ..................... 12.97 NA 14.21 2.03 NA 29.21 090 25024 .......... ............ A Decompress forearm 2 spaces ................... 9.51 NA 7.28 1.36 NA 18.15 090 25025 .......... ............ A Decompress forearm 2 spaces ................... 16.55 NA 9.75 1.82 NA 28.13 090 25028 .......... ............ A Drainage of forearm lesion .......................... 5.25 NA 7.73 0.81 NA 13.79 090


## 45892

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

25031 .......... ............ A Drainage of forearm bursa .......................... 4.14 NA 7.45 0.63 NA 12.22 090 25035 .......... ............ A Treat forearm bone lesion ........................... 7.36 NA 12.69 1.24 NA 21.29 090 25040 .......... ............ A Explore/treat wrist joint ................................ 7.18 NA 7.00 1.15 NA 15.34 090 25065 .......... ............ A Biopsy forearm soft tissues ......................... 1.99 3.49 1.85 0.15 5.64 4.00 010 25066 .......... ............ A Biopsy forearm soft tissues ......................... 4.13 NA 6.69 0.64 NA 11.46 090 25075 .......... ............ A Removal forearm lesion subcu ................... 3.74 NA 5.66 0.55 NA 9.95 090 25076 .......... ............ A Removal forearm lesion deep ..................... 4.92 NA 8.98 0.74 NA 14.64 090 25077 .......... ............ A Remove tumor, forearm/wrist ...................... 9.77 NA 11.47 1.42 NA 22.66 090 25085 .......... ............ A Incision of wrist capsule .............................. 5.50 NA 6.78 0.85 NA 13.13 090 25100 .......... ............ A Biopsy of wrist joint ..................................... 3.90 NA 5.04 0.59 NA 9.53 090 25101 .......... ............ A Explore/treat wrist joint ................................ 4.69 NA 5.64 0.75 NA 11.08 090 25105 .......... ............ A Remove wrist joint lining ............................. 5.85 NA 6.97 0.92 NA 13.74 090 25107 .......... ............ A Remove wrist joint cartilage ........................ 6.43 NA 7.98 0.99 NA 15.41 090 25110 .......... ............ A Remove wrist tendon lesion ........................ 3.92 NA 6.65 0.62 NA 11.19 090 25111 .......... ............ A Remove wrist tendon lesion ........................ 3.39 NA 4.51 0.53 NA 8.43 090 25112 .......... ............ A Reremove wrist tendon lesion ..................... 4.53 NA 5.05 0.70 NA 10.28 090 25115 .......... ............ A Remove wrist/forearm lesion ....................... 8.83 NA 13.21 1.31 NA 23.35 090 25116 .......... ............ A Remove wrist/forearm lesion ....................... 7.11 NA 12.34 1.11 NA 20.56 090
25118 .......... ............ A Excise wrist tendon sheath ......................... 4.37 NA 5.49 0.68 NA 10.54 090 25119 .......... ............ A Partial removal of ulna ................................ 6.04 NA 7.25 0.96 NA 14.25 090 25120 .......... ............ A Removal of forearm lesion .......................... 6.10 NA 11.29 1.00 NA 18.39 090 25125 .......... ............ A Remove/graft forearm lesion ....................... 7.48 NA 12.05 1.06 NA 20.60 090 25126 .......... ............ A Remove/graft forearm lesion ....................... 7.56 NA 12.20 1.27 NA 21.02 090 25130 .......... ............ A Removal of wrist lesion ............................... 5.26 NA 6.15 0.80 NA 12.21 090 25135 .......... ............ A Remove & graft wrist lesion ........................ 6.89 NA 7.22 1.02 NA 15.13 090 25136 .......... ............ A Remove & graft wrist lesion ........................ 5.97 NA 6.35 1.03 NA 13.35 090 25145 .......... ............ A Remove forearm bone lesion ...................... 6.37 NA 11.29 1.01 NA 18.67 090 25150 .......... ............ A Partial removal of ulna ................................ 7.09 NA 7.83 1.14 NA 16.06 090 25151 .......... ............ A Partial removal of radius ............................. 7.39 NA 11.93 1.18 NA 20.50 090 25170 .......... ............ A Extensive forearm surgery .......................... 11.09 NA 14.28 1.77 NA 27.15 090 25210 .......... ............ A Removal of wrist bone ................................ 5.95 NA 6.52 0.88 NA 13.35 090 25215 .......... ............ A Removal of wrist bones ............................... 7.90 NA 8.37 1.19 NA 17.46 090 25230 .......... ............ A Partial removal of radius ............................. 5.23 NA 5.89 0.79 NA 11.91 090 25240 .......... ............ A Partial removal of ulna ................................ 5.17 NA 6.61 0.81 NA 12.59 090 25246 .......... ............ A Injection for wrist x-ray ................................ 1.45 3.36 0.50 0.09 4.90 2.05 000 25248 .......... ............ A Remove forearm foreign body .................... 5.14 NA 8.08 0.72 NA 13.94 090 25250 .......... ............ A Removal of wrist prosthesis ........................ 6.60 NA 5.92 1.01 NA 13.53 090 25251 .......... ............ A Removal of wrist prosthesis ........................ 9.58 NA 7.68 1.26 NA 18.52 090 25259 .......... ............ A Manipulate wrist w/anesthes ....................... 3.75 NA 5.53 0.62 NA 9.90 090 25260 .......... ............ A Repair forearm tendon/muscle .................... 7.81 NA 12.49 1.19 NA 21.49 090 25263 .......... ............ A Repair forearm tendon/muscle .................... 7.83 NA 12.46 1.18 NA 21.47 090 25265 .......... ............ A Repair forearm tendon/muscle .................... 9.89 NA 13.46 1.47 NA 24.82 090 25270 .......... ............ A Repair forearm tendon/muscle .................... 6.00 NA 11.23 0.95 NA 18.18 090 25272 .......... ............ A Repair forearm tendon/muscle .................... 7.04 NA 11.96 1.11 NA 20.11 090 25274 .......... ............ A Repair forearm tendon/muscle .................... 8.76 NA 12.81 1.36 NA 22.92 090 25275 .......... ............ A Repair forearm tendon sheath .................... 8.51 NA 7.34 1.31 NA 17.15 090 25280 .......... ............ A Revise wrist/forearm tendon ....................... 7.22 NA 11.85 1.08 NA 20.15 090 25290 .......... ............ A Incise wrist/forearm tendon ......................... 5.29 NA 13.90 0.82 NA 20.01 090 25295 .......... ............ A Release wrist/forearm tendon ..................... 6.55 NA 11.39 1.00 NA 18.94 090 25300 .......... ............ A Fusion of tendons at wrist ........................... 8.81 NA 8.15 1.26 NA 18.22 090 25301 .......... ............ A Fusion of tendons at wrist ........................... 8.41 NA 7.76 1.29 NA 17.46 090 25310 .......... ............ A Transplant forearm tendon .......................... 8.15 NA 12.25 1.21 NA 21.61 090 25312 .......... ............ A Transplant forearm tendon .......................... 9.58 NA 13.12 1.41 NA 24.11 090 25315 .......... ............ A Revise palsy hand tendon(s) ...................... 10.20 NA 13.54 1.58 NA 25.32 090 25316 .......... ............ A Revise palsy hand tendon(s) ...................... 12.33 NA 15.27 1.74 NA 29.35 090 25320 .......... ............ A Repair/revise wrist joint ............................... 10.77 NA 11.02 1.61 NA 23.40 090 25332 .......... ............ A Revise wrist joint ......................................... 11.41 NA 8.89 1.83 NA 22.13 090 25335 .......... ............ A Realignment of hand ................................... 12.89 NA 11.18 1.92 NA 25.99 090 25337 .......... ............ A Reconstruct ulna/radioulnar ........................ 10.17 NA 10.64 1.61 NA 22.42 090
25350 .......... ............ A Revision of radius ........................................ 8.79 NA 13.10 1.46 NA 23.35 090 25355 .......... ............ A Revision of radius ........................................ 10.17 NA 13.71 1.73 NA 25.61 090 25360 .......... ............ A Revision of ulna ........................................... 8.44 NA 12.99 1.41 NA 22.84 090
25365 .......... ............ A Revise radius & ulna ................................... 12.40 NA 14.72 2.15 NA 29.28 090
25370 .......... ............ A Revise radius or ulna .................................. 13.37 NA 15.25 2.28 NA 30.89 090
25375 .......... ............ A Revise radius & ulna ................................... 13.05 NA 15.43 2.26 NA 30.73 090 25390 .......... ............ A Shorten radius or ulna ................................. 10.40 NA 13.71 1.65 NA 25.76 090 25391 .......... ............ A Lengthen radius or ulna .............................. 13.66 NA 15.64 2.21 NA 31.51 090 25392 .......... ............ A Shorten radius & ulna ................................. 13.96 NA 15.22 2.10 NA 31.28 090 25393 .......... ............ A Lengthen radius & ulna ............................... 15.88 NA 16.66 2.76 NA 35.30 090 25394 .......... ............ A Repair carpal bone, shorten ........................ 10.40 NA 7.82 1.59 NA 19.81 090 25400 .......... ............ A Repair radius or ulna ................................... 10.92 NA 14.27 1.82 NA 27.01 090 25405 .......... ............ A Repair/graft radius or ulna .......................... 14.39 NA 16.29 2.32 NA 33.00 090 25415 .......... ............ A Repair radius & ulna ................................... 13.36 NA 15.55 2.17 NA 31.07 090 25420 .......... ............ A Repair/graft radius & ulna ........................... 16.34 NA 17.27 2.61 NA 36.23 090


## 45893

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

25425 .......... ............ A Repair/graft radius or ulna .......................... 13.22 NA 20.06 2.08 NA 35.36 090 25426 .......... ............ A Repair/graft radius & ulna ........................... 15.83 NA 15.84 2.54 NA 34.22 090 25430 .......... ............ A Vasc graft into carpal bone ......................... 9.26 NA 7.15 1.27 NA 17.68 090 25431 .......... ............ A Repair nonunion carpal bone ...................... 10.44 NA 8.14 1.90 NA 20.48 090 25440 .......... ............ A Repair/graft wrist bone ................................ 10.44 NA 9.04 1.63 NA 21.11 090 25441 .......... ............ A Reconstruct wrist joint ................................. 12.91 NA 9.69 2.07 NA 24.67 090 25442 .......... ............ A Reconstruct wrist joint ................................. 10.85 NA 8.61 1.53 NA 21.00 090 25443 .......... ............ A Reconstruct wrist joint ................................. 10.39 NA 8.50 1.37 NA 20.26 090 25444 .......... ............ A Reconstruct wrist joint ................................. 11.15 NA 8.75 1.71 NA 21.61 090 25445 .......... ............ A Reconstruct wrist joint ................................. 9.70 NA 7.74 1.55 NA 18.99 090 25446 .......... ............ A Wrist replacement ....................................... 16.56 NA 11.56 2.47 NA 30.59 090 25447 .......... ............ A Repair wrist joint(s) ..................................... 10.37 NA 8.38 1.61 NA 20.36 090 25449 .......... ............ A Remove wrist joint implant .......................... 14.50 NA 10.34 2.21 NA 27.05 090 25450 .......... ............ A Revision of wrist joint .................................. 7.88 NA 9.64 1.36 NA 18.87 090 25455 .......... ............ A Revision of wrist joint .................................. 9.50 NA 10.38 0.96 NA 20.84 090 25490 .......... ............ A Reinforce radius .......................................... 9.55 NA 12.92 1.43 NA 23.90 090 25491 .......... ............ A Reinforce ulna ............................................. 9.97 NA 13.59 1.60 NA 25.16 090 25492 .......... ............ A Reinforce radius and ulna ........................... 12.33 NA 14.41 2.14 NA 28.89 090 25500 .......... ............ A Treat fracture of radius ................................ 2.45 3.74 2.64 0.35 6.55 5.44 090 25505 .......... ............ A Treat fracture of radius ................................ 5.21 6.63 5.27 0.90 12.74 11.38 090 25515 .......... ............ A Treat fracture of radius ................................ 9.19 NA 7.21 1.59 NA 17.99 090 25520 .......... ............ A Treat fracture of radius ................................ 6.26 6.94 5.89 1.08 14.28 13.23 090 25525 .......... ............ A Treat fracture of radius ................................ 12.24 NA 9.67 2.12 NA 24.04 090 25526 .......... ............ A Treat fracture of radius ................................ 12.99 NA 13.19 2.19 NA 28.36 090 25530 .......... ............ A Treat fracture of ulna ................................... 2.09 3.93 2.78 0.34 6.37 5.21 090 25535 .......... ............ A Treat fracture of ulna ................................... 5.14 6.11 5.15 0.89 12.14 11.18 090 25545 .......... ............ A Treat fracture of ulna ................................... 8.91 NA 7.41 1.53 NA 17.85 090 25560 .......... ............ A Treat fracture radius & ulna ........................ 2.44 3.86 2.52 0.35 6.66 5.31 090 25565 .......... ............ A Treat fracture radius & ulna ........................ 5.63 6.78 5.27 0.93 13.34 11.83 090 25574 .......... ............ A Treat fracture radius & ulna ........................ 7.01 NA 6.97 1.21 NA 15.19 090 25575 .......... ............ A Treat fracture radius/ulna ............................ 10.45 NA 9.21 1.81 NA 21.47 090 25600 .......... ............ A Treat fracture radius/ulna ............................ 2.64 4.25 2.88 0.42 7.31 5.93 090 25605 .......... ............ A Treat fracture radius/ulna ............................ 5.81 7.30 6.05 1.00 14.11 12.86 090 25611 .......... ............ A Treat fracture radius/ulna ............................ 7.78 NA 8.63 1.34 NA 17.75 090 25620 .......... ............ A Treat fracture radius/ulna ............................ 8.56 NA 7.02 1.42 NA 17.00 090 25622 .......... ............ A Treat wrist bone fracture ............................. 2.62 4.43 3.00 0.41 7.45 6.03 090 25624 .......... ............ A Treat wrist bone fracture ............................. 4.53 6.13 4.93 0.76 11.42 10.22 090 25628 .......... ............ A Treat wrist bone fracture ............................. 8.44 NA 7.58 1.37 NA 17.38 090 25630 .......... ............ A Treat wrist bone fracture ............................. 2.89 4.34 2.85 0.45 7.68 6.18 090 25635 .......... ............ A Treat wrist bone fracture ............................. 4.39 6.05 3.80 0.74 11.18 8.92 090 25645 .......... ............ A Treat wrist bone fracture ............................. 7.25 NA 6.41 1.20 NA 14.86 090 25650 .......... ............ A Treat wrist bone fracture ............................. 3.06 4.20 3.07 0.45 7.71 6.57 090 25651 .......... ............ A Pin ulnar styloid fracture ............................. 5.36 NA 5.32 0.86 NA 11.54 090 25652 .......... ............ A Treat fracture ulnar styloid .......................... 7.61 NA 6.78 1.21 NA 15.60 090
25660 .......... ............ A Treat wrist dislocation ................................. 4.76 NA 4.57 0.58 NA 9.91 090 25670 .......... ............ A Treat wrist dislocation ................................. 7.93 NA 6.76 1.28 NA 15.96 090 25671 .......... ............ A Pin radioulnar dislocation ............................ 6.00 NA 5.95 1.00 NA 12.96 090 25675 .......... ............ A Treat wrist dislocation ................................. 4.67 5.76 4.51 0.62 11.05 9.80 090 25676 .......... ............ A Treat wrist dislocation ................................. 8.05 NA 7.06 1.34 NA 16.45 090 25680 .......... ............ A Treat wrist fracture ...................................... 5.99 NA 4.65 0.78 NA 11.42 090 25685 .......... ............ A Treat wrist fracture ...................................... 9.79 NA 7.57 1.60 NA 18.96 090
25690 .......... ............ A Treat wrist dislocation ................................. 5.50 NA 5.34 0.88 NA 11.72 090 25695 .......... ............ A Treat wrist dislocation ................................. 8.35 NA 6.86 1.32 NA 16.53 090 25800 .......... ............ A Fusion of wrist joint ..................................... 9.77 NA 8.74 1.57 NA 20.08 090 25805 .......... ............ A Fusion/graft of wrist joint ............................. 11.28 NA 9.86 1.80 NA 22.94 090 25810 .......... ............ A Fusion/graft of wrist joint ............................. 10.57 NA 9.54 1.67 NA 21.78 090
25820 .......... ............ A Fusion of hand bones ................................. 7.45 NA 7.54 1.22 NA 16.21 090 25825 .......... ............ A Fuse hand bones with graft ........................ 9.28 NA 8.88 1.41 NA 19.57 090 25830 .......... ............ A Fusion, radioulnar jnt/ulna ........................... 10.06 NA 13.60 1.55 NA 25.21 090 25900 .......... ............ A Amputation of forearm ................................. 9.02 NA 11.89 1.30 NA 22.21 090 25905 .......... ............ A Amputation of forearm ................................. 9.13 NA 11.58 1.40 NA 22.11 090 25907 .......... ............ A Amputation follow-up surgery ...................... 7.81 NA 11.06 1.10 NA 19.96 090 25909 .......... ............ A Amputation follow-up surgery ...................... 8.97 NA 11.60 1.44 NA 22.01 090 25915 .......... ............ A Amputation of forearm ................................. 17.08 NA 17.81 2.93 NA 37.83 090 25920 .......... ............ A Amputate hand at wrist ............................... 8.69 NA 7.56 1.35 NA 17.59 090 25922 .......... ............ A Amputate hand at wrist ............................... 7.42 NA 6.76 1.12 NA 15.31 090 25924 .......... ............ A Amputation follow-up surgery ...................... 8.47 NA 7.77 1.32 NA 17.56 090 25927 .......... ............ A Amputation of hand ..................................... 8.81 NA 11.04 1.27 NA 21.11 090 25929 .......... ............ A Amputation follow-up surgery ...................... 7.60 NA 5.70 1.14 NA 14.43 090 25931 .......... ............ A Amputation follow-up surgery ...................... 7.82 NA 10.79 1.15 NA 19.75 090 25999 .......... ............ C Forearm or wrist surgery ............................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY 26010 .......... ............ A Drainage of finger abscess ......................... 1.54 5.21 1.56 0.18 6.93 3.29 010 26011 .......... ............ A Drainage of finger abscess ......................... 2.19 8.22 2.23 0.33 10.74 4.75 010
26020 .......... ............ A Drain hand tendon sheath ........................... 4.67 NA 5.17 0.73 NA 10.56 090


## 45894

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

26025 .......... ............ A Drainage of palm bursa ............................... 4.82 NA 4.94 0.76 NA 10.52 090 26030 .......... ............ A Drainage of palm bursa(s) .......................... 5.93 NA 5.53 0.92 NA 12.38 090
26034 .......... ............ A Treat hand bone lesion ............................... 6.23 NA 6.14 1.01 NA 13.38 090 26035 .......... ............ A Decompress fingers/hand ........................... 9.52 NA 7.64 1.47 NA 18.62 090 26037 .......... ............ A Decompress fingers/hand ........................... 7.25 NA 6.11 1.13 NA 14.50 090 26040 .......... ............ A Release palm contracture ........................... 3.34 NA 3.91 0.53 NA 7.77 090 26045 .......... ............ A Release palm contracture ........................... 5.56 NA 5.45 0.93 NA 11.94 090 26055 .......... ............ A Incise finger tendon sheath ......................... 2.70 13.25 3.79 0.43 16.38 6.92 090 26060 .......... ............ A Incision of finger tendon .............................. 2.82 NA 3.39 0.45 NA 6.65 090 26070 .......... ............ A Explore/treat hand joint ............................... 3.69 NA 3.29 0.48 NA 7.45 090 26075 .......... ............ A Explore/treat finger joint .............................. 3.79 NA 3.68 0.53 NA 7.99 090 26080 .......... ............ A Explore/treat finger joint .............................. 4.24 NA 4.69 0.66 NA 9.59 090 26100 .......... ............ A Biopsy hand joint lining ............................... 3.67 NA 3.99 0.54 NA 8.19 090 26105 .......... ............ A Biopsy finger joint lining .............................. 3.71 NA 4.08 0.59 NA 8.38 090 26110 .......... ............ A Biopsy finger joint lining .............................. 3.53 NA 3.91 0.53 NA 7.97 090
26115 .......... ............ A Removal hand lesion subcut ....................... 3.86 12.36 4.61 0.59 16.81 9.06 090 26116 .......... ............ A Removal hand lesion, deep ........................ 5.53 NA 5.81 0.84 NA 12.18 090 26117 .......... ............ A Remove tumor, hand/finger ......................... 8.56 NA 6.86 1.26 NA 16.67 090 26121 .......... ............ A Release palm contracture ........................... 7.55 NA 6.73 1.17 NA 15.44 090 26123 .......... ............ A Release palm contracture ........................... 9.30 NA 8.57 1.43 NA 19.30 090 26125 .......... ............ A Release palm contracture ........................... 4.61 NA 2.37 0.70 NA 7.68 ZZZ 26130 .......... ............ A Remove wrist joint lining ............................. 5.42 NA 5.17 0.94 NA 11.53 090 26135 .......... ............ A Revise finger joint, each .............................. 6.96 NA 6.25 1.07 NA 14.28 090 26140 .......... ............ A Revise finger joint, each .............................. 6.17 NA 5.85 0.92 NA 12.94 090 26145 .......... ............ A Tendon excision, palm/finger ...................... 6.32 NA 5.85 0.97 NA 13.15 090
26160 .......... ............ A Remove tendon sheath lesion .................... 3.16 11.58 3.98 0.49 15.23 7.63 090 26170 .......... ............ A Removal of palm tendon, each ................... 4.77 NA 4.78 0.69 NA 10.24 090 26180 .......... ............ A Removal of finger tendon ............................ 5.18 NA 5.23 0.78 NA 11.19 090 26185 .......... ............ A Remove finger bone .................................... 5.25 NA 5.85 0.81 NA 11.91 090
26200 .......... ............ A Remove hand bone lesion .......................... 5.51 NA 5.19 0.88 NA 11.58 090 26205 .......... ............ A Remove/graft bone lesion ........................... 7.71 NA 6.67 1.20 NA 15.57 090 26210 .......... ............ A Removal of finger lesion ............................. 5.15 NA 5.24 0.79 NA 11.18 090 26215 .......... ............ A Remove/graft finger lesion .......................... 7.10 NA 6.17 0.98 NA 14.25 090 26230 .......... ............ A Partial removal of hand bone ...................... 6.33 NA 5.71 1.01 NA 13.05 090 26235 .......... ............ A Partial removal, finger bone ........................ 6.19 NA 5.62 0.95 NA 12.76 090 26236 .......... ............ A Partial removal, finger bone ........................ 5.32 NA 5.14 0.81 NA 11.27 090 26250 .......... ............ A Extensive hand surgery ............................... 7.56 NA 6.23 1.07 NA 14.85 090 26255 .......... ............ A Extensive hand surgery ............................... 12.43 NA 9.06 1.68 NA 23.18 090 26260 .......... ............ A Extensive finger surgery .............................. 7.03 NA 5.99 1.01 NA 14.03 090 26261 .......... ............ A Extensive finger surgery .............................. 9.10 NA 5.99 1.14 NA 16.23 090 26262 .......... ............ A Partial removal of finger .............................. 5.67 NA 5.16 0.88 NA 11.71 090 26320 .......... ............ A Removal of implant from hand .................... 3.98 NA 4.17 0.59 NA 8.74 090 26340 .......... ............ A Manipulate finger w/anesth ......................... 2.51 NA 4.73 0.39 NA 7.62 090 26350 .......... ............ A Repair finger/hand tendon ........................... 5.99 NA 13.59 0.93 NA 20.51 090 26352 .......... ............ A Repair/graft hand tendon ............................ 7.69 NA 14.33 1.13 NA 23.15 090 26356 .......... ............ A Repair finger/hand tendon ........................... 8.08 NA 17.23 1.21 NA 26.52 090 26357 .......... ............ A Repair finger/hand tendon ........................... 8.59 NA 14.61 1.33 NA 24.52 090 26358 .......... ............ A Repair/graft hand tendon ............................ 9.15 NA 15.56 1.38 NA 26.09 090 26370 .......... ............ A Repair finger/hand tendon ........................... 7.11 NA 14.05 1.12 NA 22.28 090 26372 .......... ............ A Repair/graft hand tendon ............................ 8.77 NA 15.41 1.40 NA 25.58 090 26373 .......... ............ A Repair finger/hand tendon ........................... 8.17 NA 14.94 1.23 NA 24.33 090 26390 .......... ............ A Revise hand/finger tendon .......................... 9.20 NA 12.48 1.40 NA 23.08 090 26392 .......... ............ A Repair/graft hand tendon ............................ 10.26 NA 15.62 1.57 NA 27.45 090 26410 .......... ............ A Repair hand tendon ..................................... 4.63 NA 11.08 0.73 NA 16.44 090 26412 .......... ............ A Repair/graft hand tendon ............................ 6.31 NA 12.37 0.97 NA 19.65 090 26415 .......... ............ A Excision, hand/finger tendon ....................... 8.35 NA 11.10 0.98 NA 20.43 090 26416 .......... ............ A Graft hand or finger tendon ......................... 9.38 NA 13.70 0.79 NA 23.87 090 26418 .......... ............ A Repair finger tendon .................................... 4.25 NA 11.46 0.67 NA 16.37 090 26420 .......... ............ A Repair/graft finger tendon ........................... 6.77 NA 12.71 1.07 NA 20.55 090 26426 .......... ............ A Repair finger/hand tendon ........................... 6.15 NA 12.28 0.95 NA 19.38 090 26428 .......... ............ A Repair/graft finger tendon ........................... 7.21 NA 12.96 1.09 NA 21.26 090 26432 .......... ............ A Repair finger tendon .................................... 4.02 NA 9.55 0.64 NA 14.21 090 26433 .......... ............ A Repair finger tendon .................................... 4.56 NA 10.05 0.72 NA 15.32 090 26434 .......... ............ A Repair/graft finger tendon ........................... 6.09 NA 10.81 0.93 NA 17.84 090 26437 .......... ............ A Realignment of tendons .............................. 5.82 NA 10.83 0.89 NA 17.54 090 26440 .......... ............ A Release palm/finger tendon ........................ 5.02 NA 12.48 0.75 NA 18.25 090 26442 .......... ............ A Release palm & finger tendon .................... 8.17 NA 14.98 1.20 NA 24.35 090 26445 .......... ............ A Release hand/finger tendon ........................ 4.31 NA 12.19 0.65 NA 17.15 090 26449 .......... ............ A Release forearm/hand tendon ..................... 7.00 NA 14.77 1.06 NA 22.83 090 26450 .......... ............ A Incision of palm tendon ............................... 3.67 NA 6.88 0.59 NA 11.14 090 26455 .......... ............ A Incision of finger tendon .............................. 3.64 NA 6.84 0.58 NA 11.05 090 26460 .......... ............ A Incise hand/finger tendon ............................ 3.46 NA 6.72 0.55 NA 10.72 090 26471 .......... ............ A Fusion of finger tendons ............................. 5.73 NA 10.54 0.88 NA 17.15 090 26474 .......... ............ A Fusion of finger tendons ............................. 5.32 NA 10.64 0.76 NA 16.72 090


## 45895

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

26476 .......... ............ A Tendon lengthening ..................................... 5.18 NA 10.25 0.79 NA 16.22 090 26477 .......... ............ A Tendon shortening ...................................... 5.15 NA 10.36 0.81 NA 16.32 090 26478 .......... ............ A Lengthening of hand tendon ....................... 5.80 NA 11.05 0.90 NA 17.75 090 26479 .......... ............ A Shortening of hand tendon .......................... 5.74 NA 10.82 0.92 NA 17.48 090 26480 .......... ............ A Transplant hand tendon .............................. 6.69 NA 14.01 1.02 NA 21.73 090 26483 .......... ............ A Transplant/graft hand tendon ...................... 8.30 NA 14.50 1.26 NA 24.06 090 26485 .......... ............ A Transplant palm tendon .............................. 7.71 NA 14.35 1.15 NA 23.20 090 26489 .......... ............ A Transplant/graft palm tendon ...................... 9.56 NA 11.43 1.26 NA 22.25 090
26490 .......... ............ A Revise thumb tendon .................................. 8.42 NA 12.07 1.21 NA 21.70 090 26492 .......... ............ A Tendon transfer with graft ........................... 9.63 NA 12.83 1.40 NA 23.86 090 26494 .......... ............ A Hand tendon/muscle transfer ...................... 8.48 NA 12.21 1.28 NA 21.97 090
26496 .......... ............ A Revise thumb tendon .................................. 9.60 NA 12.51 1.45 NA 23.56 090 26497 .......... ............ A Finger tendon transfer ................................. 9.58 NA 12.79 1.41 NA 23.78 090 26498 .......... ............ A Finger tendon transfer ................................. 14.01 NA 15.30 2.10 NA 31.41 090 26499 .......... ............ A Revision of finger ........................................ 8.99 NA 12.25 1.35 NA 22.59 090
26500 .......... ............ A Hand tendon reconstruction ........................ 5.96 NA 10.72 0.90 NA 17.58 090 26502 .......... ............ A Hand tendon reconstruction ........................ 7.14 NA 11.30 1.13 NA 19.57 090 26504 .......... ............ A Hand tendon reconstruction ........................ 7.47 NA 11.78 1.24 NA 20.50 090 26508 .......... ............ A Release thumb contracture ......................... 6.01 NA 10.92 0.98 NA 17.92 090 26510 .......... ............ A Thumb tendon transfer ................................ 5.43 NA 10.60 0.79 NA 16.82 090 26516 .......... ............ A Fusion of knuckle joint ................................ 7.15 NA 11.48 1.10 NA 19.73 090 26517 .......... ............ A Fusion of knuckle joints ............................... 8.84 NA 12.69 1.41 NA 22.94 090 26518 .......... ............ A Fusion of knuckle joints ............................... 9.03 NA 12.59 1.35 NA 22.97 090
26520 .......... ............ A Release knuckle contracture ....................... 5.30 NA 12.91 0.80 NA 19.01 090 26525 .......... ............ A Release finger contracture .......................... 5.33 NA 12.98 0.81 NA 19.12 090 26530 .......... ............ A Revise knuckle joint .................................... 6.69 NA 5.96 1.04 NA 13.70 090 26531 .......... ............ A Revise knuckle with implant ........................ 7.92 NA 6.91 1.17 NA 16.00 090 26535 .......... ............ A Revise finger joint ........................................ 5.24 NA 3.74 0.71 NA 9.69 090 26536 .......... ............ A Revise/implant finger joint ........................... 6.37 NA 9.37 0.96 NA 16.70 090 26540 .......... ............ A Repair hand joint ......................................... 6.43 NA 11.12 0.99 NA 18.55 090 26541 .......... ............ A Repair hand joint with graft ......................... 8.63 NA 12.57 1.28 NA 22.48 090 26542 .......... ............ A Repair hand joint with graft ......................... 6.78 NA 11.28 1.02 NA 19.08 090 26545 .......... ............ A Reconstruct finger joint ............................... 6.92 NA 11.40 1.05 NA 19.37 090 26546 .......... ............ A Repair nonunion hand ................................. 8.93 NA 14.18 1.44 NA 24.54 090 26548 .......... ............ A Reconstruct finger joint ............................... 8.04 NA 12.05 1.20 NA 21.29 090 26550 .......... ............ A Construct thumb replacement ..................... 21.25 NA 16.68 2.45 NA 40.38 090 26551 .......... ............ A Great toe-hand transfer ............................... 46.60 NA 30.93 7.96 NA 85.49 090 26553 .......... ............ A Single transfer, toe-hand ............................. 46.29 NA 24.09 2.41 NA 72.79 090 26554 .......... ............ A Double transfer, toe-hand ........................... 54.98 NA 35.75 9.41 NA 100.14 090 26555 .......... ............ A Positional change of finger .......................... 16.64 NA 17.43 2.48 NA 36.56 090 26556 .......... ............ A Toe joint transfer ......................................... 47.28 NA 33.97 2.57 NA 83.82 090 26560 .......... ............ A Repair of web finger .................................... 5.38 NA 9.22 0.85 NA 15.45 090 26561 .......... ............ A Repair of web finger .................................... 10.92 NA 11.75 1.45 NA 24.12 090 26562 .......... ............ A Repair of web finger .................................... 15.01 NA 16.25 2.23 NA 33.49 090 26565 .......... ............ A Correct metacarpal flaw .............................. 6.74 NA 11.26 1.00 NA 19.01 090 26567 .......... ............ A Correct finger deformity ............................... 6.82 NA 11.21 1.04 NA 19.08 090 26568 .......... ............ A Lengthen metacarpal/finger ......................... 9.09 NA 14.50 1.49 NA 25.08 090 26580 .......... ............ A Repair hand deformity ................................. 18.19 NA 13.16 2.28 NA 33.63 090 26587 .......... ............ A Reconstruct extra finger .............................. 14.06 NA 8.99 1.53 NA 24.58 090 26590 .......... ............ A Repair finger deformity ................................ 17.97 NA 13.46 2.77 NA 34.20 090 26591 .......... ............ A Repair muscles of hand .............................. 3.26 NA 8.94 0.48 NA 12.68 090 26593 .......... ............ A Release muscles of hand ............................ 5.31 NA 10.45 0.78 NA 16.54 090 26596 .......... ............ A Excision constricting tissue ......................... 8.96 NA 8.42 1.43 NA 18.81 090 26600 .......... ............ A Treat metacarpal fracture ............................ 1.96 3.79 2.57 0.30 6.05 4.83 090 26605 .......... ............ A Treat metacarpal fracture ............................ 2.86 4.70 3.55 0.49 8.05 6.90 090 26607 .......... ............ A Treat metacarpal fracture ............................ 5.36 NA 5.98 0.87 NA 12.21 090 26608 .......... ............ A Treat metacarpal fracture ............................ 5.36 NA 6.00 0.88 NA 12.25 090 26615 .......... ............ A Treat metacarpal fracture ............................ 5.33 NA 5.12 0.86 NA 11.31 090
26641 .......... ............ A Treat thumb dislocation ............................... 3.94 4.72 3.42 0.39 9.05 7.75 090 26645 .......... ............ A Treat thumb fracture .................................... 4.41 5.31 4.08 0.67 10.39 9.16 090 26650 .......... ............ A Treat thumb fracture .................................... 5.72 NA 6.43 0.94 NA 13.09 090 26665 .......... ............ A Treat thumb fracture .................................... 7.61 NA 6.39 0.90 NA 14.90 090
26670 .......... ............ A Treat hand dislocation ................................. 3.69 4.41 2.85 0.39 8.49 6.92 090
26675 .......... ............ A Treat hand dislocation ................................. 4.64 5.57 4.34 0.77 10.98 9.75 090
26676 .......... ............ A Pin hand dislocation .................................... 5.52 NA 6.43 0.91 NA 12.86 090
26685 .......... ............ A Treat hand dislocation ................................. 6.98 NA 5.94 1.09 NA 14.02 090
26686 .......... ............ A Treat hand dislocation ................................. 7.95 NA 6.67 1.24 NA 15.86 090
26700 .......... ............ A Treat knuckle dislocation ............................. 3.69 3.68 2.76 0.35 7.71 6.80 090
26705 .......... ............ A Treat knuckle dislocation ............................. 4.19 5.43 4.18 0.66 10.28 9.03 090
26706 .......... ............ A Pin knuckle dislocation ................................ 5.12 NA 4.95 0.81 NA 10.88 090
26715 .......... ............ A Treat knuckle dislocation ............................. 5.74 NA 5.33 0.91 NA 11.98 090 26720 .......... ............ A Treat finger fracture, each ........................... 1.66 2.70 1.98 0.24 4.60 3.89 090 26725 .......... ............ A Treat finger fracture, each ........................... 3.34 4.60 3.40 0.53 8.47 7.26 090 26727 .......... ............ A Treat finger fracture, each ........................... 5.23 NA 5.98 0.84 NA 12.05 090


## 45896

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

26735 .......... ............ A Treat finger fracture, each ........................... 5.98 NA 5.37 0.95 NA 12.30 090 26740 .......... ............ A Treat finger fracture, each ........................... 1.94 3.04 2.63 0.31 5.30 4.88 090 26742 .......... ............ A Treat finger fracture, each ........................... 3.85 5.11 3.78 0.58 9.54 8.21 090 26746 .......... ............ A Treat finger fracture, each ........................... 5.81 NA 5.37 0.91 NA 12.09 090 26750 .......... ............ A Treat finger fracture, each ........................... 1.70 2.41 1.94 0.22 4.33 3.86 090 26755 .......... ............ A Treat finger fracture, each ........................... 3.11 4.27 2.91 0.42 7.80 6.44 090 26756 .......... ............ A Pin finger fracture, each .............................. 4.39 NA 5.49 0.71 NA 10.59 090 26765 .......... ............ A Treat finger fracture, each ........................... 4.17 NA 4.24 0.66 NA 9.07 090 26770 .......... ............ A Treat finger dislocation ................................ 3.03 3.34 2.32 0.27 6.64 5.62 090 26775 .......... ............ A Treat finger dislocation ................................ 3.71 5.29 3.69 0.54 9.54 7.94 090 26776 .......... ............ A Pin finger dislocation ................................... 4.80 NA 5.76 0.77 NA 11.33 090 26785 .......... ............ A Treat finger dislocation ................................ 4.21 NA 4.37 0.68 NA 9.26 090 26820 .......... ............ A Thumb fusion with graft ............................... 8.27 NA 12.42 1.30 NA 21.99 090 26841 .......... ............ A Fusion of thumb .......................................... 7.13 NA 12.37 1.18 NA 20.69 090 26842 .......... ............ A Thumb fusion with graft ............................... 8.25 NA 12.54 1.32 NA 22.11 090 26843 .......... ............ A Fusion of hand joint ..................................... 7.62 NA 11.60 1.15 NA 20.37 090 26844 .......... ............ A Fusion/graft of hand joint ............................ 8.74 NA 12.56 1.33 NA 22.63 090 26850 .......... ............ A Fusion of knuckle ........................................ 6.97 NA 11.44 1.06 NA 19.48 090 26852 .......... ............ A Fusion of knuckle with graft ........................ 8.47 NA 12.16 1.22 NA 21.85 090 26860 .......... ............ A Fusion of finger joint .................................... 4.69 NA 10.46 0.73 NA 15.88 090 26861 .......... ............ A Fusion of finger jnt, add-on ......................... 1.74 NA 0.90 0.27 NA 2.92 ZZZ 26862 .......... ............ A Fusion/graft of finger joint ........................... 7.37 NA 11.62 1.10 NA 20.09 090 26863 .......... ............ A Fuse/graft added joint ................................. 3.90 NA 2.05 0.56 NA 6.50 ZZZ 26910 .......... ............ A Amputate metacarpal bone ......................... 7.61 NA 10.59 1.16 NA 19.36 090 26951 .......... ............ A Amputation of finger/thumb ......................... 4.59 NA 9.50 0.71 NA 14.80 090 26952 .......... ............ A Amputation of finger/thumb ......................... 6.31 NA 10.91 0.95 NA 18.17 090 26989 .......... ............ C Hand/finger surgery ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 26990 .......... ............ A Drainage of pelvis lesion ............................. 7.48 NA 6.97 1.22 NA 15.67 090 26991 .......... ............ A Drainage of pelvis bursa ............................. 6.68 10.53 5.30 1.11 18.32 13.09 090 26992 .......... ............ A Drainage of bone lesion .............................. 13.03 NA 9.96 2.16 NA 25.15 090 27000 .......... ............ A Incision of hip tendon .................................. 5.62 NA 5.11 0.98 NA 11.71 090 27001 .......... ............ A Incision of hip tendon .................................. 6.94 NA 5.89 1.24 NA 14.08 090 27003 .......... ............ A Incision of hip tendon .................................. 7.34 NA 6.33 1.12 NA 14.79 090 27005 .......... ............ A Incision of hip tendon .................................. 9.67 NA 7.57 1.72 NA 18.95 090 27006 .......... ............ A Incision of hip tendons ................................ 9.69 NA 7.73 1.69 NA 19.11 090 27025 .......... ............ A Incision of hip/thigh fascia ........................... 11.16 NA 8.32 1.84 NA 21.33 090 27030 .......... ............ A Drainage of hip joint .................................... 13.02 NA 9.33 2.26 NA 24.61 090 27033 .......... ............ A Exploration of hip joint ................................. 13.40 NA 9.61 2.32 NA 25.33 090 27035 .......... ............ A Denervation of hip joint ............................... 16.69 NA 10.89 2.15 NA 29.73 090 27036 .......... ............ A Excision of hip joint/muscle ......................... 12.89 NA 9.70 2.26 NA 24.85 090 27040 .......... ............ A Biopsy of soft tissues .................................. 2.88 5.38 2.05 0.27 8.53 5.20 010 27041 .......... ............ A Biopsy of soft tissues .................................. 9.90 NA 6.60 1.35 NA 17.85 090 27047 .......... ............ A Remove hip/pelvis lesion ............................ 7.45 7.18 4.71 1.03 15.67 13.19 090 27048 .......... ............ A Remove hip/pelvis lesion ............................ 6.25 NA 4.72 0.92 NA 11.89 090 27049 .......... ............ A Remove tumor, hip/pelvis ............................ 13.67 NA 8.24 2.06 NA 23.97 090 27050 .......... ............ A Biopsy of sacroiliac joint .............................. 4.36 NA 4.30 0.60 NA 9.26 090 27052 .......... ............ A Biopsy of hip joint ........................................ 6.23 NA 5.71 1.08 NA 13.02 090 27054 .......... ............ A Removal of hip joint lining ........................... 8.55 NA 7.11 1.47 NA 17.13 090 27060 .......... ............ A Removal of ischial bursa ............................. 5.43 NA 4.27 0.80 NA 10.50 090 27062 .......... ............ A Remove femur lesion/bursa ........................ 5.37 NA 5.02 0.93 NA 11.32 090 27065 .......... ............ A Removal of hip bone lesion ........................ 5.90 NA 5.29 1.01 NA 12.20 090 27066 .......... ............ A Removal of hip bone lesion ........................ 10.33 NA 8.19 1.79 NA 20.31 090 27067 .......... ............ A Remove/graft hip bone lesion ..................... 13.84 NA 10.34 1.84 NA 26.02 090 27070 .......... ............ A Partial removal of hip bone ......................... 10.72 NA 8.80 1.74 NA 21.26 090 27071 .......... ............ A Partial removal of hip bone ......................... 11.46 NA 9.74 1.92 NA 23.12 090 27075 .......... ............ A Extensive hip surgery .................................. 35.02 NA 18.71 5.64 NA 59.37 090 27076 .......... ............ A Extensive hip surgery .................................. 22.13 NA 14.10 3.70 NA 39.94 090 27077 .......... ............ A Extensive hip surgery .................................. 40.02 NA 22.00 6.12 NA 68.14 090 27078 .......... ............ A Extensive hip surgery .................................. 13.45 NA 9.64 2.22 NA 25.31 090 27079 .......... ............ A Extensive hip surgery .................................. 13.76 NA 9.29 1.94 NA 24.99 090 27080 .......... ............ A Removal of tail bone ................................... 6.39 NA 4.72 0.93 NA 12.05 090 27086 .......... ............ A Remove hip foreign body ............................ 1.87 4.44 1.80 0.25 6.56 3.92 010 27087 .......... ............ A Remove hip foreign body ............................ 8.55 NA 6.51 1.35 NA 16.41 090 27090 .......... ............ A Removal of hip prosthesis ........................... 11.15 NA 8.50 1.94 NA 21.59 090 27091 .......... ............ A Removal of hip prosthesis ........................... 22.15 NA 13.56 3.84 NA 39.56 090 27093 .......... ............ A Injection for hip x-ray ................................... 1.30 4.24 0.49 0.13 5.67 1.92 000 27095 .......... ............ A Injection for hip x-ray ................................... 1.50 5.37 0.52 0.14 7.01 2.17 000 27096 .......... ............ A Inject sacroiliac joint .................................... 1.40 4.02 0.32 0.08 5.50 1.81 000 27097 .......... ............ A Revision of hip tendon ................................ 8.81 NA 6.21 1.57 NA 16.58 090 27098 .......... ............ A Transfer tendon to pelvis ............................ 8.84 NA 6.82 0.95 NA 16.61 090 27100 .......... ............ A Transfer of abdominal muscle ..................... 11.08 NA 8.39 1.85 NA 21.33 090 27105 .......... ............ A Transfer of spinal muscle ............................ 11.77 NA 8.87 1.72 NA 22.37 090 27110 .......... ............ A Transfer of iliopsoas muscle ....................... 13.27 NA 8.88 2.18 NA 24.32 090 27111 .......... ............ A Transfer of iliopsoas muscle ....................... 12.15 NA 8.85 1.94 NA 22.95 090


## 45897

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

27120 .......... ............ A Reconstruction of hip socket ....................... 18.02 NA 11.51 3.08 NA 32.60 090 27122 .......... ............ A Reconstruction of hip socket ....................... 14.99 NA 10.69 2.61 NA 28.29 090 27125 .......... ............ A Partial hip replacement ............................... 14.70 NA 10.30 2.54 NA 27.54 090 27130 .......... ............ A Total hip arthroplasty ................................... 20.13 NA 12.88 3.50 NA 36.51 090 27132 .......... ............ A Total hip arthroplasty ................................... 23.32 NA 15.15 4.04 NA 42.51 090 27134 .......... ............ A Revise hip joint replacement ....................... 28.54 NA 17.24 4.94 NA 50.72 090 27137 .......... ............ A Revise hip joint replacement ....................... 21.18 NA 13.50 3.67 NA 38.35 090 27138 .......... ............ A Revise hip joint replacement ....................... 22.18 NA 13.95 3.84 NA 39.97 090 27140 .......... ............ A Transplant femur ridge ................................ 12.24 NA 9.11 2.11 NA 23.47 090 27146 .......... ............ A Incision of hip bone ..................................... 17.43 NA 11.77 2.96 NA 32.17 090 27147 .......... ............ A Revision of hip bone ................................... 20.59 NA 12.90 3.57 NA 37.06 090 27151 .......... ............ A Incision of hip bones ................................... 22.52 NA 7.72 3.91 NA 34.16 090 27156 .......... ............ A Revision of hip bones .................................. 24.64 NA 15.58 4.21 NA 44.43 090 27158 .......... ............ A Revision of pelvis ........................................ 19.75 NA 10.86 3.16 NA 33.77 090 27161 .......... ............ A Incision of neck of femur ............................. 16.71 NA 11.73 2.94 NA 31.38 090 27165 .......... ............ A Incision/fixation of femur ............................. 17.92 NA 12.51 3.10 NA 33.53 090 27170 .......... ............ A Repair/graft femur head/neck ...................... 16.08 NA 10.95 2.81 NA 29.85 090 27175 .......... ............ A Treat slipped epiphysis ............................... 8.47 NA 6.48 1.46 NA 16.41 090 27176 .......... ............ A Treat slipped epiphysis ............................... 12.05 NA 8.73 2.22 NA 23.01 090 27177 .......... ............ A Treat slipped epiphysis ............................... 15.09 NA 10.56 2.61 NA 28.26 090 27178 .......... ............ A Treat slipped epiphysis ............................... 11.99 NA 8.16 2.08 NA 22.24 090 27179 .......... ............ A Revise head/neck of femur ......................... 12.99 NA 9.67 2.25 NA 24.91 090 27181 .......... ............ A Treat slipped epiphysis ............................... 14.69 NA 9.92 1.57 NA 26.18 090 27185 .......... ............ A Revision of femur epiphysis ........................ 9.19 NA 7.28 2.39 NA 18.86 090 27187 .......... ............ A Reinforce hip bones .................................... 13.55 NA 9.99 2.37 NA 25.90 090 27193 .......... ............ A Treat pelvic ring fracture ............................. 5.56 4.94 4.94 0.96 11.47 11.47 090 27194 .......... ............ A Treat pelvic ring fracture ............................. 9.66 NA 7.43 1.65 NA 18.74 090 27200 .......... ............ A Treat tail bone fracture ................................ 1.84 2.16 2.09 0.28 4.29 4.21 090 27202 .......... ............ A Treat tail bone fracture ................................ 7.04 NA 15.72 1.06 NA 23.83 090 27215 .......... ............ A Treat pelvic fracture(s) ................................ 10.05 NA 6.86 1.97 NA 18.88 090 27216 .......... ............ A Treat pelvic ring fracture ............................. 15.20 NA 9.29 2.63 NA 27.12 090 27217 .......... ............ A Treat pelvic ring fracture ............................. 14.12 NA 9.83 2.41 NA 26.36 090 27218 .......... ............ A Treat pelvic ring fracture ............................. 20.16 NA 11.08 3.48 NA 34.72 090 27220 .......... ............ A Treat hip socket fracture ............................. 6.18 5.56 5.47 1.07 12.81 12.72 090 27222 .......... ............ A Treat hip socket fracture ............................. 12.71 NA 9.65 2.19 NA 24.54 090 27226 .......... ............ A Treat hip wall fracture ................................. 14.92 NA 7.58 2.48 NA 24.97 090 27227 .......... ............ A Treat hip fracture(s) ..................................... 23.46 NA 14.93 4.05 NA 42.44 090 27228 .......... ............ A Treat hip fracture(s) ..................................... 27.17 NA 17.08 4.66 NA 48.92 090 27230 .......... ............ A Treat thigh fracture ...................................... 5.50 5.35 4.95 0.95 11.80 11.41 090 27232 .......... ............ A Treat thigh fracture ...................................... 10.68 NA 6.97 1.85 NA 19.50 090 27235 .......... ............ A Treat thigh fracture ...................................... 12.16 NA 9.14 2.11 NA 23.42 090 27236 .......... ............ A Treat thigh fracture ...................................... 15.61 NA 10.71 2.71 NA 29.03 090 27238 .......... ............ A Treat thigh fracture ...................................... 5.52 NA 4.99 0.89 NA 11.40 090 27240 .......... ............ A Treat thigh fracture ...................................... 12.50 NA 9.20 2.16 NA 23.87 090 27244 .......... ............ A Treat thigh fracture ...................................... 15.95 NA 10.94 2.77 NA 29.67 090 27245 .......... ............ A Treat thigh fracture ...................................... 20.32 NA 13.31 3.52 NA 37.15 090 27246 .......... ............ A Treat thigh fracture ...................................... 4.71 4.33 4.30 0.81 9.85 9.82 090 27248 .......... ............ A Treat thigh fracture ...................................... 10.45 NA 7.95 1.81 NA 20.21 090 27250 .......... ............ A Treat hip dislocation .................................... 6.95 NA 4.46 0.62 NA 12.03 090 27252 .......... ............ A Treat hip dislocation .................................... 10.39 NA 7.21 1.66 NA 19.26 090 27253 .......... ............ A Treat hip dislocation .................................... 12.93 NA 9.47 2.24 NA 24.63 090 27254 .......... ............ A Treat hip dislocation .................................... 18.27 NA 11.66 3.17 NA 33.10 090 27256 .......... ............ A Treat hip dislocation .................................... 4.12 3.43 2.02 0.46 8.01 6.60 010 27257 .......... ............ A Treat hip dislocation .................................... 5.22 NA 2.73 0.69 NA 8.64 010 27258 .......... ............ A Treat hip dislocation .................................... 15.44 NA 10.55 2.64 NA 28.63 090 27259 .......... ............ A Treat hip dislocation .................................... 21.56 NA 13.80 3.74 NA 39.11 090 27265 .......... ............ A Treat hip dislocation .................................... 5.05 NA 4.64 0.63 NA 10.32 090 27266 .......... ............ A Treat hip dislocation .................................... 7.49 NA 6.15 1.29 NA 14.94 090 27275 .......... ............ A Manipulation of hip joint .............................. 2.27 NA 2.04 0.39 NA 4.71 010 27280 .......... ............ A Fusion of sacroiliac joint .............................. 13.40 NA 9.96 2.53 NA 25.89 090 27282 .......... ............ A Fusion of pubic bones ................................. 11.34 NA 8.03 1.86 NA 21.24 090 27284 .......... ............ A Fusion of hip joint ........................................ 23.46 NA 14.32 3.92 NA 41.69 090 27286 .......... ............ A Fusion of hip joint ........................................ 23.46 NA 15.30 3.12 NA 41.88 090 27290 .......... ............ A Amputation of leg at hip .............................. 23.30 NA 13.67 3.43 NA 40.40 090 27295 .......... ............ A Amputation of leg at hip .............................. 18.66 NA 10.98 2.95 NA 32.59 090 27299 .......... ............ C Pelvis/hip joint surgery ................................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 27301 .......... ............ A Drain thigh/knee lesion ................................ 6.49 9.54 5.00 1.04 17.08 12.54 090 27303 .......... ............ A Drainage of bone lesion .............................. 8.29 NA 6.75 1.43 NA 16.47 090 27305 .......... ............ A Incise thigh tendon & fascia ........................ 5.92 NA 5.02 1.01 NA 11.95 090 27306 .......... ............ A Incision of thigh tendon ............................... 4.62 NA 4.56 0.85 NA 10.03 090 27307 .......... ............ A Incision of thigh tendons ............................. 5.80 NA 5.21 1.04 NA 12.05 090 27310 .......... ............ A Exploration of knee joint .............................. 9.28 NA 7.35 1.61 NA 18.24 090 27315 .......... ............ A Partial removal, thigh nerve ........................ 6.97 NA 4.85 1.09 NA 12.91 090 27320 .......... ............ A Partial removal, thigh nerve ........................ 6.30 NA 5.10 1.06 NA 12.46 090


## 45898

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

27323 .......... ............ A Biopsy, thigh soft tissues ............................ 2.28 3.74 1.85 0.24 6.26 4.37 010 27324 .......... ............ A Biopsy, thigh soft tissues ............................ 4.90 NA 4.09 0.75 NA 9.74 090 27327 .......... ............ A Removal of thigh lesion ............................... 4.47 5.95 3.65 0.64 11.06 8.76 090 27328 .......... ............ A Removal of thigh lesion ............................... 5.57 NA 4.27 0.84 NA 10.68 090 27329 .......... ............ A Remove tumor, thigh/knee .......................... 14.15 NA 8.81 2.14 NA 25.09 090 27330 .......... ............ A Biopsy, knee joint lining .............................. 4.97 NA 4.42 0.86 NA 10.25 090 27331 .......... ............ A Explore/treat knee joint ............................... 5.88 NA 5.34 1.02 NA 12.24 090 27332 .......... ............ A Removal of knee cartilage .......................... 8.28 NA 6.89 1.43 NA 16.60 090 27333 .......... ............ A Removal of knee cartilage .......................... 7.30 NA 6.46 1.26 NA 15.02 090 27334 .......... ............ A Remove knee joint lining ............................. 8.71 NA 7.18 1.51 NA 17.39 090 27335 .......... ............ A Remove knee joint lining ............................. 10.01 NA 7.96 1.74 NA 19.71 090 27340 .......... ............ A Removal of kneecap bursa ......................... 4.18 NA 4.41 0.72 NA 9.31 090 27345 .......... ............ A Removal of knee cyst .................................. 5.92 NA 5.44 1.00 NA 12.37 090 27347 .......... ............ A Remove knee cyst ....................................... 5.78 NA 5.27 0.98 NA 12.03 090 27350 .......... ............ A Removal of kneecap ................................... 8.18 NA 7.01 1.41 NA 16.60 090 27355 .......... ............ A Remove femur lesion .................................. 7.66 NA 6.55 1.32 NA 15.53 090 27356 .......... ............ A Remove femur lesion/graft .......................... 9.49 NA 7.61 1.65 NA 18.75 090 27357 .......... ............ A Remove femur lesion/graft .......................... 10.53 NA 8.42 1.95 NA 20.90 090 27358 .......... ............ A Remove femur lesion/fixation ...................... 4.74 NA 2.44 0.82 NA 8.00 ZZZ 27360 .......... ............ A Partial removal, leg bone(s) ........................ 10.50 NA 9.16 1.83 NA 21.49 090 27365 .......... ............ A Extensive leg surgery .................................. 16.28 NA 11.33 2.79 NA 30.40 090 27370 .......... ............ A Injection for knee x-ray ................................ 0.96 3.56 0.33 0.08 4.60 1.38 000 27372 .......... ............ A Removal of foreign body ............................. 5.07 9.52 4.54 0.84 15.43 10.45 090 27380 .......... ............ A Repair of kneecap tendon ........................... 7.16 NA 6.99 1.24 NA 15.40 090 27381 .......... ............ A Repair/graft kneecap tendon ....................... 10.34 NA 8.75 1.79 NA 20.88 090 27385 .......... ............ A Repair of thigh muscle ................................ 7.77 NA 7.33 1.36 NA 16.45 090 27386 .......... ............ A Repair/graft of thigh muscle ........................ 10.56 NA 9.15 1.85 NA 21.56 090 27390 .......... ............ A Incision of thigh tendon ............................... 5.33 NA 4.95 0.92 NA 11.20 090 27391 .......... ............ A Incision of thigh tendons ............................. 7.20 NA 6.35 1.23 NA 14.78 090 27392 .......... ............ A Incision of thigh tendons ............................. 9.21 NA 7.35 1.57 NA 18.13 090 27393 .......... ............ A Lengthening of thigh tendon ....................... 6.39 NA 5.64 1.10 NA 13.13 090 27394 .......... ............ A Lengthening of thigh tendons ...................... 8.51 NA 6.98 1.47 NA 16.96 090 27395 .......... ............ A Lengthening of thigh tendons ...................... 11.73 NA 9.02 2.04 NA 22.79 090 27396 .......... ............ A Transplant of thigh tendon .......................... 7.87 NA 6.77 1.34 NA 15.97 090 27397 .......... ............ A Transplants of thigh tendons ....................... 11.28 NA 8.76 1.82 NA 21.87 090 27400 .......... ............ A Revise thigh muscles/tendons .................... 9.03 NA 7.04 1.31 NA 17.37 090 27403 .......... ............ A Repair of knee cartilage .............................. 8.34 NA 6.95 1.44 NA 16.72 090 27405 .......... ............ A Repair of knee ligament .............................. 8.66 NA 7.25 1.51 NA 17.42 090 27407 .......... ............ A Repair of knee ligament .............................. 10.28 NA 8.05 1.78 NA 20.11 090 27409 .......... ............ A Repair of knee ligaments ............................ 12.91 NA 9.63 2.24 NA 24.78 090 27412 .......... ............ A Autochondrocyte implant knee .................... 23.28 NA 14.69 4.35 NA 42.32 090 27415 .......... ............ A Osteochondral knee allograft ...................... 18.53 NA 12.45 4.35 NA 35.33 090 27418 .......... ............ A Repair degenerated kneecap ...................... 10.85 NA 8.61 1.88 NA 21.34 090 27420 .......... ............ A Revision of unstable kneecap ..................... 9.84 NA 7.85 1.71 NA 19.40 090 27422 .......... ............ A Revision of unstable kneecap ..................... 9.79 NA 7.86 1.70 NA 19.35 090 27424 .......... ............ A Revision/removal of kneecap ...................... 9.82 NA 7.83 1.70 NA 19.35 090 27425 .......... ............ A Lat retinacular release open ....................... 5.22 NA 5.33 0.90 NA 11.45 090 27427 .......... ............ A Reconstruction, knee ................................... 9.37 NA 7.56 1.63 NA 18.55 090 27428 .......... ............ A Reconstruction, knee ................................... 14.01 NA 10.90 2.42 NA 27.33 090 27429 .......... ............ A Reconstruction, knee ................................... 15.53 NA 12.03 2.70 NA 30.27 090 27430 .......... ............ A Revision of thigh muscles ........................... 9.68 NA 7.75 1.69 NA 19.12 090 27435 .......... ............ A Incision of knee joint ................................... 9.50 NA 8.21 1.69 NA 19.40 090 27437 .......... ............ A Revise kneecap ........................................... 8.47 NA 7.01 1.49 NA 16.96 090 27438 .......... ............ A Revise kneecap with implant ...................... 11.23 NA 8.28 1.95 NA 21.46 090 27440 .......... ............ A Revision of knee joint .................................. 10.43 NA 5.82 1.81 NA 18.06 090 27441 .......... ............ A Revision of knee joint .................................. 10.82 NA 6.50 1.88 NA 19.20 090 27442 .......... ............ A Revision of knee joint .................................. 11.89 NA 8.64 2.09 NA 22.62 090 27443 .......... ............ A Revision of knee joint .................................. 10.93 NA 8.44 1.90 NA 21.27 090 27445 .......... ............ A Revision of knee joint .................................. 17.69 NA 11.96 3.08 NA 32.73 090 27446 .......... ............ A Revision of knee joint .................................. 15.85 NA 10.91 2.80 NA 29.57 090 27447 .......... ............ A Total knee arthroplasty ................................ 21.49 NA 14.16 3.79 NA 39.44 090 27448 .......... ............ A Incision of thigh ........................................... 11.06 NA 8.33 1.94 NA 21.33 090 27450 .......... ............ A Incision of thigh ........................................... 13.99 NA 10.24 2.42 NA 26.65 090 27454 .......... ............ A Realignment of thigh bone .......................... 17.57 NA 12.12 3.12 NA 32.81 090 27455 .......... ............ A Realignment of knee ................................... 12.83 NA 9.54 2.24 NA 24.61 090 27457 .......... ............ A Realignment of knee ................................... 13.46 NA 9.60 2.34 NA 25.40 090 27465 .......... ............ A Shortening of thigh bone ............................. 13.88 NA 9.89 2.47 NA 26.24 090 27466 .......... ............ A Lengthening of thigh bone .......................... 16.34 NA 11.46 2.77 NA 30.58 090 27468 .......... ............ A Shorten/lengthen thighs .............................. 18.98 NA 12.09 3.30 NA 34.37 090 27470 .......... ............ A Repair of thigh ............................................. 16.08 NA 11.42 2.79 NA 30.29 090 27472 .......... ............ A Repair/graft of thigh ..................................... 17.73 NA 12.28 3.07 NA 33.07 090 27475 .......... ............ A Surgery to stop leg growth .......................... 8.65 NA 6.97 1.36 NA 16.98 090 27477 .......... ............ A Surgery to stop leg growth .......................... 9.86 NA 7.49 1.73 NA 19.08 090 27479 .......... ............ A Surgery to stop leg growth .......................... 12.81 NA 9.48 2.78 NA 25.07 090


## 45899

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

27485 .......... ............ A Surgery to stop leg growth .......................... 8.85 NA 7.16 1.53 NA 17.53 090 27486 .......... ............ A Revise/replace knee joint ............................ 19.28 NA 13.08 3.36 NA 35.71 090 27487 .......... ............ A Revise/replace knee joint ............................ 25.28 NA 16.04 4.39 NA 45.71 090 27488 .......... ............ A Removal of knee prosthesis ........................ 15.75 NA 11.34 2.74 NA 29.83 090 27495 .......... ............ A Reinforce thigh ............................................ 15.56 NA 11.05 2.71 NA 29.32 090 27496 .......... ............ A Decompression of thigh/knee ...................... 6.11 NA 5.42 0.99 NA 12.52 090 27497 .......... ............ A Decompression of thigh/knee ...................... 7.17 NA 5.28 1.15 NA 13.61 090 27498 .......... ............ A Decompression of thigh/knee ...................... 8.00 NA 5.79 1.24 NA 15.03 090 27499 .......... ............ A Decompression of thigh/knee ...................... 9.01 NA 6.64 1.47 NA 17.11 090 27500 .......... ............ A Treatment of thigh fracture .......................... 5.92 6.67 4.85 1.02 13.61 11.79 090 27501 .......... ............ A Treatment of thigh fracture .......................... 5.92 6.35 5.23 1.03 13.30 12.18 090 27502 .......... ............ A Treatment of thigh fracture .......................... 10.58 NA 7.88 1.78 NA 20.24 090 27503 .......... ............ A Treatment of thigh fracture .......................... 10.58 NA 8.05 1.84 NA 20.47 090 27506 .......... ............ A Treatment of thigh fracture .......................... 17.45 NA 12.39 3.03 NA 32.87 090 27507 .......... ............ A Treatment of thigh fracture .......................... 14.00 NA 9.53 2.42 NA 25.95 090 27508 .......... ............ A Treatment of thigh fracture .......................... 5.83 6.55 5.32 0.97 13.35 12.12 090 27509 .......... ............ A Treatment of thigh fracture .......................... 7.72 NA 7.64 1.34 NA 16.69 090 27510 .......... ............ A Treatment of thigh fracture .......................... 9.14 NA 7.12 1.53 NA 17.79 090 27511 .......... ............ A Treatment of thigh fracture .......................... 13.65 NA 10.77 2.37 NA 26.79 090 27513 .......... ............ A Treatment of thigh fracture .......................... 17.93 NA 13.38 3.12 NA 34.43 090 27514 .......... ............ A Treatment of thigh fracture .......................... 17.30 NA 12.88 3.00 NA 33.19 090 27516 .......... ............ A Treat thigh fx growth plate .......................... 5.37 6.45 5.36 0.81 12.63 11.54 090 27517 .......... ............ A Treat thigh fx growth plate .......................... 8.79 NA 7.24 1.22 NA 17.25 090 27519 .......... ............ A Treat thigh fx growth plate .......................... 15.03 NA 11.17 2.55 NA 28.75 090 27520 .......... ............ A Treat kneecap fracture ................................ 2.87 4.69 3.34 0.47 8.03 6.67 090 27524 .......... ............ A Treat kneecap fracture ................................ 10.01 NA 7.97 1.74 NA 19.72 090 27530 .......... ............ A Treat knee fracture ...................................... 3.78 5.44 4.30 0.65 9.87 8.72 090 27532 .......... ............ A Treat knee fracture ...................................... 7.30 7.13 6.27 1.26 15.69 14.83 090 27535 .......... ............ A Treat knee fracture ...................................... 11.50 NA 9.71 2.00 NA 23.21 090 27536 .......... ............ A Treat knee fracture ...................................... 15.66 NA 11.25 2.73 NA 29.64 090 27538 .......... ............ A Treat knee fracture(s) .................................. 4.87 6.23 5.04 0.84 11.94 10.75 090 27540 .......... ............ A Treat knee fracture ...................................... 13.11 NA 9.21 2.27 NA 24.59 090
27550 .......... ............ A Treat knee dislocation ................................. 5.76 6.12 4.78 0.76 12.64 11.30 090 27552 .......... ............ A Treat knee dislocation ................................. 7.91 NA 6.75 1.36 NA 16.01 090 27556 .......... ............ A Treat knee dislocation ................................. 14.42 NA 11.21 2.50 NA 28.13 090 27557 .......... ............ A Treat knee dislocation ................................. 16.77 NA 12.63 2.97 NA 32.38 090 27558 .......... ............ A Treat knee dislocation ................................. 17.73 NA 12.57 3.08 NA 33.38 090 27560 .......... ............ A Treat kneecap dislocation ........................... 3.82 4.97 3.08 0.40 9.19 7.29 090 27562 .......... ............ A Treat kneecap dislocation ........................... 5.79 NA 4.62 0.94 NA 11.36 090 27566 .......... ............ A Treat kneecap dislocation ........................... 12.23 NA 9.03 2.12 NA 23.38 090 27570 .......... ............ A Fixation of knee joint ................................... 1.74 NA 1.72 0.30 NA 3.77 010 27580 .......... ............ A Fusion of knee ............................................. 19.38 NA 14.25 3.37 NA 37.00 090 27590 .......... ............ A Amputate leg at thigh .................................. 12.03 NA 6.53 1.74 NA 20.30 090 27591 .......... ............ A Amputate leg at thigh .................................. 12.69 NA 8.40 2.02 NA 23.11 090 27592 .......... ............ A Amputate leg at thigh .................................. 10.02 NA 6.02 1.45 NA 17.49 090 27594 .......... ............ A Amputation follow-up surgery ...................... 6.92 NA 5.04 1.02 NA 12.99 090 27596 .......... ............ A Amputation follow-up surgery ...................... 10.60 NA 6.65 1.57 NA 18.82 090 27598 .......... ............ A Amputate lower leg at knee ........................ 10.53 NA 6.85 1.65 NA 19.03 090 27599 .......... ............ C Leg surgery procedure ................................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 27600 .......... ............ A Decompression of lower leg ........................ 5.65 NA 4.37 0.86 NA 10.88 090 27601 .......... ............ A Decompression of lower leg ........................ 5.64 NA 4.68 0.80 NA 11.13 090 27602 .......... ............ A Decompression of lower leg ........................ 7.35 NA 4.97 1.10 NA 13.43 090 27603 .......... ............ A Drain lower leg lesion .................................. 4.94 7.21 4.07 0.74 12.89 9.75 090 27604 .......... ............ A Drain lower leg bursa .................................. 4.47 5.96 3.87 0.69 11.12 9.03 090 27605 .......... ............ A Incision of achilles tendon ........................... 2.88 7.29 2.26 0.41 10.58 5.55 010 27606 .......... ............ A Incision of achilles tendon ........................... 4.14 NA 3.25 0.69 NA 8.07 010 27607 .......... ............ A Treat lower leg bone lesion ......................... 7.98 NA 6.02 1.31 NA 15.30 090 27610 .......... ............ A Explore/treat ankle joint ............................... 8.35 NA 6.79 1.40 NA 16.54 090 27612 .......... ............ A Exploration of ankle joint ............................. 7.33 NA 5.95 1.13 NA 14.42 090 27613 .......... ............ A Biopsy lower leg soft tissue ........................ 2.17 3.43 1.77 0.20 5.81 4.14 010 27614 .......... ............ A Biopsy lower leg soft tissue ........................ 5.66 7.24 4.34 0.78 13.69 10.78 090 27615 .......... ............ A Remove tumor, lower leg ............................ 12.57 NA 9.08 1.83 NA 23.48 090 27618 .......... ............ A Remove lower leg lesion ............................. 5.09 6.11 3.92 0.72 11.92 9.73 090 27619 .......... ............ A Remove lower leg lesion ............................. 8.41 9.38 5.82 1.25 19.03 15.48 090 27620 .......... ............ A Explore/treat ankle joint ............................... 5.98 NA 5.31 0.97 NA 12.26 090 27625 .......... ............ A Remove ankle joint lining ............................ 8.31 NA 6.30 1.28 NA 15.89 090 27626 .......... ............ A Remove ankle joint lining ............................ 8.92 NA 6.73 1.48 NA 17.12 090 27630 .......... ............ A Removal of tendon lesion ........................... 4.80 7.39 4.27 0.74 12.93 9.81 090 27635 .......... ............ A Remove lower leg bone lesion .................... 7.79 NA 6.54 1.31 NA 15.63 090 27637 .......... ............ A Remove/graft leg bone lesion ..................... 9.86 NA 8.03 1.66 NA 19.55 090 27638 .......... ............ A Remove/graft leg bone lesion ..................... 10.57 NA 8.04 1.84 NA 20.45 090
27640 .......... ............ A Partial removal of tibia ................................ 11.37 NA 9.90 1.88 NA 23.15 090 27641 .......... ............ A Partial removal of fibula .............................. 9.25 NA 8.03 1.46 NA 18.74 090 27645 .......... ............ A Extensive lower leg surgery ........................ 14.18 NA 11.57 2.41 NA 28.16 090


## 45900

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

27646 .......... ............ A Extensive lower leg surgery ........................ 12.67 NA 10.60 2.05 NA 25.32 090 27647 .......... ............ A Extensive ankle/heel surgery ...................... 12.24 NA 7.48 1.75 NA 21.47 090 27648 .......... ............ A Injection for ankle x-ray ............................... 0.96 3.39 0.34 0.08 4.43 1.38 000 27650 .......... ............ A Repair achilles tendon ................................. 9.70 NA 7.30 1.59 NA 18.59 090 27652 .......... ............ A Repair/graft achilles tendon ........................ 10.33 NA 7.81 1.71 NA 19.85 090 27654 .......... ............ A Repair of achilles tendon ............................ 10.02 NA 6.97 1.58 NA 18.57 090 27656 .......... ............ A Repair leg fascia defect .............................. 4.57 8.20 3.70 0.69 13.46 8.96 090 27658 .......... ............ A Repair of leg tendon, each .......................... 4.98 NA 4.45 0.79 NA 10.22 090 27659 .......... ............ A Repair of leg tendon, each .......................... 6.81 NA 5.50 1.09 NA 13.40 090 27664 .......... ............ A Repair of leg tendon, each .......................... 4.59 NA 4.42 0.76 NA 9.77 090 27665 .......... ............ A Repair of leg tendon, each .......................... 5.40 NA 4.84 0.89 NA 11.14 090 27675 .......... ............ A Repair lower leg tendons ............................ 7.18 NA 5.59 1.11 NA 13.89 090 27676 .......... ............ A Repair lower leg tendons ............................ 8.43 NA 6.57 1.37 NA 16.36 090 27680 .......... ............ A Release of lower leg tendon ....................... 5.74 NA 4.96 0.93 NA 11.63 090 27681 .......... ............ A Release of lower leg tendons ..................... 6.82 NA 5.74 1.15 NA 13.72 090 27685 .......... ............ A Revision of lower leg tendon ....................... 6.50 7.38 5.35 0.97 14.86 12.82 090 27686 .......... ............ A Revise lower leg tendons ............................ 7.46 NA 6.30 1.24 NA 15.00 090 27687 .......... ............ A Revision of calf tendon ................................ 6.24 NA 5.18 1.00 NA 12.43 090 27690 .......... ............ A Revise lower leg tendon .............................. 8.72 NA 6.22 1.33 NA 16.27 090 27691 .......... ............ A Revise lower leg tendon .............................. 9.97 NA 7.54 1.64 NA 19.15 090 27692 .......... ............ A Revise additional leg tendon ....................... 1.87 NA 0.90 0.32 NA 3.10 ZZZ 27695 .......... ............ A Repair of ankle ligament ............................. 6.51 NA 5.71 1.05 NA 13.27 090 27696 .......... ............ A Repair of ankle ligaments ........................... 8.28 NA 6.28 1.28 NA 15.83 090 27698 .......... ............ A Repair of ankle ligament ............................. 9.37 NA 6.77 1.47 NA 17.61 090 27700 .......... ............ A Revision of ankle joint ................................. 9.30 NA 5.63 1.30 NA 16.23 090 27702 .......... ............ A Reconstruct ankle joint ................................ 13.68 NA 10.12 2.37 NA 26.17 090 27703 .......... ............ A Reconstruction, ankle joint .......................... 15.88 NA 10.91 2.76 NA 29.56 090 27704 .......... ............ A Removal of ankle implant ............................ 7.63 NA 5.42 1.27 NA 14.31 090 27705 .......... ............ A Incision of tibia ............................................ 10.38 NA 7.92 1.80 NA 20.10 090 27707 .......... ............ A Incision of fibula .......................................... 4.37 NA 4.78 0.76 NA 9.91 090 27709 .......... ............ A Incision of tibia & fibula ............................... 9.96 NA 7.87 1.73 NA 19.56 090 27712 .......... ............ A Realignment of lower leg ............................ 14.26 NA 10.43 2.47 NA 27.15 090 27715 .......... ............ A Revision of lower leg ................................... 14.40 NA 10.43 2.49 NA 27.32 090 27720 .......... ............ A Repair of tibia .............................................. 11.79 NA 9.10 2.04 NA 22.93 090 27722 .......... ............ A Repair/graft of tibia ...................................... 11.82 NA 8.84 2.05 NA 22.72 090 27724 .......... ............ A Repair/graft of tibia ...................................... 18.21 NA 11.98 3.16 NA 33.34 090 27725 .......... ............ A Repair of lower leg ...................................... 15.60 NA 11.56 2.71 NA 29.87 090 27727 .......... ............ A Repair of lower leg ...................................... 14.02 NA 10.02 2.43 NA 26.47 090 27730 .......... ............ A Repair of tibia epiphysis .............................. 7.41 NA 6.21 1.72 NA 15.35 090 27732 .......... ............ A Repair of fibula epiphysis ............................ 5.32 NA 4.80 0.77 NA 10.90 090 27734 .......... ............ A Repair lower leg epiphyses ......................... 8.49 NA 6.11 1.35 NA 15.95 090 27740 .......... ............ A Repair of leg epiphyses .............................. 9.31 NA 7.72 1.62 NA 18.65 090 27742 .......... ............ A Repair of leg epiphyses .............................. 10.30 NA 5.76 1.79 NA 17.85 090 27745 .......... ............ A Reinforce tibia ............................................. 10.07 NA 7.91 1.75 NA 19.73 090 27750 .......... ............ A Treatment of tibia fracture ........................... 3.20 4.90 3.74 0.55 8.65 7.49 090 27752 .......... ............ A Treatment of tibia fracture ........................... 5.84 6.74 5.51 1.01 13.59 12.36 090 27756 .......... ............ A Treatment of tibia fracture ........................... 6.78 NA 6.25 1.17 NA 14.20 090 27758 .......... ............ A Treatment of tibia fracture ........................... 11.67 NA 8.89 2.03 NA 22.59 090 27759 .......... ............ A Treatment of tibia fracture ........................... 13.77 NA 9.99 2.38 NA 26.13 090 27760 .......... ............ A Treatment of ankle fracture ......................... 3.02 4.83 3.48 0.48 8.32 6.98 090 27762 .......... ............ A Treatment of ankle fracture ......................... 5.25 6.43 5.12 0.85 12.53 11.22 090 27766 .......... ............ A Treatment of ankle fracture ......................... 8.37 NA 6.99 1.44 NA 16.80 090 27780 .......... ............ A Treatment of fibula fracture ......................... 2.66 4.05 3.12 0.41 7.12 6.18 090 27781 .......... ............ A Treatment of fibula fracture ......................... 4.40 5.61 4.51 0.73 10.74 9.64 090 27784 .......... ............ A Treatment of fibula fracture ......................... 7.11 NA 6.26 1.23 NA 14.60 090 27786 .......... ............ A Treatment of ankle fracture ......................... 2.85 4.61 3.23 0.46 7.92 6.54 090 27788 .......... ............ A Treatment of ankle fracture ......................... 4.45 5.76 4.52 0.74 10.95 9.71 090 27792 .......... ............ A Treatment of ankle fracture ......................... 7.67 NA 6.74 1.32 NA 15.72 090 27808 .......... ............ A Treatment of ankle fracture ......................... 2.84 4.94 3.59 0.46 8.24 6.89 090 27810 .......... ............ A Treatment of ankle fracture ......................... 5.13 6.35 5.00 0.82 12.30 10.96 090 27814 .......... ............ A Treatment of ankle fracture ......................... 10.68 NA 8.29 1.85 NA 20.82 090 27816 .......... ............ A Treatment of ankle fracture ......................... 2.90 4.54 3.31 0.43 7.86 6.63 090 27818 .......... ............ A Treatment of ankle fracture ......................... 5.50 6.47 5.02 0.82 12.79 11.34 090 27822 .......... ............ A Treatment of ankle fracture ......................... 11.00 NA 13.08 1.91 NA 25.99 090 27823 .......... ............ A Treatment of ankle fracture ......................... 13.01 NA 13.87 2.25 NA 29.12 090 27824 .......... ............ A Treat lower leg fracture ............................... 2.90 4.22 3.47 0.45 7.56 6.81 090 27825 .......... ............ A Treat lower leg fracture ............................... 6.19 6.69 5.23 1.02 13.91 12.44 090 27826 .......... ............ A Treat lower leg fracture ............................... 8.55 NA 11.29 1.47 NA 21.31 090 27827 .......... ............ A Treat lower leg fracture ............................... 14.07 NA 15.09 2.43 NA 31.58 090 27828 .......... ............ A Treat lower leg fracture ............................... 16.24 NA 16.21 2.81 NA 35.26 090 27829 .......... ............ A Treat lower leg joint ..................................... 5.49 NA 8.63 0.95 NA 15.08 090 27830 .......... ............ A Treat lower leg dislocation .......................... 3.79 4.54 3.74 0.54 8.87 8.07 090 27831 .......... ............ A Treat lower leg dislocation .......................... 4.56 NA 4.32 0.73 NA 9.61 090 27832 .......... ............ A Treat lower leg dislocation .......................... 6.49 NA 5.97 1.03 NA 13.49 090


## 45901

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

27840 .......... ............ A Treat ankle dislocation ................................ 4.58 NA 3.63 0.46 NA 8.67 090 27842 .......... ............ A Treat ankle dislocation ................................ 6.21 NA 4.96 1.00 NA 12.17 090 27846 .......... ............ A Treat ankle dislocation ................................ 9.80 NA 7.68 1.70 NA 19.18 090 27848 .......... ............ A Treat ankle dislocation ................................ 11.20 NA 11.46 1.94 NA 24.61 090 27860 .......... ............ A Fixation of ankle joint .................................. 2.34 NA 1.93 0.39 NA 4.67 010 27870 .......... ............ A Fusion of ankle joint, open .......................... 13.92 NA 10.21 2.36 NA 26.49 090 27871 .......... ............ A Fusion of tibiofibular joint ............................ 9.18 NA 7.35 1.59 NA 18.12 090 27880 .......... ............ A Amputation of lower leg .............................. 11.85 NA 6.96 1.75 NA 20.56 090 27881 .......... ............ A Amputation of lower leg .............................. 12.34 NA 8.58 1.98 NA 22.90 090 27882 .......... ............ A Amputation of lower leg .............................. 8.95 NA 6.29 1.29 NA 16.53 090 27884 .......... ............ A Amputation follow-up surgery ...................... 8.22 NA 5.60 1.22 NA 15.04 090 27886 .......... ............ A Amputation follow-up surgery ...................... 9.33 NA 6.34 1.40 NA 17.06 090 27888 .......... ............ A Amputation of foot at ankle ......................... 9.68 NA 7.28 1.51 NA 18.47 090 27889 .......... ............ A Amputation of foot at ankle ......................... 9.99 NA 6.30 1.46 NA 17.75 090 27892 .......... ............ A Decompression of leg ................................. 7.39 NA 5.44 1.10 NA 13.93 090 27893 .......... ............ A Decompression of leg ................................. 7.35 NA 5.32 1.10 NA 13.78 090 27894 .......... ............ A Decompression of leg ................................. 10.49 NA 7.57 1.65 NA 19.71 090 27899 .......... ............ C Leg/ankle surgery procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 28001 .......... ............ A Drainage of bursa of foot ............................ 2.74 3.15 1.93 0.33 6.21 5.00 010 28002 .......... ............ A Treatment of foot infection .......................... 4.62 5.17 3.71 0.61 10.39 8.94 010 28003 .......... ............ A Treatment of foot infection .......................... 8.42 6.42 5.15 1.12 15.96 14.69 090 28005 .......... ............ A Treat foot bone lesion ................................. 8.69 NA 5.96 1.16 NA 15.81 090 28008 .......... ............ A Incision of foot fascia .................................. 4.45 4.77 3.20 0.57 9.79 8.22 090 28010 .......... ............ A Incision of toe tendon .................................. 2.85 2.45 2.42 0.36 5.66 5.62 090 28011 .......... ............ A Incision of toe tendons ................................ 4.14 0.00 3.28 0.59 4.73 8.01 090 28020 .......... ............ A Exploration of foot joint ............................... 5.01 6.09 4.06 0.72 11.82 9.79 090 28022 .......... ............ A Exploration of foot joint ............................... 4.67 5.39 3.80 0.62 10.68 9.09 090 28024 .......... ............ A Exploration of toe joint ................................ 4.38 5.38 3.85 0.58 10.34 8.81 090 28030 .......... ............ A Removal of foot nerve ................................. 6.15 NA 3.67 0.74 NA 10.56 090 28035 .......... ............ A Decompression of tibia nerve ..................... 5.09 6.00 4.03 0.70 11.79 9.82 090 28043 .......... ............ A Excision of foot lesion ................................. 3.54 3.94 3.14 0.46 7.94 7.13 090 28045 .......... ............ A Excision of foot lesion ................................. 4.72 5.58 3.58 0.63 10.93 8.93 090 28046 .......... ............ A Resection of tumor, foot .............................. 10.18 8.90 6.37 1.36 20.44 17.91 090 28050 .......... ............ A Biopsy of foot joint lining ............................. 4.25 5.11 3.55 0.60 9.96 8.40 090 28052 .......... ............ A Biopsy of foot joint lining ............................. 3.94 5.08 3.38 0.53 9.55 7.85 090 28054 .......... ............ A Biopsy of toe joint lining .............................. 3.45 4.89 3.18 0.46 8.80 7.09 090 28060 .......... ............ A Partial removal, foot fascia .......................... 5.23 5.69 3.86 0.70 11.62 9.79 090 28062 .......... ............ A Removal of foot fascia ................................ 6.52 6.70 4.03 0.83 14.05 11.38 090 28070 .......... ............ A Removal of foot joint lining .......................... 5.10 5.45 3.78 0.73 11.28 9.61 090 28072 .......... ............ A Removal of foot joint lining .......................... 4.58 5.68 4.20 0.68 10.94 9.46 090 28080 .......... ............ A Removal of foot lesion ................................ 3.58 5.41 3.72 0.47 9.45 7.77 090 28086 .......... ............ A Excise foot tendon sheath ........................... 4.78 7.81 4.55 0.76 13.35 10.09 090 28088 .......... ............ A Excise foot tendon sheath ........................... 3.86 5.80 3.79 0.61 10.26 8.26 090 28090 .......... ............ A Removal of foot lesion ................................ 4.41 5.34 3.44 0.59 10.34 8.44 090 28092 .......... ............ A Removal of toe lesions ................................ 3.64 5.34 3.47 0.49 9.47 7.59 090 28100 .......... ............ A Removal of ankle/heel lesion ...................... 5.66 7.86 4.61 0.82 14.34 11.09 90 28102 .......... ............ A Remove/graft foot lesion ............................. 7.74 NA 5.81 1.14 NA 14.68 090 28103 .......... ............ A Remove/graft foot lesion ............................. 6.50 NA 4.57 0.91 NA 11.98 090 28104 .......... ............ A Removal of foot lesion ................................ 5.12 5.69 3.88 0.70 11.51 9.70 090 28106 .......... ............ A Remove/graft foot lesion ............................. 7.16 NA 4.44 0.97 NA 12.58 090 28107 .......... ............ A Remove/graft foot lesion ............................. 5.56 6.67 4.17 0.74 12.97 10.47 090 28108 .......... ............ A Removal of toe lesions ................................ 4.16 4.85 3.25 0.53 9.54 7.94 090 28110 .......... ............ A Part removal of metatarsal .......................... 4.08 5.43 3.22 0.54 10.05 7.84 090 28111 .......... ............ A Part removal of metatarsal .......................... 5.01 6.36 3.62 0.67 12.04 9.30 090 28112 .......... ............ A Part removal of metatarsal .......................... 4.49 5.96 3.54 0.61 11.06 8.64 090 28113 .......... ............ A Part removal of metatarsal .......................... 4.79 6.33 4.34 0.63 11.75 9.76 090 28114 .......... ............ A Removal of metatarsal heads ..................... 9.80 11.63 8.27 1.42 22.85 19.49 090 28116 .......... ............ A Revision of foot ........................................... 7.76 7.08 5.17 1.03 15.87 13.96 090 28118 .......... ............ A Removal of heel bone ................................. 5.96 6.41 4.30 0.84 13.21 11.11 090 28119 .......... ............ A Removal of heel spur .................................. 5.39 5.67 3.73 0.70 11.76 9.83 090 28120 .......... ............ A Part removal of ankle/heel .......................... 5.40 7.28 4.34 0.77 13.45 10.51 090
28122 .......... ............ A Partial removal of foot bone ........................ 7.29 7.04 5.23 0.98 15.31 13.50 090 28124 .......... ............ A Partial removal of toe .................................. 4.81 5.27 3.67 0.60 10.68 9.08 090 28126 .......... ............ A Partial removal of toe .................................. 3.52 4.46 2.98 0.45 8.43 6.95 090 28130 .......... ............ A Removal of ankle bone ............................... 8.12 NA 6.57 1.26 NA 15.94 090 28140 .......... ............ A Removal of metatarsal ................................ 6.91 7.29 4.70 0.92 15.12 12.53 090 28150 .......... ............ A Removal of toe ............................................ 4.09 5.05 3.27 0.53 9.67 7.89 090 28153 .......... ............ A Partial removal of toe .................................. 3.66 4.58 2.73 0.47 8.70 6.86 090 28160 .......... ............ A Partial removal of toe .................................. 3.74 4.80 3.31 0.49 9.03 7.53 090 28171 .......... ............ A Extensive foot surgery ................................. 9.61 NA 5.43 1.33 NA 16.37 090 28173 .......... ............ A Extensive foot surgery ................................. 8.81 7.79 5.16 1.12 17.71 15.08 090 28175 .......... ............ A Extensive foot surgery ................................. 6.05 5.93 3.73 0.73 12.71 10.51 090 28190 .......... ............ A Removal of foot foreign body ...................... 1.96 3.47 1.44 0.22 5.65 3.62 010 28192 .......... ............ A Removal of foot foreign body ...................... 4.64 5.62 3.60 0.61 10.87 8.85 090


## 45902

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

28193 .......... ............ A Removal of foot foreign body ...................... 5.73 5.84 3.91 0.73 12.30 10.37 090 28200 .......... ............ A Repair of foot tendon .................................. 4.60 5.32 3.53 0.61 10.53 8.74 090 28202 .......... ............ A Repair/graft of foot tendon .......................... 6.84 7.31 4.47 0.91 15.06 12.23 090 28208 .......... ............ A Repair of foot tendon .................................. 4.37 5.05 3.30 0.58 10.00 8.25 090 28210 .......... ............ A Repair/graft of foot tendon .......................... 6.35 6.38 4.03 0.81 13.55 11.20 090 28220 .......... ............ A Release of foot tendon ................................ 4.53 4.93 3.41 0.57 10.03 8.51 090 28222 .......... ............ A Release of foot tendons .............................. 5.62 5.50 4.08 0.69 11.81 10.39 090 28225 .......... ............ A Release of foot tendon ................................ 3.66 4.53 2.90 0.46 8.64 7.02 090 28226 .......... ............ A Release of foot tendons .............................. 4.53 5.06 3.70 0.58 10.16 8.81 090 28230 .......... ............ A Incision of foot tendon(s) ............................. 4.24 4.90 3.61 0.55 9.69 8.40 090 28232 .......... ............ A Incision of toe tendon .................................. 3.39 4.71 3.26 0.44 8.54 7.08 090 28234 .......... ............ A Incision of foot tendon ................................. 3.37 4.87 3.33 0.44 8.68 7.14 090 28238 .......... ............ A Revision of foot tendon ............................... 7.74 7.39 4.89 1.06 16.19 13.69 090 28240 .......... ............ A Release of big toe ....................................... 4.36 4.87 3.45 0.58 9.81 8.39 090 28250 .......... ............ A Revision of foot fascia ................................. 5.92 5.82 4.10 0.82 12.57 10.84 090 28260 .......... ............ A Release of midfoot joint .............................. 7.97 6.56 4.95 1.14 15.67 14.06 090 28261 .......... ............ A Revision of foot tendon ............................... 11.73 8.87 7.22 1.57 22.17 20.53 090 28262 .......... ............ A Revision of foot and ankle .......................... 15.84 13.37 10.63 2.59 31.81 29.06 090 28264 .......... ............ A Release of midfoot joint .............................. 10.35 7.94 7.12 1.54 19.83 19.01 090 28270 .......... ............ A Release of foot contracture ......................... 4.76 5.16 3.72 0.62 10.54 9.10 090 28272 .......... ............ A Release of toe joint, each ........................... 3.80 4.44 2.87 0.46 8.70 7.12 090 28280 .......... ............ A Fusion of toes .............................................. 5.19 6.34 4.39 0.73 12.26 10.31 090 28285 .......... ............ A Repair of hammertoe .................................. 4.59 5.12 3.44 0.59 10.30 8.62 090 28286 .......... ............ A Repair of hammertoe .................................. 4.56 5.06 3.27 0.57 10.19 8.40 090 28288 .......... ............ A Partial removal of foot bone ........................ 4.74 6.20 4.83 0.65 11.59 10.22 090 28289 .......... ............ A Repair hallux rigidus .................................... 7.04 8.06 5.68 1.02 16.12 13.74 090 28290 .......... ............ A Correction of bunion .................................... 5.66 6.44 4.63 0.82 12.92 11.11 090 28292 .......... ............ A Correction of bunion .................................... 7.04 7.80 5.60 0.91 15.75 13.55 090 28293 .......... ............ A Correction of bunion .................................... 9.16 11.26 6.22 1.13 21.55 16.51 090 28294 .......... ............ A Correction of bunion .................................... 8.57 7.68 4.72 1.09 17.34 14.38 090 28296 .......... ............ A Correction of bunion .................................... 9.19 8.36 5.39 1.19 18.74 15.77 090 28297 .......... ............ A Correction of bunion .................................... 9.19 9.04 6.14 1.32 19.55 16.65 090 28298 .......... ............ A Correction of bunion .................................... 7.95 7.47 4.98 1.05 16.47 13.98 090 28299 .......... ............ A Correction of bunion .................................... 10.58 8.99 6.05 1.37 20.94 18.00 090 28300 .......... ............ A Incision of heel bone ................................... 9.55 NA 6.86 1.54 NA 17.95 090 28302 .......... ............ A Incision of ankle bone ................................. 9.56 NA 6.72 1.42 NA 17.70 090 28304 .......... ............ A Incision of midfoot bones ............................ 9.17 8.16 5.67 1.27 18.60 16.11 090 28305 .......... ............ A Incise/graft midfoot bones ........................... 10.50 NA 6.72 1.27 NA 18.49 090 28306 .......... ............ A Incision of metatarsal .................................. 5.86 6.96 4.14 0.84 13.66 10.84 090 28307 .......... ............ A Incision of metatarsal .................................. 6.33 10.64 5.16 0.90 17.87 12.39 090 28308 .......... ............ A Incision of metatarsal .................................. 5.29 6.01 3.71 0.70 12.00 9.71 090 28309 .......... ............ A Incision of metatarsals ................................ 12.79 NA 7.83 2.04 NA 22.65 090 28310 .......... ............ A Revision of big toe ...................................... 5.43 5.98 3.56 0.70 12.12 9.70 090 28312 .......... ............ A Revision of toe ............................................ 4.55 5.67 3.60 0.63 10.85 8.78 090 28313 .......... ............ A Repair deformity of toe ................................ 5.01 5.47 4.69 0.73 11.21 10.43 090 28315 .......... ............ A Removal of sesamoid bone ........................ 4.86 5.15 3.35 0.63 10.63 8.84 090 28320 .......... ............ A Repair of foot bones .................................... 9.19 NA 6.56 1.43 NA 17.18 090 28322 .......... ............ A Repair of metatarsals .................................. 8.35 9.10 6.19 1.27 18.72 15.81 090 28340 .......... ............ A Resect enlarged toe tissue ......................... 6.98 6.67 4.24 0.84 14.49 12.07 090 28341 .......... ............ A Resect enlarged toe .................................... 8.42 7.22 4.82 1.01 16.64 14.25 090 28344 .......... ............ A Repair extra toe(s) ...................................... 4.26 5.88 3.60 0.51 10.65 8.37 090 28345 .......... ............ A Repair webbed toe(s) .................................. 5.92 6.38 4.61 0.80 13.10 11.33 090 28360 .......... ............ A Reconstruct cleft foot .................................. 13.35 NA 10.20 2.28 NA 25.83 090 28400 .......... ............ A Treatment of heel fracture ........................... 2.16 3.82 2.96 0.35 6.33 5.48 090 28405 .......... ............ A Treatment of heel fracture ........................... 4.57 5.00 4.50 0.73 10.30 9.80 090 28406 .......... ............ A Treatment of heel fracture ........................... 6.31 NA 6.54 1.11 NA 13.97 090 28415 .......... ............ A Treat heel fracture ....................................... 15.98 NA 15.56 2.66 NA 34.20 090 28420 .......... ............ A Treat/graft heel fracture ............................... 16.65 NA 15.18 2.80 NA 34.63 090
28430 .......... ............ A Treatment of ankle fracture ......................... 2.09 3.58 2.48 0.31 5.98 4.88 090 28435 .......... ............ A Treatment of ankle fracture ......................... 3.40 4.07 3.64 0.55 8.02 7.59 090 28436 .......... ............ A Treatment of ankle fracture ......................... 4.71 NA 5.69 0.81 NA 11.21 090 28445 .......... ............ A Treat ankle fracture ..................................... 15.63 NA 10.73 2.58 NA 28.94 090 28450 .......... ............ A Treat midfoot fracture, each ........................ 1.90 3.31 2.40 0.28 5.50 4.58 090 28455 .......... ............ A Treat midfoot fracture, each ........................ 3.10 3.64 3.37 0.44 7.18 6.91 090 28456 .......... ............ A Treat midfoot fracture .................................. 2.69 NA 4.03 0.44 NA 7.15 090 28465 .......... ............ A Treat midfoot fracture, each ........................ 7.01 NA 7.98 1.10 NA 16.10 090 28470 .......... ............ A Treat metatarsal fracture ............................. 1.99 3.31 2.36 0.30 5.60 4.66 090 28475 .......... ............ A Treat metatarsal fracture ............................. 2.98 3.53 3.12 0.44 6.94 6.54 090 28476 .......... ............ A Treat metatarsal fracture ............................. 3.38 NA 4.82 0.54 NA 8.74 090 28485 .......... ............ A Treat metatarsal fracture ............................. 5.71 NA 7.53 0.83 NA 14.07 090 28490 .......... ............ A Treat big toe fracture ................................... 1.09 2.00 1.59 0.14 3.23 2.82 090 28495 .......... ............ A Treat big toe fracture ................................... 1.58 2.21 2.01 0.20 3.99 3.79 090 28496 .......... ............ A Treat big toe fracture ................................... 2.33 7.96 3.12 0.36 10.66 5.82 090 28505 .......... ............ A Treat big toe fracture ................................... 3.81 9.34 5.68 0.56 13.71 10.05 090


## 45903

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

28510 .......... ............ A Treatment of toe fracture ............................ 1.09 1.54 1.49 0.14 2.77 2.72 090 28515 .......... ............ A Treatment of toe fracture ............................ 1.46 1.93 1.85 0.18 3.58 3.50 090 28525 .......... ............ A Treat toe fracture ......................................... 3.33 8.76 5.19 0.49 12.58 9.01 090 28530 .......... ............ A Treat sesamoid bone fracture ..................... 1.06 1.67 1.41 0.14 2.87 2.61 090 28531 .......... ............ A Treat sesamoid bone fracture ..................... 2.35 7.40 3.45 0.34 10.09 6.14 090 28540 .......... ............ A Treat foot dislocation ................................... 2.04 2.65 2.41 0.26 4.95 4.72 090 28545 .......... ............ A Treat foot dislocation ................................... 2.45 2.60 2.48 0.37 5.42 5.30 090 28546 .......... ............ A Treat foot dislocation ................................... 3.21 6.89 4.25 0.52 10.62 7.97 090 28555 .......... ............ A Repair foot dislocation ................................. 6.30 11.09 7.52 1.04 18.43 14.86 090 28570 .......... ............ A Treat foot dislocation ................................... 1.66 2.65 2.27 0.23 4.54 4.17 090 28575 .......... ............ A Treat foot dislocation ................................... 3.32 3.92 3.70 0.56 7.79 7.58 090 28576 .......... ............ A Treat foot dislocation ................................... 4.17 NA 4.11 0.69 NA 8.97 090 28585 .......... ............ A Repair foot dislocation ................................. 8.00 8.69 7.47 1.25 17.94 16.71 090 28600 .......... ............ A Treat foot dislocation ................................... 1.89 3.03 2.61 0.27 5.20 4.77 090 28605 .......... ............ A Treat foot dislocation ................................... 2.72 3.35 3.16 0.40 6.46 6.28 090 28606 .......... ............ A Treat foot dislocation ................................... 4.90 NA 4.64 0.82 NA 10.36 090 28615 .......... ............ A Repair foot dislocation ................................. 7.78 NA 9.80 1.30 NA 18.87 090
28630 .......... ............ A Treat toe dislocation .................................... 1.70 1.61 0.96 0.20 3.51 2.87 010 28635 .......... ............ A Treat toe dislocation .................................... 1.91 2.21 1.51 0.26 4.38 3.68 010 28636 .......... ............ A Treat toe dislocation .................................... 2.78 3.87 2.55 0.43 7.08 5.75 010 28645 .......... ............ A Repair toe dislocation .................................. 4.22 5.95 4.24 0.57 10.74 9.03 090 28660 .......... ............ A Treat toe dislocation .................................... 1.23 1.48 0.76 0.13 2.84 2.13 010 28665 .......... ............ A Treat toe dislocation .................................... 1.92 0.00 1.42 0.26 2.18 3.60 010 28666 .......... ............ A Treat toe dislocation .................................... 2.67 NA 2.48 0.43 NA 5.58 010 28675 .......... ............ A Repair of toe dislocation ............................. 2.93 7.92 4.53 0.45 11.29 7.91 090 28705 .......... ............ A Fusion of foot bones ................................... 18.81 NA 12.10 3.08 NA 33.99 090 28715 .......... ............ A Fusion of foot bones ................................... 13.11 NA 9.48 2.16 NA 24.75 090 28725 .......... ............ A Fusion of foot bones ................................... 11.61 NA 8.02 1.86 NA 21.49 090 28730 .......... ............ A Fusion of foot bones ................................... 10.76 NA 8.29 1.70 NA 20.75 090 28735 .......... ............ A Fusion of foot bones ................................... 10.85 NA 7.65 1.68 NA 20.18 090 28737 .......... ............ A Revision of foot bones ................................ 9.65 NA 6.70 1.47 NA 17.82 090 28740 .......... ............ A Fusion of foot bones ................................... 8.03 10.65 6.34 1.22 19.89 15.58 090 28750 .......... ............ A Fusion of big toe joint .................................. 7.30 11.53 6.49 1.13 19.97 14.93 090 28755 .......... ............ A Fusion of big toe joint .................................. 4.74 6.22 3.72 0.65 11.61 9.11 090 28760 .......... ............ A Fusion of big toe joint .................................. 7.76 8.16 5.48 1.05 16.96 14.28 090 28800 .......... ............ A Amputation of midfoot ................................. 8.22 NA 5.67 1.15 NA 15.04 090 28805 .......... ............ A Amputation thru metatarsal ......................... 8.40 NA 5.52 1.18 NA 15.10 090 28810 .......... ............ A Amputation toe & metatarsal ....................... 6.21 NA 4.39 0.86 NA 11.46 090 28820 .......... ............ A Amputation of toe ........................................ 4.41 7.47 3.72 0.61 12.49 8.74 090 28825 .......... ............ A Partial amputation of toe ............................. 3.59 6.95 3.42 0.50 11.03 7.50 090 28899 .......... ............ C Foot/toes surgery procedure ....................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 29000 .......... ............ A Application of body cast .............................. 2.25 3.98 1.70 0.41 6.64 4.37 000 29010 .......... ............ A Application of body cast .............................. 2.06 4.62 1.73 0.45 7.14 4.25 000 29015 .......... ............ A Application of body cast .............................. 2.41 4.23 1.57 0.28 6.92 4.27 000 29020 .......... ............ A Application of body cast .............................. 2.11 4.69 1.39 0.28 7.08 3.79 000 29025 .......... ............ A Application of body cast .............................. 2.40 4.38 1.82 0.44 7.23 4.66 000 29035 .......... ............ A Application of body cast .............................. 1.77 5.06 1.54 0.28 7.11 3.60 000 29040 .......... ............ A Application of body cast .............................. 2.22 3.53 1.49 0.36 6.12 4.08 000 29044 .......... ............ A Application of body cast .............................. 2.12 5.87 1.85 0.35 8.35 4.33 000 29046 .......... ............ A Application of body cast .............................. 2.41 4.95 2.04 0.42 7.79 4.87 000 29049 .......... ............ A Application of figure eight ............................ 0.89 2.01 0.51 0.13 3.03 1.54 000 29055 .......... ............ A Application of shoulder cast ........................ 1.78 4.12 1.44 0.30 6.21 3.52 000 29058 .......... ............ A Application of shoulder cast ........................ 1.31 2.28 0.70 0.17 3.76 2.19 000 29065 .......... ............ A Application of long arm cast ........................ 0.87 2.25 0.73 0.15 3.28 1.75 000 29075 .......... ............ A Application of forearm cast ......................... 0.77 2.08 0.66 0.13 2.98 1.57 000 29085 .......... ............ A Apply hand/wrist cast .................................. 0.87 1.98 0.62 0.14 3.00 1.63 000 29086 .......... ............ A Apply finger cast .......................................... 0.62 0.95 0.48 0.07 1.65 1.17 000 29105 .......... ............ A Apply long arm splint ................................... 0.87 1.76 0.49 0.12 2.76 1.49 000 29125 .......... ............ A Apply forearm splint .................................... 0.59 1.51 0.38 0.07 2.17 1.04 000 29126 .......... ............ A Apply forearm splint .................................... 0.77 1.49 0.45 0.07 2.33 1.29 000 29130 .......... ............ A Application of finger splint ........................... 0.50 0.46 0.17 0.06 1.02 0.73 000 29131 .......... ............ A Application of finger splint ........................... 0.55 0.74 0.23 0.03 1.32 0.81 000 29200 .......... ............ A Strapping of chest ....................................... 0.65 0.76 0.33 0.04 1.45 1.02 000 29220 .......... ............ A Strapping of low back .................................. 0.64 0.74 0.39 0.04 1.42 1.07 000 29240 .......... ............ A Strapping of shoulder .................................. 0.71 0.86 0.35 0.06 1.64 1.12 000 29260 .......... ............ A Strapping of elbow or wrist ......................... 0.55 0.78 0.31 0.05 1.38 0.91 000 29280 .......... ............ A Strapping of hand or finger ......................... 0.51 0.82 0.31 0.03 1.36 0.85 000 29305 .......... ............ A Application of hip cast ................................. 2.03 4.78 1.72 0.35 7.17 4.10 000 29325 .......... ............ A Application of hip casts ............................... 2.32 4.95 1.90 0.40 7.67 4.63 000 29345 .......... ............ A Application of long leg cast ......................... 1.40 2.53 1.03 0.24 4.17 2.67 000 29355 .......... ............ A Application of long leg cast ......................... 1.53 2.59 1.09 0.26 4.38 2.89 000 29358 .......... ............ A Apply long leg cast brace ............................ 1.43 2.76 1.06 0.25 4.44 2.74 000 29365 .......... ............ A Application of long leg cast ......................... 1.18 2.64 0.92 0.20 4.02 2.31 000 29405 .......... ............ A Apply short leg cast ..................................... 0.86 2.14 0.69 0.14 3.14 1.70 000


## 45904

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

29425 .......... ............ A Apply short leg cast ..................................... 1.01 2.20 0.73 0.15 3.36 1.89 000 29435 .......... ............ A Apply short leg cast ..................................... 1.18 2.22 0.90 0.20 3.60 2.29 000 29440 .......... ............ A Addition of walker to cast ............................ 0.57 1.06 0.27 0.08 1.71 0.92 000 29445 .......... ............ A Apply rigid leg cast ...................................... 1.78 2.49 0.95 0.27 4.54 3.00 000 29450 .......... ............ A Application of leg cast ................................. 2.08 1.97 1.07 0.27 4.32 3.43 000 29505 .......... ............ A Application, long leg splint .......................... 0.69 1.50 0.44 0.08 2.27 1.21 000 29515 .......... ............ A Application lower leg splint .......................... 0.73 1.16 0.45 0.09 1.98 1.27 000 29520 .......... ............ A Strapping of hip ........................................... 0.54 0.88 0.46 0.03 1.45 1.03 000 29530 .......... ............ A Strapping of knee ........................................ 0.57 0.83 0.32 0.05 1.45 0.94 000 29540 .......... ............ A Strapping of ankle and/or ft ......................... 0.51 0.48 0.31 0.06 1.05 0.88 000 29550 .......... ............ A Strapping of toes ......................................... 0.47 0.46 0.29 0.06 0.99 0.82 000 29580 .......... ............ A Application of paste boot ............................. 0.57 0.76 0.35 0.07 1.40 0.99 000 29590 .......... ............ A Application of foot splint .............................. 0.76 0.53 0.28 0.09 1.38 1.13 000 29700 .......... ............ A Removal/revision of cast ............................. 0.57 0.89 0.27 0.08 1.54 0.92 000 29705 .......... ............ A Removal/revision of cast ............................. 0.76 0.80 0.37 0.13 1.69 1.26 000 29710 .......... ............ A Removal/revision of cast ............................. 1.34 1.49 0.68 0.20 3.03 2.22 000 29715 .......... ............ A Removal/revision of cast ............................. 0.94 1.82 0.39 0.09 2.85 1.42 000 29720 .......... ............ A Repair of body cast ..................................... 0.68 1.53 0.38 0.12 2.33 1.18 000 29730 .......... ............ A Windowing of cast ....................................... 0.75 0.79 0.34 0.12 1.67 1.21 000 29740 .......... ............ A Wedging of cast .......................................... 1.12 1.38 0.48 0.18 2.68 1.78 000 29750 .......... ............ A Wedging of clubfoot cast ............................. 1.26 1.27 0.57 0.21 2.74 2.04 000 29799 .......... ............ C Casting/strapping procedure ....................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 29800 .......... ............ A Jaw arthroscopy/surgery ............................. 6.43 NA 6.72 0.99 NA 14.14 090 29804 .......... ............ A Jaw arthroscopy/surgery ............................. 8.15 NA 7.64 1.38 NA 17.16 090 29805 .......... ............ A Shoulder arthroscopy, dx ............................ 5.89 NA 5.48 1.02 NA 12.39 090 29806 .......... ............ A Shoulder arthroscopy/surgery ..................... 14.38 NA 10.80 2.49 NA 27.67 090 29807 .......... ............ A Shoulder arthroscopy/surgery ..................... 13.91 NA 10.64 2.41 NA 26.96 090 29819 .......... ............ A Shoulder arthroscopy/surgery ..................... 7.63 NA 6.56 1.32 NA 15.51 090 29820 .......... ............ A Shoulder arthroscopy/surgery ..................... 7.07 NA 6.01 1.22 NA 14.31 090 29821 .......... ............ A Shoulder arthroscopy/surgery ..................... 7.73 NA 6.57 1.33 NA 15.63 090 29822 .......... ............ A Shoulder arthroscopy/surgery ..................... 7.43 NA 6.46 1.28 NA 15.18 090 29823 .......... ............ A Shoulder arthroscopy/surgery ..................... 8.18 NA 6.98 1.41 NA 16.57 090 29824 .......... ............ A Shoulder arthroscopy/surgery ..................... 8.26 NA 7.29 1.42 NA 16.96 090 29825 .......... ............ A Shoulder arthroscopy/surgery ..................... 7.63 NA 6.54 1.32 NA 15.48 090 29826 .......... ............ A Shoulder arthroscopy/surgery ..................... 9.00 NA 7.28 1.55 NA 17.83 090 29827 .......... ............ A Arthroscop rotator cuff repr ......................... 15.37 NA 11.16 2.66 NA 29.19 090 29830 .......... ............ A Elbow arthroscopy ....................................... 5.76 NA 5.18 0.99 NA 11.93 090 29834 .......... ............ A Elbow arthroscopy/surgery .......................... 6.28 NA 5.64 1.08 NA 13.00 090 29835 .......... ............ A Elbow arthroscopy/surgery .......................... 6.48 NA 5.69 1.13 NA 13.30 090 29836 .......... ............ A Elbow arthroscopy/surgery .......................... 7.56 NA 6.56 1.22 NA 15.33 090 29837 .......... ............ A Elbow arthroscopy/surgery .......................... 6.87 NA 5.92 1.19 NA 13.99 090 29838 .......... ............ A Elbow arthroscopy/surgery .......................... 7.72 NA 6.66 1.30 NA 15.67 090 29840 .......... ............ A Wrist arthroscopy ........................................ 5.54 NA 5.15 0.84 NA 11.53 090 29843 .......... ............ A Wrist arthroscopy/surgery ........................... 6.01 NA 5.44 0.92 NA 12.37 090 29844 .......... ............ A Wrist arthroscopy/surgery ........................... 6.37 NA 5.63 1.04 NA 13.04 090 29845 .......... ............ A Wrist arthroscopy/surgery ........................... 7.53 NA 6.29 0.99 NA 14.81 090 29846 .......... ............ A Wrist arthroscopy/surgery ........................... 6.75 NA 5.86 1.07 NA 13.68 090 29847 .......... ............ A Wrist arthroscopy/surgery ........................... 7.08 NA 5.99 1.08 NA 14.16 090 29848 .......... ............ A Wrist endoscopy/surgery ............................. 5.44 NA 5.43 0.86 NA 11.73 090 29850 .......... ............ A Knee arthroscopy/surgery ........................... 8.20 NA 5.02 1.25 NA 14.47 090 29851 .......... ............ A Knee arthroscopy/surgery ........................... 13.11 NA 9.49 2.34 NA 24.93 090 29855 .......... ............ A Tibial arthroscopy/surgery ........................... 10.62 NA 8.48 1.84 NA 20.95 090 29856 .......... ............ A Tibial arthroscopy/surgery ........................... 14.15 NA 10.34 2.39 NA 26.87 090 29860 .......... ............ A Hip arthroscopy, dx ..................................... 8.06 NA 6.73 1.36 NA 16.15 090 29861 .......... ............ A Hip arthroscopy/surgery .............................. 9.16 NA 7.11 1.59 NA 17.86 090 29862 .......... ............ A Hip arthroscopy/surgery .............................. 9.91 NA 8.29 1.62 NA 19.82 090 29863 .......... ............ A Hip arthroscopy/surgery .............................. 9.91 NA 8.25 1.42 NA 19.58 090 29866 .......... ............ A Autgrft implnt, knee w/scope ....................... 13.91 NA 10.98 2.39 NA 27.28 090 29867 .......... ............ A Allgrft implnt, knee w/scope ........................ 17.03 NA 12.80 2.78 NA 32.61 090 29868 .......... ............ A Meniscal trnspl, knee w/scpe ...................... 23.64 NA 16.26 4.35 NA 44.25 090 29870 .......... ............ A Knee arthroscopy, dx .................................. 5.07 NA 4.72 0.85 NA 10.64 090 29871 .......... ............ A Knee arthroscopy/drainage ......................... 6.55 NA 5.68 1.14 NA 13.38 090 29873 .......... ............ A Knee arthroscopy/surgery ........................... 6.00 NA 6.35 1.04 NA 13.39 090 29874 .......... ............ A Knee arthroscopy/surgery ........................... 7.05 NA 5.88 1.11 NA 14.04 090 29875 .......... ............ A Knee arthroscopy/surgery ........................... 6.31 NA 5.65 1.09 NA 13.06 090 29876 .......... ............ A Knee arthroscopy/surgery ........................... 7.93 NA 6.80 1.37 NA 16.09 090 29877 .......... ............ A Knee arthroscopy/surgery ........................... 7.35 NA 6.52 1.28 NA 15.16 090 29879 .......... ............ A Knee arthroscopy/surgery ........................... 8.05 NA 6.89 1.39 NA 16.32 090 29880 .......... ............ A Knee arthroscopy/surgery ........................... 8.51 NA 7.12 1.47 NA 17.10 090 29881 .......... ............ A Knee arthroscopy/surgery ........................... 7.77 NA 6.73 1.34 NA 15.84 090 29882 .......... ............ A Knee arthroscopy/surgery ........................... 8.66 NA 7.01 1.50 NA 17.16 090 29883 .......... ............ A Knee arthroscopy/surgery ........................... 11.05 NA 8.77 1.92 NA 21.74 090 29884 .......... ............ A Knee arthroscopy/surgery ........................... 7.33 NA 6.48 1.27 NA 15.09 090 29885 .......... ............ A Knee arthroscopy/surgery ........................... 9.10 NA 7.71 1.58 NA 18.39 090


## 45905

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

29886 .......... ............ A Knee arthroscopy/surgery ........................... 7.55 NA 6.63 1.30 NA 15.47 090 29887 .......... ............ A Knee arthroscopy/surgery ........................... 9.05 NA 7.67 1.57 NA 18.29 090 29888 .......... ............ A Knee arthroscopy/surgery ........................... 13.91 NA 9.87 2.41 NA 26.19 090 29889 .......... ............ A Knee arthroscopy/surgery ........................... 16.01 NA 12.04 2.78 NA 30.83 090 29891 .......... ............ A Ankle arthroscopy/surgery ........................... 8.41 NA 7.29 1.39 NA 17.09 090 29892 .......... ............ A Ankle arthroscopy/surgery ........................... 9.01 NA 7.52 1.41 NA 17.94 090 29893 .......... ............ A Scope, plantar fasciotomy ........................... 5.22 6.64 4.09 0.63 12.49 9.94 090 29894 .......... ............ A Ankle arthroscopy/surgery ........................... 7.21 NA 5.34 1.15 NA 13.71 090 29895 .......... ............ A Ankle arthroscopy/surgery ........................... 6.99 NA 5.34 1.11 NA 13.44 090 29897 .......... ............ A Ankle arthroscopy/surgery ........................... 7.18 NA 5.71 1.17 NA 14.06 090 29898 .......... ............ A Ankle arthroscopy/surgery ........................... 8.33 NA 6.05 1.28 NA 15.66 090 29899 .......... ............ A Ankle arthroscopy/surgery ........................... 13.92 NA 10.23 2.40 NA 26.54 090 29900 .......... ............ A Mcp joint arthroscopy, dx ............................ 5.42 NA 5.67 0.94 NA 12.03 090 29901 .......... ............ A Mcp joint arthroscopy, surg ......................... 6.13 NA 6.05 1.06 NA 13.25 090 29902 .......... ............ A Mcp joint arthroscopy, surg ......................... 6.70 NA 6.33 1.12 NA 14.15 090 29999 .......... ............ C Arthroscopy of joint ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 30000 .......... ............ A Drainage of nose lesion .............................. 1.43 3.99 1.37 0.12 5.54 2.92 010 30020 .......... ............ A Drainage of nose lesion .............................. 1.43 3.41 1.45 0.12 4.97 3.00 010 30100 .......... ............ A Intranasal biopsy ......................................... 0.94 2.03 0.80 0.07 3.04 1.82 000 30110 .......... ............ A Removal of nose polyp(s) ........................... 1.63 3.28 1.54 0.14 5.05 3.31 010 30115 .......... ............ A Removal of nose polyp(s) ........................... 4.35 NA 5.73 0.41 NA 10.49 090 30117 .......... ............ A Removal of intranasal lesion ....................... 3.17 13.54 4.61 0.26 16.97 8.04 090 30118 .......... ............ A Removal of intranasal lesion ....................... 9.70 NA 9.03 0.78 NA 19.50 090 30120 .......... ............ A Revision of nose .......................................... 5.27 6.80 5.78 0.52 12.59 11.57 090 30124 .......... ............ A Removal of nose lesion ............................... 3.11 NA 3.63 0.25 NA 6.98 090 30125 .......... ............ A Removal of nose lesion ............................... 7.16 NA 8.11 0.63 NA 15.90 090 30130 .......... ............ A Removal of turbinate bones ........................ 3.38 NA 5.52 0.31 NA 9.21 090 30140 .......... ............ A Removal of turbinate bones ........................ 3.43 NA 6.22 0.35 NA 10.00 090 30150 .......... ............ A Partial removal of nose ............................... 9.15 NA 10.64 0.93 NA 20.72 090 30160 .......... ............ A Removal of nose ......................................... 9.59 NA 9.92 0.88 NA 20.39 090 30200 .......... ............ A Injection treatment of nose .......................... 0.78 1.64 0.73 0.06 2.48 1.57 000 30210 .......... ............ A Nasal sinus therapy ..................................... 1.08 2.12 1.29 0.09 3.30 2.46 010 30220 .......... ............ A Insert nasal septal button ............................ 1.54 4.36 1.51 0.12 6.02 3.18 010 30300 .......... ............ A Remove nasal foreign body ........................ 1.04 4.50 1.84 0.08 5.62 2.96 010 30310 .......... ............ A Remove nasal foreign body ........................ 1.96 NA 3.04 0.16 NA 5.16 010 30320 .......... ............ A Remove nasal foreign body ........................ 4.52 NA 6.84 0.39 NA 11.75 090 30400 .......... ............ R Reconstruction of nose ............................... 9.84 NA 15.01 1.04 NA 25.89 090 30410 .......... ............ R Reconstruction of nose ............................... 12.99 NA 17.64 1.42 NA 32.05 090 30420 .......... ............ R Reconstruction of nose ............................... 15.89 NA 17.44 1.46 NA 34.80 090 30430 .......... ............ R Revision of nose .......................................... 7.21 NA 15.31 0.77 NA 23.30 090 30435 .......... ............ R Revision of nose .......................................... 11.71 NA 18.43 1.22 NA 31.36 090 30450 .......... ............ R Revision of nose .......................................... 18.66 NA 21.03 1.96 NA 41.65 090 30460 .......... ............ A Revision of nose .......................................... 9.97 NA 9.57 1.03 NA 20.57 090 30462 .......... ............ A Revision of nose .......................................... 19.58 NA 19.21 2.53 NA 41.32 090 30465 .......... ............ A Repair nasal stenosis .................................. 11.64 NA 11.57 1.06 NA 24.28 090 30520 .......... ............ A Repair of nasal septum ............................... 5.70 NA 6.65 0.46 NA 12.81 090 30540 .......... ............ A Repair nasal defect ..................................... 7.76 NA 9.00 0.67 NA 17.43 090 30545 .......... ............ A Repair nasal defect ..................................... 11.38 NA 11.78 1.70 NA 24.86 090 30560 .......... ............ A Release of nasal adhesions ........................ 1.26 4.73 2.09 0.10 6.09 3.45 010 30580 .......... ............ A Repair upper jaw fistula .............................. 6.69 7.88 5.69 0.89 15.46 13.27 090 30600 .......... ............ A Repair mouth/nose fistula ........................... 6.02 7.54 4.90 0.70 14.26 11.63 090
30620 .......... ............ A Intranasal reconstruction ............................. 5.97 NA 8.69 0.57 NA 15.23 090 30630 .......... ............ A Repair nasal septum defect ........................ 7.12 NA 7.85 0.61 NA 15.58 090 30801 .......... ............ A Cauterization, inner nose ............................ 1.09 4.06 1.92 0.09 5.25 3.10 010 30802 .......... ............ A Cauterization, inner nose ............................ 2.03 4.58 2.36 0.16 6.78 4.56 010 30901 .......... ............ A Control of nosebleed ................................... 1.21 1.34 0.31 0.11 2.67 1.63 000 30903 .......... ............ A Control of nosebleed ................................... 1.54 2.74 0.48 0.13 4.42 2.16 000 30905 .......... ............ A Control of nosebleed ................................... 1.97 3.51 0.73 0.17 5.65 2.88 000 30906 .......... ............ A Repeat control of nosebleed ....................... 2.45 3.89 1.15 0.20 6.55 3.81 000 30915 .......... ............ A Ligation, nasal sinus artery ......................... 7.20 NA 6.62 0.58 NA 14.40 090 30920 .......... ............ A Ligation, upper jaw artery ............................ 9.84 NA 8.89 0.80 NA 19.52 090 30930 .......... ............ A Therapy, fracture of nose ............................ 1.26 NA 1.61 0.12 NA 2.99 010 30999 .......... ............ C Nasal surgery procedure ............................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY 31000 .......... ............ A Irrigation, maxillary sinus ............................. 1.15 2.85 1.38 0.09 4.09 2.63 010 31002 .......... ............ A Irrigation, sphenoid sinus ............................ 1.91 NA 3.13 0.15 NA 5.19 010 31020 .......... ............ A Exploration, maxillary sinus ......................... 2.95 8.41 5.16 0.29 11.65 8.40 090 31030 .......... ............ A Exploration, maxillary sinus ......................... 5.92 11.21 6.59 0.60 17.73 13.11 090 31032 .......... ............ A Explore sinus, remove polyps ..................... 6.57 NA 7.16 0.59 NA 14.32 090 31040 .......... ............ A Exploration behind upper jaw ...................... 9.43 NA 9.43 0.87 NA 19.73 090 31050 .......... ............ A Exploration, sphenoid sinus ........................ 5.28 NA 6.29 0.49 NA 12.06 090 31051 .......... ............ A Sphenoid sinus surgery ............................... 7.11 NA 8.19 0.62 NA 15.92 090 31070 .......... ............ A Exploration of frontal sinus .......................... 4.28 NA 5.90 0.38 NA 10.56 090 31075 .......... ............ A Exploration of frontal sinus .......................... 9.17 NA 9.59 0.75 NA 19.51 090 31080 .......... ............ A Removal of frontal sinus ............................. 11.42 NA 13.18 1.23 NA 25.83 090


## 45906

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

31081 .......... ............ A Removal of frontal sinus ............................. 12.76 NA 13.68 2.46 NA 28.90 090 31084 .......... ............ A Removal of frontal sinus ............................. 13.52 NA 13.27 1.19 NA 27.98 090 31085 .......... ............ A Removal of frontal sinus ............................. 14.21 NA 13.72 1.72 NA 29.65 090 31086 .......... ............ A Removal of frontal sinus ............................. 12.87 NA 13.07 1.07 NA 27.00 090 31087 .......... ............ A Removal of frontal sinus ............................. 13.11 NA 12.29 1.44 NA 26.83 090 31090 .......... ............ A Exploration of sinuses ................................. 9.54 NA 12.48 0.94 NA 22.96 090 31200 .......... ............ A Removal of ethmoid sinus ........................... 4.97 NA 8.87 0.29 NA 14.13 090 31201 .......... ............ A Removal of ethmoid sinus ........................... 8.38 NA 9.09 0.82 NA 18.28 090 31205 .......... ............ A Removal of ethmoid sinus ........................... 10.24 NA 11.45 0.67 NA 22.36 090 31225 .......... ............ A Removal of upper jaw ................................. 19.24 NA 17.49 1.59 NA 38.32 090 31230 .......... ............ A Removal of upper jaw ................................. 21.95 NA 18.89 1.77 NA 42.62 090 31231 .......... ............ A Nasal endoscopy, dx ................................... 1.10 3.34 0.86 0.09 4.54 2.05 000 31233 .......... ............ A Nasal/sinus endoscopy, dx ......................... 2.18 4.23 1.44 0.20 6.62 3.82 000 31235 .......... ............ A Nasal/sinus endoscopy, dx ......................... 2.65 4.82 1.67 0.26 7.72 4.57 000 31237 .......... ............ A Nasal/sinus endoscopy, surg ...................... 2.99 5.08 1.82 0.28 8.35 5.09 000 31238 .......... ............ A Nasal/sinus endoscopy, surg ...................... 3.27 5.11 2.02 0.27 8.65 5.56 000 31239 .......... ............ A Nasal/sinus endoscopy, surg ...................... 8.71 NA 7.73 0.62 NA 17.05 010 31240 .......... ............ A Nasal/sinus endoscopy, surg ...................... 2.62 NA 1.68 0.24 NA 4.53 000 31254 .......... ............ A Revision of ethmoid sinus ........................... 4.65 NA 2.75 0.45 NA 7.85 000 31255 .......... ............ A Removal of ethmoid sinus ........................... 6.96 NA 3.96 0.73 NA 11.65 000 31256 .......... ............ A Exploration maxillary sinus .......................... 3.30 NA 2.04 0.33 NA 5.67 000 31267 .......... ............ A Endoscopy, maxillary sinus ......................... 5.46 NA 3.17 0.55 NA 9.18 000 31276 .......... ............ A Sinus endoscopy, surgical .......................... 8.86 NA 4.93 0.92 NA 14.71 000 31287 .......... ............ A Nasal/sinus endoscopy, surg ...................... 3.92 NA 2.37 0.39 NA 6.68 000 31288 .......... ............ A Nasal/sinus endoscopy, surg ...................... 4.58 NA 2.71 0.46 NA 7.75 000 31290 .......... ............ A Nasal/sinus endoscopy, surg ...................... 17.24 NA 11.64 1.40 NA 30.29 010 31291 .......... ............ A Nasal/sinus endoscopy, surg ...................... 18.20 NA 12.08 1.68 NA 31.95 010 31292 .......... ............ A Nasal/sinus endoscopy, surg ...................... 14.77 NA 10.26 1.21 NA 26.24 010 31293 .......... ............ A Nasal/sinus endoscopy, surg ...................... 16.22 NA 11.00 1.28 NA 28.50 010 31294 .......... ............ A Nasal/sinus endoscopy, surg ...................... 19.07 NA 12.43 1.53 NA 33.03 010 31299 .......... ............ C Sinus surgery procedure ............................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY 31300 .......... ............ A Removal of larynx lesion ............................. 14.30 NA 14.71 1.17 NA 30.18 090 31320 .......... ............ A Diagnostic incision, larynx ........................... 5.26 NA 10.05 0.46 NA 15.77 090 31360 .......... ............ A Removal of larynx ....................................... 17.08 NA 16.42 1.38 NA 34.88 090 31365 .......... ............ A Removal of larynx ....................................... 24.17 NA 19.92 1.97 NA 46.06 090 31367 .......... ............ A Partial removal of larynx ............................. 21.87 NA 21.49 1.78 NA 45.14 090 31368 .......... ............ A Partial removal of larynx ............................. 27.10 NA 25.03 2.20 NA 54.33 090 31370 .......... ............ A Partial removal of larynx ............................. 21.39 NA 21.85 1.74 NA 44.98 090 31375 .......... ............ A Partial removal of larynx ............................. 20.22 NA 20.05 1.63 NA 41.90 090 31380 .......... ............ A Partial removal of larynx ............................. 20.22 NA 20.20 1.70 NA 42.12 090 31382 .......... ............ A Partial removal of larynx ............................. 20.53 NA 21.26 1.67 NA 43.46 090 31390 .......... ............ A Removal of larynx & pharynx ...................... 27.54 NA 23.90 2.23 NA 53.67 090 31395 .......... ............ A Reconstruct larynx & pharynx ..................... 31.10 NA 27.81 2.48 NA 61.39 090 31400 .......... ............ A Revision of larynx ........................................ 10.31 NA 13.38 0.83 NA 24.52 090 31420 .......... ............ A Removal of epiglottis ................................... 10.22 NA 9.33 0.83 NA 20.38 090 31500 .......... ............ A Insert emergency airway ............................. 2.33 NA 0.54 0.17 NA 3.04 000 31502 .......... ............ A Change of windpipe airway ......................... 0.65 NA 0.28 0.05 NA 0.98 000 31505 .......... ............ A Diagnostic laryngoscopy ............................. 0.61 1.43 0.60 0.05 2.09 1.26 000 31510 .......... ............ A Laryngoscopy with biopsy ........................... 1.92 3.23 1.22 0.16 5.31 3.30 000 31511 .......... ............ A Remove foreign body, larynx ...................... 2.16 3.06 1.03 0.19 5.41 3.38 000 31512 .......... ............ A Removal of larynx lesion ............................. 2.07 3.15 1.32 0.18 5.40 3.58 000 31513 .......... ............ A Injection into vocal cord .............................. 2.10 NA 1.42 0.17 NA 3.69 000 31515 .......... ............ A Laryngoscopy for aspiration ........................ 1.80 3.44 1.04 0.14 5.38 2.98 000 31520 .......... ............ A Diagnostic laryngoscopy ............................. 2.57 NA 1.52 0.20 NA 4.28 000 31525 .......... ............ A Diagnostic laryngoscopy ............................. 2.64 3.59 1.61 0.21 6.43 4.46 000 31526 .......... ............ A Diagnostic laryngoscopy ............................. 2.58 NA 1.67 0.21 NA 4.45 000 31527 .......... ............ A Laryngoscopy for treatment ........................ 3.28 NA 1.82 0.26 NA 5.36 000 31528 .......... ............ A Laryngoscopy and dilation .......................... 2.37 NA 1.43 0.19 NA 3.99 000 31529 .......... ............ A Laryngoscopy and dilation .......................... 2.69 NA 1.66 0.22 NA 4.56 000 31530 .......... ............ A Operative laryngoscopy ............................... 3.39 NA 1.89 0.29 NA 5.57 000 31531 .......... ............ A Operative laryngoscopy ............................... 3.59 NA 2.20 0.29 NA 6.07 000 31535 .......... ............ A Operative laryngoscopy ............................... 3.17 NA 1.93 0.26 NA 5.36 000 31536 .......... ............ A Operative laryngoscopy ............................... 3.56 NA 2.18 0.29 NA 6.02 000 31540 .......... ............ A Operative laryngoscopy ............................... 4.13 NA 2.45 0.33 NA 6.91 000 31541 .......... ............ A Operative laryngoscopy ............................... 4.53 NA 2.69 0.37 NA 7.58 000 31545 .......... ............ A Remove vc lesion w/scope ......................... 6.31 NA 3.38 0.37 NA 10.07 000 31546 .......... ............ A Remove vc lesion scope/graft ..................... 9.75 NA 4.88 0.78 NA 15.41 000 31560 .......... ............ A Operative laryngoscopy ............................... 5.46 NA 3.04 0.43 NA 8.93 000 31561 .......... ............ A Operative laryngoscopy ............................... 6.00 NA 3.25 0.49 NA 9.74 000 31570 .......... ............ A Laryngoscopy with injection ........................ 3.87 5.43 2.30 0.31 9.61 6.48 000 31571 .......... ............ A Laryngoscopy with injection ........................ 4.27 NA 2.51 0.35 NA 7.13 000 31575 .......... ............ A Diagnostic laryngoscopy ............................. 1.10 1.86 0.87 0.09 3.05 2.06 000 31576 .......... ............ A Laryngoscopy with biopsy ........................... 1.97 3.62 1.26 0.14 5.73 3.37 000 31577 .......... ............ A Remove foreign body, larynx ...................... 2.47 3.67 1.49 0.21 6.36 4.17 000


## 45907

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

31578 .......... ............ A Removal of larynx lesion ............................. 2.85 4.19 1.48 0.23 7.27 4.55 000 31579 .......... ............ A Diagnostic laryngoscopy ............................. 2.26 3.64 1.44 0.18 6.09 3.88 000 31580 .......... ............ A Revision of larynx ........................................ 12.38 NA 15.50 1.00 NA 28.89 090 31582 .......... ............ A Revision of larynx ........................................ 21.63 NA 25.01 1.75 NA 48.40 090 31584 .......... ............ A Treat larynx fracture .................................... 19.65 NA 17.74 1.71 NA 39.10 090 31585 .......... ............ A Treat larynx fracture .................................... 4.64 NA 6.55 0.38 NA 11.57 090 31586 .......... ............ A Treat larynx fracture .................................... 8.04 NA 10.59 0.67 NA 19.29 090 31587 .......... ............ A Revision of larynx ........................................ 11.99 NA 9.04 0.97 NA 22.00 090 31588 .......... ............ A Revision of larynx ........................................ 13.12 NA 13.31 1.06 NA 27.48 090 31590 .......... ............ A Reinnervate larynx ...................................... 6.97 NA 14.97 0.84 NA 22.79 090 31595 .......... ............ A Larynx nerve surgery .................................. 8.35 NA 10.28 0.68 NA 19.31 090 31599 .......... ............ C Larynx surgery procedure ........................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 31600 .......... ............ A Incision of windpipe ..................................... 7.18 NA 3.09 0.80 NA 11.08 000 31601 .......... ............ A Incision of windpipe ..................................... 4.45 NA 2.32 0.40 NA 7.17 000 31603 .......... ............ A Incision of windpipe ..................................... 4.15 NA 1.65 0.44 NA 6.24 000 31605 .......... ............ A Incision of windpipe ..................................... 3.58 NA 1.15 0.40 NA 5.13 000 31610 .......... ............ A Incision of windpipe ..................................... 8.77 NA 8.10 0.79 NA 17.66 090 31611 .......... ............ A Surgery/speech prosthesis .......................... 5.64 NA 6.98 0.46 NA 13.08 090 31612 .......... ............ A Puncture/clear windpipe .............................. 0.91 1.10 0.34 0.08 2.09 1.33 000 31613 .......... ............ A Repair windpipe opening ............................. 4.59 NA 5.91 0.42 NA 10.92 090 31614 .......... ............ A Repair windpipe opening ............................. 7.12 NA 8.67 0.58 NA 16.38 090 31615 .......... ............ A Visualization of windpipe ............................. 2.09 2.55 1.17 0.16 4.80 3.43 000
31620 .......... ............ A Endobronchial us add-on ............................ 1.40 5.59 0.54 0.11 7.10 2.05 ZZZ 31622 .......... ............ A Dx bronchoscope/wash ............................... 2.79 5.46 1.04 0.18 8.42 4.00 000 31623 .......... ............ A Dx bronchoscope/brush .............................. 2.89 6.17 1.03 0.13 9.19 4.05 000 31624 .......... ............ A Dx bronchoscope/lavage ............................. 2.89 5.56 1.03 0.13 8.57 4.05 000 31625 .......... ............ A Bronchoscopy w/biopsy(s) .......................... 3.37 5.61 1.18 0.18 9.16 4.73 000 31628 .......... ............ A Bronchoscopy/lung bx, each ....................... 3.81 6.81 1.28 0.18 10.80 5.26 000 31629 .......... ............ A Bronchoscopy/needle bx, each ................... 4.10 13.48 1.37 0.16 17.74 5.63 000 31630 .......... ............ A Bronchoscopy dilate/fx repr ......................... 3.82 NA 1.66 0.32 NA 5.80 000 31631 .......... ............ A Bronchoscopy, dilate w/stent ...................... 4.37 NA 1.72 0.34 NA 6.43 000 31632 .......... ............ A Bronchoscopy/lung bx, add ’ l ....................... 1.03 0.80 0.30 0.18 2.01 1.52 ZZZ 31633 .......... ............ A Bronchoscopy/needle bx add ’ l .................... 1.32 0.91 0.39 0.16 2.39 1.87 ZZZ 31635 .......... ............ A Bronchoscopy w/fb removal ........................ 3.68 5.90 1.39 0.24 9.81 5.31 000 31636 .......... ............ A Bronchoscopy, bronch stents ...................... 4.31 NA 1.72 0.31 NA 6.34 000 31637 .......... ............ A Bronchoscopy, stent add-on ....................... 1.58 NA 0.55 0.13 NA 2.26 ZZZ 31638 .......... ............ A Bronchoscopy, revise stent ......................... 4.89 NA 1.92 0.22 NA 7.03 000 31640 .......... ............ A Bronchoscopy w/tumor excise .................... 4.94 NA 2.01 0.46 NA 7.41 000 31641 .......... ............ A Bronchoscopy, treat blockage ..................... 5.03 NA 1.83 0.35 NA 7.21 000 31643 .......... ............ A Diag bronchoscope/catheter ....................... 3.50 NA 1.20 0.20 NA 4.90 000 31645 .......... ............ A Bronchoscopy, clear airways ...................... 3.17 4.95 1.10 0.16 8.28 4.43 000 31646 .......... ............ A Bronchoscopy, reclear airway ..................... 2.73 4.68 0.98 0.14 7.54 3.85 000 31656 .......... ............ A Bronchoscopy, inj for x-ray ......................... 2.17 6.94 0.83 0.15 9.27 3.16 000 31700 .......... ............ A Insertion of airway catheter ......................... 1.34 2.16 0.67 0.08 3.58 2.10 000 31708 .......... ............ A Instill airway contrast dye ............................ 1.41 NA 0.48 0.07 NA 1.97 000 31710 .......... ............ A Insertion of airway catheter ......................... 1.30 NA 0.42 0.12 NA 1.84 000 31715 .......... ............ A Injection for bronchus x-ray ......................... 1.11 NA 0.34 0.07 NA 1.53 000 31717 .......... ............ A Bronchial brush biopsy ................................ 2.12 7.76 0.78 0.14 10.02 3.05 000 31720 .......... ............ A Clearance of airways ................................... 1.06 NA 0.32 0.07 NA 1.46 000 31725 .......... ............ A Clearance of airways ................................... 1.96 NA 0.57 0.14 NA 2.67 000 31730 .......... ............ A Intro, windpipe wire/tube ............................. 2.86 7.21 0.97 0.21 10.27 4.03 000 31750 .......... ............ A Repair of windpipe ...................................... 13.03 NA 17.23 1.05 NA 31.30 090 31755 .......... ............ A Repair of windpipe ...................................... 15.94 NA 24.11 1.29 NA 41.34 090 31760 .......... ............ A Repair of windpipe ...................................... 22.36 NA 10.59 2.94 NA 35.89 090 31766 .......... ............ A Reconstruction of windpipe ......................... 30.44 NA 13.49 4.52 NA 48.45 090 31770 .......... ............ A Repair/graft of bronchus .............................. 22.52 NA 10.00 2.83 NA 35.35 090
31775 .......... ............ A Reconstruct bronchus ................................. 23.55 NA 11.47 3.01 NA 38.02 090 31780 .......... ............ A Reconstruct windpipe .................................. 17.73 NA 10.66 1.65 NA 30.03 090 31781 .......... ............ A Reconstruct windpipe .................................. 23.54 NA 11.70 2.24 NA 37.48 090 31785 .......... ............ A Remove windpipe lesion ............................. 17.23 NA 9.85 1.59 NA 28.67 090 31786 .......... ............ A Remove windpipe lesion ............................. 23.99 NA 12.72 3.29 NA 40.00 090 31800 .......... ............ A Repair of windpipe injury ............................. 7.43 NA 8.95 0.79 NA 17.17 090 31805 .......... ............ A Repair of windpipe injury ............................. 13.14 NA 7.04 1.82 NA 22.00 090 31820 .......... ............ A Closure of windpipe lesion .......................... 4.49 5.62 3.57 0.38 10.49 8.44 090 31825 .......... ............ A Repair of windpipe defect ........................... 6.81 7.56 5.24 0.53 14.90 12.58 090 31830 .......... ............ A Revise windpipe scar .................................. 4.50 5.72 3.90 0.44 10.66 8.83 090 31899 .......... ............ C Airways surgical procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 32000 .......... ............ A Drainage of chest ........................................ 1.54 2.92 0.48 0.08 4.54 2.10 000 32002 .......... ............ A Treatment of collapsed lung ........................ 2.19 3.14 1.08 0.12 5.45 3.39 000 32005 .......... ............ A Treat lung lining chemically ......................... 2.19 6.09 0.68 0.23 8.51 3.11 000 32019 .......... ............ A Insert pleural catheter ................................. 4.18 18.66 1.62 0.42 23.26 6.22 000 32020 .......... ............ A Insertion of chest tube ................................. 3.98 NA 1.32 0.43 NA 5.73 000 32035 .......... ............ A Exploration of chest ..................................... 8.68 NA 5.73 1.26 NA 15.67 090 32036 .......... ............ A Exploration of chest ..................................... 9.69 NA 6.26 1.43 NA 17.38 090


## 45908

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

32095 .......... ............ A Biopsy through chest wall ........................... 8.37 NA 5.25 1.22 NA 14.83 090 32100 .......... ............ A Exploration/biopsy of chest ......................... 15.25 NA 7.65 2.23 NA 25.13 090 32110 .......... ............ A Explore/repair chest .................................... 23.02 NA 10.50 3.21 NA 36.72 090 32120 .......... ............ A Re-exploration of chest ............................... 11.54 NA 6.89 1.63 NA 20.06 090 32124 .......... ............ A Explore chest free adhesions ...................... 12.73 NA 7.08 1.89 NA 21.69 090 32140 .......... ............ A Removal of lung lesion(s) ........................... 13.94 NA 7.53 1.96 NA 23.43 090 32141 .......... ............ A Remove/treat lung lesions ........................... 14.01 NA 7.39 2.00 NA 23.40 090 32150 .......... ............ A Removal of lung lesion(s) ........................... 14.16 NA 7.47 2.00 NA 23.63 090 32151 .......... ............ A Remove lung foreign body .......................... 14.22 NA 7.93 2.03 NA 24.18 090 32160 .......... ............ A Open chest heart massage ......................... 9.31 NA 5.19 1.31 NA 15.81 090 32200 .......... ............ A Drain, open, lung lesion .............................. 15.30 NA 8.72 2.13 NA 26.16 090 32201 .......... ............ A Drain, percut, lung lesion ............................ 4.00 21.42 1.37 0.24 25.66 5.60 000 32215 .......... ............ A Treat chest lining ......................................... 11.33 NA 6.72 1.68 NA 19.73 090 32220 .......... ............ A Release of lung ........................................... 24.01 NA 12.63 3.56 NA 40.20 090 32225 .......... ............ A Partial release of lung ................................. 13.97 NA 7.49 2.06 NA 23.52 090 32310 .......... ............ A Removal of chest lining ............................... 13.45 NA 7.24 1.99 NA 22.67 090 32320 .......... ............ A Free/remove chest lining ............................. 24.01 NA 11.91 3.51 NA 39.42 090 32400 .......... ............ A Needle biopsy chest lining .......................... 1.76 2.16 0.56 0.10 4.03 2.42 000 32402 .......... ............ A Open biopsy chest lining ............................. 7.57 NA 4.98 1.07 NA 13.62 090 32405 .......... ............ A Biopsy, lung or mediastinum ....................... 1.93 0.69 0.66 0.11 2.74 2.71 000 32420 .......... ............ A Puncture/clear lung ..................................... 2.18 NA 0.69 0.12 NA 2.99 000 32440 .......... ............ A Removal of lung .......................................... 25.01 NA 12.36 3.68 NA 41.05 090 32442 .......... ............ A Sleeve pneumonectomy .............................. 26.25 NA 14.11 3.84 NA 44.21 090 32445 .......... ............ A Removal of lung .......................................... 25.10 NA 13.42 3.71 NA 42.23 090 32480 .......... ............ A Partial removal of lung ................................ 23.76 NA 11.57 3.49 NA 38.82 090 32482 .......... ............ A Bilobectomy ................................................. 25.01 NA 12.42 3.66 NA 41.09 090 32484 .......... ............ A Segmentectomy ........................................... 20.70 NA 10.89 3.03 NA 34.62 090 32486 .......... ............ A Sleeve lobectomy ........................................ 23.93 NA 12.60 3.51 NA 40.04 090 32488 .......... ............ A Completion pneumonectomy ....................... 25.72 NA 13.17 3.80 NA 42.69 090 32491 .......... ............ R Lung volume reduction ................................ 21.26 NA 11.97 2.98 NA 36.21 090 32500 .......... ............ A Partial removal of lung ................................ 22.01 NA 11.78 3.25 NA 37.04 090 32501 .......... ............ A Repair bronchus add-on .............................. 4.69 NA 1.51 0.65 NA 6.85 ZZZ 32520 .......... ............ A Remove lung & revise chest ....................... 21.69 NA 10.81 3.20 NA 35.70 090 32522 .......... ............ A Remove lung & revise chest ....................... 24.21 NA 11.65 3.32 NA 39.18 090 32525 .......... ............ A Remove lung & revise chest ....................... 26.51 NA 12.30 3.87 NA 42.68 090 32540 .......... ............ A Removal of lung lesion ................................ 14.65 NA 9.15 2.07 NA 25.87 090 32601 .......... ............ A Thoracoscopy, diagnostic ............................ 5.46 NA 2.30 0.80 NA 8.57 000 32602 .......... ............ A Thoracoscopy, diagnostic ............................ 5.96 NA 2.47 0.87 NA 9.30 000 32603 .......... ............ A Thoracoscopy, diagnostic ............................ 7.82 NA 2.97 1.14 NA 11.92 000 32604 .......... ............ A Thoracoscopy, diagnostic ............................ 8.79 NA 3.39 1.25 NA 13.43 000 32605 .......... ............ A Thoracoscopy, diagnostic ............................ 6.93 NA 2.84 1.00 NA 10.78 000 32606 .......... ............ A Thoracoscopy, diagnostic ............................ 8.41 NA 3.27 1.22 NA 12.89 000 32650 .......... ............ A Thoracoscopy, surgical ............................... 10.75 NA 6.45 1.58 NA 18.78 090 32651 .......... ............ A Thoracoscopy, surgical ............................... 12.92 NA 6.95 1.86 NA 21.73 090 32652 .......... ............ A Thoracoscopy, surgical ............................... 18.67 NA 9.69 2.72 NA 31.08 090 32653 .......... ............ A Thoracoscopy, surgical ............................... 12.88 NA 6.67 1.88 NA 21.42 090 32654 .......... ............ A Thoracoscopy, surgical ............................... 12.44 NA 7.15 1.63 NA 21.22 090 32655 .......... ............ A Thoracoscopy, surgical ............................... 13.11 NA 6.96 1.89 NA 21.96 090 32656 .......... ............ A Thoracoscopy, surgical ............................... 12.92 NA 7.54 1.89 NA 22.34 090 32657 .......... ............ A Thoracoscopy, surgical ............................... 13.66 NA 7.35 1.99 NA 22.99 090 32658 .......... ............ A Thoracoscopy, surgical ............................... 11.63 NA 6.95 1.69 NA 20.27 090 32659 .......... ............ A Thoracoscopy, surgical ............................... 11.59 NA 7.08 1.62 NA 20.29 090 32660 .......... ............ A Thoracoscopy, surgical ............................... 17.43 NA 8.99 2.08 NA 28.50 090 32661 .......... ............ A Thoracoscopy, surgical ............................... 13.26 NA 7.43 1.92 NA 22.61 090 32662 .......... ............ A Thoracoscopy, surgical ............................... 16.45 NA 8.45 2.17 NA 27.07 090 32663 .......... ............ A Thoracoscopy, surgical ............................... 18.48 NA 10.24 2.72 NA 31.44 090 32664 .......... ............ A Thoracoscopy, surgical ............................... 14.21 NA 7.35 2.32 NA 23.88 090 32665 .......... ............ A Thoracoscopy, surgical ............................... 15.55 NA 7.88 2.15 NA 25.58 090 32800 .......... ............ A Repair lung hernia ....................................... 13.70 NA 7.28 1.98 NA 22.96 090 32810 .......... ............ A Close chest after drainage .......................... 13.06 NA 7.37 1.93 NA 22.36 090 32815 .......... ............ A Close bronchial fistula ................................. 23.17 NA 10.69 3.27 NA 37.12 090 32820 .......... ............ A Reconstruct injured chest ............................ 21.49 NA 11.99 2.52 NA 36.00 090 32851 .......... ............ A Lung transplant, single ................................ 38.65 NA 25.98 5.56 NA 70.19 090 32852 .......... ............ A Lung transplant with bypass ....................... 41.82 NA 30.94 6.00 NA 78.76 090 32853 .......... ............ A Lung transplant, double ............................... 47.84 NA 29.88 7.05 NA 84.77 090 32854 .......... ............ A Lung transplant with bypass ....................... 51.00 NA 32.72 7.20 NA 90.92 090 32855 .......... ............ C Prepare donor lung, single .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 32856 .......... ............ C Prepare donor lung, double ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 32900 .......... ............ A Removal of rib(s) ......................................... 20.28 NA 9.73 2.93 NA 32.94 090 32905 .......... ............ A Revise & repair chest wall .......................... 20.76 NA 9.90 3.15 NA 33.81 090 32906 .......... ............ A Revise & repair chest wall .......................... 26.78 NA 11.79 3.97 NA 42.54 090 32940 .......... ............ A Revision of lung ........................................... 19.44 NA 9.22 2.88 NA 31.54 090 32960 .......... ............ A Therapeutic pneumothorax ......................... 1.84 1.72 0.55 0.16 3.72 2.55 000 32997 .......... ............ A Total lung lavage ......................................... 6.00 NA 1.86 0.55 NA 8.41 000


## 45909

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

32999 .......... ............ C Chest surgery procedure ............................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY 33010 .......... ............ A Drainage of heart sac .................................. 2.24 NA 0.80 0.14 NA 3.19 000 33011 .......... ............ A Repeat drainage of heart sac ..................... 2.24 NA 0.84 0.15 NA 3.23 000 33015 .......... ............ A Incision of heart sac .................................... 6.80 NA 4.87 0.65 NA 12.33 090 33020 .......... ............ A Incision of heart sac .................................... 12.62 NA 6.63 1.79 NA 21.03 090 33025 .......... ............ A Incision of heart sac .................................... 12.09 NA 6.19 1.80 NA 20.09 090 33030 .......... ............ A Partial removal of heart sac ........................ 18.72 NA 9.25 2.83 NA 30.80 090 33031 .......... ............ A Partial removal of heart sac ........................ 21.80 NA 9.77 3.13 NA 34.71 090 33050 .......... ............ A Removal of heart sac lesion ....................... 14.37 NA 7.68 2.14 NA 24.18 090 33120 .......... ............ A Removal of heart lesion .............................. 24.57 NA 11.29 3.69 NA 39.54 090 33130 .......... ............ A Removal of heart lesion .............................. 21.40 NA 9.93 3.00 NA 34.34 090 33140 .......... ............ A Heart revascularize (tmr) ............................. 20.01 NA 10.59 2.85 NA 33.45 090 33141 .......... ............ A Heart tmr w/other procedure ....................... 4.84 NA 1.55 0.69 NA 7.08 ZZZ 33200 .......... ............ A Insertion of heart pacemaker ...................... 12.48 NA 6.92 1.70 NA 21.11 090 33201 .......... ............ A Insertion of heart pacemaker ...................... 10.18 NA 6.49 1.36 NA 18.03 090 33206 .......... ............ A Insertion of heart pacemaker ...................... 6.67 NA 4.59 0.52 NA 11.79 090 33207 .......... ............ A Insertion of heart pacemaker ...................... 8.05 NA 4.83 0.59 NA 13.46 090 33208 .......... ............ A Insertion of heart pacemaker ...................... 8.14 NA 4.98 0.56 NA 13.67 090 33210 .......... ............ A Insertion of heart electrode ......................... 3.31 NA 1.30 0.18 NA 4.78 000 33211 .......... ............ A Insertion of heart electrode ......................... 3.40 NA 1.37 0.21 NA 4.97 000 33212 .......... ............ A Insertion of pulse generator ........................ 5.52 NA 3.44 0.43 NA 9.39 090 33213 .......... ............ A Insertion of pulse generator ........................ 6.37 NA 3.86 0.45 NA 10.68 090 33214 .......... ............ A Upgrade of pacemaker system ................... 7.76 NA 5.09 0.58 NA 13.43 090 33215 .......... ............ A Reposition pacing-defib lead ....................... 4.76 NA 3.38 0.37 NA 8.51 090 33216 .......... ............ A Insert lead pace-defib, one ......................... 5.78 NA 4.39 0.36 NA 10.54 090 33217 .......... ............ A Insert lead pace-defib, dual ......................... 5.75 NA 4.45 0.39 NA 10.59 090 33218 .......... ............ A Repair lead pace-defib, one ........................ 5.44 NA 4.46 0.37 NA 10.27 090 33220 .......... ............ A Repair lead pace-defib, dual ....................... 5.52 NA 4.46 0.37 NA 10.35 090 33222 .......... ............ A Revise pocket, pacemaker .......................... 4.96 NA 4.42 0.42 NA 9.80 090 33223 .......... ............ A Revise pocket, pacing-defib ........................ 6.46 NA 4.77 0.45 NA 11.68 090 33224 .......... ............ A Insert pacing lead & connect ...................... 9.06 NA 4.21 0.54 NA 13.80 000 33225 .......... ............ A L ventric pacing lead add-on ....................... 8.35 NA 3.40 0.45 NA 12.20 ZZZ 33226 .......... ............ A Reposition l ventric lead .............................. 8.70 NA 3.97 0.59 NA 13.25 000 33233 .......... ............ A Removal of pacemaker system ................... 3.30 NA 3.42 0.22 NA 6.94 090 33234 .......... ............ A Removal of pacemaker system ................... 7.83 NA 5.06 0.56 NA 13.45 090 33235 .......... ............ A Removal pacemaker electrode ................... 9.41 NA 7.06 0.73 NA 17.20 090 33236 .......... ............ A Remove electrode/thoracotomy .................. 12.61 NA 7.35 1.68 NA 21.64 090 33237 .......... ............ A Remove electrode/thoracotomy .................. 13.72 NA 7.78 1.59 NA 23.08 090 33238 .......... ............ A Remove electrode/thoracotomy .................. 15.23 NA 8.15 2.02 NA 25.40 090 33240 .......... ............ A Insert pulse generator ................................. 7.61 NA 4.72 0.41 NA 12.74 090 33241 .......... ............ A Remove pulse generator ............................. 3.25 NA 3.09 0.18 NA 6.52 090 33243 .......... ............ A Remove eltrd/thoracotomy .......................... 22.66 NA 11.36 2.09 NA 36.11 090 33244 .......... ............ A Remove eltrd, transven ............................... 13.77 NA 9.12 0.99 NA 23.88 090 33245 .......... ............ A Insert epic eltrd pace-defib .......................... 14.31 NA 8.05 2.01 NA 24.37 090 33246 .......... ............ A Insert epic eltrd/generator ........................... 20.72 NA 10.36 2.63 NA 33.71 090 33249 .......... ............ A Eltrd/insert pace-defib ................................. 14.24 NA 8.82 0.77 NA 23.83 090 33250 .......... ............ A Ablate heart dysrhythm focus ..................... 21.86 NA 11.92 3.18 NA 36.96 090 33251 .......... ............ A Ablate heart dysrhythm focus ..................... 24.89 NA 11.44 3.59 NA 39.92 090
33253 .......... ............ A Reconstruct atria ......................................... 31.07 NA 13.48 4.52 NA 49.08 090 33261 .......... ............ A Ablate heart dysrhythm focus ..................... 24.89 NA 11.47 3.45 NA 39.81 090 33282 .......... ............ A Implant pat-active ht record ........................ 4.17 NA 4.20 0.23 NA 8.60 090 33284 .......... ............ A Remove pat-active ht record ....................... 2.51 NA 3.56 0.14 NA 6.20 090 33300 .......... ............ A Repair of heart wound ................................. 17.93 NA 9.18 2.65 NA 29.76 090 33305 .......... ............ A Repair of heart wound ................................. 21.45 NA 10.32 3.12 NA 34.90 090 33310 .......... ............ A Exploratory heart surgery ............................ 18.52 NA 9.32 2.58 NA 30.42 090 33315 .......... ............ A Exploratory heart surgery ............................ 22.38 NA 10.57 3.27 NA 36.22 090 33320 .......... ............ A Repair major blood vessel(s) ...................... 16.79 NA 8.23 2.07 NA 27.09 090 33321 .......... ............ A Repair major vessel .................................... 20.21 NA 9.56 2.90 NA 32.67 090 33322 .......... ............ A Repair major blood vessel(s) ...................... 20.63 NA 10.16 2.85 NA 33.64 090 33330 .......... ............ A Insert major vessel graft .............................. 21.44 NA 10.06 2.81 NA 34.31 090 33332 .......... ............ A Insert major vessel graft .............................. 23.97 NA 10.31 3.02 NA 37.30 090 33335 .......... ............ A Insert major vessel graft .............................. 30.02 NA 12.98 4.27 NA 47.27 090 33400 .......... ............ A Repair of aortic valve .................................. 28.52 NA 14.97 4.10 NA 47.59 090 33401 .......... ............ A Valvuloplasty, open ..................................... 23.92 NA 13.45 3.56 NA 40.93 090 33403 .......... ............ A Valvuloplasty, w/cp bypass ......................... 24.90 NA 13.75 3.54 NA 42.19 090 33404 .......... ............ A Prepare heart-aorta conduit ........................ 28.56 NA 13.97 4.32 NA 46.84 090 33405 .......... ............ A Replacement of aortic valve ........................ 35.02 NA 17.44 5.31 NA 57.77 090 33406 .......... ............ A Replacement of aortic valve ........................ 37.51 NA 18.22 5.43 NA 61.16 090 33410 .......... ............ A Replacement of aortic valve ........................ 32.47 NA 15.85 4.68 NA 53.00 090 33411 .......... ............ A Replacement of aortic valve ........................ 36.27 NA 17.89 5.46 NA 59.63 090 33412 .......... ............ A Replacement of aortic valve ........................ 42.02 NA 19.54 6.37 NA 67.93 090 33413 .......... ............ A Replacement of aortic valve ........................ 43.52 NA 19.98 6.51 NA 70.00 090 33414 .......... ............ A Repair of aortic valve .................................. 30.36 NA 13.80 4.56 NA 48.72 090 33415 .......... ............ A Revision, subvalvular tissue ........................ 27.16 NA 11.72 4.13 NA 43.02 090


## 45910

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

33416 .......... ............ A Revise ventricle muscle .............................. 30.36 NA 13.13 4.56 NA 48.05 090 33417 .......... ............ A Repair of aortic valve .................................. 28.55 NA 13.26 4.09 NA 45.90 090 33420 .......... ............ A Revision of mitral valve ............................... 22.72 NA 9.43 1.81 NA 33.95 090 33422 .......... ............ A Revision of mitral valve ............................... 25.95 NA 12.99 3.93 NA 42.87 090 33425 .......... ............ A Repair of mitral valve .................................. 27.01 NA 12.48 4.06 NA 43.56 090 33426 .......... ............ A Repair of mitral valve .................................. 33.02 NA 16.35 5.01 NA 54.37 090 33427 .......... ............ A Repair of mitral valve .................................. 40.02 NA 18.50 6.07 NA 64.59 090 33430 .......... ............ A Replacement of mitral valve ........................ 33.52 NA 16.51 5.08 NA 55.10 090 33460 .......... ............ A Revision of tricuspid valve .......................... 23.61 NA 10.97 3.44 NA 38.02 090 33463 .......... ............ A Valvuloplasty, tricuspid ................................ 25.63 NA 12.58 3.86 NA 42.07 090 33464 .......... ............ A Valvuloplasty, tricuspid ................................ 27.34 NA 13.16 4.14 NA 44.65 090 33465 .......... ............ A Replace tricuspid valve ............................... 28.81 NA 12.64 4.38 NA 45.82 090 33468 .......... ............ A Revision of tricuspid valve .......................... 30.13 NA 13.24 4.06 NA 47.43 090 33470 .......... ............ A Revision of pulmonary valve ....................... 20.82 NA 10.71 1.03 NA 32.56 090 33471 .......... ............ A Valvotomy, pulmonary valve ....................... 22.26 NA 9.77 3.38 NA 35.41 090 33472 .......... ............ A Revision of pulmonary valve ....................... 22.26 NA 11.93 3.54 NA 37.73 090 33474 .......... ............ A Revision of pulmonary valve ....................... 23.06 NA 10.74 3.21 NA 37.00 090 33475 .......... ............ A Replacement, pulmonary valve ................... 33.02 NA 15.10 4.92 NA 53.04 090 33476 .......... ............ A Revision of heart chamber .......................... 25.78 NA 12.17 2.41 NA 40.36 090 33478 .......... ............ A Revision of heart chamber .......................... 26.75 NA 12.66 3.88 NA 43.29 090 33496 .......... ............ A Repair, prosth valve clot ............................. 27.26 NA 12.45 4.12 NA 43.83 090 33500 .......... ............ A Repair heart vessel fistula ........................... 25.56 NA 11.23 3.86 NA 40.65 090 33501 .......... ............ A Repair heart vessel fistula ........................... 17.79 NA 8.19 1.90 NA 27.87 090 33502 .......... ............ A Coronary artery correction .......................... 21.05 NA 10.82 2.99 NA 34.86 090 33503 .......... ............ A Coronary artery graft ................................... 21.79 NA 9.79 1.77 NA 33.36 090 33504 .......... ............ A Coronary artery graft ................................... 24.67 NA 11.64 3.35 NA 39.66 090 33505 .......... ............ A Repair artery w/tunnel ................................. 26.85 NA 12.68 2.18 NA 41.72 090 33506 .......... ............ A Repair artery, translocation ......................... 35.52 NA 14.19 4.65 NA 54.36 090 33508 .......... ............ A Endoscopic vein harvest ............................. 0.31 NA 0.10 0.04 NA 0.45 ZZZ 33510 .......... ............ A CABG, vein, single ...................................... 29.02 NA 15.53 4.40 NA 48.95 090 33511 .......... ............ A CABG, vein, two .......................................... 30.02 NA 16.23 4.55 NA 50.80 090 33512 .......... ............ A CABG, vein, three ....................................... 31.81 NA 16.76 4.66 NA 53.24 090 33513 .......... ............ A CABG, vein, four ......................................... 32.01 NA 16.93 4.87 NA 53.81 090 33514 .......... ............ A CABG, vein, five .......................................... 32.77 NA 17.19 4.76 NA 54.72 090 33516 .......... ............ A Cabg, vein, six or more ............................... 35.02 NA 17.95 5.11 NA 58.08 090 33517 .......... ............ A CABG, artery-vein, single ............................ 2.58 NA 0.82 0.39 NA 3.79 ZZZ 33518 .......... ............ A CABG, artery-vein, two ............................... 4.85 NA 1.55 0.73 NA 7.13 ZZZ 33519 .......... ............ A CABG, artery-vein, three ............................. 7.12 NA 2.28 1.04 NA 10.44 ZZZ 33521 .......... ............ A CABG, artery-vein, four ............................... 9.41 NA 3.01 1.37 NA 13.79 ZZZ 33522 .......... ............ A CABG, artery-vein, five ............................... 11.67 NA 3.74 1.77 NA 17.18 ZZZ 33523 .......... ............ A Cabg, art-vein, six or more ......................... 13.96 NA 4.44 2.12 NA 20.52 ZZZ 33530 .......... ............ A Coronary artery, bypass/reop ...................... 5.86 NA 1.87 0.88 NA 8.61 ZZZ 33533 .......... ............ A CABG, arterial, single .................................. 30.02 NA 15.67 4.55 NA 50.24 090 33534 .......... ............ A CABG, arterial, two ..................................... 32.21 NA 16.85 4.69 NA 53.75 090 33535 .......... ............ A CABG, arterial, three ................................... 34.52 NA 17.30 5.01 NA 56.83 090 33536 .......... ............ A Cabg, arterial, four or more ......................... 37.51 NA 17.58 5.42 NA 60.52 090 33542 .......... ............ A Removal of heart lesion .............................. 28.87 NA 12.67 4.37 NA 45.91 090 33545 .......... ............ A Repair of heart damage .............................. 36.79 NA 15.37 5.19 NA 57.35 090 33572 .......... ............ A Open coronary endarterectomy .................. 4.45 NA 1.42 0.65 NA 6.52 ZZZ 33600 .......... ............ A Closure of valve .......................................... 29.53 NA 12.38 4.41 NA 46.32 090 33602 .......... ............ A Closure of valve .......................................... 28.56 NA 12.52 3.81 NA 44.88 090 33606 .......... ............ A Anastomosis/artery-aorta ............................ 30.75 NA 13.32 4.40 NA 48.47 090 33608 .......... ............ A Repair anomaly w/conduit ........................... 31.10 NA 13.68 4.73 NA 49.51 090 33610 .......... ............ A Repair by enlargement ................................ 30.62 NA 13.44 4.55 NA 48.61 090 33611 .......... ............ A Repair double ventricle ............................... 34.02 NA 13.78 4.36 NA 52.16 090 33612 .......... ............ A Repair double ventricle ............................... 35.02 NA 14.82 5.28 NA 55.12 090 33615 .......... ............ A Repair, modified fontan ............................... 34.02 NA 12.93 4.31 NA 51.26 090 33617 .......... ............ A Repair single ventricle ................................. 37.01 NA 15.54 5.64 NA 58.19 090 33619 .......... ............ A Repair single ventricle ................................. 45.02 NA 20.23 6.44 NA 71.69 090 33641 .......... ............ A Repair heart septum defect ......................... 21.40 NA 9.33 3.22 NA 33.95 090 33645 .......... ............ A Revision of heart veins ................................ 24.83 NA 11.50 3.78 NA 40.11 090 33647 .......... ............ A Repair heart septum defects ....................... 28.75 NA 13.50 3.31 NA 45.56 090 33660 .......... ............ A Repair of heart defects ................................ 30.02 NA 13.24 4.48 NA 47.74 090 33665 .......... ............ A Repair of heart defects ................................ 28.62 NA 13.32 3.99 NA 45.93 090 33670 .......... ............ A Repair of heart chambers ........................... 35.02 NA 13.52 4.64 NA 53.18 090 33681 .......... ............ A Repair heart septum defect ......................... 30.62 NA 14.26 4.44 NA 49.32 090 33684 .......... ............ A Repair heart septum defect ......................... 29.67 NA 13.27 3.38 NA 46.32 090 33688 .......... ............ A Repair heart septum defect ......................... 30.63 NA 10.17 4.72 NA 45.52 090 33690 .......... ............ A Reinforce pulmonary artery ......................... 19.56 NA 9.86 1.96 NA 31.38 090 33692 .......... ............ A Repair of heart defects ................................ 30.76 NA 13.32 4.57 NA 48.66 090 33694 .......... ............ A Repair of heart defects ................................ 34.02 NA 13.87 5.26 NA 53.15 090 33697 .......... ............ A Repair of heart defects ................................ 36.02 NA 14.41 4.08 NA 54.51 090 33702 .......... ............ A Repair of heart defects ................................ 26.55 NA 12.26 3.67 NA 42.48 090 33710 .......... ............ A Repair of heart defects ................................ 29.73 NA 13.76 4.42 NA 47.91 090


## 45911

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

33720 .......... ............ A Repair of heart defect ................................. 26.57 NA 11.98 3.83 NA 42.38 090 33722 .......... ............ A Repair of heart defect ................................. 28.43 NA 13.09 1.30 NA 42.82 090 33730 .......... ............ A Repair heart-vein defect(s) .......................... 34.27 NA 14.33 5.01 NA 53.61 090 33732 .......... ............ A Repair heart-vein defect .............................. 28.18 NA 13.51 3.67 NA 45.36 090 33735 .......... ............ A Revision of heart chamber .......................... 21.40 NA 9.04 1.91 NA 32.35 090 33736 .......... ............ A Revision of heart chamber .......................... 23.53 NA 11.97 3.08 NA 38.57 090 33737 .......... ............ A Revision of heart chamber .......................... 21.77 NA 11.26 3.24 NA 36.27 090 33750 .......... ............ A Major vessel shunt ...................................... 21.42 NA 10.37 1.16 NA 32.95 090 33755 .......... ............ A Major vessel shunt ...................................... 21.80 NA 8.58 3.25 NA 33.64 090 33762 .......... ............ A Major vessel shunt ...................................... 21.80 NA 10.24 3.13 NA 35.18 090 33764 .......... ............ A Major vessel shunt & graft .......................... 21.80 NA 10.24 3.00 NA 35.04 090 33766 .......... ............ A Major vessel shunt ...................................... 22.78 NA 11.07 3.69 NA 37.53 090 33767 .......... ............ A Major vessel shunt ...................................... 24.51 NA 11.37 3.81 NA 39.69 090 33770 .......... ............ A Repair great vessels defect ........................ 37.01 NA 14.36 5.72 NA 57.09 090 33771 .......... ............ A Repair great vessels defect ........................ 34.67 NA 12.11 5.66 NA 52.44 090 33774 .......... ............ A Repair great vessels defect ........................ 30.99 NA 14.46 4.80 NA 50.25 090 33775 .......... ............ A Repair great vessels defect ........................ 32.21 NA 14.39 4.98 NA 51.58 090 33776 .......... ............ A Repair great vessels defect ........................ 34.06 NA 15.27 5.07 NA 54.40 090 33777 .......... ............ A Repair great vessels defect ........................ 33.48 NA 14.86 5.47 NA 53.81 090 33778 .......... ............ A Repair great vessels defect ........................ 40.02 NA 16.36 6.18 NA 62.56 090 33779 .......... ............ A Repair great vessels defect ........................ 36.23 NA 15.87 2.91 NA 55.01 090 33780 .......... ............ A Repair great vessels defect ........................ 41.77 NA 18.55 3.67 NA 64.00 090 33781 .......... ............ A Repair great vessels defect ........................ 36.47 NA 13.19 5.95 NA 55.61 090 33786 .......... ............ A Repair arterial trunk ..................................... 39.02 NA 15.99 5.69 NA 60.69 090 33788 .......... ............ A Revision of pulmonary artery ...................... 26.63 NA 11.48 4.02 NA 42.13 090 33800 .......... ............ A Aortic suspension ........................................ 16.25 NA 7.95 2.45 NA 26.65 090 33802 .......... ............ A Repair vessel defect .................................... 17.67 NA 9.00 2.26 NA 28.93 090 33803 .......... ............ A Repair vessel defect .................................... 19.61 NA 9.30 3.19 NA 32.10 090 33813 .......... ............ A Repair septal defect .................................... 20.66 NA 10.52 3.12 NA 34.30 090 33814 .......... ............ A Repair septal defect .................................... 25.78 NA 12.31 3.84 NA 41.93 090 33820 .......... ............ A Revise major vessel .................................... 16.30 NA 8.10 2.34 NA 26.74 090 33822 .......... ............ A Revise major vessel .................................... 17.32 NA 8.59 2.67 NA 28.59 090 33824 .......... ............ A Revise major vessel .................................... 19.53 NA 9.68 2.88 NA 32.09 090 33840 .......... ............ A Remove aorta constriction .......................... 20.64 NA 9.97 2.15 NA 32.76 090 33845 .......... ............ A Remove aorta constriction .......................... 22.13 NA 10.97 3.21 NA 36.31 090 33851 .......... ............ A Remove aorta constriction .......................... 21.28 NA 10.39 3.17 NA 34.84 090 33852 .......... ............ A Repair septal defect .................................... 23.72 NA 11.20 2.15 NA 37.07 090 33853 .......... ............ A Repair septal defect .................................... 31.73 NA 14.43 4.47 NA 50.63 090 33860 .......... ............ A Ascending aortic graft ................................. 38.02 NA 16.03 5.74 NA 59.79 090 33861 .......... ............ A Ascending aortic graft ................................. 42.02 NA 17.31 6.35 NA 65.68 090 33863 .......... ............ A Ascending aortic graft ................................. 45.02 NA 18.24 6.57 NA 69.83 090 33870 .......... ............ A Transverse aortic arch graft ........................ 44.02 NA 17.91 6.60 NA 68.53 090 33875 .......... ............ A Thoracic aortic graft .................................... 33.08 NA 13.78 4.88 NA 51.73 090 33877 .......... ............ A Thoracoabdominal graft .............................. 42.63 NA 16.01 5.92 NA 64.56 090 33910 .......... ............ A Remove lung artery emboli ......................... 24.60 NA 11.12 3.69 NA 39.41 090 33915 .......... ............ A Remove lung artery emboli ......................... 21.03 NA 9.71 1.44 NA 32.18 090 33916 .......... ............ A Surgery of great vessel ............................... 25.84 NA 11.10 3.66 NA 40.60 090 33917 .......... ............ A Repair pulmonary artery .............................. 24.51 NA 11.84 3.69 NA 40.04 090 33918 .......... ............ A Repair pulmonary atresia ............................ 26.46 NA 11.61 4.14 NA 42.21 090 33919 .......... ............ A Repair pulmonary atresia ............................ 40.02 NA 17.47 5.95 NA 63.44 090 33920 .......... ............ A Repair pulmonary atresia ............................ 31.96 NA 13.44 4.37 NA 49.77 090 33922 .......... ............ A Transect pulmonary artery .......................... 23.53 NA 10.87 3.09 NA 37.48 090 33924 .......... ............ A Remove pulmonary shunt ........................... 5.50 NA 1.79 0.82 NA 8.11 ZZZ 33933 .......... ............ C Prepare donor heart/lung ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 33935 .......... ............ R Transplantation, heart/lung .......................... 60.99 NA 27.47 9.03 NA 97.50 090 33944 .......... ............ C Prepare donor heart .................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 33945 .......... ............ R Transplantation of heart .............................. 42.12 NA 20.34 6.24 NA 68.70 090
33960 .......... ............ A External circulation assist ............................ 19.37 NA 4.83 2.66 NA 26.86 000
33961 .......... ............ A External circulation assist ............................ 10.93 NA 3.52 0.88 NA 15.33 ZZZ 33967 .......... ............ A Insert ia percut device ................................. 4.85 NA 1.91 0.35 NA 7.11 000
33968 .......... ............ A Remove aortic assist device ....................... 0.64 NA 0.23 0.07 NA 0.94 000
33970 .......... ............ A Aortic circulation assist ................................ 6.75 NA 2.27 0.82 NA 9.84 000
33971 .......... ............ A Aortic circulation assist ................................ 9.70 NA 6.06 1.25 NA 17.01 090
33973 .......... ............ A Insert balloon device ................................... 9.77 NA 3.29 1.26 NA 14.32 000
33974 .......... ............ A Remove intra-aortic balloon ........................ 14.42 NA 7.94 1.73 NA 24.09 090 33975 .......... ............ A Implant ventricular device ........................... 21.01 NA 6.15 3.06 NA 30.22 XXX 33976 .......... ............ A Implant ventricular device ........................... 23.02 NA 7.41 3.25 NA 33.68 XXX
33977 .......... ............ A Remove ventricular device .......................... 19.30 NA 10.77 2.80 NA 32.87 090
33978 .......... ............ A Remove ventricular device .......................... 21.74 NA 11.54 3.30 NA 36.58 090 33979 .......... ............ A Insert intracorporeal device ......................... 46.02 NA 14.63 6.95 NA 67.60 XXX 33980 .......... ............ A Remove intracorporeal device .................... 56.28 NA 24.71 8.56 NA 89.55 090 33999 .......... ............ C Cardiac surgery procedure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 34001 .......... ............ A Removal of artery clot ................................. 12.92 NA 6.54 1.84 NA 21.29 090 34051 .......... ............ A Removal of artery clot ................................. 15.22 NA 7.62 2.20 NA 25.04 090


## 45912

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

34101 .......... ............ A Removal of artery clot ................................. 10.01 NA 5.21 1.41 NA 16.63 090 34111 .......... ............ A Removal of arm artery clot .......................... 10.01 NA 5.24 1.40 NA 16.65 090 34151 .......... ............ A Removal of artery clot ................................. 25.01 NA 10.17 3.55 NA 38.73 090 34201 .......... ............ A Removal of artery clot ................................. 10.03 NA 5.25 1.45 NA 16.73 090 34203 .......... ............ A Removal of leg artery clot ........................... 16.51 NA 7.83 2.35 NA 26.70 090 34401 .......... ............ A Removal of vein clot .................................... 25.01 NA 10.75 3.09 NA 38.85 090 34421 .......... ............ A Removal of vein clot .................................... 12.00 NA 6.19 1.55 NA 19.75 090 34451 .......... ............ A Removal of vein clot .................................... 27.01 NA 11.17 3.83 NA 42.02 090 34471 .......... ............ A Removal of vein clot .................................... 10.18 NA 5.27 1.18 NA 16.63 090 34490 .......... ............ A Removal of vein clot .................................... 9.87 NA 5.32 1.41 NA 16.60 090 34501 .......... ............ A Repair valve, femoral vein .......................... 16.01 NA 8.30 2.34 NA 26.66 090
34502 .......... ............ A Reconstruct vena cava ................................ 26.96 NA 12.14 3.62 NA 42.72 090 34510 .......... ............ A Transposition of vein valve ......................... 18.96 NA 9.10 2.32 NA 30.37 090 34520 .......... ............ A Cross-over vein graft ................................... 17.96 NA 8.32 2.28 NA 28.56 090 34530 .......... ............ A Leg vein fusion ............................................ 16.65 NA 8.38 1.73 NA 26.77 090 34800 .......... ............ A Endovas aaa repr w/sm tube ...................... 20.76 NA 9.00 2.45 NA 32.21 090 34802 .......... ............ A Endovas aaa repr w/2-p part ...................... 23.02 NA 9.69 2.32 NA 35.03 090 34803 .......... ............ A Endovas aaa repr w/3-p part ...................... 24.05 NA 10.04 2.00 NA 36.08 090 34804 .......... ............ A Endovas aaa repr w/1-p part ...................... 23.02 NA 9.71 2.29 NA 35.02 090 34805 .......... ............ A Endovas aaa repr w/long tube .................... 21.89 NA 9.29 2.00 NA 33.18 090
34808 .......... ............ A Endovas iliac a device add-on .................... 4.13 NA 1.36 0.59 NA 6.08 ZZZ 34812 .......... ............ A Xpose for endoprosth, femorl ...................... 6.75 NA 2.18 1.18 NA 10.12 000 34813 .......... ............ A Femoral endovas graft add-on .................... 4.80 NA 1.54 0.67 NA 7.01 ZZZ 34820 .......... ............ A Xpose for endoprosth, iliac ......................... 9.76 NA 3.16 1.50 NA 14.42 000 34825 .......... ............ A Endovasc extend prosth, init ....................... 12.00 NA 6.06 1.28 NA 19.35 090 34826 .......... ............ A Endovasc exten prosth, add ’ l ...................... 4.13 NA 1.36 0.44 NA 5.93 ZZZ 34830 .......... ............ A Open aortic tube prosth repr ....................... 32.61 NA 13.30 4.54 NA 50.45 090 34831 .......... ............ A Open aortoiliac prosth repr ......................... 35.36 NA 11.49 4.88 NA 51.73 090 34832 .......... ............ A Open aortofemor prosth repr ...................... 35.36 NA 14.18 4.84 NA 54.38 090 34833 .......... ............ A Xpose for endoprosth, iliac ......................... 12.00 NA 4.44 1.69 NA 18.14 000 34834 .......... ............ A Xpose, endoprosth, brachial ....................... 5.35 NA 2.20 0.76 NA 8.31 000 34900 .......... ............ A Endovasc iliac repr w/graft .......................... 16.39 NA 7.46 1.99 NA 25.84 090 35001 .......... ............ A Repair defect of artery ................................ 19.65 NA 9.25 2.80 NA 31.70 090 35002 .......... ............ A Repair artery rupture, neck ......................... 21.01 NA 9.62 2.99 NA 33.62 090 35005 .......... ............ A Repair defect of artery ................................ 18.13 NA 8.98 1.76 NA 28.87 090 35011 .......... ............ A Repair defect of artery ................................ 18.01 NA 7.76 2.54 NA 28.31 090 35013 .......... ............ A Repair artery rupture, arm ........................... 22.01 NA 9.41 3.09 NA 34.52 090 35021 .......... ............ A Repair defect of artery ................................ 19.66 NA 9.21 2.86 NA 31.73 090 35022 .......... ............ A Repair artery rupture, chest ........................ 23.20 NA 9.69 3.16 NA 36.05 090 35045 .......... ............ A Repair defect of arm artery ......................... 17.58 NA 7.31 2.44 NA 27.33 090 35081 .......... ............ A Repair defect of artery ................................ 28.03 NA 11.15 4.00 NA 43.18 090 35082 .......... ............ A Repair artery rupture, aorta ......................... 38.52 NA 14.91 5.42 NA 58.85 090 35091 .......... ............ A Repair defect of artery ................................ 35.42 NA 13.20 5.12 NA 53.74 090 35092 .......... ............ A Repair artery rupture, aorta ......................... 45.02 NA 17.18 6.38 NA 68.58 090 35102 .......... ............ A Repair defect of artery ................................ 30.77 NA 12.04 4.47 NA 47.28 090 35103 .......... ............ A Repair artery rupture, groin ......................... 40.52 NA 15.45 5.74 NA 61.71 090 35111 .......... ............ A Repair defect of artery ................................ 25.01 NA 10.22 3.46 NA 38.69 090 35112 .......... ............ A Repair artery rupture,spleen ....................... 30.02 NA 11.74 4.07 NA 45.83 090 35121 .......... ............ A Repair defect of artery ................................ 30.02 NA 12.04 4.29 NA 46.35 090 35122 .......... ............ A Repair artery rupture, belly ......................... 35.02 NA 13.53 4.74 NA 53.29 090 35131 .......... ............ A Repair defect of artery ................................ 25.01 NA 10.45 3.79 NA 39.25 090 35132 .......... ............ A Repair artery rupture, groin ......................... 30.02 NA 12.07 4.29 NA 46.38 090 35141 .......... ............ A Repair defect of artery ................................ 20.01 NA 8.64 2.89 NA 31.54 090 35142 .......... ............ A Repair artery rupture, thigh ......................... 23.32 NA 10.07 3.35 NA 36.73 090 35151 .......... ............ A Repair defect of artery ................................ 22.66 NA 9.70 3.23 NA 35.59 090 35152 .......... ............ A Repair artery rupture, knee ......................... 25.63 NA 11.02 3.60 NA 40.25 090 35180 .......... ............ A Repair blood vessel lesion .......................... 13.63 NA 6.76 1.00 NA 21.39 090 35182 .......... ............ A Repair blood vessel lesion .......................... 30.02 NA 12.67 4.35 NA 47.04 090 35184 .......... ............ A Repair blood vessel lesion .......................... 18.01 NA 8.08 2.52 NA 28.60 090 35188 .......... ............ A Repair blood vessel lesion .......................... 14.29 NA 7.41 2.15 NA 23.85 090 35189 .......... ............ A Repair blood vessel lesion .......................... 28.02 NA 11.63 4.00 NA 43.65 090 35190 .......... ............ A Repair blood vessel lesion .......................... 12.76 NA 6.29 1.79 NA 20.83 090 35201 .......... ............ A Repair blood vessel lesion .......................... 16.15 NA 7.72 2.33 NA 26.20 090 35206 .......... ............ A Repair blood vessel lesion .......................... 13.26 NA 6.37 1.86 NA 21.48 090 35207 .......... ............ A Repair blood vessel lesion .......................... 10.15 NA 7.14 1.48 NA 18.77 090 35211 .......... ............ A Repair blood vessel lesion .......................... 22.13 NA 10.31 3.19 NA 35.63 090 35216 .......... ............ A Repair blood vessel lesion .......................... 18.76 NA 8.81 2.64 NA 30.21 090 35221 .......... ............ A Repair blood vessel lesion .......................... 24.40 NA 9.73 3.36 NA 37.49 090 35226 .......... ............ A Repair blood vessel lesion .......................... 14.51 NA 7.48 2.01 NA 24.00 090 35231 .......... ............ A Repair blood vessel lesion .......................... 20.01 NA 9.46 2.88 NA 32.35 090 35236 .......... ............ A Repair blood vessel lesion .......................... 17.11 NA 7.66 2.42 NA 27.19 090 35241 .......... ............ A Repair blood vessel lesion .......................... 23.14 NA 10.80 3.52 NA 37.46 090 35246 .......... ............ A Repair blood vessel lesion .......................... 26.46 NA 11.26 3.85 NA 41.58 090 35251 .......... ............ A Repair blood vessel lesion .......................... 30.21 NA 11.57 4.12 NA 45.90 090


## 45913

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

35256 .......... ............ A Repair blood vessel lesion .......................... 18.37 NA 8.09 2.62 NA 29.08 090 35261 .......... ............ A Repair blood vessel lesion .......................... 17.81 NA 7.90 2.60 NA 28.31 090 35266 .......... ............ A Repair blood vessel lesion .......................... 14.92 NA 6.83 2.09 NA 23.84 090 35271 .......... ............ A Repair blood vessel lesion .......................... 22.13 NA 10.20 3.15 NA 35.48 090 35276 .......... ............ A Repair blood vessel lesion .......................... 24.26 NA 10.98 3.48 NA 38.72 090 35281 .......... ............ A Repair blood vessel lesion .......................... 28.02 NA 11.44 3.96 NA 43.42 090 35286 .......... ............ A Repair blood vessel lesion .......................... 16.17 NA 7.82 2.34 NA 26.34 090 35301 .......... ............ A Rechanneling of artery ................................ 18.71 NA 8.19 2.67 NA 29.56 090 35311 .......... ............ A Rechanneling of artery ................................ 27.01 NA 11.26 3.41 NA 41.69 090 35321 .......... ............ A Rechanneling of artery ................................ 16.01 NA 7.16 2.24 NA 25.41 090 35331 .......... ............ A Rechanneling of artery ................................ 26.21 NA 10.90 3.82 NA 40.93 090 35341 .......... ............ A Rechanneling of artery ................................ 25.12 NA 10.55 3.77 NA 39.44 090 35351 .......... ............ A Rechanneling of artery ................................ 23.02 NA 9.34 3.34 NA 35.69 090 35355 .......... ............ A Rechanneling of artery ................................ 18.51 NA 7.87 2.66 NA 29.04 090 35361 .......... ............ A Rechanneling of artery ................................ 28.22 NA 11.40 4.14 NA 43.75 090 35363 .......... ............ A Rechanneling of artery ................................ 30.21 NA 12.24 4.32 NA 46.77 090 35371 .......... ............ A Rechanneling of artery ................................ 14.73 NA 6.75 2.13 NA 23.61 090 35372 .......... ............ A Rechanneling of artery ................................ 18.01 NA 7.81 2.62 NA 28.44 090 35381 .......... ............ A Rechanneling of artery ................................ 15.82 NA 7.58 2.25 NA 25.65 090 35390 .......... ............ A Reoperation, carotid add-on ........................ 3.20 NA 1.04 0.46 NA 4.69 ZZZ 35400 .......... ............ A Angioscopy .................................................. 3.01 NA 1.08 0.43 NA 4.52 ZZZ 35450 .......... ............ A Repair arterial blockage .............................. 10.07 NA 3.53 1.25 NA 14.85 000 35452 .......... ............ A Repair arterial blockage .............................. 6.91 NA 2.54 0.94 NA 10.40 000 35454 .......... ............ A Repair arterial blockage .............................. 6.04 NA 2.26 0.87 NA 9.17 000 35456 .......... ............ A Repair arterial blockage .............................. 7.35 NA 2.70 1.04 NA 11.10 000 35458 .......... ............ A Repair arterial blockage .............................. 9.50 NA 3.38 1.26 NA 14.14 000 35459 .......... ............ A Repair arterial blockage .............................. 8.64 NA 3.10 1.21 NA 12.95 000 35460 .......... ............ A Repair venous blockage .............................. 6.04 NA 2.22 0.83 NA 9.09 000 35470 .......... ............ A Repair arterial blockage .............................. 8.64 87.06 3.50 0.69 96.39 12.82 000 35471 .......... ............ A Repair arterial blockage .............................. 10.07 97.32 4.16 0.67 108.06 14.90 000 35472 .......... ............ A Repair arterial blockage .............................. 6.91 63.69 2.86 0.58 71.19 10.36 000 35473 .......... ............ A Repair arterial blockage .............................. 6.04 59.64 2.53 0.51 66.20 9.08 000 35474 .......... ............ A Repair arterial blockage .............................. 7.36 85.82 3.03 0.57 93.76 10.96 000 35475 .......... ............ R Repair arterial blockage .............................. 9.50 57.78 3.73 0.62 67.90 13.85 000 35476 .......... ............ A Repair venous blockage .............................. 6.04 45.66 2.47 0.34 52.04 8.85 000 35480 .......... ............ A Atherectomy, open ...................................... 11.08 NA 4.00 1.28 NA 16.36 000 35481 .......... ............ A Atherectomy, open ...................................... 7.62 NA 2.83 1.13 NA 11.58 000 35482 .......... ............ A Atherectomy, open ...................................... 6.65 NA 2.54 0.89 NA 10.08 000 35483 .......... ............ A Atherectomy, open ...................................... 8.11 NA 2.98 1.15 NA 12.24 000 35484 .......... ............ A Atherectomy, open ...................................... 10.44 NA 3.69 1.27 NA 15.40 000 35485 .......... ............ A Atherectomy, open ...................................... 9.50 NA 3.49 1.35 NA 14.34 000 35490 .......... ............ A Atherectomy, percutaneous ........................ 11.08 NA 4.92 0.71 NA 16.72 000 35491 .......... ............ A Atherectomy, percutaneous ........................ 7.62 NA 3.37 0.74 NA 11.72 000 35492 .......... ............ A Atherectomy, percutaneous ........................ 6.65 NA 3.29 0.43 NA 10.37 000 35493 .......... ............ A Atherectomy, percutaneous ........................ 8.11 NA 3.99 0.56 NA 12.66 000 35494 .......... ............ A Atherectomy, percutaneous ........................ 10.44 NA 4.70 0.59 NA 15.73 000 35495 .......... ............ A Atherectomy, percutaneous ........................ 9.50 NA 4.63 0.69 NA 14.82 000 35500 .......... ............ A Harvest vein for bypass .............................. 6.45 NA 1.97 0.93 NA 9.35 ZZZ 35501 .......... ............ A Artery bypass graft ...................................... 19.20 NA 8.16 2.80 NA 30.16 090 35506 .......... ............ A Artery bypass graft ...................................... 19.68 NA 9.16 2.86 NA 31.70 090 35507 .......... ............ A Artery bypass graft ...................................... 19.68 NA 9.10 2.84 NA 31.62 090 35508 .......... ............ A Artery bypass graft ...................................... 18.66 NA 9.26 2.77 NA 30.68 090 35509 .......... ............ A Artery bypass graft ...................................... 18.08 NA 8.46 2.61 NA 29.14 090 35510 .......... ............ A Artery bypass graft ...................................... 23.02 NA 10.15 2.11 NA 35.27 090 35511 .......... ............ A Artery bypass graft ...................................... 21.21 NA 9.12 2.90 NA 33.23 090 35512 .......... ............ A Artery bypass graft ...................................... 22.51 NA 9.96 2.11 NA 34.58 090 35515 .......... ............ A Artery bypass graft ...................................... 18.66 NA 9.19 2.77 NA 30.61 090 35516 .......... ............ A Artery bypass graft ...................................... 16.33 NA 6.58 2.33 NA 25.25 090 35518 .......... ............ A Artery bypass graft ...................................... 21.21 NA 8.73 3.02 NA 32.97 090 35521 .......... ............ A Artery bypass graft ...................................... 22.21 NA 9.54 3.12 NA 34.88 090 35522 .......... ............ A Artery bypass graft ...................................... 21.77 NA 9.61 2.11 NA 33.50 090 35525 .......... ............ A Artery bypass graft ...................................... 20.64 NA 9.13 2.11 NA 31.88 090 35526 .......... ............ A Artery bypass graft ...................................... 29.97 NA 12.27 3.62 NA 45.86 090 35531 .......... ............ A Artery bypass graft ...................................... 36.22 NA 14.08 5.16 NA 55.47 090 35533 .......... ............ A Artery bypass graft ...................................... 28.02 NA 11.43 3.84 NA 43.28 090 35536 .......... ............ A Artery bypass graft ...................................... 31.71 NA 12.60 4.61 NA 48.93 090 35541 .......... ............ A Artery bypass graft ...................................... 25.81 NA 10.90 3.70 NA 40.41 090 35546 .......... ............ A Artery bypass graft ...................................... 25.55 NA 10.58 3.69 NA 39.82 090 35548 .......... ............ A Artery bypass graft ...................................... 21.58 NA 9.19 2.97 NA 33.74 090 35549 .......... ............ A Artery bypass graft ...................................... 23.36 NA 10.07 3.29 NA 36.72 090 35551 .......... ............ A Artery bypass graft ...................................... 26.68 NA 11.14 3.74 NA 41.57 090 35556 .......... ............ A Artery bypass graft ...................................... 21.77 NA 9.44 3.09 NA 34.30 090 35558 .......... ............ A Artery bypass graft ...................................... 21.21 NA 9.28 2.99 NA 33.48 090 35560 .......... ............ A Artery bypass graft ...................................... 32.01 NA 12.93 4.74 NA 49.68 090


## 45914

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

35563 .......... ............ A Artery bypass graft ...................................... 24.21 NA 10.24 3.51 NA 37.95 090 35565 .......... ............ A Artery bypass graft ...................................... 23.22 NA 9.85 3.29 NA 36.36 090 35566 .......... ............ A Artery bypass graft ...................................... 26.93 NA 11.05 3.82 NA 41.81 090 35571 .......... ............ A Artery bypass graft ...................................... 24.07 NA 10.52 3.42 NA 38.01 090 35572 .......... ............ A Harvest femoropopliteal vein ....................... 6.82 NA 2.20 0.99 NA 10.02 ZZZ 35583 .......... ............ A Vein bypass graft ........................................ 22.38 NA 9.86 3.16 NA 35.41 090 35585 .......... ............ A Vein bypass graft ........................................ 28.41 NA 11.88 4.01 NA 44.30 090 35587 .......... ............ A Vein bypass graft ........................................ 24.76 NA 11.12 3.51 NA 39.39 090 35600 .......... ............ A Harvest artery for cabg ............................... 4.95 NA 1.59 0.73 NA 7.27 ZZZ 35601 .......... ............ A Artery bypass graft ...................................... 17.50 NA 8.32 2.49 NA 28.31 090 35606 .......... ............ A Artery bypass graft ...................................... 18.72 NA 8.71 2.69 NA 30.12 090 35612 .......... ............ A Artery bypass graft ...................................... 15.77 NA 7.64 2.08 NA 25.49 090 35616 .......... ............ A Artery bypass graft ...................................... 15.71 NA 7.81 2.19 NA 25.71 090 35621 .......... ............ A Artery bypass graft ...................................... 20.01 NA 8.42 2.91 NA 31.34 090 35623 .......... ............ A Bypass graft, not vein ................................. 24.01 NA 10.18 3.45 NA 37.63 090 35626 .......... ............ A Artery bypass graft ...................................... 27.77 NA 11.71 4.07 NA 43.54 090 35631 .......... ............ A Artery bypass graft ...................................... 34.02 NA 13.43 4.95 NA 52.40 090 35636 .......... ............ A Artery bypass graft ...................................... 29.52 NA 12.07 4.09 NA 45.68 090 35641 .......... ............ A Artery bypass graft ...................................... 24.58 NA 10.71 3.53 NA 38.82 090 35642 .......... ............ A Artery bypass graft ...................................... 17.99 NA 8.74 2.27 NA 28.99 090 35645 .......... ............ A Artery bypass graft ...................................... 17.47 NA 8.09 2.49 NA 28.06 090 35646 .......... ............ A Artery bypass graft ...................................... 31.01 NA 12.72 4.43 NA 48.16 090 35647 .......... ............ A Artery bypass graft ...................................... 28.02 NA 11.42 3.98 NA 43.42 090 35650 .......... ............ A Artery bypass graft ...................................... 19.01 NA 8.12 2.71 NA 29.84 090 35651 .......... ............ A Artery bypass graft ...................................... 25.05 NA 10.43 3.35 NA 38.83 090 35654 .......... ............ A Artery bypass graft ...................................... 25.01 NA 10.36 3.52 NA 38.89 090 35656 .......... ............ A Artery bypass graft ...................................... 19.54 NA 8.36 2.79 NA 30.69 090 35661 .......... ............ A Artery bypass graft ...................................... 19.01 NA 8.66 2.71 NA 30.38 090 35663 .......... ............ A Artery bypass graft ...................................... 22.01 NA 9.68 3.10 NA 34.80 090 35665 .......... ............ A Artery bypass graft ...................................... 21.01 NA 9.17 3.00 NA 33.18 090 35666 .......... ............ A Artery bypass graft ...................................... 22.20 NA 10.32 3.15 NA 35.67 090 35671 .......... ............ A Artery bypass graft ...................................... 19.34 NA 9.08 2.77 NA 31.19 090 35681 .......... ............ A Composite bypass graft .............................. 1.60 NA 0.52 0.23 NA 2.35 ZZZ 35682 .......... ............ A Composite bypass graft .............................. 7.20 NA 2.32 1.03 NA 10.56 ZZZ 35683 .......... ............ A Composite bypass graft .............................. 8.51 NA 2.75 1.20 NA 12.46 ZZZ 35685 .......... ............ A Bypass graft patency/patch ......................... 4.05 NA 1.34 0.58 NA 5.96 ZZZ 35686 .......... ............ A Bypass graft/av fist patency ........................ 3.35 NA 1.12 0.47 NA 4.94 ZZZ 35691 .......... ............ A Arterial transposition .................................... 18.06 NA 8.16 2.58 NA 28.79 090 35693 .......... ............ A Arterial transposition .................................... 15.37 NA 7.60 2.21 NA 25.18 090 35694 .......... ............ A Arterial transposition .................................... 19.17 NA 8.36 2.69 NA 30.22 090 35695 .......... ............ A Arterial transposition .................................... 19.17 NA 8.30 2.73 NA 30.20 090 35697 .......... ............ A Reimplant artery each ................................. 3.01 NA 1.00 0.41 NA 4.42 ZZZ 35700 .......... ............ A Reoperation, bypass graft ........................... 3.09 NA 1.00 0.44 NA 4.52 ZZZ 35701 .......... ............ A Exploration, carotid artery ........................... 8.51 NA 5.00 1.12 NA 14.63 090 35721 .......... ............ A Exploration, femoral artery .......................... 7.18 NA 4.28 1.03 NA 12.49 090 35741 .......... ............ A Exploration popliteal artery .......................... 8.01 NA 4.53 1.12 NA 13.65 090 35761 .......... ............ A Exploration of artery/vein ............................ 5.37 NA 3.89 0.75 NA 10.01 090 35800 .......... ............ A Explore neck vessels .................................. 7.02 NA 4.49 0.95 NA 12.47 090 35820 .......... ............ A Explore chest vessels ................................. 12.89 NA 7.01 1.94 NA 21.84 090 35840 .......... ............ A Explore abdominal vessels ......................... 9.78 NA 5.16 1.34 NA 16.28 090 35860 .......... ............ A Explore limb vessels ................................... 5.55 NA 3.90 0.78 NA 10.23 090 35870 .......... ............ A Repair vessel graft defect ........................... 22.18 NA 9.48 3.00 NA 34.67 090 35875 .......... ............ A Removal of clot in graft ............................... 10.13 NA 5.10 1.41 NA 16.64 090 35876 .......... ............ A Removal of clot in graft ............................... 17.00 NA 7.33 2.39 NA 26.72 090 35879 .......... ............ A Revise graft w/vein ...................................... 16.01 NA 7.48 2.27 NA 25.76 090 35881 .......... ............ A Revise graft w/vein ...................................... 18.01 NA 8.43 2.55 NA 28.99 090 35901 .......... ............ A Excision, graft, neck .................................... 8.20 NA 5.13 1.15 NA 14.48 090 35903 .......... ............ A Excision, graft, extremity ............................. 9.40 NA 5.97 1.30 NA 16.67 090 35905 .......... ............ A Excision, graft, thorax .................................. 31.26 NA 12.78 4.43 NA 48.47 090 35907 .......... ............ A Excision, graft, abdomen ............................. 35.02 NA 13.79 4.91 NA 53.71 090
36000 .......... ............ A Place needle in vein .................................... 0.18 0.56 0.05 0.01 0.75 0.24 XXX 36002 .......... ............ A Pseudoaneurysm injection trt ...................... 1.96 2.77 1.00 0.17 4.90 3.13 000 36005 .......... ............ A Injection ext venography ............................. 0.95 8.00 0.33 0.05 9.00 1.33 000
36010 .......... ............ A Place catheter in vein .................................. 2.43 18.12 0.80 0.20 20.76 3.44 XXX
36011 .......... ............ A Place catheter in vein .................................. 3.15 27.36 1.09 0.27 30.78 4.51 XXX
36012 .......... ............ A Place catheter in vein .................................. 3.52 20.90 1.26 0.23 24.64 5.00 XXX 36013 .......... ............ A Place catheter in artery ............................... 2.53 20.81 0.69 0.25 23.58 3.46 XXX 36014 .......... ............ A Place catheter in artery ............................... 3.03 20.65 1.09 0.19 23.86 4.31 XXX 36015 .......... ............ A Place catheter in artery ............................... 3.52 23.90 1.26 0.21 27.63 4.98 XXX 36100 .......... ............ A Establish access to artery ........................... 3.03 12.20 1.14 0.26 15.49 4.43 XXX 36120 .......... ............ A Establish access to artery ........................... 2.01 10.97 0.67 0.14 13.13 2.83 XXX 36140 .......... ............ A Establish access to artery ........................... 2.01 12.60 0.66 0.16 14.77 2.83 XXX 36145 .......... ............ A Artery to vein shunt ..................................... 2.01 12.69 0.69 0.11 14.81 2.82 XXX
36160 .......... ............ A Establish access to aorta ............................ 2.53 13.15 0.85 0.26 15.93 3.63 XXX


## 45915

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

36200 .......... ............ A Place catheter in aorta ................................ 3.03 16.72 1.06 0.24 19.99 4.33 XXX 36215 .......... ............ A Place catheter in artery ............................... 4.68 27.47 1.69 0.27 32.42 6.64 XXX 36216 .......... ............ A Place catheter in artery ............................... 5.28 29.85 1.88 0.31 35.44 7.47 XXX 36217 .......... ............ A Place catheter in artery ............................... 6.30 55.46 2.28 0.44 62.20 9.02 XXX 36218 .......... ............ A Place catheter in artery ............................... 1.01 5.04 0.36 0.07 6.12 1.44 ZZZ 36245 .......... ............ A Place catheter in artery ............................... 4.68 32.95 1.76 0.31 37.94 6.75 XXX 36246 .......... ............ A Place catheter in artery ............................... 5.28 30.80 1.91 0.38 36.46 7.57 XXX 36247 .......... ............ A Place catheter in artery ............................... 6.30 50.01 2.25 0.47 56.79 9.02 XXX 36248 .......... ............ A Place catheter in artery ............................... 1.01 4.05 0.36 0.07 5.13 1.44 ZZZ 36260 .......... ............ A Insertion of infusion pump ........................... 9.72 NA 4.82 1.29 NA 15.83 090 36261 .......... ............ A Revision of infusion pump ........................... 5.45 NA 3.59 0.70 NA 9.75 090 36262 .......... ............ A Removal of infusion pump .......................... 4.02 NA 2.71 0.54 NA 7.27 090 36299 .......... ............ C Vessel injection procedure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 36400 .......... ............ A Bl draw < 3 yrs fem/jugular ......................... 0.38 0.29 0.09 0.03 0.70 0.50 XXX 36405 .......... ............ A Bl draw < 3 yrs scalp vein ........................... 0.31 0.26 0.08 0.03 0.60 0.42 XXX 36406 .......... ............ A Bl draw < 3 yrs other vein ........................... 0.18 0.28 0.05 0.01 0.47 0.24 XXX 36410 .......... ............ A Non-routine bl draw > 3 yrs ........................ 0.18 0.30 0.05 0.01 0.49 0.24 XXX 36416 .......... ............ B Capillary blood draw .................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 36420 .......... ............ A Vein access cutdown < 1 yr ........................ 1.01 NA 0.27 0.07 NA 1.35 XXX 36425 .......... ............ A Vein access cutdown > 1 yr ........................ 0.76 NA 0.22 0.06 NA 1.04 XXX 36430 .......... ............ A Blood transfusion service ............................ 0.00 0.96 NA 0.06 1.02 NA XXX 36440 .......... ............ A Bl push transfuse, 2 yr or < ........................ 1.03 NA 0.28 0.10 NA 1.42 XXX 36450 .......... ............ A Bl exchange/transfuse, nb ........................... 2.23 NA 0.69 0.21 NA 3.14 XXX 36455 .......... ............ A Bl exchange/transfuse non-nb .................... 2.43 NA 0.98 0.15 NA 3.57 XXX 36460 .......... ............ A Transfusion service, fetal ............................ 6.59 NA 2.18 0.79 NA 9.57 XXX 36468 .......... ............ R Injection(s), spider veins ............................. 0.00 0.00 0.00 0.00 0.00 0.00 000 36469 .......... ............ R Injection(s), spider veins ............................. 0.00 0.00 0.00 0.00 0.00 0.00 000 36470 .......... ............ A Injection therapy of vein .............................. 1.09 2.62 0.76 0.12 3.83 1.97 010 36471 .......... ............ A Injection therapy of veins ............................ 1.57 2.99 0.95 0.19 4.75 2.71 010 36475 .......... ............ A Endovenous rf, 1st vein .............................. 6.73 48.94 2.56 0.37 56.05 9.67 000 36476 .......... ............ A Endovenous rf, vein add-on ........................ 3.39 7.59 1.16 0.18 11.15 4.72 ZZZ 36478 .......... ............ A Endovenous laser, 1st vein ......................... 6.73 44.54 2.56 0.37 51.64 9.67 000 36479 .......... ............ A Endovenous laser vein add-on ................... 3.39 7.69 1.16 0.18 11.26 4.72 ZZZ 36481 .......... ............ A Insertion of catheter, vein ............................ 6.99 NA 2.68 0.55 NA 10.22 000 36500 .......... ............ A Insertion of catheter, vein ............................ 3.52 NA 1.39 0.20 NA 5.11 000 36510 .......... ............ A Insertion of catheter, vein ............................ 1.09 3.44 0.56 0.10 4.63 1.75 000 36511 .......... ............ A Apheresis wbc ............................................. 1.74 NA 0.71 0.08 NA 2.53 000 36512 .......... ............ A Apheresis rbc .............................................. 1.74 NA 0.72 0.08 NA 2.54 000 36513 .......... ............ A Apheresis platelets ...................................... 1.74 NA 0.71 0.17 NA 2.62 000 36514 .......... ............ A Apheresis plasma ........................................ 1.74 15.88 0.69 0.08 17.70 2.52 000 36515 .......... ............ A Apheresis, adsorp/reinfuse .......................... 1.74 62.05 0.65 0.08 63.87 2.47 000 36516 .......... ............ A Apheresis, selective .................................... 1.22 76.84 0.47 0.08 78.15 1.77 000 36522 .......... ............ A Photopheresis .............................................. 1.67 32.02 1.04 0.13 33.83 2.85 000 36540 .......... ............ B Collect blood venous device ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
36550 .......... ............ A Declot vascular device ................................ 0.00 0.38 NA 0.37 0.75 NA XXX 36555 .......... ............ A Insert non-tunnel cv cath ............................. 2.69 5.43 0.79 0.11 8.22 3.58 000 36556 .......... ............ A Insert non-tunnel cv cath ............................. 2.51 5.21 0.72 0.19 7.91 3.42 000 36557 .......... ............ A Insert tunneled cv cath ................................ 5.10 20.41 2.67 0.57 26.08 8.34 010 36558 .......... ............ A Insert tunneled cv cath ................................ 4.80 20.32 2.61 0.57 25.69 7.97 010 36560 .......... ............ A Insert tunneled cv cath ................................ 6.25 28.86 3.04 0.57 35.68 9.87 010 36561 .......... ............ A Insert tunneled cv cath ................................ 6.00 28.25 2.93 0.57 34.82 9.50 010 36563 .......... ............ A Insert tunneled cv cath ................................ 6.20 24.94 2.90 0.84 31.99 9.95 010 36565 .......... ............ A Insert tunneled cv cath ................................ 6.00 24.32 2.91 0.57 30.89 9.48 010
36566 .......... ............ A Insert tunneled cv cath ................................ 6.50 24.65 3.04 0.57 31.72 10.12 010 36568 .......... ............ A Insert picc cath ............................................ 1.92 7.06 0.60 0.11 9.10 2.64 000 36569 .......... ............ A Insert picc cath ............................................ 1.82 7.26 0.62 0.19 9.27 2.63 000 36570 .......... ............ A Insert picvad cath ........................................ 5.32 31.95 2.74 0.57 37.84 8.63 010 36571 .......... ............ A Insert picvad cath ........................................ 5.30 31.47 2.71 0.57 37.34 8.58 010 36575 .......... ............ A Repair tunneled cv cath .............................. 0.67 4.06 0.27 0.20 4.93 1.14 000 36576 .......... ............ A Repair tunneled cv cath .............................. 3.20 6.61 1.84 0.19 10.00 5.23 010 36578 .......... ............ A Replace tunneled cv cath ............................ 3.50 11.13 2.34 0.19 14.82 6.03 010 36580 .......... ............ A Replace cvad cath ....................................... 1.31 6.63 0.43 0.19 8.13 1.93 000 36581 .......... ............ A Replace tunneled cv cath ............................ 3.44 19.51 1.98 0.19 23.13 5.61 010 36582 .......... ............ A Replace tunneled cv cath ............................ 5.20 26.90 2.91 0.19 32.29 8.30 010 36583 .......... ............ A Replace tunneled cv cath ............................ 5.25 26.86 2.99 0.19 32.30 8.43 010 36584 .......... ............ A Replace picc cath ........................................ 1.20 6.64 0.61 0.19 8.04 2.00 000 36585 .......... ............ A Replace picvad cath .................................... 4.80 28.57 2.80 0.19 33.56 7.79 010
36589 .......... ............ A Removal tunneled cv cath ........................... 2.27 2.16 1.41 0.24 4.68 3.92 010
36590 .......... ............ A Removal tunneled cv cath ........................... 3.31 3.35 1.72 0.44 7.10 5.46 010
36595 .......... ............ A Mech remov tunneled cv cath ..................... 3.60 16.43 1.51 0.21 20.23 5.32 000
36596 .......... ............ A Mech remov tunneled cv cath ..................... 0.75 3.62 0.52 0.05 4.43 1.32 000 36597 .......... ............ A Reposition venous catheter ......................... 1.21 2.44 0.46 0.07 3.72 1.74 000 36600 .......... ............ A Withdrawal of arterial blood ........................ 0.32 0.48 0.09 0.02 0.82 0.43 XXX 36620 .......... ............ A Insertion catheter, artery ............................. 1.15 NA 0.23 0.07 NA 1.45 000


## 45916

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

36625 .......... ............ A Insertion catheter, artery ............................. 2.11 NA 0.52 0.26 NA 2.89 000 36640 .......... ............ A Insertion catheter, artery ............................. 2.10 NA 1.02 0.21 NA 3.34 000 36660 .......... ............ A Insertion catheter, artery ............................. 1.40 NA 0.43 0.14 NA 1.97 000 36680 .......... ............ A Insert needle, bone cavity ........................... 1.20 NA 0.49 0.11 NA 1.81 000 36800 .......... ............ A Insertion of cannula ..................................... 2.43 NA 1.76 0.25 NA 4.44 000 36810 .......... ............ A Insertion of cannula ..................................... 3.97 NA 1.67 0.45 NA 6.09 000 36815 .......... ............ A Insertion of cannula ..................................... 2.63 NA 1.14 0.35 NA 4.12 000 36818 .......... ............ A Av fuse, uppr arm, cephalic ........................ 11.54 NA 6.06 1.89 NA 19.49 090 36819 .......... ............ A Av fuse, uppr arm, basilic ........................... 14.01 NA 6.20 1.95 NA 22.16 090 36820 .......... ............ A Av fusion/forearm vein ................................ 14.01 NA 6.21 1.94 NA 22.16 090 36821 .......... ............ A Av fusion direct any site .............................. 8.94 NA 4.55 1.23 NA 14.71 090 36822 .......... ............ A Insertion of cannula(s) ................................. 5.42 NA 4.32 0.79 NA 10.53 090 36823 .......... ............ A Insertion of cannula(s) ................................. 21.01 NA 9.19 2.88 NA 33.09 090 36825 .......... ............ A Artery-vein autograft .................................... 9.85 NA 4.92 1.35 NA 16.12 090 36830 .......... ............ A Artery-vein nonautograft .............................. 12.00 NA 5.10 1.66 NA 18.77 090 36831 .......... ............ A Open thrombect av fistula ........................... 8.01 NA 3.88 1.09 NA 12.98 090 36832 .......... ............ A Av fistula revision, open .............................. 10.50 NA 4.62 1.44 NA 16.56 090 36833 .......... ............ A Av fistula revision ........................................ 11.95 NA 5.08 1.65 NA 18.68 090 36834 .......... ............ A Repair A-V aneurysm .................................. 9.94 NA 4.67 1.37 NA 15.98 090 36835 .......... ............ A Artery to vein shunt ..................................... 7.15 NA 4.23 0.98 NA 12.37 090 36838 .......... ............ A Dist revas ligation, hemo ............................. 20.64 NA 9.21 3.01 NA 32.86 090 36860 .......... ............ A External cannula declotting ......................... 2.01 2.26 0.70 0.11 4.38 2.82 000 36861 .......... ............ A Cannula declotting ....................................... 2.53 NA 1.54 0.27 NA 4.33 000 36870 .......... ............ A Percut thrombect av fistula ......................... 5.16 52.60 3.30 0.29 58.05 8.75 090 37140 .......... ............ A Revision of circulation ................................. 23.61 NA 10.93 2.01 NA 36.54 090 37145 .......... ............ A Revision of circulation ................................. 24.62 NA 10.73 3.25 NA 38.60 090 37160 .......... ............ A Revision of circulation ................................. 21.61 NA 9.10 2.81 NA 33.52 090 37180 .......... ............ A Revision of circulation ................................. 24.62 NA 10.06 3.34 NA 38.02 090 37181 .......... ............ A Splice spleen/kidney veins .......................... 26.69 NA 10.89 3.40 NA 40.98 090 37182 .......... ............ A Insert hepatic shunt (tips) ............................ 17.00 NA 6.37 1.00 NA 24.37 000 37183 .......... ............ A Remove hepatic shunt (tips) ....................... 8.01 NA 3.16 0.47 NA 11.63 000 37195 .......... ............ C Thrombolytic therapy, stroke ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 37200 .......... ............ A Transcatheter biopsy ................................... 4.56 NA 1.58 0.27 NA 6.41 000 37201 .......... ............ A Transcatheter therapy infuse ...................... 5.00 NA 2.67 0.33 NA 8.00 000 37202 .......... ............ A Transcatheter therapy infuse ...................... 5.68 NA 3.25 0.43 NA 9.36 000
37203 .......... ............ A Transcatheter retrieval ................................ 5.03 33.96 2.14 0.29 39.28 7.46 000 37204 .......... ............ A Transcatheter occlusion .............................. 18.15 NA 6.22 1.48 NA 25.84 000 37205 .......... ............ A Transcath iv stent, percut ............................ 8.29 NA 3.95 0.60 NA 12.84 000 37206 .......... ............ A Transcath iv stent/perc addl ........................ 4.13 NA 1.50 0.31 NA 5.94 ZZZ 37207 .......... ............ A Transcath iv stent, open .............................. 8.29 NA 3.10 1.17 NA 12.56 000 37208 .......... ............ A Transcath iv stent/open addl ....................... 4.13 NA 1.36 0.59 NA 6.08 ZZZ 37209 .......... ............ A Exchange arterial catheter .......................... 2.27 NA 0.78 0.15 NA 3.21 000 37215 .......... ............ R Transcath stent, cca w/eps ......................... 18.75 NA 9.55 1.09 NA 29.39 090 37216 .......... ............ R Transcath stent, cca w/o eps ...................... 18.02 NA 9.26 1.04 NA 28.31 090 37250 .......... ............ A Iv us first vessel add-on .............................. 2.10 NA 0.76 0.21 NA 3.08 ZZZ
37251 .......... ............ A Iv us each add vessel add-on ..................... 1.60 NA 0.55 0.19 NA 2.35 ZZZ 37500 .......... ............ A Endoscopy ligate perf veins ........................ 11.00 NA 6.76 1.54 NA 19.30 090 37501 .......... ............ C Vascular endoscopy procedure ................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 37565 .......... ............ A Ligation of neck vein ................................... 10.88 NA 5.51 1.33 NA 17.72 090 37600 .......... ............ A Ligation of neck artery ................................. 11.25 NA 6.44 1.41 NA 19.11 090 37605 .......... ............ A Ligation of neck artery ................................. 13.12 NA 6.74 1.98 NA 21.84 090 37606 .......... ............ A Ligation of neck artery ................................. 6.28 NA 4.46 1.23 NA 11.97 090 37607 .......... ............ A Ligation of a-v fistula ................................... 6.16 NA 3.48 0.85 NA 10.49 090 37609 .......... ............ A Temporal artery procedure .......................... 3.01 4.38 1.93 0.36 7.75 5.29 010 37615 .......... ............ A Ligation of neck artery ................................. 5.73 NA 4.00 0.68 NA 10.41 090 37616 .......... ............ A Ligation of chest artery ................................ 16.50 NA 7.92 2.32 NA 26.74 090 37617 .......... ............ A Ligation of abdomen artery ......................... 22.07 NA 9.00 2.97 NA 34.05 090 37618 .......... ............ A Ligation of extremity artery .......................... 4.84 NA 3.50 0.67 NA 9.01 090 37620 .......... ............ A Revision of major vein ................................. 10.56 NA 5.83 0.91 NA 17.30 090 37650 .......... ............ A Revision of major vein ................................. 7.81 NA 4.55 1.01 NA 13.36 090 37660 .......... ............ A Revision of major vein ................................. 21.01 NA 8.86 2.48 NA 32.35 090 37700 .......... ............ A Revise leg vein ............................................ 3.73 NA 2.73 0.53 NA 6.99 090 37720 .......... ............ A Removal of leg vein .................................... 5.66 NA 3.62 0.80 NA 10.08 090 37730 .......... ............ A Removal of leg veins ................................... 7.33 NA 4.20 1.04 NA 12.57 090 37735 .......... ............ A Removal of leg veins/lesion ........................ 10.53 NA 5.36 1.48 NA 17.37 090 37760 .......... ............ A Ligation, leg veins, open ............................. 10.47 NA 5.22 1.44 NA 17.13 090
37765 .......... ............ A Phleb veins - extrem - to 20 ....................... 7.35 NA 4.46 0.48 NA 12.30 090
37766 .......... ............ A Phleb veins - extrem 20+ ............................ 9.31 NA 5.18 0.48 NA 14.97 090 37780 .......... ............ A Revision of leg vein ..................................... 3.84 NA 2.79 0.53 NA 7.15 090 37785 .......... ............ A Ligate/divide/excise vein ............................. 3.84 5.13 2.67 0.54 9.51 7.05 090 37788 .......... ............ A Revascularization, penis ............................. 22.02 NA 10.13 2.25 NA 34.40 090
37790 .......... ............ A Penile venous occlusion .............................. 8.35 NA 4.76 0.59 NA 13.70 090 37799 .......... ............ C Vascular surgery procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 38100 .......... ............ A Removal of spleen, total ............................. 14.51 NA 6.10 1.91 NA 22.52 090


## 45917

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

38101 .......... ............ A Removal of spleen, partial .......................... 15.32 NA 6.48 2.04 NA 23.84 090 38102 .......... ............ A Removal of spleen, total ............................. 4.80 NA 1.61 0.63 NA 7.04 ZZZ 38115 .......... ............ A Repair of ruptured spleen ........................... 15.83 NA 6.57 2.08 NA 24.48 090 38120 .......... ............ A Laparoscopy, splenectomy .......................... 17.00 NA 7.30 2.24 NA 26.55 090 38129 .......... ............ C Laparoscope proc, spleen ........................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 38200 .......... ............ A Injection for spleen x-ray ............................. 2.65 NA 0.93 0.14 NA 3.72 000 38204 .......... ............ B Bl donor search management ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38205 .......... ............ R Harvest allogenic stem cells ....................... 1.50 NA 0.65 0.07 NA 2.22 000 38206 .......... ............ R Harvest auto stem cells ............................... 1.50 NA 0.65 0.07 NA 2.22 000 38207 .......... ............ I Cryopreserve stem cells .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38208 .......... ............ I Thaw preserved stem cells ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38209 .......... ............ I Wash harvest stem cells ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38210 .......... ............ I T-cell depletion of harvest ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38211 .......... ............ I Tumor cell deplete of harvst ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38212 .......... ............ I Rbc depletion of harvest ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38213 .......... ............ I Platelet deplete of harvest .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38214 .......... ............ I Volume deplete of harvest .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
38215 .......... ............ I Harvest stem cell concentrte ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 38220 .......... ............ A Bone marrow aspiration .............................. 1.08 3.52 0.51 0.05 4.66 1.64 XXX 38221 .......... ............ A Bone marrow biopsy ................................... 1.37 3.73 0.63 0.07 5.17 2.07 XXX 38230 .......... ............ R Bone marrow collection ............................... 4.54 NA 3.13 0.48 NA 8.15 010 38240 .......... ............ R Bone marrow/stem transplant ..................... 2.24 NA 1.00 0.11 NA 3.35 XXX 38241 .......... ............ R Bone marrow/stem transplant ..................... 2.24 NA 1.01 0.11 NA 3.36 XXX 38242 .......... ............ A Lymphocyte infuse transplant ..................... 1.71 NA 0.76 0.08 NA 2.55 000 38300 .......... ............ A Drainage, lymph node lesion ...................... 1.99 4.20 2.04 0.25 6.45 4.28 010 38305 .......... ............ A Drainage, lymph node lesion ...................... 6.00 NA 4.41 0.88 NA 11.29 090 38308 .......... ............ A Incision of lymph channels .......................... 6.45 NA 3.68 0.85 NA 10.99 090 38380 .......... ............ A Thoracic duct procedure ............................. 7.46 NA 5.54 0.74 NA 13.75 090 38381 .......... ............ A Thoracic duct procedure ............................. 12.89 NA 6.70 1.84 NA 21.43 090 38382 .......... ............ A Thoracic duct procedure ............................. 10.08 NA 5.67 1.37 NA 17.12 090 38500 .......... ............ A Biopsy/removal, lymph nodes ..................... 3.75 3.64 2.06 0.49 7.88 6.30 010 38505 .......... ............ A Needle biopsy, lymph nodes ....................... 1.14 2.05 0.80 0.09 3.28 2.03 000 38510 .......... ............ A Biopsy/removal, lymph nodes ..................... 6.43 5.44 3.41 0.72 12.59 10.56 010 38520 .......... ............ A Biopsy/removal, lymph nodes ..................... 6.67 NA 3.96 0.84 NA 11.47 090 38525 .......... ............ A Biopsy/removal, lymph nodes ..................... 6.07 NA 3.27 0.80 NA 10.15 090 38530 .......... ............ A Biopsy/removal, lymph nodes ..................... 7.99 NA 4.30 1.12 NA 13.40 090 38542 .......... ............ A Explore deep node(s), neck ........................ 5.91 NA 4.39 0.60 NA 10.90 090 38550 .......... ............ A Removal, neck/armpit lesion ....................... 6.92 NA 3.86 0.88 NA 11.66 090 38555 .......... ............ A Removal, neck/armpit lesion ....................... 14.15 NA 8.26 1.75 NA 24.16 090 38562 .......... ............ A Removal, pelvic lymph nodes ..................... 10.49 NA 5.88 1.20 NA 17.57 090 38564 .......... ............ A Removal, abdomen lymph nodes ............... 10.83 NA 5.25 1.32 NA 17.40 090 38570 .......... ............ A Laparoscopy, lymph node biop ................... 9.26 NA 3.99 1.13 NA 14.38 010 38571 .......... ............ A Laparoscopy, lymphadenectomy ................. 14.69 NA 6.36 1.15 NA 22.20 010 38572 .......... ............ A Laparoscopy, lymphadenectomy ................. 16.60 NA 7.09 1.90 NA 25.60 010 38589 .......... ............ C Laparoscope proc, lymphatic ...................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 38700 .......... ............ A Removal of lymph nodes, neck ................... 8.25 NA 6.11 0.72 NA 15.08 090 38720 .......... ............ A Removal of lymph nodes, neck ................... 13.62 NA 9.11 1.20 NA 23.92 090 38724 .......... ............ A Removal of lymph nodes, neck ................... 14.55 NA 9.57 1.28 NA 25.40 090 38740 .......... ............ A Remove armpit lymph nodes ...................... 10.03 NA 4.90 1.32 NA 16.25 090 38745 .......... ............ A Remove armpit lymph nodes ...................... 13.11 NA 6.02 1.73 NA 20.85 090 38746 .......... ............ A Remove thoracic lymph nodes .................... 4.89 NA 1.57 0.72 NA 7.18 ZZZ 38747 .......... ............ A Remove abdominal lymph nodes ................ 4.89 NA 1.63 0.64 NA 7.16 ZZZ 38760 .......... ............ A Remove groin lymph nodes ........................ 12.96 NA 6.08 1.71 NA 20.75 090 38765 .......... ............ A Remove groin lymph nodes ........................ 19.99 NA 8.92 2.47 NA 31.38 090 38770 .......... ............ A Remove pelvis lymph nodes ....................... 13.24 NA 6.35 1.40 NA 20.99 090 38780 .......... ............ A Remove abdomen lymph nodes ................. 16.60 NA 8.20 1.88 NA 26.69 090 38790 .......... ............ A Inject for lymphatic x-ray ............................. 1.29 NA 0.78 0.13 NA 2.20 000 38792 .......... ............ A Identify sentinel node .................................. 0.52 NA 0.46 0.06 NA 1.04 000 38794 .......... ............ A Access thoracic lymph duct ........................ 4.45 NA 3.68 0.32 NA 8.45 090 38999 .......... ............ C Blood/lymph system procedure ................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 39000 .......... ............ A Exploration of chest ..................................... 6.10 NA 4.54 0.89 NA 11.53 090 39010 .......... ............ A Exploration of chest ..................................... 11.79 NA 7.16 1.75 NA 20.70 090
39200 .......... ............ A Removal chest lesion .................................. 13.63 NA 7.22 2.02 NA 22.86 090
39220 .......... ............ A Removal chest lesion .................................. 17.42 NA 8.95 2.45 NA 28.83 090 39400 .......... ............ A Visualization of chest .................................. 5.61 NA 4.56 0.82 NA 10.99 010 39499 .......... ............ C Chest procedure .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 39501 .......... ............ A Repair diaphragm laceration ....................... 13.20 NA 6.33 1.77 NA 21.29 090 39502 .......... ............ A Repair paraesophageal hernia .................... 16.34 NA 7.04 2.16 NA 25.54 090 39503 .......... ............ A Repair of diaphragm hernia ........................ 95.05 NA 32.58 10.95 NA 138.58 090 39520 .......... ............ A Repair of diaphragm hernia ........................ 16.11 NA 7.79 2.23 NA 26.14 090 39530 .......... ............ A Repair of diaphragm hernia ........................ 15.42 NA 6.96 2.10 NA 24.48 090 39531 .......... ............ A Repair of diaphragm hernia ........................ 16.43 NA 7.20 2.21 NA 25.84 090 39540 .......... ............ A Repair of diaphragm hernia ........................ 13.33 NA 6.11 1.79 NA 21.23 090 39541 .......... ............ A Repair of diaphragm hernia ........................ 14.42 NA 6.45 1.92 NA 22.79 090


## 45918

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

39545 .......... ............ A Revision of diaphragm ................................ 13.38 NA 7.43 1.83 NA 22.64 090 39560 .......... ............ A Resect diaphragm, simple ........................... 12.00 NA 6.12 1.59 NA 19.72 090 39561 .......... ............ A Resect diaphragm, complex ........................ 17.50 NA 9.27 2.44 NA 29.21 090 39599 .......... ............ C Diaphragm surgery procedure .................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 4000F ......... ............ I Tobacco use txmnt counseling ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 4001F ......... ............ I Tobacco use txmnt, pharmacol ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 4002F ......... ............ I Statin therapy, rx ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 4006F ......... ............ I Beta-blocker therapy, rx .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 4009F ......... ............ I Ace inhibitor therapy, rx .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 4011F ......... ............ I Oral antiplatelet tx, rx .................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 40490 .......... ............ A Biopsy of lip ................................................. 1.22 1.72 0.62 0.05 3.00 1.89 000 40500 .......... ............ A Partial excision of lip ................................... 4.28 7.24 4.29 0.38 11.90 8.95 090 40510 .......... ............ A Partial excision of lip ................................... 4.70 6.69 3.93 0.49 11.88 9.12 090 40520 .......... ............ A Partial excision of lip ................................... 4.67 7.48 4.01 0.52 12.67 9.20 090 40525 .......... ............ A Reconstruct lip with flap .............................. 7.56 NA 6.14 0.85 NA 14.55 090 40527 .......... ............ A Reconstruct lip with flap .............................. 9.14 NA 7.15 0.97 NA 17.26 090 40530 .......... ............ A Partial removal of lip ................................... 5.40 7.88 4.49 0.55 13.83 10.44 090 40650 .......... ............ A Repair lip ..................................................... 3.64 6.63 3.19 0.38 10.65 7.21 090 40652 .......... ............ A Repair lip ..................................................... 4.26 7.65 4.15 0.52 12.43 8.93 090 40654 .......... ............ A Repair lip ..................................................... 5.31 8.62 4.82 0.60 14.53 10.73 090 40700 .......... ............ A Repair cleft lip/nasal .................................... 12.80 NA 8.83 0.95 NA 22.57 090 40701 .......... ............ A Repair cleft lip/nasal .................................... 15.86 NA 10.99 1.65 NA 28.51 090 40702 .......... ............ A Repair cleft lip/nasal .................................... 13.05 NA 8.06 1.23 NA 22.34 090 40720 .......... ............ A Repair cleft lip/nasal .................................... 13.56 NA 9.60 1.79 NA 24.95 090 40761 .......... ............ A Repair cleft lip/nasal .................................... 14.73 NA 9.96 1.93 NA 26.62 090 40799 .......... ............ C Lip surgery procedure ................................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY 40800 .......... ............ A Drainage of mouth lesion ............................ 1.17 3.06 1.77 0.13 4.36 3.07 010 40801 .......... ............ A Drainage of mouth lesion ............................ 2.54 4.13 2.73 0.31 6.98 5.57 010 40804 .......... ............ A Removal, foreign body, mouth .................... 1.24 3.40 1.80 0.11 4.75 3.15 010 40805 .......... ............ A Removal, foreign body, mouth .................... 2.70 4.51 2.77 0.32 7.52 5.79 010 40806 .......... ............ A Incision of lip fold ........................................ 0.31 1.86 0.50 0.04 2.21 0.85 000 40808 .......... ............ A Biopsy of mouth lesion ................................ 0.96 2.75 1.48 0.10 3.81 2.54 010 40810 .......... ............ A Excision of mouth lesion ............................. 1.31 2.97 1.65 0.13 4.41 3.09 010 40812 .......... ............ A Excise/repair mouth lesion .......................... 2.31 3.83 2.37 0.28 6.42 4.96 010 40814 .......... ............ A Excise/repair mouth lesion .......................... 3.42 5.05 3.85 0.41 8.88 7.67 090 40816 .......... ............ A Excision of mouth lesion ............................. 3.67 5.28 3.95 0.40 9.35 8.02 090 40818 .......... ............ A Excise oral mucosa for graft ....................... 2.41 5.21 3.88 0.21 7.84 6.50 090 40819 .......... ............ A Excise lip or cheek fold ............................... 2.41 4.19 3.09 0.29 6.90 5.79 090 40820 .......... ............ A Treatment of mouth lesion .......................... 1.28 4.09 2.45 0.11 5.48 3.84 010 40830 .......... ............ A Repair mouth laceration .............................. 1.76 3.71 2.00 0.19 5.66 3.96 010 40831 .......... ............ A Repair mouth laceration .............................. 2.46 4.69 2.96 0.30 7.45 5.73 010 40840 .......... ............ R Reconstruction of mouth ............................. 8.74 9.82 6.80 1.08 19.64 16.62 090 40842 .......... ............ R Reconstruction of mouth ............................. 8.74 10.09 6.62 1.08 19.91 16.44 090 40843 .......... ............ R Reconstruction of mouth ............................. 12.10 12.11 7.61 1.39 25.60 21.11 090 40844 .......... ............ R Reconstruction of mouth ............................. 16.02 15.74 11.32 1.99 33.76 29.33 090 40845 .......... ............ R Reconstruction of mouth ............................. 18.59 17.02 12.90 2.00 37.61 33.48 090 40899 .......... ............ C Mouth surgery procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 41000 .......... ............ A Drainage of mouth lesion ............................ 1.30 2.32 1.40 0.12 3.74 2.82 010 41005 .......... ............ A Drainage of mouth lesion ............................ 1.26 3.42 1.71 0.12 4.80 3.09 010 41006 .......... ............ A Drainage of mouth lesion ............................ 3.25 4.87 3.13 0.35 8.47 6.73 090 41007 .......... ............ A Drainage of mouth lesion ............................ 3.11 5.08 2.98 0.31 8.50 6.40 090 41008 .......... ............ A Drainage of mouth lesion ............................ 3.37 4.79 3.16 0.42 8.58 6.95 090 41009 .......... ............ A Drainage of mouth lesion ............................ 3.59 5.09 3.53 0.47 9.15 7.59 090 41010 .......... ............ A Incision of tongue fold ................................. 1.06 3.43 1.65 0.07 4.56 2.78 010 41015 .......... ............ A Drainage of mouth lesion ............................ 3.96 5.52 4.14 0.46 9.93 8.56 090 41016 .......... ............ A Drainage of mouth lesion ............................ 4.07 5.70 4.22 0.53 10.30 8.82 090 41017 .......... ............ A Drainage of mouth lesion ............................ 4.07 5.72 4.29 0.53 10.32 8.89 090 41018 .......... ............ A Drainage of mouth lesion ............................ 5.10 6.20 4.53 0.68 11.98 10.31 090 41100 .......... ............ A Biopsy of tongue ......................................... 1.63 2.45 1.40 0.15 4.24 3.18 010 41105 .......... ............ A Biopsy of tongue ......................................... 1.42 2.34 1.30 0.13 3.89 2.85 010 41108 .......... ............ A Biopsy of floor of mouth .............................. 1.05 2.11 1.11 0.10 3.26 2.27 010 41110 .......... ............ A Excision of tongue lesion ............................ 1.51 3.04 1.63 0.13 4.68 3.27 010 41112 .......... ............ A Excision of tongue lesion ............................ 2.74 4.56 3.19 0.28 7.57 6.21 090 41113 .......... ............ A Excision of tongue lesion ............................ 3.20 4.84 3.44 0.34 8.38 6.97 090 41114 .......... ............ A Excision of tongue lesion ............................ 8.48 NA 7.11 0.83 NA 16.41 090 41115 .......... ............ A Excision of tongue fold ................................ 1.74 3.40 1.83 0.18 5.33 3.75 010 41116 .......... ............ A Excision of mouth lesion ............................. 2.44 4.49 2.78 0.23 7.16 5.45 090 41120 .......... ............ A Partial removal of tongue ............................ 9.78 NA 15.03 0.79 NA 25.60 090 41130 .......... ............ A Partial removal of tongue ............................ 11.15 NA 15.86 0.93 NA 27.94 090 41135 .......... ............ A Tongue and neck surgery ........................... 23.11 NA 22.62 1.88 NA 47.60 090 41140 .......... ............ A Removal of tongue ...................................... 25.51 NA 25.94 2.26 NA 53.71 090 41145 .......... ............ A Tongue removal, neck surgery ................... 30.07 NA 29.85 2.54 NA 62.46 090 41150 .......... ............ A Tongue, mouth, jaw surgery ....................... 23.06 NA 24.08 1.94 NA 49.08 090 41153 .......... ............ A Tongue, mouth, neck surgery ..................... 23.78 NA 24.40 2.00 NA 50.17 090


## 45919

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

41155 .......... ............ A Tongue, jaw, & neck surgery ...................... 27.74 NA 26.14 2.33 NA 56.21 090 41250 .......... ............ A Repair tongue laceration ............................. 1.91 2.94 1.24 0.18 5.03 3.33 010 41251 .......... ............ A Repair tongue laceration ............................. 2.27 3.33 1.61 0.22 5.83 4.10 010 41252 .......... ............ A Repair tongue laceration ............................. 2.98 3.98 2.22 0.29 7.25 5.49 010 41500 .......... ............ A Fixation of tongue ........................................ 3.71 NA 7.33 0.30 NA 11.34 090 41510 .......... ............ A Tongue to lip surgery .................................. 3.42 NA 7.57 0.20 NA 11.18 090 41520 .......... ............ A Reconstruction, tongue fold ........................ 2.74 4.77 3.55 0.27 7.78 6.56 090 41599 .......... ............ C Tongue and mouth surgery ......................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 41800 .......... ............ A Drainage of gum lesion ............................... 1.17 2.92 1.40 0.12 4.21 2.69 010 41805 .......... ............ A Removal foreign body, gum ........................ 1.24 3.00 2.30 0.13 4.37 3.68 010 41806 .......... ............ A Removal foreign body,jawbone ................... 2.70 3.96 3.09 0.37 7.03 6.16 010 41820 .......... ............ R Excision, gum, each quadrant ..................... 0.00 0.00 0.00 0.00 0.00 0.00 000 41821 .......... ............ R Excision of gum flap .................................... 0.00 0.00 0.00 0.00 0.00 0.00 000 41822 .......... ............ R Excision of gum lesion ................................ 2.31 3.99 1.90 0.31 6.62 4.53 010 41823 .......... ............ R Excision of gum lesion ................................ 3.31 5.68 3.99 0.47 9.46 7.77 090 41825 .......... ............ A Excision of gum lesion ................................ 1.31 3.12 2.11 0.15 4.59 3.57 010 41826 .......... ............ A Excision of gum lesion ................................ 2.31 2.95 2.19 0.30 5.56 4.81 010 41827 .......... ............ A Excision of gum lesion ................................ 3.42 5.67 3.61 0.35 9.44 7.38 090 41828 .......... ............ R Excision of gum lesion ................................ 3.10 3.86 2.82 0.44 7.40 6.35 010 41830 .......... ............ R Removal of gum tissue ............................... 3.35 5.14 3.57 0.44 8.93 7.35 010 41850 .......... ............ R Treatment of gum lesion ............................. 0.00 0.00 0.00 0.00 0.00 0.00 000 41870 .......... ............ R Gum graft .................................................... 0.00 0.00 0.00 0.00 0.00 0.00 000 41872 .......... ............ R Repair gum .................................................. 2.60 5.14 3.43 0.30 8.03 6.33 090 41874 .......... ............ R Repair tooth socket ..................................... 3.10 4.96 3.14 0.45 8.51 6.69 090 41899 .......... ............ C Dental surgery procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 42000 .......... ............ A Drainage mouth roof lesion ......................... 1.23 2.52 1.25 0.12 3.87 2.60 010 42100 .......... ............ A Biopsy roof of mouth ................................... 1.31 2.09 1.34 0.13 3.53 2.78 010 42104 .......... ............ A Excision lesion, mouth roof ......................... 1.64 2.69 1.56 0.16 4.49 3.37 010 42106 .......... ............ A Excision lesion, mouth roof ......................... 2.10 3.41 2.38 0.25 5.76 4.73 010 42107 .......... ............ A Excision lesion, mouth roof ......................... 4.44 5.85 3.92 0.44 10.73 8.80 090 42120 .......... ............ A Remove palate/lesion .................................. 6.17 NA 11.56 0.52 NA 18.25 090 42140 .......... ............ A Excision of uvula ......................................... 1.62 3.76 2.07 0.13 5.52 3.82 090 42145 .......... ............ A Repair palate, pharynx/uvula ...................... 8.06 NA 7.39 0.65 NA 16.10 090 42160 .......... ............ A Treatment mouth roof lesion ....................... 1.80 4.16 2.20 0.17 6.13 4.17 010 42180 .......... ............ A Repair palate ............................................... 2.51 3.11 2.06 0.21 5.82 4.78 010 42182 .......... ............ A Repair palate ............................................... 3.83 3.90 2.95 0.40 8.13 7.18 010 42200 .......... ............ A Reconstruct cleft palate ............................... 12.00 NA 9.92 1.27 NA 23.20 090 42205 .......... ............ A Reconstruct cleft palate ............................... 13.30 NA 9.82 1.58 NA 24.70 090 42210 .......... ............ A Reconstruct cleft palate ............................... 14.51 NA 11.21 2.16 NA 27.88 090 42215 .......... ............ A Reconstruct cleft palate ............................... 8.83 NA 8.74 1.31 NA 18.88 090 42220 .......... ............ A Reconstruct cleft palate ............................... 7.02 NA 6.92 0.73 NA 14.67 090 42225 .......... ............ A Reconstruct cleft palate ............................... 9.55 NA 16.15 0.86 NA 26.56 090 42226 .......... ............ A Lengthening of palate .................................. 10.01 NA 14.14 1.01 NA 25.16 090 42227 .......... ............ A Lengthening of palate .................................. 9.53 NA 14.78 0.98 NA 25.29 090 42235 .......... ............ A Repair palate ............................................... 7.88 NA 11.93 0.72 NA 20.52 090 42260 .......... ............ A Repair nose to lip fistula ............................. 9.81 10.14 6.90 1.26 21.21 17.97 090 42280 .......... ............ A Preparation, palate mold ............................. 1.54 1.98 1.11 0.19 3.71 2.85 010 42281 .......... ............ A Insertion, palate prosthesis ......................... 1.93 2.69 1.84 0.17 4.79 3.94 010 42299 .......... ............ C Palate/uvula surgery .................................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 42300 .......... ............ A Drainage of salivary gland .......................... 1.93 2.83 1.80 0.16 4.92 3.89 010 42305 .......... ............ A Drainage of salivary gland .......................... 6.07 NA 4.62 0.51 NA 11.21 090 42310 .......... ............ A Drainage of salivary gland .......................... 1.56 2.33 1.52 0.13 4.02 3.21 010 42320 .......... ............ A Drainage of salivary gland .......................... 2.35 3.31 2.06 0.21 5.88 4.62 010 42325 .......... ............ A Create salivary cyst drain ............................ 2.76 4.68 2.36 0.27 7.71 5.38 090 42326 .......... ............ A Create salivary cyst drain ............................ 3.78 6.24 3.09 0.29 10.31 7.16 090 42330 .......... ............ A Removal of salivary stone ........................... 2.21 3.15 1.81 0.19 5.56 4.21 010 42335 .......... ............ A Removal of salivary stone ........................... 3.32 4.98 3.10 0.29 8.59 6.71 090 42340 .......... ............ A Removal of salivary stone ........................... 4.60 6.10 3.86 0.42 11.12 8.88 090 42400 .......... ............ A Biopsy of salivary gland .............................. 0.78 1.68 0.72 0.06 2.52 1.56 000 42405 .......... ............ A Biopsy of salivary gland .............................. 3.30 3.98 2.40 0.28 7.56 5.98 010 42408 .......... ............ A Excision of salivary cyst .............................. 4.54 5.96 3.55 0.45 10.95 8.54 090 42409 .......... ............ A Drainage of salivary cyst ............................. 2.82 4.58 2.72 0.27 7.67 5.80 090 42410 .......... ............ A Excise parotid gland/lesion ......................... 9.35 NA 6.08 0.91 NA 16.34 090 42415 .......... ............ A Excise parotid gland/lesion ......................... 16.89 NA 10.54 1.43 NA 28.87 090 42420 .......... ............ A Excise parotid gland/lesion ......................... 19.60 NA 11.99 1.65 NA 33.24 090 42425 .......... ............ A Excise parotid gland/lesion ......................... 13.03 NA 8.37 1.05 NA 22.45 090 42426 .......... ............ A Excise parotid gland/lesion ......................... 21.27 NA 12.61 1.80 NA 35.68 090 42440 .......... ............ A Excise submaxillary gland ........................... 6.97 NA 4.67 0.59 NA 12.23 090 42450 .......... ............ A Excise sublingual gland ............................... 4.62 5.96 4.22 0.42 11.00 9.26 090 42500 .......... ............ A Repair salivary duct ..................................... 4.30 5.74 4.11 0.41 10.45 8.82 090 42505 .......... ............ A Repair salivary duct ..................................... 6.18 7.14 5.27 0.55 13.87 12.00 090
42507 .......... ............ A Parotid duct diversion .................................. 6.11 NA 6.45 0.49 NA 13.05 090
42508 .......... ............ A Parotid duct diversion .................................. 9.11 NA 8.25 1.04 NA 18.40 090
42509 .......... ............ A Parotid duct diversion .................................. 11.54 NA 9.97 0.93 NA 22.44 090


## 45920

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

42510 .......... ............ A Parotid duct diversion .................................. 8.16 NA 7.61 0.66 NA 16.43 090 42550 .......... ............ A Injection for salivary x-ray ........................... 1.25 3.10 0.43 0.07 4.43 1.75 000 42600 .......... ............ A Closure of salivary fistula ............................ 4.82 6.55 4.03 0.43 11.80 9.28 090 42650 .......... ............ A Dilation of salivary duct ............................... 0.77 1.11 0.71 0.07 1.96 1.55 000 42660 .......... ............ A Dilation of salivary duct ............................... 1.13 1.37 0.88 0.09 2.60 2.10 000 42665 .......... ............ A Ligation of salivary duct .............................. 2.54 4.27 2.55 0.23 7.03 5.31 090 42699 .......... ............ C Salivary surgery procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 42700 .......... ............ A Drainage of tonsil abscess .......................... 1.62 2.65 1.68 0.13 4.40 3.43 010 42720 .......... ............ A Drainage of throat abscess ......................... 5.42 4.79 3.69 0.44 10.65 9.55 010 42725 .......... ............ A Drainage of throat abscess ......................... 10.72 NA 8.03 0.91 NA 19.66 090 42800 .......... ............ A Biopsy of throat ........................................... 1.39 2.19 1.38 0.11 3.69 2.88 010 42802 .......... ............ A Biopsy of throat ........................................... 1.54 4.59 1.99 0.12 6.26 3.65 010 42804 .......... ............ A Biopsy of upper nose/throat ........................ 1.24 3.65 1.68 0.10 4.99 3.02 010 42806 .......... ............ A Biopsy of upper nose/throat ........................ 1.58 3.97 1.87 0.13 5.68 3.58 010 42808 .......... ............ A Excise pharynx lesion ................................. 2.30 3.08 1.88 0.19 5.58 4.38 010 42809 .......... ............ A Remove pharynx foreign body .................... 1.81 2.30 1.30 0.16 4.27 3.27 010 42810 .......... ............ A Excision of neck cyst ................................... 3.26 5.63 3.51 0.29 9.18 7.06 090 42815 .......... ............ A Excision of neck cyst ................................... 7.07 NA 6.34 0.61 NA 14.02 090
42820 .......... ............ A Remove tonsils and adenoids ..................... 3.91 NA 3.22 0.31 NA 7.44 090 42821 .......... ............ A Remove tonsils and adenoids ..................... 4.29 NA 3.43 0.35 NA 8.07 090 42825 .......... ............ A Removal of tonsils ....................................... 3.42 NA 3.12 0.25 NA 6.78 090 42826 .......... ............ A Removal of tonsils ....................................... 3.38 NA 2.97 0.27 NA 6.62 090 42830 .......... ............ A Removal of adenoids .................................. 2.58 NA 2.52 0.20 NA 5.30 090 42831 .......... ............ A Removal of adenoids .................................. 2.72 NA 2.80 0.22 NA 5.73 090 42835 .......... ............ A Removal of adenoids .................................. 2.30 NA 2.42 0.21 NA 4.93 090 42836 .......... ............ A Removal of adenoids .................................. 3.19 NA 2.91 0.26 NA 6.35 090 42842 .......... ............ A Extensive surgery of throat ......................... 8.77 NA 10.81 0.71 NA 20.29 090 42844 .......... ............ A Extensive surgery of throat ......................... 14.32 NA 15.91 1.16 NA 31.39 090 42845 .......... ............ A Extensive surgery of throat ......................... 24.30 NA 22.66 1.98 NA 48.94 090 42860 .......... ............ A Excision of tonsil tags ................................. 2.22 NA 2.37 0.18 NA 4.78 090 42870 .......... ............ A Excision of lingual tonsil .............................. 5.40 NA 8.48 0.44 NA 14.32 090 42890 .......... ............ A Partial removal of pharynx .......................... 12.95 NA 13.90 1.05 NA 27.90 090 42892 .......... ............ A Revision of pharyngeal walls ...................... 15.84 NA 16.83 1.28 NA 33.95 090 42894 .......... ............ A Revision of pharyngeal walls ...................... 22.90 NA 21.54 1.86 NA 46.30 090 42900 .......... ............ A Repair throat wound .................................... 5.25 NA 3.57 0.50 NA 9.32 010 42950 .......... ............ A Reconstruction of throat .............................. 8.11 NA 11.60 0.72 NA 20.42 090 42953 .......... ............ A Repair throat, esophagus ............................ 8.97 NA 16.55 0.88 NA 26.40 090 42955 .......... ............ A Surgical opening of throat ........................... 7.39 NA 10.46 0.80 NA 18.66 090 42960 .......... ............ A Control throat bleeding ................................ 2.33 NA 1.93 0.19 NA 4.46 010 42961 .......... ............ A Control throat bleeding ................................ 5.59 NA 4.89 0.45 NA 10.93 090 42962 .......... ............ A Control throat bleeding ................................ 7.14 NA 5.80 0.58 NA 13.52 090 42970 .......... ............ A Control nose/throat bleeding ....................... 5.43 NA 4.09 0.39 NA 9.91 090 42971 .......... ............ A Control nose/throat bleeding ....................... 6.21 NA 5.02 0.51 NA 11.74 090 42972 .......... ............ A Control nose/throat bleeding ....................... 7.20 NA 5.58 0.62 NA 13.41 090 42999 .......... ............ C Throat surgery procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 43020 .......... ............ A Incision of esophagus ................................. 8.10 NA 5.31 0.87 NA 14.27 090 43030 .......... ............ A Throat muscle surgery ................................ 7.70 NA 5.34 0.70 NA 13.74 090 43045 .......... ............ A Incision of esophagus ................................. 20.13 NA 10.51 2.58 NA 33.22 090 43100 .......... ............ A Excision of esophagus lesion ...................... 9.20 NA 6.06 0.93 NA 16.19 090 43101 .......... ............ A Excision of esophagus lesion ...................... 16.25 NA 7.77 2.31 NA 26.33 090 43107 .......... ............ A Removal of esophagus ............................... 40.02 NA 17.70 5.22 NA 62.94 090 43108 .......... ............ A Removal of esophagus ............................... 34.21 NA 13.87 4.07 NA 52.14 090 43112 .......... ............ A Removal of esophagus ............................... 43.52 NA 18.73 5.79 NA 68.04 090 43113 .......... ............ A Removal of esophagus ............................... 35.29 NA 14.88 4.42 NA 54.59 090 43116 .......... ............ A Partial removal of esophagus ..................... 31.23 NA 16.17 3.05 NA 50.45 090 43117 .......... ............ A Partial removal of esophagus ..................... 40.02 NA 16.75 5.17 NA 61.94 090 43118 .......... ............ A Partial removal of esophagus ..................... 33.22 NA 13.41 4.10 NA 50.73 090 43121 .......... ............ A Partial removal of esophagus ..................... 29.21 NA 13.19 3.90 NA 46.30 090 43122 .......... ............ A Partial removal of esophagus ..................... 40.02 NA 16.93 5.40 NA 62.35 090 43123 .......... ............ A Partial removal of esophagus ..................... 33.22 NA 13.85 4.15 NA 51.22 090 43124 .......... ............ A Removal of esophagus ............................... 27.33 NA 12.85 3.73 NA 43.92 090 43130 .......... ............ A Removal of esophagus pouch .................... 11.75 NA 7.35 1.16 NA 20.27 090 43135 .......... ............ A Removal of esophagus pouch .................... 16.11 NA 7.95 2.33 NA 26.39 090 43200 .......... ............ A Esophagus endoscopy ................................ 1.59 4.08 1.08 0.13 5.80 2.80 000 43201 .......... ............ A Esoph scope w/submucous inj .................... 2.09 4.71 1.14 0.15 6.95 3.39 000 43202 .......... ............ A Esophagus endoscopy, biopsy ................... 1.89 5.75 0.98 0.15 7.79 3.03 000 43204 .......... ............ A Esoph scope w/sclerosis inj ........................ 3.77 NA 1.66 0.30 NA 5.73 000 43205 .......... ............ A Esophagus endoscopy/ligation .................... 3.79 NA 1.66 0.28 NA 5.73 000 43215 .......... ............ A Esophagus endoscopy ................................ 2.61 NA 1.25 0.22 NA 4.08 000 43216 .......... ............ A Esophagus endoscopy/lesion ...................... 2.40 0.00 1.13 0.20 2.60 3.73 000 43217 .......... ............ A Esophagus endoscopy ................................ 2.91 7.19 1.27 0.26 10.35 4.43 000 43219 .......... ............ A Esophagus endoscopy ................................ 2.81 NA 1.45 0.24 NA 4.50 000 43220 .......... ............ A Esoph endoscopy, dilation .......................... 2.10 NA 1.04 0.17 NA 3.32 000 43226 .......... ............ A Esoph endoscopy, dilation .......................... 2.34 NA 1.13 0.19 NA 3.66 000


## 45921

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

43227 .......... ............ A Esoph endoscopy, repair ............................ 3.60 NA 1.57 0.28 NA 5.45 000 43228 .......... ............ A Esoph endoscopy, ablation ......................... 3.77 NA 1.64 0.34 NA 5.75 000 43231 .......... ............ A Esoph endoscopy w/us exam ..................... 3.20 NA 1.42 0.23 NA 4.85 000 43232 .......... ............ A Esoph endoscopy w/us fn bx ...................... 4.48 NA 1.92 0.34 NA 6.74 000 43234 .......... ............ A Upper GI endoscopy, exam ........................ 2.01 5.49 0.92 0.17 7.67 3.11 000 43235 .......... ............ A Uppr gi endoscopy, diagnosis ..................... 2.39 5.55 1.11 0.19 8.13 3.70 000 43236 .......... ............ A Uppr gi scope w/submuc inj ........................ 2.93 6.89 1.34 0.21 10.02 4.48 000 43237 .......... ............ A Endoscopic us exam, esoph ....................... 3.99 NA 1.75 0.43 NA 6.17 000 43238 .......... ............ A Uppr gi endoscopy w/us fn bx .................... 5.03 NA 2.14 0.43 NA 7.60 000 43239 .......... ............ A Upper GI endoscopy, biopsy ....................... 2.88 6.18 1.30 0.22 9.28 4.39 000 43240 .......... ............ A Esoph endoscope w/drain cyst ................... 6.86 NA 2.83 0.56 NA 10.25 000 43241 .......... ............ A Upper GI endoscopy with tube ................... 2.60 NA 1.19 0.21 NA 4.00 000 43242 .......... ............ A Uppr gi endoscopy w/us fn bx .................... 7.31 NA 2.93 0.53 NA 10.78 000 43243 .......... ............ A Upper gi endoscopy & inject ....................... 4.57 NA 1.95 0.33 NA 6.85 000 43244 .......... ............ A Upper GI endoscopy/ligation ....................... 5.05 NA 2.14 0.37 NA 7.56 000 43245 .......... ............ A Uppr gi scope dilate strictr .......................... 3.19 NA 1.40 0.26 NA 4.85 000 43246 .......... ............ A Place gastrostomy tube ............................... 4.33 NA 1.81 0.34 NA 6.48 000 43247 .......... ............ A Operative upper GI endoscopy ................... 3.39 NA 1.49 0.27 NA 5.14 000 43248 .......... ............ A Uppr gi endoscopy/guide wire ..................... 3.16 NA 1.45 0.23 NA 4.83 000 43249 .......... ............ A Esoph endoscopy, dilation .......................... 2.91 NA 1.33 0.22 NA 4.46 000 43250 .......... ............ A Upper GI endoscopy/tumor ......................... 3.21 NA 1.42 0.26 NA 4.89 000 43251 .......... ............ A Operative upper GI endoscopy ................... 3.70 NA 1.61 0.29 NA 5.59 000 43255 .......... ............ A Operative upper GI endoscopy ................... 4.82 NA 2.05 0.35 NA 7.22 000 43256 .......... ............ A Uppr gi endoscopy w/stent .......................... 4.35 NA 1.85 0.32 NA 6.52 000 43257 .......... ............ A Uppr gi scope w/thrml txmnt ....................... 5.51 NA 2.27 0.36 NA 8.14 000 43258 .......... ............ A Operative upper GI endoscopy ................... 4.55 NA 1.93 0.33 NA 6.81 000 43259 .......... ............ A Endoscopic ultrasound exam ...................... 5.20 NA 2.15 0.35 NA 7.70 000 43260 .......... ............ A Endo cholangiopancreatograph .................. 5.96 NA 2.48 0.43 NA 8.87 000 43261 .......... ............ A Endo cholangiopancreatograph .................. 6.27 NA 2.60 0.46 NA 9.33 000 43262 .......... ............ A Endo cholangiopancreatograph .................. 7.39 NA 3.02 0.54 NA 10.96 000 43263 .......... ............ A Endo cholangiopancreatograph .................. 7.29 NA 3.02 0.54 NA 10.85 000 43264 .......... ............ A Endo cholangiopancreatograph .................. 8.91 NA 3.59 0.65 NA 13.15 000 43265 .......... ............ A Endo cholangiopancreatograph .................. 10.02 NA 4.00 0.73 NA 14.75 000 43267 .......... ............ A Endo cholangiopancreatograph .................. 7.39 NA 3.00 0.54 NA 10.94 000 43268 .......... ............ A Endo cholangiopancreatograph .................. 7.39 NA 3.15 0.54 NA 11.08 000 43269 .......... ............ A Endo cholangiopancreatograph .................. 8.22 NA 3.33 0.60 NA 12.15 000 43271 .......... ............ A Endo cholangiopancreatograph .................. 7.39 NA 3.01 0.54 NA 10.94 000 43272 .......... ............ A Endo cholangiopancreatograph .................. 7.39 NA 3.01 0.54 NA 10.94 000 43280 .......... ............ A Laparoscopy, fundoplasty ........................... 17.25 NA 7.17 2.27 NA 26.69 090 43289 .......... ............ C Laparoscope proc, esoph ............................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 43300 .......... ............ A Repair of esophagus ................................... 9.15 NA 6.22 1.12 NA 16.49 090 43305 .......... ............ A Repair esophagus and fistula ..................... 17.39 NA 10.37 1.54 NA 29.30 090 43310 .......... ............ A Repair of esophagus ................................... 25.40 NA 10.89 3.60 NA 39.89 090 43312 .......... ............ A Repair esophagus and fistula ..................... 28.44 NA 11.55 4.00 NA 43.99 090 43313 .......... ............ A Esophagoplasty congenital ......................... 45.30 NA 18.40 5.45 NA 69.15 090 43314 .......... ............ A Tracheo-esophagoplasty cong .................... 50.29 NA 18.88 6.63 NA 75.80 090 43320 .......... ............ A Fuse esophagus & stomach ....................... 19.94 NA 9.05 2.73 NA 31.72 090 43324 .......... ............ A Revise esophagus & stomach .................... 20.58 NA 8.62 2.75 NA 31.95 090 43325 .......... ............ A Revise esophagus & stomach .................... 20.07 NA 8.66 2.59 NA 31.32 090 43326 .......... ............ A Revise esophagus & stomach .................... 19.75 NA 9.17 2.84 NA 31.76 090 43330 .......... ............ A Repair of esophagus ................................... 19.78 NA 8.46 2.62 NA 30.86 090 43331 .......... ............ A Repair of esophagus ................................... 20.14 NA 9.83 2.93 NA 32.90 090 43340 .......... ............ A Fuse esophagus & intestine ........................ 19.62 NA 8.81 2.45 NA 30.87 090 43341 .......... ............ A Fuse esophagus & intestine ........................ 20.86 NA 10.35 2.91 NA 34.12 090 43350 .......... ............ A Surgical opening, esophagus ...................... 15.79 NA 8.31 1.42 NA 25.52 090 43351 .......... ............ A Surgical opening, esophagus ...................... 18.36 NA 9.70 2.46 NA 30.51 090 43352 .......... ............ A Surgical opening, esophagus ...................... 15.27 NA 8.27 2.05 NA 25.59 090 43360 .......... ............ A Gastrointestinal repair ................................. 35.72 NA 14.98 4.96 NA 55.66 090 43361 .......... ............ A Gastrointestinal repair ................................. 40.52 NA 16.63 4.49 NA 61.64 090 43400 .......... ............ A Ligate esophagus veins .............................. 21.21 NA 10.06 1.95 NA 33.22 090 43401 .......... ............ A Esophagus surgery for veins ...................... 22.10 NA 9.26 3.04 NA 34.40 090 43405 .......... ............ A Ligate/staple esophagus ............................. 20.02 NA 9.60 2.83 NA 32.45 090 43410 .......... ............ A Repair esophagus wound ........................... 13.48 NA 7.54 1.71 NA 22.72 090 43415 .......... ............ A Repair esophagus wound ........................... 25.01 NA 11.61 3.52 NA 40.14 090 43420 .......... ............ A Repair esophagus opening ......................... 14.36 NA 7.24 1.43 NA 23.03 090 43425 .......... ............ A Repair esophagus opening ......................... 21.04 NA 9.84 3.02 NA 33.90 090 43450 .......... ............ A Dilate esophagus ......................................... 1.38 2.83 0.77 0.11 4.32 2.26 000 43453 .......... ............ A Dilate esophagus ......................................... 1.51 6.53 0.82 0.11 8.15 2.44 000 43456 .......... ............ A Dilate esophagus ......................................... 2.58 14.11 1.21 0.20 16.89 3.99 000 43458 .......... ............ A Dilate esophagus ......................................... 3.07 7.20 1.40 0.24 10.51 4.70 000 43460 .......... ............ A Pressure treatment esophagus ................... 3.80 NA 1.57 0.31 NA 5.68 000 43496 .......... ............ C Free jejunum flap, microvasc ...................... 0.00 0.00 0.00 0.00 0.00 0.00 090 43499 .......... ............ C Esophagus surgery procedure .................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 43500 .......... ............ A Surgical opening of stomach ....................... 11.05 NA 4.93 1.45 NA 17.43 090


## 45922

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

43501 .......... ............ A Surgical repair of stomach .......................... 20.05 NA 8.20 2.64 NA 30.89 090 43502 .......... ............ A Surgical repair of stomach .......................... 23.15 NA 9.34 3.09 NA 35.57 090 43510 .......... ............ A Surgical opening of stomach ....................... 13.09 NA 6.97 1.48 NA 21.54 090 43520 .......... ............ A Incision of pyloric muscle ............................ 10.00 NA 5.09 1.36 NA 16.45 090 43600 .......... ............ A Biopsy of stomach ....................................... 1.91 NA 0.69 0.14 NA 2.74 000 43605 .......... ............ A Biopsy of stomach ....................................... 11.98 NA 5.22 1.58 NA 18.79 090 43610 .......... ............ A Excision of stomach lesion .......................... 14.61 NA 6.07 1.93 NA 22.61 090 43611 .......... ............ A Excision of stomach lesion .......................... 17.85 NA 7.47 2.35 NA 27.67 090 43620 .......... ............ A Removal of stomach ................................... 30.05 NA 11.60 3.95 NA 45.60 090 43621 .......... ............ A Removal of stomach ................................... 30.74 NA 11.77 4.03 NA 46.54 090 43622 .......... ............ A Removal of stomach ................................... 32.54 NA 12.36 4.29 NA 49.20 090 43631 .......... ............ A Removal of stomach, partial ....................... 22.61 NA 9.03 2.98 NA 34.61 090 43632 .......... ............ A Removal of stomach, partial ....................... 22.61 NA 9.03 2.98 NA 34.61 090 43633 .......... ............ A Removal of stomach, partial ....................... 23.12 NA 9.19 3.05 NA 35.35 090 43634 .......... ............ A Removal of stomach, partial ....................... 25.13 NA 9.90 3.32 NA 38.35 090 43635 .......... ............ A Removal of stomach, partial ....................... 2.06 NA 0.68 0.27 NA 3.02 ZZZ 43638 .......... ............ A Removal of stomach, partial ....................... 29.02 NA 11.70 3.80 NA 44.52 090 43639 .......... ............ A Removal of stomach, partial ....................... 29.67 NA 11.47 3.90 NA 45.04 090 43640 .......... ............ A Vagotomy & pylorus repair .......................... 17.02 NA 7.17 2.25 NA 26.44 090 43641 .......... ............ A Vagotomy & pylorus repair .......................... 17.27 NA 7.28 2.24 NA 26.79 090 43644 .......... ............ A Lap gastric bypass/roux-en-y ...................... 27.89 NA 11.14 3.15 NA 42.18 090 43645 .......... ............ A Lap gastr bypass incl smll i ......................... 30.02 NA 12.02 3.53 NA 45.57 090 43651 .......... ............ A Laparoscopy, vagus nerve .......................... 10.15 NA 4.71 1.33 NA 16.19 090 43652 .......... ............ A Laparoscopy, vagus nerve .......................... 12.15 NA 5.63 1.55 NA 19.33 090 43653 .......... ............ A Laparoscopy, gastrostomy .......................... 7.74 NA 4.16 1.01 NA 12.90 090 43659 .......... ............ C Laparoscope proc, stom .............................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY 43750 .......... ............ A Place gastrostomy tube ............................... 4.49 NA 2.14 0.43 NA 7.06 010 43752 .......... ............ A Nasal/orogastric w/stent .............................. 0.81 NA 0.27 0.02 NA 1.10 000 43760 .......... ............ A Change gastrostomy tube ........................... 1.10 5.82 0.45 0.09 7.01 1.65 000 43761 .......... ............ A Reposition gastrostomy tube ....................... 2.01 1.18 0.69 0.13 3.32 2.84 000 43800 .......... ............ A Reconstruction of pylorus ............................ 13.70 NA 5.81 1.81 NA 21.32 090 43810 .......... ............ A Fusion of stomach and bowel ..................... 14.66 NA 6.10 1.93 NA 22.69 090 43820 .......... ............ A Fusion of stomach and bowel ..................... 15.38 NA 6.33 2.03 NA 23.74 090 43825 .......... ............ A Fusion of stomach and bowel ..................... 19.23 NA 7.91 2.53 NA 29.67 090 43830 .......... ............ A Place gastrostomy tube ............................... 9.54 NA 4.85 1.25 NA 15.64 090 43831 .......... ............ A Place gastrostomy tube ............................... 7.85 NA 4.53 1.03 NA 13.41 090 43832 .......... ............ A Place gastrostomy tube ............................... 15.61 NA 6.83 1.97 NA 24.41 090 43840 .......... ............ A Repair of stomach lesion ............................ 15.57 NA 6.69 2.05 NA 24.31 090 43842 .......... ............ A V-band gastroplasty .................................... 18.48 NA 7.69 2.44 NA 28.60 090 43843 .......... ............ A Gastroplasty w/o v-band ............................. 18.66 NA 7.68 2.45 NA 28.79 090 43845 .......... ............ C Gastroplasty duodenal switch ..................... 0.00 0.00 0.00 0.00 0.00 0.00 090 43846 .......... ............ A Gastric bypass for obesity ........................... 24.06 NA 9.88 3.18 NA 37.12 090 43847 .......... ............ A Gastric bypass incl small i .......................... 26.93 NA 10.74 3.55 NA 41.23 090 43848 .......... ............ A Revision gastroplasty .................................. 29.41 NA 11.64 3.87 NA 44.92 090 43850 .......... ............ A Revise stomach-bowel fusion ..................... 24.73 NA 9.69 3.27 NA 37.69 090 43855 .......... ............ A Revise stomach-bowel fusion ..................... 26.17 NA 10.20 3.46 NA 39.83 090 43860 .......... ............ A Revise stomach-bowel fusion ..................... 25.01 NA 9.81 3.30 NA 38.12 090 43865 .......... ............ A Revise stomach-bowel fusion ..................... 26.53 NA 10.32 3.50 NA 40.35 090 43870 .......... ............ A Repair stomach opening ............................. 9.70 NA 4.51 1.27 NA 15.48 090 43880 .......... ............ A Repair stomach-bowel fistula ...................... 24.66 NA 9.78 3.26 NA 37.70 090 43999 .......... ............ C Stomach surgery procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44005 .......... ............ A Freeing of bowel adhesion .......................... 16.24 NA 6.64 2.14 NA 25.02 090 44010 .......... ............ A Incision of small bowel ................................ 12.53 NA 5.39 1.64 NA 19.56 090
44015 .......... ............ A Insert needle cath bowel ............................. 2.63 NA 0.87 0.35 NA 3.84 ZZZ 44020 .......... ............ A Explore small intestine ................................ 14.00 NA 5.87 1.85 NA 21.72 090 44021 .......... ............ A Decompress small bowel ............................ 14.09 NA 5.92 1.86 NA 21.86 090 44025 .......... ............ A Incision of large bowel ................................ 14.29 NA 5.96 1.89 NA 22.14 090
44050 .......... ............ A Reduce bowel obstruction ........................... 14.04 NA 5.88 1.85 NA 21.77 090 44055 .......... ............ A Correct malrotation of bowel ....................... 22.01 NA 8.59 2.90 NA 33.51 090 44100 .......... ............ A Biopsy of bowel ........................................... 2.01 NA 0.75 0.17 NA 2.94 000 44110 .......... ............ A Excise intestine lesion(s) ............................. 11.81 NA 5.18 1.55 NA 18.54 090 44111 .......... ............ A Excision of bowel lesion(s) .......................... 14.30 NA 6.03 1.86 NA 22.19 090
44120 .......... ............ A Removal of small intestine .......................... 17.00 NA 6.99 2.24 NA 26.23 090 44121 .......... ............ A Removal of small intestine .......................... 4.45 NA 1.49 0.58 NA 6.51 ZZZ 44125 .......... ............ A Removal of small intestine .......................... 17.55 NA 7.16 2.26 NA 26.97 090 44126 .......... ............ A Enterectomy w/o taper, cong ...................... 35.52 NA 13.91 4.68 NA 54.11 090 44127 .......... ............ A Enterectomy w/taper, cong ......................... 41.02 NA 15.47 5.75 NA 62.24 090 44128 .......... ............ A Enterectomy cong, add-on .......................... 4.45 NA 1.49 0.61 NA 6.55 ZZZ 44130 .......... ............ A Bowel to bowel fusion ................................. 14.50 NA 6.15 1.87 NA 22.52 090 44132 .......... ............ R Enterectomy, cadaver donor ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44133 .......... ............ R Enterectomy, live donor .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44135 .......... ............ R Intestine transplnt, cadaver ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44136 .......... ............ R Intestine transplant, live .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44137 .......... ............ C Remove intestinal allograft .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX


## 45923

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

44139 .......... ............ A Mobilization of colon .................................... 2.23 NA 0.74 0.28 NA 3.26 ZZZ 44140 .......... ............ A Partial removal of colon .............................. 21.01 NA 8.53 2.70 NA 32.25 090 44141 .......... ............ A Partial removal of colon .............................. 19.52 NA 9.91 2.52 NA 31.95 090 44143 .......... ............ A Partial removal of colon .............................. 23.01 NA 10.52 3.04 NA 36.57 090 44144 .......... ............ A Partial removal of colon .............................. 21.54 NA 9.50 2.85 NA 33.89 090 44145 .......... ............ A Partial removal of colon .............................. 26.43 NA 10.68 3.28 NA 40.39 090 44146 .......... ............ A Partial removal of colon .............................. 27.56 NA 12.67 3.40 NA 43.62 090 44147 .......... ............ A Partial removal of colon .............................. 20.72 NA 8.60 2.55 NA 31.87 090 44150 .......... ............ A Removal of colon ........................................ 23.96 NA 11.88 3.03 NA 38.87 090 44151 .......... ............ A Removal of colon/ileostomy ........................ 26.89 NA 13.23 3.48 NA 43.60 090 44152 .......... ............ A Removal of colon/ileostomy ........................ 27.85 NA 11.39 3.51 NA 42.75 090 44153 .......... ............ A Removal of colon/ileostomy ........................ 30.60 NA 14.27 3.54 NA 48.41 090 44155 .......... ............ A Removal of colon/ileostomy ........................ 27.88 NA 13.17 3.27 NA 44.31 090 44156 .......... ............ A Removal of colon/ileostomy ........................ 30.80 NA 14.81 3.94 NA 49.56 090 44160 .......... ............ A Removal of colon ........................................ 18.63 NA 7.65 2.36 NA 28.64 090 44200 .......... ............ A Laparoscopy, enterolysis ............................. 14.45 NA 6.12 1.89 NA 22.46 090 44201 .......... ............ A Laparoscopy, jejunostomy ........................... 9.79 NA 4.60 1.30 NA 15.69 090 44202 .......... ............ A Lap resect s/intestine singl .......................... 22.05 NA 8.81 2.84 NA 33.71 090 44203 .......... ............ A Lap resect s/intestine, addl ......................... 4.45 NA 1.46 0.57 NA 6.48 ZZZ 44204 .......... ............ A Laparo partial colectomy ............................. 25.09 NA 9.81 3.10 NA 38.00 090 44205 .......... ............ A Lap colectomy part w/ileum ........................ 22.24 NA 8.72 2.74 NA 33.71 090 44206 .......... ............ A Lap part colectomy w/stoma ....................... 27.01 NA 11.08 3.45 NA 41.54 090 44207 .......... ............ A L colectomy/coloproctostomy ...................... 30.02 NA 11.32 3.66 NA 45.00 090 44208 .......... ............ A L colectomy/coloproctostomy ...................... 32.01 NA 12.97 3.87 NA 48.85 090 44210 .......... ............ A Laparo total proctocolectomy ...................... 28.02 NA 11.74 3.41 NA 43.17 090 44211 .......... ............ A Laparo total proctocolectomy ...................... 35.02 NA 14.52 4.16 NA 53.70 090 44212 .......... ............ A Laparo total proctocolectomy ...................... 32.51 NA 13.56 3.77 NA 49.84 090 44238 .......... ............ C Laparoscope proc, intestine ........................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44239 .......... ............ C Laparoscope proc, rectum .......................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44300 .......... ............ A Open bowel to skin ..................................... 12.11 NA 5.43 1.60 NA 19.15 090 44310 .......... ............ A Ileostomy/jejunostomy ................................. 15.96 NA 6.62 1.98 NA 24.57 090 44312 .......... ............ A Revision of ileostomy .................................. 8.03 NA 4.12 0.92 NA 13.06 090 44314 .......... ............ A Revision of ileostomy .................................. 15.06 NA 6.65 1.74 NA 23.45 090 44316 .......... ............ A Devise bowel pouch .................................... 21.10 NA 8.65 2.37 NA 32.12 090 44320 .......... ............ A Colostomy .................................................... 17.65 NA 7.58 2.25 NA 27.48 090 44322 .......... ............ A Colostomy with biopsies .............................. 11.98 NA 8.49 1.54 NA 22.01 090 44340 .......... ............ A Revision of colostomy ................................. 7.73 NA 4.26 0.99 NA 12.98 090 44345 .......... ............ A Revision of colostomy ................................. 15.44 NA 6.83 1.96 NA 24.23 090 44346 .......... ............ A Revision of colostomy ................................. 16.99 NA 7.34 2.12 NA 26.45 090 44360 .......... ............ A Small bowel endoscopy .............................. 2.60 NA 1.21 0.19 NA 4.00 000 44361 .......... ............ A Small bowel endoscopy/biopsy ................... 2.88 NA 1.32 0.21 NA 4.40 000 44363 .......... ............ A Small bowel endoscopy .............................. 3.50 NA 1.48 0.27 NA 5.25 000 44364 .......... ............ A Small bowel endoscopy .............................. 3.74 NA 1.62 0.27 NA 5.63 000 44365 .......... ............ A Small bowel endoscopy .............................. 3.32 NA 1.49 0.24 NA 5.05 000 44366 .......... ............ A Small bowel endoscopy .............................. 4.41 NA 1.88 0.32 NA 6.61 000 44369 .......... ............ A Small bowel endoscopy .............................. 4.52 NA 1.85 0.33 NA 6.70 000 44370 .......... ............ A Small bowel endoscopy/stent ...................... 4.80 NA 2.16 0.37 NA 7.33 000 44372 .......... ............ A Small bowel endoscopy .............................. 4.41 NA 1.85 0.35 NA 6.61 000 44373 .......... ............ A Small bowel endoscopy .............................. 3.50 NA 1.53 0.27 NA 5.30 000 44376 .......... ............ A Small bowel endoscopy .............................. 5.26 NA 2.17 0.42 NA 7.85 000 44377 .......... ............ A Small bowel endoscopy/biopsy ................... 5.53 NA 2.32 0.40 NA 8.25 000 44378 .......... ............ A Small bowel endoscopy .............................. 7.13 NA 2.92 0.52 NA 10.58 000 44379 .......... ............ A S bowel endoscope w/stent ........................ 7.47 NA 3.13 0.62 NA 11.23 000 44380 .......... ............ A Small bowel endoscopy .............................. 1.05 NA 0.63 0.08 NA 1.76 000 44382 .......... ............ A Small bowel endoscopy .............................. 1.27 NA 0.71 0.12 NA 2.10 000 44383 .......... ............ A Ileoscopy w/stent ......................................... 2.95 NA 1.42 0.21 NA 4.57 000 44385 .......... ............ A Endoscopy of bowel pouch ......................... 1.82 3.53 0.83 0.15 5.51 2.80 000 44386 .......... ............ A Endoscopy, bowel pouch/biop .................... 2.12 7.02 0.93 0.20 9.34 3.26 000 44388 .......... ............ A Colonoscopy ................................................ 2.83 5.31 1.21 0.26 8.40 4.30 000 44389 .......... ............ A Colonoscopy with biopsy ............................. 3.14 7.02 1.36 0.27 10.43 4.76 000 44390 .......... ............ A Colonoscopy for foreign body ..................... 3.83 7.54 1.59 0.32 11.68 5.74 000 44391 .......... ............ A Colonoscopy for bleeding ............................ 4.32 8.94 1.82 0.34 13.60 6.48 000 44392 .......... ............ A Colonoscopy & polypectomy ....................... 3.82 6.91 1.57 0.34 11.06 5.73 000 44393 .......... ............ A Colonoscopy, lesion removal ...................... 4.84 7.17 1.99 0.42 12.43 7.25 000 44394 .......... ............ A Colonoscopy w/snare .................................. 4.43 8.31 1.82 0.38 13.12 6.63 000 44397 .......... ............ A Colonoscopy w/stent ................................... 4.71 NA 1.88 0.39 NA 6.98 000 44500 .......... ............ A Intro, gastrointestinal tube ........................... 0.49 NA 0.17 0.03 NA 0.69 000 44602 .......... ............ A Suture, small intestine ................................. 16.04 NA 6.29 2.11 NA 24.44 090 44603 .......... ............ A Suture, small intestine ................................. 18.67 NA 7.15 2.41 NA 28.23 090 44604 .......... ............ A Suture, large intestine ................................. 16.04 NA 6.36 2.11 NA 24.51 090 44605 .......... ............ A Repair of bowel lesion ................................. 19.54 NA 8.24 2.51 NA 30.29 090 44615 .......... ............ A Intestinal stricturoplasty ............................... 15.94 NA 6.60 2.06 NA 24.60 090 44620 .......... ............ A Repair bowel opening ................................. 12.20 NA 5.27 1.51 NA 18.99 090 44625 .......... ............ A Repair bowel opening ................................. 15.06 NA 6.23 1.85 NA 23.14 090


## 45924

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

44626 .......... ............ A Repair bowel opening ................................. 25.37 NA 9.65 3.26 NA 38.28 090 44640 .......... ............ A Repair bowel-skin fistula ............................. 21.66 NA 8.45 2.77 NA 32.89 090 44650 .......... ............ A Repair bowel fistula ..................................... 22.59 NA 8.78 2.92 NA 34.28 090 44660 .......... ............ A Repair bowel-bladder fistula ........................ 21.37 NA 8.77 2.13 NA 32.27 090 44661 .......... ............ A Repair bowel-bladder fistula ........................ 24.82 NA 9.74 2.80 NA 37.36 090 44680 .......... ............ A Surgical revision, intestine .......................... 15.41 NA 6.37 1.99 NA 23.77 090 44700 .......... ............ A Suspend bowel w/prosthesis ....................... 16.12 NA 6.68 1.83 NA 24.63 090 44701 .......... ............ A Intraop colon lavage add-on ....................... 3.11 NA 1.03 0.37 NA 4.51 ZZZ 44715 .......... ............ C Prepare donor intestine ............................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44720 .......... ............ A Prep donor intestine/venous ....................... 5.01 NA 1.67 0.37 NA 7.05 XXX 44721 .......... ............ A Prep donor intestine/artery .......................... 7.01 NA 2.33 0.97 NA 10.32 XXX 44799 .......... ............ C Unlisted procedure intestine ........................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44800 .......... ............ A Excision of bowel pouch ............................. 11.23 NA 5.38 1.47 NA 18.08 090 44820 .......... ............ A Excision of mesentery lesion ...................... 12.09 NA 5.44 1.59 NA 19.12 090 44850 .......... ............ A Repair of mesentery .................................... 10.74 NA 4.94 1.39 NA 17.07 090 44899 .......... ............ C Bowel surgery procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44900 .......... ............ A Drain app abscess, open ............................ 10.14 NA 4.67 1.33 NA 16.14 090 44901 .......... ............ A Drain app abscess, percut .......................... 3.38 26.78 1.15 0.22 30.37 4.74 000 44950 .......... ............ A Appendectomy ............................................. 10.01 NA 4.26 1.31 NA 15.58 090 44955 .......... ............ A Appendectomy add-on ................................ 1.53 NA 0.53 0.20 NA 2.26 ZZZ 44960 .......... ............ A Appendectomy ............................................. 12.34 NA 5.27 1.63 NA 19.24 090 44970 .......... ............ A Laparoscopy, appendectomy ...................... 8.71 NA 4.06 1.14 NA 13.90 090 44979 .......... ............ C Laparoscope proc, app ............................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 45000 .......... ............ A Drainage of pelvic abscess ......................... 4.52 NA 3.02 0.52 NA 8.06 090 45005 .......... ............ A Drainage of rectal abscess ......................... 1.99 3.94 1.55 0.25 6.19 3.80 010 45020 .......... ............ A Drainage of rectal abscess ......................... 4.72 NA 3.33 0.55 NA 8.60 090 45100 .......... ............ A Biopsy of rectum ......................................... 3.68 NA 2.40 0.44 NA 6.52 090 45108 .......... ............ A Removal of anorectal lesion ........................ 4.76 NA 2.78 0.59 NA 8.13 090 45110 .......... ............ A Removal of rectum ...................................... 28.02 NA 12.24 3.35 NA 43.61 090 45111 .......... ............ A Partial removal of rectum ............................ 16.49 NA 7.10 2.06 NA 25.65 090 45112 .......... ............ A Removal of rectum ...................................... 30.55 NA 11.60 3.42 NA 45.57 090 45113 .......... ............ A Partial proctectomy ...................................... 30.59 NA 12.48 3.48 NA 46.56 090 45114 .......... ............ A Partial removal of rectum ............................ 27.33 NA 10.73 3.35 NA 41.42 090 45116 .......... ............ A Partial removal of rectum ............................ 24.59 NA 9.88 2.87 NA 37.34 090 45119 .......... ............ A Remove rectum w/reservoir ........................ 30.85 NA 12.33 3.35 NA 46.54 090 45120 .......... ............ A Removal of rectum ...................................... 24.61 NA 10.07 2.89 NA 37.57 090 45121 .......... ............ A Removal of rectum and colon ..................... 27.05 NA 10.96 3.24 NA 41.26 090 45123 .......... ............ A Partial proctectomy ...................................... 16.71 NA 6.81 1.85 NA 25.37 090 45126 .......... ............ A Pelvic exenteration ...................................... 45.18 NA 19.60 4.32 NA 69.10 090 45130 .......... ............ A Excision of rectal prolapse .......................... 16.45 NA 6.73 1.79 NA 24.98 090 45135 .......... ............ A Excision of rectal prolapse .......................... 19.29 NA 8.34 2.35 NA 29.98 090
45136 .......... ............ A Excise ileoanal reservior ............................. 27.31 NA 12.34 2.81 NA 42.47 090 45150 .......... ............ A Excision of rectal stricture ........................... 5.67 NA 3.01 0.61 NA 9.29 090 45160 .......... ............ A Excision of rectal lesion .............................. 15.33 NA 6.62 1.67 NA 23.62 090 45170 .......... ............ A Excision of rectal lesion .............................. 11.49 NA 5.21 1.35 NA 18.06 090 45190 .......... ............ A Destruction, rectal tumor ............................. 9.75 NA 4.64 1.13 NA 15.52 090 45300 .......... ............ A Proctosigmoidoscopy dx ............................. 0.38 1.56 0.29 0.04 1.98 0.71 000 45303 .......... ............ A Proctosigmoidoscopy dilate ......................... 0.44 18.29 0.37 0.05 18.78 0.86 000 45305 .......... ............ A Proctosigmoidoscopy w/bx .......................... 1.01 2.68 0.51 0.11 3.80 1.63 000 45307 .......... ............ A Proctosigmoidoscopy fb .............................. 0.94 3.03 0.49 0.11 4.09 1.54 000 45308 .......... ............ A Proctosigmoidoscopy removal .................... 0.83 2.10 0.45 0.09 3.02 1.37 000 45309 .......... ............ A Proctosigmoidoscopy removal .................... 2.01 2.86 0.85 0.22 5.09 3.09 000 45315 .......... ............ A Proctosigmoidoscopy removal .................... 1.40 2.95 0.65 0.15 4.50 2.20 000 45317 .......... ............ A Proctosigmoidoscopy bleed ........................ 1.50 2.57 0.68 0.15 4.22 2.33 000 45320 .......... ............ A Proctosigmoidoscopy ablate ....................... 1.58 3.10 0.74 0.16 4.84 2.48 000 45321 .......... ............ A Proctosigmoidoscopy volvul ........................ 1.17 NA 0.58 0.13 NA 1.89 000 45327 .......... ............ A Proctosigmoidoscopy w/stent ...................... 1.65 NA 0.69 0.16 NA 2.51 000 45330 .......... ............ A Diagnostic sigmoidoscopy ........................... 0.96 2.33 0.55 0.08 3.37 1.59 000 45331 .......... ............ A Sigmoidoscopy and biopsy ......................... 1.15 3.20 0.65 0.09 4.44 1.90 000 45332 .......... ............ A Sigmoidoscopy w/fb removal ...................... 1.79 5.02 0.86 0.16 6.97 2.82 000 45333 .......... ............ A Sigmoidoscopy & polypectomy ................... 1.79 5.08 0.87 0.15 7.02 2.81 000 45334 .......... ............ A Sigmoidoscopy for bleeding ........................ 2.74 NA 1.24 0.20 NA 4.18 000 45335 .......... ............ A Sigmoidoscopy w/submuc inj ...................... 1.46 3.34 0.75 0.11 4.91 2.33 000 45337 .......... ............ A Sigmoidoscopy & decompress .................... 2.36 NA 1.07 0.21 NA 3.65 000 45338 .......... ............ A Sigmoidoscopy w/tumr remove ................... 2.34 5.50 .09 0.19 8.04 3.62 000 45339 .......... ............ A Sigmoidoscopy w/ablate tumr ..................... 3.15 3.72 1.39 0.26 7.12 4.79 000 45340 .......... ............ A Sig w/balloon dilation .................................. 1.89 6.40 0.89 0.15 8.44 2.94 000 45341 .......... ............ A Sigmoidoscopy w/ultrasound ....................... 2.61 NA 1.11 0.19 NA 3.90 000 45342 .......... ............ A Sigmoidoscopy w/us guide bx ..................... 4.06 NA 1.61 0.30 NA 5.97 000 45345 .......... ............ A Sigmoidoscopy w/stent ................................ 2.93 NA 1.21 0.23 NA 4.37 000 45355 .......... ............ A Surgical colonoscopy .................................. 3.52 NA 1.41 0.36 NA 5.29 000 45378 .......... ............ A Diagnostic colonoscopy ............................... 3.70 6.60 1.58 0.30 10.59 5.57 000 45378 .......... 53 ....... A Diagnostic colonoscopy ............................... 0.96 2.33 0.55 0.08 3.37 1.59 000 45379 .......... ............ A Colonoscopy w/fb removal .......................... 4.69 7.80 1.93 0.39 12.88 7.01 000


## 45925

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

45380 .......... ............ A Colonoscopy and biopsy ............................. 4.44 7.80 1.86 0.35 12.59 6.65 000 45381 .......... ............ A Colonoscopy, submucous inj ...................... 4.20 7.72 1.79 0.30 12.22 6.29 000 45382 .......... ............ A Colonoscopy/control bleeding ..................... 5.69 10.76 2.36 0.41 16.86 8.47 000 45383 .......... ............ A Lesion removal colonoscopy ....................... 5.87 8.55 2.37 0.48 14.91 8.72 000 45384 .......... ............ A Lesion remove colonoscopy ........................ 4.70 7.38 1.96 0.38 12.46 7.04 000 45385 .......... ............ A Lesion removal colonoscopy ....................... 5.31 8.44 2.18 0.42 14.17 7.91 000 45386 .......... ............ A Colonoscopy dilate stricture ........................ 4.58 13.23 1.91 0.39 18.20 6.88 000 45387 .......... ............ A Colonoscopy w/stent ................................... 5.91 NA 2.50 0.48 NA 8.89 000 45391 .......... ............ A Colonoscopy w/endoscope us .................... 5.10 NA 2.15 0.42 NA 7.67 000 45392 .......... ............ A Colonoscopy w/endoscopic fnb ................... 6.55 NA 2.69 0.42 NA 9.66 000 45500 .......... ............ A Repair of rectum .......................................... 7.29 NA 3.57 0.75 NA 11.61 090 45505 .......... ............ A Repair of rectum .......................................... 7.59 NA 3.91 0.86 NA 12.36 090 45520 .......... ............ A Treatment of rectal prolapse ....................... 0.55 1.77 0.40 0.05 2.37 1.00 000 45540 .......... ............ A Correct rectal prolapse ................................ 16.28 NA 6.73 1.84 NA 24.85 090 45541 .......... ............ A Correct rectal prolapse ................................ 13.41 NA 5.92 1.55 NA 20.88 090 45550 .......... ............ A Repair rectum/remove sigmoid ................... 23.02 NA 9.11 2.61 NA 34.74 090 45560 .......... ............ A Repair of rectocele ...................................... 10.58 NA 5.13 1.13 NA 16.84 090 45562 .......... ............ A Exploration/repair of rectum ........................ 15.39 NA 7.05 1.83 NA 24.27 090 45563 .......... ............ A Exploration/repair of rectum ........................ 23.48 NA 10.44 3.10 NA 37.02 090 45800 .......... ............ A Repair rect/bladder fistula ........................... 17.78 NA 7.84 1.85 NA 27.46 090 45805 .......... ............ A Repair fistula w/colostomy .......................... 20.79 NA 9.62 2.02 NA 32.43 090 45820 .......... ............ A Repair rectourethral fistula .......................... 18.49 NA 8.03 1.58 NA 28.09 090 45825 .......... ............ A Repair fistula w/colostomy .......................... 21.26 NA 9.95 2.31 NA 33.53 090 45900 .......... ............ A Reduction of rectal prolapse ....................... 2.62 NA 1.50 0.30 NA 4.41 010 45905 .......... ............ A Dilation of anal sphincter ............................. 2.30 NA 1.47 0.27 NA 4.05 010 45910 .......... ............ A Dilation of rectal narrowing ......................... 2.81 NA 1.76 0.30 NA 4.86 010
45915 .......... ............ A Remove rectal obstruction .......................... 3.15 4.28 2.06 0.30 7.72 5.51 010 45999 .......... ............ C Rectum surgery procedure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 46020 .......... ............ A Placement of seton ..................................... 2.91 2.40 1.89 0.31 5.62 5.10 010 46030 .......... ............ A Removal of rectal marker ............................ 1.23 1.41 0.72 0.14 2.78 2.09 010 46040 .......... ............ A Incision of rectal abscess ............................ 4.96 5.50 3.59 0.62 11.08 9.17 090 46045 .......... ............ A Incision of rectal abscess ............................ 4.32 NA 2.92 0.54 NA 7.78 090 46050 .......... ............ A Incision of anal abscess .............................. 1.19 2.55 0.84 0.14 3.88 2.17 010 46060 .......... ............ A Incision of rectal abscess ............................ 5.69 NA 3.28 0.67 NA 9.64 090 46070 .......... ............ A Incision of anal septum ............................... 2.72 NA 1.86 0.36 NA 4.93 090 46080 .......... ............ A Incision of anal sphincter ............................ 2.49 2.40 1.13 0.30 5.20 3.92 010
46083 .......... ............ A Incise external hemorrhoid .......................... 1.40 2.46 0.91 0.15 4.01 2.47 010 46200 .......... ............ A Removal of anal fissure .............................. 3.42 4.08 2.92 0.39 7.89 6.73 090 46210 .......... ............ A Removal of anal crypt ................................. 2.68 5.04 2.65 0.31 8.02 5.64 090 46211 .......... ............ A Removal of anal crypts ............................... 4.25 5.43 3.67 0.48 10.16 8.40 090 46220 .......... ............ A Removal of anal tag .................................... 1.56 2.33 0.96 0.17 4.06 2.70 010 46221 .......... ............ A Ligation of hemorrhoid(s) ............................ 2.04 2.71 1.77 0.23 4.98 4.05 010 46230 .......... ............ A Removal of anal tags .................................. 2.58 3.06 1.29 0.30 5.94 4.17 010 46250 .......... ............ A Hemorrhoidectomy ...................................... 3.89 5.25 2.60 0.48 9.62 6.97 090 46255 .......... ............ A Hemorrhoidectomy ...................................... 4.60 5.85 2.82 0.58 11.03 8.00 090 46257 .......... ............ A Remove hemorrhoids & fissure ................... 5.40 NA 2.89 0.64 NA 8.93 090 46258 .......... ............ A Remove hemorrhoids & fistula .................... 5.73 NA 3.31 0.68 NA 9.72 090 46260 .......... ............ A Hemorrhoidectomy ...................................... 6.37 NA 3.20 0.76 NA 10.33 090 46261 .......... ............ A Remove hemorrhoids & fissure ................... 7.08 NA 3.64 0.79 NA 11.51 090 46262 .......... ............ A Remove hemorrhoids & fistula .................... 7.50 NA 3.77 0.83 NA 12.10 090 46270 .......... ............ A Removal of anal fistula ................................ 3.72 4.97 2.85 0.46 9.15 7.02 090 46275 .......... ............ A Removal of anal fistula ................................ 4.56 4.76 3.00 0.52 9.84 8.08 090 46280 .......... ............ A Removal of anal fistula ................................ 5.98 NA 3.29 0.66 NA 9.94 090 46285 .......... ............ A Removal of anal fistula ................................ 4.09 3.95 2.77 0.44 8.48 7.30 090 46288 .......... ............ A Repair anal fistula ....................................... 7.13 NA 3.69 0.79 NA 11.62 090 46320 .......... ............ A Removal of hemorrhoid clot ........................ 1.61 2.12 0.84 0.18 3.91 2.63 010 46500 .......... ............ A Injection into hemorrhoid(s) ......................... 1.61 2.26 1.26 0.16 4.04 3.04 010 46600 .......... ............ A Diagnostic anoscopy ................................... 0.50 1.52 0.34 0.05 2.07 0.89 000 46604 .......... ............ A Anoscopy and dilation ................................. 1.31 9.37 0.64 0.12 10.81 2.08 000 46606 .......... ............ A Anoscopy and biopsy .................................. 0.81 3.69 0.44 0.09 4.59 1.34 000 46608 .......... ............ A Anoscopy, remove for body ........................ 1.51 4.23 0.65 0.16 5.91 2.32 000 46610 .......... ............ A Anoscopy, remove lesion ............................ 1.32 3.92 0.62 0.15 5.40 2.10 000 46611 .......... ............ A Anoscopy ..................................................... 1.81 3.20 0.78 0.19 5.20 2.78 000 46612 .......... ............ A Anoscopy, remove lesions .......................... 2.34 5.32 1.01 0.28 7.95 3.64 000 46614 .......... ............ A Anoscopy, control bleeding ......................... 2.01 2.48 0.87 0.20 4.69 3.08 000 46615 .......... ............ A Anoscopy ..................................................... 2.69 2.43 1.07 0.33 5.45 4.09 000 46700 .......... ............ A Repair of anal stricture ................................ 9.14 NA 4.24 0.94 NA 14.32 090 46705 .......... ............ A Repair of anal stricture ................................ 6.90 NA 3.77 0.91 NA 11.58 090 46706 .......... ............ A Repr of anal fistula w/glue .......................... 2.39 0.00 1.27 0.28 2.67 3.94 010 46715 .......... ............ A Rep perf anoper fistu .................................. 7.20 NA 3.63 0.92 NA 11.75 090 46716 .......... ............ A Rep perf anoper/vestib fistu ........................ 15.08 NA 7.93 1.58 NA 24.59 090 46730 .......... ............ A Construction of absent anus ....................... 26.76 NA 11.97 2.46 NA 41.19 090 46735 .......... ............ A Construction of absent anus ....................... 32.18 NA 13.46 3.20 NA 48.85 090 46740 .......... ............ A Construction of absent anus ....................... 30.02 NA 13.17 2.41 NA 45.60 090


## 45926

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

46742 .......... ............ A Repair of imperforated anus ....................... 35.82 NA 16.88 3.19 NA 55.89 090 46744 .......... ............ A Repair of cloacal anomaly ........................... 52.66 NA 21.39 6.38 NA 80.42 090 46746 .......... ............ A Repair of cloacal anomaly ........................... 58.25 NA 24.73 7.68 NA 90.65 090 46748 .......... ............ A Repair of cloacal anomaly ........................... 64.24 NA 25.56 3.36 NA 93.15 090 46750 .......... ............ A Repair of anal sphincter .............................. 10.25 NA 5.05 1.10 NA 16.40 090 46751 .......... ............ A Repair of anal sphincter .............................. 8.78 NA 5.23 0.94 NA 14.94 090 46753 .......... ............ A Reconstruction of anus ............................... 8.30 NA 3.85 0.94 NA 13.08 090 46754 .......... ............ A Removal of suture from anus ...................... 2.20 3.53 1.72 0.19 5.93 4.11 010 46760 .......... ............ A Repair of anal sphincter .............................. 14.44 NA 7.10 1.59 NA 23.13 090 46761 .......... ............ A Repair of anal sphincter .............................. 13.85 NA 6.00 1.43 NA 21.28 090 46762 .......... ............ A Implant artificial sphincter ............................ 12.72 NA 5.77 1.24 NA 19.72 090 46900 .......... ............ A Destruction, anal lesion(s) ........................... 1.91 2.72 1.33 0.17 4.80 3.41 010 46910 .......... ............ A Destruction, anal lesion(s) ........................... 1.86 3.04 1.07 0.19 5.09 3.13 010 46916 .......... ............ A Cryosurgery, anal lesion(s) ......................... 1.86 3.30 1.52 0.11 5.27 3.49 010 46917 .......... ............ A Laser surgery, anal lesions ......................... 1.86 9.15 1.15 0.21 11.23 3.22 010 46922 .......... ............ A Excision of anal lesion(s) ............................ 1.86 3.33 1.08 0.22 5.42 3.16 010 46924 .......... ............ A Destruction, anal lesion(s) ........................... 2.77 8.93 1.36 0.26 11.95 4.39 010 46934 .......... ............ A Destruction of hemorrhoids ......................... 3.51 5.32 3.23 0.32 9.14 7.06 090 46935 .......... ............ A Destruction of hemorrhoids ......................... 2.43 3.49 1.25 0.23 6.15 3.91 010 46936 .......... ............ A Destruction of hemorrhoids ......................... 3.69 5.13 2.63 0.34 9.16 6.66 090 46937 .......... ............ A Cryotherapy of rectal lesion ........................ 2.70 3.09 1.23 0.14 5.92 4.07 010 46938 .......... ............ A Cryotherapy of rectal lesion ........................ 4.66 4.24 3.08 0.58 9.48 8.32 090 46940 .......... ............ A Treatment of anal fissure ............................ 2.32 2.08 1.10 0.23 4.63 3.65 010 46942 .......... ............ A Treatment of anal fissure ............................ 2.04 1.94 1.07 0.19 4.17 3.31 010 46945 .......... ............ A Ligation of hemorrhoids ............................... 1.84 3.37 2.65 0.19 5.41 4.69 090 46946 .......... ............ A Ligation of hemorrhoids ............................... 2.59 3.73 2.58 0.27 6.59 5.44 090 46947 .......... ............ A Hemorrhoidopexy by stapling ...................... 5.21 NA 2.73 0.75 NA 8.69 090 46999 .......... ............ C Anus surgery procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47000 .......... ............ A Needle biopsy of liver .................................. 1.90 4.66 0.66 0.12 6.69 2.69 000 47001 .......... ............ A Needle biopsy, liver add-on ........................ 1.90 NA 0.64 0.25 NA 2.79 ZZZ 47010 .......... ............ A Open drainage, liver lesion ......................... 16.02 NA 8.67 1.80 NA 26.49 090 47011 .......... ............ A Percut drain, liver lesion .............................. 3.70 NA 1.27 0.22 NA 5.18 000 47015 .......... ............ A Inject/aspirate liver cyst ............................... 15.12 NA 7.48 1.83 NA 24.43 090 47100 .......... ............ A Wedge biopsy of liver .................................. 11.67 NA 5.98 1.53 NA 19.18 090 47120 .......... ............ A Partial removal of liver ................................ 35.52 NA 14.87 4.65 NA 55.05 090 47122 .......... ............ A Extensive removal of liver ........................... 55.16 NA 20.98 7.19 NA 83.33 090 47125 .......... ............ A Partial removal of liver ................................ 49.22 NA 19.10 6.45 NA 74.76 090 47130 .......... ............ A Partial removal of liver ................................ 53.38 NA 20.51 6.94 NA 80.83 090 47135 .......... ............ R Transplantation of liver ................................ 81.56 NA 31.02 9.93 NA 122.51 090 47136 .......... ............ R Transplantation of liver ................................ 68.64 NA 26.67 8.41 NA 103.72 090 47140 .......... ............ A Partial removal, donor liver ......................... 55.03 NA 22.05 5.17 NA 82.25 090 47141 .......... ............ A Partial removal, donor liver ......................... 67.53 NA 26.60 5.17 NA 99.30 090 47142 .......... ............ A Partial removal, donor liver ......................... 75.04 NA 29.09 5.17 NA 109.30 090 47143 .......... ............ C Prep donor liver, whole ............................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 47144 .......... ............ C Prep donor liver, 3-segment ........................ 0.00 0.00 0.00 0.00 0.00 0.00 090 47145 .......... ............ C Prep donor liver, lobe split .......................... 0.00 0.00 0.00 0.00 0.00 0.00 090 47146 .......... ............ A Prep donor liver/venous .............................. 6.01 NA 2.00 0.83 NA 8.84 XXX 47147 .......... ............ A Prep donor liver/arterial ............................... 7.01 NA 2.33 0.97 NA 10.32 XXX 47300 .......... ............ A Surgery for liver lesion ................................ 15.09 NA 7.14 1.98 NA 24.21 090 47350 .......... ............ A Repair liver wound ...................................... 19.57 NA 8.75 2.58 NA 30.90 090 47360 .......... ............ A Repair liver wound ...................................... 26.93 NA 11.43 3.37 NA 41.73 090 47361 .......... ............ A Repair liver wound ...................................... 47.14 NA 18.17 5.85 NA 71.16 090 47362 .......... ............ A Repair liver wound ...................................... 18.52 NA 8.58 2.50 NA 29.60 090 47370 .......... ............ A Laparo ablate liver tumor rf ......................... 19.70 NA 8.04 2.55 NA 30.29 090 47371 .......... ............ A Laparo ablate liver cryosurg ........................ 19.70 NA 8.03 2.60 NA 30.33 090 47379 .......... ............ C Laparoscope procedure, liver ...................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47380 .......... ............ A Open ablate liver tumor rf ........................... 23.02 NA 9.22 2.86 NA 35.10 090 47381 .......... ............ A Open ablate liver tumor cryo ....................... 23.29 NA 9.55 2.84 NA 35.68 090
47382 .......... ............ A Percut ablate liver rf .................................... 15.20 NA 6.19 0.96 NA 22.35 010 47399 .......... ............ C Liver surgery procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
47400 .......... ............ A Incision of liver duct .................................... 32.50 NA 13.33 3.07 NA 48.90 090 47420 .......... ............ A Incision of bile duct ..................................... 19.89 NA 8.62 2.62 NA 31.13 090 47425 .......... ............ A Incision of bile duct ..................................... 19.84 NA 8.70 2.61 NA 31.15 090 47460 .......... ............ A Incise bile duct sphincter ............................. 18.05 NA 8.55 2.20 NA 28.80 090 47480 .......... ............ A Incision of gallbladder ................................. 10.82 NA 5.85 1.42 NA 18.09 090 47490 .......... ............ A Incision of gallbladder ................................. 7.23 NA 5.80 0.43 NA 13.47 090 47500 .......... ............ A Injection for liver x-rays ............................... 1.96 NA 0.68 0.12 NA 2.76 000 47505 .......... ............ A Injection for liver x-rays ............................... 0.76 NA 0.26 0.04 NA 1.06 000 47510 .......... ............ A Insert catheter, bile duct .............................. 7.84 NA 5.27 0.46 NA 13.56 090
47511 .......... ............ A Insert bile duct drain .................................... 10.50 NA 5.35 0.62 NA 16.47 090 47525 .......... ............ A Change bile duct catheter ........................... 5.55 15.88 2.95 0.33 21.77 8.83 010 47530 .......... ............ A Revise/reinsert bile tube .............................. 5.85 34.20 3.89 0.37 40.42 10.11 090 47550 .......... ............ A Bile duct endoscopy add-on ........................ 3.03 NA 1.00 0.40 NA 4.42 ZZZ 47552 .......... ............ A Biliary endoscopy thru skin ......................... 6.04 NA 2.43 0.42 NA 8.89 000


## 45927

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

47553 .......... ............ A Biliary endoscopy thru skin ......................... 6.35 NA 2.17 0.37 NA 8.89 000 47554 .......... ............ A Biliary endoscopy thru skin ......................... 9.07 NA 3.38 0.96 NA 13.41 000 47555 .......... ............ A Biliary endoscopy thru skin ......................... 7.57 NA 2.60 0.45 NA 10.62 000 47556 .......... ............ A Biliary endoscopy thru skin ......................... 8.57 NA 2.94 0.50 NA 12.01 000 47560 .......... ............ A Laparoscopy w/cholangio ............................ 4.89 NA 1.63 0.65 NA 7.17 000 47561 .......... ............ A Laparo w/cholangio/biopsy .......................... 5.18 NA 1.88 0.66 NA 7.72 000 47562 .......... ............ A Laparoscopic cholecystectomy ................... 11.09 NA 4.93 1.46 NA 17.48 090 47563 .......... ............ A Laparo cholecystectomy/graph ................... 11.94 NA 5.24 1.58 NA 18.76 090 47564 .......... ............ A Laparo cholecystectomy/explr ..................... 14.24 NA 5.87 1.88 NA 21.99 090 47570 .......... ............ A Laparo cholecystoenterostomy ................... 12.59 NA 5.31 1.65 NA 19.55 090 47579 .......... ............ C Laparoscope proc, biliary ............................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47600 .......... ............ A Removal of gallbladder ............................... 13.59 NA 6.04 1.79 NA 21.42 090 47605 .......... ............ A Removal of gallbladder ............................... 14.70 NA 6.41 1.94 NA 23.04 090 47610 .......... ............ A Removal of gallbladder ............................... 18.83 NA 7.80 2.48 NA 29.11 090 47612 .......... ............ A Removal of gallbladder ............................... 18.79 NA 7.76 2.47 NA 29.01 090 47620 .......... ............ A Removal of gallbladder ............................... 20.65 NA 8.37 2.73 NA 31.76 090
47630 .......... ............ A Remove bile duct stone .............................. 9.12 NA 5.10 0.65 NA 14.86 090 47700 .......... ............ A Exploration of bile ducts .............................. 15.63 NA 7.31 2.06 NA 25.00 090
47701 .......... ............ A Bile duct revision ......................................... 27.83 NA 11.28 3.67 NA 42.77 090 47711 .......... ............ A Excision of bile duct tumor .......................... 23.05 NA 9.75 3.04 NA 35.84 090 47712 .......... ............ A Excision of bile duct tumor .......................... 30.25 NA 12.16 3.92 NA 46.33 090 47715 .......... ............ A Excision of bile duct cyst ............................. 18.81 NA 8.31 2.48 NA 29.60 090 47716 .......... ............ A Fusion of bile duct cyst ............................... 16.45 NA 7.69 2.14 NA 26.29 090 47720 .......... ............ A Fuse gallbladder & bowel ............................ 15.92 NA 7.37 2.10 NA 25.39 090 47721 .......... ............ A Fuse upper gi structures ............................. 19.13 NA 8.43 2.52 NA 30.08 090 47740 .......... ............ A Fuse gallbladder & bowel ............................ 18.49 NA 8.24 2.41 NA 29.14 090 47741 .......... ............ A Fuse gallbladder & bowel ............................ 21.35 NA 9.13 2.82 NA 33.31 090 47760 .......... ............ A Fuse bile ducts and bowel .......................... 25.86 NA 10.66 3.41 NA 39.93 090 47765 .......... ............ A Fuse liver ducts & bowel ............................. 24.89 NA 10.59 3.29 NA 38.77 090 47780 .......... ............ A Fuse bile ducts and bowel .......................... 26.51 NA 11.02 3.49 NA 41.02 090 47785 .......... ............ A Fuse bile ducts and bowel .......................... 31.19 NA 12.65 4.09 NA 47.93 090 47800 .......... ............ A Reconstruction of bile ducts ........................ 23.32 NA 9.89 3.07 NA 36.27 090 47801 .......... ............ A Placement, bile duct support ....................... 15.18 NA 8.39 1.16 NA 24.73 090 47802 .......... ............ A Fuse liver duct & intestine ........................... 21.56 NA 9.49 2.85 NA 33.90 090 47900 .......... ............ A Suture bile duct injury ................................. 19.91 NA 8.73 2.64 NA 31.28 090 47999 .......... ............ C Bile tract surgery procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 48000 .......... ............ A Drainage of abdomen .................................. 28.09 NA 11.45 3.47 NA 43.01 090 48001 .......... ............ A Placement of drain, pancreas ..................... 35.47 NA 13.61 4.68 NA 53.77 090 48005 .......... ............ A Resect/debride pancreas ............................ 42.19 NA 16.29 5.54 NA 64.02 090 48020 .......... ............ A Removal of pancreatic stone ...................... 15.71 NA 7.25 2.12 NA 25.09 090 48100 .......... ............ A Biopsy of pancreas, open ........................... 12.23 NA 5.54 1.62 NA 19.39 090 48102 .......... ............ A Needle biopsy, pancreas ............................. 4.68 8.56 2.01 0.28 13.52 6.97 010 48120 .......... ............ A Removal of pancreas lesion ........................ 15.86 NA 6.81 2.09 NA 24.76 090 48140 .......... ............ A Partial removal of pancreas ........................ 22.96 NA 9.40 3.02 NA 35.37 090 48145 .......... ............ A Partial removal of pancreas ........................ 24.03 NA 9.69 3.17 NA 36.88 090 48146 .......... ............ A Pancreatectomy ........................................... 26.41 NA 11.78 3.49 NA 41.68 090 48148 .......... ............ A Removal of pancreatic duct ........................ 17.34 NA 7.48 2.29 NA 27.12 090 48150 .......... ............ A Partial removal of pancreas ........................ 48.03 NA 19.10 6.30 NA 73.43 090 48152 .......... ............ A Pancreatectomy ........................................... 43.77 NA 17.84 5.78 NA 67.39 090 48153 .......... ............ A Pancreatectomy ........................................... 47.92 NA 19.14 6.29 NA 73.35 090 48154 .......... ............ A Pancreatectomy ........................................... 44.12 NA 17.89 5.82 NA 67.83 090 48155 .......... ............ A Removal of pancreas .................................. 24.65 NA 11.47 3.26 NA 39.38 090 48160 .......... ............ N Pancreas removal/transplant ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 48180 .......... ............ A Fuse pancreas and bowel ........................... 24.73 NA 10.02 3.27 NA 38.02 090 48400 .......... ............ A Injection, intraop add-on .............................. 1.95 NA 0.67 0.15 NA 2.77 ZZZ 48500 .......... ............ A Surgery of pancreatic cyst .......................... 15.29 NA 7.24 2.02 NA 24.55 090 48510 .......... ............ A Drain pancreatic pseudocyst ....................... 14.32 NA 7.52 1.82 NA 23.66 090 48511 .......... ............ A Drain pancreatic pseudocyst ....................... 4.00 21.86 1.37 0.24 26.10 5.61 000 48520 .......... ............ A Fuse pancreas cyst and bowel ................... 15.60 NA 6.62 2.05 NA 24.27 090 48540 .......... ............ A Fuse pancreas cyst and bowel ................... 19.73 NA 7.98 2.60 NA 30.31 090 48545 .......... ............ A Pancreatorrhaphy ........................................ 18.19 NA 7.86 2.37 NA 28.42 090
48547 .......... ............ A Duodenal exclusion ..................................... 25.84 NA 10.33 3.41 NA 39.58 090 48551 .......... ............ C Prep donor pancreas ................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 48552 .......... ............ A Prep donor pancreas/venous ...................... 4.31 NA 1.44 0.31 NA 6.06 XXX 48554 .......... ............ R Transpl allograft pancreas ........................... 34.19 NA 18.44 4.18 NA 56.81 090 48556 .......... ............ A Removal, allograft pancreas ....................... 15.72 NA 8.08 2.07 NA 25.87 090 48999 .......... ............ C Pancreas surgery procedure ....................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 49000 .......... ............ A Exploration of abdomen .............................. 11.68 NA 5.34 1.52 NA 18.54 090 49002 .......... ............ A Reopening of abdomen ............................... 10.49 NA 4.98 1.37 NA 16.85 090 49010 .......... ............ A Exploration behind abdomen ...................... 12.28 NA 5.89 1.51 NA 19.68 090
49020 .......... ............ A Drain abdominal abscess ............................ 22.86 NA 10.37 2.84 NA 36.07 090
49021 .......... ............ A Drain abdominal abscess ............................ 3.38 21.59 1.15 0.20 25.17 4.73 000 49040 .......... ............ A Drain, open, abdom abscess ...................... 13.53 NA 6.52 1.69 NA 21.74 090 49041 .......... ............ A Drain, percut, abdom abscess .................... 4.00 20.71 1.37 0.24 24.95 5.60 000


## 45928

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

49060 .......... ............ A Drain, open, retrop abscess ........................ 15.87 NA 7.69 1.74 NA 25.30 090 49061 .......... ............ A Drain, percut, retroper absc ........................ 3.70 20.47 1.27 0.22 24.39 5.18 000 49062 .......... ............ A Drain to peritoneal cavity ............................ 11.36 NA 5.43 1.39 NA 18.18 090 49080 .......... ............ A Puncture, peritoneal cavity .......................... 1.35 3.87 0.48 0.08 5.30 1.91 000 49081 .......... ............ A Removal of abdominal fluid ......................... 1.26 2.80 0.45 0.09 4.15 1.80 000 49085 .......... ............ A Remove abdomen foreign body .................. 12.14 NA 5.45 1.62 NA 19.22 090 49180 .......... ............ A Biopsy, abdominal mass ............................. 1.73 3.17 0.60 0.10 5.00 2.43 000 49200 .......... ............ A Removal of abdominal lesion ...................... 10.25 NA 5.04 1.24 NA 16.53 090 49201 .......... ............ A Remove abdom lesion, complex ................. 14.85 NA 6.97 1.87 NA 23.69 090 49215 .......... ............ A Excise sacral spine tumor ........................... 33.52 NA 13.82 4.37 NA 51.70 090 49220 .......... ............ A Multiple surgery, abdomen .......................... 14.89 NA 6.56 1.88 NA 23.33 090 49250 .......... ............ A Excision of umbilicus ................................... 8.36 NA 4.23 1.08 NA 13.67 090 49255 .......... ............ A Removal of omentum .................................. 11.14 NA 5.56 1.43 NA 18.13 090 49320 .......... ............ A Diag laparo separate proc ........................... 5.10 NA 2.61 0.65 NA 8.36 010 49321 .......... ............ A Laparoscopy, biopsy ................................... 5.40 NA 2.62 0.70 NA 8.72 010 49322 .......... ............ A Laparoscopy, aspiration .............................. 5.70 NA 2.95 0.71 NA 9.36 010 49323 .......... ............ A Laparo drain lymphocele ............................. 9.49 NA 4.56 1.20 NA 15.25 090 49329 .......... ............ C Laparo proc, abdm/per/oment ..................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 49400 .......... ............ A Air injection into abdomen ........................... 1.88 3.03 0.64 0.15 5.06 2.67 000 49419 .......... ............ A Insrt abdom cath for chemotx ..................... 6.65 NA 3.52 0.81 NA 10.99 090 49420 .......... ............ A Insert abdom drain, temp ............................ 2.22 NA 1.16 0.21 NA 3.59 000 49421 .......... ............ A Insert abdom drain, perm ............................ 5.54 NA 3.12 0.74 NA 9.40 090 49422 .......... ............ A Remove perm cannula/catheter .................. 6.25 NA 2.86 0.83 NA 9.94 010 49423 .......... ............ A Exchange drainage catheter ....................... 1.46 14.27 0.55 0.09 15.82 2.10 000 49424 .......... ............ A Assess cyst, contrast inject ......................... 0.76 3.70 0.31 0.04 4.50 1.11 000 49425 .......... ............ A Insert abdomen-venous drain ..................... 11.37 NA 5.48 1.54 NA 18.40 090 49426 .......... ............ A Revise abdomen-venous shunt ................... 9.64 NA 4.71 1.28 NA 15.63 090 49427 .......... ............ A Injection, abdominal shunt .......................... 0.89 NA 0.31 0.07 NA 1.27 000 49428 .......... ............ A Ligation of shunt .......................................... 6.06 NA 3.73 0.80 NA 10.59 010 49429 .......... ............ A Removal of shunt ........................................ 7.40 NA 3.35 1.02 NA 11.77 010 49491 .......... ............ A Rpr hern preemie reduc .............................. 11.13 NA 5.10 1.40 NA 17.63 090 49492 .......... ............ A Rpr ing hern premie, blocked ...................... 14.04 NA 6.08 1.80 NA 21.92 090 49495 .......... ............ A Rpr ing hernia baby, reduc ......................... 5.89 NA 2.97 0.74 NA 9.60 090 49496 .......... ............ A Rpr ing hernia baby, blocked ...................... 8.80 NA 4.26 1.07 NA 14.13 090 49500 .......... ............ A Rpr ing hernia, init, reduce .......................... 5.48 NA 3.18 0.71 NA 9.37 090 49501 .......... ............ A Rpr ing hernia, init blocked ......................... 8.89 NA 4.19 1.12 NA 14.20 090 49505 .......... ............ A Prp i/hern init reduc >5 yr ........................... 7.61 NA 3.73 1.03 NA 12.37 090 49507 .......... ............ A Prp i/hern init block >5 yr ............................ 9.58 NA 4.42 1.27 NA 15.27 090 49520 .......... ............ A Rerepair ing hernia, reduce ........................ 9.64 NA 4.40 1.28 NA 15.32 090 49521 .......... ............ A Rerepair ing hernia, blocked ....................... 11.97 NA 5.18 1.59 NA 18.75 090 49525 .......... ............ A Repair ing hernia, sliding ............................ 8.58 NA 4.06 1.13 NA 13.77 090 49540 .......... ............ A Repair lumbar hernia ................................... 10.39 NA 4.70 1.37 NA 16.47 090 49550 .......... ............ A Rpr rem hernia, init, reduce ........................ 8.64 NA 4.09 1.14 NA 13.87 090 49553 .......... ............ A Rpr fem hernia, init blocked ........................ 9.45 NA 4.38 1.24 NA 15.07 090 49555 .......... ............ A Rerepair fem hernia, reduce ....................... 9.04 NA 4.23 1.20 NA 14.47 090 49557 .......... ............ A Rerepair fem hernia, blocked ...................... 11.15 NA 4.93 1.47 NA 17.56 090 49560 .......... ............ A Rpr ventral hern init, reduc ......................... 11.57 NA 5.09 1.52 NA 18.18 090 49561 .......... ............ A Rpr ventral hern init, block .......................... 14.26 NA 5.98 1.88 NA 22.12 090 49565 .......... ............ A Rerepair ventrl hern, reduce ....................... 11.57 NA 5.16 1.52 NA 18.25 090 49566 .......... ............ A Rerepair ventrl hern, block .......................... 14.41 NA 6.05 1.90 NA 22.36 090 49568 .......... ............ A Hernia repair w/mesh .................................. 4.89 NA 1.63 0.64 NA 7.16 ZZZ 49570 .......... ............ A Rpr epigastric hern, reduce ......................... 5.69 NA 3.15 0.75 NA 9.59 090 49572 .......... ............ A Rpr epigastric hern, blocked ....................... 6.73 NA 3.44 0.88 NA 11.06 090 49580 .......... ............ A Rpr umbil hern, reduc < 5 yr ....................... 4.11 NA 2.58 0.54 NA 7.23 090 49582 .......... ............ A Rpr umbil hern, block < 5 yr ....................... 6.65 NA 3.45 0.88 NA 10.99 090 49585 .......... ............ A Rpr umbil hern, reduc > 5 yr ....................... 6.23 NA 3.28 0.82 NA 10.34 090 49587 .......... ............ A Rpr umbil hern, block > 5 yr ....................... 7.57 NA 3.71 0.99 NA 12.27 090 49590 .......... ............ A Repair spigelian hernia ............................... 8.55 NA 4.06 1.13 NA 13.73 090 49600 .......... ............ A Repair umbilical lesion ................................ 10.96 NA 5.26 1.32 NA 17.54 090 49605 .......... ............ A Repair umbilical lesion ................................ 76.04 NA 27.99 9.36 NA 113.39 090 49606 .......... ............ A Repair umbilical lesion ................................ 18.61 NA 7.55 2.45 NA 28.60 090 49610 .......... ............ A Repair umbilical lesion ................................ 10.50 NA 5.11 1.07 NA 16.68 090 49611 .......... ............ A Repair umbilical lesion ................................ 8.93 NA 6.74 0.78 NA 16.45 090 49650 .......... ............ A Laparo hernia repair initial .......................... 6.27 NA 3.18 0.93 NA 10.38 090 49651 .......... ............ A Laparo hernia repair recur .......................... 8.25 NA 4.03 1.14 NA 13.41 090 49659 .......... ............ C Laparo proc, hernia repair ........................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 49900 .......... ............ A Repair of abdominal wall ............................. 12.28 NA 6.21 1.62 NA 20.12 090 49904 .......... ............ A Omental flap, extra-abdom .......................... 20.01 NA 14.59 2.69 NA 37.29 090 49905 .......... ............ A Omental flap, intra-abdom ........................... 6.55 NA 2.26 0.75 NA 9.57 ZZZ 49906 .......... ............ C Free omental flap, microvasc ...................... 0.00 0.00 0.00 0.00 0.00 0.00 090 49999 .......... ............ C Abdomen surgery procedure ....................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 50010 .......... ............ A Exploration of kidney ................................... 10.98 NA 5.82 0.93 NA 17.74 090 50020 .......... ............ A Renal abscess, open drain ......................... 14.67 NA 8.25 1.34 NA 24.26 090 50021 .......... ............ A Renal abscess, percut drain ....................... 3.38 22.82 1.16 0.20 26.39 4.74 000


## 45929

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

50040 .......... ............ A Drainage of kidney ...................................... 14.95 NA 7.61 1.03 NA 23.59 090 50045 .......... ............ A Exploration of kidney ................................... 15.47 NA 7.41 1.24 NA 24.12 090 50060 .......... ............ A Removal of kidney stone ............................. 19.31 NA 9.10 1.36 NA 29.76 090 50065 .......... ............ A Incision of kidney ......................................... 20.80 NA 6.01 1.59 NA 28.40 090 50070 .......... ............ A Incision of kidney ......................................... 20.33 NA 9.43 1.44 NA 31.20 090 50075 .......... ............ A Removal of kidney stone ............................. 25.35 NA 11.47 1.80 NA 38.62 090 50080 .......... ............ A Removal of kidney stone ............................. 14.72 NA 7.28 1.04 NA 23.04 090 50081 .......... ............ A Removal of kidney stone ............................. 21.81 NA 10.27 1.54 NA 33.62 090 50100 .......... ............ A Revise kidney blood vessels ....................... 16.10 NA 7.67 2.06 NA 25.83 090 50120 .......... ............ A Exploration of kidney ................................... 15.92 NA 7.79 1.21 NA 24.92 090 50125 .......... ............ A Explore and drain kidney ............................ 16.53 NA 7.75 1.43 NA 25.71 090 50130 .......... ............ A Removal of kidney stone ............................. 17.29 NA 8.29 1.22 NA 26.81 090 50135 .......... ............ A Exploration of kidney ................................... 19.19 NA 8.99 1.33 NA 29.51 090 50200 .......... ............ A Biopsy of kidney .......................................... 2.64 NA 1.32 0.16 NA 4.11 000 50205 .......... ............ A Biopsy of kidney .......................................... 11.31 NA 5.32 1.30 NA 17.93 090 50220 .......... ............ A Remove kidney, open ................................. 17.15 NA 8.12 1.35 NA 26.63 090 50225 .......... ............ A Removal kidney open, complex .................. 20.24 NA 9.34 1.50 NA 31.08 090 50230 .......... ............ A Removal kidney open, radical ..................... 22.08 NA 9.88 1.55 NA 33.51 090 50234 .......... ............ A Removal of kidney & ureter ........................ 22.41 NA 10.18 1.59 NA 34.19 090 50236 .......... ............ A Removal of kidney & ureter ........................ 24.87 NA 11.78 1.76 NA 38.41 090 50240 .......... ............ A Partial removal of kidney ............................. 22.01 NA 10.38 1.55 NA 33.94 090 50280 .......... ............ A Removal of kidney lesion ............................ 15.68 NA 7.62 1.19 NA 24.49 090 50290 .......... ............ A Removal of kidney lesion ............................ 14.74 NA 6.95 1.41 NA 23.10 090 50320 .......... ............ A Remove kidney, living donor ....................... 22.22 NA 11.43 2.35 NA 36.00 090 50323 .......... ............ C Prep cadaver renal allograft ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 50325 .......... ............ C Prep donor renal graft ................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 50327 .......... ............ A Prep renal graft/venous ............................... 4.01 NA 1.35 0.29 NA 5.65 XXX 50328 .......... ............ A Prep renal graft/arterial ............................... 3.51 NA 1.18 0.26 NA 4.95 XXX 50329 .......... ............ A Prep renal graft/ureteral .............................. 3.35 NA 1.13 0.25 NA 4.73 XXX 50340 .......... ............ A Removal of kidney ....................................... 12.15 NA 6.71 1.65 NA 20.51 090 50360 .......... ............ A Transplantation of kidney ............................ 31.54 NA 15.94 3.81 NA 51.29 090 50365 .......... ............ A Transplantation of kidney ............................ 36.82 NA 18.27 4.42 NA 59.52 090 50370 .......... ............ A Remove transplanted kidney ....................... 13.73 NA 7.40 1.67 NA 22.80 090 50380 .......... ............ A Reimplantation of kidney ............................. 20.77 NA 12.41 2.50 NA 35.69 090 50390 .......... ............ A Drainage of kidney lesion ............................ 1.96 NA 0.68 0.12 NA 2.76 000 50391 .......... ............ A Instll rx agnt into rnal tub ............................ 1.96 1.68 0.74 0.14 3.79 2.85 000 50392 .......... ............ A Insert kidney drain ....................................... 3.38 NA 1.61 0.20 NA 5.18 000 50393 .......... ............ A Insert ureteral tube ...................................... 4.16 NA 1.88 0.25 NA 6.29 000 50394 .......... ............ A Injection for kidney x-ray ............................. 0.76 2.72 0.70 0.05 3.53 1.51 000 50395 .......... ............ A Create passage to kidney ........................... 3.38 NA 1.61 0.21 NA 5.19 000 50396 .......... ............ A Measure kidney pressure ............................ 2.09 NA 1.15 0.13 NA 3.38 000 50398 .......... ............ A Change kidney tube .................................... 1.46 16.40 0.55 0.09 17.95 2.10 000 50400 .......... ............ A Revision of kidney/ureter ............................. 19.51 NA 9.04 1.38 NA 29.93 090 50405 .......... ............ A Revision of kidney/ureter ............................. 23.94 NA 10.26 1.78 NA 35.98 090 50500 .......... ............ A Repair of kidney wound .............................. 19.58 NA 8.86 2.01 NA 30.45 090 50520 .......... ............ A Close kidney-skin fistula .............................. 17.23 NA 8.35 1.49 NA 27.07 090 50525 .......... ............ A Repair renal-abdomen fistula ...................... 22.28 NA 9.57 1.83 NA 33.68 090 50526 .......... ............ A Repair renal-abdomen fistula ...................... 24.03 NA 10.40 1.96 NA 36.38 090 50540 .......... ............ A Revision of horseshoe kidney ..................... 19.94 NA 8.96 1.36 NA 30.26 090 50541 .......... ............ A Laparo ablate renal cyst .............................. 16.01 NA 7.41 1.13 NA 24.55 090 50542 .......... ............ A Laparo ablate renal mass ........................... 20.01 NA 9.49 1.39 NA 30.89 090 50543 .......... ............ A Laparo partial nephrectomy ........................ 25.51 NA 11.90 1.80 NA 39.21 090 50544 .......... ............ A Laparoscopy, pyeloplasty ............................ 22.41 NA 9.75 1.58 NA 33.74 090 50545 .......... ............ A Laparo radical nephrectomy ........................ 24.01 NA 10.60 1.70 NA 36.31 090 50546 .......... ............ A Laparoscopic nephrectomy ......................... 20.49 NA 9.49 1.57 NA 31.55 090 50547 .......... ............ A Laparo removal donor kidney ..................... 25.51 NA 11.70 2.76 NA 39.97 090 50548 .......... ............ A Laparo remove w/ureter .............................. 24.41 NA 10.57 1.72 NA 36.70 090 50549 .......... ............ C Laparoscope proc, renal ............................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY 50551 .......... ............ A Kidney endoscopy ....................................... 5.60 4.47 2.34 0.40 10.48 8.35 000 50553 .......... ............ A Kidney endoscopy ....................................... 5.99 4.72 2.52 0.39 11.11 8.90 000 50555 .......... ............ A Kidney endoscopy & biopsy ........................ 6.53 5.03 2.69 0.45 12.01 9.67 000 50557 .......... ............ A Kidney endoscopy & treatment ................... 6.62 5.04 2.73 0.47 12.13 9.82 000 50561 .......... ............ A Kidney endoscopy & treatment ................... 7.60 5.51 3.09 0.54 13.64 11.22 000 50562 .......... ............ A Renal scope w/tumor resect ....................... 10.92 NA 4.95 0.73 NA 16.60 090 50570 .......... ............ A Kidney endoscopy ....................................... 9.55 NA 3.81 0.68 NA 14.04 000 50572 .......... ............ A Kidney endoscopy ....................................... 10.35 NA 4.07 0.85 NA 15.27 000 50574 .......... ............ A Kidney endoscopy & biopsy ........................ 11.02 NA 4.37 0.77 NA 16.16 000 50575 .......... ............ A Kidney endoscopy ....................................... 13.99 NA 5.49 0.99 NA 20.46 000 50576 .......... ............ A Kidney endoscopy & treatment ................... 10.99 NA 4.34 0.78 NA 16.11 000 50580 .......... ............ A Kidney endoscopy & treatment ................... 11.86 NA 4.69 0.83 NA 17.38 000 50590 .......... ............ A Fragmenting of kidney stone ....................... 9.10 13.68 4.92 0.65 23.43 14.67 090 50600 .......... ............ A Exploration of ureter .................................... 15.85 NA 7.56 1.13 NA 24.54 090 50605 .......... ............ A Insert ureteral support ................................. 15.47 NA 7.37 1.45 NA 24.29 090 50610 .......... ............ A Removal of ureter stone .............................. 15.93 NA 7.84 1.43 NA 25.20 090


## 45930

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

50620 .......... ............ A Removal of ureter stone .............................. 15.17 NA 7.35 1.07 NA 23.59 090 50630 .......... ............ A Removal of ureter stone .............................. 14.95 NA 7.26 1.09 NA 23.30 090 50650 .......... ............ A Removal of ureter ........................................ 17.41 NA 8.32 1.23 NA 26.97 090 50660 .......... ............ A Removal of ureter ........................................ 19.56 NA 9.17 1.38 NA 30.11 090 50684 .......... ............ A Injection for ureter x-ray .............................. 0.76 4.95 0.55 0.05 5.76 1.37 000 50686 .......... ............ A Measure ureter pressure ............................. 1.51 3.46 0.88 0.11 5.08 2.50 000 50688 .......... ............ A Change of ureter tube ................................. 1.17 NA 1.12 0.07 NA 2.37 010 50690 .......... ............ A Injection for ureter x-ray .............................. 1.16 1.88 0.78 0.07 3.12 2.02 000 50700 .......... ............ A Revision of ureter ........................................ 15.22 NA 7.83 1.27 NA 24.32 090 50715 .......... ............ A Release of ureter ......................................... 18.91 NA 8.92 2.13 NA 29.96 090 50722 .......... ............ A Release of ureter ......................................... 16.36 NA 7.93 1.90 NA 26.19 090 50725 .......... ............ A Release/revise ureter .................................. 18.50 NA 8.71 1.52 NA 28.73 090
50727 .......... ............ A Revise ureter ............................................... 8.19 NA 4.89 0.61 NA 13.68 090 50728 .......... ............ A Revise ureter ............................................... 12.02 NA 6.12 1.00 NA 19.15 090 50740 .......... ............ A Fusion of ureter & kidney ............................ 18.43 NA 8.33 1.96 NA 28.72 090 50750 .......... ............ A Fusion of ureter & kidney ............................ 19.52 NA 9.27 1.38 NA 30.17 090 50760 .......... ............ A Fusion of ureters ......................................... 18.43 NA 8.59 1.55 NA 28.56 090 50770 .......... ............ A Splicing of ureters ....................................... 19.52 NA 9.08 1.45 NA 30.05 090 50780 .......... ............ A Reimplant ureter in bladder ......................... 18.37 NA 8.59 1.51 NA 28.47 090 50782 .......... ............ A Reimplant ureter in bladder ......................... 19.55 NA 9.12 1.61 NA 30.28 090 50783 .......... ............ A Reimplant ureter in bladder ......................... 20.56 NA 9.37 1.98 NA 31.91 090 50785 .......... ............ A Reimplant ureter in bladder ......................... 20.53 NA 9.44 1.45 NA 31.42 090 50800 .......... ............ A Implant ureter in bowel ................................ 14.53 NA 7.37 1.19 NA 23.09 090 50810 .......... ............ A Fusion of ureter & bowel ............................. 20.06 NA 9.22 2.31 NA 31.59 090
50815 .......... ............ A Urine shunt to intestine ............................... 19.94 NA 9.51 1.54 NA 30.99 090 50820 .......... ............ A Construct bowel bladder ............................. 21.90 NA 9.64 1.89 NA 33.44 090 50825 .......... ............ A Construct bowel bladder ............................. 28.20 NA 12.72 2.07 NA 42.98 090 50830 .......... ............ A Revise urine flow ......................................... 31.29 NA 13.62 2.37 NA 47.28 090 50840 .......... ............ A Replace ureter by bowel ............................. 20.01 NA 9.67 1.47 NA 31.15 090 50845 .......... ............ A Appendico-vesicostomy ............................... 20.90 NA 10.32 1.57 NA 32.79 090 50860 .......... ............ A Transplant ureter to skin ............................. 15.37 NA 7.50 1.29 NA 24.16 090 50900 .......... ............ A Repair of ureter ........................................... 13.63 NA 6.74 1.14 NA 21.51 090 50920 .......... ............ A Closure ureter/skin fistula ............................ 14.34 NA 7.23 1.01 NA 22.58 090 50930 .......... ............ A Closure ureter/bowel fistula ......................... 18.73 NA 8.70 1.28 NA 28.71 090 50940 .......... ............ A Release of ureter ......................................... 14.52 NA 7.19 1.26 NA 22.97 090 50945 .......... ............ A Laparoscopy ureterolithotomy ..................... 17.00 NA 8.00 1.36 NA 26.37 090 50947 .......... ............ A Laparo new ureter/bladder .......................... 24.51 NA 11.02 2.16 NA 37.69 090 50948 .......... ............ A Laparo new ureter/bladder .......................... 22.51 NA 9.77 1.70 NA 33.99 090 50949 .......... ............ C Laparoscope proc, ureter ............................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 50951 .......... ............ A Endoscopy of ureter .................................... 5.84 4.63 2.43 0.41 10.88 8.68 000 50953 .......... ............ A Endoscopy of ureter .................................... 6.24 4.79 2.81 0.43 11.46 9.49 000 50955 .......... ............ A Ureter endoscopy & biopsy ......................... 6.75 6.34 3.09 0.48 13.58 10.32 000 50957 .......... ............ A Ureter endoscopy & treatment .................... 6.79 4.97 2.79 0.48 12.24 10.06 000 50961 .......... ............ A Ureter endoscopy & treatment .................... 6.05 4.74 2.53 0.41 11.20 8.99 000 50970 .......... ............ A Ureter endoscopy ........................................ 7.14 NA 2.91 0.52 NA 10.57 000 50972 .......... ............ A Ureter endoscopy & catheter ...................... 6.89 NA 2.84 0.49 NA 10.23 000 50974 .......... ............ A Ureter endoscopy & biopsy ......................... 9.18 NA 3.63 0.64 NA 13.45 000 50976 .......... ............ A Ureter endoscopy & treatment .................... 9.05 NA 3.62 0.66 NA 13.33 000 50980 .......... ............ A Ureter endoscopy & treatment .................... 6.85 NA 2.80 0.48 NA 10.13 000 51000 .......... ............ A Drainage of bladder ..................................... 0.78 1.80 0.26 0.05 2.63 1.09 000 51005 .......... ............ A Drainage of bladder ..................................... 1.02 4.33 0.36 0.10 5.45 1.48 000 51010 .......... ............ A Drainage of bladder ..................................... 3.53 5.61 2.03 0.28 9.42 5.83 010
51020 .......... ............ A Incise & treat bladder .................................. 6.71 NA 4.32 0.47 NA 11.50 090
51030 .......... ............ A Incise & treat bladder .................................. 6.77 NA 4.37 0.58 NA 11.72 090
51040 .......... ............ A Incise & drain bladder ................................. 4.40 NA 3.13 0.31 NA 7.84 090 51045 .......... ............ A Incise bladder/drain ureter .......................... 6.77 NA 4.21 0.52 NA 11.50 090
51050 .......... ............ A Removal of bladder stone ........................... 6.92 NA 4.21 0.49 NA 11.62 090 51060 .......... ............ A Removal of ureter stone .............................. 8.86 NA 5.16 0.62 NA 14.64 090
51065 .......... ............ A Remove ureter calculus .............................. 8.86 NA 5.01 0.63 NA 14.50 090 51080 .......... ............ A Drainage of bladder abscess ...................... 5.96 NA 3.93 0.43 NA 10.32 090 51500 .......... ............ A Removal of bladder cyst ............................. 10.14 NA 5.26 1.03 NA 16.43 090 51520 .......... ............ A Removal of bladder lesion .......................... 9.30 NA 5.29 0.69 NA 15.28 090 51525 .......... ............ A Removal of bladder lesion .......................... 13.98 NA 7.05 0.99 NA 22.01 090 51530 .......... ............ A Removal of bladder lesion .......................... 12.38 NA 6.32 1.05 NA 19.76 090 51535 .......... ............ A Repair of ureter lesion ................................. 12.58 NA 6.54 1.23 NA 20.35 090 51550 .......... ............ A Partial removal of bladder ........................... 15.67 NA 7.46 1.31 NA 24.44 090 51555 .......... ............ A Partial removal of bladder ........................... 21.24 NA 9.74 1.69 NA 32.68 090 51565 .......... ............ A Revise bladder & ureter(s) .......................... 21.63 NA 10.17 1.63 NA 33.44 090
51570 .......... ............ A Removal of bladder ..................................... 24.25 NA 11.12 1.71 NA 37.08 090 51575 .......... ............ A Removal of bladder & nodes ...................... 30.46 NA 13.75 2.16 NA 46.37 090 51580 .......... ............ A Remove bladder/revise tract ....................... 31.09 NA 14.21 2.24 NA 47.54 090
51585 .......... ............ A Removal of bladder & nodes ...................... 35.25 NA 15.79 2.48 NA 53.52 090 51590 .......... ............ A Remove bladder/revise tract ....................... 32.68 NA 14.45 2.27 NA 49.39 090 51595 .......... ............ A Remove bladder/revise tract ....................... 37.15 NA 16.33 2.59 NA 56.08 090


## 45931

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

51596 .......... ............ A Remove bladder/create pouch .................... 39.54 NA 17.59 2.77 NA 59.90 090 51597 .......... ............ A Removal of pelvic structures ....................... 38.37 NA 16.73 2.81 NA 57.90 090 51600 .......... ............ A Injection for bladder x-ray ........................... 0.88 5.08 0.32 0.06 6.02 1.26 000 51605 .......... ............ A Preparation for bladder xray ....................... 0.64 NA 0.39 0.04 NA 1.07 000 51610 .......... ............ A Injection for bladder x-ray ........................... 1.05 2.29 0.68 0.07 3.41 1.80 000 51700 .......... ............ A Irrigation of bladder ..................................... 0.88 1.65 0.32 0.06 2.59 1.26 000
51701 .......... ............ A Insert bladder catheter ................................ 0.50 1.55 0.20 0.04 2.09 0.74 000 51702 .......... ............ A Insert temp bladder cath ............................. 0.50 2.06 0.25 0.04 2.60 0.79 000 51703 .......... ............ A Insert bladder cath, complex ....................... 1.47 2.77 0.67 0.10 4.35 2.24 000 51705 .......... ............ A Change of bladder tube .............................. 1.02 2.31 0.69 0.07 3.41 1.79 010 51710 .......... ............ A Change of bladder tube .............................. 1.49 3.37 0.92 0.11 4.97 2.53 010 51715 .......... ............ A Endoscopic injection/implant ....................... 3.74 NA 1.59 0.29 NA 5.61 000 51720 .......... ............ A Treatment of bladder lesion ........................ 1.96 1.86 0.81 0.14 3.97 2.92 000 51725 .......... ............ A Simple cystometrogram ............................... 1.51 5.51 NA 0.16 7.19 NA 000 51725 .......... 26 ....... A Simple cystometrogram ............................... 1.51 0.57 0.57 0.12 2.20 2.20 000 51725 .......... TC ...... A Simple cystometrogram ............................... 0.00 4.94 NA 0.04 4.98 NA 000 51726 .......... ............ A Complex cystometrogram ........................... 1.71 7.56 NA 0.18 9.45 NA 000 51726 .......... 26 ....... A Complex cystometrogram ........................... 1.71 0.65 0.65 0.13 2.49 2.49 000 51726 .......... TC ...... A Complex cystometrogram ........................... 0.00 6.91 NA 0.05 6.96 NA 000 51736 .......... ............ A Urine flow measurement ............................. 0.61 0.66 NA 0.06 1.33 NA 000 51736 .......... 26 ....... A Urine flow measurement ............................. 0.61 0.23 0.23 0.05 0.89 0.89 000 51736 .......... TC ...... A Urine flow measurement ............................. 0.00 0.43 NA 0.01 0.44 NA 000 51741 .......... ............ A Electro-uroflowmetry, first ............................ 1.14 0.92 NA 0.11 2.17 NA 000 51741 .......... 26 ....... A Electro-uroflowmetry, first ............................ 1.14 0.43 0.43 0.09 1.66 1.66 000 51741 .......... TC ...... A Electro-uroflowmetry, first ............................ 0.00 0.49 NA 0.02 0.51 NA 000 51772 .......... ............ A Urethra pressure profile .............................. 1.61 5.53 NA 0.20 7.34 NA 000 51772 .......... 26 ....... A Urethra pressure profile .............................. 1.61 0.61 0.61 0.15 2.37 2.37 000 51772 .......... TC ...... A Urethra pressure profile .............................. 0.00 4.91 NA 0.05 4.96 NA 000 51784 .......... ............ A Anal/urinary muscle study ........................... 1.53 4.03 NA 0.16 5.73 NA 000 51784 .......... 26 ....... A Anal/urinary muscle study ........................... 1.53 0.57 0.57 0.12 2.23 2.23 000 51784 .......... TC ...... A Anal/urinary muscle study ........................... 0.00 3.46 NA 0.04 3.50 NA 000 51785 .......... ............ A Anal/urinary muscle study ........................... 1.53 4.52 NA 0.15 6.21 NA 000 51785 .......... 26 ....... A Anal/urinary muscle study ........................... 1.53 0.58 0.58 0.11 2.22 2.22 000 51785 .......... TC ...... A Anal/urinary muscle study ........................... 0.00 3.95 NA 0.04 3.99 NA 000 51792 .......... ............ A Urinary reflex study ..................................... 1.10 5.83 NA 0.20 7.13 NA 000 51792 .......... 26 ....... A Urinary reflex study ..................................... 1.10 0.43 0.43 0.07 1.61 1.61 000 51792 .......... TC ...... A Urinary reflex study ..................................... 0.00 5.39 NA 0.13 5.52 NA 000 51795 .......... ............ A Urine voiding pressure study ...................... 1.53 7.32 NA 0.22 9.08 NA 000 51795 .......... 26 ....... A Urine voiding pressure study ...................... 1.53 0.58 0.58 0.12 2.23 2.23 000 51795 .......... TC ...... A Urine voiding pressure study ...................... 0.00 6.75 NA 0.10 6.85 NA 000 51797 .......... ............ A Intraabdominal pressure test ....................... 1.60 5.74 NA 0.17 7.51 NA 000 51797 .......... 26 ....... A Intraabdominal pressure test ....................... 1.60 0.61 0.61 0.12 2.33 2.33 000 51797 .......... TC ...... A Intraabdominal pressure test ....................... 0.00 5.13 NA 0.05 5.18 NA 000 51798 .......... ............ A Us urine capacity measure ......................... 0.00 0.39 NA 0.08 0.47 NA XXX 51800 .......... ............ A Revision of bladder/urethra ......................... 17.42 NA 8.48 1.32 NA 27.22 090 51820 .......... ............ A Revision of urinary tract .............................. 17.90 NA 8.52 1.74 NA 28.16 090 51840 .......... ............ A Attach bladder/urethra ................................. 10.71 NA 5.82 1.06 NA 17.59 090 51841 .......... ............ A Attach bladder/urethra ................................. 13.04 NA 6.70 1.24 NA 20.97 090 51845 .......... ............ A Repair bladder neck .................................... 9.74 NA 5.32 0.79 NA 15.85 090 51860 .......... ............ A Repair of bladder wound ............................. 12.02 NA 6.15 1.16 NA 19.33 090 51865 .......... ............ A Repair of bladder wound ............................. 15.05 NA 7.37 1.23 NA 23.65 090 51880 .......... ............ A Repair of bladder opening ........................... 7.67 NA 4.26 0.72 NA 12.64 090 51900 .......... ............ A Repair bladder/vagina lesion ....................... 12.98 NA 6.71 1.21 NA 20.90 090 51920 .......... ............ A Close bladder-uterus fistula ........................ 11.81 NA 6.19 1.18 NA 19.18 090 51925 .......... ............ A Hysterectomy/bladder repair ....................... 15.59 NA 8.45 2.03 NA 26.08 090 51940 .......... ............ A Correction of bladder defect ........................ 28.45 NA 12.82 2.14 NA 43.40 090
51960 .......... ............ A Revision of bladder & bowel ....................... 23.03 NA 11.01 1.63 NA 35.67 090 51980 .......... ............ A Construct bladder opening .......................... 11.36 NA 6.10 0.86 NA 18.33 090 51990 .......... ............ A Laparo urethral suspension ......................... 12.50 NA 6.34 1.39 NA 20.23 090 51992 .......... ............ A Laparo sling operation ................................. 14.02 NA 6.88 1.41 NA 22.30 090 52000 .......... ............ A Cystoscopy .................................................. 2.01 3.39 0.90 0.14 5.55 3.06 000 52001 .......... ............ A Cystoscopy, removal of clots ...................... 5.45 5.34 2.21 0.39 11.18 8.06 000 52005 .......... ............ A Cystoscopy & ureter catheter ...................... 2.37 5.72 1.07 0.17 8.26 3.62 000 52007 .......... ............ A Cystoscopy and biopsy ............................... 3.03 16.13 1.38 0.22 19.37 4.62 000 52010 .......... ............ A Cystoscopy & duct catheter ........................ 3.03 10.59 1.37 0.21 13.83 4.61 000 52204 .......... ............ A Cystoscopy .................................................. 2.37 14.04 1.08 0.17 16.59 3.63 000 52214 .......... ............ A Cystoscopy and treatment .......................... 3.71 36.60 1.59 0.26 40.57 5.56 000 52224 .......... ............ A Cystoscopy and treatment .......................... 3.15 34.94 1.38 0.22 38.31 4.74 000 52234 .......... ............ A Cystoscopy and treatment .......................... 4.63 NA 1.98 0.33 NA 6.94 000 52235 .......... ............ A Cystoscopy and treatment .......................... 5.45 NA 2.31 0.39 NA 8.15 000 52240 .......... ............ A Cystoscopy and treatment .......................... 9.73 NA 3.93 0.69 NA 14.34 000 52250 .......... ............ A Cystoscopy and radiotracer ........................ 4.50 NA 1.98 0.32 NA 6.80 000 52260 .......... ............ A Cystoscopy and treatment .......................... 3.92 NA 1.70 0.28 NA 5.89 000 52265 .......... ............ A Cystoscopy and treatment .......................... 2.95 12.97 1.33 0.22 16.13 4.49 000


## 45932

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

52270 .......... ............ A Cystoscopy & revise urethra ....................... 3.37 10.79 1.49 0.24 14.40 5.10 000 52275 .......... ............ A Cystoscopy & revise urethra ....................... 4.70 15.22 1.99 0.33 20.24 7.02 000 52276 .......... ............ A Cystoscopy and treatment .......................... 5.00 NA 2.13 0.35 NA 7.48 000 52277 .......... ............ A Cystoscopy and treatment .......................... 6.17 NA 2.59 0.44 NA 9.20 000 52281 .......... ............ A Cystoscopy and treatment .......................... 2.81 7.08 1.30 0.20 10.08 4.31 000 52282 .......... ............ A Cystoscopy, implant stent ........................... 6.40 NA 2.66 0.45 NA 9.51 000 52283 .......... ............ A Cystoscopy and treatment .......................... 3.74 4.14 1.65 0.26 8.14 5.65 000 52285 .......... ............ A Cystoscopy and treatment .......................... 3.61 4.23 1.60 0.26 8.09 5.47 000 52290 .......... ............ A Cystoscopy and treatment .......................... 4.59 NA 1.97 0.32 NA 6.88 000 52300 .......... ............ A Cystoscopy and treatment .......................... 5.31 NA 2.27 0.38 NA 7.97 000 52301 .......... ............ A Cystoscopy and treatment .......................... 5.51 NA 2.03 0.46 NA 8.00 000 52305 .......... ............ A Cystoscopy and treatment .......................... 5.31 NA 2.21 0.38 NA 7.90 000 52310 .......... ............ A Cystoscopy and treatment .......................... 2.82 4.79 1.23 0.20 7.81 4.25 000 52315 .......... ............ A Cystoscopy and treatment .......................... 5.21 8.76 2.18 0.37 14.34 7.76 000
52317 .......... ............ A Remove bladder stone ................................ 6.72 28.18 2.71 0.48 35.38 9.91 000 52318 .......... ............ A Remove bladder stone ................................ 9.20 NA 3.67 0.65 NA 13.52 000 52320 .......... ............ A Cystoscopy and treatment .......................... 4.70 NA 1.94 0.33 NA 6.97 000 52325 .......... ............ A Cystoscopy, stone removal ......................... 6.16 NA 2.52 0.44 NA 9.12 000 52327 .......... ............ A Cystoscopy, inject material ......................... 5.19 30.65 2.14 0.37 36.21 7.70 000 52330 .......... ............ A Cystoscopy and treatment .......................... 5.04 37.29 2.08 0.36 42.69 7.48 000 52332 .......... ............ A Cystoscopy and treatment .......................... 2.84 5.70 1.26 0.21 8.75 4.31 000 52334 .......... ............ A Create passage to kidney ........................... 4.83 NA 2.05 0.35 NA 7.23 000 52341 .......... ............ A Cysto w/ureter stricture tx ........................... 6.00 NA 2.62 0.43 NA 9.05 000 52342 .......... ............ A Cysto w/up stricture tx ................................. 6.50 NA 2.79 0.46 NA 9.75 000 52343 .......... ............ A Cysto w/renal stricture tx ............................. 7.20 NA 3.06 0.51 NA 10.77 000 52344 .......... ............ A Cysto/uretero, stricture tx ............................ 7.71 NA 3.34 0.55 NA 11.59 000 52345 .......... ............ A Cysto/uretero w/up stricture ........................ 8.21 NA 3.53 0.58 NA 12.31 000 52346 .......... ............ A Cystouretero w/renal strict .......................... 9.24 NA 3.92 0.65 NA 13.81 000 52351 .......... ............ A Cystouretero & or pyeloscope ..................... 5.86 NA 2.56 0.41 NA 8.83 000 52352 .......... ............ A Cystouretero w/stone remove ..................... 6.88 NA 2.99 0.49 NA 10.37 000 52353 .......... ............ A Cystouretero w/lithotripsy ............................ 7.98 NA 3.40 0.57 NA 11.95 000 52354 .......... ............ A Cystouretero w/biopsy ................................. 7.34 NA 3.16 0.52 NA 11.03 000 52355 .......... ............ A Cystouretero w/excise tumor ....................... 8.83 NA 3.73 0.63 NA 13.19 000 52400 .......... ............ A Cystouretero w/congen repr ........................ 9.69 NA 4.48 0.68 NA 14.85 090 52402 .......... ............ A Cystourethro cut ejacul duct ....................... 5.28 NA 2.02 0.40 NA 7.70 000 52450 .......... ............ A Incision of prostate ...................................... 7.65 NA 4.40 0.54 NA 12.58 090 52500 .......... ............ A Revision of bladder neck ............................. 8.48 NA 4.70 0.60 NA 13.78 090 52510 .......... ............ A Dilation prostatic urethra ............................. 6.72 NA 3.71 0.48 NA 10.91 090 52601 .......... ............ A Prostatectomy (TURP) ................................ 12.37 NA 6.08 0.87 NA 19.33 090 52606 .......... ............ A Control postop bleeding .............................. 8.14 NA 4.23 0.57 NA 12.93 090 52612 .......... ............ A Prostatectomy, first stage ............................ 7.99 NA 4.40 0.56 NA 12.95 090 52614 .......... ............ A Prostatectomy, second stage ...................... 6.84 NA 4.00 0.48 NA 11.33 090 52620 .......... ............ A Remove residual prostate ........................... 6.61 NA 3.57 0.47 NA 10.65 090 52630 .......... ............ A Remove prostate regrowth .......................... 7.26 NA 3.82 0.51 NA 11.59 090 52640 .......... ............ A Relieve bladder contracture ........................ 6.62 NA 3.53 0.47 NA 10.63 090 52647 .......... ............ A Laser surgery of prostate ............................ 10.36 70.90 5.42 0.73 81.99 16.51 090 52648 .......... ............ A Laser surgery of prostate ............................ 11.21 NA 5.70 0.79 NA 17.70 090 52700 .......... ............ A Drainage of prostate abscess ..................... 6.80 NA 3.78 0.48 NA 11.06 090 53000 .......... ............ A Incision of urethra ........................................ 2.28 NA 1.67 0.16 NA 4.11 010 53010 .......... ............ A Incision of urethra ........................................ 3.64 NA 3.21 0.24 NA 7.09 090 53020 .......... ............ A Incision of urethra ........................................ 1.77 NA 0.80 0.13 NA 2.70 000 53025 .......... ............ A Incision of urethra ........................................ 1.13 NA 0.63 0.08 NA 1.84 000 53040 .......... ............ A Drainage of urethra abscess ....................... 6.40 NA 3.88 0.45 NA 10.73 090 53060 .......... ............ A Drainage of urethra abscess ....................... 2.64 2.08 1.50 0.28 4.99 4.42 010 53080 .......... ............ A Drainage of urinary leakage ........................ 6.29 NA 6.21 0.52 NA 13.02 090 53085 .......... ............ A Drainage of urinary leakage ........................ 10.27 NA 7.86 0.92 NA 19.05 090 53200 .......... ............ A Biopsy of urethra ......................................... 2.60 1.46 1.15 0.20 4.25 3.95 000 53210 .......... ............ A Removal of urethra ...................................... 12.58 NA 6.55 0.89 NA 20.01 090 53215 .......... ............ A Removal of urethra ...................................... 15.59 NA 7.67 1.10 NA 24.36 090 53220 .......... ............ A Treatment of urethra lesion ......................... 7.00 NA 4.21 0.49 NA 11.70 090 53230 .......... ............ A Removal of urethra lesion ........................... 9.59 NA 5.39 0.73 NA 15.71 090 53235 .......... ............ A Removal of urethra lesion ........................... 10.14 NA 5.61 0.72 NA 16.47 090 53240 .......... ............ A Surgery for urethra pouch ........................... 6.45 NA 3.96 0.52 NA 10.93 090 53250 .......... ............ A Removal of urethra gland ............................ 5.89 NA 3.64 0.49 NA 10.02 090 53260 .......... ............ A Treatment of urethra lesion ......................... 2.99 2.27 1.63 0.25 5.51 4.87 010 53265 .......... ............ A Treatment of urethra lesion ......................... 3.13 2.83 1.67 0.24 6.19 5.04 010 53270 .......... ............ A Removal of urethra gland ............................ 3.10 2.30 1.69 0.30 5.70 5.09 010 53275 .......... ............ A Repair of urethra defect .............................. 4.53 NA 2.55 0.32 NA 7.39 010 53400 .......... ............ A Revise urethra, stage 1 ............................... 12.78 NA 6.83 0.98 NA 20.58 090 53405 .......... ............ A Revise urethra, stage 2 ............................... 14.49 NA 7.31 1.10 NA 22.90 090 53410 .......... ............ A Reconstruction of urethra ............................ 16.45 NA 8.18 1.16 NA 25.80 090 53415 .......... ............ A Reconstruction of urethra ............................ 19.42 NA 8.22 1.37 NA 29.01 090 53420 .......... ............ A Reconstruct urethra, stage 1 ....................... 14.09 NA 6.54 0.96 NA 21.59 090 53425 .......... ............ A Reconstruct urethra, stage 2 ....................... 15.99 NA 7.86 1.13 NA 24.99 090


## 45933

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

53430 .......... ............ A Reconstruction of urethra ............................ 16.35 NA 7.95 1.15 NA 25.45 090 53431 .......... ............ A Reconstruct urethra/bladder ........................ 19.90 NA 9.43 1.41 NA 30.74 090 53440 .......... ............ A Male sling procedure ................................... 13.63 NA 6.96 0.96 NA 21.55 090 53442 .......... ............ A Remove/revise male sling ........................... 11.57 NA 6.10 0.82 NA 18.50 090 53444 .......... ............ A Insert tandem cuff ....................................... 13.41 NA 6.75 0.94 NA 21.10 090 53445 .......... ............ A Insert uro/ves nck sphincter ........................ 14.07 NA 8.00 0.99 NA 23.06 090 53446 .......... ............ A Remove uro sphincter ................................. 10.23 NA 5.98 0.72 NA 16.93 090 53447 .......... ............ A Remove/replace ur sphincter ...................... 13.50 NA 7.35 0.95 NA 21.80 090 53448 .......... ............ A Remov/replc ur sphinctr comp .................... 21.16 NA 10.38 1.50 NA 33.04 090 53449 .......... ............ A Repair uro sphincter .................................... 9.71 NA 5.49 0.68 NA 15.88 090 53450 .......... ............ A Revision of urethra ...................................... 6.14 NA 3.83 0.43 NA 10.40 090 53460 .......... ............ A Revision of urethra ...................................... 7.12 NA 4.26 0.50 NA 11.88 090 53500 .......... ............ A Urethrlys, transvag w/ scope ....................... 12.21 NA 6.83 0.90 NA 19.95 090 53502 .......... ............ A Repair of urethra injury ............................... 7.64 NA 4.47 0.62 NA 12.73 090 53505 .......... ............ A Repair of urethra injury ............................... 7.64 NA 4.46 0.54 NA 12.63 090 53510 .......... ............ A Repair of urethra injury ............................... 10.11 NA 5.77 0.74 NA 16.62 090 53515 .......... ............ A Repair of urethra injury ............................... 13.32 NA 6.71 1.05 NA 21.08 090 53520 .......... ............ A Repair of urethra defect .............................. 8.69 NA 5.13 0.61 NA 14.43 090
53600 .......... ............ A Dilate urethra stricture ................................. 1.21 1.21 0.50 0.09 2.51 1.81 000 53601 .......... ............ A Dilate urethra stricture ................................. 0.98 1.34 0.44 0.07 2.39 1.49 000 53605 .......... ............ A Dilate urethra stricture ................................. 1.28 NA 0.48 0.09 NA 1.85 000 53620 .......... ............ A Dilate urethra stricture ................................. 1.62 2.05 0.71 0.11 3.78 2.44 000 53621 .......... ............ A Dilate urethra stricture ................................. 1.35 2.13 0.58 0.10 3.58 2.04 000 53660 .......... ............ A Dilation of urethra ........................................ 0.71 1.36 0.37 0.05 2.12 1.13 000 53661 .......... ............ A Dilation of urethra ........................................ 0.72 1.35 0.35 0.05 2.12 1.12 000 53665 .......... ............ A Dilation of urethra ........................................ 0.76 NA 0.28 0.06 NA 1.10 000
53850 .......... ............ A Prostatic microwave thermotx ..................... 9.46 88.85 4.72 0.67 98.98 14.85 090 53852 .......... ............ A Prostatic rf thermotx .................................... 9.89 84.87 5.22 0.70 95.46 15.81 090
53853 .......... ............ A Prostatic water thermother .......................... 5.24 53.22 3.35 0.37 58.83 8.96 090 53899 .......... ............ C Urology surgery procedure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 54000 .......... ............ A Slitting of prepuce ....................................... 1.54 2.98 1.12 0.11 4.63 2.77 010 54001 .......... ............ A Slitting of prepuce ....................................... 2.19 3.29 1.32 0.15 5.63 3.66 010 54015 .......... ............ A Drain penis lesion ........................................ 5.32 NA 2.90 0.38 NA 8.60 010 54050 .......... ............ A Destruction, penis lesion(s) ......................... 1.24 1.81 1.15 0.08 3.13 2.48 010 54055 .......... ............ A Destruction, penis lesion(s) ......................... 1.22 1.72 0.92 0.08 3.02 2.22 010 54056 .......... ............ A Cryosurgery, penis lesion(s) ....................... 1.24 1.88 1.23 0.06 3.18 2.53 010 54057 .......... ............ A Laser surg, penis lesion(s) .......................... 1.24 2.38 1.00 0.09 3.71 2.33 010 54060 .......... ............ A Excision of penis lesion(s) .......................... 1.93 3.23 1.25 0.13 5.29 3.32 010 54065 .......... ............ A Destruction, penis lesion(s) ......................... 2.42 2.90 1.43 0.13 5.45 3.99 010 54100 .......... ............ A Biopsy of penis ............................................ 1.90 3.02 0.99 0.10 5.02 2.99 000 54105 .......... ............ A Biopsy of penis ............................................ 3.50 4.45 2.18 0.25 8.20 5.93 010 54110 .......... ............ A Treatment of penis lesion ............................ 10.13 NA 5.51 0.72 NA 16.36 090 54111 .......... ............ A Treat penis lesion, graft .............................. 13.58 NA 6.75 0.96 NA 21.29 090 54112 .......... ............ A Treat penis lesion, graft .............................. 15.87 NA 7.86 1.11 NA 24.84 090 54115 .......... ............ A Treatment of penis lesion ............................ 6.15 4.90 3.98 0.43 11.48 10.56 090 54120 .......... ............ A Partial removal of penis .............................. 9.98 NA 5.45 0.68 NA 16.11 090 54125 .......... ............ A Removal of penis ........................................ 13.54 NA 6.79 0.95 NA 21.28 090 54130 .......... ............ A Remove penis & nodes ............................... 20.15 NA 9.51 1.52 NA 31.18 090 54135 .......... ............ A Remove penis & nodes ............................... 26.37 NA 11.79 1.87 NA 40.03 090 54150 .......... ............ A Circumcision ................................................ 1.81 4.16 0.70 0.16 6.13 2.67 XXX 54152 .......... ............ A Circumcision ................................................ 2.31 NA 1.36 0.19 NA 3.86 010 54160 .......... ............ A Circumcision ................................................ 2.48 4.20 1.25 0.19 6.88 3.92 010 54161 .......... ............ A Circumcision ................................................ 3.28 NA 1.83 0.23 NA 5.34 010 54162 .......... ............ A Lysis penil circumic lesion ........................... 3.01 4.74 1.72 0.21 7.96 4.94 010 54163 .......... ............ A Repair of circumcision ................................. 3.01 NA 2.30 0.21 NA 5.52 010 54164 .......... ............ A Frenulotomy of penis ................................... 2.51 NA 2.10 0.18 NA 4.78 010 54200 .......... ............ A Treatment of penis lesion ............................ 1.06 1.90 1.02 0.08 3.04 2.16 010 54205 .......... ............ A Treatment of penis lesion ............................ 7.94 NA 5.26 0.56 NA 13.76 090 54220 .......... ............ A Treatment of penis lesion ............................ 2.42 3.90 1.14 0.17 6.49 3.73 000 54230 .......... ............ A Prepare penis study .................................... 1.34 1.21 0.75 0.09 2.65 2.18 000 54231 .......... ............ A Dynamic cavernosometry ............................ 2.04 1.48 1.02 0.16 3.68 3.23 000 54235 .......... ............ A Penile injection ............................................ 1.19 1.09 0.70 0.08 2.36 1.97 000 54240 .......... ............ A Penis study .................................................. 1.31 1.12 NA 0.17 2.60 NA 000 54240 .......... 26 ....... A Penis study .................................................. 1.31 0.47 0.47 0.11 1.90 1.90 000 54240 .......... TC ...... A Penis study .................................................. 0.00 0.64 NA 0.06 0.70 NA 000 54250 .......... ............ A Penis study .................................................. 2.22 0.98 NA 0.02 3.23 NA 000 54250 .......... 26 ....... A Penis study .................................................. 2.22 0.82 0.82 0.16 3.20 3.20 000 54250 .......... TC ...... A Penis study .................................................. 0.00 0.17 NA 0.02 0.19 NA 000 54300 .......... ............ A Revision of penis ......................................... 10.41 NA 6.23 0.76 NA 17.40 090 54304 .......... ............ A Revision of penis ......................................... 12.49 NA 7.09 0.88 NA 20.47 090 54308 .......... ............ A Reconstruction of urethra ............................ 11.83 NA 6.69 0.84 NA 19.36 090 54312 .......... ............ A Reconstruction of urethra ............................ 13.58 NA 7.82 1.24 NA 22.63 090 54316 .......... ............ A Reconstruction of urethra ............................ 16.82 NA 8.81 1.21 NA 26.84 090 54318 .......... ............ A Reconstruction of urethra ............................ 11.25 NA 6.34 1.39 NA 18.98 090


## 45934

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

54322 .......... ............ A Reconstruction of urethra ............................ 13.02 NA 7.28 0.92 NA 21.22 090 54324 .......... ............ A Reconstruction of urethra ............................ 16.32 NA 8.87 1.14 NA 26.34 090 54326 .......... ............ A Reconstruction of urethra ............................ 15.73 NA 8.66 1.11 NA 25.51 090 54328 .......... ............ A Revise penis/urethra ................................... 15.66 NA 8.24 0.98 NA 24.88 090 54332 .......... ............ A Revise penis/urethra ................................... 17.08 NA 8.69 1.21 NA 26.98 090 54336 .......... ............ A Revise penis/urethra ................................... 20.05 NA 11.00 2.20 NA 33.25 090 54340 .......... ............ A Secondary urethral surgery ......................... 8.92 NA 5.40 0.63 NA 14.95 090 54344 .......... ............ A Secondary urethral surgery ......................... 15.95 NA 8.70 1.54 NA 26.19 090 54348 .......... ............ A Secondary urethral surgery ......................... 17.15 NA 9.18 1.23 NA 27.57 090 54352 .......... ............ A Reconstruct urethra/penis ........................... 24.75 NA 12.36 2.24 NA 39.35 090 54360 .......... ............ A Penis plastic surgery ................................... 11.93 NA 6.83 0.84 NA 19.60 090 54380 .......... ............ A Repair penis ................................................ 13.19 NA 7.19 0.93 NA 21.31 090 54385 .......... ............ A Repair penis ................................................ 15.40 NA 9.36 0.86 NA 25.62 090 54390 .......... ............ A Repair penis and bladder ............................ 21.62 NA 10.88 1.54 NA 34.04 090 54400 .......... ............ A Insert semi-rigid prosthesis ......................... 9.00 NA 5.00 0.64 NA 14.64 090 54401 .......... ............ A Insert self-contd prosthesis ......................... 10.28 NA 6.69 0.73 NA 17.70 090 54405 .......... ............ A Insert multi-comp penis pros ....................... 13.44 NA 6.85 0.95 NA 21.24 090 54406 .......... ............ A Remove muti-comp penis pros ................... 12.10 NA 6.33 0.86 NA 19.30 090 54408 .......... ............ A Repair multi-comp penis pros ..................... 12.76 NA 6.73 0.90 NA 20.39 090 54410 .......... ............ A Remove/replace penis prosth ..................... 15.51 NA 7.78 1.10 NA 24.39 090 54411 .......... ............ A Remov/replc penis pros, comp ................... 16.01 NA 8.24 1.13 NA 25.38 090 54415 .......... ............ A Remove self-contd penis pros .................... 8.21 NA 4.88 0.58 NA 13.66 090 54416 .......... ............ A Remv/repl penis contain pros ..................... 10.87 NA 6.30 0.77 NA 17.94 090 54417 .......... ............ A Remv/replc penis pros, compl ..................... 14.20 NA 7.28 1.00 NA 22.48 090 54420 .......... ............ A Revision of penis ......................................... 11.42 NA 6.21 0.81 NA 18.45 090 54430 .......... ............ A Revision of penis ......................................... 10.15 NA 5.85 0.72 NA 16.72 090 54435 .......... ............ A Revision of penis ......................................... 6.12 NA 4.09 0.43 NA 10.64 090 54440 .......... ............ C Repair of penis ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 090 54450 .......... ............ A Preputial stretching ...................................... 1.12 0.99 0.50 0.08 2.20 1.70 000 54500 .......... ............ A Biopsy of testis ............................................ 1.31 NA 0.65 0.10 NA 2.06 000 54505 .......... ............ A Biopsy of testis ............................................ 3.46 NA 2.15 0.27 NA 5.88 010
54512 .......... ............ A Excise lesion testis ...................................... 8.59 NA 4.70 0.67 NA 13.96 090 54520 .......... ............ A Removal of testis ......................................... 5.23 NA 3.16 0.50 NA 8.89 090 54522 .......... ............ A Orchiectomy, partial .................................... 9.51 NA 5.36 0.89 NA 15.76 090 54530 .......... ............ A Removal of testis ......................................... 8.59 NA 4.87 0.66 NA 14.11 090 54535 .......... ............ A Extensive testis surgery .............................. 12.16 NA 6.19 0.95 NA 19.30 090 54550 .......... ............ A Exploration for testis .................................... 7.79 NA 4.31 0.59 NA 12.68 090 54560 .......... ............ A Exploration for testis .................................... 11.13 NA 5.74 0.90 NA 17.77 090
54600 .......... ............ A Reduce testis torsion ................................... 7.01 NA 4.05 0.51 NA 11.57 090 54620 .......... ............ A Suspension of testis .................................... 4.90 NA 2.78 0.37 NA 8.05 010 54640 .......... ............ A Suspension of testis .................................... 6.90 NA 4.20 0.62 NA 11.72 090 54650 .......... ............ A Orchiopexy (Fowler-Stephens) .................... 11.45 NA 6.03 1.16 NA 18.64 090 54660 .......... ............ A Revision of testis ......................................... 5.11 NA 3.39 0.44 NA 8.94 090 54670 .......... ............ A Repair testis injury ....................................... 6.41 NA 3.95 0.47 NA 10.83 090 54680 .......... ............ A Relocation of testis(es) ................................ 12.66 NA 6.67 1.16 NA 20.48 090 54690 .......... ............ A Laparoscopy, orchiectomy .......................... 10.96 NA 5.61 1.02 NA 17.59 090 54692 .......... ............ A Laparoscopy, orchiopexy ............................ 12.89 NA 6.14 1.30 NA 20.33 090 54699 .......... ............ C Laparoscope proc, testis ............................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY 54700 .......... ............ A Drainage of scrotum .................................... 3.43 NA 2.13 0.28 NA 5.84 010 54800 .......... ............ A Biopsy of epididymis ................................... 2.33 NA 1.03 0.23 NA 3.60 000 54820 .......... ............ A Exploration of epididymis ............................ 5.14 NA 3.32 0.40 NA 8.86 090 54830 .......... ............ A Remove epididymis lesion .......................... 5.38 NA 3.45 0.41 NA 9.25 090 54840 .......... ............ A Remove epididymis lesion .......................... 5.20 NA 3.19 0.37 NA 8.76 090 54860 .......... ............ A Removal of epididymis ................................ 6.32 NA 3.85 0.45 NA 10.62 090 54861 .......... ............ A Removal of epididymis ................................ 8.91 NA 5.03 0.63 NA 14.57 090 54900 .......... ............ A Fusion of spermatic ducts ........................... 13.21 NA 6.74 0.93 NA 20.87 090 54901 .......... ............ A Fusion of spermatic ducts ........................... 17.95 NA 8.13 1.82 NA 27.89 090 55000 .......... ............ A Drainage of hydrocele ................................. 1.43 2.08 0.74 0.11 3.63 2.28 000 55040 .......... ............ A Removal of hydrocele ................................. 5.36 NA 3.26 0.43 NA 9.05 090 55041 .......... ............ A Removal of hydroceles ................................ 7.75 NA 4.52 0.60 NA 12.86 090 55060 .......... ............ A Repair of hydrocele ..................................... 5.52 NA 3.45 0.46 NA 9.43 090 55100 .......... ............ A Drainage of scrotum abscess ..................... 2.13 3.74 1.72 0.17 6.04 4.02 010 55110 .......... ............ A Explore scrotum .......................................... 5.70 NA 3.58 0.43 NA 9.71 090 55120 .......... ............ A Removal of scrotum lesion .......................... 5.09 NA 3.35 0.39 NA 8.83 090 55150 .......... ............ A Removal of scrotum .................................... 7.22 NA 4.36 0.56 NA 12.15 090 55175 .......... ............ A Revision of scrotum ..................................... 5.24 NA 3.45 0.37 NA 9.06 090 55180 .......... ............ A Revision of scrotum ..................................... 10.72 NA 6.05 0.90 NA 17.67 090 55200 .......... ............ A Incision of sperm duct ................................. 4.24 12.12 2.67 0.33 16.69 7.23 090 55250 .......... ............ A Removal of sperm duct(s) ........................... 3.30 11.22 2.51 0.25 14.77 6.05 090 55300 .......... ............ A Prepare, sperm duct x-ray .......................... 3.51 NA 1.53 0.25 NA 5.28 000 55400 .......... ............ A Repair of sperm duct ................................... 8.50 NA 4.68 0.64 NA 13.81 090 55450 .......... ............ A Ligation of sperm duct ................................. 4.12 7.06 2.20 0.29 11.47 6.61 010 55500 .......... ............ A Removal of hydrocele ................................. 5.59 NA 3.35 0.55 NA 9.49 090 55520 .......... ............ A Removal of sperm cord lesion .................... 6.03 NA 3.31 0.75 NA 10.09 090


## 45935

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

55530 .......... ............ A Revise spermatic cord veins ....................... 5.66 NA 3.41 0.45 NA 9.52 090 55535 .......... ............ A Revise spermatic cord veins ....................... 6.56 NA 3.89 0.47 NA 10.92 090 55540 .......... ............ A Revise hernia & sperm veins ...................... 7.68 NA 3.86 0.94 NA 12.47 090 55550 .......... ............ A Laparo ligate spermatic vein ....................... 6.57 NA 3.59 0.57 NA 10.74 090 55559 .......... ............ C Laparo proc, spermatic cord ....................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 55600 .......... ............ A Incise sperm duct pouch ............................. 6.38 NA 3.89 0.62 NA 10.89 090 55605 .......... ............ A Incise sperm duct pouch ............................. 7.97 NA 4.86 0.64 NA 13.46 090 55650 .......... ............ A Remove sperm duct pouch ......................... 11.80 NA 6.12 0.92 NA 18.84 090 55680 .......... ............ A Remove sperm pouch lesion ...................... 5.19 NA 3.39 0.47 NA 9.05 090 55700 .......... ............ A Biopsy of prostate ....................................... 1.57 4.22 0.76 0.11 5.90 2.45 000 55705 .......... ............ A Biopsy of prostate ....................................... 4.57 NA 2.60 0.32 NA 7.49 010 55720 .......... ............ A Drainage of prostate abscess ..................... 7.65 NA 4.35 0.95 NA 12.94 090 55725 .......... ............ A Drainage of prostate abscess ..................... 8.69 NA 5.02 0.70 NA 14.40 090 55801 .......... ............ A Removal of prostate .................................... 17.81 NA 8.72 1.34 NA 27.86 090 55810 .......... ............ A Extensive prostate surgery .......................... 22.60 NA 10.31 1.60 NA 34.51 090 55812 .......... ............ A Extensive prostate surgery .......................... 27.52 NA 12.47 2.04 NA 42.03 090 55815 .......... ............ A Extensive prostate surgery .......................... 30.47 NA 13.65 2.16 NA 46.28 090 55821 .......... ............ A Removal of prostate .................................... 14.26 NA 7.15 1.01 NA 22.42 090 55831 .......... ............ A Removal of prostate .................................... 15.63 NA 7.67 1.10 NA 24.40 090 55840 .......... ............ A Extensive prostate surgery .......................... 22.71 NA 10.68 1.61 NA 35.00 090 55842 .......... ............ A Extensive prostate surgery .......................... 24.39 NA 11.28 1.72 NA 37.39 090 55845 .......... ............ A Extensive prostate surgery .......................... 28.57 NA 12.67 2.02 NA 43.25 090 55859 .......... ............ A Percut/needle insert, pros ........................... 12.53 NA 6.72 0.89 NA 20.13 090 55860 .......... ............ A Surgical exposure, prostate ........................ 14.46 NA 7.23 1.02 NA 22.71 090 55862 .......... ............ A Extensive prostate surgery .......................... 18.40 NA 8.62 1.49 NA 28.51 090 55865 .......... ............ A Extensive prostate surgery .......................... 22.89 NA 10.64 1.63 NA 35.16 090 55866 .......... ............ A Laparo radical prostatectomy ...................... 30.75 NA 13.70 2.16 NA 46.62 090 55870 .......... ............ A Electroejaculation ........................................ 2.59 1.83 1.25 0.16 4.57 3.99 000 55873 .......... ............ A Cryoablate prostate ..................................... 19.48 NA 10.16 1.38 NA 31.02 090 55899 .......... ............ C Genital surgery procedure ........................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 55970 .......... ............ N Sex transformation, M to F ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 55980 .......... ............ N Sex transformation, F to M ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 56405 .......... ............ A I & D of vulva/perineum .............................. 1.44 1.31 1.14 0.17 2.92 2.75 010 56420 .......... ............ A Drainage of gland abscess ......................... 1.39 2.14 0.98 0.16 3.69 2.53 010 56440 .......... ............ A Surgery for vulva lesion .............................. 2.85 NA 1.70 0.34 NA 4.88 010 56441 .......... ............ A Lysis of labial lesion(s) ................................ 1.97 1.82 1.48 0.20 4.00 3.65 010 56501 .......... ............ A Destroy, vulva lesions, sim ......................... 1.53 1.76 1.24 0.18 3.48 2.95 010 56515 .......... ............ A Destroy vulva lesion/s compl ...................... 2.77 2.55 1.79 0.33 5.64 4.89 010 56605 .......... ............ A Biopsy of vulva/perineum ............................ 1.10 1.05 0.45 0.13 2.28 1.68 000 56606 .......... ............ A Biopsy of vulva/perineum ............................ 0.55 0.47 0.22 0.07 1.09 0.84 ZZZ 56620 .......... ............ A Partial removal of vulva ............................... 7.47 NA 4.72 0.90 NA 13.09 090 56625 .......... ............ A Complete removal of vulva ......................... 8.41 NA 5.22 1.02 NA 14.64 090 56630 .......... ............ A Extensive vulva surgery .............................. 12.36 NA 6.69 1.49 NA 20.55 090 56631 .......... ............ A Extensive vulva surgery .............................. 16.21 NA 8.62 1.95 NA 26.78 090 56632 .......... ............ A Extensive vulva surgery .............................. 20.30 NA 9.30 2.38 NA 31.98 090 56633 .......... ............ A Extensive vulva surgery .............................. 16.48 NA 8.40 1.97 NA 26.86 090 56634 .......... ............ A Extensive vulva surgery .............................. 17.89 NA 9.22 2.16 NA 29.26 090 56637 .......... ............ A Extensive vulva surgery .............................. 21.98 NA 10.81 2.60 NA 35.39 090 56640 .......... ............ A Extensive vulva surgery .............................. 22.18 NA 10.38 2.88 NA 35.44 090 56700 .......... ............ A Partial removal of hymen ............................ 2.53 NA 1.84 0.30 NA 4.67 010 56720 .......... ............ A Incision of hymen ........................................ 0.68 NA 0.51 0.08 NA 1.27 000 56740 .......... ............ A Remove vagina gland lesion ....................... 4.57 NA 2.53 0.56 NA 7.66 010 56800 .......... ............ A Repair of vagina .......................................... 3.89 NA 2.21 0.44 NA 6.54 010 56805 .......... ............ A Repair clitoris ............................................... 18.87 NA 9.45 2.14 NA 30.46 090 56810 .......... ............ A Repair of perineum ...................................... 4.13 NA 2.27 0.49 NA 6.89 010 56820 .......... ............ A Exam of vulva w/scope ............................... 1.50 1.30 0.66 0.18 2.98 2.34 000 56821 .......... ............ A Exam/biopsy of vulva w/scope .................... 2.05 1.72 0.89 0.25 4.03 3.20 000 57000 .......... ............ A Exploration of vagina ................................... 2.98 NA 1.78 0.31 NA 5.06 010 57010 .......... ............ A Drainage of pelvic abscess ......................... 6.03 NA 3.81 0.71 NA 10.55 090 57020 .......... ............ A Drainage of pelvic fluid ................................ 1.50 0.92 0.58 0.18 2.60 2.26 000 57022 .......... ............ A I & d vaginal hematoma, pp ........................ 2.57 NA 1.49 0.26 NA 4.32 010 57023 .......... ............ A I & d vag hematoma, non-ob ...................... 4.75 NA 2.57 0.58 NA 7.90 010 57061 .......... ............ A Destroy vag lesions, simple ........................ 1.25 1.63 1.13 0.15 3.03 2.53 010 57065 .......... ............ A Destroy vag lesions, complex ..................... 2.62 2.26 1.66 0.31 5.19 4.58 010 57100 .......... ............ A Biopsy of vagina .......................................... 1.20 1.06 0.48 0.14 2.40 1.82 000 57105 .......... ............ A Biopsy of vagina .......................................... 1.69 1.76 1.42 0.20 3.65 3.31 010 57106 .......... ............ A Remove vagina wall, partial ........................ 6.36 NA 4.16 0.73 NA 11.25 090 57107 .......... ............ A Remove vagina tissue, part ........................ 23.02 NA 10.42 2.71 NA 36.14 090 57109 .......... ............ A Vaginectomy partial w/nodes ...................... 27.01 NA 12.16 3.21 NA 42.39 090 57110 .......... ............ A Remove vagina wall, complete ................... 14.30 NA 7.17 1.73 NA 23.20 090 57111 .......... ............ A Remove vagina tissue, compl ..................... 27.01 NA 12.41 3.17 NA 42.60 090 57112 .......... ............ A Vaginectomy w/nodes, compl ..................... 29.02 NA 12.99 3.07 NA 45.08 090 57120 .......... ............ A Closure of vagina ........................................ 7.41 NA 4.55 0.89 NA 12.85 090 57130 .......... ............ A Remove vagina lesion ................................. 2.43 2.13 1.55 0.29 4.86 4.27 010


## 45936

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

57135 .......... ............ A Remove vagina lesion ................................. 2.68 2.23 1.66 0.31 5.21 4.64 010 57150 .......... ............ A Treat vagina infection .................................. 0.55 1.01 0.21 0.07 1.64 0.83 000 57155 .......... ............ A Insert uteri tandems/ovoids ......................... .27 NA 4.44 0.43 NA 11.15 090 57160 .......... ............ A Insert pessary/other device ......................... 0.89 1.01 0.34 0.10 2.01 1.33 000 57170 .......... ............ A Fitting of diaphragm/cap .............................. 0.91 1.33 0.32 0.11 2.35 1.34 000 57180 .......... ............ A Treat vaginal bleeding ................................. 1.58 2.08 1.21 0.19 3.85 2.99 010 57200 .......... ............ A Repair of vagina .......................................... 3.94 NA 2.90 0.46 NA 7.30 090 57210 .......... ............ A Repair vagina/perineum .............................. 5.17 NA 3.41 0.62 NA 9.20 090 57220 .......... ............ A Revision of urethra ...................................... 4.31 NA 3.10 0.51 NA 7.92 090 57230 .......... ............ A Repair of urethral lesion .............................. 5.64 NA 3.54 0.54 NA 9.72 090 57240 .......... ............ A Repair bladder & vagina ............................. 6.07 NA 3.93 0.62 NA 10.62 090 57250 .......... ............ A Repair rectum & vagina .............................. 5.53 NA 3.55 0.65 NA 9.74 090 57260 .......... ............ A Repair of vagina .......................................... 8.28 NA 4.79 0.97 NA 14.04 090 57265 .......... ............ A Extensive repair of vagina ........................... 11.34 NA 5.98 1.32 NA 18.64 090 57267 .......... ............ A Insert mesh/pelvic flr addon ........................ 4.89 NA 1.93 0.64 NA 7.46 ZZZ 57268 .......... ............ A Repair of bowel bulge ................................. 6.76 NA 4.19 0.79 NA 11.74 090 57270 .......... ............ A Repair of bowel pouch ................................ 12.11 NA 6.22 1.42 NA 19.75 090 57280 .......... ............ A Suspension of vagina .................................. 15.05 NA 7.37 1.67 NA 24.09 090 57282 .......... ............ A Colpopexy, extraperitoneal .......................... 6.87 NA 4.49 1.02 NA 12.38 090 57283 .......... ............ A Colpopexy, intraperitoneal ........................... 10.86 NA 5.90 1.02 NA 17.78 090 57284 .......... ............ A Repair paravaginal defect ........................... 12.71 NA 7.20 1.41 NA 21.32 090 57287 .......... ............ A Revise/remove sling repair .......................... 10.71 NA 6.02 0.90 NA 17.63 090 57288 .......... ............ A Repair bladder defect .................................. 13.03 NA 6.58 1.12 NA 20.73 090 57289 .......... ............ A Repair bladder & vagina ............................. 11.58 NA 6.31 1.21 NA 19.10 090 57291 .......... ............ A Construction of vagina ................................ 7.96 NA 4.96 0.93 NA 13.85 090 57292 .......... ............ A Construct vagina with graft ......................... 13.10 NA 6.94 1.58 NA 21.61 090 57300 .......... ............ A Repair rectum-vagina fistula ....................... 7.62 NA 4.27 0.87 NA 12.76 090 57305 .......... ............ A Repair rectum-vagina fistula ....................... 13.78 NA 6.22 1.72 NA 21.72 090 57307 .......... ............ A Fistula repair & colostomy ........................... 15.94 NA 6.93 2.01 NA 24.88 090 57308 .......... ............ A Fistula repair, transperine ........................... 9.95 NA 5.08 1.14 NA 16.17 090 57310 .......... ............ A Repair urethrovaginal lesion ....................... 6.78 NA 4.24 0.54 NA 11.56 090 57311 .......... ............ A Repair urethrovaginal lesion ....................... 7.99 NA 4.58 0.65 NA 13.22 090 57320 .......... ............ A Repair bladder-vagina lesion ...................... 8.02 NA 4.75 0.69 NA 13.46 090 57330 .......... ............ A Repair bladder-vagina lesion ...................... 12.35 NA 6.33 1.06 NA 19.74 090 57335 .......... ............ A Repair vagina .............................................. 18.74 NA 9.27 1.91 NA 29.92 090 57400 .......... ............ A Dilation of vagina ......................................... 2.27 NA 1.12 0.26 NA 3.65 000
57410 .......... ............ A Pelvic examination ...................................... 1.75 NA 0.92 0.18 NA 2.86 000 57415 .......... ............ A Remove vaginal foreign body ..................... 2.17 NA 1.46 0.24 NA 3.88 010 57420 .......... ............ A Exam of vagina w/scope ............................. 1.60 1.34 0.69 0.19 3.13 2.48 000 57421 .......... ............ A Exam/biopsy of vag w/scope ...................... 2.20 1.81 0.94 0.27 4.28 3.42 000 57425 .......... ............ A Laparoscopy, surg, colpopexy .................... 15.76 NA 6.86 1.75 NA 24.37 090 57452 .......... ............ A Exam of cervix w/scope .............................. 1.50 1.27 0.80 0.18 2.95 2.49 000 57454 .......... ............ A Bx/curett of cervix w/scope ......................... 2.33 1.61 1.13 0.28 4.23 3.75 000 57455 .......... ............ A Biopsy of cervix w/scope ............................. 1.99 1.69 0.85 0.24 3.93 3.09 000 57456 .......... ............ A Endocerv curettage w/scope ....................... 1.85 1.63 0.81 0.22 3.70 2.88 000 57460 .......... ............ A Bx of cervix w/scope, leep .......................... 2.84 5.57 1.36 0.34 8.75 4.53 000 57461 .......... ............ A Conz of cervix w/scope, leep ...................... 3.44 5.84 1.44 0.41 9.69 5.29 000 57500 .......... ............ A Biopsy of cervix ........................................... 0.97 2.43 0.63 0.12 3.52 1.72 000 57505 .......... ............ A Endocervical curettage ................................ 1.14 1.44 1.09 0.14 2.72 2.38 010 57510 .......... ............ A Cauterization of cervix ................................. 1.90 1.53 1.03 0.23 3.66 3.17 010 57511 .......... ............ A Cryocautery of cervix .................................. 1.90 1.79 1.36 0.23 3.92 3.49 010 57513 .......... ............ A Laser surgery of cervix ................................ 1.90 1.70 1.39 0.23 3.83 3.52 010 57520 .......... ............ A Conization of cervix ..................................... 4.04 3.85 2.83 0.49 8.38 7.36 090 57522 .......... ............ A Conization of cervix ..................................... 3.36 3.09 2.42 0.41 6.85 6.19 090
57530 .......... ............ A Removal of cervix ........................................ 4.79 NA 3.34 0.58 NA 8.71 090 57531 .......... ............ A Removal of cervix, radical ........................... 28.02 NA 13.03 3.34 NA 44.39 090 57540 .......... ............ A Removal of residual cervix .......................... 12.22 NA 6.16 1.49 NA 19.88 090 57545 .......... ............ A Remove cervix/repair pelvis ........................ 13.04 NA 6.60 1.52 NA 21.15 090
57550 .......... ............ A Removal of residual cervix .......................... 5.53 NA 3.79 0.67 NA 9.99 090 57555 .......... ............ A Remove cervix/repair vagina ....................... 8.96 NA 5.03 1.09 NA 15.08 090 57556 .......... ............ A Remove cervix, repair bowel ....................... 8.38 NA 4.85 0.92 NA 14.15 090 57700 .......... ............ A Revision of cervix ........................................ 3.55 NA 3.14 0.41 NA 7.10 090 57720 .......... ............ A Revision of cervix ........................................ 4.13 NA 3.09 0.49 NA 7.71 090 57800 .......... ............ A Dilation of cervical canal ............................. 0.77 0.75 0.47 0.09 1.62 1.33 000 57820 .......... ............ A D & c of residual cervix ............................... 1.67 1.46 1.13 0.20 3.33 3.00 010 58100 .......... ............ A Biopsy of uterus lining ................................. 1.53 1.30 0.71 0.18 3.01 2.42 000 58120 .......... ............ A Dilation and curettage ................................. 3.28 2.27 1.85 0.39 5.94 5.51 010 58140 .......... ............ A Myomectomy abdom method ...................... 14.61 NA 6.99 1.81 NA 23.41 090 58145 .......... ............ A Myomectomy vag method ........................... 8.05 NA 4.74 0.97 NA 13.75 090 58146 .......... ............ A Myomectomy abdom complex .................... 19.01 NA 8.83 2.32 NA 30.16 090 58150 .......... ............ A Total hysterectomy ...................................... 15.25 NA 7.36 1.84 NA 24.45 090 58152 .......... ............ A Total hysterectomy ...................................... 20.61 NA 9.68 2.47 NA 32.76 090 58180 .......... ............ A Partial hysterectomy .................................... 15.30 NA 7.32 1.64 NA 24.27 090 58200 .......... ............ A Extensive hysterectomy .............................. 21.60 NA 9.79 2.54 NA 33.93 090


## 45937

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

58210 .......... ............ A Extensive hysterectomy .............................. 28.87 NA 12.91 3.37 NA 45.14 090 58240 .......... ............ A Removal of pelvis contents ......................... 38.41 NA 17.43 4.22 NA 60.06 090 58260 .......... ............ A Vaginal hysterectomy .................................. 12.99 NA 6.61 1.57 NA 21.16 090 58262 .......... ............ A Vag hyst including t/o .................................. 14.78 NA 7.28 1.79 NA 23.85 090 58263 .......... ............ A Vag hyst w/t/o & vag repair ......................... 16.07 NA 7.77 1.94 NA 25.78 090 58267 .......... ............ A Vag hyst w/urinary repair ............................ 17.04 NA 8.25 2.06 NA 27.35 090 58270 .......... ............ A Vag hyst w/enterocele repair ...................... 14.27 NA 6.96 1.73 NA 22.96 090 58275 .......... ............ A Hysterectomy/revise vagina ........................ 15.77 NA 7.66 1.91 NA 25.34 090 58280 .......... ............ A Hysterectomy/revise vagina ........................ 17.01 NA 8.15 2.06 NA 27.23 090 58285 .......... ............ A Extensive hysterectomy .............................. 22.27 NA 9.74 2.70 NA 34.72 090 58290 .......... ............ A Vag hyst complex ........................................ 19.01 NA 8.96 2.29 NA 30.26 090 58291 .......... ............ A Vag hyst incl t/o, complex ........................... 20.80 NA 9.69 2.52 NA 33.01 090 58292 .......... ............ A Vag hyst t/o & repair, compl ....................... 22.09 NA 10.16 2.67 NA 34.93 090 58293 .......... ............ A Vag hyst w/uro repair, compl ...................... 23.08 NA 10.44 2.78 NA 36.29 090 58294 .......... ............ A Vag hyst w/enterocele, compl ..................... 20.29 NA 9.37 2.39 NA 32.05 090
58300 .......... ............ N Insert intrauterine device ............................. 1.01 1.33 0.38 0.12 2.46 1.51 XXX 58301 .......... ............ A Remove intrauterine device ........................ 1.27 1.28 0.47 0.15 2.70 1.89 000 58321 .......... ............ A Artificial insemination ................................... 0.92 1.12 0.36 0.10 2.14 1.38 000 58322 .......... ............ A Artificial insemination ................................... 1.10 1.18 0.41 0.13 2.41 1.64 000 58323 .......... ............ A Sperm washing ............................................ 0.23 0.47 0.09 0.03 0.73 0.35 000 58340 .......... ............ A Catheter for hysterography ......................... 0.88 3.02 0.68 0.09 3.99 1.65 000 58345 .......... ............ A Reopen fallopian tube ................................. 4.66 NA 2.48 0.41 NA 7.55 010 58346 .......... ............ A Insert heyman uteri capsule ........................ 6.75 NA 3.93 0.56 NA 11.24 090 58350 .......... ............ A Reopen fallopian tube ................................. 1.01 1.50 0.92 0.12 2.64 2.05 010 58353 .......... ............ A Endometr ablate, thermal ............................ 3.56 33.29 2.02 0.43 37.28 6.01 010 58356 .......... ............ A Endometrial cryoablation ............................. 6.37 6.85 2.59 0.82 14.05 9.78 010 58400 .......... ............ A Suspension of uterus .................................. 6.36 NA 3.91 0.75 NA 11.03 090 58410 .......... ............ A Suspension of uterus .................................. 12.74 NA 6.33 1.45 NA 20.51 090 58520 .......... ............ A Repair of ruptured uterus ............................ 11.92 NA 5.92 1.47 NA 19.31 090 58540 .......... ............ A Revision of uterus ....................................... 14.65 NA 6.85 1.78 NA 23.28 090 58545 .......... ............ A Laparoscopic myomectomy ......................... 14.61 NA 7.06 1.77 NA 23.44 090 58546 .......... ............ A Laparo-myomectomy, complex ................... 19.01 NA 8.75 2.30 NA 30.06 090 58550 .......... ............ A Laparo-asst vag hysterectomy .................... 14.20 NA 7.18 1.72 NA 23.10 090 58552 .......... ............ A Laparo-vag hyst incl t/o ............................... 16.01 NA 7.88 1.72 NA 25.62 090 58553 .......... ............ A Laparo-vag hyst, complex ........................... 19.01 NA 8.78 2.30 NA 30.09 090 58554 .......... ............ A Laparo-vag hyst w/t/o, compl ...................... 22.01 NA 10.24 2.27 NA 34.52 090 58555 .......... ............ A Hysteroscopy, dx, sep proc ......................... 3.34 2.16 1.52 0.40 5.90 5.26 000 58558 .......... ............ A Hysteroscopy, biopsy .................................. 4.75 NA 2.13 0.57 NA 7.45 000 58559 .......... ............ A Hysteroscopy, lysis ...................................... 6.17 NA 2.68 0.74 NA 9.60 000 58560 .......... ............ A Hysteroscopy, resect septum ...................... 7.00 NA 3.02 0.84 NA 10.86 000 58561 .......... ............ A Hysteroscopy, remove myoma .................... 10.01 NA 4.19 1.21 NA 15.41 000 58562 .......... ............ A Hysteroscopy, remove fb ............................ 5.21 NA 2.30 0.63 NA 8.14 000 58563 .......... ............ A Hysteroscopy, ablation ................................ 6.17 52.70 2.70 0.74 59.62 9.61 000 58565 .......... ............ A Hysteroscopy, sterilization ........................... 7.03 46.78 3.88 1.19 55.01 12.11 090 58578 .......... ............ C Laparo proc, uterus ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 58579 .......... ............ C Hysteroscope procedure ............................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY 58600 .......... ............ A Division of fallopian tube ............................. 5.60 NA 3.29 0.66 NA 9.55 090 58605 .......... ............ A Division of fallopian tube ............................. 5.00 NA 3.06 0.59 NA 8.65 090 58611 .......... ............ A Ligate oviduct(s) add-on .............................. 1.45 NA 0.56 0.18 NA 2.19 ZZZ 58615 .......... ............ A Occlude fallopian tube(s) ............................ 3.90 NA 2.62 0.47 NA 6.98 010 58660 .......... ............ A Laparoscopy, lysis ....................................... 11.29 NA 5.17 1.40 NA 17.87 090 58661 .......... ............ A Laparoscopy, remove adnexa ..................... 11.05 NA 5.02 1.34 NA 17.41 010 58662 .......... ............ A Laparoscopy, excise lesions ....................... 11.79 NA 5.68 1.43 NA 18.90 090 58670 .......... ............ A Laparoscopy, tubal cautery ......................... 5.60 NA 3.23 0.67 NA 9.50 090 58671 .......... ............ A Laparoscopy, tubal block ............................ 5.60 NA 3.23 0.68 NA 9.51 090 58672 .......... ............ A Laparoscopy, fimbrioplasty .......................... 12.89 NA 6.06 1.60 NA 20.55 090 58673 .......... ............ A Laparoscopy, salpingostomy ....................... 13.75 NA 6.45 1.69 NA 21.88 090 58679 .......... ............ C Laparo proc, oviduct-ovary .......................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 58700 .......... ............ A Removal of fallopian tube ........................... 12.05 NA 5.91 1.51 NA 19.48 090 58720 .......... ............ A Removal of ovary/tube(s) ............................ 11.36 NA 5.69 1.39 NA 18.44 090 58740 .......... ............ A Revise fallopian tube(s) ............................... 14.01 NA 7.03 1.71 NA 22.74 090 58750 .......... ............ A Repair oviduct ............................................. 14.85 NA 7.22 1.84 NA 23.91 090 58752 .......... ............ A Revise ovarian tube(s) ................................ 14.85 NA 6.79 1.80 NA 23.44 090
58760 .......... ............ A Remove tubal obstruction ........................... 13.14 NA 6.62 1.79 NA 21.54 090 58770 .......... ............ A Create new tubal opening ........................... 13.98 NA 6.78 1.73 NA 22.49 090 58800 .......... ............ A Drainage of ovarian cyst(s) ......................... 4.14 3.56 2.93 0.43 8.13 7.50 090 58805 .......... ............ A Drainage of ovarian cyst(s) ......................... 5.88 NA 3.49 0.69 NA 10.06 090 58820 .......... ............ A Drain ovary abscess, open ......................... 4.22 NA 3.35 0.52 NA 8.09 090 58822 .......... ............ A Drain ovary abscess, percut ....................... 10.13 NA 5.19 1.16 NA 16.48 090 58823 .......... ............ A Drain pelvic abscess, percut ....................... 3.38 21.63 1.16 0.24 25.24 4.77 000 58825 .......... ............ A Transposition, ovary(s) ................................ 10.98 NA 5.69 1.32 NA 17.99 090 58900 .......... ............ A Biopsy of ovary(s) ....................................... 5.99 NA 3.57 0.69 NA 10.25 090 58920 .......... ............ A Partial removal of ovary(s) .......................... 11.36 NA 5.49 1.43 NA 18.28 090 58925 .......... ............ A Removal of ovarian cyst(s) ......................... 11.36 NA 5.62 1.41 NA 18.39 090


## 45938

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

58940 .......... ............ A Removal of ovary(s) .................................... 7.29 NA 4.08 0.91 NA 12.29 090 58943 .......... ............ A Removal of ovary(s) .................................... 18.44 NA 8.48 2.22 NA 29.13 090 58950 .......... ............ A Resect ovarian malignancy ......................... 16.93 NA 8.24 2.04 NA 27.22 090 58951 .......... ............ A Resect ovarian malignancy ......................... 22.39 NA 10.22 2.63 NA 35.24 090 58952 .......... ............ A Resect ovarian malignancy ......................... 25.02 NA 11.50 3.02 NA 39.54 090 58953 .......... ............ A Tah, rad dissect for debulk ......................... 32.01 NA 14.24 3.83 NA 50.08 090 58954 .......... ............ A Tah rad debulk/lymph remove .................... 35.02 NA 15.44 4.17 NA 54.63 090 58956 .......... ............ A Bso, omentectomy w/tah ............................. 20.82 NA 10.08 4.00 NA 34.90 090 58960 .......... ............ A Exploration of abdomen .............................. 14.66 NA 7.21 1.79 NA 23.66 090 58970 .......... ............ A Retrieval of oocyte ...................................... 3.53 2.27 1.46 0.43 6.23 5.42 000 58974 .......... ............ C Transfer of embryo ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 000 58976 .......... ............ A Transfer of embryo ...................................... 3.83 2.63 1.79 0.47 6.93 6.09 000 58999 .......... ............ C Genital surgery procedure ........................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 59000 .......... ............ A Amniocentesis, diagnostic ........................... 1.30 2.01 0.66 0.31 3.63 2.27 000 59001 .......... ............ A Amniocentesis, therapeutic ......................... 3.01 NA 1.39 0.71 NA 5.10 000 59012 .......... ............ A Fetal cord puncture,prenatal ....................... 3.45 NA 1.51 0.82 NA 5.77 000 59015 .......... ............ A Chorion biopsy ............................................ 2.20 1.54 1.02 0.52 4.26 3.75 000
59020 .......... ............ A Fetal contract stress test ............................. 0.66 0.83 NA 0.26 1.76 NA 000 59020 .......... 26 ....... A Fetal contract stress test ............................. 0.66 0.26 0.26 0.16 1.08 1.08 000 59020 .......... TC ...... A Fetal contract stress test ............................. 0.00 0.58 NA 0.10 0.68 NA 000
59025 .......... ............ A Fetal non-stress test .................................... 0.53 0.48 NA 0.15 1.16 NA 000 59025 .......... 26 ....... A Fetal non-stress test .................................... 0.53 0.21 0.21 0.13 0.87 0.87 000 59025 .......... TC ...... A Fetal non-stress test .................................... 0.00 0.27 NA 0.02 0.29 NA 000 59030 .......... ............ A Fetal scalp blood sample ............................ 1.99 NA 0.75 0.47 NA 3.22 000 59050 .......... ............ A Fetal monitor w/report ................................. 0.89 NA 0.34 0.21 NA 1.44 XXX 59051 .......... ............ A Fetal monitor/interpret only ......................... 0.74 NA 0.28 0.17 NA 1.19 XXX 59070 .......... ............ A Transabdom amnioinfus w/us ..................... 5.25 5.16 2.29 0.28 10.69 7.82 000 59072 .......... ............ A Umbilical cord occlud w/us .......................... 9.01 NA 3.56 0.16 NA 12.73 000 59074 .......... ............ A Fetal fluid drainage w/us ............................. 5.25 4.51 2.29 0.28 10.04 7.82 000 59076 .......... ............ A Fetal shunt placement, w/us ....................... 9.01 NA 3.56 0.16 NA 12.73 000
59100 .......... ............ A Remove uterus lesion ................................. 12.35 NA 6.36 2.94 NA 21.65 090 59120 .......... ............ A Treat ectopic pregnancy .............................. 11.49 NA 6.14 2.72 NA 20.35 090 59121 .......... ............ A Treat ectopic pregnancy .............................. 11.67 NA 6.21 2.78 NA 20.67 090 59130 .......... ............ A Treat ectopic pregnancy .............................. 14.23 NA 4.59 3.38 NA 22.20 090 59135 .......... ............ A Treat ectopic pregnancy .............................. 13.89 NA 7.09 3.30 NA 24.28 090 59136 .......... ............ A Treat ectopic pregnancy .............................. 13.19 NA 6.48 3.13 NA 22.80 090 59140 .......... ............ A Treat ectopic pregnancy .............................. 5.46 NA 2.49 1.29 NA 9.24 090 59150 .......... ............ A Treat ectopic pregnancy .............................. 11.67 NA 5.90 2.78 NA 20.35 090 59151 .......... ............ A Treat ectopic pregnancy .............................. 11.49 NA 5.95 2.73 NA 20.17 090 59160 .......... ............ A D & c after delivery ..................................... 2.72 3.09 1.99 0.64 6.44 5.35 010
59200 .......... ............ A Insert cervical dilator ................................... 0.79 1.15 0.30 0.19 2.13 1.28 000 59300 .......... ............ A Episiotomy or vaginal repair ........................ 2.41 2.34 1.02 0.57 5.33 4.01 000 59320 .......... ............ A Revision of cervix ........................................ 2.48 NA 1.22 0.59 NA 4.30 000 59325 .......... ............ A Revision of cervix ........................................ 4.07 NA 1.86 0.88 NA 6.80 000 59350 .......... ............ A Repair of uterus ........................................... 4.95 NA 1.84 1.17 NA 7.96 000 59400 .......... ............ A Obstetrical care ........................................... 23.08 NA 15.13 5.48 NA 43.68 MMM 59409 .......... ............ A Obstetrical care ........................................... 13.51 NA 5.17 3.21 NA 21.89 MMM 59410 .......... ............ A Obstetrical care ........................................... 14.79 NA 6.16 3.51 NA 24.46 MMM 59412 .......... ............ A Antepartum manipulation ............................ 1.71 NA 0.80 0.40 NA 2.91 MMM 59414 .......... ............ A Deliver placenta ........................................... 1.61 NA 0.62 0.38 NA 2.62 MMM 59425 .......... ............ A Antepartum care only .................................. 4.81 4.16 1.80 1.14 10.11 7.75 MMM 59426 .......... ............ A Antepartum care only .................................. 8.29 7.48 3.14 1.97 17.74 13.40 MMM 59430 .......... ............ A Care after delivery ....................................... 2.13 1.21 0.91 0.50 3.84 3.55 MMM 59510 .......... ............ A Cesarean delivery ....................................... 26.23 NA 17.03 6.23 NA 49.50 MMM 59514 .......... ............ A Cesarean delivery only ................................ 15.98 NA 6.06 3.79 NA 25.83 MMM 59515 .......... ............ A Cesarean delivery ....................................... 17.37 NA 7.67 4.12 NA 29.16 MMM
59525 .......... ............ A Remove uterus after cesarean .................... 8.55 NA 3.22 1.94 NA 13.71 ZZZ 59610 .......... ............ A Vbac delivery ............................................... 24.63 NA 15.63 5.85 NA 46.11 MMM 59612 .......... ............ A Vbac delivery only ....................................... 15.07 NA 5.90 3.58 NA 24.55 MMM 59614 .......... ............ A Vbac care after delivery .............................. 16.35 NA 6.77 3.88 NA 27.00 MMM 59618 .......... ............ A Attempted vbac delivery .............................. 27.80 NA 17.88 6.59 NA 52.26 MMM 59620 .......... ............ A Attempted vbac delivery only ...................... 17.54 NA 6.59 4.16 NA 28.28 MMM 59622 .......... ............ A Attempted vbac after care ........................... 18.94 NA 8.59 4.49 NA 32.02 MMM 59812 .......... ............ A Treatment of miscarriage ............................ 4.01 NA 2.50 0.95 NA 7.46 090 59820 .......... ............ A Care of miscarriage ..................................... 4.01 4.34 3.53 0.95 9.30 8.49 090 59821 .......... ............ A Treatment of miscarriage ............................ 4.47 4.20 3.36 1.06 9.72 8.89 090 59830 .......... ............ A Treat uterus infection .................................. 6.11 NA 3.91 1.44 NA 11.46 090
59840 .......... ............ R Abortion ....................................................... 3.02 NA 2.09 0.71 NA 5.81 010
59841 .......... ............ R Abortion ....................................................... 5.24 NA 2.93 1.24 NA 9.41 010
59850 .......... ............ R Abortion ....................................................... 5.91 NA 3.22 1.28 NA 10.41 090
59851 .......... ............ R Abortion ....................................................... 5.93 NA 3.70 1.28 NA 10.91 090
59852 .......... ............ R Abortion ....................................................... 8.25 NA 4.94 1.80 NA 14.99 090
59855 .......... ............ R Abortion ....................................................... 6.12 NA 3.48 1.45 NA 11.05 090
59856 .......... ............ R Abortion ....................................................... 7.48 NA 4.00 1.78 NA 13.26 090


## 45939

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

59857 .......... ............ R Abortion ....................................................... 9.30 NA 4.63 2.01 NA 15.94 090 59866 .......... ............ R Abortion (mpr) ............................................. 4.00 NA 1.86 0.87 NA 6.73 000 59870 .......... ............ A Evacuate mole of uterus ............................. 6.01 NA 4.43 1.42 NA 11.87 090 59871 .......... ............ A Remove cerclage suture ............................. 2.13 NA 1.11 0.50 NA 3.75 000 59897 .......... ............ C Fetal invas px w/us ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 59898 .......... ............ C Laparo proc, ob care/deliver ....................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 59899 .......... ............ C Maternity care procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 60000 .......... ............ A Drain thyroid/tongue cyst ............................ 1.76 1.94 1.73 0.15 3.85 3.64 010 60001 .......... ............ A Aspirate/inject thyriod cyst .......................... 0.97 1.57 0.33 0.07 2.61 1.38 000 60100 .......... ............ A Biopsy of thyroid .......................................... 1.56 1.38 0.55 0.10 3.05 2.21 000 60200 .......... ............ A Remove thyroid lesion ................................. 9.56 NA 5.87 1.01 NA 16.44 090 60210 .......... ............ A Partial thyroid excision ................................ 10.88 NA 5.53 1.23 NA 17.65 090 60212 .......... ............ A Partial thyroid excision ................................ 16.04 NA 7.54 1.94 NA 25.52 090 60220 .......... ............ A Partial removal of thyroid ............................ 11.90 NA 6.03 1.32 NA 19.25 090 60225 .......... ............ A Partial removal of thyroid ............................ 14.20 NA 7.28 1.64 NA 23.12 090 60240 .......... ............ A Removal of thyroid ...................................... 16.07 NA 7.41 1.85 NA 25.33 090 60252 .......... ............ A Removal of thyroid ...................................... 20.58 NA 9.87 2.29 NA 32.75 090 60254 .......... ............ A Extensive thyroid surgery ............................ 27.00 NA 13.74 2.60 NA 43.35 090 60260 .......... ............ A Repeat thyroid surgery ................................ 17.47 NA 8.44 1.93 NA 27.84 090 60270 .......... ............ A Removal of thyroid ...................................... 20.28 NA 10.12 2.32 NA 32.72 090 60271 .......... ............ A Removal of thyroid ...................................... 16.83 NA 8.36 1.74 NA 26.93 090 60280 .......... ............ A Remove thyroid duct lesion ......................... 5.87 NA 4.59 0.54 NA 11.00 090 60281 .......... ............ A Remove thyroid duct lesion ......................... 8.54 NA 5.72 0.73 NA 14.98 090 60500 .......... ............ A Explore parathyroid glands ......................... 16.24 NA 7.28 2.00 NA 25.52 090 60502 .......... ............ A Re-explore parathyroids .............................. 20.36 NA 9.19 2.53 NA 32.08 090 60505 .......... ............ A Explore parathyroid glands ......................... 21.50 NA 10.63 2.64 NA 34.77 090 60512 .......... ............ A Autotransplant parathyroid .......................... 4.45 NA 1.58 0.53 NA 6.55 ZZZ 60520 .......... ............ A Removal of thymus gland ........................... 16.81 NA 8.03 2.19 NA 27.04 090 60521 .......... ............ A Removal of thymus gland ........................... 18.88 NA 9.28 2.81 NA 30.97 090 60522 .......... ............ A Removal of thymus gland ........................... 23.11 NA 11.00 3.26 NA 37.37 090 60540 .......... ............ A Explore adrenal gland ................................. 17.03 NA 7.94 1.74 NA 26.71 090 60545 .......... ............ A Explore adrenal gland ................................. 19.89 NA 8.85 2.07 NA 30.81 090 60600 .......... ............ A Remove carotid body lesion ........................ 17.94 NA 10.62 2.19 NA 30.75 090 60605 .......... ............ A Remove carotid body lesion ........................ 20.25 NA 11.93 2.49 NA 34.67 090 60650 .......... ............ A Laparoscopy adrenalectomy ....................... 20.01 NA 8.14 2.28 NA 30.43 090 60659 .......... ............ C Laparo proc, endocrine ............................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 60699 .......... ............ C Endocrine surgery procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 61000 .......... ............ A Remove cranial cavity fluid ......................... 1.58 0.00 0.98 0.13 1.71 2.70 000 61001 .......... ............ A Remove cranial cavity fluid ......................... 1.49 0.00 1.03 0.16 1.65 2.68 000 61020 .......... ............ A Remove brain cavity fluid ............................ 1.51 0.00 1.33 0.34 1.85 3.18 000 61026 .......... ............ A Injection into brain canal ............................. 1.69 0.00 1.38 0.33 2.02 3.40 000 61050 .......... ............ A Remove brain canal fluid ............................ 1.51 NA 1.31 0.11 NA 2.94 000 61055 .......... ............ A Injection into brain canal ............................. 2.10 NA 1.48 0.17 NA 3.75 000 61070 .......... ............ A Brain canal shunt procedure ....................... 0.89 0.00 1.02 0.17 1.06 2.08 000 61105 .......... ............ A Twist drill hole ............................................. 5.14 NA 3.87 1.32 NA 10.33 090 61107 .......... ............ A Drill skull for implantation ............................ 5.00 NA 2.46 1.29 NA 8.75 000 61108 .......... ............ A Drill skull for drainage ................................. 10.19 NA 7.02 2.63 NA 19.84 090 61120 .......... ............ A Burr hole for puncture ................................. 8.77 NA 5.88 2.09 NA 16.74 090 61140 .......... ............ A Pierce skull for biopsy ................................. 15.91 NA 9.69 4.11 NA 29.71 090 61150 .......... ............ A Pierce skull for drainage ............................. 17.58 NA 10.16 4.31 NA 32.05 090 61151 .......... ............ A Pierce skull for drainage ............................. 12.42 NA 7.65 3.00 NA 23.08 090
61154 .......... ............ A Pierce skull & remove clot .......................... 15.00 NA 9.30 4.20 NA 28.50 090 61156 .......... ............ A Pierce skull for drainage ............................. 16.33 NA 9.63 4.22 NA 30.18 090 61210 .......... ............ A Pierce skull, implant device ......................... 5.84 NA 2.84 1.50 NA 10.18 000 61215 .......... ............ A Insert brain-fluid device ............................... 4.89 NA 3.95 1.26 NA 10.10 090 61250 .......... ............ A Pierce skull & explore ................................. 10.42 NA 6.72 2.76 NA 19.90 090 61253 .......... ............ A Pierce skull & explore ................................. 12.36 NA 7.56 2.61 NA 22.54 090 61304 .......... ............ A Open skull for exploration ........................... 21.97 NA 12.56 5.61 NA 40.14 090 61305 .......... ............ A Open skull for exploration ........................... 26.62 NA 14.98 6.07 NA 47.67 090 61312 .......... ............ A Open skull for drainage ............................... 24.58 NA 14.74 6.34 NA 45.66 090 61313 .......... ............ A Open skull for drainage ............................... 24.94 NA 14.50 6.43 NA 45.87 090 61314 .......... ............ A Open skull for drainage ............................... 24.24 NA 12.75 6.26 NA 43.25 090 61315 .......... ............ A Open skull for drainage ............................... 27.70 NA 15.67 7.14 NA 50.51 090 61316 .......... ............ A Implt cran bone flap to abdo ....................... 1.39 NA 0.59 0.35 NA 2.33 ZZZ 61320 .......... ............ A Open skull for drainage ............................... 25.63 NA 14.43 6.60 NA 46.66 090 61321 .......... ............ A Open skull for drainage ............................... 28.52 NA 15.77 7.12 NA 51.41 090 61322 .......... ............ A Decompressive craniotomy ......................... 29.52 NA 15.34 7.61 NA 52.46 090 61323 .......... ............ A Decompressive lobectomy .......................... 31.01 NA 15.73 8.01 NA 54.76 090 61330 .......... ............ A Decompress eye socket .............................. 23.34 NA 13.39 2.31 NA 39.03 090 61332 .......... ............ A Explore/biopsy eye socket .......................... 27.29 NA 15.22 4.82 NA 47.33 090 61333 .......... ............ A Explore orbit/remove lesion ......................... 27.97 NA 15.20 3.91 NA 47.07 090 61334 .......... ............ A Explore orbit/remove object ........................ 18.28 NA 10.39 1.74 NA 30.41 090 61340 .......... ............ A Subtemporal decompression ....................... 18.67 NA 10.90 4.83 NA 34.40 090 61343 .......... ............ A Incise skull (press relief) ............................. 29.79 NA 16.44 7.62 NA 53.84 090


## 45940

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

61345 .......... ............ A Relieve cranial pressure .............................. 27.21 NA 15.07 7.02 NA 49.30 090 61440 .......... ............ A Incise skull for surgery ................................ 26.64 NA 13.94 6.88 NA 47.46 090 61450 .......... ............ A Incise skull for surgery ................................ 25.96 NA 13.98 5.77 NA 45.71 090 61458 .......... ............ A Incise skull for brain wound ........................ 27.30 NA 15.18 7.01 NA 49.49 090 61460 .......... ............ A Incise skull for surgery ................................ 28.41 NA 16.01 6.02 NA 50.43 090 61470 .......... ............ A Incise skull for surgery ................................ 26.07 NA 13.55 5.88 NA 45.51 090 61480 .......... ............ A Incise skull for surgery ................................ 26.50 NA 14.94 6.71 NA 48.16 090 61490 .......... ............ A Incise skull for surgery ................................ 25.67 NA 14.02 6.90 NA 46.59 090 61500 .......... ............ A Removal of skull lesion ............................... 17.93 NA 10.58 4.10 NA 32.60 090 61501 .......... ............ A Remove infected skull bone ........................ 14.85 NA 9.06 3.21 NA 27.12 090 61510 .......... ............ A Removal of brain lesion .............................. 28.47 NA 16.35 7.33 NA 52.15 090 61512 .......... ............ A Remove brain lining lesion .......................... 35.11 NA 19.25 9.05 NA 63.41 090 61514 .......... ............ A Removal of brain abscess ........................... 25.27 NA 14.13 6.52 NA 45.92 090 61516 .......... ............ A Removal of brain lesion .............................. 24.62 NA 13.97 6.33 NA 44.91 090 61517 .......... ............ A Implt brain chemotx add-on ........................ 1.38 NA 0.62 0.35 NA 2.36 ZZZ 61518 .......... ............ A Removal of brain lesion .............................. 37.33 NA 20.64 9.62 NA 67.60 090 61519 .......... ............ A Remove brain lining lesion .......................... 41.41 NA 22.14 10.60 NA 74.15 090 61520 .......... ............ A Removal of brain lesion .............................. 54.87 NA 29.56 11.18 NA 95.61 090 61521 .......... ............ A Removal of brain lesion .............................. 44.50 NA 23.66 11.36 NA 79.52 090 61522 .......... ............ A Removal of brain abscess ........................... 29.47 NA 16.06 7.60 NA 53.13 090 61524 .......... ............ A Removal of brain lesion .............................. 27.88 NA 15.32 7.14 NA 50.34 090 61526 .......... ............ A Removal of brain lesion .............................. 52.19 NA 28.57 7.05 NA 87.82 090 61530 .......... ............ A Removal of brain lesion .............................. 43.88 NA 24.30 6.13 NA 74.31 090 61531 .......... ............ A Implant brain electrodes .............................. 14.64 NA 8.96 3.78 NA 27.37 090 61533 .......... ............ A Implant brain electrodes .............................. 19.72 NA 11.30 5.10 NA 36.12 090 61534 .......... ............ A Removal of brain lesion .............................. 20.98 NA 11.83 5.42 NA 38.24 090
61535 .......... ............ A Remove brain electrodes ............................ 11.63 NA 7.29 3.01 NA 21.93 090 61536 .......... ............ A Removal of brain lesion .............................. 35.54 NA 19.34 9.18 NA 64.06 090 61537 .......... ............ A Removal of brain tissue .............................. 25.01 NA 14.46 6.92 NA 46.39 090 61538 .......... ............ A Removal of brain tissue .............................. 26.82 NA 14.99 6.92 NA 48.73 090 61539 .......... ............ A Removal of brain tissue .............................. 32.09 NA 17.37 8.30 NA 57.76 090 61540 .......... ............ A Removal of brain tissue .............................. 30.02 NA 16.93 8.30 NA 55.25 090 61541 .......... ............ A Incision of brain tissue ................................ 28.87 NA 15.84 6.58 NA 51.29 090 61542 .......... ............ A Removal of brain tissue .............................. 31.03 NA 17.43 8.01 NA 56.47 090 61543 .......... ............ A Removal of brain tissue .............................. 29.24 NA 16.02 7.54 NA 52.80 090
61544 .......... ............ A Remove & treat brain lesion ....................... 25.51 NA 13.50 5.95 NA 44.96 090 61545 .......... ............ A Excision of brain tumor ............................... 43.82 NA 23.67 10.60 NA 78.09 090 61546 .......... ............ A Removal of pituitary gland .......................... 31.31 NA 17.12 7.65 NA 56.08 090 61548 .......... ............ A Removal of pituitary gland .......................... 21.54 NA 12.46 3.42 NA 37.43 090 61550 .......... ............ A Release of skull seams ............................... 14.66 NA 6.92 0.98 NA 22.56 090 61552 .......... ............ A Release of skull seams ............................... 19.57 NA 9.46 1.06 NA 30.09 090 61556 .......... ............ A Incise skull/sutures ...................................... 22.27 NA 11.14 4.64 NA 38.05 090 61557 .......... ............ A Incise skull/sutures ...................................... 22.39 NA 13.35 5.78 NA 41.52 090 61558 .......... ............ A Excision of skull/sutures .............................. 25.59 NA 13.91 1.36 NA 40.86 090 61559 .......... ............ A Excision of skull/sutures .............................. 32.81 NA 18.91 8.48 NA 60.19 090 61563 .......... ............ A Excision of skull tumor ................................ 26.84 NA 14.87 5.15 NA 46.87 090 61564 .......... ............ A Excision of skull tumor ................................ 33.85 NA 17.88 8.75 NA 60.48 090 61566 .......... ............ A Removal of brain tissue .............................. 31.01 NA 17.43 6.92 NA 55.36 090 61567 .......... ............ A Incision of brain tissue ................................ 35.52 NA 20.22 6.52 NA 62.26 090 61570 .......... ............ A Remove foreign body, brain ........................ 24.61 NA 13.62 5.86 NA 44.09 090 61571 .......... ............ A Incise skull for brain wound ........................ 26.40 NA 14.81 6.77 NA 47.98 090 61575 .......... ............ A Skull base/brainstem surgery ...................... 34.38 NA 19.10 5.32 NA 58.80 090 61576 .......... ............ A Skull base/brainstem surgery ...................... 52.45 NA 33.91 5.56 NA 91.92 090 61580 .......... ............ A Craniofacial approach, skull ........................ 30.36 NA 24.92 3.36 NA 58.65 090 61581 .......... ............ A Craniofacial approach, skull ........................ 34.62 NA 22.74 3.91 NA 61.27 090 61582 .......... ............ A Craniofacial approach, skull ........................ 31.67 NA 26.53 7.19 NA 65.39 090 61583 .......... ............ A Craniofacial approach, skull ........................ 36.23 NA 24.49 9.18 NA 69.90 090 61584 .......... ............ A Orbitocranial approach/skull ........................ 34.67 NA 23.90 8.16 NA 66.72 090 61585 .......... ............ A Orbitocranial approach/skull ........................ 38.63 NA 25.74 7.01 NA 71.37 090 61586 .......... ............ A Resect nasopharynx, skull .......................... 25.11 NA 21.90 4.36 NA 51.37 090 61590 .......... ............ A Infratemporal approach/skull ....................... 41.80 NA 27.92 5.29 NA 75.01 090 61591 .......... ............ A Infratemporal approach/skull ....................... 43.70 NA 28.74 5.64 NA 78.08 090 61592 .......... ............ A Orbitocranial approach/skull ........................ 39.66 NA 25.87 10.04 NA 75.57 090 61595 .......... ............ A Transtemporal approach/skull ..................... 29.59 NA 21.85 3.97 NA 55.41 090 61596 .......... ............ A Transcochlear approach/skull ..................... 35.65 NA 23.83 3.39 NA 62.87 090 61597 .......... ............ A Transcondylar approach/skull ..................... 37.98 NA 22.44 8.81 NA 69.23 090 61598 .......... ............ A Transpetrosal approach/skull ...................... 33.43 NA 22.65 5.68 NA 61.75 090 61600 .......... ............ A Resect/excise cranial lesion ........................ 25.86 NA 19.34 3.78 NA 48.98 090 61601 .......... ............ A Resect/excise cranial lesion ........................ 27.91 NA 19.99 6.61 NA 54.51 090 61605 .......... ............ A Resect/excise cranial lesion ........................ 29.35 NA 21.48 2.85 NA 53.68 090 61606 .......... ............ A Resect/excise cranial lesion ........................ 38.85 NA 24.52 8.94 NA 72.31 090 61607 .......... ............ A Resect/excise cranial lesion ........................ 36.29 NA 23.18 6.88 NA 66.35 090 61608 .......... ............ A Resect/excise cranial lesion ........................ 42.12 NA 25.94 10.72 NA 78.79 090 61609 .......... ............ A Transect artery, sinus .................................. 9.90 NA 4.72 2.55 NA 17.17 ZZZ


## 45941

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

61610 .......... ............ A Transect artery, sinus .................................. 29.69 NA 12.81 7.66 NA 50.15 ZZZ 61611 .......... ............ A Transect artery, sinus .................................. 7.42 NA 3.72 1.88 NA 13.03 ZZZ 61612 .......... ............ A Transect artery, sinus .................................. 27.90 NA 12.98 4.30 NA 45.18 ZZZ 61613 .......... ............ A Remove aneurysm, sinus ............................ 40.88 NA 25.62 8.42 NA 74.92 090 61615 .......... ............ A Resect/excise lesion, skull .......................... 32.08 NA 22.18 4.72 NA 58.98 090 61616 .......... ............ A Resect/excise lesion, skull .......................... 43.36 NA 27.92 8.24 NA 79.52 090 61618 .......... ............ A Repair dura .................................................. 16.99 NA 10.21 3.71 NA 30.92 090 61619 .......... ............ A Repair dura .................................................. 20.72 NA 11.95 3.94 NA 36.62 090 61623 .......... ............ A Endovasc tempory vessel occl .................... 9.97 NA 4.07 1.05 NA 15.09 000 61624 .......... ............ A Transcath occlusion, cns ............................. 20.16 NA 7.17 1.95 NA 29.28 000 61626 .......... ............ A Transcath occlusion, non-cns ..................... 16.63 NA 5.79 1.24 NA 23.66 000 61680 .......... ............ A Intracranial vessel surgery .......................... 30.72 NA 17.06 7.93 NA 55.71 090 61682 .......... ............ A Intracranial vessel surgery .......................... 61.60 NA 31.45 15.85 NA 108.90 090 61684 .......... ............ A Intracranial vessel surgery .......................... 39.83 NA 21.58 10.28 NA 71.69 090 61686 .......... ............ A Intracranial vessel surgery .......................... 64.52 NA 33.92 16.66 NA 115.09 090 61690 .......... ............ A Intracranial vessel surgery .......................... 29.33 NA 16.37 6.92 NA 52.62 090 61692 .......... ............ A Intracranial vessel surgery .......................... 51.89 NA 26.84 13.39 NA 92.12 090 61697 .......... ............ A Brain aneurysm repr, complx ...................... 50.54 NA 27.39 12.81 NA 90.74 090 61698 .......... ............ A Brain aneurysm repr, complx ...................... 48.44 NA 26.12 12.50 NA 87.06 090 61700 .......... ............ A Brain aneurysm repr, simple ....................... 50.54 NA 27.19 12.98 NA 90.72 090 61702 .......... ............ A Inner skull vessel surgery ........................... 48.44 NA 25.43 10.76 NA 84.63 090 61703 .......... ............ A Clamp neck artery ....................................... 17.47 NA 10.25 4.05 NA 31.78 090
61705 .......... ............ A Revise circulation to head ........................... 36.22 NA 18.95 8.84 NA 64.01 090 61708 .......... ............ A Revise circulation to head ........................... 35.32 NA 15.74 2.50 NA 53.56 090 61710 .......... ............ A Revise circulation to head ........................... 29.69 NA 13.97 4.51 NA 48.16 090 61711 .......... ............ A Fusion of skull arteries ................................ 36.35 NA 19.36 9.39 NA 65.10 090 61720 .......... ............ A Incise skull/brain surgery ............................. 16.77 NA 9.79 2.78 NA 29.34 090 61735 .......... ............ A Incise skull/brain surgery ............................. 20.44 NA 11.91 2.72 NA 35.07 090 61750 .......... ............ A Incise skull/brain biopsy .............................. 18.21 NA 10.39 4.71 NA 33.31 090 61751 .......... ............ A Brain biopsy w/ct/mr guide .......................... 17.63 NA 10.61 4.55 NA 32.79 090 61760 .......... ............ A Implant brain electrodes .............................. 22.28 NA 8.51 5.40 NA 36.19 090 61770 .......... ............ A Incise skull for treatment ............................. 21.45 NA 12.04 3.54 NA 37.03 090 61790 .......... ............ A Treat trigeminal nerve ................................. 10.86 NA 5.79 2.81 NA 19.47 090 61791 .......... ............ A Treat trigeminal tract ................................... 14.62 NA 8.74 3.39 NA 26.75 090 61793 .......... ............ A Focus radiation beam .................................. 17.24 NA 9.91 4.45 NA 31.61 090 61795 .......... ............ A Brain surgery using computer ..................... 4.04 NA 1.98 0.79 NA 6.80 ZZZ 61850 .......... ............ A Implant neuroelectrodes .............................. 12.39 NA 7.61 3.21 NA 23.22 090 61860 .......... ............ A Implant neuroelectrodes .............................. 20.88 NA 11.78 4.94 NA 37.61 090 61863 .......... ............ A Implant neuroelectrode ................................ 19.01 NA 11.56 5.41 NA 35.98 090 61864 .......... ............ A Implant neuroelectrde, add ’ l ........................ 4.50 NA 2.23 5.41 NA 12.14 ZZZ 61867 .......... ............ A Implant neuroelectrode ................................ 31.35 NA 17.66 5.41 NA 54.42 090 61868 .......... ............ A Implant neuroelectrde, add ’ l ........................ 7.93 NA 3.92 5.41 NA 17.25 ZZZ 61870 .......... ............ A Implant neuroelectrodes .............................. 14.95 NA 9.43 3.86 NA 28.24 090 61875 .......... ............ A Implant neuroelectrodes .............................. 15.07 NA 8.60 2.94 NA 26.61 090 61880 .......... ............ A Revise/remove neuroelectrode ................... 6.29 NA 4.50 1.66 NA 12.45 090 61885 .......... ............ A Insrt/redo neurostim 1 array ........................ 5.85 NA 5.25 1.59 NA 12.69 090 61886 .......... ............ A Implant neurostim arrays ............................. 8.01 NA 6.26 1.96 NA 16.22 090 61888 .......... ............ A Revise/remove neuroreceiver ..................... 5.07 NA 3.56 1.33 NA 9.96 010 62000 .......... ............ A Treat skull fracture ...................................... 12.54 NA 6.22 1.06 NA 19.82 090 62005 .......... ............ A Treat skull fracture ...................................... 16.18 NA 8.90 3.86 NA 28.94 090 62010 .......... ............ A Treatment of head injury ............................. 19.82 NA 11.47 5.12 NA 36.41 090 62100 .......... ............ A Repair brain fluid leakage ........................... 22.04 NA 12.49 4.83 NA 39.37 090 62115 .......... ............ A Reduction of skull defect ............................. 21.67 NA 11.50 5.49 NA 38.67 090 62116 .......... ............ A Reduction of skull defect ............................. 23.60 NA 13.10 6.09 NA 42.78 090 62117 .......... ............ A Reduction of skull defect ............................. 26.61 NA 15.04 4.52 NA 46.17 090 62120 .......... ............ A Repair skull cavity lesion ............................. 23.36 NA 18.07 2.99 NA 44.42 090 62121 .......... ............ A Incise skull repair ........................................ 21.59 NA 15.08 4.16 NA 40.83 090 62140 .......... ............ A Repair of skull defect .................................. 13.52 NA 8.16 3.46 NA 25.14 090 62141 .......... ............ A Repair of skull defect .................................. 14.92 NA 8.86 3.75 NA 27.53 090 62142 .......... ............ A Remove skull plate/flap ............................... 10.79 NA 6.86 2.72 NA 20.37 090 62143 .......... ............ A Replace skull plate/flap ............................... 13.06 NA 7.89 3.36 NA 24.30 090 62145 .......... ............ A Repair of skull & brain ................................. 18.83 NA 10.66 4.49 NA 33.98 090 62146 .......... ............ A Repair of skull with graft ............................. 16.13 NA 9.43 3.61 NA 29.17 090 62147 .......... ............ A Repair of skull with graft ............................. 19.35 NA 11.05 4.31 NA 34.71 090 62148 .......... ............ A Retr bone flap to fix skull ............................ 2.00 NA 0.84 0.48 NA 3.32 ZZZ 62160 .......... ............ A Neuroendoscopy add-on ............................. 3.01 NA 1.49 0.77 NA 5.27 ZZZ 62161 .......... ............ A Dissect brain w/scope ................................. 20.01 NA 11.85 5.17 NA 37.03 090 62162 .......... ............ A Remove colloid cyst w/scope ...................... 25.26 NA 14.54 5.89 NA 45.69 090 62163 .......... ............ A Neuroendoscopy w/fb removal .................... 15.51 NA 9.73 4.00 NA 29.24 090 62164 .......... ............ A Remove brain tumor w/scope ..................... 27.51 NA 14.65 5.36 NA 47.53 090 62165 .......... ............ A Remove pituit tumor w/scope ...................... 22.01 NA 13.05 3.00 NA 38.07 090 62180 .......... ............ A Establish brain cavity shunt ........................ 21.07 NA 12.03 4.97 NA 38.07 090 62190 .......... ............ A Establish brain cavity shunt ........................ 11.07 NA 6.95 2.79 NA 20.81 090 62192 .......... ............ A Establish brain cavity shunt ........................ 12.25 NA 7.48 3.01 NA 22.74 090


## 45942

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

62194 .......... ............ A Replace/irrigate catheter ............................. 5.03 NA 2.47 0.92 NA 8.42 010 62200 .......... ............ A Establish brain cavity shunt ........................ 18.33 NA 10.62 4.64 NA 33.59 090 62201 .......... ............ A Brain cavity shunt w/scope ......................... 14.87 NA 9.26 3.67 NA 27.80 090 62220 .......... ............ A Establish brain cavity shunt ........................ 13.01 NA 7.83 3.34 NA 24.18 090 62223 .......... ............ A Establish brain cavity shunt ........................ 12.88 NA 8.10 3.13 NA 24.11 090 62225 .......... ............ A Replace/irrigate catheter ............................. 5.41 NA 4.03 1.39 NA 10.83 090 62230 .......... ............ A Replace/revise brain shunt .......................... 10.54 NA 6.36 2.70 NA 19.60 090 62252 .......... ............ A Csf shunt reprogram ................................... 0.74 1.35 NA 0.21 2.30 NA XXX 62252 .......... 26 ....... A Csf shunt reprogram ................................... 0.74 0.36 0.36 0.19 1.29 1.29 XXX 62252 .......... TC ...... A Csf shunt reprogram ................................... 0.00 0.99 NA 0.02 1.01 NA XXX 62256 .......... ............ A Remove brain cavity shunt .......................... 6.60 NA 4.62 1.71 NA 12.93 090 62258 .......... ............ A Replace brain cavity shunt .......................... 14.55 NA 8.54 3.73 NA 26.82 090 62263 .......... ............ A Epidural lysis mult sessions ........................ 6.14 12.01 3.10 0.41 18.56 9.65 010 62264 .......... ............ A Epidural lysis on single day ........................ 4.43 7.34 1.38 0.27 12.04 6.08 010 62268 .......... ............ A Drain spinal cord cyst .................................. 4.74 10.84 2.19 0.43 16.01 7.36 000 62269 .......... ............ A Needle biopsy, spinal cord .......................... 5.02 13.60 2.02 0.37 18.99 7.41 000 62270 .......... ............ A Spinal fluid tap, diagnostic .......................... 1.13 2.88 0.56 0.08 4.09 1.78 000 62272 .......... ............ A Drain cerebro spinal fluid ............................ 1.35 3.51 0.71 0.18 5.05 2.24 000 62273 .......... ............ A Inject epidural patch .................................... 2.15 2.60 0.69 0.13 4.88 2.98 000 62280 .......... ............ A Treat spinal cord lesion ............................... 2.64 6.38 0.99 0.30 9.32 3.93 010 62281 .......... ............ A Treat spinal cord lesion ............................... 2.67 5.32 0.87 0.19 8.18 3.72 010 62282 .......... ............ A Treat spinal canal lesion ............................. 2.33 7.60 0.90 0.17 10.10 3.40 010 62284 .......... ............ A Injection for myelogram ............................... 1.54 4.79 0.69 0.13 6.46 2.36 000 62287 .......... ............ A Percutaneous diskectomy ........................... 8.09 NA 5.57 0.58 NA 14.23 090 62290 .......... ............ A Inject for spine disk x-ray ............................ 3.01 6.76 1.38 0.23 9.99 4.61 000 62291 .......... ............ A Inject for spine disk x-ray ............................ 2.92 5.66 1.23 0.26 8.83 4.41 000 62292 .......... ............ A Injection into disk lesion .............................. 7.87 NA 4.34 0.82 NA 13.03 090 62294 .......... ............ A Injection into spinal artery ........................... 11.83 NA 5.73 1.24 NA 18.80 090 62310 .......... ............ A Inject spine c/t ............................................. 1.91 4.51 0.63 0.12 6.55 2.67 000 62311 .......... ............ A Inject spine l/s (cd) ...................................... 1.54 4.58 0.58 0.09 6.21 2.21 000 62318 .......... ............ A Inject spine w/cath, c/t ................................. 2.04 5.36 0.63 0.12 7.53 2.80 000 62319 .......... ............ A Inject spine w/cath l/s (cd) .......................... 1.87 4.65 0.59 0.11 6.64 2.58 000 62350 .......... ............ A Implant spinal canal cath ............................ 6.87 NA 3.85 1.02 NA 11.74 090 62351 .......... ............ A Implant spinal canal cath ............................ 10.01 NA 6.96 2.24 NA 19.21 090 62355 .......... ............ A Remove spinal canal catheter ..................... 5.45 NA 3.09 0.71 NA 9.25 090 62360 .......... ............ A Insert spine infusion device ......................... 2.63 NA 2.63 0.34 NA 5.59 090 62361 .......... ............ A Implant spine infusion pump ....................... 5.42 NA 3.82 0.80 NA 10.04 090 62362 .......... ............ A Implant spine infusion pump ....................... 7.04 NA 4.27 1.18 NA 12.50 090 62365 .......... ............ A Remove spine infusion device .................... 5.42 NA 3.50 0.86 NA 9.79 090 62367 .......... ............ A Analyze spine infusion pump ...................... 0.48 0.22 0.12 0.00 0.70 0.60 XXX 62368 .......... ............ A Analyze spine infusion pump ...................... 0.75 0.29 0.18 0.00 1.04 0.93 XXX 63001 .......... ............ A Removal of spinal lamina ............................ 15.83 NA 9.30 3.76 NA 28.90 090 63003 .......... ............ A Removal of spinal lamina ............................ 15.96 NA 9.63 3.72 NA 29.31 090 63005 .......... ............ A Removal of spinal lamina ............................ 14.93 NA 9.73 3.34 NA 28.00 090 63011 .......... ............ A Removal of spinal lamina ............................ 14.53 NA 8.08 3.37 NA 25.98 090 63012 .......... ............ A Removal of spinal lamina ............................ 15.41 NA 9.87 3.48 NA 28.76 090 63015 .......... ............ A Removal of spinal lamina ............................ 19.36 NA 11.62 4.75 NA 35.73 090 63016 .......... ............ A Removal of spinal lamina ............................ 19.21 NA 11.52 4.58 NA 35.30 090 63017 .......... ............ A Removal of spinal lamina ............................ 15.95 NA 10.15 3.63 NA 29.73 090 63020 .......... ............ A Neck spine disk surgery .............................. 14.82 NA 9.47 3.71 NA 28.00 090 63030 .......... ............ A Low back disk surgery ................................ 12.00 NA 8.23 3.00 NA 23.24 090 63035 .......... ............ A Spinal disk surgery add-on ......................... 3.16 NA 1.55 0.79 NA 5.49 ZZZ 63040 .......... ............ A Laminotomy, single cervical ........................ 18.82 NA 11.23 4.67 NA 34.72 090 63042 .......... ............ A Laminotomy, single lumbar ......................... 17.47 NA 11.06 4.25 NA 32.78 090 63043 .......... ............ C Laminotomy, add ’ l cervical .......................... 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 63044 .......... ............ C Laminotomy, add ’ l lumbar ........................... 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 63045 .......... ............ A Removal of spinal lamina ............................ 16.51 NA 10.13 3.98 NA 30.62 090 63046 .......... ............ A Removal of spinal lamina ............................ 15.81 NA 9.94 3.55 NA 29.30 090 63047 .......... ............ A Removal of spinal lamina ............................ 14.62 NA 9.65 3.23 NA 27.50 090 63048 .......... ............ A Remove spinal lamina add-on .................... 3.27 NA 1.62 0.72 NA 5.60 ZZZ 63050 .......... ............ A Cervical laminoplasty .................................. 20.79 NA 11.41 4.66 NA 36.86 090 63051 .......... ............ A C-laminoplasty w/graft/plate ........................ 24.30 NA 12.97 4.66 NA 41.93 090 63055 .......... ............ A Decompress spinal cord .............................. 22.00 NA 12.84 5.27 NA 40.11 090 63056 .......... ............ A Decompress spinal cord .............................. 20.37 NA 12.25 4.75 NA 37.37 090 63057 .......... ............ A Decompress spine cord add-on .................. 5.26 NA 2.56 1.22 NA 9.04 ZZZ 63064 .......... ............ A Decompress spinal cord .............................. 24.62 NA 14.08 5.69 NA 44.39 090 63066 .......... ............ A Decompress spine cord add-on .................. 3.27 NA 1.62 0.69 NA 5.57 ZZZ 63075 .......... ............ A Neck spine disk surgery .............................. 19.42 NA 11.81 4.62 NA 35.85 090 63076 .......... ............ A Neck spine disk surgery .............................. 4.05 NA 2.00 0.96 NA 7.00 ZZZ 63077 .......... ............ A Spine disk surgery, thorax .......................... 21.45 NA 12.43 3.98 NA 37.87 090 63078 .......... ............ A Spine disk surgery, thorax .......................... 3.29 NA 1.59 0.66 NA 5.54 ZZZ 63081 .......... ............ A Removal of vertebral body .......................... 23.74 NA 13.98 5.54 NA 43.26 090 63082 .......... ............ A Remove vertebral body add-on ................... 4.37 NA 2.16 1.02 NA 7.55 ZZZ 63085 .......... ............ A Removal of vertebral body .......................... 26.93 NA 15.05 4.48 NA 46.47 090


## 45943

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

63086 .......... ............ A Remove vertebral body add-on ................... 3.20 NA 1.55 0.59 NA 5.33 ZZZ 63087 .......... ............ A Removal of vertebral body .......................... 35.59 NA 18.93 6.20 NA 60.72 090 63088 .......... ............ A Remove vertebral body add-on ................... 4.33 NA 2.11 0.82 NA 7.26 ZZZ 63090 .......... ............ A Removal of vertebral body .......................... 28.18 NA 15.60 4.21 NA 47.99 090 63091 .......... ............ A Remove vertebral body add-on ................... 3.04 NA 1.42 0.48 NA 4.93 ZZZ 63101 .......... ............ A Removal of vertebral body .......................... 32.01 NA 18.84 5.69 NA 56.54 090 63102 .......... ............ A Removal of vertebral body .......................... 32.01 NA 18.78 5.69 NA 56.48 090 63103 .......... ............ A Remove vertebral body add-on ................... 4.83 NA 2.41 0.69 NA 7.93 ZZZ 63170 .......... ............ A Incise spinal cord tract(s) ............................ 19.84 NA 11.62 4.86 NA 36.32 090 63172 .......... ............ A Drainage of spinal cyst ................................ 17.67 NA 10.42 4.48 NA 32.57 090 63173 .......... ............ A Drainage of spinal cyst ................................ 22.00 NA 12.54 5.68 NA 40.22 090 63180 .......... ............ A Revise spinal cord ligaments ...................... 18.28 NA 10.77 3.95 NA 33.00 090 63182 .......... ............ A Revise spinal cord ligaments ...................... 20.51 NA 10.76 5.30 NA 36.57 090 63185 .......... ............ A Incise spinal column/nerves ........................ 15.05 NA 7.93 2.79 NA 25.77 090 63190 .......... ............ A Incise spinal column/nerves ........................ 17.45 NA 9.90 3.24 NA 30.59 090 63191 .......... ............ A Incise spinal column/nerves ........................ 17.55 NA 10.21 6.34 NA 34.10 090 63194 .......... ............ A Incise spinal column & cord ........................ 19.20 NA 11.48 3.26 NA 33.94 090 63195 .......... ............ A Incise spinal column & cord ........................ 18.85 NA 10.81 4.87 NA 34.53 090 63196 .......... ............ A Incise spinal column & cord ........................ 22.31 NA 13.11 5.76 NA 41.18 090 63197 .......... ............ A Incise spinal column & cord ........................ 21.12 NA 11.95 5.36 NA 38.44 090 63198 .......... ............ A Incise spinal column & cord ........................ 25.39 NA 8.28 6.43 NA 40.10 090 63199 .......... ............ A Incise spinal column & cord ........................ 26.90 NA 14.73 1.40 NA 43.04 090 63200 .......... ............ A Release of spinal cord ................................ 19.19 NA 11.10 4.96 NA 35.25 090 63250 .......... ............ A Revise spinal cord vessels .......................... 40.78 NA 19.47 9.01 NA 69.26 090 63251 .......... ............ A Revise spinal cord vessels .......................... 41.22 NA 22.08 10.41 NA 73.72 090 63252 .......... ............ A Revise spinal cord vessels .......................... 41.21 NA 21.75 10.64 NA 73.60 090 63265 .......... ............ A Excise intraspinal lesion .............................. 21.57 NA 12.49 5.43 NA 39.49 090 63266 .......... ............ A Excise intraspinal lesion .............................. 22.31 NA 12.89 5.54 NA 40.74 090 63267 .......... ............ A Excise intraspinal lesion .............................. 17.96 NA 10.83 4.37 NA 33.16 090 63268 .......... ............ A Excise intraspinal lesion .............................. 18.53 NA 10.13 3.69 NA 32.35 090 63270 .......... ............ A Excise intraspinal lesion .............................. 26.81 NA 15.13 6.82 NA 48.76 090 63271 .......... ............ A Excise intraspinal lesion .............................. 26.93 NA 15.23 6.90 NA 49.06 090 63272 .......... ............ A Excise intraspinal lesion .............................. 25.33 NA 14.36 6.18 NA 45.87 090 63273 .......... ............ A Excise intraspinal lesion .............................. 24.30 NA 14.03 5.74 NA 44.06 090 63275 .......... ............ A Biopsy/excise spinal tumor .......................... 23.69 NA 13.47 5.80 NA 42.95 090 63276 .......... ............ A Biopsy/excise spinal tumor .......................... 23.46 NA 13.38 5.83 NA 42.66 090 63277 .......... ............ A Biopsy/excise spinal tumor .......................... 20.84 NA 12.24 5.01 NA 38.09 090 63278 .......... ............ A Biopsy/excise spinal tumor .......................... 20.57 NA 12.10 4.55 NA 37.22 090 63280 .......... ............ A Biopsy/excise spinal tumor .......................... 28.37 NA 15.96 7.27 NA 51.59 090 63281 .......... ............ A Biopsy/excise spinal tumor .......................... 28.07 NA 15.82 7.17 NA 51.06 090 63282 .......... ............ A Biopsy/excise spinal tumor .......................... 26.40 NA 15.00 6.76 NA 48.17 090 63283 .......... ............ A Biopsy/excise spinal tumor .......................... 25.01 NA 14.34 6.26 NA 45.61 090 63285 .......... ............ A Biopsy/excise spinal tumor .......................... 36.02 NA 19.49 9.18 NA 64.69 090 63286 .......... ............ A Biopsy/excise spinal tumor .......................... 35.65 NA 19.46 9.21 NA 64.32 090 63287 .......... ............ A Biopsy/excise spinal tumor .......................... 36.71 NA 19.96 9.39 NA 66.06 090 63290 .......... ............ A Biopsy/excise spinal tumor .......................... 37.39 NA 20.12 9.02 NA 66.54 090 63295 .......... ............ A Repair of laminectomy defect ..................... 5.26 NA 2.07 1.03 NA 8.36 ZZZ 63300 .......... ............ A Removal of vertebral body .......................... 24.44 NA 13.97 5.97 NA 44.37 090 63301 .......... ............ A Removal of vertebral body .......................... 27.62 NA 15.16 5.39 NA 48.17 090 63302 .......... ............ A Removal of vertebral body .......................... 27.83 NA 15.47 5.53 NA 48.82 090 63303 .......... ............ A Removal of vertebral body .......................... 30.51 NA 16.47 4.68 NA 51.66 090 63304 .......... ............ A Removal of vertebral body .......................... 30.34 NA 16.88 6.41 NA 53.63 090 63305 .......... ............ A Removal of vertebral body .......................... 32.04 NA 17.60 5.71 NA 55.35 090 63306 .......... ............ A Removal of vertebral body .......................... 32.23 NA 17.37 8.33 NA 57.93 090 63307 .......... ............ A Removal of vertebral body .......................... 31.64 NA 16.65 4.46 NA 52.75 090 63308 .......... ............ A Remove vertebral body add-on ................... 5.25 NA 2.53 1.29 NA 9.07 ZZZ 63600 .......... ............ A Remove spinal cord lesion .......................... 14.03 NA 5.29 1.52 NA 20.83 090 63610 .......... ............ A Stimulation of spinal cord ............................ 8.74 53.74 2.21 0.86 63.34 11.80 000 63615 .......... ............ A Remove lesion of spinal cord ...................... 16.29 NA 9.07 2.84 NA 28.20 090 63650 .......... ............ A Implant neuroelectrodes .............................. 6.74 NA 3.09 0.53 NA 10.36 090 63655 .......... ............ A Implant neuroelectrodes .............................. 10.29 NA 6.75 2.43 NA 19.47 090 63660 .......... ............ A Revise/remove neuroelectrode ................... 6.16 NA 3.53 0.78 NA 10.47 090 63685 .......... ............ A Insrt/redo spine n generator ........................ 7.04 NA 4.05 1.05 NA 12.14 090 63688 .......... ............ A Revise/remove neuroreceiver ..................... 5.39 NA 3.47 0.89 NA 9.76 090 63700 .......... ............ A Repair of spinal herniation .......................... 16.54 NA 10.06 3.52 NA 30.12 090 63702 .......... ............ A Repair of spinal herniation .......................... 18.49 NA 10.87 4.12 NA 33.48 090 63704 .......... ............ A Repair of spinal herniation .......................... 21.19 NA 12.61 4.57 NA 38.37 090 63706 .......... ............ A Repair of spinal herniation .......................... 24.12 NA 13.24 6.23 NA 43.58 090 63707 .......... ............ A Repair spinal fluid leakage .......................... 11.26 NA 7.53 2.51 NA 21.30 090 63709 .......... ............ A Repair spinal fluid leakage .......................... 14.33 NA 9.16 3.09 NA 26.58 090 63710 .......... ............ A Graft repair of spine defect ......................... 14.08 NA 8.84 3.40 NA 26.32 090 63740 .......... ............ A Install spinal shunt ....................................... 11.36 NA 7.22 2.93 NA 21.51 090 63741 .......... ............ A Install spinal shunt ....................................... 8.26 NA 4.68 1.66 NA 14.60 090 63744 .......... ............ A Revision of spinal shunt .............................. 8.11 NA 5.16 1.89 NA 15.16 090


## 45944

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

63746 .......... ............ A Removal of spinal shunt .............................. 6.43 NA 3.70 1.53 NA 11.66 090 64400 .......... ............ A N block inj, trigeminal .................................. 1.11 1.83 0.42 0.07 3.01 1.60 000 64402 .......... ............ A N block inj, facial ......................................... 1.25 1.59 0.59 0.09 2.93 1.93 000 64405 .......... ............ A N block inj, occipital .................................... 1.32 1.42 0.45 0.08 2.82 1.85 000 64408 .......... ............ A N block inj, vagus ........................................ 1.41 1.57 0.83 0.10 3.08 2.34 000 64410 .......... ............ A N block inj, phrenic ...................................... 1.43 2.36 0.45 0.09 3.89 1.97 000 64412 .......... ............ A N block inj, spinal accessor ........................ 1.18 2.49 0.42 0.08 3.75 1.68 000 64413 .......... ............ A N block inj, cervical plexus .......................... 1.40 1.77 0.49 0.08 3.25 1.97 000 64415 .......... ............ A N block inj, brachial plexus ......................... 1.48 2.66 0.45 0.09 4.23 2.02 000 64416 .......... ............ A N block cont infuse, b plex .......................... 3.50 NA 0.77 0.31 NA 4.58 010 64417 .......... ............ A N block inj, axillary ...................................... 1.44 2.84 0.48 0.11 4.40 2.03 000 64418 .......... ............ A N block inj, suprascapular ........................... 1.32 2.49 0.43 0.07 3.89 1.82 000 64420 .......... ............ A N block inj, intercost, sng ............................ 1.18 3.62 0.41 0.08 4.89 1.67 000 64421 .......... ............ A N block inj, intercost, mlt ............................. 1.68 5.65 0.51 0.11 7.44 2.30 000 64425 .......... ............ A N block inj, ilio-ing/hypogi ........................... 1.75 1.62 0.53 0.13 3.51 2.41 000 64430 .......... ............ A N block inj, pudendal ................................... 1.46 2.47 0.56 0.10 4.03 2.12 000 64435 .......... ............ A N block inj, paracervical .............................. 1.45 2.42 0.68 0.16 4.03 2.29 000 64445 .......... ............ A N block inj, sciatic, sng ............................... 1.48 2.52 0.49 0.10 4.11 2.07 000 64446 .......... ............ A N blk inj, sciatic, cont inf ............................. 3.26 NA 0.97 0.20 NA 4.43 010 64447 .......... ............ A N block inj fem, single ................................. 1.50 NA 0.42 0.09 NA 2.01 000 64448 .......... ............ A N block inj fem, cont inf .............................. 3.01 NA 0.79 0.18 NA 3.98 010 64449 .......... ............ A N block inj, lumbar plexus ........................... 3.01 NA 0.91 0.15 NA 4.07 010 64450 .......... ............ A N block, other peripheral ............................. 1.27 1.25 0.47 0.13 2.65 1.87 000 64470 .......... ............ A Inj paravertebral c/t ..................................... 1.85 6.70 0.69 0.11 8.66 2.66 000 64472 .......... ............ A Inj paravertebral c/t add-on ......................... 1.29 2.16 0.33 0.08 3.53 1.71 ZZZ 64475 .......... ............ A Inj paravertebral l/s ...................................... 1.41 6.37 0.62 0.10 7.89 2.13 000 64476 .......... ............ A Inj paravertebral l/s add-on ......................... 0.98 1.95 0.24 0.07 3.00 1.29 ZZZ 64479 .......... ............ A Inj foramen epidural c/t ............................... 2.20 6.90 0.87 0.12 9.22 3.19 000 64480 .......... ............ A Inj foramen epidural add-on ........................ 1.54 2.62 0.46 0.10 4.26 2.10 ZZZ 64483 .......... ............ A Inj foramen epidural l/s ................................ 1.90 7.23 0.81 0.11 9.25 2.82 000 64484 .......... ............ A Inj foramen epidural add-on ........................ 1.33 3.01 0.36 0.08 4.42 1.77 ZZZ 64505 .......... ............ A N block, spenopalatine gangl ...................... 1.36 1.21 0.64 0.10 2.68 2.10 000 64508 .......... ............ A N block, carotid sinus s/p ............................ 1.12 3.15 0.76 0.07 4.35 1.95 000 64510 .......... ............ A N block, stellate ganglion ............................ 1.22 3.19 0.50 0.07 4.49 1.79 000 64517 .......... ............ A N block inj, hypogas plxs ............................ 2.20 2.65 0.87 0.11 4.96 3.19 000 64520 .......... ............ A N block, lumbar/thoracic .............................. 1.35 4.76 0.54 0.08 6.19 1.97 000 64530 .......... ............ A N block inj, celiac pelus .............................. 1.58 4.14 0.64 0.10 5.82 2.32 000 64550 .......... ............ A Apply neurostimulator .................................. 0.18 0.27 0.05 0.01 0.46 0.24 000 64553 .......... ............ A Implant neuroelectrodes .............................. 2.31 2.70 1.81 0.18 5.20 4.31 010 64555 .......... ............ A Implant neuroelectrodes .............................. 2.27 2.98 1.26 0.19 5.44 3.73 010 64560 .......... ............ A Implant neuroelectrodes .............................. 2.36 2.54 1.25 0.22 5.12 3.84 010 64561 .......... ............ A Implant neuroelectrodes .............................. 6.74 29.47 3.21 0.51 36.73 10.46 010 64565 .......... ............ A Implant neuroelectrodes .............................. 1.76 3.12 1.24 0.13 5.01 3.14 010 64573 .......... ............ A Implant neuroelectrodes .............................. 7.50 NA 5.15 1.60 NA 14.25 090 64575 .......... ............ A Implant neuroelectrodes .............................. 4.35 NA 2.84 0.61 NA 7.80 090 64577 .......... ............ A Implant neuroelectrodes .............................. 4.62 NA 3.20 1.04 NA 8.86 090 64580 .......... ............ A Implant neuroelectrodes .............................. 4.12 NA 3.44 0.36 NA 7.92 090 64581 .......... ............ A Implant neuroelectrodes .............................. 13.51 NA 6.11 1.05 NA 20.67 090 64585 .......... ............ A Revise/remove neuroelectrode ................... 2.06 10.39 2.13 0.20 12.65 4.39 010 64590 .......... ............ A Insrt/redo perph n generator ....................... 2.40 6.92 2.33 0.19 9.51 4.92 010 64595 .......... ............ A Revise/remove neuroreceiver ..................... 1.73 9.61 1.90 0.19 11.54 3.83 010 64600 .......... ............ A Injection treatment of nerve ........................ 3.45 8.75 1.62 0.34 12.54 5.40 010 64605 .......... ............ A Injection treatment of nerve ........................ 5.61 8.92 2.13 0.79 15.32 8.53 010 64610 .......... ............ A Injection treatment of nerve ........................ 7.16 8.48 3.64 1.58 17.22 12.38 010 64612 .......... ............ A Destroy nerve, face muscle ........................ 1.96 2.41 1.30 0.11 4.48 3.38 010 64613 .......... ............ A Destroy nerve, spine muscle ....................... 1.96 2.86 1.20 0.11 4.93 3.28 010 64614 .......... ............ A Destroy nerve, extrem musc ....................... 2.20 3.07 1.28 0.10 5.37 3.58 010 64620 .......... ............ A Injection treatment of nerve ........................ 2.85 4.75 1.29 0.20 7.80 4.33 010 64622 .......... ............ A Destr paravertebrl nerve l/s ......................... 3.01 7.17 1.33 0.18 10.35 4.52 010 64623 .......... ............ A Destr paravertebral n add-on ...................... 0.99 2.74 0.22 0.06 3.79 1.27 ZZZ 64626 .......... ............ A Destr paravertebrl nerve c/t ........................ 3.29 7.26 1.90 0.20 10.75 5.39 010 64627 .......... ............ A Destr paravertebral n add-on ...................... 1.16 4.18 0.26 0.07 5.41 1.50 ZZZ 64630 .......... ............ A Injection treatment of nerve ........................ 3.01 2.69 1.42 0.22 5.92 4.65 010 64640 .......... ............ A Injection treatment of nerve ........................ 2.77 3.94 1.78 0.29 7.00 4.84 010 64680 .......... ............ A Injection treatment of nerve ........................ 2.63 6.22 1.40 0.18 9.03 4.20 010 64681 .......... ............ A Injection treatment of nerve ........................ 3.55 8.67 2.01 0.28 12.50 5.84 010 64702 .......... ............ A Revise finger/toe nerve ............................... 4.23 NA 3.76 0.61 NA 8.60 090 64704 .......... ............ A Revise hand/foot nerve ............................... 4.57 NA 3.29 0.61 NA 8.47 090 64708 .......... ............ A Revise arm/leg nerve .................................. 6.12 NA 4.73 0.96 NA 11.81 090
64712 .......... ............ A Revision of sciatic nerve ............................. 7.76 NA 4.79 0.95 NA 13.49 090 64713 .......... ............ A Revision of arm nerve(s) ............................. 11.00 NA 5.70 1.82 NA 18.52 090 64714 .......... ............ A Revise low back nerve(s) ............................ 10.33 NA 4.09 1.19 NA 15.61 090
64716 .......... ............ A Revision of cranial nerve ............................. 6.31 NA 5.84 0.63 NA 12.78 090
64718 .......... ............ A Revise ulnar nerve at elbow ....................... 5.99 NA 5.84 1.05 NA 12.88 090


## 45945

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

64719 .......... ............ A Revise ulnar nerve at wrist ......................... 4.85 NA 4.39 0.77 NA 10.01 090 64721 .......... ............ A Carpal tunnel surgery .................................. 4.29 0.00 5.17 0.73 5.02 10.19 090 64722 .......... ............ A Relieve pressure on nerve(s) ...................... 4.70 NA 2.96 0.48 NA 8.14 090 64726 .......... ............ A Release foot/toe nerve ................................ 4.18 NA 2.77 0.54 NA 7.49 090
64727 .......... ............ A Internal nerve revision ................................. 3.11 NA 1.46 0.48 NA 5.04 ZZZ 64732 .......... ............ A Incision of brow nerve ................................. 4.41 NA 3.45 0.98 NA 8.84 090 64734 .......... ............ A Incision of cheek nerve ............................... 4.92 NA 3.99 0.89 NA 9.80 090 64736 .......... ............ A Incision of chin nerve .................................. 4.60 NA 3.98 0.52 NA 9.10 090 64738 .......... ............ A Incision of jaw nerve ................................... 5.73 NA 4.54 1.08 NA 11.36 090 64740 .......... ............ A Incision of tongue nerve .............................. 5.59 NA 5.06 0.69 NA 11.34 090 64742 .......... ............ A Incision of facial nerve ................................ 6.22 NA 4.61 0.73 NA 11.56 090 64744 .......... ............ A Incise nerve, back of head .......................... 5.24 NA 3.71 1.16 NA 10.11 090 64746 .......... ............ A Incise diaphragm nerve ............................... 5.93 NA 4.29 0.82 NA 11.04 090 64752 .......... ............ A Incision of vagus nerve ............................... 7.06 NA 4.18 0.93 NA 12.17 090 64755 .......... ............ A Incision of stomach nerves ......................... 13.53 NA 5.57 1.83 NA 20.93 090 64760 .......... ............ A Incision of vagus nerve ............................... 6.96 NA 3.41 0.81 NA 11.19 090 64761 .......... ............ A Incision of pelvis nerve ................................ 6.41 NA 3.50 0.53 NA 10.44 090 64763 .......... ............ A Incise hip/thigh nerve .................................. 6.93 NA 5.06 0.94 NA 12.93 090 64766 .......... ............ A Incise hip/thigh nerve .................................. 8.68 NA 5.25 1.06 NA 14.99 090 64771 .......... ............ A Sever cranial nerve ..................................... 7.35 NA 5.45 1.23 NA 14.03 090 64772 .......... ............ A Incision of spinal nerve ............................... 7.21 NA 4.83 1.40 NA 13.45 090
64774 .......... ............ A Remove skin nerve lesion ........................... 5.17 NA 3.77 0.74 NA 9.68 090 64776 .......... ............ A Remove digit nerve lesion ........................... 5.12 NA 3.61 0.76 NA 9.49 090 64778 .......... ............ A Digit nerve surgery add-on .......................... 3.12 NA 1.46 0.46 NA 5.03 ZZZ 64782 .......... ............ A Remove limb nerve lesion ........................... 6.23 NA 3.76 0.86 NA 10.85 090 64783 .......... ............ A Limb nerve surgery add-on ......................... 3.72 NA 1.78 0.51 NA 6.01 ZZZ 64784 .......... ............ A Remove nerve lesion .................................. 9.83 NA 6.43 1.38 NA 17.64 090 64786 .......... ............ A Remove sciatic nerve lesion ....................... 15.47 NA 9.57 2.60 NA 27.64 090 64787 .......... ............ A Implant nerve end ....................................... 4.30 NA 2.06 0.58 NA 6.94 ZZZ 64788 .......... ............ A Remove skin nerve lesion ........................... 4.61 NA 3.43 0.73 NA 8.77 090 64790 .......... ............ A Removal of nerve lesion ............................. 11.31 NA 7.05 2.10 NA 20.46 090 64792 .......... ............ A Removal of nerve lesion ............................. 14.93 NA 8.63 2.48 NA 26.04 090 64795 .......... ............ A Biopsy of nerve ........................................... 3.02 NA 1.53 0.52 NA 5.07 000 64802 .......... ............ A Remove sympathetic nerves ....................... 9.16 NA 4.96 1.29 NA 15.41 090 64804 .......... ............ A Remove sympathetic nerves ....................... 14.65 NA 6.92 2.14 NA 23.71 090 64809 .......... ............ A Remove sympathetic nerves ....................... 13.68 NA 5.58 1.50 NA 20.76 090 64818 .......... ............ A Remove sympathetic nerves ....................... 10.30 NA 5.10 1.33 NA 16.73 090 64820 .......... ............ A Remove sympathetic nerves ....................... 10.37 NA 6.92 1.49 NA 18.78 090 64821 .......... ............ A Remove sympathetic nerves ....................... 8.76 NA 7.13 1.24 NA 17.13 090 64822 .......... ............ A Remove sympathetic nerves ....................... 8.76 NA 7.03 1.30 NA 17.09 090 64823 .......... ............ A Remove sympathetic nerves ....................... 10.37 NA 7.91 1.57 NA 19.85 090 64831 .......... ............ A Repair of digit nerve .................................... 9.45 NA 6.88 1.41 NA 17.74 090 64832 .......... ............ A Repair nerve add-on ................................... 5.66 NA 2.85 0.85 NA 9.36 ZZZ 64834 .......... ............ A Repair of hand or foot nerve ....................... 10.19 NA 6.90 1.54 NA 18.63 090 64835 .......... ............ A Repair of hand or foot nerve ....................... 10.94 NA 7.48 1.73 NA 20.15 090 64836 .......... ............ A Repair of hand or foot nerve ....................... 10.94 NA 7.45 1.67 NA 20.07 090 64837 .......... ............ A Repair nerve add-on ................................... 6.26 NA 3.14 0.97 NA 10.37 ZZZ 64840 .......... ............ A Repair of leg nerve ...................................... 13.03 NA 8.05 1.37 NA 22.44 090 64856 .......... ............ A Repair/transpose nerve ............................... 13.81 NA 8.93 2.12 NA 24.86 090 64857 .......... ............ A Repair arm/leg nerve ................................... 14.50 NA 9.37 2.21 NA 26.08 090 64858 .......... ............ A Repair sciatic nerve ..................................... 16.50 NA 10.48 3.33 NA 30.31 090 64859 .......... ............ A Nerve surgery .............................................. 4.26 NA 2.13 0.67 NA 7.06 ZZZ 64861 .......... ............ A Repair of arm nerves .................................. 19.25 NA 11.42 4.08 NA 34.75 090 64862 .......... ............ A Repair of low back nerves .......................... 19.45 NA 11.75 4.31 NA 35.50 090 64864 .......... ............ A Repair of facial nerve .................................. 12.56 NA 8.49 1.26 NA 22.31 090 64865 .......... ............ A Repair of facial nerve .................................. 15.25 NA 13.11 1.50 NA 29.86 090 64866 .......... ............ A Fusion of facial/other nerve ......................... 15.75 NA 12.78 2.04 NA 30.57 090 64868 .......... ............ A Fusion of facial/other nerve ......................... 14.05 NA 11.16 1.43 NA 26.64 090 64870 .......... ............ A Fusion of facial/other nerve ......................... 16.00 NA 8.55 1.30 NA 25.85 090 64872 .......... ............ A Subsequent repair of nerve ......................... 1.99 NA 1.05 0.29 NA 3.33 ZZZ 64874 .......... ............ A Repair & revise nerve add-on ..................... 2.99 NA 1.48 0.42 NA 4.89 ZZZ 64876 .......... ............ A Repair nerve/shorten bone .......................... 3.38 NA 1.70 0.47 NA 5.54 ZZZ 64885 .......... ............ A Nerve graft, head or neck ........................... 17.54 NA 11.26 1.63 NA 30.42 090 64886 .......... ............ A Nerve graft, head or neck ........................... 20.76 NA 13.11 2.08 NA 35.96 090 64890 .......... ............ A Nerve graft, hand or foot ............................. 15.16 NA 9.71 2.29 NA 27.16 090 64891 .......... ............ A Nerve graft, hand or foot ............................. 16.15 NA 7.41 1.63 NA 25.19 090 64892 .......... ............ A Nerve graft, arm or leg ................................ 14.66 NA 8.65 2.47 NA 25.78 090 64893 .......... ............ A Nerve graft, arm or leg ................................ 15.61 NA 9.60 2.61 NA 27.82 090 64895 .......... ............ A Nerve graft, hand or foot ............................. 19.26 NA 9.45 2.57 NA 31.27 090 64896 .......... ............ A Nerve graft, hand or foot ............................. 20.50 NA 10.93 3.16 NA 34.59 090 64897 .......... ............ A Nerve graft, arm or leg ................................ 18.25 NA 10.41 2.54 NA 31.20 090 64898 .......... ............ A Nerve graft, arm or leg ................................ 19.51 NA 11.53 2.77 NA 33.80 090 64901 .......... ............ A Nerve graft add-on ...................................... 10.22 NA 5.09 1.37 NA 16.68 ZZZ 64902 .......... ............ A Nerve graft add-on ...................................... 11.83 NA 5.76 1.55 NA 19.15 ZZZ


## 45946

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

64905 .......... ............ A Nerve pedicle transfer ................................. 14.03 NA 8.29 2.00 NA 24.32 090 64907 .......... ............ A Nerve pedicle transfer ................................. 18.84 NA 12.19 3.16 NA 34.19 090 64999 .......... ............ C Nervous system surgery ............................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY 65091 .......... ............ A Revise eye ................................................... 6.46 NA 8.01 0.32 NA 14.79 090 65093 .......... ............ A Revise eye with implant .............................. 6.87 NA 8.36 0.34 NA 15.57 090 65101 .......... ............ A Removal of eye ........................................... 7.03 NA 9.15 0.35 NA 16.53 090 65103 .......... ............ A Remove eye/insert implant .......................... 7.58 NA 9.37 0.37 NA 17.31 090 65105 .......... ............ A Remove eye/attach implant ......................... 8.50 NA 10.07 0.42 NA 18.99 090 65110 .......... ............ A Removal of eye ........................................... 13.96 NA 13.20 0.81 NA 27.96 090 65112 .......... ............ A Remove eye/revise socket .......................... 16.39 NA 15.51 1.30 NA 33.20 090 65114 .......... ............ A Remove eye/revise socket .......................... 17.54 NA 15.76 1.02 NA 34.31 090 65125 .......... ............ A Revise ocular implant .................................. 3.13 8.39 3.52 0.19 11.71 6.83 090 65130 .......... ............ A Insert ocular implant .................................... 7.15 NA 8.82 0.35 NA 16.32 090 65135 .......... ............ A Insert ocular implant .................................... 7.33 NA 8.96 0.36 NA 16.65 090 65140 .......... ............ A Attach ocular implant ................................... 8.03 NA 9.51 0.40 NA 17.93 090 65150 .......... ............ A Revise ocular implant .................................. 6.26 NA 7.66 0.31 NA 14.23 090 65155 .......... ............ A Reinsert ocular implant ............................... 8.67 NA 10.07 0.50 NA 19.24 090 65175 .......... ............ A Removal of ocular implant .......................... 6.28 NA 8.16 0.31 NA 14.75 090 65205 .......... ............ A Remove foreign body from eye ................... 0.71 0.63 0.28 0.03 1.37 1.02 000 65210 .......... ............ A Remove foreign body from eye ................... 0.84 0.80 0.37 0.04 1.68 1.25 000 65220 .......... ............ A Remove foreign body from eye ................... 0.71 0.63 0.27 0.05 1.39 1.03 000 65222 .......... ............ A Remove foreign body from eye ................... 0.93 0.87 0.37 0.04 1.85 1.34 000 65235 .......... ............ A Remove foreign body from eye ................... 7.58 NA 6.60 0.37 NA 14.55 090 65260 .......... ............ A Remove foreign body from eye ................... 10.96 NA 9.39 0.57 NA 20.92 090 65265 .......... ............ A Remove foreign body from eye ................... 12.60 NA 10.34 0.62 NA 23.56 090 65270 .......... ............ A Repair of eye wound ................................... 1.90 4.94 1.36 0.09 6.93 3.35 010 65272 .......... ............ A Repair of eye wound ................................... 3.82 7.38 3.21 0.19 11.38 7.22 090 65273 .......... ............ A Repair of eye wound ................................... 4.36 NA 3.49 0.22 NA 8.07 090 65275 .......... ............ A Repair of eye wound ................................... 5.34 6.16 3.85 0.26 11.76 9.45 090 65280 .......... ............ A Repair of eye wound ................................... 7.67 NA 6.08 0.38 NA 14.13 090 65285 .......... ............ A Repair of eye wound ................................... 12.91 NA 8.99 0.64 NA 22.54 090 65286 .......... ............ A Repair of eye wound ................................... 5.51 10.63 4.51 0.27 16.41 10.30 090 65290 .......... ............ A Repair of eye socket wound ....................... 5.41 NA 4.61 0.31 NA 10.33 090 65400 .......... ............ A Removal of eye lesion ................................. 6.06 8.08 5.99 0.30 14.45 12.35 090 65410 .......... ............ A Biopsy of cornea ......................................... 1.47 2.03 0.95 0.07 3.57 2.49 000 65420 .......... ............ A Removal of eye lesion ................................. 4.17 8.48 4.35 0.21 12.86 8.73 090 65426 .......... ............ A Removal of eye lesion ................................. 5.25 9.74 4.82 0.25 15.24 10.32 090 65430 .......... ............ A Corneal smear ............................................. 1.47 1.26 0.96 0.07 2.80 2.50 000 65435 .......... ............ A Curette/treat cornea .................................... 0.92 0.98 0.70 0.04 1.94 1.66 000 65436 .......... ............ A Curette/treat cornea .................................... 4.19 4.00 3.60 0.21 8.40 8.00 090 65450 .......... ............ A Treatment of corneal lesion ........................ 3.28 3.98 3.86 0.16 7.42 7.30 090 65600 .......... ............ A Revision of cornea ...................................... 3.40 4.85 3.28 0.17 8.42 6.85 090 65710 .......... ............ A Corneal transplant ....................................... 12.35 NA 10.92 0.61 NA 23.89 090 65730 .......... ............ A Corneal transplant ....................................... 14.26 NA 11.73 0.70 NA 26.69 090 65750 .......... ............ A Corneal transplant ....................................... 15.01 NA 11.67 0.74 NA 27.42 090 65755 .......... ............ A Corneal transplant ....................................... 14.90 NA 11.59 0.73 NA 27.22 090 65760 .......... ............ N Revision of cornea ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 65765 .......... ............ N Revision of cornea ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 65767 .......... ............ N Corneal tissue transplant ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 65770 .......... ............ A Revise cornea with implant ......................... 17.57 NA 12.88 0.87 NA 31.31 090 65771 .......... ............ N Radial keratotomy ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 65772 .......... ............ A Correction of astigmatism ........................... 4.29 5.36 4.05 0.21 9.86 8.55 090 65775 .......... ............ A Correction of astigmatism ........................... 5.79 NA 5.80 0.28 NA 11.88 090 65780 .......... ............ A Ocular reconst, transplant ........................... 10.25 NA 10.04 0.44 NA 20.73 090 65781 .......... ............ A Ocular reconst, transplant ........................... 17.68 NA 13.35 0.44 NA 31.46 090 65782 .......... ............ A Ocular reconst, transplant ........................... 15.01 NA 11.71 0.44 NA 27.16 090 65800 .......... ............ A Drainage of eye ........................................... 1.91 1.73 1.16 0.09 3.73 3.16 000 65805 .......... ............ A Drainage of eye ........................................... 1.91 2.09 1.17 0.09 4.10 3.17 000 65810 .......... ............ A Drainage of eye ........................................... 4.87 NA 4.60 0.24 NA 9.71 090 65815 .......... ............ A Drainage of eye ........................................... 5.05 9.56 4.71 0.25 14.86 10.01 090 65820 .......... ............ A Relieve inner eye pressure ......................... 8.14 NA 8.75 0.40 NA 17.29 090 65850 .......... ............ A Incision of eye ............................................. 10.52 NA 8.21 0.52 NA 19.25 090 65855 .......... ............ A Laser surgery of eye ................................... 3.85 4.18 3.03 0.19 8.21 7.07 010 65860 .......... ............ A Incise inner eye adhesions ......................... 3.55 3.92 2.45 0.18 7.64 6.17 090 65865 .......... ............ A Incise inner eye adhesions ......................... 5.60 NA 5.47 0.28 NA 11.35 090 65870 .......... ............ A Incise inner eye adhesions ......................... 6.27 NA 6.24 0.31 NA 12.82 090 65875 .......... ............ A Incise inner eye adhesions ......................... 6.54 NA 6.61 0.32 NA 13.48 090 65880 .......... ............ A Incise inner eye adhesions ......................... 7.09 NA 6.85 0.35 NA 14.29 090 65900 .......... ............ A Remove eye lesion ...................................... 10.93 NA 9.95 0.54 NA 21.42 090 65920 .......... ............ A Remove implant of eye ............................... 8.41 NA 7.96 0.41 NA 16.78 090 65930 .......... ............ A Remove blood clot from eye ....................... 7.44 NA 6.64 0.37 NA 14.45 090 66020 .......... ............ A Injection treatment of eye ............................ 1.59 2.99 1.41 0.08 4.66 3.08 010 66030 .......... ............ A Injection treatment of eye ............................ 1.25 2.84 1.26 0.06 4.15 2.57 010 66130 .......... ............ A Remove eye lesion ...................................... 7.70 9.24 5.49 0.38 17.31 13.56 090


## 45947

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

66150 .......... ............ A Glaucoma surgery ....................................... 8.31 NA 9.16 0.46 NA 17.93 090 66155 .......... ............ A Glaucoma surgery ....................................... 8.30 NA 9.11 0.41 NA 17.81 090 66160 .......... ............ A Glaucoma surgery ....................................... 10.17 NA 9.93 0.50 NA 20.60 090 66165 .......... ............ A Glaucoma surgery ....................................... 8.02 NA 9.01 0.40 NA 17.42 090 66170 .......... ............ A Glaucoma surgery ....................................... 12.16 NA 11.92 0.60 NA 24.68 090 66172 .......... ............ A Incision of eye ............................................. 15.05 NA 14.84 0.74 NA 30.63 090 66180 .......... ............ A Implant eye shunt ........................................ 14.56 NA 10.51 0.71 NA 25.78 090 66185 .......... ............ A Revise eye shunt ......................................... 8.15 NA 7.20 0.40 NA 15.75 090 66220 .......... ............ A Repair eye lesion ........................................ 7.78 NA 6.93 0.40 NA 15.11 090 66225 .......... ............ A Repair/graft eye lesion ................................ 11.05 NA 8.54 0.55 NA 20.14 090 66250 .......... ............ A Follow-up surgery of eye ............................. 5.98 11.17 5.37 0.30 17.45 11.65 090 66500 .......... ............ A Incision of iris .............................................. 3.71 NA 4.49 0.18 NA 8.38 090 66505 .......... ............ A Incision of iris .............................................. 4.08 NA 4.84 0.20 NA 9.12 090
66600 .......... ............ A Remove iris and lesion ................................ 8.69 NA 8.01 0.43 NA 17.12 090 66605 .......... ............ A Removal of iris ............................................ 12.80 NA 9.77 0.77 NA 23.34 090 66625 .......... ............ A Removal of iris ............................................ 5.13 NA 4.63 0.26 NA 10.02 090 66630 .......... ............ A Removal of iris ............................................ 6.16 NA 5.59 0.31 NA 12.06 090 66635 .......... ............ A Removal of iris ............................................ 6.25 NA 5.62 0.31 NA 12.18 090 66680 .......... ............ A Repair iris & ciliary body ............................. 5.44 NA 5.15 0.27 NA 10.86 090 66682 .......... ............ A Repair iris & ciliary body ............................. 6.21 NA 6.42 0.31 NA 12.95 090 66700 .......... ............ A Destruction, ciliary body .............................. 4.78 5.20 3.87 0.24 10.21 8.88 090 66710 .......... ............ A Ciliary transsleral therapy ............................ 4.78 5.03 3.77 0.23 10.04 8.78 090 66711 .......... ............ A Ciliary endoscopic ablation ......................... 6.61 NA 6.35 0.30 NA 13.26 090 66720 .......... ............ A Destruction, ciliary body .............................. 4.78 5.65 4.63 0.26 10.69 9.67 090 66740 .......... ............ A Destruction, ciliary body .............................. 4.78 4.96 3.89 0.23 9.97 8.90 090 6761 ............ ............ A Revision of iris ............................................. 4.07 5.44 4.23 0.20 9.70 8.49 090 66762 .......... ............ A Revision of iris ............................................. 4.58 5.49 4.20 0.23 10.30 9.01 090 66770 .......... ............ A Removal of inner eye lesion ....................... 5.18 5.91 4.70 0.26 11.35 10.14 090 66820 .......... ............ A Incision, secondary cataract ........................ 3.89 NA 5.58 0.19 NA 9.66 090 66821 .......... ............ A After cataract laser surgery ......................... 2.35 3.97 3.52 0.11 6.44 5.98 090 66825 .......... ............ A Reposition intraocular lens .......................... 8.24 NA 8.76 0.40 NA 17.40 090 66830 .......... ............ A Removal of lens lesion ................................ 8.21 NA 6.80 0.36 NA 15.36 090 66840 .......... ............ A Removal of lens material ............................ 7.92 NA 6.71 0.39 NA 15.01 090 66850 .......... ............ A Removal of lens material ............................ 9.12 NA 7.47 0.45 NA 17.04 090 66852 .......... ............ A Removal of lens material ............................ 9.98 NA 7.92 0.49 NA 18.39 090 66920 .......... ............ A Extraction of lens ......................................... 8.87 NA 7.13 0.44 NA 16.44 090 66930 .......... ............ A Extraction of lens ......................................... 10.18 NA 7.96 0.49 NA 18.63 090 66940 .......... ............ A Extraction of lens ......................................... 8.94 NA 7.43 0.43 NA 16.80 090 66982 .......... ............ A Cataract surgery, complex .......................... 13.51 NA 9.65 0.63 NA 23.79 090 66983 .......... ............ A Cataract surg w/iol, 1 stage ........................ 9.00 NA 6.09 0.14 NA 15.23 090 66984 .......... ............ A Cataract surg w/iol, 1 stage ........................ 10.23 NA 7.27 0.39 NA 17.89 090 66985 .......... ............ A Insert lens prosthesis .................................. 8.40 NA 7.30 0.36 NA 16.06 090 66986 .......... ............ A Exchange lens prosthesis ........................... 12.28 NA 8.98 0.60 NA 21.86 090 66990 .......... ............ A Ophthalmic endoscope add-on ................... 1.51 NA 0.67 0.07 NA 2.26 ZZZ 66999 .......... ............ C Eye surgery procedure ................................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67005 .......... ............ A Partial removal of eye fluid ......................... 5.70 NA 4.77 0.28 NA 10.75 090 67010 .......... ............ A Partial removal of eye fluid ......................... 6.87 NA 5.30 0.34 NA 12.52 090 67015 .......... ............ A Release of eye fluid .................................... 6.92 NA 6.29 0.34 NA 13.55 090 67025 .......... ............ A Replace eye fluid ......................................... 6.84 8.89 6.09 0.34 16.08 13.27 090 67027 .......... ............ A Implant eye drug system ............................. 10.85 NA 7.82 0.54 NA 19.21 090 67028 .......... ............ A Injection eye drug ........................................ 2.53 2.60 1.43 0.12 5.25 4.08 000 67030 .......... ............ A Incise inner eye strands .............................. 4.84 NA 5.70 0.24 NA 10.78 090 67031 .......... ............ A Laser surgery, eye strands ......................... 3.67 4.46 3.56 0.18 8.31 7.41 090 67036 .......... ............ A Removal of inner eye fluid .......................... 11.89 NA 8.91 0.58 NA 21.38 090 67038 .......... ............ A Strip retinal membrane ................................ 21.25 NA 15.11 1.04 NA 37.40 090
67039 .......... ............ A Laser treatment of retina ............................. 14.53 NA 11.87 0.71 NA 27.11 090 67040 .......... ............ A Laser treatment of retina ............................. 17.23 NA 13.34 0.85 NA 31.43 090 67101 .......... ............ A Repair detached retina ................................ 7.54 8.91 6.39 0.37 16.81 14.30 090 67105 .......... ............ A Repair detached retina ................................ 7.41 7.88 6.02 0.37 15.67 13.80 090 67107 .......... ............ A Repair detached retina ................................ 14.85 NA 11.06 0.73 NA 26.64 090 67108 .......... ............ A Repair detached retina ................................ 20.83 NA 14.10 1.02 NA 35.95 090 67110 .......... ............ A Repair detached retina ................................ 8.82 9.91 7.23 0.44 19.16 16.49 090 67112 .......... ............ A Rerepair detached retina ............................. 16.86 NA 11.54 0.83 NA 29.24 090 67115 .......... ............ A Release encircling material ......................... 4.99 NA 4.97 0.25 NA 10.21 090 67120 .......... ............ A Remove eye implant material ..................... 5.98 8.27 5.42 0.29 14.54 11.69 090 67121 .......... ............ A Remove eye implant material ..................... 10.67 NA 8.34 0.53 NA 19.54 090 67141 .......... ............ A Treatment of retina ...................................... 5.20 5.70 4.76 0.26 11.16 10.22 090 67145 .......... ............ A Treatment of retina ...................................... 5.37 5.58 4.83 0.27 11.22 10.47 090 67208 .......... ............ A Treatment of retinal lesion .......................... 6.70 5.98 5.40 0.33 13.01 12.43 090 67210 .......... ............ A Treatment of retinal lesion .......................... 8.83 6.41 5.75 0.44 15.68 15.02 090 67218 .......... ............ A Treatment of retinal lesion .......................... 18.54 NA 11.83 0.92 NA 31.29 090 67220 .......... ............ A Treatment of choroid lesion ........................ 13.14 10.16 8.81 0.65 23.94 22.60 090 67221 .......... ............ R Ocular photodynamic ther ........................... 4.01 4.15 1.79 0.20 8.35 6.00 000 67225 .......... ............ A Eye photodynamic ther add-on ................... 0.47 0.25 0.21 0.02 0.74 0.70 ZZZ


## 45948

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

67227 .......... ............ A Treatment of retinal lesion .......................... 6.58 6.42 5.40 0.33 13.33 12.32 090 67228 .......... ............ A Treatment of retinal lesion .......................... 12.75 11.17 8.35 0.63 24.54 21.73 090 67250 .......... ............ A Reinforce eye wall ....................................... 8.67 NA 8.85 0.47 NA 17.98 090 67255 .......... ............ A Reinforce/graft eye wall ............................... 8.91 NA 9.54 0.44 NA 18.89 090 67299 .......... ............ C Eye surgery procedure ................................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67311 .......... ............ A Revise eye muscle ...................................... 6.65 NA 5.88 0.37 NA 12.91 090 67312 .......... ............ A Revise two eye muscles ............................. 8.55 NA 6.60 0.43 NA 15.58 090 67314 .......... ............ A Revise eye muscle ...................................... 7.53 NA 6.41 0.39 NA 14.32 090 67316 .......... ............ A Revise two eye muscles ............................. 9.67 NA 7.33 0.49 NA 17.49 090 67318 .......... ............ A Revise eye muscle(s) .................................. 7.86 NA 6.78 0.41 NA 15.05 090 67320 .......... ............ A Revise eye muscle(s) add-on ..................... 4.33 NA 1.90 0.22 NA 6.45 ZZZ 67331 .......... ............ A Eye surgery follow-up add-on ..................... 4.06 NA 1.79 0.21 NA 6.05 ZZZ 67332 .......... ............ A Rerevise eye muscles add-on ..................... 4.49 NA 1.97 0.23 NA 6.69 ZZZ 67334 .......... ............ A Revise eye muscle w/suture ....................... 3.98 NA 1.75 0.20 NA 5.93 ZZZ 67335 .......... ............ A Eye suture during surgery ........................... 2.49 NA 1.09 0.13 NA 3.72 ZZZ 67340 .......... ............ A Revise eye muscle add-on .......................... 4.93 NA 2.15 0.25 NA 7.33 ZZZ 67343 .......... ............ A Release eye tissue ...................................... 7.35 NA 6.37 0.37 NA 14.09 090 67345 .......... ............ A Destroy nerve of eye muscle ...................... 2.97 2.52 1.97 0.17 5.65 5.10 010 67350 .......... ............ A Biopsy eye muscle ...................................... 2.88 NA 1.84 0.15 NA 4.86 000 67399 .......... ............ C Eye muscle surgery procedure ................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67400 .......... ............ A Explore/biopsy eye socket .......................... 9.77 NA 10.83 0.56 NA 21.16 090 67405 .......... ............ A Explore/drain eye socket ............................. 7.94 NA 9.42 0.44 NA 17.80 090 67412 .......... ............ A Explore/treat eye socket .............................. 9.51 NA 10.47 0.48 NA 20.46 090 67413 .......... ............ A Explore/treat eye socket .............................. 10.01 NA 10.36 0.50 NA 20.87 090 67414 .......... ............ A Explr/decompress eye socket ..................... 11.13 NA 11.56 0.65 NA 23.34 090 67415 .......... ............ A Aspiration, orbital contents .......................... 1.76 NA 0.74 0.09 NA 2.60 000 67420 .......... ............ A Explore/treat eye socket .............................. 20.07 NA 16.76 1.15 NA 37.98 090 67430 .......... ............ A Explore/treat eye socket .............................. 13.40 NA 14.29 0.86 NA 28.55 090 67440 .......... ............ A Explore/drain eye socket ............................. 13.10 NA 13.73 0.70 NA 27.52 090 67445 .......... ............ A Explr/decompress eye socket ..................... 14.43 NA 13.40 0.90 NA 28.73 090 67450 .......... ............ A Explore/biopsy eye socket .......................... 13.52 NA 14.17 0.68 NA 28.36 090 67500 .......... ............ A Inject/treat eye socket ................................. 0.79 0.65 0.28 0.05 1.49 1.12 000 67505 .......... ............ A Inject/treat eye socket ................................. 0.82 0.67 0.30 0.05 1.54 1.17 000 67515 .......... ............ A Inject/treat eye socket ................................. 0.61 0.57 0.37 0.03 1.21 1.01 000 67550 .......... ............ A Insert eye socket implant ............................ 10.19 NA 10.89 0.72 NA 21.80 090 67560 .......... ............ A Revise eye socket implant .......................... 10.60 NA 10.97 0.60 NA 22.17 090 67570 .......... ............ A Decompress optic nerve ............................. 13.59 NA 13.08 0.68 NA 27.35 090 67599 .......... ............ C Orbit surgery procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67700 .......... ............ A Drainage of eyelid abscess ......................... 1.35 5.70 1.24 0.07 7.12 2.66 010 67710 .......... ............ A Incision of eyelid .......................................... 1.02 5.07 1.18 0.05 6.14 2.25 010 67715 .......... ............ A Incision of eyelid fold ................................... 1.22 5.09 1.26 0.06 6.37 2.54 010 67800 .......... ............ A Remove eyelid lesion .................................. 1.38 1.58 1.02 0.07 3.03 2.47 010 67801 .......... ............ A Remove eyelid lesions ................................ 1.88 1.91 1.23 0.09 3.89 3.21 010 67805 .......... ............ A Remove eyelid lesions ................................ 2.22 2.46 1.61 0.11 4.79 3.95 010 67808 .......... ............ A Remove eyelid lesion(s) .............................. 3.80 NA 3.69 0.19 NA 7.68 090 67810 .......... ............ A Biopsy of eyelid ........................................... 1.48 3.44 0.67 0.06 4.98 2.22 000 67820 .......... ............ A Revise eyelashes ........................................ 0.89 0.59 0.56 0.04 1.52 1.49 000 67825 .......... ............ A Revise eyelashes ........................................ 1.38 1.67 1.38 0.07 3.13 2.84 010 67830 .......... ............ A Revise eyelashes ........................................ 1.70 5.26 1.47 0.08 7.04 3.25 010 67835 .......... ............ A Revise eyelashes ........................................ 5.56 NA 4.52 0.28 NA 10.36 090 67840 .......... ............ A Remove eyelid lesion .................................. 2.04 5.22 1.62 0.10 7.37 3.76 010 67850 .......... ............ A Treat eyelid lesion ....................................... 1.69 3.41 1.45 0.07 5.17 3.21 010 67875 .......... ............ A Closure of eyelid by suture ......................... 1.35 3.13 0.92 0.07 4.56 2.35 000 67880 .......... ............ A Revision of eyelid ........................................ 3.80 6.35 3.71 0.19 10.34 7.70 090 67882 .......... ............ A Revision of eyelid ........................................ 5.07 7.35 4.70 0.25 12.67 10.02 090 67900 .......... ............ A Repair brow defect ...................................... 6.14 8.72 5.11 0.38 15.24 11.63 090 67901 .......... ............ A Repair eyelid defect .................................... 6.97 NA 5.26 0.51 NA 12.74 090 67902 .......... ............ A Repair eyelid defect .................................... 7.03 NA 5.32 0.45 NA 12.80 090 67903 .......... ............ A Repair eyelid defect .................................... 6.37 9.07 5.33 0.47 15.92 12.17 090 67904 .......... ............ A Repair eyelid defect .................................... 6.26 9.25 5.11 0.41 15.92 11.78 090 67906 .......... ............ A Repair eyelid defect .................................... 6.79 NA 4.92 0.46 NA 12.17 090 67908 .......... ............ A Repair eyelid defect .................................... 5.13 6.41 5.19 0.28 11.82 10.60 090 67909 .......... ............ A Revise eyelid defect .................................... 5.40 7.70 4.82 0.31 13.41 10.53 090 67911 .......... ............ A Revise eyelid defect .................................... 5.27 NA 4.66 0.31 NA 10.24 090 67912 .......... ............ A Correction eyelid w/implant ......................... 5.68 17.75 5.37 0.28 23.71 11.33 090 67914 .......... ............ A Repair eyelid defect .................................... 3.68 6.06 2.99 0.19 9.92 6.85 090 67915 .......... ............ A Repair eyelid defect .................................... 3.19 5.70 2.74 0.16 9.05 6.09 090 67916 .......... ............ A Repair eyelid defect .................................... 5.31 7.74 4.65 0.28 13.33 10.24 090 67917 .......... ............ A Repair eyelid defect .................................... 6.02 8.14 4.95 0.36 14.52 11.33 090 67921 .......... ............ A Repair eyelid defect .................................... 3.40 5.91 2.83 0.17 9.48 6.40 090 67922 .......... ............ A Repair eyelid defect .................................... 3.07 5.63 2.70 0.15 8.84 5.91 090 67923 .......... ............ A Repair eyelid defect .................................... 5.88 7.82 4.86 0.30 14.00 11.04 090 67924 .......... ............ A Repair eyelid defect .................................... 5.79 8.56 4.58 0.30 14.65 10.67 090 67930 .......... ............ A Repair eyelid wound .................................... 3.61 5.47 2.12 0.19 9.26 5.91 010


## 45949

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

67935 .......... ............ A Repair eyelid wound .................................... 6.22 8.21 4.28 0.39 14.82 10.89 090 67938 .......... ............ A Remove eyelid foreign body ....................... 1.33 5.11 1.24 0.06 6.50 2.63 010 67950 .......... ............ A Revision of eyelid ........................................ 5.82 8.28 5.07 0.36 14.46 11.25 090 67961 .......... ............ A Revision of eyelid ........................................ 5.69 8.35 4.90 0.33 14.37 10.92 090 67966 .......... ............ A Revision of eyelid ........................................ 6.57 8.78 5.41 0.37 15.72 12.35 090 67971 .......... ............ A Reconstruction of eyelid .............................. 9.80 NA 7.11 0.53 NA 17.44 090 67973 .......... ............ A Reconstruction of eyelid .............................. 12.88 NA 9.07 0.75 NA 22.69 090 67974 .......... ............ A Reconstruction of eyelid .............................. 12.85 NA 9.00 0.75 NA 22.59 090 67975 .......... ............ A Reconstruction of eyelid .............................. 9.14 NA 6.79 0.50 NA 16.43 090 67999 .......... ............ C Revision of eyelid ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY 68020 .......... ............ A Incise/drain eyelid lining .............................. 1.37 1.38 1.18 0.06 2.81 2.62 010 68040 .......... ............ A Treatment of eyelid lesions ......................... 0.85 0.69 0.42 0.04 1.59 1.31 000 68100 .......... ............ A Biopsy of eyelid lining ................................. 1.35 3.09 0.93 0.07 4.51 2.36 000 68110 .......... ............ A Remove eyelid lining lesion ........................ 1.77 3.91 1.62 0.09 5.78 3.48 010 68115 .......... ............ A Remove eyelid lining lesion ........................ 2.36 5.67 1.87 0.12 8.15 4.36 010 68130 .......... ............ A Remove eyelid lining lesion ........................ 4.93 8.34 4.50 0.24 13.51 9.67 090 68135 .......... ............ A Remove eyelid lining lesion ........................ 1.84 1.77 1.62 0.09 3.70 3.55 010 68200 .......... ............ A Treat eyelid by injection .............................. 0.49 0.52 0.32 0.02 1.03 0.83 000 68320 .......... ............ A Revise/graft eyelid lining ............................. 5.37 10.81 5.41 0.27 16.45 11.05 090 68325 .......... ............ A Revise/graft eyelid lining ............................. 7.36 NA 6.39 0.44 NA 14.19 090 68326 .......... ............ A Revise/graft eyelid lining ............................. 7.15 NA 6.27 0.35 NA 13.77 090 68328 .......... ............ A Revise/graft eyelid lining ............................. 8.19 NA 7.08 0.54 NA 15.81 090 68330 .......... ............ A Revise eyelid lining ..................................... 4.83 9.00 4.62 0.24 14.07 9.69 090 68335 .......... ............ A Revise/graft eyelid lining ............................. 7.19 NA 6.24 0.36 NA 13.80 090 68340 .......... ............ A Separate eyelid adhesions .......................... 4.17 8.47 4.02 0.21 12.85 8.39 090 68360 .......... ............ A Revise eyelid lining ..................................... 4.37 7.70 4.10 0.22 12.29 8.68 090 68362 .......... ............ A Revise eyelid lining ..................................... 7.34 NA 6.27 0.36 NA 13.97 090 68371 .......... ............ A Harvest eye tissue, alograft ........................ 4.90 NA 4.61 0.44 NA 9.95 010 68399 .......... ............ C Eyelid lining surgery .................................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 68400 .......... ............ A Incise/drain tear gland ................................. 1.69 5.61 1.72 0.08 7.38 3.49 010 68420 .......... ............ A Incise/drain tear sac .................................... 2.30 5.90 1.99 0.11 8.31 4.40 010 68440 .......... ............ A Incise tear duct opening .............................. 0.94 1.93 1.24 0.05 2.92 2.23 010 68500 .......... ............ A Removal of tear gland ................................. 11.02 NA 9.45 0.55 NA 21.02 090 68505 .......... ............ A Partial removal, tear gland .......................... 10.94 NA 10.29 0.55 NA 21.78 090 68510 .......... ............ A Biopsy of tear gland .................................... 4.61 6.97 2.13 0.23 11.81 6.97 000 68520 .......... ............ A Removal of tear sac .................................... 7.52 NA 7.21 0.37 NA 15.09 090 68525 .......... ............ A Biopsy of tear sac ....................................... 4.43 NA 1.97 0.22 NA 6.62 000 68530 .......... ............ A Clearance of tear duct ................................. 3.66 7.71 2.55 0.18 11.55 6.39 010 68540 .......... ............ A Remove tear gland lesion ........................... 10.60 NA 9.14 0.52 NA 20.26 090 68550 .......... ............ A Remove tear gland lesion ........................... 13.27 NA 11.03 0.80 NA 25.09 090 68700 .......... ............ A Repair tear ducts ......................................... 6.60 NA 5.84 0.32 NA 12.76 090 68705 .......... ............ A Revise tear duct opening ............................ 2.06 3.97 1.75 0.10 6.13 3.92 010 68720 .......... ............ A Create tear sac drain .................................. 8.97 NA 7.65 0.44 NA 17.05 090 68745 .......... ............ A Create tear duct drain ................................. 8.64 NA 7.65 0.52 NA 16.80 090 68750 .......... ............ A Create tear duct drain ................................. 8.67 NA 8.04 0.43 NA 17.14 090 68760 .......... ............ A Close tear duct opening .............................. 1.73 3.37 1.60 0.09 5.19 3.42 010 68761 .......... ............ A Close tear duct opening .............................. 1.36 2.19 1.31 0.06 3.62 2.73 010 68770 .......... ............ A Close tear system fistula ............................. 7.02 NA 3.78 0.35 NA 11.15 090 68801 .......... ............ A Dilate tear duct opening .............................. 0.94 1.90 1.46 0.05 2.89 2.45 010 68810 .......... ............ A Probe nasolacrimal duct .............................. 1.90 3.55 2.62 0.10 5.56 4.62 010 68811 .......... ............ A Probe nasolacrimal duct .............................. 2.35 NA 2.35 0.13 NA 4.84 010 68815 .......... ............ A Probe nasolacrimal duct .............................. 3.21 7.87 2.75 0.17 11.25 6.12 010 68840 .......... ............ A Explore/irrigate tear ducts ........................... 1.25 1.55 1.11 0.06 2.86 2.42 010 68850 .......... ............ A Injection for tear sac x-ray .......................... 0.80 0.87 0.71 0.04 1.71 1.55 000 68899 .......... ............ C Tear duct system surgery ........................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
69000 .......... ............ A Drain external ear lesion ............................. 1.45 2.83 1.32 0.12 4.41 2.90 010
69005 .......... ............ A Drain external ear lesion ............................. 2.11 2.90 1.79 0.17 5.18 4.07 010
69020 .......... ............ A Drain outer ear canal lesion ........................ 1.48 3.93 2.00 0.12 5.54 3.60 010
69090 .......... ............ N Pierce earlobes ........................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 69100 .......... ............ A Biopsy of external ear ................................. 0.81 1.76 0.41 0.03 2.61 1.25 000 69105 .......... ............ A Biopsy of external ear canal ....................... 0.85 2.35 0.76 0.07 3.27 1.68 000 69110 .......... ............ A Remove external ear, partial ....................... 3.44 7.01 4.35 0.30 10.75 8.09 090 69120 .......... ............ A Removal of external ear .............................. 4.05 NA 5.99 0.38 NA 10.42 090 69140 .......... ............ A Remove ear canal lesion(s) ........................ 7.98 NA 13.09 0.65 NA 21.72 090 69145 .......... ............ A Remove ear canal lesion(s) ........................ 2.63 5.85 3.28 0.21 8.68 6.11 090 69150 .......... ............ A Extensive ear canal surgery ........................ 13.44 NA 13.05 1.22 NA 27.71 090 69155 .......... ............ A Extensive ear/neck surgery ......................... 20.81 NA 19.00 1.92 NA 41.73 090 69200 .......... ............ A Clear outer ear canal .................................. 0.77 2.30 0.54 0.06 3.13 1.37 000 69205 .......... ............ A Clear outer ear canal .................................. 1.20 NA 1.34 0.10 NA 2.64 010 69210 .......... ............ A Remove impacted ear wax ......................... 0.61 0.62 0.22 0.05 1.28 0.88 000 69220 .......... ............ A Clean out mastoid cavity ............................. 0.83 2.34 0.72 0.07 3.24 1.62 000 69222 .......... ............ A Clean out mastoid cavity ............................. 1.40 3.80 2.01 0.12 5.32 3.53 010
69300 .......... ............ R Revise external ear ..................................... 6.36 0.00 4.43 0.72 7.08 11.51 YYY
69310 .......... ............ A Rebuild outer ear canal ............................... 10.79 NA 15.97 0.85 NA 27.61 090


## 45950

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

69320 .......... ............ A Rebuild outer ear canal ............................... 16.96 NA 21.39 1.37 NA 39.72 090 69399 .......... ............ C Outer ear surgery procedure ....................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69400 .......... ............ A Inflate middle ear canal ............................... 0.83 2.20 0.67 0.07 3.11 1.57 000 69401 .......... ............ A Inflate middle ear canal ............................... 0.63 1.27 0.64 0.05 1.95 1.32 000 69405 .......... ............ A Catheterize middle ear canal ...................... 2.64 3.49 2.26 0.21 6.33 5.10 010 69410 .......... ............ A Inset middle ear (baffle) .............................. 0.33 2.06 0.48 0.03 2.42 0.84 000 69420 .......... ............ A Incision of eardrum ...................................... 1.33 3.12 1.57 0.11 4.56 3.01 010 69421 .......... ............ A Incision of eardrum ...................................... 1.73 NA 2.10 0.15 NA 3.98 010 69424 .......... ............ A Remove ventilating tube .............................. 0.85 2.16 0.67 0.07 3.09 1.60 000 69433 .......... ............ A Create eardrum opening ............................. 1.52 3.07 1.62 0.13 4.72 3.27 010 69436 .......... ............ A Create eardrum opening ............................. 1.96 NA 2.22 0.19 NA 4.37 010 69440 .......... ............ A Exploration of middle ear ............................ 7.58 NA 8.74 0.61 NA 16.93 090
69450 .......... ............ A Eardrum revision ......................................... 5.57 NA 7.04 0.45 NA 13.06 090 69501 .......... ............ A Mastoidectomy ............................................ 9.08 NA 8.89 0.73 NA 18.70 090 69502 .......... ............ A Mastoidectomy ............................................ 12.38 NA 11.46 1.00 NA 24.85 090 69505 .......... ............ A Remove mastoid structures ........................ 13.00 NA 16.86 1.05 NA 30.90 090 69511 .......... ............ A Extensive mastoid surgery .......................... 13.53 NA 17.13 1.09 NA 31.75 090 69530 .......... ............ A Extensive mastoid surgery .......................... 19.20 NA 21.15 1.54 NA 41.89 090 69535 .......... ............ A Remove part of temporal bone ................... 36.16 NA 31.12 2.92 NA 70.20 090
69540 .......... ............ A Remove ear lesion ...................................... 1.20 3.69 1.93 0.10 4.99 3.23 010 69550 .......... ............ A Remove ear lesion ...................................... 10.99 NA 14.61 0.89 NA 26.49 090 69552 .......... ............ A Remove ear lesion ...................................... 19.47 NA 20.18 1.59 NA 41.23 090 69554 .......... ............ A Remove ear lesion ...................................... 33.18 NA 29.40 2.91 NA 65.48 090 69601 .......... ............ A Mastoid surgery revision ............................. 13.25 NA 12.52 1.07 NA 26.84 090 69602 .......... ............ A Mastoid surgery revision ............................. 13.59 NA 13.10 1.10 NA 27.79 090 69603 .......... ............ A Mastoid surgery revision ............................. 14.03 NA 17.92 1.14 NA 33.08 090 69604 .......... ............ A Mastoid surgery revision ............................. 14.03 NA 13.49 1.14 NA 28.66 090 69605 .......... ............ A Mastoid surgery revision ............................. 18.50 NA 20.72 1.50 NA 40.71 090 69610 .......... ............ A Repair of eardrum ....................................... 4.43 5.43 3.19 0.36 10.22 7.98 010 69620 .......... ............ A Repair of eardrum ....................................... 5.89 10.93 6.17 0.48 17.30 12.54 090 69631 .......... ............ A Repair eardrum structures .......................... 9.87 NA 11.14 0.80 NA 21.81 090 69632 .......... ............ A Rebuild eardrum structures ......................... 12.76 NA 13.35 1.03 NA 27.14 090 69633 .......... ............ A Rebuild eardrum structures ......................... 12.10 NA 12.97 0.98 NA 26.05 090 69635 .......... ............ A Repair eardrum structures .......................... 13.34 NA 16.44 1.08 NA 30.86 090 69636 .......... ............ A Rebuild eardrum structures ......................... 15.23 NA 18.98 1.23 NA 35.44 090 69637 .......... ............ A Rebuild eardrum structures ......................... 15.12 NA 18.91 1.22 NA 35.25 090 69641 .......... ............ A Revise middle ear & mastoid ...................... 12.72 NA 12.67 1.03 NA 26.41 090 69642 .......... ............ A Revise middle ear & mastoid ...................... 16.84 NA 16.10 1.36 NA 34.30 090 69643 .......... ............ A Revise middle ear & mastoid ...................... 15.33 NA 14.66 1.24 NA 31.23 090 69644 .......... ............ A Revise middle ear & mastoid ...................... 16.97 NA 20.00 1.37 NA 38.35 090 69645 .......... ............ A Revise middle ear & mastoid ...................... 16.39 NA 19.64 1.33 NA 37.36 090 69646 .......... ............ A Revise middle ear & mastoid ...................... 18.00 NA 20.38 1.46 NA 39.83 090 69650 .......... ............ A Release middle ear bone ............................ 9.67 NA 9.84 0.78 NA 20.29 090 69660 .......... ............ A Revise middle ear bone .............................. 11.90 NA 11.04 0.96 NA 23.91 090 69661 .......... ............ A Revise middle ear bone .............................. 15.75 NA 14.47 1.27 NA 31.49 090 69662 .......... ............ A Revise middle ear bone .............................. 15.45 NA 13.54 1.25 NA 30.24 090 69666 .......... ............ A Repair middle ear structures ....................... 9.76 NA 9.90 0.79 NA 20.45 090 69667 .......... ............ A Repair middle ear structures ....................... 9.77 NA 9.90 0.79 NA 20.46 090 69670 .......... ............ A Remove mastoid air cells ............................ 11.51 NA 11.57 0.93 NA 24.01 090 69676 .......... ............ A Remove middle ear nerve ........................... 9.53 NA 10.65 0.81 NA 20.99 090 69700 .......... ............ A Close mastoid fistula ................................... 8.24 NA 9.06 0.67 NA 17.97 090 69710 .......... ............ N Implant/replace hearing aid ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 69711 .......... ............ A Remove/repair hearing aid .......................... 10.44 NA 10.65 0.83 NA 21.92 090 69714 .......... ............ A Implant temple bone w/stimul ..................... 14.01 NA 12.46 1.13 NA 27.60 090 69715 .......... ............ A Temple bne implnt w/stimulat ..................... 18.26 NA 14.75 1.48 NA 34.49 090 69717 .......... ............ A Temple bone implant revision ..................... 14.99 NA 14.01 0.90 NA 29.90 090 69718 .......... ............ A Revise temple bone implant ........................ 18.51 NA 14.97 3.21 NA 36.69 090 69720 .......... ............ A Release facial nerve .................................... 14.39 NA 14.34 1.16 NA 29.89 090 69725 .......... ............ A Release facial nerve .................................... 25.39 NA 19.77 2.44 NA 47.60 090 69740 .......... ............ A Repair facial nerve ...................................... 15.97 NA 13.13 1.27 NA 30.37 090 69745 .......... ............ A Repair facial nerve ...................................... 16.69 NA 14.67 1.14 NA 32.50 090 69799 .......... ............ C Middle ear surgery procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
69801 .......... ............ A Incise inner ear ............................................ 8.57 NA 9.41 0.69 NA 18.67 090
69802 .......... ............ A Incise inner ear ............................................ 13.11 NA 12.21 1.06 NA 26.37 090 69805 .......... ............ A Explore inner ear ......................................... 13.83 NA 11.70 1.12 NA 26.64 090 69806 .......... ............ A Explore inner ear ......................................... 12.35 NA 10.92 1.00 NA 24.27 090
69820 .......... ............ A Establish inner ear window ......................... 10.34 NA 11.04 0.90 NA 22.28 090
69840 .......... ............ A Revise inner ear window ............................. 10.26 NA 12.73 0.79 NA 23.78 090
69905 .......... ............ A Remove inner ear ........................................ 11.10 NA 11.23 0.90 NA 23.23 090
69910 .......... ............ A Remove inner ear & mastoid ...................... 13.64 NA 11.72 1.07 NA 26.42 090
69915 .......... ............ A Incise inner ear nerve ................................. 21.24 NA 16.16 1.69 NA 39.09 090 69930 .......... ............ A Implant cochlear device .............................. 16.81 NA 14.44 1.36 NA 32.61 090 69949 .......... ............ C Inner ear surgery procedure ....................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
69950 .......... ............ A Incise inner ear nerve ................................. 25.65 NA 18.47 2.28 NA 46.40 090


## 45951

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

69955 .......... ............ A Release facial nerve .................................... 27.05 NA 20.91 2.48 NA 50.45 090
69960 .......... ............ A Release inner ear canal .............................. 27.05 NA 19.59 2.17 NA 48.81 090 69970 .......... ............ A Remove inner ear lesion ............................. 30.05 NA 22.69 2.41 NA 55.15 090 69979 .......... ............ C Temporal bone surgery ............................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69990 .......... ............ R Microsurgery add-on ................................... 3.47 NA 1.74 0.89 NA 6.09 ZZZ 70010 .......... ............ A Contrast x-ray of brain ................................ 1.19 4.33 NA 0.27 5.79 NA XXX 70010 .......... 26 ....... A Contrast x-ray of brain ................................ 1.19 0.41 0.41 0.05 1.65 1.65 XXX 70010 .......... TC ...... A Contrast x-ray of brain ................................ 0.00 3.92 NA 0.22 4.14 NA XXX 70015 .......... ............ A Contrast x-ray of brain ................................ 1.19 2.34 NA 0.16 3.70 NA XXX 70015 .......... 26 ....... A Contrast x-ray of brain ................................ 1.19 0.41 0.41 0.08 1.68 1.68 XXX 70015 .......... TC ...... A Contrast x-ray of brain ................................ 0.00 1.94 NA 0.08 2.02 NA XXX 70030 .......... ............ A X-ray eye for foreign body .......................... 0.17 0.53 NA 0.03 0.73 NA XXX 70030 .......... 26 ....... A X-ray eye for foreign body .......................... 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70030 .......... TC ...... A X-ray eye for foreign body .......................... 0.00 0.47 NA 0.02 0.49 NA XXX 70100 .......... ............ A X-ray exam of jaw ....................................... 0.18 0.62 NA 0.03 0.83 NA XXX 70100 .......... 26 ....... A X-ray exam of jaw ....................................... 0.18 0.06 0.06 0.01 0.25 0.25 XXX 70100 .......... TC ...... A X-ray exam of jaw ....................................... 0.00 0.56 NA 0.02 0.58 NA XXX 70110 .......... ............ A X-ray exam of jaw ....................................... 0.25 0.74 NA 0.05 1.04 NA XXX 70110 .......... 26 ....... A X-ray exam of jaw ....................................... 0.25 0.09 0.09 0.01 0.35 0.35 XXX 70110 .......... TC ...... A X-ray exam of jaw ....................................... 0.00 0.66 NA 0.04 0.70 NA XXX 70120 .......... ............ A X-ray exam of mastoids .............................. 0.18 0.72 NA 0.05 0.95 NA XXX 70120 .......... 26 ....... A X-ray exam of mastoids .............................. 0.18 0.06 0.06 0.01 0.25 0.25 XXX 70120 .......... TC ...... A X-ray exam of mastoids .............................. 0.00 0.66 NA 0.04 0.70 NA XXX 70130 .......... ............ A X-ray exam of mastoids .............................. 0.34 1.03 NA 0.07 1.44 NA XXX 70130 .......... 26 ....... A X-ray exam of mastoids .............................. 0.34 0.12 0.12 0.02 0.48 0.48 XXX 70130 .......... TC ...... A X-ray exam of mastoids .............................. 0.00 0.91 NA 0.05 0.96 NA XXX 70134 .......... ............ A X-ray exam of middle ear ............................ 0.34 0.93 NA 0.07 1.34 NA XXX 70134 .......... 26 ....... A X-ray exam of middle ear ............................ 0.34 0.12 0.12 0.02 0.48 0.48 XXX 70134 .......... TC ...... A X-ray exam of middle ear ............................ 0.00 0.81 NA 0.05 0.86 NA XXX 70140 .......... ............ A X-ray exam of facial bones ......................... 0.19 0.66 NA 0.05 0.90 NA XXX 70140 .......... 26 ....... A X-ray exam of facial bones ......................... 0.19 0.06 0.06 0.01 0.26 0.26 XXX 70140 .......... TC ...... A X-ray exam of facial bones ......................... 0.00 0.60 NA 0.04 0.64 NA XXX 70150 .......... ............ A X-ray exam of facial bones ......................... 0.26 0.87 NA 0.06 1.19 NA XXX 70150 .......... 26 ....... A X-ray exam of facial bones ......................... 0.26 0.09 0.09 0.01 0.36 0.36 XXX 70150 .......... TC ...... A X-ray exam of facial bones ......................... 0.00 0.78 NA 0.05 0.83 NA XXX 70160 .......... ............ A X-ray exam of nasal bones ......................... 0.17 0.61 NA 0.03 0.81 NA XXX 70160 .......... 26 ....... A X-ray exam of nasal bones ......................... 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70160 .......... TC ...... A X-ray exam of nasal bones ......................... 0.00 0.55 NA 0.02 0.57 NA XXX 70170 .......... ............ A X-ray exam of tear duct .............................. 0.30 NA NA 0.07 NA NA XXX 70170 .......... 26 ....... A X-ray exam of tear duct .............................. 0.30 0.11 0.11 0.01 0.42 0.42 XXX 70170 .......... TC ...... A X-ray exam of tear duct .............................. 0.00 NA NA 0.06 NA NA XXX 70190 .......... ............ A X-ray exam of eye sockets ......................... 0.21 0.71 NA 0.05 0.97 NA XXX 70190 .......... 26 ....... A X-ray exam of eye sockets ......................... 0.21 0.07 0.07 0.01 0.29 0.29 XXX 70190 .......... TC ...... A X-ray exam of eye sockets ......................... 0.00 0.64 NA 0.04 0.68 NA XXX 70200 .......... ............ A X-ray exam of eye sockets ......................... 0.28 0.89 NA 0.06 1.23 NA XXX 70200 .......... 26 ....... A X-ray exam of eye sockets ......................... 0.28 0.10 0.10 0.01 0.39 0.39 XXX 70200 .......... TC ...... A X-ray exam of eye sockets ......................... 0.00 0.80 NA 0.05 0.85 NA XXX 70210 .......... ............ A X-ray exam of sinuses ................................ 0.17 0.68 NA 0.05 0.90 NA XXX 70210 .......... 26 ....... A X-ray exam of sinuses ................................ 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70210 .......... TC ...... A X-ray exam of sinuses ................................ 0.00 0.62 NA 0.04 0.66 NA XXX 70220 .......... ............ A X-ray exam of sinuses ................................ 0.25 0.85 NA 0.06 1.16 NA XXX 70220 .......... 26 ....... A X-ray exam of sinuses ................................ 0.25 0.09 0.09 0.01 0.35 0.35 XXX 70220 .......... TC ...... A X-ray exam of sinuses ................................ 0.00 0.77 NA 0.05 0.82 NA XXX 70240 .......... ............ A X-ray exam, pituitary saddle ....................... 0.19 0.53 NA 0.03 0.75 NA XXX 70240 .......... 26 ....... A X-ray exam, pituitary saddle ....................... 0.19 0.06 0.06 0.01 0.26 0.26 XXX 70240 .......... TC ...... A X-ray exam, pituitary saddle ....................... 0.00 0.47 NA 0.02 0.49 NA XXX 70250 .......... ............ A X-ray exam of skull ..................................... 0.24 0.71 NA 0.05 1.00 NA XXX 70250 .......... 26 ....... A X-ray exam of skull ..................................... 0.24 0.08 0.08 0.01 0.33 0.33 XXX 70250 .......... TC ...... A X-ray exam of skull ..................................... 0.00 0.63 NA 0.04 0.67 NA XXX 70260 .......... ............ A X-ray exam of skull ..................................... 0.34 0.99 NA 0.08 1.41 NA XXX 70260 .......... 26 ....... A X-ray exam of skull ..................................... 0.34 0.12 0.12 0.02 0.48 0.48 XXX 70260 .......... TC ...... A X-ray exam of skull ..................................... 0.00 0.87 NA 0.06 0.93 NA XXX 70300 .......... ............ A X-ray exam of teeth ..................................... 0.10 0.29 NA 0.03 0.42 NA XXX 70300 .......... 26 ....... A X-ray exam of teeth ..................................... 0.10 0.05 0.05 0.01 0.16 0.16 XXX 70300 .......... TC ...... A X-ray exam of teeth ..................................... 0.00 0.24 NA 0.02 0.26 NA XXX 70310 .......... ............ A X-ray exam of teeth ..................................... 0.16 0.54 NA 0.03 0.73 NA XXX 70310 .......... 26 ....... A X-ray exam of teeth ..................................... 0.16 0.08 0.08 0.01 0.25 0.25 XXX 70310 .......... TC ...... A X-ray exam of teeth ..................................... 0.00 0.46 NA 0.02 0.48 NA XXX 70320 .......... ............ A Full mouth x-ray of teeth ............................. 0.22 0.88 NA 0.06 1.16 NA XXX 70320 .......... 26 ....... A Full mouth x-ray of teeth ............................. 0.22 0.08 0.08 0.01 0.31 0.31 XXX 70320 .......... TC ...... A Full mouth x-ray of teeth ............................. 0.00 0.80 NA 0.05 0.85 NA XXX 70328 .......... ............ A X-ray exam of jaw joint ............................... 0.18 0.58 NA 0.03 0.79 NA XXX 70328 .......... 26 ....... A X-ray exam of jaw joint ............................... 0.18 0.06 0.06 0.01 0.25 0.25 XXX 70328 .......... TC ...... A X-ray exam of jaw joint ............................... 0.00 0.52 NA 0.02 0.54 NA XXX


## 45952

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

70330 .......... ............ A X-ray exam of jaw joints .............................. 0.24 0.98 NA 0.06 1.28 NA XXX 70330 .......... 26 ....... A X-ray exam of jaw joints .............................. 0.24 0.08 0.08 0.01 0.33 0.33 XXX 70330 .......... TC ...... A X-ray exam of jaw joints .............................. 0.00 0.89 NA 0.05 0.94 NA XXX 70332 .......... ............ A X-ray exam of jaw joint ............................... 0.54 2.14 NA 0.14 2.83 NA XXX 70332 .......... 26 ....... A X-ray exam of jaw joint ............................... 0.54 0.21 0.21 0.02 0.77 0.77 XXX 70332 .......... TC ...... A X-ray exam of jaw joint ............................... 0.00 1.94 NA 0.12 2.06 NA XXX 70336 .......... ............ A Magnetic image, jaw joint ............................ 1.48 11.68 NA 0.66 13.82 NA XXX 70336 .......... 26 ....... A Magnetic image, jaw joint ............................ 1.48 0.51 0.51 0.07 2.07 2.07 XXX 70336 .......... TC ...... A Magnetic image, jaw joint ............................ 0.00 11.16 NA 0.59 11.75 NA XXX 70350 .......... ............ A X-ray head for orthodontia .......................... 0.17 0.42 NA 0.03 0.62 NA XXX 70350 .......... 26 ....... A X-ray head for orthodontia .......................... 0.17 0.07 0.07 0.01 0.25 0.25 XXX 70350 .......... TC ...... A X-ray head for orthodontia .......................... 0.00 0.35 NA 0.02 0.37 NA XXX 70355 .......... ............ A Panoramic x-ray of jaws .............................. 0.20 0.56 NA 0.05 0.81 NA XXX 70355 .......... 26 ....... A Panoramic x-ray of jaws .............................. 0.20 0.07 0.07 0.01 0.28 0.28 XXX 70355 .......... TC ...... A Panoramic x-ray of jaws .............................. 0.00 0.48 NA 0.04 0.52 NA XXX 70360 .......... ............ A X-ray exam of neck ..................................... 0.17 0.50 NA 0.03 0.70 NA XXX 70360 .......... 26 ....... A X-ray exam of neck ..................................... 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70360 .......... TC ...... A X-ray exam of neck ..................................... 0.00 0.44 NA 0.02 0.46 NA XXX 70370 .......... ............ A Throat x-ray & fluoroscopy .......................... 0.32 1.52 NA 0.08 1.92 NA XXX 70370 .......... 26 ....... A Throat x-ray & fluoroscopy .......................... 0.32 0.11 0.11 0.01 0.44 0.44 XXX 70370 .......... TC ...... A Throat x-ray & fluoroscopy .......................... 0.00 1.42 NA 0.07 1.49 NA XXX 70371 .......... ............ A Speech evaluation, complex ....................... 0.84 2.22 NA 0.16 3.22 NA XXX 70371 .......... 26 ....... A Speech evaluation, complex ....................... 0.84 0.29 0.29 0.04 1.17 1.17 XXX 70371 .......... TC ...... A Speech evaluation, complex ....................... 0.00 1.93 NA 0.12 2.05 NA XXX 70373 .......... ............ A Contrast x-ray of larynx ............................... 0.44 1.86 NA 0.13 2.43 NA XXX 70373 .......... 26 ....... A Contrast x-ray of larynx ............................... 0.44 0.15 0.15 0.02 0.61 0.61 XXX 70373 .......... TC ...... A Contrast x-ray of larynx ............................... 0.00 1.71 NA 0.11 1.82 NA XXX 70380 .......... ............ A X-ray exam of salivary gland ...................... 0.17 0.77 NA 0.05 0.99 NA XXX 70380 .......... 26 ....... A X-ray exam of salivary gland ...................... 0.17 0.06 0.06 0.01 0.24 0.24 XXX 70380 .......... TC ...... A X-ray exam of salivary gland ...................... 0.00 0.71 NA 0.04 0.75 NA XXX 70390 .......... ............ A X-ray exam of salivary duct ........................ 0.38 2.07 NA 0.13 2.58 NA XXX 70390 .......... 26 ....... A X-ray exam of salivary duct ........................ 0.38 0.13 0.13 0.02 0.53 0.53 XXX 70390 .......... TC ...... A X-ray exam of salivary duct ........................ 0.00 1.94 NA 0.11 2.05 NA XXX 70450 .......... ............ A Ct head/brain w/o dye ................................. 0.85 4.94 NA 0.29 6.09 NA XXX 70450 .......... 26 ....... A Ct head/brain w/o dye ................................. 0.85 0.29 0.29 0.04 1.18 1.18 XXX 70450 .......... TC ...... A Ct head/brain w/o dye ................................. 0.00 4.65 NA 0.25 4.90 NA XXX 70460 .......... ............ A Ct head/brain w/dye .................................... 1.13 6.12 NA 0.35 7.61 NA XXX 70460 .......... 26 ....... A Ct head/brain w/dye .................................... 1.13 0.39 0.39 0.05 1.57 1.57 XXX 70460 .......... TC ...... A Ct head/brain w/dye .................................... 0.00 5.74 NA 0.30 6.04 NA XXX 70470 .......... ............ A Ct head/brain w/o & w/dye .......................... 1.27 7.58 NA 0.43 9.28 NA XXX 70470 .......... 26 ....... A Ct head/brain w/o & w/dye .......................... 1.27 0.44 0.44 0.06 1.77 1.77 XXX 70470 .......... TC ...... A Ct head/brain w/o & w/dye .......................... 0.00 7.14 NA 0.37 7.51 NA XXX 70480 .......... ............ A Ct orbit/ear/fossa w/o dye ........................... 1.28 5.94 NA 0.31 7.53 NA XXX 70480 .......... 26 ....... A Ct orbit/ear/fossa w/o dye ........................... 1.28 0.44 0.44 0.06 1.78 1.78 XXX 70480 .......... TC ...... A Ct orbit/ear/fossa w/o dye ........................... 0.00 5.50 NA 0.25 5.75 NA XXX 70481 .......... ............ A Ct orbit/ear/fossa w/dye .............................. 1.38 7.04 NA 0.36 8.78 NA XXX 70481 .......... 26 ....... A Ct orbit/ear/fossa w/dye .............................. 1.38 0.47 0.47 0.06 1.92 1.92 XXX 70481 .......... TC ...... A Ct orbit/ear/fossa w/dye .............................. 0.00 6.57 NA 0.30 6.87 NA XXX 70482 .......... ............ A Ct orbit/ear/fossa w/o&w/dye ...................... 1.45 8.49 NA 0.43 10.38 NA XXX 70482 .......... 26 ....... A Ct orbit/ear/fossa w/o&w/dye ...................... 1.45 0.50 0.50 0.06 2.02 2.02 XXX 70482 .......... TC ...... A Ct orbit/ear/fossa w/o&w/dye ...................... 0.00 7.99 NA 0.37 8.36 NA XXX 70486 .......... ............ A Ct maxillofacial w/o dye .............................. 1.14 5.48 NA 0.30 6.93 NA XXX 70486 .......... 26 ....... A Ct maxillofacial w/o dye .............................. 1.14 0.39 0.39 0.05 1.58 1.58 XXX 70486 .......... TC ...... A Ct maxillofacial w/o dye .............................. 0.00 5.09 NA 0.25 5.34 NA XXX 70487 .......... ............ A Ct maxillofacial w/dye .................................. 1.30 6.63 NA 0.36 8.30 NA XXX 70487 .......... 26 ....... A Ct maxillofacial w/dye .................................. 1.30 0.45 0.45 0.06 1.81 1.81 XXX 70487 .......... TC ...... A Ct maxillofacial w/dye .................................. 0.00 6.18 NA 0.30 6.48 NA XXX 70488 .......... ............ A Ct maxillofacial w/o & w/dye ....................... 1.42 8.20 NA 0.43 10.06 NA XXX 70488 .......... 26 ....... A Ct maxillofacial w/o & w/dye ....................... 1.42 0.49 0.49 0.06 1.97 1.97 XXX 70488 .......... TC ...... A Ct maxillofacial w/o & w/dye ....................... 0.00 7.72 NA 0.37 8.09 NA XXX 70490 .......... ............ A Ct soft tissue neck w/o dye ......................... 1.28 5.44 NA 0.31 7.03 NA XXX 70490 .......... 26 ....... A Ct soft tissue neck w/o dye ......................... 1.28 0.44 0.44 0.06 1.78 1.78 XXX 70490 .......... TC ...... A Ct soft tissue neck w/o dye ......................... 0.00 4.99 NA 0.25 5.24 NA XXX 70491 .......... ............ A Ct soft tissue neck w/dye ............................ 1.38 6.59 NA 0.36 8.33 NA XXX 70491 .......... 26 ....... A Ct soft tissue neck w/dye ............................ 1.38 0.47 0.47 0.06 1.92 1.92 XXX 70491 .......... TC ...... A Ct soft tissue neck w/dye ............................ 0.00 6.12 NA 0.30 6.42 NA XXX 70492 .......... ............ A Ct sft tsue nck w/o & w/dye ........................ 1.45 8.14 NA 0.43 10.02 NA XXX 70492 .......... 26 ....... A Ct sft tsue nck w/o & w/dye ........................ 1.45 0.50 0.50 0.06 2.01 2.01 XXX 70492 .......... TC ...... A Ct sft tsue nck w/o & w/dye ........................ 0.00 7.64 NA 0.37 8.01 NA XXX 70496 .......... ............ A Ct angiography, head .................................. 1.75 12.21 NA 0.66 14.63 NA XXX 70496 .......... 26 ....... A Ct angiography, head .................................. 1.75 0.60 0.60 0.08 2.43 2.43 XXX 70496 .......... TC ...... A Ct angiography, head .................................. 0.00 11.62 NA 0.58 12.20 NA XXX 70498 .......... ............ A Ct angiography, neck .................................. 1.75 12.31 NA 0.66 14.73 NA XXX 70498 .......... 26 ....... A Ct angiography, neck .................................. 1.75 0.60 0.60 0.08 2.43 2.43 XXX


## 45953

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

70498 .......... TC ...... A Ct angiography, neck .................................. 0.00 11.71 NA 0.58 12.29 NA XXX 70540 .......... ............ A Mri orbit/face/neck w/o dye ......................... 1.35 12.19 NA 0.45 13.99 NA XXX 70540 .......... 26 ....... A Mri orbit/face/neck w/o dye ......................... 1.35 0.46 0.46 0.06 1.88 1.88 XXX 70540 .......... TC ...... A Mri orbit/face/neck w/o dye ......................... 0.00 11.73 NA 0.39 12.12 NA XXX 70542 .......... ............ A Mri orbit/face/neck w/dye ............................ 1.62 14.04 NA 0.54 16.20 NA XXX 70542 .......... 26 ....... A Mri orbit/face/neck w/dye ............................ 1.62 0.56 0.56 0.07 2.25 2.25 XXX 70542 .......... TC ...... A Mri orbit/face/neck w/dye ............................ 0.00 13.48 NA 0.47 13.95 NA XXX 70543 .......... ............ A Mri orbt/fac/nck w/o & w/dye ....................... 2.15 23.46 NA 0.94 26.55 NA XXX 70543 .......... 26 ....... A Mri orbt/fac/nck w/o & w/dye ....................... 2.15 0.74 0.74 0.10 3.00 3.00 XXX 70543 .......... TC ...... A Mri orbt/fac/nck w/o & w/dye ....................... 0.00 22.71 NA 0.84 23.55 NA XXX 70544 .......... ............ A Mr angiography head w/o dye .................... 1.20 12.25 NA 0.64 14.09 NA XXX 70544 .......... 26 ....... A Mr angiography head w/o dye .................... 1.20 0.42 0.42 0.05 1.67 1.67 XXX 70544 .......... TC ...... A Mr angiography head w/o dye .................... 0.00 11.83 NA 0.59 12.42 NA XXX 70545 .......... ............ A Mr angiography head w/dye ........................ 1.20 12.22 NA 0.64 14.06 NA XXX 70545 .......... 26 ....... A Mr angiography head w/dye ........................ 1.20 0.41 0.41 0.05 1.66 1.66 XXX 70545 .......... TC ...... A Mr angiography head w/dye ........................ 0.00 11.81 NA 0.59 12.40 NA XXX 70546 .......... ............ A Mr angiograph head w/o&w/dye ................. 1.80 22.67 NA 0.67 25.14 NA XXX 70546 .......... 26 ....... A Mr angiograph head w/o&w/dye ................. 1.80 0.62 0.62 0.08 2.50 2.50 XXX 70546 .......... TC ...... A Mr angiograph head w/o&w/dye ................. 0.00 22.05 NA 0.59 22.64 NA XXX 70547 .......... ............ A Mr angiography neck w/o dye ..................... 1.20 12.23 NA 0.64 14.08 NA XXX 70547 .......... 26 ....... A Mr angiography neck w/o dye ..................... 1.20 0.41 0.41 0.05 1.66 1.66 XXX 70547 .......... TC ...... A Mr angiography neck w/o dye ..................... 0.00 11.82 NA 0.59 12.41 NA XXX 70548 .......... ............ A Mr angiography neck w/dye ........................ 1.20 12.55 NA 0.64 14.39 NA XXX 70548 .......... 26 ....... A Mr angiography neck w/dye ........................ 1.20 0.41 0.41 0.05 1.66 1.66 XXX 70548 .......... TC ...... A Mr angiography neck w/dye ........................ 0.00 12.13 NA 0.59 12.72 NA XXX 70549 .......... ............ A Mr angiograph neck w/o&w/dye .................. 1.80 22.83 NA 0.67 25.30 NA XXX 70549 .......... 26 ....... A Mr angiograph neck w/o&w/dye .................. 1.80 0.62 0.62 0.08 2.50 2.50 XXX 70549 .......... TC ...... A Mr angiograph neck w/o&w/dye .................. 0.00 22.21 NA 0.59 22.80 NA XXX 70551 .......... ............ A Mri brain w/o dye ......................................... 1.48 12.02 NA 0.66 14.16 NA XXX 70551 .......... 26 ....... A Mri brain w/o dye ......................................... 1.48 0.51 0.51 0.07 2.07 2.07 XXX 70551 .......... TC ...... A Mri brain w/o dye ......................................... 0.00 11.51 NA 0.59 12.10 NA XXX 70552 .......... ............ A Mri brain w/dye ............................................ 1.78 14.21 NA 0.78 16.77 NA XXX 70552 .......... 26 ....... A Mri brain w/dye ............................................ 1.78 0.62 0.62 0.08 2.48 2.48 XXX 70552 .......... TC ...... A Mri brain w/dye ............................................ 0.00 13.59 NA 0.70 14.29 NA XXX 70553 .......... ............ A Mri brain w/o & w/dye ................................. 2.36 23.54 NA 1.41 27.31 NA XXX 70553 .......... 26 ....... A Mri brain w/o & w/dye ................................. 2.36 0.82 0.82 0.10 3.28 3.28 XXX 70553 .......... TC ...... A Mri brain w/o & w/dye ................................. 0.00 22.72 NA 1.31 24.03 NA XXX 70557 .......... ............ C Mri brain w/o dye ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 70557 .......... 26 ....... A Mri brain w/o dye ......................................... 2.91 1.16 1.16 0.08 4.15 4.15 XXX 70557 .......... TC ...... C Mri brain w/o dye ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 70558 .......... ............ C Mri brain w/dye ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 70558 .......... 26 ....... A Mri brain w/dye ............................................ 3.21 1.28 1.28 0.10 4.58 4.58 XXX 70558 .......... TC ...... C Mri brain w/dye ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 70559 .......... ............ C Mri brain w/o & w/dye ................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 70559 .......... 26 ....... A Mri brain w/o & w/dye ................................. 3.21 1.27 1.27 0.12 4.60 4.60 XXX 70559 .......... TC ...... C Mri brain w/o & w/dye ................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 71010 .......... ............ A Chest x-ray .................................................. 0.18 0.50 NA 0.03 0.71 NA XXX 71010 .......... 26 ....... A Chest x-ray .................................................. 0.18 0.06 0.06 0.01 0.25 0.25 XXX 71010 .......... TC ...... A Chest x-ray .................................................. 0.00 0.44 NA 0.02 0.46 NA XXX 71015 .......... ............ A Chest x-ray .................................................. 0.21 0.55 NA 0.03 0.79 NA XXX 71015 .......... 26 ....... A Chest x-ray .................................................. 0.21 0.07 0.07 0.01 0.29 0.29 XXX 71015 .......... TC ...... A Chest x-ray .................................................. 0.00 0.48 NA 0.02 0.50 NA XXX 71020 .......... ............ A Chest x-ray .................................................. 0.22 0.68 NA 0.05 0.95 NA XXX 71020 .......... 26 ....... A Chest x-ray .................................................. 0.22 0.08 0.08 0.01 0.31 0.31 XXX 71020 .......... TC ...... A Chest x-ray .................................................. 0.00 0.60 NA 0.04 0.64 NA XXX 71021 .......... ............ A Chest x-ray .................................................. 0.27 0.81 NA 0.06 1.14 NA XXX 71021 .......... 26 ....... A Chest x-ray .................................................. 0.27 0.10 0.10 0.01 0.38 0.38 XXX 71021 .......... TC ...... A Chest x-ray .................................................. 0.00 0.72 NA 0.05 0.77 NA XXX 71022 .......... ............ A Chest x-ray .................................................. 0.31 0.83 NA 0.06 1.20 NA XXX 71022 .......... 26 ....... A Chest x-ray .................................................. 0.31 0.11 0.11 0.01 0.43 0.43 XXX 71022 .......... TC ...... A Chest x-ray .................................................. 0.00 0.73 NA 0.05 0.78 NA XXX 71023 .......... ............ A Chest x-ray and fluoroscopy ....................... 0.38 1.08 NA 0.06 1.52 NA XXX 71023 .......... 26 ....... A Chest x-ray and fluoroscopy ....................... 0.38 0.14 0.14 0.01 0.53 0.53 XXX 71023 .......... TC ...... A Chest x-ray and fluoroscopy ....................... 0.00 0.94 NA 0.05 0.99 NA XXX 71030 .......... ............ A Chest x-ray .................................................. 0.31 0.92 NA 0.06 1.29 NA XXX 71030 .......... 26 ....... A Chest x-ray .................................................. 0.31 0.11 0.11 0.01 0.43 0.43 XXX 71030 .......... TC ...... A Chest x-ray .................................................. 0.00 0.82 NA 0.05 0.87 NA XXX 71034 .......... ............ A Chest x-ray and fluoroscopy ....................... 0.46 1.72 NA 0.10 2.28 NA XXX 71034 .......... 26 ....... A Chest x-ray and fluoroscopy ....................... 0.46 0.17 0.17 0.02 0.65 0.65 XXX 71034 .......... TC ...... A Chest x-ray and fluoroscopy ....................... 0.00 1.55 NA 0.08 1.63 NA XXX 71035 .......... ............ A Chest x-ray .................................................. 0.18 0.66 NA 0.03 0.87 NA XXX 71035 .......... 26 ....... A Chest x-ray .................................................. 0.18 0.06 0.06 0.01 0.25 0.25 XXX 71035 .......... TC ...... A Chest x-ray .................................................. 0.00 0.59 NA 0.02 0.61 NA XXX 71040 .......... ............ A Contrast x-ray of bronchi ............................. 0.58 1.86 NA 0.11 2.55 NA XXX


## 45954

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

71040 .......... 26 ....... A Contrast x-ray of bronchi ............................. 0.58 0.20 0.20 0.03 0.81 0.81 XXX 71040 .......... TC ...... A Contrast x-ray of bronchi ............................. 0.00 1.66 NA 0.08 1.74 NA XXX 71060 .......... ............ A Contrast x-ray of bronchi ............................. 0.74 2.68 NA 0.16 3.58 NA XXX 71060 .......... 26 ....... A Contrast x-ray of bronchi ............................. 0.74 0.25 0.25 0.03 1.02 1.02 XXX 71060 .......... TC ...... A Contrast x-ray of bronchi ............................. 0.00 2.42 NA 0.13 2.55 NA XXX 71090 .......... ............ A X-ray & pacemaker insertion ....................... 0.54 NA NA 0.13 NA NA XXX 71090 .......... 26 ....... A X-ray & pacemaker insertion ....................... 0.54 0.22 0.22 0.02 0.78 0.78 XXX 71090 .......... TC ...... A X-ray & pacemaker insertion ....................... 0.00 NA NA 0.11 NA NA XXX 71100 .......... ............ A X-ray exam of ribs ....................................... 0.22 0.65 NA 0.05 0.92 NA XXX 71100 .......... 26 ....... A X-ray exam of ribs ....................................... 0.22 0.08 0.08 0.01 0.31 0.31 XXX 71100 .......... TC ...... A X-ray exam of ribs ....................................... 0.00 0.58 NA 0.04 0.62 NA XXX 71101 .......... ............ A X-ray exam of ribs/chest ............................. 0.27 0.78 NA 0.05 1.10 NA XXX 71101 .......... 26 ....... A X-ray exam of ribs/chest ............................. 0.27 0.10 0.10 0.01 0.38 0.38 XXX 71101 .......... TC ...... A X-ray exam of ribs/chest ............................. 0.00 0.68 NA 0.04 0.72 NA XXX 71110 .......... ............ A X-ray exam of ribs ....................................... 0.27 0.87 NA 0.06 1.20 NA XXX 71110 .......... 26 ....... A X-ray exam of ribs ....................................... 0.27 0.09 0.09 0.01 0.37 0.37 XXX 71110 .......... TC ...... A X-ray exam of ribs ....................................... 0.00 0.77 NA 0.05 0.82 NA XXX 71111 .......... ............ A X-ray exam of ribs/chest ............................. 0.32 1.03 NA 0.07 1.43 NA XXX 71111 .......... 26 ....... A X-ray exam of ribs/chest ............................. 0.32 0.11 0.11 0.01 0.44 0.44 XXX 71111 .......... TC ...... A X-ray exam of ribs/chest ............................. 0.00 0.93 NA 0.06 0.99 NA XXX 71120 .......... ............ A X-ray exam of breastbone ........................... 0.20 0.72 NA 0.05 0.97 NA XXX 71120 .......... 26 ....... A X-ray exam of breastbone ........................... 0.20 0.07 0.07 0.01 0.28 0.28 XXX 71120 .......... TC ...... A X-ray exam of breastbone ........................... 0.00 0.64 NA 0.04 0.68 NA XXX 71130 .......... ............ A X-ray exam of breastbone ........................... 0.22 0.79 NA 0.05 1.06 NA XXX 71130 .......... 26 ....... A X-ray exam of breastbone ........................... 0.22 0.08 0.08 0.01 0.31 0.31 XXX 71130 .......... TC ...... A X-ray exam of breastbone ........................... 0.00 0.72 NA 0.04 0.76 NA XXX 71250 .......... ............ A Ct thorax w/o dye ........................................ 1.16 6.29 NA 0.36 7.81 NA XXX 71250 .......... 26 ....... A Ct thorax w/o dye ........................................ 1.16 0.40 0.40 0.05 1.61 1.61 XXX 71250 .......... TC ...... A Ct thorax w/o dye ........................................ 0.00 5.89 NA 0.31 6.20 NA XXX 71260 .......... ............ A Ct thorax w/dye ........................................... 1.24 7.63 NA 0.42 9.30 NA XXX 71260 .......... 26 ....... A Ct thorax w/dye ........................................... 1.24 0.43 0.43 0.05 1.72 1.72 XXX 71260 .......... TC ...... A Ct thorax w/dye ........................................... 0.00 7.20 NA 0.37 7.57 NA XXX 71270 .......... ............ A Ct thorax w/o & w/dye ................................. 1.38 9.45 NA 0.52 11.35 NA XXX 71270 .......... 26 ....... A Ct thorax w/o & w/dye ................................. 1.38 0.47 0.47 0.06 1.92 1.92 XXX 71270 .......... TC ...... A Ct thorax w/o & w/dye ................................. 0.00 8.98 NA 0.46 9.44 NA XXX 71275 .......... ............ A Ct angiography, chest ................................. 1.92 12.83 NA 0.48 15.23 NA XXX 71275 .......... 26 ....... A Ct angiography, chest ................................. 1.92 0.66 0.66 0.09 2.68 2.68 XXX 71275 .......... TC ...... A Ct angiography, chest ................................. 0.00 12.17 NA 0.39 12.56 NA XXX 71550 .......... ............ A Mri chest w/o dye ........................................ 1.46 12.57 NA 0.51 14.55 NA XXX 71550 .......... 26 ....... A Mri chest w/o dye ........................................ 1.46 0.50 0.50 0.06 2.03 2.03 XXX 71550 .......... TC ...... A Mri chest w/o dye ........................................ 0.00 12.07 NA 0.45 12.52 NA XXX 71551 .......... ............ A Mri chest w/dye ........................................... 1.73 14.97 NA 0.60 17.30 NA XXX 71551 .......... 26 ....... A Mri chest w/dye ........................................... 1.73 0.60 0.60 0.08 2.41 2.41 XXX 71551 .......... TC ...... A Mri chest w/dye ........................................... 0.00 14.37 NA 0.52 14.89 NA XXX 71552 .......... ............ A Mri chest w/o & w/dye ................................. 2.26 24.34 NA 0.78 27.38 NA XXX 71552 .......... 26 ....... A Mri chest w/o & w/dye ................................. 2.26 0.78 0.78 0.10 3.14 3.14 XXX 71552 .......... TC ...... A Mri chest w/o & w/dye ................................. 0.00 23.56 NA 0.68 24.24 NA XXX 71555 .......... ............ R Mri angio chest w or w/o dye ...................... 1.81 12.49 NA 0.67 14.97 NA XXX 71555 .......... 26 ....... R Mri angio chest w or w/o dye ...................... 1.81 0.63 0.63 0.08 2.52 2.52 XXX 71555 .......... TC ...... R Mri angio chest w or w/o dye ...................... 0.00 11.86 NA 0.59 12.45 NA XXX 72010 .......... ............ A X-ray exam of spine .................................... 0.45 1.29 NA 0.08 1.82 NA XXX 72010 .......... 26 ....... A X-ray exam of spine .................................... 0.45 0.16 0.16 0.02 0.63 0.63 XXX 72010 .......... TC ...... A X-ray exam of spine .................................... 0.00 1.13 NA 0.06 1.19 NA XXX 72020 .......... ............ A X-ray exam of spine .................................... 0.15 0.48 NA 0.03 0.66 NA XXX 72020 .......... 26 ....... A X-ray exam of spine .................................... 0.15 0.05 0.05 0.01 0.21 0.21 XXX 72020 .......... TC ...... A X-ray exam of spine .................................... 0.00 0.43 NA 0.02 0.45 NA XXX 72040 .......... ............ A X-ray exam of neck spine ........................... 0.22 0.71 NA 0.05 0.98 NA XXX 72040 .......... 26 ....... A X-ray exam of neck spine ........................... 0.22 0.08 0.08 0.01 0.31 0.31 XXX 72040 .......... TC ...... A X-ray exam of neck spine ........................... 0.00 0.63 NA 0.04 0.67 NA XXX 72050 .......... ............ A X-ray exam of neck spine ........................... 0.31 1.04 NA 0.07 1.42 NA XXX 72050 .......... 26 ....... A X-ray exam of neck spine ........................... 0.31 0.11 0.11 0.01 0.43 0.43 XXX 72050 .......... TC ...... A X-ray exam of neck spine ........................... 0.00 0.93 NA 0.06 0.99 NA XXX 72052 .......... ............ A X-ray exam of neck spine ........................... 0.36 1.32 NA 0.08 1.76 NA XXX 72052 .......... 26 ....... A X-ray exam of neck spine ........................... 0.36 0.13 0.13 0.02 0.51 0.51 XXX 72052 .......... TC ...... A X-ray exam of neck spine ........................... 0.00 1.20 NA 0.06 1.26 NA XXX 72069 .......... ............ A X-ray exam of trunk spine ........................... 0.22 0.64 NA 0.03 0.89 NA XXX 72069 .......... 26 ....... A X-ray exam of trunk spine ........................... 0.22 0.08 0.08 0.01 0.31 0.31 XXX 72069 .......... TC ...... A X-ray exam of trunk spine ........................... 0.00 0.56 NA 0.02 0.58 NA XXX 72070 .......... ............ A X-ray exam of thoracic spine ...................... 0.22 0.72 NA 0.05 0.99 NA XXX 72070 .......... 26 ....... A X-ray exam of thoracic spine ...................... 0.22 0.08 0.08 0.01 0.31 0.31 XXX 72070 .......... TC ...... A X-ray exam of thoracic spine ...................... 0.00 0.65 NA 0.04 0.69 NA XXX 72072 .......... ............ A X-ray exam of thoracic spine ...................... 0.22 0.82 NA 0.06 1.10 NA XXX 72072 .......... 26 ....... A X-ray exam of thoracic spine ...................... 0.22 0.08 0.08 0.01 0.31 0.31 XXX 72072 .......... TC ...... A X-ray exam of thoracic spine ...................... 0.00 0.75 NA 0.05 0.80 NA XXX


## 45955

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

72074 .......... ............ A X-ray exam of thoracic spine ...................... 0.22 1.00 NA 0.07 1.29 NA XXX 72074 .......... 26 ....... A X-ray exam of thoracic spine ...................... 0.22 0.08 0.08 0.01 0.31 0.31 XXX 72074 .......... TC ...... A X-ray exam of thoracic spine ...................... 0.00 0.93 NA 0.06 0.99 NA XXX 72080 .......... ............ A X-ray exam of trunk spine ........................... 0.22 0.74 NA 0.05 1.01 NA XXX 72080 .......... 26 ....... A X-ray exam of trunk spine ........................... 0.22 0.08 0.08 0.01 0.31 0.31 XXX 72080 .......... TC ...... A X-ray exam of trunk spine ........................... 0.00 0.67 NA 0.04 0.71 NA XXX 72090 .......... ............ A X-ray exam of trunk spine ........................... 0.28 0.85 NA 0.05 1.18 NA XXX 72090 .......... 26 ....... A X-ray exam of trunk spine ........................... 0.28 0.10 0.10 0.01 0.39 0.39 XXX 72090 .......... TC ...... A X-ray exam of trunk spine ........................... 0.00 0.76 NA 0.04 0.80 NA XXX 72100 .......... ............ A X-ray exam of lower spine .......................... 0.22 0.77 NA 0.05 1.04 NA XXX 72100 .......... 26 ....... A X-ray exam of lower spine .......................... 0.22 0.08 0.08 0.01 0.31 0.31 XXX 72100 .......... TC ...... A X-ray exam of lower spine .......................... 0.00 0.70 NA 0.04 0.74 NA XXX 72110 .......... ............ A X-ray exam of lower spine .......................... 0.31 1.08 NA 0.07 1.46 NA XXX 72110 .......... 26 ....... A X-ray exam of lower spine .......................... 0.31 0.11 0.11 0.01 0.43 0.43 XXX 72110 .......... TC ...... A X-ray exam of lower spine .......................... 0.00 0.97 NA 0.06 1.03 NA XXX 72114 .......... ............ A X-ray exam of lower spine .......................... 0.36 1.41 NA 0.08 1.85 NA XXX 72114 .......... 26 ....... A X-ray exam of lower spine .......................... 0.36 0.13 0.13 0.02 0.51 0.51 XXX 72114 .......... TC ...... A X-ray exam of lower spine .......................... 0.00 1.29 NA 0.06 1.35 NA XXX 72120 .......... ............ A X-ray exam of lower spine .......................... 0.22 1.00 NA 0.07 1.29 NA XXX 72120 .......... 26 ....... A X-ray exam of lower spine .......................... 0.22 0.07 0.07 0.01 0.30 0.30 XXX 72120 .......... TC ...... A X-ray exam of lower spine .......................... 0.00 0.93 NA 0.06 0.99 NA XXX 72125 .......... ............ A Ct neck spine w/o dye ................................. 1.16 6.29 NA 0.36 7.81 NA XXX 72125 .......... 26 ....... A Ct neck spine w/o dye ................................. 1.16 0.40 0.40 0.05 1.61 1.61 XXX 72125 .......... TC ...... A Ct neck spine w/o dye ................................. 0.00 5.89 NA 0.31 6.20 NA XXX 72126 .......... ............ A Ct neck spine w/dye .................................... 1.22 7.60 NA 0.42 9.25 NA XXX 72126 .......... 26 ....... A Ct neck spine w/dye .................................... 1.22 0.42 0.42 0.05 1.69 1.69 XXX 72126 .......... TC ...... A Ct neck spine w/dye .................................... 0.00 7.18 NA 0.37 7.55 NA XXX 72127 .......... ............ A Ct neck spine w/o & w/dye ......................... 1.27 9.40 NA 0.52 11.19 NA XXX 72127 .......... 26 ....... A Ct neck spine w/o & w/dye ......................... 1.27 0.44 0.44 0.06 1.77 1.77 XXX 72127 .......... TC ...... A Ct neck spine w/o & w/dye ......................... 0.00 8.96 NA 0.46 9.42 NA XXX 72128 .......... ............ A Ct chest spine w/o dye ................................ 1.16 6.29 NA 0.36 7.81 NA XXX 72128 .......... 26 ....... A Ct chest spine w/o dye ................................ 1.16 0.40 0.40 0.05 1.61 1.61 XXX 72128 .......... TC ...... A Ct chest spine w/o dye ................................ 0.00 5.89 NA 0.31 6.20 NA XXX 72129 .......... ............ A Ct chest spine w/dye ................................... 1.22 7.58 NA 0.42 9.22 NA XXX 72129 .......... 26 ....... A Ct chest spine w/dye ................................... 1.22 0.42 0.42 0.05 1.69 1.69 XXX 72129 .......... TC ...... A Ct chest spine w/dye ................................... 0.00 7.15 NA 0.37 7.52 NA XXX 72130 .......... ............ A Ct chest spine w/o & w/dye ........................ 1.27 9.44 NA 0.52 11.23 NA XXX 72130 .......... 26 ....... A Ct chest spine w/o & w/dye ........................ 1.27 0.44 0.44 0.06 1.77 1.77 XXX 72130 .......... TC ...... A Ct chest spine w/o & w/dye ........................ 0.00 9.00 NA 0.46 9.46 NA XXX 72131 .......... ............ A Ct lumbar spine w/o dye ............................. 1.16 6.30 NA 0.36 7.82 NA XXX 72131 .......... 26 ....... A Ct lumbar spine w/o dye ............................. 1.16 0.40 0.40 0.05 1.61 1.61 XXX 72131 .......... TC ...... A Ct lumbar spine w/o dye ............................. 0.00 5.90 NA 0.31 6.21 NA XXX 72132 .......... ............ A Ct lumbar spine w/dye ................................ 1.22 7.57 NA 0.42 9.22 NA XXX 72132 .......... 26 ....... A Ct lumbar spine w/dye ................................ 1.22 0.42 0.42 0.05 1.69 1.69 XXX 72132 .......... TC ...... A Ct lumbar spine w/dye ................................ 0.00 7.15 NA 0.37 7.52 NA XXX 72133 .......... ............ A Ct lumbar spine w/o & w/dye ...................... 1.27 9.42 NA 0.52 11.22 NA XXX 72133 .......... 26 ....... A Ct lumbar spine w/o & w/dye ...................... 1.27 0.44 0.44 0.06 1.77 1.77 XXX 72133 .......... TC ...... A Ct lumbar spine w/o & w/dye ...................... 0.00 8.98 NA 0.46 9.44 NA XXX 72141 .......... ............ A Mri neck spine w/o dye ............................... 1.60 11.72 NA 0.66 13.99 NA XXX 72141 .......... 26 ....... A Mri neck spine w/o dye ............................... 1.60 0.56 0.56 0.07 2.23 2.23 XXX 72141 .......... TC ...... A Mri neck spine w/o dye ............................... 0.00 11.17 NA 0.59 11.76 NA XXX 72142 .......... ............ A Mri neck spine w/dye .................................. 1.92 14.23 NA 0.79 16.94 NA XXX 72142 .......... 26 ....... A Mri neck spine w/dye .................................. 1.92 0.67 0.67 0.09 2.68 2.68 XXX 72142 .......... TC ...... A Mri neck spine w/dye .................................. 0.00 13.56 NA 0.70 14.26 NA XXX 72146 .......... ............ A Mri chest spine w/o dye .............................. 1.60 12.68 NA 0.71 14.99 NA XXX 72146 .......... 26 ....... A Mri chest spine w/o dye .............................. 1.60 0.56 0.56 0.07 2.23 2.23 XXX 72146 .......... TC ...... A Mri chest spine w/o dye .............................. 0.00 12.12 NA 0.64 12.76 NA XXX 72147 .......... ............ A Mri chest spine w/dye ................................. 1.92 13.76 NA 0.79 16.48 NA XXX 72147 .......... 26 ....... A Mri chest spine w/dye ................................. 1.92 0.66 0.66 0.09 2.68 2.68 XXX 72147 .......... TC ...... A Mri chest spine w/dye ................................. 0.00 13.10 NA 0.70 13.80 NA XXX 72148 .......... ............ A Mri lumbar spine w/o dye ............................ 1.48 12.61 NA 0.71 14.80 NA XXX 72148 .......... 26 ....... A Mri lumbar spine w/o dye ............................ 1.48 0.51 0.51 0.07 2.07 2.07 XXX 72148 .......... TC ...... A Mri lumbar spine w/o dye ............................ 0.00 12.10 NA 0.64 12.74 NA XXX 72149 .......... ............ A Mri lumbar spine w/dye ............................... 1.78 14.26 NA 0.78 16.82 NA XXX 72149 .......... 26 ....... A Mri lumbar spine w/dye ............................... 1.78 0.63 0.63 0.08 2.49 2.49 XXX 72149 .......... TC ...... A Mri lumbar spine w/dye ............................... 0.00 13.63 NA 0.70 14.33 NA XXX 72156 .......... ............ A Mri neck spine w/o & w/dye ........................ 2.58 23.52 NA 1.42 27.52 NA XXX 72156 .......... 26 ....... A Mri neck spine w/o & w/dye ........................ 2.58 0.89 0.89 0.11 3.57 3.57 XXX 72156 .......... TC ...... A Mri neck spine w/o & w/dye ........................ 0.00 22.63 NA 1.31 23.94 NA XXX 72157 .......... ............ A Mri chest spine w/o & w/dye ....................... 2.58 23.15 NA 1.42 27.15 NA XXX 72157 .......... 26 ....... A Mri chest spine w/o & w/dye ....................... 2.58 0.88 0.88 0.11 3.57 3.57 XXX 72157 .......... TC ...... A Mri chest spine w/o & w/dye ....................... 0.00 22.27 NA 1.31 23.58 NA XXX 72158 .......... ............ A Mri lumbar spine w/o & w/dye ..................... 2.36 23.45 NA 1.41 27.22 NA XXX 72158 .......... 26 ....... A Mri lumbar spine w/o & w/dye ..................... 2.36 0.82 0.82 0.10 3.28 3.28 XXX


## 45956

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

72158 .......... TC ...... A Mri lumbar spine w/o & w/dye ..................... 0.00 22.63 NA 1.31 23.94 NA XXX 72159 .......... ............ N Mr angio spine w/o&w/dye .......................... 1.80 13.69 NA 0.74 16.23 NA XXX 72159 .......... 26 ....... N Mr angio spine w/o&w/dye .......................... 1.80 0.69 0.69 0.10 2.59 2.59 XXX 72159 .......... TC ...... N Mr angio spine w/o&w/dye .......................... 0.00 13.00 NA 0.64 13.64 NA XXX 72170 .......... ............ A X-ray exam of pelvis ................................... 0.17 0.57 NA 0.03 0.77 NA XXX 72170 .......... 26 ....... A X-ray exam of pelvis ................................... 0.17 0.06 0.06 0.01 0.24 0.24 XXX 72170 .......... TC ...... A X-ray exam of pelvis ................................... 0.00 0.51 NA 0.02 0.53 NA XXX 72190 .......... ............ A X-ray exam of pelvis ................................... 0.21 0.78 NA 0.05 1.04 NA XXX 72190 .......... 26 ....... A X-ray exam of pelvis ................................... 0.21 0.07 0.07 0.01 0.29 0.29 XXX 72190 .......... TC ...... A X-ray exam of pelvis ................................... 0.00 0.71 NA 0.04 0.75 NA XXX 72191 .......... ............ A Ct angiograph pelv w/o&w/dye ................... 1.81 12.28 NA 0.47 14.56 NA XXX 72191 .......... 26 ....... A Ct angiograph pelv w/o&w/dye ................... 1.81 0.62 0.62 0.08 2.52 2.52 XXX 72191 .......... TC ...... A Ct angiograph pelv w/o&w/dye ................... 0.00 11.66 NA 0.39 12.05 NA XXX 72192 .......... ............ A Ct pelvis w/o dye ......................................... 1.09 6.18 NA 0.36 7.63 NA XXX 72192 .......... 26 ....... A Ct pelvis w/o dye ......................................... 1.09 0.38 0.38 0.05 1.52 1.52 XXX 72192 .......... TC ...... A Ct pelvis w/o dye ......................................... 0.00 5.80 NA 0.31 6.11 NA XXX 72193 .......... ............ A Ct pelvis w/dye ............................................ 1.16 7.32 NA 0.41 8.89 NA XXX 72193 .......... 26 ....... A Ct pelvis w/dye ............................................ 1.16 0.40 0.40 0.05 1.61 1.61 XXX 72193 .......... TC ...... A Ct pelvis w/dye ............................................ 0.00 6.92 NA 0.36 7.28 NA XXX 72194 .......... ............ A Ct pelvis w/o & w/dye .................................. 1.22 9.11 NA 0.48 10.81 NA XXX 72194 .......... 26 ....... A Ct pelvis w/o & w/dye .................................. 1.22 0.42 0.42 0.05 1.69 1.69 XXX 72194 .......... TC ...... A Ct pelvis w/o & w/dye .................................. 0.00 8.69 NA 0.43 9.12 NA XXX 72195 .......... ............ A Mri pelvis w/o dye ....................................... 1.46 12.01 NA 0.51 13.98 NA XXX 72195 .......... 26 ....... A Mri pelvis w/o dye ....................................... 1.46 0.50 0.50 0.06 2.03 2.03 XXX 72195 .......... TC ...... A Mri pelvis w/o dye ....................................... 0.00 11.50 NA 0.45 11.95 NA XXX 72196 .......... ............ A Mri pelvis w/dye ........................................... 1.73 14.11 NA 0.60 16.44 NA XXX 72196 .......... 26 ....... A Mri pelvis w/dye ........................................... 1.73 0.60 0.60 0.08 2.41 2.41 XXX 72196 .......... TC ...... A Mri pelvis w/dye ........................................... 0.00 13.51 NA 0.52 14.03 NA XXX 72197 .......... ............ A Mri pelvis w/o & w/dye ................................ 2.26 23.58 NA 1.02 26.87 NA XXX 72197 .......... 26 ....... A Mri pelvis w/o & w/dye ................................ 2.26 0.78 0.78 0.10 3.14 3.14 XXX 72197 .......... TC ...... A Mri pelvis w/o & w/dye ................................ 0.00 22.81 NA 0.92 23.73 NA XXX 72198 .......... ............ A Mr angio pelvis w/o & w/dye ....................... 1.80 12.37 NA 0.67 14.85 NA XXX 72198 .......... 26 ....... A Mr angio pelvis w/o & w/dye ....................... 1.80 0.62 0.62 0.08 2.50 2.50 XXX 72198 .......... TC ...... A Mr angio pelvis w/o & w/dye ....................... 0.00 11.75 NA 0.59 12.34 NA XXX 72200 .......... ............ A X-ray exam sacroiliac joints ........................ 0.17 0.61 NA 0.03 0.81 NA XXX 72200 .......... 26 ....... A X-ray exam sacroiliac joints ........................ 0.17 0.06 0.06 0.01 0.24 0.24 XXX 72200 .......... TC ...... A X-ray exam sacroiliac joints ........................ 0.00 0.54 NA 0.02 0.56 NA XXX 72202 .......... ............ A X-ray exam sacroiliac joints ........................ 0.19 0.72 NA 0.05 0.96 NA XXX 72202 .......... 26 ....... A X-ray exam sacroiliac joints ........................ 0.19 0.06 0.06 0.01 0.26 0.26 XXX 72202 .......... TC ...... A X-ray exam sacroiliac joints ........................ 0.00 0.66 NA 0.04 0.70 NA XXX 72220 .......... ............ A X-ray exam of tailbone ................................ 0.17 0.63 NA 0.05 0.85 NA XXX 72220 .......... 26 ....... A X-ray exam of tailbone ................................ 0.17 0.06 0.06 0.01 0.24 0.24 XXX 72220 .......... TC ...... A X-ray exam of tailbone ................................ 0.00 0.57 NA 0.04 0.61 NA XXX 72240 .......... ............ A Contrast x-ray of neck spine ....................... 0.91 4.45 NA 0.29 5.66 NA XXX 72240 .......... 26 ....... A Contrast x-ray of neck spine ....................... 0.91 0.30 0.30 0.04 1.25 1.25 XXX 72240 .......... TC ...... A Contrast x-ray of neck spine ....................... 0.00 4.15 NA 0.25 4.40 NA XXX 72255 .......... ............ A Contrast x-ray, thorax spine ........................ 0.91 4.03 NA 0.26 5.20 NA XXX 72255 .......... 26 ....... A Contrast x-ray, thorax spine ........................ 0.91 0.28 0.28 0.04 1.23 1.23 XXX 72255 .......... TC ...... A Contrast x-ray, thorax spine ........................ 0.00 3.74 NA 0.22 3.96 NA XXX 72265 .......... ............ A Contrast x-ray, lower spine ......................... 0.83 3.91 NA 0.26 5.00 NA XXX 72265 .......... 26 ....... A Contrast x-ray, lower spine ......................... 0.83 0.26 0.26 0.04 1.13 1.13 XXX 72265 .......... TC ...... A Contrast x-ray, lower spine ......................... 0.00 3.65 NA 0.22 3.87 NA XXX 72270 .......... ............ A Contrast x-ray, spine ................................... 1.33 5.96 NA 0.39 7.68 NA XXX 72270 .......... 26 ....... A Contrast x-ray, spine ................................... 1.33 0.44 0.44 0.06 1.83 1.83 XXX 72270 .......... TC ...... A Contrast x-ray, spine ................................... 0.00 5.52 NA 0.33 5.85 NA XXX 72275 .......... ............ A Epidurography ............................................. 0.76 2.22 NA 0.26 3.25 NA XXX 72275 .......... 26 ....... A Epidurography ............................................. 0.76 0.20 0.20 0.04 1.00 1.00 XXX 72275 .......... TC ...... A Epidurography ............................................. 0.00 2.03 NA 0.22 2.25 NA XXX 72285 .......... ............ A X-ray c/t spine disk ...................................... 1.16 7.10 NA 0.50 8.76 NA XXX 72285 .......... 26 ....... A X-ray c/t spine disk ...................................... 1.16 0.37 0.37 0.07 1.60 1.60 XXX 72285 .......... TC ...... A X-ray c/t spine disk ...................................... 0.00 6.73 NA 0.43 7.16 NA XXX 72295 .......... ............ A X-ray of lower spine disk ............................. 0.83 6.61 NA 0.46 7.90 NA XXX 72295 .......... 26 ....... A X-ray of lower spine disk ............................. 0.83 0.28 0.28 0.06 1.17 1.17 XXX 72295 .......... TC ...... A X-ray of lower spine disk ............................. 0.00 6.34 NA 0.40 6.74 NA XXX 73000 .......... ............ A X-ray exam of collar bone ........................... 0.16 0.57 NA 0.03 0.76 NA XXX 73000 .......... 26 ....... A X-ray exam of collar bone ........................... 0.16 0.05 0.05 0.01 0.22 0.22 XXX 73000 .......... TC ...... A X-ray exam of collar bone ........................... 0.00 0.52 NA 0.02 0.54 NA XXX 73010 .......... ............ A X-ray exam of shoulder blade ..................... 0.17 0.59 NA 0.03 0.79 NA XXX 73010 .......... 26 ....... A X-ray exam of shoulder blade ..................... 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73010 .......... TC ...... A X-ray exam of shoulder blade ..................... 0.00 0.52 NA 0.02 0.54 NA XXX 73020 .......... ............ A X-ray exam of shoulder ............................... 0.15 0.51 NA 0.03 0.69 NA XXX 73020 .......... 26 ....... A X-ray exam of shoulder ............................... 0.15 0.05 0.05 0.01 0.21 0.21 XXX 73020 .......... TC ...... A X-ray exam of shoulder ............................... 0.00 0.45 NA 0.02 0.47 NA XXX 73030 .......... ............ A X-ray exam of shoulder ............................... 0.18 0.62 NA 0.05 0.85 NA XXX


## 45957

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

73030 .......... 26 ....... A X-ray exam of shoulder ............................... 0.18 0.06 0.06 0.01 0.25 0.25 XXX 73030 .......... TC ...... A X-ray exam of shoulder ............................... 0.00 0.56 NA 0.04 0.60 NA XXX 73040 .......... ............ A Contrast x-ray of shoulder ........................... 0.54 2.30 NA 0.14 2.99 NA XXX 73040 .......... 26 ....... A Contrast x-ray of shoulder ........................... 0.54 0.19 0.19 0.02 0.75 0.75 XXX 73040 .......... TC ...... A Contrast x-ray of shoulder ........................... 0.00 2.11 NA 0.12 2.23 NA XXX 73050 .......... ............ A X-ray exam of shoulders ............................. 0.20 0.74 NA 0.05 0.99 NA XXX 73050 .......... 26 ....... A X-ray exam of shoulders ............................. 0.20 0.07 0.07 0.01 0.28 0.28 XXX 73050 .......... TC ...... A X-ray exam of shoulders ............................. 0.00 0.67 NA 0.04 0.71 NA XXX 73060 .......... ............ A X-ray exam of humerus ............................... 0.17 0.63 NA 0.05 0.85 NA XXX 73060 .......... 26 ....... A X-ray exam of humerus ............................... 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73060 .......... TC ...... A X-ray exam of humerus ............................... 0.00 0.57 NA 0.04 0.61 NA XXX 73070 .......... ............ A X-ray exam of elbow ................................... 0.15 0.57 NA 0.03 0.75 NA XXX 73070 .......... 26 ....... A X-ray exam of elbow ................................... 0.15 0.05 0.05 0.01 0.21 0.21 XXX 73070 .......... TC ...... A X-ray exam of elbow ................................... 0.00 0.52 NA 0.02 0.54 NA XXX 73080 .......... ............ A X-ray exam of elbow ................................... 0.17 0.67 NA 0.05 0.89 NA XXX 73080 .......... 26 ....... A X-ray exam of elbow ................................... 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73080 .......... TC ...... A X-ray exam of elbow ................................... 0.00 0.61 NA 0.04 0.65 NA XXX 73085 .......... ............ A Contrast x-ray of elbow ............................... 0.54 2.20 NA 0.14 2.88 NA XXX 73085 .......... 26 ....... A Contrast x-ray of elbow ............................... 0.54 0.19 0.19 0.02 0.75 0.75 XXX 73085 .......... TC ...... A Contrast x-ray of elbow ............................... 0.00 2.01 NA 0.12 2.13 NA XXX 73090 .......... ............ A X-ray exam of forearm ................................ 0.16 0.58 NA 0.03 0.77 NA XXX 73090 .......... 26 ....... A X-ray exam of forearm ................................ 0.16 0.05 0.05 0.01 0.22 0.22 XXX 73090 .......... TC ...... A X-ray exam of forearm ................................ 0.00 0.53 NA 0.02 0.55 NA XXX 73092 .......... ............ A X-ray exam of arm, infant ........................... 0.16 0.56 NA 0.03 0.75 NA XXX 73092 .......... 26 ....... A X-ray exam of arm, infant ........................... 0.16 0.05 0.05 0.01 0.22 0.22 XXX 73092 .......... TC ...... A X-ray exam of arm, infant ........................... 0.00 0.51 NA 0.02 0.53 NA XXX 73100 .......... ............ A X-ray exam of wrist ..................................... 0.16 0.55 NA 0.03 0.74 NA XXX 73100 .......... 26 ....... A X-ray exam of wrist ..................................... 0.16 0.05 0.05 0.01 0.22 0.22 XXX 73100 .......... TC ...... A X-ray exam of wrist ..................................... 0.00 0.50 NA 0.02 0.52 NA XXX 73110 .......... ............ A X-ray exam of wrist ..................................... 0.17 0.65 NA 0.03 0.85 NA XXX 73110 .......... 26 ....... A X-ray exam of wrist ..................................... 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73110 .......... TC ...... A X-ray exam of wrist ..................................... 0.00 0.59 NA 0.02 0.61 NA XXX 73115 .......... ............ A Contrast x-ray of wrist ................................. 0.54 1.95 NA 0.12 2.61 NA XXX 73115 .......... 26 ....... A Contrast x-ray of wrist ................................. 0.54 0.19 0.19 0.02 0.75 0.75 XXX 73115 .......... TC ...... A Contrast x-ray of wrist ................................. 0.00 1.76 NA 0.10 1.86 NA XXX 73120 .......... ............ A X-ray exam of hand ..................................... 0.16 0.56 NA 0.03 0.75 NA XXX 73120 .......... 26 ....... A X-ray exam of hand ..................................... 0.16 0.05 0.05 0.01 0.22 0.22 XXX 73120 .......... TC ...... A X-ray exam of hand ..................................... 0.00 0.51 NA 0.02 0.53 NA XXX 73130 .......... ............ A X-ray exam of hand ..................................... 0.17 0.62 NA 0.03 0.82 NA XXX 73130 .......... 26 ....... A X-ray exam of hand ..................................... 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73130 .......... TC ...... A X-ray exam of hand ..................................... 0.00 0.56 NA 0.02 0.58 NA XXX 73140 .......... ............ A X-ray exam of finger(s) ............................... 0.13 0.52 NA 0.03 0.68 NA XXX 73140 .......... 26 ....... A X-ray exam of finger(s) ............................... 0.13 0.04 0.04 0.01 0.18 0.18 XXX 73140 .......... TC ...... A X-ray exam of finger(s) ............................... 0.00 0.47 NA 0.02 0.49 NA XXX 73200 .......... ............ A Ct upper extremity w/o dye ......................... 1.09 5.54 NA 0.30 6.93 NA XXX 73200 .......... 26 ....... A Ct upper extremity w/o dye ......................... 1.09 0.38 0.38 0.05 1.52 1.52 XXX 73200 .......... TC ...... A Ct upper extremity w/o dye ......................... 0.00 5.16 NA 0.25 5.41 NA XXX 73201 .......... ............ A Ct upper extremity w/dye ............................ 1.16 6.72 NA 0.36 8.24 NA XXX 73201 .......... 26 ....... A Ct upper extremity w/dye ............................ 1.16 0.40 0.40 0.05 1.61 1.61 XXX 73201 .......... TC ...... A Ct upper extremity w/dye ............................ 0.00 6.32 NA 0.31 6.63 NA XXX 73202 .......... ............ A Ct uppr extremity w/o&w/dye ...................... 1.22 8.51 NA 0.44 10.17 NA XXX 73202 .......... 26 ....... A Ct uppr extremity w/o&w/dye ...................... 1.22 0.42 0.42 0.05 1.69 1.69 XXX 73202 .......... TC ...... A Ct uppr extremity w/o&w/dye ...................... 0.00 8.09 NA 0.39 8.48 NA XXX 73206 .......... ............ A Ct angio upr extrm w/o&w/dye .................... 1.81 11.18 NA 0.47 13.47 NA XXX 73206 .......... 26 ....... A Ct angio upr extrm w/o&w/dye .................... 1.81 0.62 0.62 0.08 2.51 2.51 XXX 73206 .......... TC ...... A Ct angio upr extrm w/o&w/dye .................... 0.00 10.56 NA 0.39 10.95 NA XXX 73218 .......... ............ A Mri upper extremity w/o dye ........................ 1.35 11.98 NA 0.45 13.78 NA XXX 73218 .......... 26 ....... A Mri upper extremity w/o dye ........................ 1.35 0.46 0.46 0.06 1.88 1.88 XXX 73218 .......... TC ...... A Mri upper extremity w/o dye ........................ 0.00 11.52 NA 0.39 11.91 NA XXX 73219 .......... ............ A Mri upper extremity w/dye ........................... 1.62 14.47 NA 0.54 16.63 NA XXX 73219 .......... 26 ....... A Mri upper extremity w/dye ........................... 1.62 0.56 0.56 0.07 2.26 2.26 XXX 73219 .......... TC ...... A Mri upper extremity w/dye ........................... 0.00 13.90 NA 0.47 14.37 NA XXX 73220 .......... ............ A Mri uppr extremity w/o&w/dye ..................... 2.15 23.76 NA 0.94 26.86 NA XXX 73220 .......... 26 ....... A Mri uppr extremity w/o&w/dye ..................... 2.15 0.75 0.75 0.10 3.00 3.00 XXX 73220 .......... TC ...... A Mri uppr extremity w/o&w/dye ..................... 0.00 23.02 NA 0.84 23.86 NA XXX 73221 .......... ............ A Mri joint upr extrem w/o dye ....................... 1.35 11.84 NA 0.45 13.64 NA XXX 73221 .......... 26 ....... A Mri joint upr extrem w/o dye ....................... 1.35 0.46 0.46 0.06 1.88 1.88 XXX 73221 .......... TC ...... A Mri joint upr extrem w/o dye ....................... 0.00 11.38 NA 0.39 11.77 NA XXX 73222 .......... ............ A Mri joint upr extrem w/dye ........................... 1.62 13.74 NA 0.54 15.91 NA XXX 73222 .......... 26 ....... A Mri joint upr extrem w/dye ........................... 1.62 0.56 0.56 0.07 2.25 2.25 XXX 73222 .......... TC ...... A Mri joint upr extrem w/dye ........................... 0.00 13.18 NA 0.47 13.65 NA XXX 73223 .......... ............ A Mri joint upr extr w/o&w/dye ........................ 2.15 23.20 NA 0.94 26.30 NA XXX 73223 .......... 26 ....... A Mri joint upr extr w/o&w/dye ........................ 2.15 0.74 0.74 0.10 3.00 3.00 XXX 73223 .......... TC ...... A Mri joint upr extr w/o&w/dye ........................ 0.00 22.46 NA 0.84 23.30 NA XXX


## 45958

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

73225 .......... ............ N Mr angio upr extr w/o&w/dye ...................... 1.73 12.75 NA 0.69 15.17 NA XXX 73225 .......... 26 ....... N Mr angio upr extr w/o&w/dye ...................... 1.73 0.66 0.66 0.10 2.50 2.50 XXX 73225 .......... TC ...... N Mr angio upr extr w/o&w/dye ...................... 0.00 12.09 NA 0.59 12.68 NA XXX 73500 .......... ............ A X-ray exam of hip ........................................ 0.17 0.52 NA 0.03 0.72 NA XXX 73500 .......... 26 ....... A X-ray exam of hip ........................................ 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73500 .......... TC ...... A X-ray exam of hip ........................................ 0.00 0.46 NA 0.02 0.48 NA XXX 73510 .......... ............ A X-ray exam of hip ........................................ 0.21 0.69 NA 0.05 0.95 NA XXX 73510 .......... 26 ....... A X-ray exam of hip ........................................ 0.21 0.07 0.07 0.01 0.29 0.29 XXX 73510 .......... TC ...... A X-ray exam of hip ........................................ 0.00 0.61 NA 0.04 0.65 NA XXX 73520 .......... ............ A X-ray exam of hips ...................................... 0.26 0.78 NA 0.05 1.09 NA XXX 73520 .......... 26 ....... A X-ray exam of hips ...................................... 0.26 0.09 0.09 0.01 0.36 0.36 XXX 73520 .......... TC ...... A X-ray exam of hips ...................................... 0.00 0.69 NA 0.04 0.73 NA XXX 73525 .......... ............ A Contrast x-ray of hip .................................... 0.54 2.24 NA 0.15 2.94 NA XXX 73525 .......... 26 ....... A Contrast x-ray of hip .................................... 0.54 0.19 0.19 0.03 0.76 0.76 XXX 73525 .......... TC ...... A Contrast x-ray of hip .................................... 0.00 2.06 NA 0.12 2.18 NA XXX 73530 .......... ............ A X-ray exam of hip ........................................ 0.29 NA NA 0.03 NA NA XXX 73530 .......... 26 ....... A X-ray exam of hip ........................................ 0.29 0.10 0.10 0.01 0.40 0.40 XXX 73530 .......... TC ...... A X-ray exam of hip ........................................ 0.00 NA NA 0.02 NA NA XXX 73540 .......... ............ A X-ray exam of pelvis & hips ........................ 0.20 0.67 NA 0.05 0.92 NA XXX 73540 .......... 26 ....... A X-ray exam of pelvis & hips ........................ 0.20 0.07 0.07 0.01 0.28 0.28 XXX 73540 .......... TC ...... A X-ray exam of pelvis & hips ........................ 0.00 0.60 NA 0.04 0.64 NA XXX 73542 .......... ............ A X-ray exam, sacroiliac joint ......................... 0.59 2.05 NA 0.15 2.79 NA XXX 73542 .......... 26 ....... A X-ray exam, sacroiliac joint ......................... 0.59 0.16 0.16 0.03 0.78 0.78 XXX 73542 .......... TC ...... A X-ray exam, sacroiliac joint ......................... 0.00 1.89 NA 0.12 2.01 NA XXX 73550 .......... ............ A X-ray exam of thigh ..................................... 0.17 0.62 NA 0.05 0.84 NA XXX 73550 .......... 26 ....... A X-ray exam of thigh ..................................... 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73550 .......... TC ...... A X-ray exam of thigh ..................................... 0.00 0.56 NA 0.04 0.60 NA XXX 73560 .......... ............ A X-ray exam of knee, 1 or 2 ......................... 0.17 0.59 NA 0.03 0.79 NA XXX 73560 .......... 26 ....... A X-ray exam of knee, 1 or 2 ......................... 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73560 .......... TC ...... A X-ray exam of knee, 1 or 2 ......................... 0.00 0.52 NA 0.02 0.54 NA XXX 73562 .......... ............ A X-ray exam of knee, 3 ................................. 0.18 0.66 NA 0.05 0.89 NA XXX 73562 .......... 26 ....... A X-ray exam of knee, 3 ................................. 0.18 0.06 0.06 0.01 0.25 0.25 XXX 73562 .......... TC ...... A X-ray exam of knee, 3 ................................. 0.00 0.59 NA 0.04 0.63 NA XXX 73564 .......... ............ A X-ray exam, knee, 4 or more ...................... 0.22 0.74 NA 0.05 1.01 NA XXX 73564 .......... 26 ....... A X-ray exam, knee, 4 or more ...................... 0.22 0.08 0.08 0.01 0.31 0.31 XXX 73564 .......... TC ...... A X-ray exam, knee, 4 or more ...................... 0.00 0.67 NA 0.04 0.71 NA XXX 73565 .......... ............ A X-ray exam of knees ................................... 0.17 0.57 NA 0.03 0.77 NA XXX 73565 .......... 26 ....... A X-ray exam of knees ................................... 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73565 .......... TC ...... A X-ray exam of knees ................................... 0.00 0.50 NA 0.02 0.52 NA XXX 73580 .......... ............ A Contrast x-ray of knee joint ......................... 0.54 2.71 NA 0.17 3.42 NA XXX 73580 .......... 26 ....... A Contrast x-ray of knee joint ......................... 0.54 0.18 0.18 0.03 0.75 0.75 XXX 73580 .......... TC ...... A Contrast x-ray of knee joint ......................... 0.00 2.53 NA 0.14 2.67 NA XXX 73590 .......... ............ A X-ray exam of lower leg .............................. 0.17 0.58 NA 0.03 0.78 NA XXX 73590 .......... 26 ....... A X-ray exam of lower leg .............................. 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73590 .......... TC ...... A X-ray exam of lower leg .............................. 0.00 0.52 NA 0.02 0.54 NA XXX 73592 .......... ............ A X-ray exam of leg, infant ............................. 0.16 0.56 NA 0.03 0.75 NA XXX 73592 .......... 26 ....... A X-ray exam of leg, infant ............................. 0.16 0.05 0.05 0.01 0.22 0.22 XXX 73592 .......... TC ...... A X-ray exam of leg, infant ............................. 0.00 0.51 NA 0.02 0.53 NA XXX 73600 .......... ............ A X-ray exam of ankle .................................... 0.16 0.55 NA 0.03 0.74 NA XXX 73600 .......... 26 ....... A X-ray exam of ankle .................................... 0.16 0.05 0.05 0.01 0.22 0.22 XXX 73600 .......... TC ...... A X-ray exam of ankle .................................... 0.00 0.50 NA 0.02 0.52 NA XXX 73610 .......... ............ A X-ray exam of ankle .................................... 0.17 0.62 NA 0.03 0.82 NA XXX 73610 .......... 26 ....... A X-ray exam of ankle .................................... 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73610 .......... TC ...... A X-ray exam of ankle .................................... 0.00 0.56 NA 0.02 0.58 NA XXX 73615 .......... ............ A Contrast x-ray of ankle ................................ 0.54 2.19 NA 0.15 2.89 NA XXX 73615 .......... 26 ....... A Contrast x-ray of ankle ................................ 0.54 0.19 0.19 0.03 0.76 0.76 XXX 73615 .......... TC ...... A Contrast x-ray of ankle ................................ 0.00 2.01 NA 0.12 2.13 NA XXX 73620 .......... ............ A X-ray exam of foot ....................................... 0.16 0.53 NA 0.03 0.72 NA XXX 73620 .......... 26 ....... A X-ray exam of foot ....................................... 0.16 0.05 0.05 0.01 0.22 0.22 XXX 73620 .......... TC ...... A X-ray exam of foot ....................................... 0.00 0.48 NA 0.02 0.50 NA XXX 73630 .......... ............ A X-ray exam of foot ....................................... 0.17 0.61 NA 0.03 0.81 NA XXX 73630 .......... 26 ....... A X-ray exam of foot ....................................... 0.17 0.06 0.06 0.01 0.24 0.24 XXX 73630 .......... TC ...... A X-ray exam of foot ....................................... 0.00 0.54 NA 0.02 0.56 NA XXX 73650 .......... ............ A X-ray exam of heel ...................................... 0.16 0.53 NA 0.03 0.72 NA XXX 73650 .......... 26 ....... A X-ray exam of heel ...................................... 0.16 0.05 0.05 0.01 0.22 0.22 XXX 73650 .......... TC ...... A X-ray exam of heel ...................................... 0.00 0.48 NA 0.02 0.50 NA XXX 73660 .......... ............ A X-ray exam of toe(s) ................................... 0.13 0.51 NA 0.03 0.67 NA XXX 73660 .......... 26 ....... A X-ray exam of toe(s) ................................... 0.13 0.04 0.04 0.01 0.18 0.18 XXX 73660 .......... TC ...... A X-ray exam of toe(s) ................................... 0.00 0.47 NA 0.02 0.49 NA XXX 73700 .......... ............ A Ct lower extremity w/o dye .......................... 1.09 5.54 NA 0.30 6.93 NA XXX 73700 .......... 26 ....... A Ct lower extremity w/o dye .......................... 1.09 0.38 0.38 0.05 1.52 1.52 XXX 73700 .......... TC ...... A Ct lower extremity w/o dye .......................... 0.00 5.16 NA 0.25 5.41 NA XXX 73701 .......... ............ A Ct lower extremity w/dye ............................. 1.16 6.68 NA 0.36 8.20 NA XXX 73701 .......... 26 ....... A Ct lower extremity w/dye ............................. 1.16 0.40 0.40 0.05 1.61 1.61 XXX


## 45959

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

73701 .......... TC ...... A Ct lower extremity w/dye ............................. 0.00 6.28 NA 0.31 6.59 NA XXX 73702 .......... ............ A Ct lwr extremity w/o&w/dye ......................... 1.22 8.40 NA 0.44 10.06 NA XXX 73702 .......... 26 ....... A Ct lwr extremity w/o&w/dye ......................... 1.22 0.42 0.42 0.05 1.69 1.69 XXX 73702 .......... TC ...... A Ct lwr extremity w/o&w/dye ......................... 0.00 7.98 NA 0.39 8.37 NA XXX 73706 .......... ............ A Ct angio lwr extr w/o&w/dye ....................... 1.90 11.68 NA 0.47 14.06 NA XXX 73706 .......... 26 ....... A Ct angio lwr extr w/o&w/dye ....................... 1.90 0.65 0.65 0.08 2.64 2.64 XXX 73706 .......... TC ...... A Ct angio lwr extr w/o&w/dye ....................... 0.00 11.03 NA 0.39 11.42 NA XXX 73718 .......... ............ A Mri lower extremity w/o dye ........................ 1.35 11.94 NA 0.45 13.74 NA XXX 73718 .......... 26 ....... A Mri lower extremity w/o dye ........................ 1.35 0.46 0.46 0.06 1.88 1.88 XXX 73718 .......... TC ...... A Mri lower extremity w/o dye ........................ 0.00 11.48 NA 0.39 11.87 NA XXX 73719 .......... ............ A Mri lower extremity w/dye ........................... 1.62 13.98 NA 0.54 16.15 NA XXX 73719 .......... 26 ....... A Mri lower extremity w/dye ........................... 1.62 0.56 0.56 0.07 2.25 2.25 XXX 73719 .......... TC ...... A Mri lower extremity w/dye ........................... 0.00 13.43 NA 0.47 13.90 NA XXX 73720 .......... ............ A Mri lwr extremity w/o&w/dye ....................... 2.15 23.69 NA 0.94 26.79 NA XXX 73720 .......... 26 ....... A Mri lwr extremity w/o&w/dye ....................... 2.15 0.74 0.74 0.10 2.99 2.99 XXX 73720 .......... TC ...... A Mri lwr extremity w/o&w/dye ....................... 0.00 22.96 NA 0.84 23.80 NA XXX 73721 .......... ............ A Mri jnt of lwr extre w/o dye .......................... 1.35 11.94 NA 0.45 13.75 NA XXX 73721 .......... 26 ....... A Mri jnt of lwr extre w/o dye .......................... 1.35 0.46 0.46 0.06 1.88 1.88 XXX 73721 .......... TC ...... A Mri jnt of lwr extre w/o dye .......................... 0.00 11.48 NA 0.39 11.87 NA XXX 73722 .......... ............ A Mri joint of lwr extr w/dye ............................ 1.62 13.75 NA 0.54 15.92 NA XXX 73722 .......... 26 ....... A Mri joint of lwr extr w/dye ............................ 1.62 0.56 0.56 0.07 2.25 2.25 XXX 73722 .......... TC ...... A Mri joint of lwr extr w/dye ............................ 0.00 13.19 NA 0.47 13.66 NA XXX 73723 .......... ............ A Mri joint lwr extr w/o&w/dye ........................ 2.15 23.23 NA 0.94 26.32 NA XXX 73723 .......... 26 ....... A Mri joint lwr extr w/o&w/dye ........................ 2.15 0.74 0.74 0.10 3.00 3.00 XXX 73723 .......... TC ...... A Mri joint lwr extr w/o&w/dye ........................ 0.00 22.48 NA 0.84 23.32 NA XXX 73725 .......... ............ R Mr ang lwr ext w or w/o dye ....................... 1.82 12.54 NA 0.67 15.03 NA XXX 73725 .......... 26 ....... R Mr ang lwr ext w or w/o dye ....................... 1.82 0.63 0.63 0.08 2.53 2.53 XXX 73725 .......... TC ...... R Mr ang lwr ext w or w/o dye ........................ 0.00 11.91 NA 0.59 12.50 NA XXX 74000 .......... ............ A X-ray exam of abdomen .............................. 0.18 0.57 NA 0.03 0.78 NA XXX 74000 .......... 26 ....... A X-ray exam of abdomen .............................. 0.18 0.06 0.06 0.01 0.25 0.25 XXX 74000 .......... TC ...... A X-ray exam of abdomen .............................. 0.00 0.50 NA 0.02 0.52 NA XXX 74010 .......... ............ A X-ray exam of abdomen .............................. 0.23 0.71 NA 0.05 0.99 NA XXX 74010 .......... 26 ....... A X-ray exam of abdomen .............................. 0.23 0.08 0.08 0.01 0.32 0.32 XXX 74010 .......... TC ...... A X-ray exam of abdomen .............................. 0.00 0.63 NA 0.04 0.67 NA XXX 74020 .......... ............ A X-ray exam of abdomen .............................. 0.27 0.75 NA 0.05 1.07 NA XXX 74020 .......... 26 ....... A X-ray exam of abdomen .............................. 0.27 0.10 0.10 0.01 0.38 0.38 XXX 74020 .......... TC ...... A X-ray exam of abdomen .............................. 0.00 0.65 NA 0.04 0.69 NA XXX 74022 .......... ............ A X-ray exam series, abdomen ...................... 0.32 0.89 NA 0.06 1.27 NA XXX 74022 .......... 26 ....... A X-ray exam series, abdomen ...................... 0.32 0.11 0.11 0.01 0.44 0.44 XXX 74022 .......... TC ...... A X-ray exam series, abdomen ...................... 0.00 0.78 NA 0.05 0.83 NA XXX 74150 .......... ............ A Ct abdomen w/o dye ................................... 1.19 6.02 NA 0.35 7.57 NA XXX 74150 .......... 26 ....... A Ct abdomen w/o dye ................................... 1.19 0.41 0.41 0.05 1.65 1.65 XXX 74150 .......... TC ...... A Ct abdomen w/o dye ................................... 0.00 5.61 NA 0.30 5.91 NA XXX 74160 .......... ............ A Ct abdomen w/dye ...................................... 1.27 7.66 NA 0.42 9.36 NA XXX 74160 .......... 26 ....... A Ct abdomen w/dye ...................................... 1.27 0.44 0.44 0.06 1.77 1.77 XXX 74160 .......... TC ...... A Ct abdomen w/dye ...................................... 0.00 7.22 NA 0.36 7.58 NA XXX 74170 .......... ............ A Ct abdomen w/o & w/dye ............................ 1.40 9.77 NA 0.49 11.66 NA XXX 74170 .......... 26 ....... A Ct abdomen w/o & w/dye ............................ 1.40 0.48 0.48 0.06 1.95 1.95 XXX 74170 .......... TC ...... A Ct abdomen w/o & w/dye ............................ 0.00 9.29 NA 0.43 9.72 NA XXX 74175 .......... ............ A Ct angio abdom w/o & w/dye ...................... 1.90 12.48 NA 0.47 14.86 NA XXX 74175 .......... 26 ....... A Ct angio abdom w/o & w/dye ...................... 1.90 0.65 0.65 0.08 2.64 2.64 XXX 74175 .......... TC ...... A Ct angio abdom w/o & w/dye ...................... 0.00 11.83 NA 0.39 12.22 NA XXX 74181 .......... ............ A Mri abdomen w/o dye .................................. 1.46 11.66 NA 0.51 13.63 NA XXX 74181 .......... 26 ....... A Mri abdomen w/o dye .................................. 1.46 0.50 0.50 0.06 2.03 2.03 XXX 74181 .......... TC ...... A Mri abdomen w/o dye .................................. 0.00 11.15 NA 0.45 11.60 NA XXX 74182 .......... ............ A Mri abdomen w/dye ..................................... 1.73 14.55 NA 0.60 16.89 NA XXX 74182 .......... 26 ....... A Mri abdomen w/dye ..................................... 1.73 0.60 0.60 0.08 2.41 2.41 XXX 74182 .......... TC ...... A Mri abdomen w/dye ..................................... 0.00 13.96 NA 0.52 14.48 NA XXX 74183 .......... ............ A Mri abdomen w/o & w/dye .......................... 2.26 23.60 NA 1.02 26.88 NA XXX 74183 .......... 26 ....... A Mri abdomen w/o & w/dye .......................... 2.26 0.78 0.78 0.10 3.14 3.14 XXX 74183 .......... TC ...... A Mri abdomen w/o & w/dye .......................... 0.00 22.82 NA 0.92 23.74 NA XXX 74185 .......... ............ R Mri angio, abdom w orw/o dye .................... 1.80 12.41 NA 0.67 14.88 NA XXX 74185 .......... 26 ....... R Mri angio, abdom w orw/o dye .................... 1.80 0.62 0.62 0.08 2.50 2.50 XXX 74185 .......... TC ...... R Mri angio, abdom w orw/o dye .................... 0.00 11.79 NA 0.59 12.38 NA XXX 74190 .......... ............ A X-ray exam of peritoneum ........................... 0.48 NA NA 0.09 NA NA XXX 74190 .......... 26 ....... A X-ray exam of peritoneum ........................... 0.48 0.17 0.17 0.02 0.67 0.67 XXX 74190 .......... TC ...... A X-ray exam of peritoneum ........................... 0.00 NA NA 0.07 NA NA XXX 74210 .......... ............ A Contrst x-ray exam of throat ....................... 0.36 1.45 NA 0.08 1.89 NA XXX 74210 .......... 26 ....... A Contrst x-ray exam of throat ....................... 0.36 0.13 0.13 0.02 0.51 0.51 XXX 74210 .......... TC ...... A Contrst x-ray exam of throat ....................... 0.00 1.33 NA 0.06 1.39 NA XXX 74220 .......... ............ A Contrast x-ray, esophagus .......................... 0.46 1.57 NA 0.08 2.11 NA XXX 74220 .......... 26 ....... A Contrast x-ray, esophagus .......................... 0.46 0.16 0.16 0.02 0.64 0.64 XXX 74220 .......... TC ...... A Contrast x-ray, esophagus .......................... 0.00 1.41 NA 0.06 1.47 NA XXX 74230 .......... ............ A Cine/vid x-ray, throat/esoph ........................ 0.53 1.63 NA 0.09 2.25 NA XXX


## 45960

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

74230 .......... 26 ....... A Cine/vid x-ray, throat/esoph ........................ 0.53 0.18 0.18 0.02 0.73 0.73 XXX 74230 .......... TC ...... A Cine/vid x-ray, throat/esoph ........................ 0.00 1.45 NA 0.07 1.52 NA XXX 74235 .......... ............ A Remove esophagus obstruction .................. 1.19 NA NA 0.19 NA NA XXX 74235 .......... 26 ....... A Remove esophagus obstruction .................. 1.19 0.41 0.41 0.05 1.65 1.65 XXX 74235 .......... TC ...... A Remove esophagus obstruction .................. 0.00 NA NA 0.14 NA NA XXX 74240 .......... ............ A X-ray exam, upper gi tract .......................... 0.69 1.89 NA 0.11 2.69 NA XXX 74240 .......... 26 ....... A X-ray exam, upper gi tract .......................... 0.69 0.24 0.24 0.03 0.96 0.96 XXX 74240 .......... TC ...... A X-ray exam, upper gi tract .......................... 0.00 1.65 NA 0.08 1.73 NA XXX 74241 .......... ............ A X-ray exam, upper gi tract .......................... 0.69 1.98 NA 0.11 2.78 NA XXX 74241 .......... 26 ....... A X-ray exam, upper gi tract .......................... 0.69 0.24 0.24 0.03 0.96 0.96 XXX 74241 .......... TC ...... A X-ray exam, upper gi tract .......................... 0.00 1.74 NA 0.08 1.82 NA XXX 74245 .......... ............ A X-ray exam, upper gi tract .......................... 0.91 3.16 NA 0.17 4.24 NA XXX 74245 .......... 26 ....... A X-ray exam, upper gi tract .......................... 0.91 0.32 0.32 0.04 1.27 1.27 XXX 74245 .......... TC ...... A X-ray exam, upper gi tract .......................... 0.00 2.85 NA 0.13 2.98 NA XXX 74246 .......... ............ A Contrst x-ray uppr gi tract ........................... 0.69 2.16 NA 0.13 2.98 NA XXX 74246 .......... 26 ....... A Contrst x-ray uppr gi tract ........................... 0.69 0.24 0.24 0.03 0.96 0.96 XXX 74246 .......... TC ...... A Contrst x-ray uppr gi tract ........................... 0.00 1.92 NA 0.10 2.02 NA XXX 74247 .......... ............ A Contrst x-ray uppr gi tract ........................... 0.69 2.30 NA 0.14 3.13 NA XXX 74247 .......... 26 ....... A Contrst x-ray uppr gi tract ........................... 0.69 0.24 0.24 0.03 0.96 0.96 XXX 74247 .......... TC ...... A Contrst x-ray uppr gi tract ........................... 0.00 2.06 NA 0.11 2.17 NA XXX 74249 .......... ............ A Contrst x-ray uppr gi tract ........................... 0.91 3.38 NA 0.18 4.47 NA XXX 74249 .......... 26 ....... A Contrst x-ray uppr gi tract ........................... 0.91 0.32 0.32 0.04 1.27 1.27 XXX 74249 .......... TC ...... A Contrst x-ray uppr gi tract ........................... 0.00 3.06 NA 0.14 3.20 NA XXX 74250 .......... ............ A X-ray exam of small bowel .......................... 0.47 1.83 NA 0.09 2.39 NA XXX 74250 .......... 26 ....... A X-ray exam of small bowel .......................... 0.47 0.16 0.16 0.02 0.65 0.65 XXX 74250 .......... TC ...... A X-ray exam of small bowel .......................... 0.00 1.67 NA 0.07 1.74 NA XXX 74251 .......... ............ A X-ray exam of small bowel .......................... 0.69 4.38 NA 0.10 5.17 NA XXX 74251 .......... 26 ....... A X-ray exam of small bowel .......................... 0.69 0.24 0.24 0.03 0.96 0.96 XXX 74251 .......... TC ...... A X-ray exam of small bowel .......................... 0.00 4.14 NA 0.07 4.21 NA XXX 74260 .......... ............ A X-ray exam of small bowel .......................... 0.50 3.97 NA 0.10 4.57 NA XXX 74260 .......... 26 ....... A X-ray exam of small bowel .......................... 0.50 0.17 0.17 0.02 0.69 0.69 XXX 74260 .......... TC ...... A X-ray exam of small bowel .......................... 0.00 3.81 NA 0.08 3.89 NA XXX 74270 .......... ............ A Contrast x-ray exam of colon ...................... 0.69 2.44 NA 0.14 3.27 NA XXX 74270 .......... 26 ....... A Contrast x-ray exam of colon ...................... 0.69 0.24 0.24 0.03 0.96 0.96 XXX 74270 .......... TC ...... A Contrast x-ray exam of colon ...................... 0.00 2.20 NA 0.11 2.31 NA XXX 74280 .......... ............ A Contrast x-ray exam of colon ...................... 0.99 3.35 NA 0.17 4.51 NA XXX 74280 .......... 26 ....... A Contrast x-ray exam of colon ...................... 0.99 0.34 0.34 0.04 1.37 1.37 XXX 74280 .......... TC ...... A Contrast x-ray exam of colon ...................... 0.00 3.02 NA 0.13 3.15 NA XXX 74283 .......... ............ A Contrast x-ray exam of colon ...................... 2.02 3.31 NA 0.23 5.57 NA XXX 74283 .......... 26 ....... A Contrast x-ray exam of colon ...................... 2.02 0.69 0.69 0.09 2.81 2.81 XXX 74283 .......... TC ...... A Contrast x-ray exam of colon ...................... 0.00 2.62 NA 0.14 2.76 NA XXX 74290 .......... ............ A Contrast x-ray, gallbladder .......................... 0.32 1.08 NA 0.06 1.47 NA XXX 74290 .......... 26 ....... A Contrast x-ray, gallbladder .......................... 0.32 0.11 0.11 0.01 0.44 0.44 XXX 74290 .......... TC ...... A Contrast x-ray, gallbladder .......................... 0.00 0.98 NA 0.05 1.03 NA XXX 74291 .......... ............ A Contrast x-rays, gallbladder ........................ 0.20 0.83 NA 0.03 1.06 NA XXX 74291 .......... 26 ....... A Contrast x-rays, gallbladder ........................ 0.20 0.07 0.07 0.01 0.28 0.28 XXX 74291 .......... TC ...... A Contrast x-rays, gallbladder ........................ 0.00 0.76 NA 0.02 0.78 NA XXX 74300 .......... ............ C X-ray bile ducts/pancreas ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 74300 .......... 26 ....... A X-ray bile ducts/pancreas ............................ 0.36 0.13 0.13 0.02 0.51 0.51 XXX 74300 .......... TC ...... C X-ray bile ducts/pancreas ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 74301 .......... ............ C X-rays at surgery add-on ............................ 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 74301 .......... 26 ....... A X-rays at surgery add-on ............................ 0.21 0.07 0.07 0.01 0.29 0.29 ZZZ 74301 .......... TC ...... C X-rays at surgery add-on ............................ 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 74305 .......... ............ A X-ray bile ducts/pancreas ............................ 0.42 NA NA 0.07 NA NA XXX 74305 .......... 26 ....... A X-ray bile ducts/pancreas ............................ 0.42 0.15 0.15 0.02 0.59 0.59 XXX 74305 .......... TC ...... A X-ray bile ducts/pancreas ............................ 0.00 NA NA 0.05 NA NA XXX 74320 .......... ............ A Contrast x-ray of bile ducts ......................... 0.54 3.15 NA 0.19 3.88 NA XXX 74320 .......... 26 ....... A Contrast x-ray of bile ducts ......................... 0.54 0.19 0.19 0.02 0.75 0.75 XXX 74320 .......... TC ...... A Contrast x-ray of bile ducts ......................... 0.00 2.96 NA 0.17 3.13 NA XXX 74327 .......... ............ A X-ray bile stone removal ............................. 0.70 2.28 NA 0.14 3.12 NA XXX 74327 .......... 26 ....... A X-ray bile stone removal ............................. 0.70 0.24 0.24 0.03 0.97 0.97 XXX 74327 .......... TC ...... A X-ray bile stone removal ............................. 0.00 2.03 NA 0.11 2.14 NA XXX 74328 .......... ............ A X-ray bile duct endoscopy ........................... 0.70 NA NA 0.20 NA NA XXX 74328 .......... 26 ....... A X-ray bile duct endoscopy ........................... 0.70 0.24 0.24 0.03 0.97 0.97 XXX 74328 .......... TC ...... A X-ray bile duct endoscopy ........................... 0.00 NA NA 0.17 NA NA XXX 74329 .......... ............ A X-ray for pancreas endoscopy .................... 0.70 NA NA 0.20 NA NA XXX 74329 .......... 26 ....... A X-ray for pancreas endoscopy .................... 0.70 0.24 0.24 0.03 0.97 0.97 XXX 74329 .......... TC ...... A X-ray for pancreas endoscopy .................... 0.00 NA NA 0.17 NA NA XXX 74330 .......... ............ A X-ray bile/panc endoscopy .......................... 0.90 NA NA 0.21 NA NA XXX 74330 .......... 26 ....... A X-ray bile/panc endoscopy .......................... 0.90 0.31 0.31 0.04 1.25 1.25 XXX 74330 .......... TC ...... A X-ray bile/panc endoscopy .......................... 0.00 NA NA 0.17 NA NA XXX 74340 .......... ............ A X-ray guide for GI tube ............................... 0.54 NA NA 0.16 NA NA XXX 74340 .......... 26 ....... A X-ray guide for GI tube ............................... 0.54 0.19 0.19 0.02 0.75 0.75 XXX 74340 .......... TC ...... A X-ray guide for GI tube ............................... 0.00 NA NA 0.14 NA NA XXX


## 45961

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

74350 .......... ............ A X-ray guide, stomach tube .......................... 0.76 3.17 NA 0.20 4.13 NA XXX 74350 .......... 26 ....... A X-ray guide, stomach tube .......................... 0.76 0.26 0.26 0.03 1.05 1.05 XXX 74350 .......... TC ...... A X-ray guide, stomach tube .......................... 0.00 2.90 NA 0.17 3.07 NA XXX 74355 .......... ............ A X-ray guide, intestinal tube ......................... 0.76 NA NA 0.17 NA NA XXX 74355 .......... 26 ....... A X-ray guide, intestinal tube ......................... 0.76 0.26 0.26 0.03 1.05 1.05 XXX 74355 .......... TC ...... A X-ray guide, intestinal tube ......................... 0.00 NA NA 0.14 NA NA XXX 74360 .......... ............ A X-ray guide, GI dilation ............................... 0.54 NA NA 0.19 NA NA XXX 74360 .......... 26 ....... A X-ray guide, GI dilation ............................... 0.54 0.20 0.20 0.02 0.76 0.76 XXX 74360 .......... TC ...... A X-ray guide, GI dilation ............................... 0.00 NA NA 0.17 NA NA XXX 74363 .......... ............ A X-ray, bile duct dilation ................................ 0.88 NA NA 0.37 NA NA XXX 74363 .......... 26 ....... A X-ray, bile duct dilation ................................ 0.88 0.31 0.31 0.04 1.23 1.23 XXX 74363 .......... TC ...... A X-ray, bile duct dilation ................................ 0.00 NA NA 0.33 NA NA XXX 74400 .......... ............ A Contrst x-ray, urinary tract .......................... 0.49 2.16 NA 0.13 2.79 NA XXX 74400 .......... 26 ....... A Contrst x-ray, urinary tract .......................... 0.49 0.17 0.17 0.02 0.68 0.68 XXX 74400 .......... TC ...... A Contrst x-ray, urinary tract .......................... 0.00 2.00 NA 0.11 2.11 NA XXX 74410 .......... ............ A Contrst x-ray, urinary tract .......................... 0.49 2.39 NA 0.13 3.01 NA XXX 74410 .......... 26 ....... A Contrst x-ray, urinary tract .......................... 0.49 0.17 0.17 0.02 0.68 0.68 XXX 74410 .......... TC ...... A Contrst x-ray, urinary tract .......................... 0.00 2.22 NA 0.11 2.33 NA XXX 74415 .......... ............ A Contrst x-ray, urinary tract .......................... 0.49 2.73 NA 0.14 3.36 NA XXX 74415 .......... 26 ....... A Contrst x-ray, urinary tract .......................... 0.49 0.17 0.17 0.02 0.68 0.68 XXX 74415 .......... TC ...... A Contrst x-ray, urinary tract .......................... 0.00 2.56 NA 0.12 2.68 NA XXX 74420 .......... ............ A Contrst x-ray, urinary tract .......................... 0.36 NA NA 0.16 NA NA XXX 74420 .......... 26 ....... A Contrst x-ray, urinary tract .......................... 0.36 0.13 0.13 0.02 0.51 0.51 XXX 74420 .......... TC ...... A Contrst x-ray, urinary tract .......................... 0.00 NA NA 0.14 NA NA XXX 74425 .......... ............ A Contrst x-ray, urinary tract .......................... 0.36 NA NA 0.09 NA NA XXX 74425 .......... 26 ....... A Contrst x-ray, urinary tract .......................... 0.36 0.13 0.13 0.02 0.51 0.51 XXX 74425 .......... TC ...... A Contrst x-ray, urinary tract .......................... 0.00 NA NA 0.07 NA NA XXX 74430 .......... ............ A Contrast x-ray, bladder ................................ 0.32 1.46 NA 0.08 1.86 NA XXX 74430 .......... 26 ....... A Contrast x-ray, bladder ................................ 0.32 0.11 0.11 0.02 0.45 0.45 XXX 74430 .......... TC ...... A Contrast x-ray, bladder ................................ 0.00 1.35 NA 0.06 1.41 NA XXX 74440 .......... ............ A X-ray, male genital tract .............................. 0.38 1.37 NA 0.08 1.83 NA XXX 74440 .......... 26 ....... A X-ray, male genital tract .............................. 0.38 0.13 0.13 0.02 0.53 0.53 XXX 74440 .......... TC ...... A X-ray, male genital tract .............................. 0.00 1.24 NA 0.06 1.30 NA XXX 74445 .......... ............ A X-ray exam of penis .................................... 1.14 NA NA 0.13 NA NA XXX 74445 .......... 26 ....... A X-ray exam of penis .................................... 1.14 0.41 0.41 0.07 1.62 1.62 XXX 74445 .......... TC ...... A X-ray exam of penis .................................... 0.00 NA NA 0.06 NA NA XXX 74450 .......... ............ A X-ray, urethra/bladder ................................. 0.33 NA NA 0.10 NA NA XXX 74450 .......... 26 ....... A X-ray, urethra/bladder ................................. 0.33 0.12 0.12 0.02 0.47 0.47 XXX 74450 .......... TC ...... A X-ray, urethra/bladder ................................. 0.00 NA NA 0.08 NA NA XXX 74455 .......... ............ A X-ray, urethra/bladder ................................. 0.33 1.87 NA 0.12 2.32 NA XXX 74455 .......... 26 ....... A X-ray, urethra/bladder ................................. 0.33 0.12 0.12 0.02 0.47 0.47 XXX 74455 .......... TC ...... A X-ray, urethra/bladder ................................. 0.00 1.76 NA 0.10 1.86 NA XXX 74470 .......... ............ A X-ray exam of kidney lesion ........................ 0.54 NA NA 0.09 NA NA XXX 74470 .......... 26 ....... A X-ray exam of kidney lesion ........................ 0.54 0.19 0.19 0.02 0.75 0.75 XXX 74470 .......... TC ...... A X-ray exam of kidney lesion ........................ 0.00 NA NA 0.07 NA NA XXX 74475 .......... ............ A X-ray control, cath insert ............................. 0.54 3.97 NA 0.24 4.75 NA XXX 74475 .......... 26 ....... A X-ray control, cath insert ............................. 0.54 0.19 0.19 0.02 0.75 0.75 XXX 74475 .......... TC ...... A X-ray control, cath insert ............................. 0.00 3.78 NA 0.22 4.00 NA XXX 74480 .......... ............ A X-ray control, cath insert ............................. 0.54 3.72 NA 0.24 4.51 NA XXX 74480 .......... 26 ....... A X-ray control, cath insert ............................. 0.54 0.19 0.19 0.02 0.75 0.75 XXX 74480 .......... TC ...... A X-ray control, cath insert ............................. 0.00 3.53 NA 0.22 3.75 NA XXX 74485 .......... ............ A X-ray guide, GU dilation .............................. 0.54 3.17 NA 0.20 3.91 NA XXX 74485 .......... 26 ....... A X-ray guide, GU dilation .............................. 0.54 0.19 0.19 0.03 0.76 0.76 XXX 74485 .......... TC ...... A X-ray guide, GU dilation .............................. 0.00 2.98 NA 0.17 3.15 NA XXX 74710 .......... ............ A X-ray measurement of pelvis ...................... 0.34 1.05 NA 0.08 1.47 NA XXX 74710 .......... 26 ....... A X-ray measurement of pelvis ...................... 0.34 0.12 0.12 0.02 0.48 0.48 XXX 74710 .......... TC ...... A X-ray measurement of pelvis ...................... 0.00 0.93 NA 0.06 0.99 NA XXX 74740 .......... ............ A X-ray, female genital tract ........................... 0.38 1.55 NA 0.09 2.02 NA XXX 74740 .......... 26 ....... A X-ray, female genital tract ........................... 0.38 0.14 0.14 0.02 0.54 0.54 XXX 74740 .......... TC ...... A X-ray, female genital tract ........................... 0.00 1.42 NA 0.07 1.49 NA XXX 74742 .......... ............ A X-ray, fallopian tube .................................... 0.61 NA NA 0.20 NA NA XXX 74742 .......... 26 ....... A X-ray, fallopian tube .................................... 0.61 0.21 0.21 0.03 0.85 0.85 XXX 74742 .......... TC ...... A X-ray, fallopian tube .................................... 0.00 NA NA 0.17 NA NA XXX 74775 .......... ............ A X-ray exam of perineum .............................. 0.62 NA NA 0.11 NA NA XXX 74775 .......... 26 ....... A X-ray exam of perineum .............................. 0.62 0.22 0.22 0.03 0.87 0.87 XXX 74775 .......... TC ...... A X-ray exam of perineum .............................. 0.00 NA NA 0.08 NA NA XXX 75552 .......... ............ A Heart mri for morph w/o dye ....................... 1.60 13.56 NA 0.66 15.82 NA XXX 75552 .......... 26 ....... A Heart mri for morph w/o dye ....................... 1.60 0.56 0.56 0.07 2.23 2.23 XXX 75552 .......... TC ...... A Heart mri for morph w/o dye ....................... 0.00 13.00 NA 0.59 13.59 NA XXX 75553 .......... ............ A Heart mri for morph w/dye .......................... 2.00 13.77 NA 0.66 16.43 NA XXX 75553 .......... 26 ....... A Heart mri for morph w/dye .......................... 2.00 0.68 0.68 0.07 2.76 2.76 XXX 75553 .......... TC ...... A Heart mri for morph w/dye .......................... 0.00 13.08 NA 0.59 13.67 NA XXX 75554 .......... ............ A Cardiac MRI/function ................................... 1.83 17.01 NA 0.66 19.50 NA XXX 75554 .......... 26 ....... A Cardiac MRI/function ................................... 1.83 0.68 0.68 0.07 2.58 2.58 XXX


## 45962

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

75554 .......... TC ...... A Cardiac MRI/function ................................... 0.00 16.33 NA 0.59 16.92 NA XXX 75555 .......... ............ A Cardiac MRI/limited study ........................... 1.74 15.87 NA 0.66 18.27 NA XXX 75555 .......... 26 ....... A Cardiac MRI/limited study ........................... 1.74 0.67 0.67 0.07 2.49 2.49 XXX 75555 .......... TC ...... A Cardiac MRI/limited study ........................... 0.00 15.20 NA 0.59 15.79 NA XXX 75556 .......... ............ N Cardiac MRI/flow mapping .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75600 .......... ............ A Contrast x-ray exam of aorta ...................... 0.49 11.90 NA 0.67 13.06 NA XXX 75600 .......... 26 ....... A Contrast x-ray exam of aorta ...................... 0.49 0.20 0.20 0.02 0.71 0.71 XXX 75600 .......... TC ...... A Contrast x-ray exam of aorta ...................... 0.00 11.70 NA 0.65 12.35 NA XXX 75605 .......... ............ A Contrast x-ray exam of aorta ...................... 1.14 10.80 NA 0.70 12.65 NA XXX 75605 .......... 26 ....... A Contrast x-ray exam of aorta ...................... 1.14 0.42 0.42 0.05 1.61 1.61 XXX 75605 .......... TC ...... A Contrast x-ray exam of aorta ...................... 0.00 10.38 NA 0.65 11.03 NA XXX 75625 .......... ............ A Contrast x-ray exam of aorta ...................... 1.14 10.87 NA 0.71 12.73 NA XXX 75625 .......... 26 ....... A Contrast x-ray exam of aorta ...................... 1.14 0.40 0.40 0.06 1.60 1.60 XXX 75625 .......... TC ...... A Contrast x-ray exam of aorta ...................... 0.00 10.47 NA 0.65 11.12 NA XXX 75630 .......... ............ A X-ray aorta, leg arteries .............................. 1.79 11.50 NA 0.80 14.09 NA XXX 75630 .......... 26 ....... A X-ray aorta, leg arteries .............................. 1.79 0.64 0.64 0.11 2.54 2.54 XXX 75630 .......... TC ...... A X-ray aorta, leg arteries .............................. 0.00 10.86 NA 0.69 11.55 NA XXX 75635 .......... ............ A Ct angio abdominal arteries ........................ 2.40 15.78 NA 0.50 18.68 NA XXX 75635 .......... 26 ....... A Ct angio abdominal arteries ........................ 2.40 0.83 0.83 0.11 3.35 3.35 XXX 75635 .......... TC ...... A Ct angio abdominal arteries ........................ 0.00 14.94 NA 0.39 15.33 NA XXX 75650 .......... ............ A Artery x-rays, head & neck ......................... 1.49 10.92 NA 0.72 13.13 NA XXX 75650 .......... 26 ....... A Artery x-rays, head & neck ......................... 1.49 0.52 0.52 0.07 2.08 2.08 XXX 75650 .......... TC ...... A Artery x-rays, head & neck ......................... 0.00 10.40 NA 0.65 11.05 NA XXX 75658 .......... ............ A Artery x-rays, arm ........................................ 1.31 10.93 NA 0.72 12.96 NA XXX 75658 .......... 26 ....... A Artery x-rays, arm ........................................ 1.31 0.49 0.49 0.07 1.87 1.87 XXX 75658 .......... TC ...... A Artery x-rays, arm ........................................ 0.00 10.44 NA 0.65 11.09 NA XXX 75660 .......... ............ A Artery x-rays, head & neck ......................... 1.31 10.89 NA 0.71 12.91 NA XXX 75660 .......... 26 ....... A Artery x-rays, head & neck ......................... 1.31 0.46 0.46 0.06 1.84 1.84 XXX 75660 .......... TC ...... A Artery x-rays, head & neck ......................... 0.00 10.42 NA 0.65 11.07 NA XXX 75662 .......... ............ A Artery x-rays, head & neck ......................... 1.66 11.28 NA 0.71 13.65 NA XXX 75662 .......... 26 ....... A Artery x-rays, head & neck ......................... 1.66 0.62 0.62 0.06 2.34 2.34 XXX 75662 .......... TC ...... A Artery x-rays, head & neck ......................... 0.00 10.66 NA 0.65 11.31 NA XXX 75665 .......... ............ A Artery x-rays, head & neck ......................... 1.31 10.88 NA 0.74 12.93 NA XXX 75665 .......... 26 ....... A Artery x-rays, head & neck ......................... 1.31 0.46 0.46 0.09 1.86 1.86 XXX 75665 .......... TC ...... A Artery x-rays, head & neck ......................... 0.00 10.42 NA 0.65 11.07 NA XXX 75671 .......... ............ A Artery x-rays, head & neck ......................... 1.66 11.32 NA 0.72 13.70 NA XXX 75671 .......... 26 ....... A Artery x-rays, head & neck ......................... 1.66 0.58 0.58 0.07 2.31 2.31 XXX 75671 .......... TC ...... A Artery x-rays, head & neck ......................... 0.00 10.74 NA 0.65 11.39 NA XXX 75676 .......... ............ A Artery x-rays, neck ...................................... 1.31 11.00 NA 0.72 13.03 NA XXX 75676 .......... 26 ....... A Artery x-rays, neck ...................................... 1.31 0.46 0.46 0.07 1.84 1.84 XXX 75676 .......... TC ...... A Artery x-rays, neck ...................................... 0.00 10.54 NA 0.65 11.19 NA XXX 75680 .......... ............ A Artery x-rays, neck ...................................... 1.66 11.21 NA 0.72 13.60 NA XXX 75680 .......... 26 ....... A Artery x-rays, neck ...................................... 1.66 0.58 0.58 0.07 2.31 2.31 XXX 75680 .......... TC ...... A Artery x-rays, neck ...................................... 0.00 10.63 NA 0.65 11.28 NA XXX 75685 .......... ............ A Artery x-rays, spine ..................................... 1.31 10.92 NA 0.71 12.94 NA XXX 75685 .......... 26 ....... A Artery x-rays, spine ..................................... 1.31 0.45 0.45 0.06 1.83 1.83 XXX 75685 .......... TC ...... A Artery x-rays, spine ..................................... 0.00 10.47 NA 0.65 11.12 NA XXX 75705 .......... ............ A Artery x-rays, spine ..................................... 2.18 11.26 NA 0.78 14.22 NA XXX 75705 .......... 26 ....... A Artery x-rays, spine ..................................... 2.18 0.77 0.77 0.13 3.08 3.08 XXX 75705 .......... TC ...... A Artery x-rays, spine ..................................... 0.00 10.49 NA 0.65 11.14 NA XXX 75710 .......... ............ A Artery x-rays, arm/leg .................................. 1.14 10.90 NA 0.72 12.76 NA XXX 75710 .......... 26 ....... A Artery x-rays, arm/leg .................................. 1.14 0.41 0.41 0.07 1.62 1.62 XXX 75710 .......... TC ...... A Artery x-rays, arm/leg .................................. 0.00 10.49 NA 0.65 11.14 NA XXX 75716 .......... ............ A Artery x-rays, arms/legs .............................. 1.31 11.30 NA 0.72 13.33 NA XXX 75716 .......... 26 ....... A Artery x-rays, arms/legs .............................. 1.31 0.46 0.46 0.07 1.84 1.84 XXX 75716 .......... TC ...... A Artery x-rays, arms/legs .............................. 0.00 10.84 NA 0.65 11.49 NA XXX 75722 .......... ............ A Artery x-rays, kidney ................................... 1.14 10.99 NA 0.70 12.84 NA XXX 75722 .......... 26 ....... A Artery x-rays, kidney ................................... 1.14 0.42 0.42 0.05 1.61 1.61 XXX 75722 .......... TC ...... A Artery x-rays, kidney ................................... 0.00 10.57 NA 0.65 11.22 NA XXX 75724 .......... ............ A Artery x-rays, kidneys .................................. 1.49 11.60 NA 0.70 13.79 NA XXX 75724 .......... 26 ....... A Artery x-rays, kidneys .................................. 1.49 0.59 0.59 0.05 2.13 2.13 XXX 75724 .......... TC ...... A Artery x-rays, kidneys .................................. 0.00 11.01 NA 0.65 11.66 NA XXX 75726 .......... ............ A Artery x-rays, abdomen ............................... 1.14 10.86 NA 0.70 12.70 NA XXX 75726 .......... 26 ....... A Artery x-rays, abdomen ............................... 1.14 0.39 0.39 0.05 1.58 1.58 XXX 75726 .......... TC ...... A Artery x-rays, abdomen ............................... 0.00 10.47 NA 0.65 11.12 NA XXX 75731 .......... ............ A Artery x-rays, adrenal gland ........................ 1.14 10.63 NA 0.71 12.49 NA XXX 75731 .......... 26 ....... A Artery x-rays, adrenal gland ........................ 1.14 0.39 0.39 0.06 1.60 1.60 XXX 75731 .......... TC ...... A Artery x-rays, adrenal gland ........................ 0.00 10.24 NA 0.65 10.89 NA XXX 75733 .......... ............ A Artery x-rays, adrenals ................................ 1.31 11.21 NA 0.71 13.24 NA XXX 75733 .......... 26 ....... A Artery x-rays, adrenals ................................ 1.31 0.46 0.46 0.06 1.84 1.84 XXX 75733 .......... TC ...... A Artery x-rays, adrenals ................................ 0.00 10.75 NA 0.65 11.40 NA XXX 75736 .......... ............ A Artery x-rays, pelvis ..................................... 1.14 10.89 NA 0.71 12.74 NA XXX 75736 .......... 26 ....... A Artery x-rays, pelvis ..................................... 1.14 0.40 0.40 0.06 1.60 1.60 XXX 75736 .......... TC ...... A Artery x-rays, pelvis ..................................... 0.00 10.49 NA 0.65 11.14 NA XXX


## 45963

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

75741 .......... ............ A Artery x-rays, lung ....................................... 1.31 10.77 NA 0.71 12.79 NA XXX 75741 .......... 26 ....... A Artery x-rays, lung ....................................... 1.31 0.46 0.46 0.06 1.83 1.83 XXX 75741 .......... TC ...... A Artery x-rays, lung ....................................... 0.00 10.32 NA 0.65 10.97 NA XXX 75743 .......... ............ A Artery x-rays, lungs ..................................... 1.66 10.97 NA 0.72 13.36 NA XXX 75743 .......... 26 ....... A Artery x-rays, lungs ..................................... 1.66 0.57 0.57 0.07 2.31 2.31 XXX 75743 .......... TC ...... A Artery x-rays, lungs ..................................... 0.00 10.40 NA 0.65 11.05 NA XXX 75746 .......... ............ A Artery x-rays, lung ....................................... 1.14 10.87 NA 0.70 12.72 NA XXX 75746 .......... 26 ....... A Artery x-rays, lung ....................................... 1.14 0.40 0.40 0.05 1.59 1.59 XXX 75746 .......... TC ...... A Artery x-rays, lung ....................................... 0.00 10.47 NA 0.65 11.12 NA XXX 75756 .......... ............ A Artery x-rays, chest ..................................... 1.14 11.30 NA 0.69 13.13 NA XXX 75756 .......... 26 ....... A Artery x-rays, chest ..................................... 1.14 0.47 0.47 0.04 1.65 1.65 XXX 75756 .......... TC ...... A Artery x-rays, chest ..................................... 0.00 10.82 NA 0.65 11.47 NA XXX 75774 .......... ............ A Artery x-ray, each vessel ............................ 0.36 10.44 NA 0.67 11.47 NA ZZZ 75774 .......... 26 ....... A Artery x-ray, each vessel ............................ 0.36 0.13 0.13 0.02 0.51 0.51 ZZZ 75774 .......... TC ...... A Artery x-ray, each vessel ............................ 0.00 10.31 NA 0.65 10.96 NA ZZZ
75790 .......... ............ A Visualize A-V shunt ..................................... 1.84 2.36 NA 0.17 4.38 NA XXX 75790 .......... 26 ....... A Visualize A-V shunt ..................................... 1.84 0.63 0.63 0.09 2.56 2.56 XXX 75790 .......... TC ...... A Visualize A-V shunt ..................................... 0.00 1.73 NA 0.08 1.81 NA XXX 75801 .......... ............ A Lymph vessel x-ray, arm/leg ....................... 0.81 NA NA 0.37 NA NA XXX 75801 .......... 26 ....... A Lymph vessel x-ray, arm/leg ....................... 0.81 0.28 0.28 0.08 1.17 1.17 XXX 75801 .......... TC ...... A Lymph vessel x-ray, arm/leg ....................... 0.00 NA NA 0.29 NA NA XXX 75803 .......... ............ A Lymph vessel x-ray,arms/legs ..................... 1.17 NA NA 0.34 NA NA XXX 75803 .......... 26 ....... A Lymph vessel x-ray,arms/legs ..................... 1.17 0.40 0.40 0.05 1.62 1.62 XXX 75803 .......... TC ...... A Lymph vessel x-ray,arms/legs ..................... 0.00 NA NA 0.29 NA NA XXX 75805 .......... ............ A Lymph vessel x-ray, trunk ........................... 0.81 NA NA 0.38 NA NA XXX 75805 .......... 26 ....... A Lymph vessel x-ray, trunk ........................... 0.81 0.28 0.28 0.05 1.14 1.14 XXX 75805 .......... TC ...... A Lymph vessel x-ray, trunk ........................... 0.00 NA NA 0.33 NA NA XXX 75807 .......... ............ A Lymph vessel x-ray, trunk ........................... 1.17 NA NA 0.38 NA NA XXX 75807 .......... 26 ....... A Lymph vessel x-ray, trunk ........................... 1.17 0.40 0.40 0.05 1.63 1.63 XXX 75807 .......... TC ...... A Lymph vessel x-ray, trunk ........................... 0.00 NA NA 0.33 NA NA XXX 75809 .......... ............ A Nonvascular shunt, x-ray ............................ 0.47 1.26 NA 0.07 1.80 NA XXX 75809 .......... 26 ....... A Nonvascular shunt, x-ray ............................ 0.47 0.16 0.16 0.02 0.65 0.65 XXX 75809 .......... TC ...... A Nonvascular shunt, x-ray ............................ 0.00 1.10 NA 0.05 1.15 NA XXX 75810 .......... ............ A Vein x-ray, spleen/liver ................................ 1.14 NA NA 0.70 NA NA XXX 75810 .......... 26 ....... A Vein x-ray, spleen/liver ................................ 1.14 0.39 0.39 0.05 1.58 1.58 XXX 75810 .......... TC ...... A Vein x-ray, spleen/liver ................................ 0.00 NA NA 0.65 NA NA XXX 75820 .......... ............ A Vein x-ray, arm/leg ...................................... 0.70 1.67 NA 0.09 2.46 NA XXX 75820 .......... 26 ....... A Vein x-ray, arm/leg ...................................... 0.70 0.24 0.24 0.03 0.97 0.97 XXX 75820 .......... TC ...... A Vein x-ray, arm/leg ...................................... 0.00 1.43 NA 0.06 1.49 NA XXX 75822 .......... ............ A Vein x-ray, arms/legs .................................. 1.06 2.25 NA 0.13 3.44 NA XXX 75822 .......... 26 ....... A Vein x-ray, arms/legs .................................. 1.06 0.37 0.37 0.05 1.48 1.48 XXX 75822 .......... TC ...... A Vein x-ray, arms/legs .................................. 0.00 1.88 NA 0.08 1.96 NA XXX 75825 .......... ............ A Vein x-ray, trunk .......................................... 1.14 10.64 NA 0.72 12.50 NA XXX 75825 .......... 26 ....... A Vein x-ray, trunk .......................................... 1.14 0.39 0.39 0.07 1.60 1.60 XXX 75825 .......... TC ...... A Vein x-ray, trunk .......................................... 0.00 10.25 NA 0.65 10.90 NA XXX 75827 .......... ............ A Vein x-ray, chest ......................................... 1.14 10.67 NA 0.70 12.51 NA XXX 75827 .......... 26 ....... A Vein x-ray, chest ......................................... 1.14 0.39 0.39 0.05 1.58 1.58 XXX 75827 .......... TC ...... A Vein x-ray, chest ......................................... 0.00 10.28 NA 0.65 10.93 NA XXX 75831 .......... ............ A Vein x-ray, kidney ........................................ 1.14 10.64 NA 0.71 12.49 NA XXX 75831 .......... 26 ....... A Vein x-ray, kidney ........................................ 1.14 0.39 0.39 0.06 1.59 1.59 XXX 75831 .......... TC ...... A Vein x-ray, kidney ........................................ 0.00 10.25 NA 0.65 10.90 NA XXX 75833 .......... ............ A Vein x-ray, kidneys ...................................... 1.49 10.96 NA 0.74 13.19 NA XXX 75833 .......... 26 ....... A Vein x-ray, kidneys ...................................... 1.49 0.52 0.52 0.09 2.10 2.10 XXX 75833 .......... TC ...... A Vein x-ray, kidneys ...................................... 0.00 10.43 NA 0.65 11.08 NA XXX 75840 .......... ............ A Vein x-ray, adrenal gland ............................ 1.14 10.79 NA 0.72 12.66 NA XXX 75840 .......... 26 ....... A Vein x-ray, adrenal gland ............................ 1.14 0.39 0.39 0.07 1.61 1.61 XXX 75840 .......... TC ...... A Vein x-ray, adrenal gland ............................ 0.00 10.40 NA 0.65 11.05 NA XXX 75842 .......... ............ A Vein x-ray, adrenal glands .......................... 1.49 10.98 NA 0.72 13.19 NA XXX 75842 .......... 26 ....... A Vein x-ray, adrenal glands .......................... 1.49 0.51 0.51 0.07 2.07 2.07 XXX 75842 .......... TC ...... A Vein x-ray, adrenal glands .......................... 0.00 10.47 NA 0.65 11.12 NA XXX 75860 .......... ............ A Vein x-ray, neck .......................................... 1.14 10.70 NA 0.69 12.53 NA XXX 75860 .......... 26 ....... A Vein x-ray, neck .......................................... 1.14 0.41 0.41 0.04 1.59 1.59 XXX 75860 .......... TC ...... A Vein x-ray, neck .......................................... 0.00 10.29 NA 0.65 10.94 NA XXX 75870 .......... ............ A Vein x-ray, skull ........................................... 1.14 10.60 NA 0.70 12.45 NA XXX 75870 .......... 26 ....... A Vein x-ray, skull ........................................... 1.14 0.41 0.41 0.05 1.60 1.60 XXX 75870 .......... TC ...... A Vein x-ray, skull ........................................... 0.00 10.20 NA 0.65 10.85 NA XXX 75872 .......... ............ A Vein x-ray, skull ........................................... 1.14 10.61 NA 0.79 12.54 NA XXX 75872 .......... 26 ....... A Vein x-ray, skull ........................................... 1.14 0.39 0.39 0.14 1.67 1.67 XXX 75872 .......... TC ...... A Vein x-ray, skull ........................................... 0.00 10.22 NA 0.65 10.87 NA XXX 75880 .......... ............ A Vein x-ray, eye socket ................................. 0.70 1.65 NA 0.09 2.44 NA XXX 75880 .......... 26 ....... A Vein x-ray, eye socket ................................. 0.70 0.24 0.24 0.03 0.97 0.97 XXX 75880 .......... TC ...... A Vein x-ray, eye socket ................................. 0.00 1.41 NA 0.06 1.47 NA XXX 75885 .......... ............ A Vein x-ray, liver ........................................... 1.44 11.06 NA 0.71 13.21 NA XXX 75885 .......... 26 ....... A Vein x-ray, liver ........................................... 1.44 0.50 0.50 0.06 2.00 2.00 XXX


## 45964

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

75885 .......... TC ...... A Vein x-ray, liver ........................................... 0.00 10.56 NA 0.65 11.21 NA XXX 75887 .......... ............ A Vein x-ray, liver ........................................... 1.44 11.75 NA 0.71 13.90 NA XXX 75887 .......... 26 ....... A Vein x-ray, liver ........................................... 1.44 0.50 0.50 0.06 2.00 2.00 XXX 75887 .......... TC ...... A Vein x-ray, liver ........................................... 0.00 11.25 NA 0.65 11.90 NA XXX 75889 .......... ............ A Vein x-ray, liver ........................................... 1.14 10.77 NA 0.70 12.61 NA XXX 75889 .......... 26 ....... A Vein x-ray, liver ........................................... 1.14 0.39 0.39 0.05 1.58 1.58 XXX 75889 .......... TC ...... A Vein x-ray, liver ........................................... 0.00 10.38 NA 0.65 11.03 NA XXX 75891 .......... ............ A Vein x-ray, liver ........................................... 1.14 10.56 NA 0.70 12.40 NA XXX 75891 .......... 26 ....... A Vein x-ray, liver ........................................... 1.14 0.39 0.39 0.05 1.58 1.58 XXX 75891 .......... TC ...... A Vein x-ray, liver ........................................... 0.00 10.17 NA 0.65 10.82 NA XXX 75893 .......... ............ A Venous sampling by catheter ...................... 0.54 11.08 NA 0.67 12.30 NA XXX 75893 .......... 26 ....... A Venous sampling by catheter ...................... 0.54 0.19 0.19 0.02 0.75 0.75 XXX 75893 .......... TC ...... A Venous sampling by catheter ...................... 0.00 10.89 NA 0.65 11.54 NA XXX 75894 .......... ............ A X-rays, transcath therapy ............................ 1.31 NA NA 1.35 NA NA XXX 75894 .......... 26 ....... A X-rays, transcath therapy ............................ 1.31 0.45 0.45 0.08 1.85 1.85 XXX 75894 .......... TC ...... A X-rays, transcath therapy ............................ 0.00 NA NA 1.27 NA NA XXX 75896 .......... ............ A X-rays, transcath therapy ............................ 1.31 NA NA 1.15 NA NA XXX 75896 .......... 26 ....... A X-rays, transcath therapy ............................ 1.31 0.47 0.47 0.05 1.84 1.84 XXX 75896 .......... TC ...... A X-rays, transcath therapy ............................ 0.00 NA NA 1.10 NA NA XXX 75898 .......... ............ A Follow-up angiography ................................ 1.65 NA NA 0.13 NA NA XXX 75898 .......... 26 ....... A Follow-up angiography ................................ 1.65 0.58 0.58 0.07 2.30 2.30 XXX 75898 .......... TC ...... A Follow-up angiography ................................ 0.00 NA NA 0.06 NA NA XXX 75900 .......... ............ A Arterial catheter exchange .......................... 0.49 NA NA 1.14 NA NA XXX 75900 .......... 26 ....... A Arterial catheter exchange .......................... 0.49 0.17 0.17 0.03 0.69 0.69 XXX 75900 .......... TC ...... A Arterial catheter exchange .......................... 0.00 NA NA 1.11 NA NA XXX
75901 .......... ............ A Remove cva device obstruct ....................... 0.49 2.30 NA 0.85 3.64 NA XXX 75901 .......... 26 ....... A Remove cva device obstruct ....................... 0.49 0.17 0.17 0.02 0.68 0.68 XXX 75901 .......... TC ...... A Remove cva device obstruct ....................... 0.00 2.13 NA 0.83 2.96 NA XXX
75902 .......... ............ A Remove cva lumen obstruct ....................... 0.39 1.56 NA 0.85 2.80 NA XXX 75902 .......... 26 ....... A Remove cva lumen obstruct ....................... 0.39 0.14 0.14 0.02 0.55 0.55 XXX 75902 .......... TC ...... A Remove cva lumen obstruct ....................... 0.00 1.43 NA 0.83 2.26 NA XXX 75940 .......... ............ A X-ray placement, vein filter ......................... 0.54 NA NA 0.69 NA NA XXX 75940 .......... 26 ....... A X-ray placement, vein filter ......................... 0.54 0.19 0.19 0.04 0.77 0.77 XXX 75940 .......... TC ...... A X-ray placement, vein filter ......................... 0.00 NA NA 0.65 NA NA XXX
75945 .......... ............ A Intravascular us ........................................... 0.40 NA NA 0.28 NA NA XXX 75945 .......... 26 ....... A Intravascular us ........................................... 0.40 0.14 0.14 0.04 0.58 0.58 XXX 75945 .......... TC ...... A Intravascular us ........................................... 0.00 NA NA 0.24 NA NA XXX
75946 .......... ............ A Intravascular us add-on ............................... 0.40 NA NA 0.18 NA NA ZZZ 75946 .......... 26 ....... A Intravascular us add-on ............................... 0.40 0.14 0.14 0.05 0.59 0.59 ZZZ 75946 .......... TC ...... A Intravascular us add-on ............................... 0.00 NA NA 0.13 NA NA ZZZ 75952 .......... ............ C Endovasc repair abdom aorta ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75952 .......... 26 ....... A Endovasc repair abdom aorta ..................... 4.50 1.51 1.51 0.43 6.44 6.44 XXX 75952 .......... TC ...... C Endovasc repair abdom aorta ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75953 .......... ............ C Abdom aneurysm endovas rpr .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75953 .......... 26 ....... A Abdom aneurysm endovas rpr .................... 1.36 0.46 0.46 0.13 1.95 1.95 XXX 75953 .......... TC ...... C Abdom aneurysm endovas rpr .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75954 .......... ............ C Iliac aneurysm endovas rpr ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75954 .......... 26 ....... A Iliac aneurysm endovas rpr ......................... 2.25 0.81 0.81 0.15 3.22 3.22 XXX 75954 .......... TC ...... C Iliac aneurysm endovas rpr ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
75960 .......... ............ A Transcath iv stent rs&i ................................ 0.82 NA NA 0.82 NA NA XXX 75960 .......... 26 ....... A Transcath iv stent rs&i ................................ 0.82 0.30 0.30 0.05 1.17 1.17 XXX 75960 .......... TC ...... A Transcath iv stent rs&i ................................ 0.00 NA NA 0.77 NA NA XXX 75961 .......... ............ A Retrieval, broken catheter ........................... 4.25 10.29 NA 0.73 15.27 NA XXX 75961 .......... 26 ....... A Retrieval, broken catheter ........................... 4.25 1.47 1.47 0.18 5.90 5.90 XXX 75961 .......... TC ...... A Retrieval, broken catheter ........................... 0.00 8.82 NA 0.55 9.37 NA XXX 75962 .......... ............ A Repair arterial blockage .............................. 0.54 13.03 NA 0.86 14.43 NA XXX 75962 .......... 26 ....... A Repair arterial blockage .............................. 0.54 0.19 0.19 0.03 0.76 0.76 XXX 75962 .......... TC ...... A Repair arterial blockage .............................. 0.00 12.84 NA 0.83 13.67 NA XXX 75964 .......... ............ A Repair artery blockage, each ...................... 0.36 7.07 NA 0.46 7.89 NA ZZZ 75964 .......... 26 ....... A Repair artery blockage, each ...................... 0.36 0.13 0.13 0.03 0.52 0.52 ZZZ 75964 .......... TC ...... A Repair artery blockage, each ...................... 0.00 6.94 NA 0.43 7.37 NA ZZZ 75966 .......... ............ A Repair arterial blockage .............................. 1.31 13.24 NA 0.89 15.44 NA XXX 75966 .......... 26 ....... A Repair arterial blockage .............................. 1.31 0.48 0.48 0.06 1.86 1.86 XXX 75966 .......... TC ...... A Repair arterial blockage .............................. 0.00 12.75 NA 0.83 13.58 NA XXX 75968 .......... ............ A Repair artery blockage, each ...................... 0.36 7.01 NA 0.45 7.82 NA ZZZ 75968 .......... 26 ....... A Repair artery blockage, each ...................... 0.36 0.14 0.14 0.02 0.52 0.52 ZZZ 75968 .......... TC ...... A Repair artery blockage, each ...................... 0.00 6.87 NA 0.43 7.30 NA ZZZ 75970 .......... ............ A Vascular biopsy ........................................... 0.83 NA NA 0.64 NA NA XXX 75970 .......... 26 ....... A Vascular biopsy ........................................... 0.83 0.30 0.30 0.04 1.17 1.17 XXX 75970 .......... TC ...... A Vascular biopsy ........................................... 0.00 NA NA 0.60 NA NA XXX 75978 .......... ............ A Repair venous blockage .............................. 0.54 13.02 NA 0.85 14.41 NA XXX 75978 .......... 26 ....... A Repair venous blockage .............................. 0.54 0.19 0.19 0.02 0.75 0.75 XXX 75978 .......... TC ...... A Repair venous blockage .............................. 0.00 12.83 NA 0.83 13.66 NA XXX 75980 .......... ............ A Contrast xray exam bile duct ...................... 1.44 NA NA 0.35 NA NA XXX


## 45965

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

75980 .......... 26 ....... A Contrast xray exam bile duct ...................... 1.44 0.50 0.50 0.06 2.00 2.00 XXX 75980 .......... TC ...... A Contrast xray exam bile duct ...................... 0.00 NA NA 0.29 NA NA XXX 75982 .......... ............ A Contrast xray exam bile duct ...................... 1.44 NA NA 0.39 NA NA XXX 75982 .......... 26 ....... A Contrast xray exam bile duct ...................... 1.44 0.50 0.50 0.06 2.00 2.00 XXX 75982 .......... TC ...... A Contrast xray exam bile duct ...................... 0.00 NA NA 0.33 NA NA XXX 75984 .......... ............ A Xray control catheter change ...................... 0.72 2.31 NA 0.14 3.18 NA XXX 75984 .......... 26 ....... A Xray control catheter change ...................... 0.72 0.25 0.25 0.03 1.00 1.00 XXX 75984 .......... TC ...... A Xray control catheter change ...................... 0.00 2.07 NA 0.11 2.18 NA XXX 75989 .......... ............ A Abscess drainage under x-ray .................... 1.19 3.31 NA 0.22 4.72 NA XXX 75989 .......... 26 ....... A Abscess drainage under x-ray .................... 1.19 0.41 0.41 0.05 1.65 1.65 XXX 75989 .......... TC ...... A Abscess drainage under x-ray .................... 0.00 2.90 NA 0.17 3.07 NA XXX 75992 .......... ............ A Atherectomy, x-ray exam ............................ 0.54 NA NA 0.86 NA NA XXX 75992 .......... 26 ....... A Atherectomy, x-ray exam ............................ 0.54 0.20 0.20 0.03 0.77 0.77 XXX 75992 .......... TC ...... A Atherectomy, x-ray exam ............................ 0.00 NA NA 0.83 NA NA XXX 75993 .......... ............ A Atherectomy, x-ray exam ............................ 0.36 NA NA 0.45 NA NA ZZZ 75993 .......... 26 ....... A Atherectomy, x-ray exam ............................ 0.36 0.14 0.14 0.02 0.52 0.52 ZZZ 75993 .......... TC ...... A Atherectomy, x-ray exam ............................ 0.00 NA NA 0.43 NA NA ZZZ 75994 .......... ............ A Atherectomy, x-ray exam ............................ 1.31 NA NA 0.90 NA NA XXX 75994 .......... 26 ....... A Atherectomy, x-ray exam ............................ 1.31 0.48 0.48 0.07 1.86 1.86 XXX 75994 .......... TC ...... A Atherectomy, x-ray exam ............................ 0.00 NA NA 0.83 NA NA XXX 75995 .......... ............ A Atherectomy, x-ray exam ............................ 1.31 NA NA 0.88 NA NA XXX 75995 .......... 26 ....... A Atherectomy, x-ray exam ............................ 1.31 0.50 0.50 0.05 1.86 1.86 XXX 75995 .......... TC ...... A Atherectomy, x-ray exam ............................ 0.00 NA NA 0.83 NA NA XXX 75996 .......... ............ A Atherectomy, x-ray exam ............................ 0.36 NA NA 0.45 NA NA ZZZ 75996 .......... 26 ....... A Atherectomy, x-ray exam ............................ 0.36 0.12 0.12 0.02 0.50 0.50 ZZZ 75996 .......... TC ...... A Atherectomy, x-ray exam ............................ 0.00 NA NA 0.43 NA NA ZZZ 75998 .......... ............ A Fluoroguide for vein device ......................... 0.38 1.88 NA 0.11 2.37 NA ZZZ 75998 .......... 26 ....... A Fluoroguide for vein device ......................... 0.38 0.14 0.14 0.01 0.53 0.53 ZZZ 75998 .......... TC ...... A Fluoroguide for vein device ......................... 0.00 1.75 NA 0.10 1.85 NA ZZZ 76000 .......... ............ A Fluoroscope examination ............................ 0.17 1.78 NA 0.08 2.03 NA XXX 76000 .......... 26 ....... A Fluoroscope examination ............................ 0.17 0.05 0.05 0.01 0.23 0.23 XXX 76000 .......... TC ...... A Fluoroscope examination ............................ 0.00 1.72 NA 0.07 1.79 NA XXX 76001 .......... ............ A Fluoroscope exam, extensive ..................... 0.67 NA NA 0.19 NA NA XXX 76001 .......... 26 ....... A Fluoroscope exam, extensive ..................... 0.67 0.23 0.23 0.05 0.95 0.95 XXX 76001 .......... TC ...... A Fluoroscope exam, extensive ..................... 0.00 NA NA 0.14 NA NA XXX 76003 .......... ............ A Needle localization by x-ray ........................ 0.54 1.47 NA 0.09 2.10 NA XXX 76003 .......... 26 ....... A Needle localization by x-ray ........................ 0.54 0.18 0.18 0.02 0.74 0.74 XXX 76003 .......... TC ...... A Needle localization by x-ray ........................ 0.00 1.30 NA 0.07 1.37 NA XXX 76005 .......... ............ A Fluoroguide for spine inject ......................... 0.60 1.34 NA 0.10 2.04 NA XXX 76005 .......... 26 ....... A Fluoroguide for spine inject ......................... 0.60 0.15 0.15 0.03 0.78 0.78 XXX 76005 .......... TC ...... A Fluoroguide for spine inject ......................... 0.00 1.19 NA 0.07 1.26 NA XXX 76006 .......... ............ A X-ray stress view ......................................... 0.41 0.32 0.17 0.06 0.79 0.64 XXX 76010 .......... ............ A X-ray, nose to rectum .................................. 0.18 0.58 NA 0.03 0.79 NA XXX 76010 .......... 26 ....... A X-ray, nose to rectum .................................. 0.18 0.06 0.06 0.01 0.25 0.25 XXX 76010 .......... TC ...... A X-ray, nose to rectum .................................. 0.00 0.52 NA 0.02 0.54 NA XXX 76012 .......... ............ C Percut vertebroplasty fluor .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76012 .......... 26 ....... A Percut vertebroplasty fluor .......................... 1.31 0.49 0.49 0.10 1.90 1.90 XXX 76012 .......... TC ...... C Percut vertebroplasty fluor .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76013 .......... ............ C Percut vertebroplasty, ct ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76013 .......... 26 ....... A Percut vertebroplasty, ct ............................. 1.38 0.50 0.50 0.07 1.96 1.96 XXX 76013 .......... TC ...... C Percut vertebroplasty, ct ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76020 .......... ............ A X-rays for bone age .................................... 0.19 0.55 NA 0.03 0.77 NA XXX 76020 .......... 26 ....... A X-rays for bone age .................................... 0.19 0.06 0.06 0.01 0.26 0.26 XXX 76020 .......... TC ...... A X-rays for bone age .................................... 0.00 0.49 NA 0.02 0.51 NA XXX 76040 .......... ............ A X-rays, bone evaluation .............................. 0.27 0.82 NA 0.06 1.15 NA XXX 76040 .......... 26 ....... A X-rays, bone evaluation .............................. 0.27 0.09 0.09 0.01 0.37 0.37 XXX 76040 .......... TC ...... A X-rays, bone evaluation .............................. 0.00 0.73 NA 0.05 0.78 NA XXX 76061 .......... ............ A X-rays, bone survey .................................... 0.45 1.31 NA 0.08 1.84 NA XXX 76061 .......... 26 ....... A X-rays, bone survey .................................... 0.45 0.16 0.16 0.02 0.63 0.63 XXX 76061 .......... TC ...... A X-rays, bone survey .................................... 0.00 1.15 NA 0.06 1.21 NA XXX 76062 .......... ............ A X-rays, bone survey .................................... 0.54 1.93 NA 0.10 2.57 NA XXX 76062 .......... 26 ....... A X-rays, bone survey .................................... 0.54 0.19 0.19 0.02 0.75 0.75 XXX 76062 .......... TC ...... A X-rays, bone survey .................................... 0.00 1.74 NA 0.08 1.82 NA XXX 76065 .......... ............ A X-rays, bone evaluation .............................. 0.70 1.27 NA 0.08 2.05 NA XXX 76065 .......... 26 ....... A X-rays, bone evaluation .............................. 0.70 0.24 0.24 0.03 0.97 0.97 XXX 76065 .......... TC ...... A X-rays, bone evaluation .............................. 0.00 1.03 NA 0.05 1.08 NA XXX 76066 .......... ............ A Joint survey, single view ............................. 0.31 1.06 NA 0.08 1.45 NA XXX 76066 .......... 26 ....... A Joint survey, single view ............................. 0.31 0.11 0.11 0.02 0.44 0.44 XXX 76066 .......... TC ...... A Joint survey, single view ............................. 0.00 0.96 NA 0.06 1.02 NA XXX 76070 .......... ............ A Ct bone density, axial .................................. 0.25 3.37 NA 0.17 3.79 NA XXX 76070 .......... 26 ....... A Ct bone density, axial .................................. 0.25 0.09 0.09 0.01 0.35 0.35 XXX 76070 .......... TC ...... A Ct bone density, axial .................................. 0.00 3.29 NA 0.16 3.45 NA XXX 76071 .......... ............ A Ct bone density, peripheral ......................... 0.22 2.43 NA 0.06 2.71 NA XXX 76071 .......... 26 ....... A Ct bone density, peripheral ......................... 0.22 0.07 0.07 0.01 0.30 0.30 XXX


## 45966

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

76071 .......... TC ...... A Ct bone density, peripheral ......................... 0.00 2.36 NA 0.05 2.41 NA XXX 76075 .......... ............ A Dxa bone density, axial ............................... 0.30 2.58 NA 0.18 3.06 NA XXX 76075 .......... 26 ....... A Dxa bone density, axial ............................... 0.30 0.11 0.11 0.01 0.42 0.42 XXX 76075 .......... TC ...... A Dxa bone density, axial ............................... 0.00 2.47 NA 0.17 2.64 NA XXX 76076 .......... ............ A Dxa bone density/peripheral ....................... 0.22 0.75 NA 0.06 1.03 NA XXX 76076 .......... 26 ....... A Dxa bone density/peripheral ....................... 0.22 0.08 0.08 0.01 0.31 0.31 XXX 76076 .......... TC ...... A Dxa bone density/peripheral ....................... 0.00 0.67 NA 0.05 0.72 NA XXX 76077 .......... ............ A Dxa bone density/v-fracture ........................ 0.17 0.71 NA 0.06 0.94 NA XXX 76077 .......... 26 ....... A Dxa bone density/v-fracture ........................ 0.17 0.06 0.06 0.01 0.24 0.24 XXX 76077 .......... TC ...... A Dxa bone density/v-fracture ........................ 0.00 0.65 NA 0.05 0.70 NA XXX 76078 .......... ............ A Radiographic absorptiometry ...................... 0.20 0.70 NA 0.06 0.96 NA XXX 76078 .......... 26 ....... A Radiographic absorptiometry ...................... 0.20 0.07 0.07 0.01 0.28 0.28 XXX 76078 .......... TC ...... A Radiographic absorptiometry ...................... 0.00 0.63 NA 0.05 0.68 NA XXX 76080 .......... ............ A X-ray exam of fistula ................................... 0.54 1.23 NA 0.08 1.86 NA XXX 76080 .......... 26 ....... A X-ray exam of fistula ................................... 0.54 0.19 0.19 0.02 0.75 0.75 XXX 76080 .......... TC ...... A X-ray exam of fistula ................................... 0.00 1.05 NA 0.06 1.11 NA XXX 76082 .......... ............ A Computer mammogram add-on .................. 0.06 0.39 NA 0.02 0.47 NA ZZZ 76082 .......... 26 ....... A Computer mammogram add-on .................. 0.06 0.02 0.02 0.01 0.09 0.09 ZZZ 76082 .......... TC ...... A Computer mammogram add-on .................. 0.00 0.37 NA 0.01 0.38 NA ZZZ 76083 .......... ............ A Computer mammogram add-on .................. 0.06 0.39 NA 0.02 0.47 NA ZZZ 76083 .......... 26 ....... A Computer mammogram add-on .................. 0.06 0.02 0.02 0.01 0.09 0.09 ZZZ 76083 .......... TC ...... A Computer mammogram add-on .................. 0.00 0.37 NA 0.01 0.38 NA ZZZ 76086 .......... ............ A X-ray of mammary duct ............................... 0.36 2.40 NA 0.16 2.92 NA XXX 76086 .......... 26 ....... A X-ray of mammary duct ............................... 0.36 0.13 0.13 0.02 0.51 0.51 XXX 76086 .......... TC ...... A X-ray of mammary duct ............................... 0.00 2.28 NA 0.14 2.42 NA XXX 76088 .......... ............ A X-ray of mammary ducts ............................. 0.45 3.32 NA 0.21 3.99 NA XXX 76088 .......... 26 ....... A X-ray of mammary ducts ............................. 0.45 0.16 0.16 0.02 0.63 0.63 XXX 76088 .......... TC ...... A X-ray of mammary ducts ............................. 0.00 3.17 NA 0.19 3.36 NA XXX 76090 .......... ............ A Mammogram, one breast ............................ 0.70 1.44 NA 0.09 2.23 NA XXX 76090 .......... 26 ....... A Mammogram, one breast ............................ 0.70 0.24 0.24 0.03 0.97 0.97 XXX 76090 .......... TC ...... A Mammogram, one breast ............................ 0.00 1.20 NA 0.06 1.26 NA XXX 76091 .......... ............ A Mammogram, both breasts ......................... 0.87 1.82 NA 0.11 2.80 NA XXX 76091 .......... 26 ....... A Mammogram, both breasts ......................... 0.87 0.30 0.30 0.04 1.21 1.21 XXX 76091 .......... TC ...... A Mammogram, both breasts ......................... 0.00 1.52 NA 0.07 1.59 NA XXX 76092 .......... ............ A Mammogram, screening .............................. 0.70 1.51 NA 0.10 2.31 NA XXX 76092 .......... 26 ....... A Mammogram, screening .............................. 0.70 0.24 0.24 0.03 0.97 0.97 XXX 76092 .......... TC ...... A Mammogram, screening .............................. 0.00 1.27 NA 0.07 1.34 NA XXX 76093 .......... ............ A Magnetic image, breast ............................... 1.63 18.79 NA 0.99 21.41 NA XXX 76093 .......... 26 ....... A Magnetic image, breast ............................... 1.63 0.56 0.56 0.07 2.26 2.26 XXX 76093 .......... TC ...... A Magnetic image, breast ............................... 0.00 18.23 NA 0.92 19.15 NA XXX 76094 .......... ............ A Magnetic image, both breasts ..................... 1.63 23.36 NA 1.31 26.31 NA XXX 76094 .......... 26 ....... A Magnetic image, both breasts ..................... 1.63 0.56 0.56 0.07 2.26 2.26 XXX 76094 .......... TC ...... A Magnetic image, both breasts ..................... 0.00 22.81 NA 1.24 24.05 NA XXX 76095 .......... ............ A Stereotactic breast biopsy ........................... 1.59 6.38 NA 0.46 8.43 NA XXX 76095 .......... 26 ....... A Stereotactic breast biopsy ........................... 1.59 0.54 0.54 0.09 2.22 2.22 XXX 76095 .......... TC ...... A Stereotactic breast biopsy ........................... 0.00 5.84 NA 0.37 6.21 NA XXX 76096 .......... ............ A X-ray of needle wire, breast ........................ 0.56 1.37 NA 0.09 2.02 NA XXX 76096 .......... 26 ....... A X-ray of needle wire, breast ........................ 0.56 0.19 0.19 0.02 0.77 0.77 XXX 76096 .......... TC ...... A X-ray of needle wire, breast ........................ 0.00 1.17 NA 0.07 1.24 NA XXX 76098 .......... ............ A X-ray exam, breast specimen ..................... 0.16 0.46 NA 0.03 0.65 NA XXX 76098 .......... 26 ....... A X-ray exam, breast specimen ..................... 0.16 0.05 0.05 0.01 0.22 0.22 XXX 76098 .......... TC ...... A X-ray exam, breast specimen ..................... 0.00 0.40 NA 0.02 0.42 NA XXX 76100 .......... ............ A X-ray exam of body section ........................ 0.58 2.02 NA 0.10 2.70 NA XXX 76100 .......... 26 ....... A X-ray exam of body section ........................ 0.58 0.20 0.20 0.03 0.81 0.81 XXX 76100 .......... TC ...... A X-ray exam of body section ........................ 0.00 1.82 NA 0.07 1.89 NA XXX 76101 .......... ............ A Complex body section x-ray ........................ 0.58 2.53 NA 0.11 3.22 NA XXX 76101 .......... 26 ....... A Complex body section x-ray ........................ 0.58 0.20 0.20 0.03 0.81 0.81 XXX 76101 .......... TC ...... A Complex body section x-ray ........................ 0.00 2.32 NA 0.08 2.40 NA XXX 76102 .......... ............ A Complex body section x-rays ...................... 0.58 3.39 NA 0.14 4.11 NA XXX 76102 .......... 26 ....... A Complex body section x-rays ...................... 0.58 0.20 0.20 0.03 0.81 0.81 XXX 76102 .......... TC ...... A Complex body section x-rays ...................... 0.00 3.19 NA 0.11 3.30 NA XXX 76120 .......... ............ A Cine/video x-rays ......................................... 0.38 1.78 NA 0.08 2.24 NA XXX 76120 .......... 26 ....... A Cine/video x-rays ......................................... 0.38 0.14 0.14 0.02 0.54 0.54 XXX 76120 .......... TC ...... A Cine/video x-rays ......................................... 0.00 1.65 NA 0.06 1.71 NA XXX 76125 .......... ............ A Cine/video x-rays add-on ............................ 0.27 NA NA 0.06 NA NA ZZZ 76125 .......... 26 ....... A Cine/video x-rays add-on ............................ 0.27 0.10 0.10 0.01 0.38 0.38 ZZZ 76125 .......... TC ...... A Cine/video x-rays add-on ............................ 0.00 NA NA 0.05 NA NA ZZZ 76140 .......... ............ I X-ray consultation ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76150 .......... ............ A X-ray exam, dry process ............................. 0.00 0.45 NA 0.02 0.47 NA XXX 76350 .......... ............ C Special x-ray contrast study ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76355 .......... ............ A Ct scan for localization ................................ 1.21 12.79 NA 0.47 14.47 NA XXX 76355 .......... 26 ....... A Ct scan for localization ................................ 1.21 0.42 0.42 0.05 1.68 1.68 XXX 76355 .......... TC ...... A Ct scan for localization ................................ 0.00 12.37 NA 0.42 12.79 NA XXX 76360 .......... ............ A Ct scan for needle biopsy ........................... 1.16 7.23 NA 0.47 8.86 NA XXX


## 45967

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

76360 .......... 26 ....... A Ct scan for needle biopsy ........................... 1.16 0.40 0.40 0.05 1.61 1.61 XXX 76360 .......... TC ...... A Ct scan for needle biopsy ........................... 0.00 6.83 NA 0.42 7.25 NA XXX 76362 .......... ............ A Ct guide for tissue ablation ......................... 4.00 NA NA 1.65 NA NA XXX 76362 .......... 26 ....... A Ct guide for tissue ablation ......................... 4.00 1.37 1.37 0.18 5.55 5.55 XXX 76362 .......... TC ...... A Ct guide for tissue ablation ......................... 0.00 NA NA 1.46 NA NA XXX 76370 .......... ............ A Ct scan for therapy guide ............................ 0.85 3.57 NA 0.20 4.63 NA XXX 76370 .......... 26 ....... A Ct scan for therapy guide ............................ 0.85 0.29 0.29 0.04 1.18 1.18 XXX 76370 .......... TC ...... A Ct scan for therapy guide ............................ 0.00 3.28 NA 0.16 3.44 NA XXX 76375 .......... ............ A 3d/holograph reconstr add-on ..................... 0.16 2.92 NA 0.19 3.27 NA XXX 76375 .......... 26 ....... A 3d/holograph reconstr add-on ..................... 0.16 0.05 0.05 0.01 0.22 0.22 XXX 76375 .......... TC ...... A 3d/holograph reconstr add-on ..................... 0.00 2.87 NA 0.18 3.05 NA XXX 76380 .......... ............ A CAT scan follow-up study ........................... 0.98 4.06 NA 0.22 5.27 NA XXX 76380 .......... 26 ....... A CAT scan follow-up study ........................... 0.98 0.34 0.34 0.04 1.36 1.36 XXX 76380 .......... TC ...... A CAT scan follow-up study ........................... 0.00 3.73 NA 0.18 3.91 NA XXX 76390 .......... ............ N Mr spectroscopy .......................................... 1.40 10.86 NA 0.66 12.92 NA XXX 76390 .......... 26 ....... N Mr spectroscopy .......................................... 1.40 0.49 0.49 0.07 1.96 1.96 XXX 76390 .......... TC ...... N Mr spectroscopy .......................................... 0.00 10.37 NA 0.59 10.96 NA XXX 76393 .......... ............ A Mr guidance for needle place ..................... 1.50 11.11 NA 0.64 13.25 NA XXX 76393 .......... 26 ....... A Mr guidance for needle place ..................... 1.50 0.52 0.52 0.09 2.11 2.11 XXX 76393 .......... TC ...... A Mr guidance for needle place ..................... 0.00 10.59 NA 0.55 11.14 NA XXX 76394 .......... ............ A Mri for tissue ablation .................................. 4.25 NA NA 1.81 NA NA XXX 76394 .......... 26 ....... A Mri for tissue ablation .................................. 4.25 1.45 1.45 0.24 5.94 5.94 XXX 76394 .......... TC ...... A Mri for tissue ablation .................................. 0.00 NA NA 1.57 NA NA XXX 76400 .......... ............ A Magnetic image, bone marrow .................... 1.60 12.18 NA 0.66 14.45 NA XXX 76400 .......... 26 ....... A Magnetic image, bone marrow .................... 1.60 0.55 0.55 0.07 2.22 2.22 XXX 76400 .......... TC ...... A Magnetic image, bone marrow .................... 0.00 11.63 NA 0.59 12.22 NA XXX 76496 .......... ............ C Fluoroscopic procedure ............................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76496 .......... 26 ....... C Fluoroscopic procedure ............................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76496 .......... TC ...... C Fluoroscopic procedure ............................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76497 .......... ............ C Ct procedure ................................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76497 .......... 26 ....... C Ct procedure ................................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76497 .......... TC ...... C Ct procedure ................................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76498 .......... ............ C Mri procedure .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76498 .......... 26 ....... C Mri procedure .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76498 .......... TC ...... C Mri procedure .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76499 .......... ............ C Radiographic procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76499 .......... 26 ....... C Radiographic procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76499 .......... TC ...... C Radiographic procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76506 .......... ............ A Echo exam of head ..................................... 0.63 1.95 NA 0.14 2.72 NA XXX 76506 .......... 26 ....... A Echo exam of head ..................................... 0.63 0.24 0.24 0.06 0.93 0.93 XXX 76506 .......... TC ...... A Echo exam of head ..................................... 0.00 1.71 NA 0.08 1.79 NA XXX 76510 .......... ............ A Ophth us, b & quant a ................................. 1.55 2.73 NA 0.10 4.38 NA XXX 76510 .......... 26 ....... A Ophth us, b & quant a ................................. 1.55 0.67 0.67 0.03 2.25 2.25 XXX 76510 .......... TC ...... A Ophth us, b & quant a ................................. 0.00 2.06 NA 0.07 2.13 NA XXX 76511 .......... ............ A Ophth us, quant a only ................................ 0.94 2.24 NA 0.10 3.28 NA XXX 76511 .......... 26 ....... A Ophth us, quant a only ................................ 0.94 0.40 0.40 0.03 1.37 1.37 XXX 76511 .......... TC ...... A Ophth us, quant a only ................................ 0.00 1.85 NA 0.07 1.92 NA XXX 76512 .......... ............ A Ophth us, b w/non-quant a ......................... 0.94 2.05 NA 0.12 3.11 NA XXX 76512 .......... 26 ....... A Ophth us, b w/non-quant a ......................... 0.94 0.41 0.41 0.02 1.37 1.37 XXX 76512 .......... TC ...... A Ophth us, b w/non-quant a ......................... 0.00 1.64 NA 0.10 1.74 NA XXX 76513 .......... ............ A Echo exam of eye, water bath .................... 0.66 1.73 NA 0.12 2.51 NA XXX 76513 .......... 26 ....... A Echo exam of eye, water bath .................... 0.66 0.28 0.28 0.02 0.96 0.96 XXX 76513 .......... TC ...... A Echo exam of eye, water bath .................... 0.00 1.45 NA 0.10 1.55 NA XXX 76514 .......... ............ A Echo exam of eye, thickness ...................... 0.17 0.13 NA 0.02 0.32 NA XXX 76514 .......... 26 ....... A Echo exam of eye, thickness ...................... 0.17 0.08 0.08 0.01 0.26 0.26 XXX 76514 .......... TC ...... A Echo exam of eye, thickness ...................... 0.00 0.05 NA 0.01 0.06 NA XXX 76516 .......... ............ A Echo exam of eye ....................................... 0.54 1.39 NA 0.08 2.01 NA XXX 76516 .......... 26 ....... A Echo exam of eye ....................................... 0.54 0.24 0.24 0.01 0.79 0.79 XXX 76516 .......... TC ...... A Echo exam of eye ....................................... 0.00 1.16 NA 0.07 1.23 NA XXX 76519 .......... ............ A Echo exam of eye ....................................... 0.54 1.48 NA 0.08 2.10 NA XXX 76519 .......... 26 ....... A Echo exam of eye ....................................... 0.54 0.24 0.24 0.01 0.79 0.79 XXX 76519 .......... TC ...... A Echo exam of eye ....................................... 0.00 1.25 NA 0.07 1.32 NA XXX 76529 .......... ............ A Echo exam of eye ....................................... 0.57 1.33 NA 0.10 2.00 NA XXX 76529 .......... 26 ....... A Echo exam of eye ....................................... 0.57 0.24 0.24 0.02 0.83 0.83 XXX 76529 .......... TC ...... A Echo exam of eye ....................................... 0.00 1.09 NA 0.08 1.17 NA XXX
76536 .......... ............ A Us exam of head and neck ......................... 0.56 1.90 NA 0.10 2.56 NA XXX 76536 .......... 26 ....... A Us exam of head and neck ......................... 0.56 0.19 0.19 0.02 0.77 0.77 XXX 76536 .......... TC ...... A Us exam of head and neck ......................... 0.00 1.71 NA 0.08 1.79 NA XXX 76604 .......... ............ A Us exam, chest, b-scan .............................. 0.55 1.66 NA 0.09 2.30 NA XXX 76604 .......... 26 ....... A Us exam, chest, b-scan .............................. 0.55 0.19 0.19 0.02 0.76 0.76 XXX 76604 .......... TC ...... A Us exam, chest, b-scan .............................. 0.00 1.47 NA 0.07 1.54 NA XXX 76645 .......... ............ A Us exam, breast(s) ...................................... 0.54 1.47 NA 0.08 2.09 NA XXX 76645 .......... 26 ....... A Us exam, breast(s) ...................................... 0.54 0.19 0.19 0.02 0.75 0.75 XXX 76645 .......... TC ...... A Us exam, breast(s) ...................................... 0.00 1.29 NA 0.06 1.35 NA XXX


## 45968

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

76700 .......... ............ A Us exam, abdom, complete ........................ 0.81 2.52 NA 0.15 3.48 NA XXX 76700 .......... 26 ....... A Us exam, abdom, complete ........................ 0.81 0.28 0.28 0.04 1.13 1.13 XXX 76700 .......... TC ...... A Us exam, abdom, complete ........................ 0.00 2.24 NA 0.11 2.35 NA XXX 76705 .......... ............ A Echo exam of abdomen .............................. 0.59 1.91 NA 0.11 2.61 NA XXX 76705 .......... 26 ....... A Echo exam of abdomen .............................. 0.59 0.20 0.20 0.03 0.82 0.82 XXX 76705 .......... TC ...... A Echo exam of abdomen .............................. 0.00 1.71 NA 0.08 1.79 NA XXX 76770 .......... ............ A Us exam abdo back wall, comp .................. 0.74 2.52 NA 0.14 3.40 NA XXX 76770 .......... 26 ....... A Us exam abdo back wall, comp .................. 0.74 0.25 0.25 0.03 1.02 1.02 XXX 76770 .......... TC ...... A Us exam abdo back wall, comp .................. 0.00 2.27 NA 0.11 2.38 NA XXX 76775 .......... ............ A Us exam abdo back wall, lim ...................... 0.58 1.89 NA 0.11 2.58 NA XXX 76775 .......... 26 ....... A Us exam abdo back wall, lim ...................... 0.58 0.20 0.20 0.03 0.81 0.81 XXX 76775 .......... TC ...... A Us exam abdo back wall, lim ...................... 0.00 1.69 NA 0.08 1.77 NA XXX 76778 .......... ............ A Us exam kidney transplant .......................... 0.74 2.52 NA 0.14 3.40 NA XXX 76778 .......... 26 ....... A Us exam kidney transplant .......................... 0.74 0.25 0.25 0.03 1.02 1.02 XXX 76778 .......... TC ...... A Us exam kidney transplant .......................... 0.00 2.27 NA 0.11 2.38 NA XXX 76800 .......... ............ A Us exam, spinal canal ................................. 1.13 1.98 NA 0.13 3.24 NA XXX 76800 .......... 26 ....... A Us exam, spinal canal ................................. 1.13 0.34 0.34 0.05 1.52 1.52 XXX 76800 .......... TC ...... A Us exam, spinal canal ................................. 0.00 1.64 NA 0.08 1.72 NA XXX 76801 .......... ............ A Ob us < 14 wks, single fetus ...................... 0.99 2.44 NA 0.16 3.59 NA XXX 76801 .......... 26 ....... A Ob us < 14 wks, single fetus ...................... 0.99 0.35 0.35 0.04 1.38 1.38 XXX 76801 .......... TC ...... A Ob us < 14 wks, single fetus ...................... 0.00 2.09 NA 0.12 2.21 NA XXX 76802 .......... ............ A Ob us < 14 wks, add ’ l fetus ........................ 0.83 1.26 NA 0.16 2.25 NA ZZZ 76802 .......... 26 ....... A Ob us < 14 wks, add ’ l fetus ........................ 0.83 0.30 0.30 0.04 1.17 1.17 ZZZ 76802 .......... TC ...... A Ob us < 14 wks, add ’ l fetus ........................ 0.00 0.96 NA 0.12 1.08 NA ZZZ 76805 .......... ............ A Ob us >/= 14 wks, sngl fetus ...................... 0.99 2.57 NA 0.16 3.72 NA XXX 76805 .......... 26 ....... A Ob us >/= 14 wks, sngl fetus ...................... 0.99 0.35 0.35 0.04 1.38 1.38 XXX 76805 .......... TC ...... A Ob us >/= 14 wks, sngl fetus ...................... 0.00 2.22 NA 0.12 2.34 NA XXX 76810 .......... ............ A Ob us >/= 14 wks, addl fetus ...................... 0.98 1.46 NA 0.26 2.70 NA ZZZ 76810 .......... 26 ....... A Ob us >/= 14 wks, addl fetus ...................... 0.98 0.35 0.35 0.04 1.37 1.37 ZZZ 76810 .......... TC ...... A Ob us >/= 14 wks, addl fetus ...................... 0.00 1.11 NA 0.22 1.33 NA ZZZ 76811 .......... ............ A Ob us, detailed, sngl fetus .......................... 1.90 3.92 NA 0.52 6.34 NA XXX 76811 .......... 26 ....... A Ob us, detailed, sngl fetus .......................... 1.90 0.71 0.71 0.09 2.71 2.71 XXX 76811 .......... TC ...... A Ob us, detailed, sngl fetus .......................... 0.00 3.21 NA 0.43 3.64 NA XXX 76812 .......... ............ A Ob us, detailed, addl fetus .......................... 1.78 2.26 NA 0.49 4.54 NA ZZZ 76812 .......... 26 ....... A Ob us, detailed, addl fetus .......................... 1.78 0.66 0.66 0.08 2.53 2.53 ZZZ 76812 .......... TC ...... A Ob us, detailed, addl fetus .......................... 0.00 1.60 NA 0.41 2.01 NA ZZZ 76815 .......... ............ A Ob us, limited, fetus(s) ................................ 0.65 1.67 NA 0.11 2.43 NA XXX 76815 .......... 26 ....... A Ob us, limited, fetus(s) ................................ 0.65 0.23 0.23 0.03 0.91 0.91 XXX 76815 .......... TC ...... A Ob us, limited, fetus(s) ................................ 0.00 1.44 NA 0.08 1.52 NA XXX 76816 .......... ............ A Ob us, follow-up, per fetus .......................... 0.85 1.64 NA 0.10 2.59 NA XXX 76816 .......... 26 ....... A Ob us, follow-up, per fetus .......................... 0.85 0.32 0.32 0.04 1.21 1.21 XXX 76816 .......... TC ...... A Ob us, follow-up, per fetus .......................... 0.00 1.32 NA 0.06 1.38 NA XXX 76817 .......... ............ A Transvaginal us, obstetric ........................... 0.75 1.83 NA 0.09 2.67 NA XXX 76817 .......... 26 ....... A Transvaginal us, obstetric ........................... 0.75 0.27 0.27 0.03 1.05 1.05 XXX 76817 .......... TC ...... A Transvaginal us, obstetric ........................... 0.00 1.56 NA 0.06 1.62 NA XXX 76818 .......... ............ A Fetal biophys profile w/nst .......................... 1.05 2.03 NA 0.15 3.24 NA XXX 76818 .......... 26 ....... A Fetal biophys profile w/nst .......................... 1.05 0.39 0.39 0.05 1.49 1.49 XXX 76818 .......... TC ...... A Fetal biophys profile w/nst .......................... 0.00 1.64 NA 0.10 1.74 NA XXX 76819 .......... ............ A Fetal biophys profil w/o nst ......................... 0.77 1.82 NA 0.13 2.73 NA XXX 76819 .......... 26 ....... A Fetal biophys profil w/o nst ......................... 0.77 0.28 0.28 0.03 1.08 1.08 XXX 76819 .......... TC ...... A Fetal biophys profil w/o nst ......................... 0.00 1.54 NA 0.10 1.64 NA XXX 76820 .......... ............ A Umbilical artery echo ................................... 0.50 1.50 NA 0.15 2.15 NA XXX 76820 .......... 26 ....... A Umbilical artery echo ................................... 0.50 0.19 0.19 0.03 0.72 0.72 XXX 76820 .......... TC ...... A Umbilical artery echo ................................... 0.00 1.32 NA 0.12 1.44 NA XXX 76821 .......... ............ A Middle cerebral artery echo ........................ 0.70 1.88 NA 0.15 2.73 NA XXX 76821 .......... 26 ....... A Middle cerebral artery echo ........................ 0.70 0.26 0.26 0.03 0.99 0.99 XXX 76821 .......... TC ...... A Middle cerebral artery echo ........................ 0.00 1.61 NA 0.12 1.73 NA XXX
76825 .......... ............ A Echo exam of fetal heart ............................. 1.67 3.06 NA 0.18 4.91 NA XXX 76825 .......... 26 ....... A Echo exam of fetal heart ............................. 1.67 0.60 0.60 0.07 2.34 2.34 XXX 76825 .......... TC ...... A Echo exam of fetal heart ............................. 0.00 2.46 NA 0.11 2.57 NA XXX
76826 .......... ............ A Echo exam of fetal heart ............................. 0.83 1.47 NA 0.08 2.38 NA XXX 76826 .......... 26 ....... A Echo exam of fetal heart ............................. 0.83 0.29 0.29 0.03 1.15 1.15 XXX 76826 .......... TC ...... A Echo exam of fetal heart ............................. 0.00 1.17 NA 0.05 1.22 NA XXX
76827 .......... ............ A Echo exam of fetal heart ............................. 0.58 1.73 NA 0.14 2.45 NA XXX 76827 .......... 26 ....... A Echo exam of fetal heart ............................. 0.58 0.21 0.21 0.02 0.81 0.81 XXX 76827 .......... TC ...... A Echo exam of fetal heart ............................. 0.00 1.52 NA 0.12 1.64 NA XXX
76828 .......... ............ A Echo exam of fetal heart ............................. 0.56 1.16 NA 0.11 1.84 NA XXX 76828 .......... 26 ....... A Echo exam of fetal heart ............................. 0.56 0.22 0.22 0.03 0.81 0.81 XXX 76828 .......... TC ...... A Echo exam of fetal heart ............................. 0.00 0.95 NA 0.08 1.03 NA XXX 76830 .......... ............ A Transvaginal us, non-ob .............................. 0.69 2.01 NA 0.13 2.83 NA XXX 76830 .......... 26 ....... A Transvaginal us, non-ob .............................. 0.69 0.24 0.24 0.03 0.96 0.96 XXX 76830 .......... TC ...... A Transvaginal us, non-ob .............................. 0.00 1.77 NA 0.10 1.87 NA XXX 76831 .......... ............ A Echo exam, uterus ...................................... 0.72 1.98 NA 0.13 2.84 NA XXX 76831 .......... 26 ....... A Echo exam, uterus ...................................... 0.72 0.26 0.26 0.03 1.01 1.01 XXX


## 45969

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

76831 .......... TC ...... A Echo exam, uterus ...................................... 0.00 1.73 NA 0.10 1.83 NA XXX 76856 .......... ............ A Us exam, pelvic, complete .......................... 0.69 2.10 NA 0.13 2.92 NA XXX 76856 .......... 26 ....... A Us exam, pelvic, complete .......................... 0.69 0.24 0.24 0.03 0.96 0.96 XXX 76856 .......... TC ...... A Us exam, pelvic, complete .......................... 0.00 1.86 NA 0.10 1.96 NA XXX 76857 .......... ............ A Us exam, pelvic, limited .............................. 0.38 2.08 NA 0.08 2.54 NA XXX 76857 .......... 26 ....... A Us exam, pelvic, limited .............................. 0.38 0.13 0.13 0.02 0.53 0.53 XXX 76857 .......... TC ...... A Us exam, pelvic, limited .............................. 0.00 1.95 NA 0.06 2.01 NA XXX 76870 .......... ............ A Us exam, scrotum ....................................... 0.64 2.12 NA 0.13 2.89 NA XXX 76870 .......... 26 ....... A Us exam, scrotum ....................................... 0.64 0.22 0.22 0.03 0.89 0.89 XXX 76870 .......... TC ...... A Us exam, scrotum ....................................... 0.00 1.90 NA 0.10 2.00 NA XXX 76872 .......... ............ A Us, transrectal ............................................. 0.69 2.59 NA 0.14 3.42 NA XXX 76872 .......... 26 ....... A Us, transrectal ............................................. 0.69 0.25 0.25 0.04 0.98 0.98 XXX 76872 .......... TC ...... A Us, transrectal ............................................. 0.00 2.35 NA 0.10 2.45 NA XXX 76873 .......... ............ A Echograp trans r, pros study ....................... 1.55 3.05 NA 0.25 4.85 NA XXX 76873 .......... 26 ....... A Echograp trans r, pros study ....................... 1.55 0.55 0.55 0.09 2.19 2.19 XXX 76873 .......... TC ...... A Echograp trans r, pros study ....................... 0.00 2.50 NA 0.16 2.66 NA XXX 76880 .......... ............ A Us exam, extremity ..................................... 0.59 2.06 NA 0.11 2.77 NA XXX 76880 .......... 26 ....... A Us exam, extremity ..................................... 0.59 0.20 0.20 0.03 0.82 0.82 XXX 76880 .......... TC ...... A Us exam, extremity ..................................... 0.00 1.86 NA 0.08 1.94 NA XXX 76885 .......... ............ A Us exam infant hips, dynamic ..................... 0.74 2.21 NA 0.13 3.09 NA XXX 76885 .......... 26 ....... A Us exam infant hips, dynamic ..................... 0.74 0.25 0.25 0.03 1.02 1.02 XXX 76885 .......... TC ...... A Us exam infant hips, dynamic ..................... 0.00 1.96 NA 0.10 2.06 NA XXX 76886 .......... ............ A Us exam infant hips, static .......................... 0.62 1.82 NA 0.11 2.55 NA XXX 76886 .......... 26 ....... A Us exam infant hips, static .......................... 0.62 0.21 0.21 0.03 0.86 0.86 XXX 76886 .......... TC ...... A Us exam infant hips, static .......................... 0.00 1.61 NA 0.08 1.69 NA XXX 76930 .......... ............ A Echo guide, cardiocentesis ......................... 0.67 1.69 NA 0.12 2.48 NA XXX 76930 .......... 26 ....... A Echo guide, cardiocentesis ......................... 0.67 0.26 0.26 0.02 0.95 0.95 XXX 76930 .......... TC ...... A Echo guide, cardiocentesis ......................... 0.00 1.43 NA 0.10 1.53 NA XXX 76932 .......... ............ A Echo guide for heart biopsy ........................ 0.67 NA NA 0.12 NA NA XXX 76932 .......... 26 ....... A Echo guide for heart biopsy ........................ 0.67 0.26 0.26 0.02 0.95 0.95 XXX 76932 .......... TC ...... A Echo guide for heart biopsy ........................ 0.00 NA NA 0.10 NA NA XXX 76936 .......... ............ A Echo guide for artery repair ........................ 1.99 6.80 NA 0.47 9.26 NA XXX 76936 .......... 26 ....... A Echo guide for artery repair ........................ 1.99 0.68 0.68 0.13 2.81 2.81 XXX 76936 .......... TC ...... A Echo guide for artery repair ........................ 0.00 6.11 NA 0.34 6.45 NA XXX 76937 .......... ............ A Us guide, vascular access .......................... 0.30 0.58 NA 0.13 1.01 NA ZZZ 76937 .......... 26 ....... A Us guide, vascular access .......................... 0.30 0.11 0.11 0.03 0.44 0.44 ZZZ 76937 .......... TC ...... A Us guide, vascular access .......................... 0.00 0.47 NA 0.10 0.57 NA ZZZ 76940 .......... ............ A Us guide, tissue ablation ............................. 2.00 NA NA 0.60 NA NA XXX 76940 .......... 26 ....... A Us guide, tissue ablation ............................. 2.00 0.67 0.67 0.31 2.98 2.98 XXX 76940 .......... TC ...... A Us guide, tissue ablation ............................. 0.00 NA NA 0.29 NA NA XXX 76941 .......... ............ A Echo guide for transfusion .......................... 1.34 NA NA 0.15 NA NA XXX 76941 .......... 26 ....... A Echo guide for transfusion .......................... 1.34 0.48 0.48 0.07 1.90 1.90 XXX 76941 .......... TC ...... A Echo guide for transfusion .......................... 0.00 NA NA 0.08 NA NA XXX 76942 .......... ............ A Echo guide for biopsy ................................. 0.67 3.73 NA 0.13 4.53 NA XXX 76942 .......... 26 ....... A Echo guide for biopsy ................................. 0.67 0.24 0.24 0.03 0.94 0.94 XXX 76942 .......... TC ...... A Echo guide for biopsy ................................. 0.00 3.49 NA 0.10 3.59 NA XXX 76945 .......... ............ A Echo guide, villus sampling ......................... 0.67 NA NA 0.11 NA NA XXX 76945 .......... 26 ....... A Echo guide, villus sampling ......................... 0.67 0.23 0.23 0.03 0.93 0.93 XXX 76945 .......... TC ...... A Echo guide, villus sampling ......................... 0.00 NA NA 0.08 NA NA XXX 76946 .......... ............ A Echo guide for amniocentesis ..................... 0.38 1.36 NA 0.12 1.86 NA XXX 76946 .......... 26 ....... A Echo guide for amniocentesis ..................... 0.38 0.14 0.14 0.02 0.54 0.54 XXX 76946 .......... TC ...... A Echo guide for amniocentesis ..................... 0.00 1.21 NA 0.10 1.31 NA XXX 76948 .......... ............ A Echo guide, ova aspiration .......................... 0.38 1.39 NA 0.12 1.89 NA XXX 76948 .......... 26 ....... A Echo guide, ova aspiration .......................... 0.38 0.14 0.14 0.02 0.54 0.54 XXX 76948 .......... TC ...... A Echo guide, ova aspiration .......................... 0.00 1.25 NA 0.10 1.35 NA XXX 76950 .......... ............ A Echo guidance radiotherapy ....................... 0.58 1.55 NA 0.10 2.23 NA XXX 76950 .......... 26 ....... A Echo guidance radiotherapy ....................... 0.58 0.20 0.20 0.03 0.81 0.81 XXX 76950 .......... TC ...... A Echo guidance radiotherapy ....................... 0.00 1.35 NA 0.07 1.42 NA XXX 76965 .......... ............ A Echo guidance radiotherapy ....................... 1.34 4.86 NA 0.37 6.57 NA XXX 76965 .......... 26 ....... A Echo guidance radiotherapy ....................... 1.34 0.49 0.49 0.08 1.91 1.91 XXX 76965 .......... TC ...... A Echo guidance radiotherapy ....................... 0.00 4.38 NA 0.29 4.67 NA XXX 76970 .......... ............ A Ultrasound exam follow-up .......................... 0.40 1.43 NA 0.08 1.91 NA XXX 76970 .......... 26 ....... A Ultrasound exam follow-up .......................... 0.40 0.14 0.14 0.02 0.56 0.56 XXX 76970 .......... TC ...... A Ultrasound exam follow-up .......................... 0.00 1.29 NA 0.06 1.35 NA XXX 76975 .......... ............ A GI endoscopic ultrasound ........................... 0.81 3.41 NA 0.14 4.37 NA XXX 76975 .......... 26 ....... A GI endoscopic ultrasound ........................... 0.81 0.30 0.30 0.04 1.15 1.15 XXX 76975 .......... TC ...... A GI endoscopic ultrasound ........................... 0.00 3.12 NA 0.10 3.22 NA XXX 76977 .......... ............ A Us bone density measure ........................... 0.05 0.65 NA 0.06 0.76 NA XXX 76977 .......... 26 ....... A Us bone density measure ........................... 0.05 0.02 0.02 0.01 0.08 0.08 XXX 76977 .......... TC ...... A Us bone density measure ........................... 0.00 0.63 NA 0.05 0.68 NA XXX 76986 .......... ............ A Ultrasound guide intraoper .......................... 1.20 NA NA 0.27 NA NA XXX 76986 .......... 26 ....... A Ultrasound guide intraoper .......................... 1.20 0.41 0.41 0.13 1.75 1.75 XXX 76986 .......... TC ...... A Ultrasound guide intraoper .......................... 0.00 NA NA 0.14 NA NA XXX 76999 .......... ............ C Echo examination procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX


## 45970

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

76999 .......... 26 ....... C Echo examination procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76999 .......... TC ...... C Echo examination procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77261 .......... ............ A Radiation therapy planning ......................... 1.39 0.53 0.52 0.07 1.99 1.98 XXX 77262 .......... ............ A Radiation therapy planning ......................... 2.11 0.77 0.76 0.11 2.99 2.99 XXX 77263 .......... ............ A Radiation therapy planning ......................... 3.15 1.12 1.12 0.16 4.43 4.43 XXX 77280 .......... ............ A Set radiation therapy field ........................... 0.70 3.85 NA 0.22 4.77 NA XXX 77280 .......... 26 ....... A Set radiation therapy field ........................... 0.70 0.23 0.23 0.04 0.97 0.97 XXX 77280 .......... TC ...... A Set radiation therapy field ........................... 0.00 3.62 NA 0.18 3.80 NA XXX 77285 .......... ............ A Set radiation therapy field ........................... 1.05 6.38 NA 0.35 7.78 NA XXX 77285 .......... 26 ....... A Set radiation therapy field ........................... 1.05 0.35 0.35 0.05 1.45 1.45 XXX 77285 .......... TC ...... A Set radiation therapy field ........................... 0.00 6.03 NA 0.30 6.33 NA XXX 77290 .......... ............ A Set radiation therapy field ........................... 1.56 8.57 NA 0.43 10.56 NA XXX 77290 .......... 26 ....... A Set radiation therapy field ........................... 1.56 0.52 0.52 0.08 2.16 2.16 XXX 77290 .......... TC ...... A Set radiation therapy field ........................... 0.00 8.05 NA 0.35 8.40 NA XXX 77295 .......... ............ A Set radiation therapy field ........................... 4.57 24.31 NA 1.72 30.60 NA XXX 77295 .......... 26 ....... A Set radiation therapy field ........................... 4.57 1.51 1.51 0.23 6.30 6.30 XXX 77295 .......... TC ...... A Set radiation therapy field ........................... 0.00 22.80 NA 1.48 24.28 NA XXX 77299 .......... ............ C Radiation therapy planning ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77299 .......... 26 ....... C Radiation therapy planning ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77299 .......... TC ...... C Radiation therapy planning ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77300 .......... ............ A Radiation therapy dose plan ....................... 0.62 1.49 NA 0.10 2.21 NA XXX 77300 .......... 26 ....... A Radiation therapy dose plan ....................... 0.62 0.21 0.21 0.03 0.86 0.86 XXX 77300 .......... TC ...... A Radiation therapy dose plan ....................... 0.00 1.28 NA 0.07 1.35 NA XXX 77301 .......... ............ A Radiotherapy dose plan, imrt ...................... 8.01 38.62 NA 1.89 48.51 NA XXX 77301 .......... 26 ....... A Radiotherapy dose plan, imrt ...................... 8.01 2.66 2.66 0.40 11.06 11.06 XXX 77301 .......... TC ...... A Radiotherapy dose plan, imrt ...................... 0.00 35.96 NA 1.48 37.44 NA XXX 77305 .......... ............ A Teletx isodose plan simple .......................... 0.70 1.83 NA 0.15 2.68 NA XXX 77305 .......... 26 ....... A Teletx isodose plan simple .......................... 0.70 0.24 0.24 0.04 0.98 0.98 XXX 77305 .......... TC ...... A Teletx isodose plan simple .......................... 0.00 1.59 NA 0.11 1.70 NA XXX 77310 .......... ............ A Teletx isodose plan intermed ...................... 1.05 2.36 NA 0.18 3.59 NA XXX 77310 .......... 26 ....... A Teletx isodose plan intermed ...................... 1.05 0.35 0.35 0.05 1.45 1.45 XXX 77310 .......... TC ...... A Teletx isodose plan intermed ...................... 0.00 2.01 NA 0.13 2.14 NA XXX 77315 .......... ............ A Teletx isodose plan complex ....................... 1.56 2.97 NA 0.22 4.75 NA XXX 77315 .......... 26 ....... A Teletx isodose plan complex ....................... 1.56 0.52 0.52 0.08 2.16 2.16 XXX 77315 .......... TC ...... A Teletx isodose plan complex ....................... 0.00 2.45 NA 0.14 2.59 NA XXX 7321 ............ ............ A Special teletx port plan ................................ 0.95 3.68 NA 0.26 4.89 NA XXX 77321 .......... 26 ....... A Special teletx port plan ................................ 0.95 0.31 0.31 0.05 1.31 1.31 XXX 77321 .......... TC ...... A Special teletx port plan ................................ 0.00 3.37 NA 0.21 3.58 NA XXX 77326 .......... ............ A Brachytx isodose calc simp ......................... 0.93 2.90 NA 0.18 4.01 NA XXX 77326 .......... 26 ....... A Brachytx isodose calc simp ......................... 0.93 0.31 0.31 0.05 1.29 1.29 XXX 77326 .......... TC ...... A Brachytx isodose calc simp ......................... 0.00 2.59 NA 0.13 2.72 NA XXX 77327 .......... ............ A Brachytx isodose calc interm ...................... 1.39 4.19 NA 0.25 5.83 NA XXX 77327 .......... 26 ....... A Brachytx isodose calc interm ...................... 1.39 0.46 0.46 0.07 1.92 1.92 XXX 77327 .......... TC ...... A Brachytx isodose calc interm ...................... 0.00 3.73 NA 0.18 3.91 NA XXX 77328 .......... ............ A Brachytx isodose plan compl ...................... 2.09 5.81 NA 0.36 8.27 NA XXX 77328 .......... 26 ....... A Brachytx isodose plan compl ...................... 2.09 0.69 0.69 0.11 2.90 2.90 XXX 77328 .......... TC ...... A Brachytx isodose plan compl ...................... 0.00 5.12 NA 0.25 5.37 NA XXX 77331 .......... ............ A Special radiation dosimetry ......................... 0.87 0.81 NA 0.06 1.74 NA XXX 77331 .......... 26 ....... A Special radiation dosimetry ......................... 0.87 0.29 0.29 0.04 1.20 1.20 XXX 77331 .......... TC ...... A Special radiation dosimetry ......................... 0.00 0.52 NA 0.02 0.54 NA XXX 77332 .......... ............ A Radiation treatment aid(s) ........................... 0.54 1.59 NA 0.10 2.23 NA XXX 77332 .......... 26 ....... A Radiation treatment aid(s) ........................... 0.54 0.18 0.18 0.03 0.75 0.75 XXX 77332 .......... TC ...... A Radiation treatment aid(s) ........................... 0.00 1.41 NA 0.07 1.48 NA XXX 77333 .......... ............ A Radiation treatment aid(s) ........................... 0.84 1.79 NA 0.15 2.78 NA XXX 77333 .......... 26 ....... A Radiation treatment aid(s) ........................... 0.84 0.28 0.28 0.04 1.16 1.16 XXX 77333 .......... TC ...... A Radiation treatment aid(s) ........................... 0.00 1.51 NA 0.11 1.62 NA XXX 77334 .......... ............ A Radiation treatment aid(s) ........................... 1.24 3.55 NA 0.23 5.02 NA XXX 77334 .......... 26 ....... A Radiation treatment aid(s) ........................... 1.24 0.41 0.41 0.06 1.71 1.71 XXX 77334 .......... TC ...... A Radiation treatment aid(s) ........................... 0.00 3.14 NA 0.17 3.31 NA XXX 77336 .......... ............ A Radiation physics consult ............................ 0.00 2.57 NA 0.16 2.73 NA XXX 77370 .......... ............ A Radiation physics consult ............................ 0.00 3.45 NA 0.18 3.63 NA XXX 77399 .......... ............ C External radiation dosimetry ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77399 .......... 26 ....... C External radiation dosimetry ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77399 .......... TC ...... C External radiation dosimetry ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77401 .......... ............ A Radiation treatment delivery ....................... 0.00 1.53 NA 0.11 1.64 NA XXX 77402 .......... ............ A Radiation treatment delivery ....................... 0.00 2.26 NA 0.11 2.37 NA XXX 77403 .......... ............ A Radiation treatment delivery ....................... 0.00 2.14 NA 0.11 2.25 NA XXX 77404 .......... ............ A Radiation treatment delivery ....................... 0.00 2.26 NA 0.11 2.37 NA XXX 77406 .......... ............ A Radiation treatment delivery ....................... 0.00 2.24 NA 0.11 2.35 NA XXX 77407 .......... ............ A Radiation treatment delivery ....................... 0.00 2.84 NA 0.12 2.96 NA XXX 77408 .......... ............ A Radiation treatment delivery ....................... 0.00 2.69 NA 0.12 2.81 NA XXX 77409 .......... ............ A Radiation treatment delivery ....................... 0.00 2.81 NA 0.12 2.93 NA XXX 77411 .......... ............ A Radiation treatment delivery ....................... 0.00 2.79 NA 0.12 2.91 NA XXX 77412 .......... ............ A Radiation treatment delivery ....................... 0.00 3.24 NA 0.13 3.37 NA XXX


## 45971

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

77413 .......... ............ A Radiation treatment delivery ....................... 0.00 3.22 NA 0.13 3.35 NA XXX 77414 .......... ............ A Radiation treatment delivery ....................... 0.00 3.39 NA 0.13 3.52 NA XXX 77416 .......... ............ A Radiation treatment delivery ....................... 0.00 3.36 NA 0.13 3.49 NA XXX 77417 .......... ............ A Radiology port film(s) .................................. 0.00 0.56 NA 0.04 0.60 NA XXX 77418 .......... ............ A Radiation tx delivery, imrt ............................ 0.00 16.71 NA 0.13 16.84 NA XXX 77427 .......... ............ A Radiation tx management, x5 ..................... 3.32 1.16 1.09 0.17 4.65 4.58 XXX 77431 .......... ............ A Radiation therapy management .................. 1.81 0.79 0.68 0.09 2.70 2.58 XXX 77432 .......... ............ A Stereotactic radiation trmt ........................... 7.94 2.92 2.92 0.41 11.27 11.27 XXX 77470 .......... ............ A Special radiation treatment ......................... 2.09 9.53 NA 0.70 12.32 NA XXX 77470 .......... 26 ....... A Special radiation treatment ......................... 2.09 0.69 0.69 0.11 2.90 2.90 XXX 77470 .......... TC ...... A Special radiation treatment ......................... 0.00 8.84 NA 0.59 9.43 NA XXX 77499 .......... ............ C Radiation therapy management .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77499 .......... 26 ....... C Radiation therapy management .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77499 .......... TC ...... C Radiation therapy management .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77520 .......... ............ C Proton trmt, simple w/o comp ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77522 .......... ............ C Proton trmt, simple w/comp ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77523 .......... ............ C Proton trmt, intermediate ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77525 .......... ............ C Proton treatment, complex .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77600 .......... ............ R Hyperthermia treatment ............................... 1.56 5.57 NA 0.24 7.38 NA XXX 77600 .......... 26 ....... R Hyperthermia treatment ............................... 1.56 0.52 0.52 0.08 2.16 2.16 XXX 77600 .......... TC ...... R Hyperthermia treatment ............................... 0.00 5.06 NA 0.16 5.22 NA XXX 77605 .......... ............ R Hyperthermia treatment ............................... 2.09 8.40 NA 0.38 10.87 NA XXX 77605 .......... 26 ....... R Hyperthermia treatment ............................... 2.09 0.68 0.68 0.16 2.94 2.94 XXX 77605 .......... TC ...... R Hyperthermia treatment ............................... 0.00 7.71 NA 0.22 7.93 NA XXX 77610 .......... ............ R Hyperthermia treatment ............................... 1.56 7.34 NA 0.24 9.14 NA XXX 77610 .......... 26 ....... R Hyperthermia treatment ............................... 1.56 0.53 0.53 0.08 2.17 2.17 XXX 77610 .......... TC ...... R Hyperthermia treatment ............................... 0.00 6.81 NA 0.16 6.97 NA XXX 77615 .......... ............ R Hyperthermia treatment ............................... 2.09 11.06 NA 0.33 13.49 NA XXX 77615 .......... 26 ....... R Hyperthermia treatment ............................... 2.09 0.69 0.69 0.11 2.89 2.89 XXX 77615 .......... TC ...... R Hyperthermia treatment ............................... 0.00 10.37 NA 0.22 10.59 NA XXX 77620 .......... ............ R Hyperthermia treatment ............................... 1.56 4.94 NA 0.36 6.87 NA XXX 77620 .......... 26 ....... R Hyperthermia treatment ............................... 1.56 0.54 0.54 0.20 2.30 2.30 XXX 77620 .......... TC ...... R Hyperthermia treatment ............................... 0.00 4.40 NA 0.16 4.56 NA XXX 77750 .......... ............ A Infuse radioactive materials ........................ 4.91 3.28 NA 0.32 8.51 NA 090 77750 .......... 26 ....... A Infuse radioactive materials ........................ 4.91 1.63 1.63 0.25 6.79 6.79 090 77750 .......... TC ...... A Infuse radioactive materials ........................ 0.00 1.65 NA 0.07 1.72 NA 090 77761 .......... ............ A Apply intrcav radiat simple .......................... 3.81 4.43 NA 0.33 8.57 NA 090 77761 .......... 26 ....... A Apply intrcav radiat simple .......................... 3.81 1.10 1.10 0.19 5.10 5.10 090 77761 .......... TC ...... A Apply intrcav radiat simple .......................... 0.00 3.32 NA 0.14 3.46 NA 090 77762 .......... ............ A Apply intrcav radiat interm .......................... 5.72 6.33 NA 0.48 12.53 NA 090 77762 .......... 26 ....... A Apply intrcav radiat interm .......................... 5.72 1.86 1.86 0.29 7.88 7.88 090 77762 .......... TC ...... A Apply intrcav radiat interm .......................... 0.00 4.47 NA 0.19 4.66 NA 090 77763 .......... ............ A Apply intrcav radiat compl ........................... 8.58 8.26 NA 0.66 17.50 NA 090 77763 .......... 26 ....... A Apply intrcav radiat compl ........................... 8.58 2.80 2.80 0.43 11.81 11.81 090 77763 .......... TC ...... A Apply intrcav radiat compl ........................... 0.00 5.46 NA 0.23 5.69 NA 090 77776 .......... ............ A Apply interstit radiat simpl ........................... 4.66 4.34 NA 0.57 9.57 NA 090 77776 .......... 26 ....... A Apply interstit radiat simpl ........................... 4.66 0.94 0.94 0.44 6.04 6.04 090 77776 .......... TC ...... A Apply interstit radiat simpl ........................... 0.00 3.40 NA 0.13 3.53 NA 090 77777 .......... ............ A Apply interstit radiat inter ............................ 7.48 6.94 NA 0.61 15.04 NA 090 77777 .......... 26 ....... A Apply interstit radiat inter ............................ 7.48 2.48 2.48 0.39 10.36 10.36 090 77777 .......... TC ...... A Apply interstit radiat inter ............................ 0.00 4.45 NA 0.22 4.67 NA 090 77778 .......... ............ A Apply interstit radiat compl .......................... 11.19 9.63 NA 0.84 21.67 NA 090 77778 .......... 26 ....... A Apply interstit radiat compl .......................... 11.19 3.71 3.71 0.57 15.47 15.47 090 77778 .......... TC ...... A Apply interstit radiat compl .......................... 0.00 5.92 NA 0.27 6.19 NA 090 77781 .......... ............ A High intensity brachytherapy ....................... 1.66 16.99 NA 1.14 19.79 NA 090 77781 .......... 26 ....... A High intensity brachytherapy ....................... 1.66 0.54 0.54 0.08 2.29 2.29 090 77781 .......... TC ...... A High intensity brachytherapy ....................... 0.00 16.45 NA 1.06 17.51 NA 090 77782 .......... ............ A High intensity brachytherapy ....................... 2.49 19.56 NA 1.19 23.24 NA 090 77782 .......... 26 ....... A High intensity brachytherapy ....................... 2.49 0.82 0.82 0.13 3.45 3.45 090 77782 .......... TC ...... A High intensity brachytherapy ....................... 0.00 18.73 NA 1.06 19.79 NA 090 77783 .......... ............ A High intensity brachytherapy ....................... 3.73 23.47 NA 1.25 28.45 NA 090 77783 .......... 26 ....... A High intensity brachytherapy ....................... 3.73 1.23 1.23 0.19 5.14 5.14 090 77783 .......... TC ...... A High intensity brachytherapy ....................... 0.00 22.24 NA 1.06 23.30 NA 090 77784 .......... ............ A High intensity brachytherapy ....................... 5.61 29.75 NA 1.35 36.71 NA 090 77784 .......... 26 ....... A High intensity brachytherapy ....................... 5.61 1.85 1.85 0.29 7.75 7.75 090 77784 .......... TC ...... A High intensity brachytherapy ....................... 0.00 27.90 NA 1.06 28.96 NA 090 77789 .......... ............ A Apply surface radiation ................................ 1.12 1.18 NA 0.08 2.38 NA 000 77789 .......... 26 ....... A Apply surface radiation ................................ 1.12 0.38 0.38 0.06 1.56 1.56 000 77789 .......... TC ...... A Apply surface radiation ................................ 0.00 0.80 NA 0.02 0.82 NA 000 77790 .......... ............ A Radiation handling ....................................... 1.05 1.02 NA 0.07 2.14 NA XXX 77790 .......... 26 ....... A Radiation handling ....................................... 1.05 0.35 0.35 0.05 1.45 1.45 XXX 77790 .......... TC ...... A Radiation handling ....................................... 0.00 0.67 NA 0.02 0.69 NA XXX 77799 .......... ............ C Radium/radioisotope therapy ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 77799 .......... 26 ....... C Radium/radioisotope therapy ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX


## 45972

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

77799 .......... TC ...... C Radium/radioisotope therapy ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78000 .......... ............ A Thyroid, single uptake ................................. 0.19 1.18 NA 0.07 1.44 NA XXX 78000 .......... 26 ....... A Thyroid, single uptake ................................. 0.19 0.06 0.06 0.01 0.26 0.26 XXX 78000 .......... TC ...... A Thyroid, single uptake ................................. 0.00 1.12 NA 0.06 1.18 NA XXX 78001 .......... ............ A Thyroid, multiple uptakes ............................ 0.26 1.60 NA 0.08 1.94 NA XXX 78001 .......... 26 ....... A Thyroid, multiple uptakes ............................ 0.26 0.09 0.09 0.01 0.36 0.36 XXX 001 .............. TC ...... A Thyroid, multiple uptakes ............................ 0.00 1.51 NA 0.07 1.58 NA XXX 78003 .......... ............ A Thyroid suppress/stimul .............................. 0.33 1.31 NA 0.07 1.71 NA XXX 78003 .......... 26 ....... A Thyroid suppress/stimul .............................. 0.33 0.12 0.12 0.01 0.46 0.46 XXX 78003 .......... TC ...... A Thyroid suppress/stimul .............................. 0.00 1.19 NA 0.06 1.25 NA XXX 78006 .......... ............ A Thyroid imaging with uptake ....................... 0.49 3.24 NA 0.15 3.88 NA XXX 78006 .......... 26 ....... A Thyroid imaging with uptake ....................... 0.49 0.17 0.17 0.02 0.68 0.68 XXX 78006 .......... TC ...... A Thyroid imaging with uptake ....................... 0.00 3.07 NA 0.13 3.20 NA XXX 78007 .......... ............ A Thyroid image, mult uptakes ....................... 0.50 2.88 NA 0.16 3.54 NA XXX 78007 .......... 26 ....... A Thyroid image, mult uptakes ....................... 0.50 0.18 0.18 0.02 0.70 0.70 XXX 78007 .......... TC ...... A Thyroid image, mult uptakes ....................... 0.00 2.70 NA 0.14 2.84 NA XXX 78010 .......... ............ A Thyroid imaging ........................................... 0.39 2.41 NA 0.13 2.93 NA XXX 78010 .......... 26 ....... A Thyroid imaging ........................................... 0.39 0.14 0.14 0.02 0.55 0.55 XXX 78010 .......... TC ...... A Thyroid imaging ........................................... 0.00 2.27 NA 0.11 2.38 NA XXX 78011 .......... ............ A Thyroid imaging with flow ............................ 0.45 2.97 NA 0.15 3.57 NA XXX 78011 .......... 26 ....... A Thyroid imaging with flow ............................ 0.45 0.16 0.16 0.02 0.63 0.63 XXX 78011 .......... TC ...... A Thyroid imaging with flow ............................ 0.00 2.81 NA 0.13 2.94 NA XXX 78015 .......... ............ A Thyroid met imaging .................................... 0.67 3.19 NA 0.17 4.04 NA XXX 78015 .......... 26 ....... A Thyroid met imaging .................................... 0.67 0.24 0.24 0.03 0.94 0.94 XXX 78015 .......... TC ...... A Thyroid met imaging .................................... 0.00 2.95 NA 0.14 3.09 NA XXX 78016 .......... ............ A Thyroid met imaging/studies ....................... 0.82 4.61 NA 0.21 5.64 NA XXX 78016 .......... 26 ....... A Thyroid met imaging/studies ....................... 0.82 0.30 0.30 0.03 1.15 1.15 XXX 78016 .......... TC ...... A Thyroid met imaging/studies ....................... 0.00 4.32 NA 0.18 4.50 NA XXX 78018 .......... ............ A Thyroid met imaging, body .......................... 0.86 5.95 NA 0.33 7.14 NA XXX 78018 .......... 26 ....... A Thyroid met imaging, body .......................... 0.86 0.31 0.31 0.04 1.21 1.21 XXX 78018 .......... TC ...... A Thyroid met imaging, body .......................... 0.00 5.64 NA 0.29 5.93 NA XXX 78020 .......... ............ A Thyroid met uptake ..................................... 0.60 1.61 NA 0.16 2.37 NA ZZZ 78020 .......... 26 ....... A Thyroid met uptake ..................................... 0.60 0.22 0.22 0.02 0.84 0.84 ZZZ 78020 .......... TC ...... A Thyroid met uptake ..................................... 0.00 1.39 NA 0.14 1.53 NA ZZZ 78070 .......... ............ A Parathyroid nuclear imaging ....................... 0.82 4.32 NA 0.15 5.30 NA XXX 78070 .......... 26 ....... A Parathyroid nuclear imaging ....................... 0.82 0.29 0.29 0.04 1.15 1.15 XXX 78070 .......... TC ...... A Parathyroid nuclear imaging ....................... 0.00 4.03 NA 0.11 4.14 NA XXX 78075 .......... ............ A Adrenal nuclear imaging ............................. 0.74 6.80 NA 0.32 7.87 NA XXX 78075 .......... 26 ....... A Adrenal nuclear imaging ............................. 0.74 0.27 0.27 0.03 1.04 1.04 XXX 78075 .......... TC ...... A Adrenal nuclear imaging ............................. 0.00 6.53 NA 0.29 6.82 NA XXX 78099 .......... ............ C Endocrine nuclear procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78099 .......... 26 ....... C Endocrine nuclear procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78099 .......... TC ...... C Endocrine nuclear procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78102 .......... ............ A Bone marrow imaging, ltd ........................... 0.55 2.64 NA 0.14 3.33 NA XXX 78102 .......... 26 ....... A Bone marrow imaging, ltd ........................... 0.55 0.20 0.20 0.02 0.77 0.77 XXX 78102 .......... TC ...... A Bone marrow imaging, ltd ........................... 0.00 2.43 NA 0.12 2.55 NA XXX 78103 .......... ............ A Bone marrow imaging, mult ........................ 0.75 3.81 NA 0.20 4.76 NA XXX 78103 .......... 26 ....... A Bone marrow imaging, mult ........................ 0.75 0.27 0.27 0.03 1.05 1.05 XXX 78103 .......... TC ...... A Bone marrow imaging, mult ........................ 0.00 3.54 NA 0.17 3.71 NA XXX 78104 .......... ............ A Bone marrow imaging, body ....................... 0.80 4.58 NA 0.25 5.63 NA XXX 78104 .......... 26 ....... A Bone marrow imaging, body ....................... 0.80 0.28 0.28 0.03 1.11 1.11 XXX 78104 .......... TC ...... A Bone marrow imaging, body ....................... 0.00 4.29 NA 0.22 4.51 NA XXX 78110 .......... ............ A Plasma volume, single ................................ 0.19 1.22 NA 0.07 1.48 NA XXX 78110 .......... 26 ....... A Plasma volume, single ................................ 0.19 0.07 0.07 0.01 0.27 0.27 XXX 78110 .......... TC ...... A Plasma volume, single ................................ 0.00 1.15 NA 0.06 1.21 NA XXX 78111 .......... ............ A Plasma volume, multiple ............................. 0.22 2.38 NA 0.15 2.75 NA XXX 78111 .......... 26 ....... A Plasma volume, multiple ............................. 0.22 0.08 0.08 0.01 0.31 0.31 XXX 78111 .......... TC ...... A Plasma volume, multiple ............................. 0.00 2.30 NA 0.14 2.44 NA XXX 78120 .......... ............ A Red cell mass, single .................................. 0.23 1.74 NA 0.12 2.09 NA XXX 78120 .......... 26 ....... A Red cell mass, single .................................. 0.23 0.08 0.08 0.01 0.32 0.32 XXX 78120 .......... TC ...... A Red cell mass, single .................................. 0.00 1.65 NA 0.11 1.76 NA XXX 78121 .......... ............ A Red cell mass, multiple ............................... 0.32 2.69 NA 0.15 3.16 NA XXX 78121 .......... 26 ....... A Red cell mass, multiple ............................... 0.32 0.12 0.12 0.01 0.45 0.45 XXX 78121 .......... TC ...... A Red cell mass, multiple ............................... 0.00 2.58 NA 0.14 2.72 NA XXX
78122 .......... ............ A Blood volume ............................................... 0.45 4.15 NA 0.26 4.86 NA XXX
78122 .......... 26 ....... A Blood volume ............................................... 0.45 0.17 0.17 0.02 0.64 0.64 XXX 78122 .......... TC ...... A Blood volume ............................................... 0.00 3.98 NA 0.24 4.22 NA XXX 78130 .......... ............ A Red cell survival study ................................ 0.61 2.95 NA 0.17 3.73 NA XXX 78130 .......... 26 ....... A Red cell survival study ................................ 0.61 0.22 0.22 0.03 0.86 0.86 XXX 78130 .......... TC ...... A Red cell survival study ................................ 0.00 2.73 NA 0.14 2.87 NA XXX
78135 .......... ............ A Red cell survival kinetics ............................. 0.64 5.59 NA 0.28 6.51 NA XXX
78135 .......... 26 ....... A Red cell survival kinetics ............................. 0.64 0.23 0.23 0.03 0.90 0.90 XXX 78135 .......... TC ...... A Red cell survival kinetics ............................. 0.00 5.36 NA 0.25 5.61 NA XXX 78140 .......... ............ A Red cell sequestration ................................. 0.61 3.79 NA 0.24 4.64 NA XXX


## 45973

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

78140 .......... 26 ....... A Red cell sequestration ................................. 0.61 0.21 0.21 0.03 0.85 0.85 XXX 78140 .......... TC ...... A Red cell sequestration ................................. 0.00 3.58 NA 0.21 3.79 NA XXX
78160 .......... ............ A Plasma iron turnover ................................... 0.33 3.04 NA 0.23 3.60 NA XXX 78160 .......... 26 ....... A Plasma iron turnover ................................... 0.33 0.12 0.12 0.04 0.49 0.49 XXX 78160 .......... TC ...... A Plasma iron turnover ................................... 0.00 2.92 NA 0.19 3.11 NA XXX 78162 .......... ............ A Radioiron absorption exam ......................... 0.45 2.73 NA 0.19 3.37 NA XXX 78162 .......... 26 ....... A Radioiron absorption exam ......................... 0.45 0.19 0.19 0.02 0.66 0.66 XXX 78162 .......... TC ...... A Radioiron absorption exam ......................... 0.00 2.54 NA 0.17 2.71 NA XXX
78170 .......... ............ A Red cell iron utilization ................................ 0.41 4.36 NA 0.30 5.07 NA XXX 78170 .......... 26 ....... A Red cell iron utilization ................................ 0.41 0.15 0.15 0.02 0.58 0.58 XXX 78170 .......... TC ...... A Red cell iron utilization ................................ 0.00 4.22 NA 0.28 4.50 NA XXX 78172 .......... ............ C Total body iron estimation ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78172 .......... 26 ....... A Total body iron estimation ........................... 0.53 0.18 0.18 0.02 0.73 0.73 XXX 78172 .......... TC ...... C Total body iron estimation ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78185 .......... ............ A Spleen imaging ............................................ 0.40 2.96 NA 0.15 3.51 NA XXX 78185 .......... 26 ....... A Spleen imaging ............................................ 0.40 0.15 0.15 0.02 0.57 0.57 XXX 78185 .......... TC ...... A Spleen imaging ............................................ 0.00 2.81 NA 0.13 2.94 NA XXX 78190 .......... ............ A Platelet survival, kinetics ............................. 1.09 6.43 NA 0.38 7.90 NA XXX 78190 .......... 26 ....... A Platelet survival, kinetics ............................. 1.09 0.41 0.41 0.08 1.58 1.58 XXX 78190 .......... TC ...... A Platelet survival, kinetics ............................. 0.00 6.02 NA 0.30 6.32 NA XXX
78191 .......... ............ A Platelet survival ........................................... 0.61 6.53 NA 0.40 7.54 NA XXX 78191 .......... 26 ....... A Platelet survival ........................................... 0.61 0.21 0.21 0.03 0.85 0.85 XXX 78191 .......... TC ...... A Platelet survival ........................................... 0.00 6.32 NA 0.37 6.69 NA XXX 78195 .......... ............ A Lymph system imaging ............................... 1.20 5.19 NA 0.28 6.68 NA XXX 78195 .......... 26 ....... A Lymph system imaging ............................... 1.20 0.43 0.43 0.06 1.69 1.69 XXX 78195 .......... TC ...... A Lymph system imaging ............................... 0.00 4.76 NA 0.22 4.98 NA XXX 78199 .......... ............ C Blood/lymph nuclear exam .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78199 .......... 26 ....... C Blood/lymph nuclear exam .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78199 .......... TC ...... C Blood/lymph nuclear exam .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78201 .......... ............ A Liver imaging ............................................... 0.44 2.96 NA 0.15 3.55 NA XXX 78201 .......... 26 ....... A Liver imaging ............................................... 0.44 0.16 0.16 0.02 0.62 0.62 XXX 78201 .......... TC ...... A Liver imaging ............................................... 0.00 2.80 NA 0.13 2.93 NA XXX 78202 .......... ............ A Liver imaging with flow ................................ 0.51 3.44 NA 0.16 4.11 NA XXX 78202 .......... 26 ....... A Liver imaging with flow ................................ 0.51 0.18 0.18 0.02 0.71 0.71 XXX 78202 .......... TC ...... A Liver imaging with flow ................................ 0.00 3.26 NA 0.14 3.40 NA XXX 78205 .......... ............ A Liver imaging (3D) ....................................... 0.71 5.87 NA 0.34 6.92 NA XXX 78205 .......... 26 ....... A Liver imaging (3D) ....................................... 0.71 0.25 0.25 0.03 0.99 0.99 XXX 78205 .......... TC ...... A Liver imaging (3D) ....................................... 0.00 5.61 NA 0.31 5.92 NA XXX 78206 .......... ............ A Liver image (3d) with flow ........................... 0.96 8.15 NA 0.15 9.26 NA XXX 78206 .......... 26 ....... A Liver image (3d) with flow ........................... 0.96 0.34 0.34 0.04 1.35 1.35 XXX 78206 .......... TC ...... A Liver image (3d) with flow ........................... 0.00 7.80 NA 0.11 7.91 NA XXX 78215 .......... ............ A Liver and spleen imaging ............................ 0.49 3.48 NA 0.16 4.13 NA XXX 78215 .......... 26 ....... A Liver and spleen imaging ............................ 0.49 0.17 0.17 0.02 0.68 0.68 XXX 78215 .......... TC ...... A Liver and spleen imaging ............................ 0.00 3.31 NA 0.14 3.45 NA XXX 78216 .......... ............ A Liver & spleen image/flow ........................... 0.57 3.49 NA 0.20 4.26 NA XXX 78216 .......... 26 ....... A Liver & spleen image/flow ........................... 0.57 0.20 0.20 0.02 0.79 0.79 XXX 78216 .......... TC ...... A Liver & spleen image/flow ........................... 0.00 3.29 NA 0.18 3.47 NA XXX 78220 .......... ............ A Liver function study ..................................... 0.49 3.67 NA 0.21 4.37 NA XXX 78220 .......... 26 ....... A Liver function study ..................................... 0.49 0.17 0.17 0.02 0.68 0.68 XXX 78220 .......... TC ...... A Liver function study ..................................... 0.00 3.50 NA 0.19 3.69 NA XXX 78223 .......... ............ A Hepatobiliary imaging .................................. 0.84 4.79 NA 0.23 5.86 NA XXX 78223 .......... 26 ....... A Hepatobiliary imaging .................................. 0.84 0.29 0.29 0.04 1.17 1.17 XXX 78223 .......... TC ...... A Hepatobiliary imaging .................................. 0.00 4.49 NA 0.19 4.68 NA XXX 78230 .......... ............ A Salivary gland imaging ................................ 0.45 2.74 NA 0.15 3.34 NA XXX 78230 .......... 26 ....... A Salivary gland imaging ................................ 0.45 0.15 0.15 0.02 0.62 0.62 XXX 78230 .......... TC ...... A Salivary gland imaging ................................ 0.00 2.58 NA 0.13 2.71 NA XXX 78231 .......... ............ A Serial salivary imaging ................................ 0.52 3.14 NA 0.19 3.85 NA XXX 78231 .......... 26 ....... A Serial salivary imaging ................................ 0.52 0.19 0.19 0.02 0.73 0.73 XXX 78231 .......... TC ...... A Serial salivary imaging ................................ 0.00 2.96 NA 0.17 3.13 NA XXX 78232 .......... ............ A Salivary gland function exam ...................... 0.47 3.47 NA 0.20 4.14 NA XXX 78232 .......... 26 ....... A Salivary gland function exam ...................... 0.47 0.17 0.17 0.02 0.66 0.66 XXX 78232 .......... TC ...... A Salivary gland function exam ...................... 0.00 3.30 NA 0.18 3.48 NA XXX 78258 .......... ............ A Esophageal motility study ........................... 0.74 3.70 NA 0.17 4.61 NA XXX 78258 .......... 26 ....... A Esophageal motility study ........................... 0.74 0.26 0.26 0.03 1.03 1.03 XXX 78258 .......... TC ...... A Esophageal motility study ........................... 0.00 3.44 NA 0.14 3.58 NA XXX 78261 .......... ............ A Gastric mucosa imaging .............................. 0.69 4.56 NA 0.25 5.51 NA XXX 78261 .......... 26 ....... A Gastric mucosa imaging .............................. 0.69 0.25 0.25 0.03 0.97 0.97 XXX 78261 .......... TC ...... A Gastric mucosa imaging .............................. 0.00 4.31 NA 0.22 4.53 NA XXX 78262 .......... ............ A Gastroesophageal reflux exam ................... 0.68 4.57 NA 0.25 5.50 NA XXX 78262 .......... 26 ....... A Gastroesophageal reflux exam ................... 0.68 0.24 0.24 0.03 0.95 0.95 XXX 78262 .......... TC ...... A Gastroesophageal reflux exam ................... 0.00 4.33 NA 0.22 4.55 NA XXX 78264 .......... ............ A Gastric emptying study ................................ 0.78 4.86 NA 0.25 5.89 NA XXX 78264 .......... 26 ....... A Gastric emptying study ................................ 0.78 0.27 0.27 0.03 1.08 1.08 XXX 78264 .......... TC ...... A Gastric emptying study ................................ 0.00 4.59 NA 0.22 4.81 NA XXX


## 45974

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

78270 .......... ............ A Vit B-12 absorption exam ............................ 0.20 1.55 NA 0.11 1.86 NA XXX 78270 .......... 26 ....... A Vit B-12 absorption exam ............................ 0.20 0.07 0.07 0.01 0.28 0.28 XXX 78270 .......... TC ...... A Vit B-12 absorption exam ............................ 0.00 1.48 NA 0.10 1.58 NA XXX 78271 .......... ............ A Vit b-12 absrp exam, int fac ........................ 0.20 1.64 NA 0.11 1.95 NA XXX 78271 .......... 26 ....... A Vit b-12 absrp exam, int fac ........................ 0.20 0.07 0.07 0.01 0.28 0.28 XXX 78271 .......... TC ...... A Vit b-12 absrp exam, int fac ........................ 0.00 1.56 NA 0.10 1.66 NA XXX 78272 .......... ............ A Vit B-12 absorp, combined .......................... 0.27 2.15 NA 0.14 2.56 NA XXX 78272 .......... 26 ....... A Vit B-12 absorp, combined .......................... 0.27 0.10 0.10 0.01 0.38 0.38 XXX 78272 .......... TC ...... A Vit B-12 absorp, combined .......................... 0.00 2.06 NA 0.13 2.19 NA XXX 78278 .......... ............ A Acute GI blood loss imaging ....................... 0.99 6.10 NA 0.29 7.38 NA XXX 78278 .......... 26 ....... A Acute GI blood loss imaging ....................... 0.99 0.35 0.35 0.04 1.38 1.38 XXX 78278 .......... TC ...... A Acute GI blood loss imaging ....................... 0.00 5.75 NA 0.25 6.00 NA XXX 78282 .......... ............ C GI protein loss exam ................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78282 .......... 26 ....... A GI protein loss exam ................................... 0.38 0.14 0.14 0.02 0.54 0.54 XXX 78282 .......... TC ...... C GI protein loss exam ................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
78290 .......... ............ A Meckel ’ s divert exam ................................... 0.68 4.32 NA 0.19 5.19 NA XXX 78290 .......... 26 ....... A Meckel ’ s divert exam ................................... 0.68 0.24 0.24 0.03 0.95 0.95 XXX 78290 .......... TC ...... A Meckel ’ s divert exam ................................... 0.00 4.08 NA 0.16 4.24 NA XXX 78291 .......... ............ A Leveen/shunt patency exam ....................... 0.88 4.00 NA 0.20 5.08 NA XXX 78291 .......... 26 ....... A Leveen/shunt patency exam ....................... 0.88 0.31 0.31 0.04 1.23 1.23 XXX 78291 .......... TC ...... A Leveen/shunt patency exam ....................... 0.00 3.68 NA 0.16 3.84 NA XXX 78299 .......... ............ C GI nuclear procedure .................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78299 .......... 26 ....... C GI nuclear procedure .................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78299 .......... TC ...... C GI nuclear procedure .................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78300 .......... ............ A Bone imaging, limited area ......................... 0.62 2.97 NA 0.17 3.76 NA XXX 78300 .......... 26 ....... A Bone imaging, limited area ......................... 0.62 0.22 0.22 0.03 0.87 0.87 XXX 78300 .......... TC ...... A Bone imaging, limited area ......................... 0.00 2.75 NA 0.14 2.89 NA XXX 78305 .......... ............ A Bone imaging, multiple areas ...................... 0.83 4.16 NA 0.23 5.22 NA XXX 78305 .......... 26 ....... A Bone imaging, multiple areas ...................... 0.83 0.29 0.29 0.04 1.16 1.16 XXX 78305 .......... TC ...... A Bone imaging, multiple areas ...................... 0.00 3.87 NA 0.19 4.06 NA XXX 78306 .......... ............ A Bone imaging, whole body .......................... 0.86 4.77 NA 0.26 5.89 NA XXX 78306 .......... 26 ....... A Bone imaging, whole body .......................... 0.86 0.30 0.30 0.04 1.20 1.20 XXX 78306 .......... TC ...... A Bone imaging, whole body .......................... 0.00 4.47 NA 0.22 4.69 NA XXX 78315 .......... ............ A Bone imaging, 3 phase ............................... 1.02 5.69 NA 0.29 7.00 NA XXX 78315 .......... 26 ....... A Bone imaging, 3 phase ............................... 1.02 0.36 0.36 0.04 1.42 1.42 XXX 78315 .......... TC ...... A Bone imaging, 3 phase ............................... 0.00 5.33 NA 0.25 5.58 NA XXX 78320 .......... ............ A Bone imaging (3D) ...................................... 1.04 5.89 NA 0.35 7.28 NA XXX 78320 .......... 26 ....... A Bone imaging (3D) ...................................... 1.04 0.38 0.38 0.04 1.46 1.46 XXX 78320 .......... TC ...... A Bone imaging (3D) ...................................... 0.00 5.51 NA 0.31 5.82 NA XXX 78350 .......... ............ A Bone mineral, single photon ....................... 0.22 1.00 NA 0.06 1.28 NA XXX 78350 .......... 26 ....... A Bone mineral, single photon ....................... 0.22 0.07 0.07 0.01 0.30 0.30 XXX 78350 .......... TC ...... A Bone mineral, single photon ....................... 0.00 0.93 NA 0.05 0.98 NA XXX 78351 .......... ............ N Bone mineral, dual photon .......................... 0.30 1.86 0.12 0.01 2.17 0.43 XXX 78399 .......... ............ C Musculoskeletal nuclear exam .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78399 .......... 26 ....... C Musculoskeletal nuclear exam .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78399 .......... TC ...... C Musculoskeletal nuclear exam .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78414 .......... ............ C Non-imaging heart function ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78414 .......... 26 ....... A Non-imaging heart function ......................... 0.45 0.17 0.17 0.02 0.64 0.64 XXX 78414 .......... TC ...... C Non-imaging heart function ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78428 .......... ............ A Cardiac shunt imaging ................................ 0.78 3.31 NA 0.16 4.25 NA XXX 78428 .......... 26 ....... A Cardiac shunt imaging ................................ 0.78 0.30 0.30 0.03 1.11 1.11 XXX 78428 .......... TC ...... A Cardiac shunt imaging ................................ 0.00 3.00 NA 0.13 3.13 NA XXX 78445 .......... ............ A Vascular flow imaging ................................. 0.49 2.74 NA 0.13 3.36 NA XXX 78445 .......... 26 ....... A Vascular flow imaging ................................. 0.49 0.18 0.18 0.02 0.69 0.69 XXX 78445 .......... TC ...... A Vascular flow imaging ................................. 0.00 2.57 NA 0.11 2.68 NA XXX 78455 .......... ............ A Venous thrombosis study ............................ 0.73 4.31 NA 0.24 5.28 NA XXX 78455 .......... 26 ....... A Venous thrombosis study ............................ 0.73 0.26 0.26 0.03 1.02 1.02 XXX 78455 .......... TC ...... A Venous thrombosis study ............................ 0.00 4.05 NA 0.21 4.26 NA XXX 78456 .......... ............ A Acute venous thrombus image ................... 1.00 5.25 NA 0.33 6.58 NA XXX 78456 .......... 26 ....... A Acute venous thrombus image ................... 1.00 0.36 0.36 0.04 1.40 1.40 XXX 78456 .......... TC ...... A Acute venous thrombus image ................... 0.00 4.89 NA 0.29 5.18 NA XXX 78457 .......... ............ A Venous thrombosis imaging ........................ 0.77 3.11 NA 0.17 4.06 NA XXX 78457 .......... 26 ....... A Venous thrombosis imaging ........................ 0.77 0.27 0.27 0.03 1.07 1.07 XXX 78457 .......... TC ...... A Venous thrombosis imaging ........................ 0.00 2.85 NA 0.14 2.99 NA XXX 78458 .......... ............ A Ven thrombosis images, bilat ...................... 0.90 4.31 NA 0.25 5.46 NA XXX 78458 .......... 26 ....... A Ven thrombosis images, bilat ...................... 0.90 0.33 0.33 0.04 1.27 1.27 XXX 78458 .......... TC ...... A Ven thrombosis images, bilat ...................... 0.00 3.98 NA 0.21 4.19 NA XXX 78459 .......... ............ C Heart muscle imaging (PET) ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78459 .......... 26 ....... A Heart muscle imaging (PET) ....................... 1.50 0.59 0.59 0.05 2.15 2.15 XXX 78459 .......... TC ...... C Heart muscle imaging (PET) ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78460 .......... ............ A Heart muscle blood, single .......................... 0.86 3.23 NA 0.17 4.27 NA XXX 78460 .......... 26 ....... A Heart muscle blood, single .......................... 0.86 0.30 0.30 0.04 1.20 1.20 XXX 78460 .......... TC ...... A Heart muscle blood, single .......................... 0.00 2.93 NA 0.13 3.06 NA XXX 78461 .......... ............ A Heart muscle blood, multiple ....................... 1.23 5.17 NA 0.30 6.70 NA XXX


## 45975

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

78461 .......... 26 ....... A Heart muscle blood, multiple ....................... 1.23 0.45 0.45 0.05 1.73 1.73 XXX 78461 .......... TC ...... A Heart muscle blood, multiple ....................... 0.00 4.72 NA 0.25 4.97 NA XXX 78464 .......... ............ A Heart image (3d), single .............................. 1.09 7.18 NA 0.41 8.68 NA XXX 78464 .......... 26 ....... A Heart image (3d), single .............................. 1.09 0.40 0.40 0.04 1.53 1.53 XXX 78464 .......... TC ...... A Heart image (3d), single .............................. 0.00 6.78 NA 0.37 7.15 NA XXX 78465 .......... ............ A Heart image (3d), multiple ........................... 1.46 12.23 NA 0.67 14.37 NA XXX 78465 .......... 26 ....... A Heart image (3d), multiple ........................... 1.46 0.54 0.54 0.05 2.06 2.06 XXX 78465 .......... TC ...... A Heart image (3d), multiple ........................... 0.00 11.69 NA 0.62 12.31 NA XXX 78466 .......... ............ A Heart infarct image ...................................... 0.69 3.35 NA 0.17 4.22 NA XXX 78466 .......... 26 ....... A Heart infarct image ...................................... 0.69 0.25 0.25 0.03 0.97 0.97 XXX 78466 .......... TC ...... A Heart infarct image ...................................... 0.00 3.10 NA 0.14 3.24 NA XXX 78468 .......... ............ A Heart infarct image (ef) ............................... 0.80 4.53 NA 0.22 5.55 NA XXX 78468 .......... 26 ....... A Heart infarct image (ef) ............................... 0.80 0.29 0.29 0.03 1.12 1.12 XXX 78468 .......... TC ...... A Heart infarct image (ef) ............................... 0.00 4.25 NA 0.19 4.44 NA XXX 78469 .......... ............ A Heart infarct image (3D) .............................. 0.92 5.38 NA 0.31 6.61 NA XXX 78469 .......... 26 ....... A Heart infarct image (3D) .............................. 0.92 0.32 0.32 0.03 1.27 1.27 XXX 78469 .......... TC ...... A Heart infarct image (3D) .............................. 0.00 5.06 NA 0.28 5.34 NA XXX 78472 .......... ............ A Gated heart, planar, single .......................... 0.98 5.73 NA 0.34 7.06 NA XXX 78472 .......... 26 ....... A Gated heart, planar, single .......................... 0.98 0.36 0.36 0.04 1.38 1.38 XXX 78472 .......... TC ...... A Gated heart, planar, single .......................... 0.00 5.38 NA 0.30 5.68 NA XXX 78473 .......... ............ A Gated heart, multiple ................................... 1.47 7.69 NA 0.48 9.64 NA XXX 78473 .......... 26 ....... A Gated heart, multiple ................................... 1.47 0.53 0.53 0.06 2.07 2.07 XXX 78473 .......... TC ...... A Gated heart, multiple ................................... 0.00 7.15 NA 0.42 7.57 NA XXX
78478 .......... ............ A Heart wall motion add-on ............................ 0.62 1.58 NA 0.12 2.32 NA XXX 78478 .......... 26 ....... A Heart wall motion add-on ............................ 0.62 0.24 0.24 0.02 0.88 0.88 XXX 78478 .......... TC ...... A Heart wall motion add-on ............................ 0.00 1.34 NA 0.10 1.44 NA XXX 78480 .......... ............ A Heart function add-on .................................. 0.62 1.57 NA 0.12 2.31 NA XXX 78480 .......... 26 ....... A Heart function add-on .................................. 0.62 0.23 0.23 0.02 0.87 0.87 XXX 78480 .......... TC ...... A Heart function add-on .................................. 0.00 1.34 NA 0.10 1.44 NA XXX 78481 .......... ............ A Heart first pass, single ................................ 0.98 4.47 NA 0.31 5.76 NA XXX 78481 .......... 26 ....... A Heart first pass, single ................................ 0.98 0.38 0.38 0.03 1.39 1.39 XXX 78481 .......... TC ...... A Heart first pass, single ................................ 0.00 4.10 NA 0.28 4.38 NA XXX 78483 .......... ............ A Heart first pass, multiple ............................. 1.47 6.69 NA 0.46 8.62 NA XXX 78483 .......... 26 ....... A Heart first pass, multiple ............................. 1.47 0.56 0.56 0.05 2.08 2.08 XXX 78483 .......... TC ...... A Heart first pass, multiple ............................. 0.00 6.13 NA 0.41 6.54 NA XXX 78491 .......... ............ C Heart image (pet), single ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78491 .......... 26 ....... A Heart image (pet), single ............................. 1.50 0.00 0.00 0.06 1.56 1.56 XXX 78491 .......... TC ...... C Heart image (pet), single ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78492 .......... ............ C Heart image (pet), multiple .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78492 .......... 26 ....... A Heart image (pet), multiple .......................... 1.87 0.00 0.00 0.07 1.94 1.94 XXX 78492 .......... TC ...... C Heart image (pet), multiple .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78494 .......... ............ A Heart image, spect ...................................... 1.19 7.24 NA 0.35 8.78 NA XXX 78494 .......... 26 ....... A Heart image, spect ...................................... 1.19 0.44 0.44 0.05 1.68 1.68 XXX 78494 .......... TC ...... A Heart image, spect ...................................... 0.00 6.80 NA 0.30 7.10 NA XXX 78496 .......... ............ A Heart first pass add-on ................................ 0.50 5.71 NA 0.32 6.53 NA ZZZ 78496 .......... 26 ....... A Heart first pass add-on ................................ 0.50 0.19 0.19 0.02 0.71 0.71 ZZZ 78496 .......... TC ...... A Heart first pass add-on ................................ 0.00 5.52 NA 0.30 5.82 NA ZZZ 78499 .......... ............ C Cardiovascular nuclear exam ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78499 .......... 26 ....... C Cardiovascular nuclear exam ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78499 .......... TC ...... C Cardiovascular nuclear exam ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78580 .......... ............ A Lung perfusion imaging ............................... 0.74 4.07 NA 0.21 5.02 NA XXX 78580 .......... 26 ....... A Lung perfusion imaging ............................... 0.74 0.26 0.26 0.03 1.03 1.03 XXX 78580 .......... TC ...... A Lung perfusion imaging ............................... 0.00 3.81 NA 0.18 3.99 NA XXX 78584 .......... ............ A Lung V/Q image single breath .................... 0.99 3.50 NA 0.21 4.70 NA XXX 78584 .......... 26 ....... A Lung V/Q image single breath .................... 0.99 0.35 0.35 0.04 1.38 1.38 XXX 78584 .......... TC ...... A Lung V/Q image single breath .................... 0.00 3.15 NA 0.17 3.32 NA XXX 78585 .......... ............ A Lung V/Q imaging ....................................... 1.09 6.36 NA 0.35 7.80 NA XXX 78585 .......... 26 ....... A Lung V/Q imaging ....................................... 1.09 0.38 0.38 0.05 1.52 1.52 XXX 78585 .......... TC ...... A Lung V/Q imaging ....................................... 0.00 5.98 NA 0.30 6.28 NA XXX 78586 .......... ............ A Aerosol lung image, single .......................... 0.40 3.04 NA 0.16 3.60 NA XXX 78586 .......... 26 ....... A Aerosol lung image, single .......................... 0.40 0.14 0.14 0.02 0.56 0.56 XXX 78586 .......... TC ...... A Aerosol lung image, single .......................... 0.00 2.90 NA 0.14 3.04 NA XXX 78587 .......... ............ A Aerosol lung image, multiple ....................... 0.49 3.41 NA 0.16 4.06 NA XXX 78587 .......... 26 ....... A Aerosol lung image, multiple ....................... 0.49 0.18 0.18 0.02 0.69 0.69 XXX 78587 .......... TC ...... A Aerosol lung image, multiple ....................... 0.00 3.23 NA 0.14 3.37 NA XXX 78588 .......... ............ A Perfusion lung image .................................. 1.09 4.60 NA 0.23 5.93 NA XXX 78588 .......... 26 ....... A Perfusion lung image .................................. 1.09 0.38 0.38 0.05 1.52 1.52 XXX 78588 .......... TC ...... A Perfusion lung image .................................. 0.00 4.23 NA 0.18 4.41 NA XXX 78591 .......... ............ A Vent image, 1 breath, 1 proj ....................... 0.40 3.12 NA 0.16 3.68 NA XXX 78591 .......... 26 ....... A Vent image, 1 breath, 1 proj ....................... 0.40 0.14 0.14 0.02 0.56 0.56 XXX 78591 .......... TC ...... A Vent image, 1 breath, 1 proj ....................... 0.00 2.98 NA 0.14 3.12 NA XXX 78593 .......... ............ A Vent image, 1 proj, gas ............................... 0.49 3.76 NA 0.20 4.45 NA XXX 78593 .......... 26 ....... A Vent image, 1 proj, gas ............................... 0.49 0.17 0.17 0.02 0.68 0.68 XXX 78593 .......... TC ...... A Vent image, 1 proj, gas ............................... 0.00 3.59 NA 0.18 3.77 NA XXX


## 45976

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

78594 .......... ............ A Vent image, mult proj, gas .......................... 0.53 5.09 NA 0.27 5.89 NA XXX 78594 .......... 26 ....... A Vent image, mult proj, gas .......................... 0.53 0.19 0.19 0.02 0.74 0.74 XXX 78594 .......... TC ...... A Vent image, mult proj, gas .......................... 0.00 4.90 NA 0.25 5.15 NA XXX 78596 .......... ............ A Lung differential function ............................. 1.27 7.35 NA 0.42 9.05 NA XXX 78596 .......... 26 ....... A Lung differential function ............................. 1.27 0.44 0.44 0.05 1.76 1.76 XXX 78596 .......... TC ...... A Lung differential function ............................. 0.00 6.92 NA 0.37 7.29 NA XXX 78599 .......... ............ C Respiratory nuclear exam ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78599 .......... 26 ....... C Respiratory nuclear exam ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78599 .......... TC ...... C Respiratory nuclear exam ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78600 .......... ............ A Brain imaging, ltd static ............................... 0.44 3.50 NA 0.16 4.11 NA XXX 78600 .......... 26 ....... A Brain imaging, ltd static ............................... 0.44 0.16 0.16 0.02 0.62 0.62 XXX 78600 .......... TC ...... A Brain imaging, ltd static ............................... 0.00 3.35 NA 0.14 3.49 NA XXX 78601 .......... ............ A Brain imaging, ltd w/flow ............................. 0.51 3.91 NA 0.20 4.62 NA XXX 78601 .......... 26 ....... A Brain imaging, ltd w/flow ............................. 0.51 0.18 0.18 0.02 0.71 0.71 XXX 78601 .......... TC ...... A Brain imaging, ltd w/flow ............................. 0.00 3.73 NA 0.18 3.91 NA XXX 78605 .......... ............ A Brain imaging, complete .............................. 0.53 3.77 NA 0.20 4.50 NA XXX 78605 .......... 26 ....... A Brain imaging, complete .............................. 0.53 0.19 0.19 0.02 0.74 0.74 XXX 78605 .......... TC ...... A Brain imaging, complete .............................. 0.00 3.58 NA 0.18 3.76 NA XXX 78606 .......... ............ A Brain imaging, compl w/flow ....................... 0.64 4.79 NA 0.24 5.67 NA XXX 78606 .......... 26 ....... A Brain imaging, compl w/flow ....................... 0.64 0.22 0.22 0.03 0.89 0.89 XXX 78606 .......... TC ...... A Brain imaging, compl w/flow ....................... 0.00 4.57 NA 0.21 4.78 NA XXX 78607 .......... ............ A Brain imaging (3D) ...................................... 1.23 8.26 NA 0.40 9.90 NA XXX 78607 .......... 26 ....... A Brain imaging (3D) ...................................... 1.23 0.45 0.45 0.05 1.73 1.73 XXX 78607 .......... TC ...... A Brain imaging (3D) ...................................... 0.00 7.82 NA 0.35 8.17 NA XXX 78608 .......... ............ C Brain imaging (PET) .................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78608 .......... 26 ....... A Brain imaging (PET) .................................... 1.50 0.00 0.00 0.06 1.56 1.56 XXX 78608 .......... TC ...... C Brain imaging (PET) .................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78609 .......... ............ C Brain imaging (PET) .................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78609 .......... 26 ....... A Brain imaging (PET) .................................... 1.50 0.00 0.00 0.06 1.56 1.56 XXX 78609 .......... TC ...... C Brain imaging (PET) .................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78610 .......... ............ A Brain flow imaging only ............................... 0.30 2.15 NA 0.11 2.56 NA XXX 78610 .......... 26 ....... A Brain flow imaging only ............................... 0.30 0.11 0.11 0.01 0.42 0.42 XXX 78610 .......... TC ...... A Brain flow imaging only ............................... 0.00 2.03 NA 0.10 2.13 NA XXX 78615 .......... ............ A Cerebral vascular flow image ...................... 0.42 4.07 NA 0.23 4.72 NA XXX 78615 .......... 26 ....... A Cerebral vascular flow image ...................... 0.42 0.16 0.16 0.02 0.60 0.60 XXX 78615 .......... TC ...... A Cerebral vascular flow image ...................... 0.00 3.91 NA 0.21 4.12 NA XXX 78630 .......... ............ A Cerebrospinal fluid scan .............................. 0.68 5.67 NA 0.30 6.65 NA XXX 78630 .......... 26 ....... A Cerebrospinal fluid scan .............................. 0.68 0.24 0.24 0.03 0.95 0.95 XXX 78630 .......... TC ...... A Cerebrospinal fluid scan .............................. 0.00 5.43 NA 0.27 5.70 NA XXX 78635 .......... ............ A CSF ventriculography .................................. 0.61 3.91 NA 0.16 4.68 NA XXX 78635 .......... 26 ....... A CSF ventriculography .................................. 0.61 0.24 0.24 0.02 0.87 0.87 XXX 78635 .......... TC ...... A CSF ventriculography .................................. 0.00 3.66 NA 0.14 3.80 NA XXX 78645 .......... ............ A CSF shunt evaluation .................................. 0.57 4.91 NA 0.20 5.68 NA XXX 78645 .......... 26 ....... A CSF shunt evaluation .................................. 0.57 0.20 0.20 0.02 0.79 0.79 XXX 78645 .......... TC ...... A CSF shunt evaluation .................................. 0.00 4.71 NA 0.18 4.89 NA XXX 78647 .......... ............ A Cerebrospinal fluid scan .............................. 0.90 8.47 NA 0.35 9.73 NA XXX 78647 .......... 26 ....... A Cerebrospinal fluid scan .............................. 0.90 0.32 0.32 0.04 1.26 1.26 XXX 78647 .......... TC ...... A Cerebrospinal fluid scan .............................. 0.00 8.15 NA 0.31 8.46 NA XXX 78650 .......... ............ A CSF leakage imaging .................................. 0.61 5.35 NA 0.27 6.23 NA XXX 78650 .......... 26 ....... A CSF leakage imaging .................................. 0.61 0.22 0.22 0.03 0.86 0.86 XXX 78650 .......... TC ...... A CSF leakage imaging .................................. 0.00 5.13 NA 0.24 5.37 NA XXX 78660 .......... ............ A Nuclear exam of tear flow ........................... 0.53 2.68 NA 0.14 3.35 NA XXX 78660 .......... 26 ....... A Nuclear exam of tear flow ........................... 0.53 0.19 0.19 0.02 0.74 0.74 XXX 78660 .......... TC ...... A Nuclear exam of tear flow ........................... 0.00 2.49 NA 0.12 2.61 NA XXX 78699 .......... ............ C Nervous system nuclear exam .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78699 .......... 26 ....... C Nervous system nuclear exam .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78699 .......... TC ...... C Nervous system nuclear exam .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78700 .......... ............ A Kidney imaging, static ................................. 0.45 3.42 NA 0.18 4.05 NA XXX 78700 .......... 26 ....... A Kidney imaging, static ................................. 0.45 0.16 0.16 0.02 0.63 0.63 XXX 78700 .......... TC ...... A Kidney imaging, static ................................. 0.00 3.26 NA 0.16 3.42 NA XXX 78701 .......... ............ A Kidney imaging with flow ............................. 0.49 3.93 NA 0.20 4.62 NA XXX 78701 .......... 26 ....... A Kidney imaging with flow ............................. 0.49 0.17 0.17 0.02 0.68 0.68 XXX 78701 .......... TC ...... A Kidney imaging with flow ............................. 0.00 3.76 NA 0.18 3.94 NA XXX 78704 .......... ............ A Imaging renogram ....................................... 0.74 4.35 NA 0.24 5.34 NA XXX 78704 .......... 26 ....... A Imaging renogram ....................................... 0.74 0.26 0.26 0.03 1.03 1.03 XXX 78704 .......... TC ...... A Imaging renogram ....................................... 0.00 4.09 NA 0.21 4.30 NA XXX 78707 .......... ............ A Kidney flow/function image ......................... 0.96 4.89 NA 0.27 6.12 NA XXX 78707 .......... 26 ....... A Kidney flow/function image ......................... 0.96 0.34 0.34 0.04 1.34 1.34 XXX 78707 .......... TC ...... A Kidney flow/function image ......................... 0.00 4.56 NA 0.23 4.79 NA XXX 78708 .......... ............ A Kidney flow/function image ......................... 1.21 4.63 NA 0.28 6.12 NA XXX 78708 .......... 26 ....... A Kidney flow/function image ......................... 1.21 0.43 0.43 0.05 1.69 1.69 XXX 78708 .......... TC ...... A Kidney flow/function image ......................... 0.00 4.20 NA 0.23 4.43 NA XXX 78709 .......... ............ A Kidney flow/function image ......................... 1.41 5.73 NA 0.29 7.43 NA XXX 78709 .......... 26 ....... A Kidney flow/function image ......................... 1.41 0.49 0.49 0.06 1.97 1.97 XXX


## 45977

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

78709 .......... TC ...... A Kidney flow/function image ......................... 0.00 5.24 NA 0.23 5.47 NA XXX 78710 .......... ............ A Kidney imaging (3D) .................................... 0.66 5.79 NA 0.34 6.79 NA XXX 78710 .......... 26 ....... A Kidney imaging (3D) .................................... 0.66 0.23 0.23 0.03 0.92 0.92 XXX 78710 .......... TC ...... A Kidney imaging (3D) .................................... 0.00 5.55 NA 0.31 5.86 NA XXX 78715 .......... ............ A Renal vascular flow exam ........................... 0.30 2.36 NA 0.11 2.78 NA XXX 78715 .......... 26 ....... A Renal vascular flow exam ........................... 0.30 0.11 0.11 0.01 0.42 0.42 XXX 78715 .......... TC ...... A Renal vascular flow exam ........................... 0.00 2.25 NA 0.10 2.35 NA XXX 78725 .......... ............ A Kidney function study .................................. 0.38 1.93 NA 0.13 2.44 NA XXX 78725 .......... 26 ....... A Kidney function study .................................. 0.38 0.14 0.14 0.02 0.54 0.54 XXX 78725 .......... TC ...... A Kidney function study .................................. 0.00 1.79 NA 0.11 1.90 NA XXX 78730 .......... ............ A Urinary bladder retention ............................. 0.36 2.27 NA 0.10 2.73 NA XXX 78730 .......... 26 ....... A Urinary bladder retention ............................. 0.36 0.13 0.13 0.02 0.51 0.51 XXX 78730 .......... TC ...... A Urinary bladder retention ............................. 0.00 2.13 NA 0.08 2.21 NA XXX 78740 .......... ............ A Ureteral reflux study .................................... 0.57 2.79 NA 0.15 3.51 NA XXX 78740 .......... 26 ....... A Ureteral reflux study .................................... 0.57 0.20 0.20 0.03 0.80 0.80 XXX 78740 .......... TC ...... A Ureteral reflux study .................................... 0.00 2.59 NA 0.12 2.71 NA XXX 78760 .......... ............ A Testicular imaging ....................................... 0.66 3.08 NA 0.17 3.91 NA XXX 78760 .......... 26 ....... A Testicular imaging ....................................... 0.66 0.23 0.23 0.03 0.92 0.92 XXX 78760 .......... TC ...... A Testicular imaging ....................................... 0.00 2.85 NA 0.14 2.99 NA XXX 78761 .......... ............ A Testicular imaging/flow ................................ 0.71 3.69 NA 0.20 4.60 NA XXX 78761 .......... 26 ....... A Testicular imaging/flow ................................ 0.71 0.25 0.25 0.03 0.99 0.99 XXX 78761 .......... TC ...... A Testicular imaging/flow ................................ 0.00 3.44 NA 0.17 3.61 NA XXX 78799 .......... ............ C Genitourinary nuclear exam ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78799 .......... 26 ....... C Genitourinary nuclear exam ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78799 .......... TC ...... C Genitourinary nuclear exam ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78800 .......... ............ A Tumor imaging, limited area ....................... 0.66 3.68 NA 0.22 4.56 NA XXX 78800 .......... 26 ....... A Tumor imaging, limited area ....................... 0.66 0.23 0.23 0.04 0.93 0.93 XXX 78800 .......... TC ...... A Tumor imaging, limited area ....................... 0.00 3.45 NA 0.18 3.63 NA XXX 78801 .......... ............ A Tumor imaging, mult areas ......................... 0.79 4.81 NA 0.27 5.87 NA XXX 78801 .......... 26 ....... A Tumor imaging, mult areas ......................... 0.79 0.28 0.28 0.05 1.12 1.12 XXX 78801 .......... TC ...... A Tumor imaging, mult areas ......................... 0.00 4.53 NA 0.22 4.75 NA XXX 78802 .......... ............ A Tumor imaging, whole body ........................ 0.86 6.11 NA 0.34 7.31 NA XXX 78802 .......... 26 ....... A Tumor imaging, whole body ........................ 0.86 0.30 0.30 0.04 1.20 1.20 XXX 78802 .......... TC ...... A Tumor imaging, whole body ........................ 0.00 5.81 NA 0.30 6.11 NA XXX 78803 .......... ............ A Tumor imaging (3D) .................................... 1.09 8.16 NA 0.40 9.65 NA XXX 78803 .......... 26 ....... A Tumor imaging (3D) .................................... 1.09 0.40 0.40 0.05 1.54 1.54 XXX 78803 .......... TC ...... A Tumor imaging (3D) .................................... 0.00 7.77 NA 0.35 8.12 NA XXX 78804 .......... ............ A Tumor imaging, whole body ........................ 1.07 11.45 NA 0.34 12.87 NA XXX 78804 .......... 26 ....... A Tumor imaging, whole body ........................ 1.07 0.39 0.39 0.04 1.50 1.50 XXX 78804 .......... TC ...... A Tumor imaging, whole body ........................ 0.00 11.06 NA 0.30 11.36 NA XXX 78805 .......... ............ A Abscess imaging, ltd area ........................... 0.73 3.72 NA 0.21 4.66 NA XXX 78805 .......... 26 ....... A Abscess imaging, ltd area ........................... 0.73 0.26 0.26 0.03 1.02 1.02 XXX 78805 .......... TC ...... A Abscess imaging, ltd area ........................... 0.00 3.46 NA 0.18 3.64 NA XXX 78806 .......... ............ A Abscess imaging, whole body ..................... 0.86 6.80 NA 0.39 8.05 NA XXX 78806 .......... 26 ....... A Abscess imaging, whole body ..................... 0.86 0.30 0.30 0.04 1.20 1.20 XXX 78806 .......... TC ...... A Abscess imaging, whole body ..................... 0.00 6.49 NA 0.35 6.84 NA XXX 78807 .......... ............ A Nuclear localization/abscess ....................... 1.09 7.96 NA 0.39 9.44 NA XXX 78807 .......... 26 ....... A Nuclear localization/abscess ....................... 1.09 0.41 0.41 0.04 1.54 1.54 XXX 78807 .......... TC ...... A Nuclear localization/abscess ....................... 0.00 7.56 NA 0.35 7.91 NA XXX 78811 .......... ............ C Tumor imaging (pet), limited ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78811 .......... 26 ....... A Tumor imaging (pet), limited ....................... 1.54 0.00 0.00 0.11 1.65 1.65 XXX 78811 .......... TC ...... C Tumor imaging (pet), limited ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78812 .......... ............ C Tumor image (pet)/skul-thigh ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78812 .......... 26 ....... A Tumor image (pet)/skul-thigh ...................... 1.93 0.00 0.00 0.11 2.04 2.04 XXX 78812 .......... TC ...... C Tumor image (pet)/skul-thigh ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78813 .......... ............ C Tumor image (pet) full body ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78813 .......... 26 ....... A Tumor image (pet) full body ........................ 2.00 0.00 0.00 0.11 2.11 2.11 XXX 78813 .......... TC ...... C Tumor image (pet) full body ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78814 .......... ............ C Tumor image pet/ct, limited ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78814 .......... 26 ....... A Tumor image pet/ct, limited ......................... 2.20 0.00 0.00 0.11 2.31 2.31 XXX 78814 .......... TC ...... C Tumor image pet/ct, limited ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78815 .......... ............ C Tumorimage pet/ct skul-thigh ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78815 .......... 26 ....... A Tumorimage pet/ct skul-thigh ...................... 2.44 0.00 0.00 0.11 2.55 2.55 XXX 78815 .......... TC ...... C Tumorimage pet/ct skul-thigh ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78816 .......... ............ C Tumor image pet/ct full body ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78816 .......... 26 ....... A Tumor image pet/ct full body ...................... 2.50 0.00 0.00 0.11 2.61 2.61 XXX 78816 .......... TC ...... C Tumor image pet/ct full body ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78890 .......... ............ B Nuclear medicine data proc ........................ 0.05 1.08 NA 0.07 1.20 NA XXX 78890 .......... 26 ....... B Nuclear medicine data proc ........................ 0.05 0.02 0.02 0.01 0.08 0.08 XXX 78890 .......... TC ...... B Nuclear medicine data proc ........................ 0.00 1.06 NA 0.06 1.12 NA XXX 78891 .......... ............ B Nuclear med data proc ................................ 0.10 2.15 NA 0.14 2.39 NA XXX 78891 .......... 26 ....... B Nuclear med data proc ................................ 0.10 0.04 0.04 0.01 0.15 0.15 XXX 78891 .......... TC ...... B Nuclear med data proc ................................ 0.00 2.11 NA 0.13 2.24 NA XXX 78999 .......... ............ C Nuclear diagnostic exam ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX


## 45978

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

78999 .......... 26 ....... C Nuclear diagnostic exam ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78999 .......... TC ...... C Nuclear diagnostic exam ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79005 .......... ............ A Nuclear rx, oral admin ................................. 1.80 2.82 NA 0.22 4.85 NA XXX 79005 .......... 26 ....... A Nuclear rx, oral admin ................................. 1.80 0.62 0.62 0.08 2.51 2.51 XXX 79005 .......... TC ...... A Nuclear rx, oral admin ................................. 0.00 2.20 NA 0.14 2.34 NA XXX 79101 .......... ............ A Nuclear rx, iv admin .................................... 1.96 2.98 NA 0.22 5.16 NA XXX 79101 .......... 26 ....... A Nuclear rx, iv admin .................................... 1.96 0.70 0.70 0.08 2.75 2.75 XXX 79101 .......... TC ...... A Nuclear rx, iv admin .................................... 0.00 2.28 NA 0.14 2.42 NA XXX 79200 .......... ............ A Nuclear rx, intracav admin .......................... 1.99 3.18 NA 0.23 5.41 NA XXX 79200 .......... 26 ....... A Nuclear rx, intracav admin .......................... 1.99 0.71 0.71 0.09 2.79 2.79 XXX 79200 .......... TC ...... A Nuclear rx, intracav admin .......................... 0.00 2.47 NA 0.14 2.61 NA XXX 79300 .......... ............ C Nuclr rx, interstit colloid ............................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79300 .......... 26 ....... A Nuclr rx, interstit colloid ............................... 1.60 0.59 0.59 0.13 2.32 2.32 XXX 79300 .......... TC ...... C Nuclr rx, interstit colloid ............................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79403 .......... ............ A Hematopoietic nuclear tx ............................. 2.25 5.17 NA 0.24 7.66 NA XXX 79403 .......... 26 ....... A Hematopoietic nuclear tx ............................. 2.25 0.92 0.92 0.10 3.28 3.28 XXX 79403 .......... TC ...... A Hematopoietic nuclear tx ............................. 0.00 4.25 NA 0.14 4.39 NA XXX 79440 .......... ............ A Nuclear rx, intra-articular ............................. 1.99 2.95 NA 0.22 5.16 NA XXX 79440 .......... 26 ....... A Nuclear rx, intra-articular ............................. 1.99 0.75 0.75 0.08 2.82 2.82 XXX 79440 .......... TC ...... A Nuclear rx, intra-articular ............................. 0.00 2.20 NA 0.14 2.34 NA XXX 79445 .......... ............ A Nuclear rx, intra-arterial ............................... 2.40 NA NA 0.28 NA NA XXX 79445 .......... 26 ....... A Nuclear rx, intra-arterial ............................... 2.40 0.86 0.86 0.12 3.39 3.39 XXX 79445 .......... TC ...... A Nuclear rx, intra-arterial ............................... 0.00 NA NA 0.16 NA NA XXX 79999 .......... ............ C Nuclear medicine therapy ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79999 .......... 26 ....... C Nuclear medicine therapy ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79999 .......... TC ...... C Nuclear medicine therapy ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 80500 .......... ............ A Lab pathology consultation ......................... 0.37 0.20 0.16 0.01 0.58 0.54 XXX 80502 .......... ............ A Lab pathology consultation ......................... 1.33 0.53 0.53 0.04 1.90 1.90 XXX 83020 .......... 26 ....... A Hemoglobin electrophoresis ........................ 0.37 0.15 0.15 0.01 0.53 0.53 XXX 83912 .......... 26 ....... A Genetic examination .................................... 0.37 0.12 0.12 0.01 0.50 0.50 XXX 84165 .......... 26 ....... A Protein e-phoresis, serum ........................... 0.37 0.14 0.14 0.01 0.52 0.52 XXX 84166 .......... 26 ....... A Protein e-phoresis/urine/csf ......................... 0.37 0.14 0.14 0.01 0.52 0.52 XXX
84181 .......... 26 ....... A Western blot test ......................................... 0.37 0.14 0.14 0.01 0.52 0.52 XXX 84182 .......... 26 ....... A Protein, western blot test ............................ 0.37 0.16 0.16 0.02 0.55 0.55 XXX 85060 .......... ............ A Blood smear interpretation .......................... 0.45 0.18 0.18 0.02 0.65 0.65 XXX 85097 .......... ............ A Bone marrow interpretation ......................... 0.94 1.82 0.40 0.04 2.80 1.38 XXX 85390 .......... 26 ....... A Fibrinolysins screen ..................................... 0.37 0.13 0.13 0.01 0.51 0.51 XXX 85396 .......... ............ A Clotting assay, whole blood ........................ 0.37 NA 0.16 0.04 NA 0.57 XXX 85576 .......... 26 ....... A Blood platelet aggregation .......................... 0.37 0.16 0.16 0.01 0.54 0.54 XXX 86077 .......... ............ A Physician blood bank service ...................... 0.94 0.38 0.38 0.03 1.35 1.35 XXX 86078 .......... ............ A Physician blood bank service ...................... 0.94 0.45 0.39 0.03 1.42 1.36 XXX 86079 .......... ............ A Physician blood bank service ...................... 0.94 0.44 0.40 0.03 1.41 1.37 XXX 86255 .......... 26 ....... A Fluorescent antibody, screen ...................... 0.37 0.15 0.15 0.01 0.53 0.53 XXX 86256 .......... 26 ....... A Fluorescent antibody, titer ........................... 0.37 0.15 0.15 0.01 0.53 0.53 XXX 86320 .......... 26 ....... A Serum immunoelectrophoresis .................... 0.37 0.15 0.15 0.01 0.53 0.53 XXX 86325 .......... 26 ....... A Other immunoelectrophoresis ..................... 0.37 0.13 0.13 0.01 0.51 0.51 XXX 86327 .......... 26 ....... A Immunoelectrophoresis assay ..................... 0.42 0.18 0.18 0.02 0.62 0.62 XXX 86334 .......... 26 ....... A Immunofix e-phoresis, serum ...................... 0.37 0.15 0.15 0.01 0.53 0.53 XXX 86335 .......... 26 ....... A Immunfix e-phorsis/urine/csf ....................... 0.37 0.14 0.14 0.01 0.52 0.52 XXX 86485 .......... ............ C Skin test, candida ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86490 .......... ............ A Coccidioidomycosis skin test ...................... 0.00 0.28 NA 0.02 0.30 NA XXX 86510 .......... ............ A Histoplasmosis skin test .............................. 0.00 0.30 NA 0.02 0.32 NA XXX 86580 .......... ............ A TB intradermal test ...................................... 0.00 0.22 NA 0.02 0.24 NA XXX
86585 .......... ............ A TB tine test .................................................. 0.00 0.21 NA 0.01 0.22 NA XXX 86586 .......... ............ C Skin test, unlisted ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
87164 .......... 26 ....... A Dark field examination ................................. 0.37 0.12 0.12 0.01 0.50 0.50 XXX 87207 .......... 26 ....... A Smear, special stain .................................... 0.37 0.17 0.16 0.01 0.55 0.54 XXX 88104 .......... ............ A Cytopathology, fluids ................................... 0.56 0.87 NA 0.04 1.47 NA XXX 88104 .......... 26 ....... A Cytopathology, fluids ................................... 0.56 0.23 0.23 0.02 0.81 0.81 XXX 88104 .......... TC ...... A Cytopathology, fluids ................................... 0.00 0.64 NA 0.02 0.66 NA XXX 88106 .......... ............ A Cytopathology, fluids ................................... 0.56 1.35 NA 0.04 1.95 NA XXX 88106 .......... 26 ....... A Cytopathology, fluids ................................... 0.56 0.23 0.23 0.02 0.81 0.81 XXX 88106 .......... TC ...... A Cytopathology, fluids ................................... 0.00 1.11 NA 0.02 1.13 NA XXX 88107 .......... ............ A Cytopathology, fluids ................................... 0.76 1.54 NA 0.05 2.35 NA XXX 88107 .......... 26 ....... A Cytopathology, fluids ................................... 0.76 0.32 0.32 0.03 1.11 1.11 XXX 88107 .......... TC ...... A Cytopathology, fluids ................................... 0.00 1.21 NA 0.02 1.23 NA XXX 88108 .......... ............ A Cytopath, concentrate tech ......................... 0.56 1.22 NA 0.04 1.82 NA XXX 88108 .......... 26 ....... A Cytopath, concentrate tech ......................... 0.56 0.23 0.23 0.02 0.81 0.81 XXX 88108 .......... TC ...... A Cytopath, concentrate tech ......................... 0.00 0.99 NA 0.02 1.01 NA XXX 88112 .......... ............ A Cytopath, cell enhance tech ........................ 1.18 1.91 NA 0.04 3.14 NA XXX 88112 .......... 26 ....... A Cytopath, cell enhance tech ........................ 1.18 0.50 0.50 0.02 1.70 1.70 XXX 88112 .......... TC ...... A Cytopath, cell enhance tech ........................ 0.00 1.42 NA 0.02 1.44 NA XXX 88125 .......... ............ A Forensic cytopathology ............................... 0.26 0.25 NA 0.02 0.53 NA XXX 88125 .......... 26 ....... A Forensic cytopathology ............................... 0.26 0.11 0.11 0.01 0.38 0.38 XXX


## 45979

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

88125 .......... TC ...... A Forensic cytopathology ............................... 0.00 0.14 NA 0.01 0.15 NA XXX 88141 .......... ............ A Cytopath, c/v, interpret ................................ 0.42 0.23 0.15 0.02 0.67 0.59 XXX 88160 .......... ............ A Cytopath smear, other source ..................... 0.50 0.83 NA 0.04 1.38 NA XXX 88160 .......... 26 ....... A Cytopath smear, other source ..................... 0.50 0.21 0.21 0.02 0.73 0.73 XXX 88160 .......... TC ...... A Cytopath smear, other source ..................... 0.00 0.63 NA 0.02 0.65 NA XXX 88161 .......... ............ A Cytopath smear, other source ..................... 0.50 0.93 NA 0.04 1.47 NA XXX 88161 .......... 26 ....... A Cytopath smear, other source ..................... 0.50 0.21 0.21 0.02 0.73 0.73 XXX 88161 .......... TC ...... A Cytopath smear, other source ..................... 0.00 0.73 NA 0.02 0.75 NA XXX 88162 .......... ............ A Cytopath smear, other source ..................... 0.76 1.03 NA 0.05 1.84 NA XXX 88162 .......... 26 ....... A Cytopath smear, other source ..................... 0.76 0.32 0.32 0.03 1.11 1.11 XXX 88162 .......... TC ...... A Cytopath smear, other source ..................... 0.00 0.71 NA 0.02 0.73 NA XXX 88172 .......... ............ A Cytopathology eval of fna ........................... 0.60 0.73 NA 0.04 1.37 NA XXX 88172 .......... 26 ....... A Cytopathology eval of fna ........................... 0.60 0.25 0.25 0.02 0.87 0.87 XXX 88172 .......... TC ...... A Cytopathology eval of fna ........................... 0.00 0.47 NA 0.02 0.49 NA XXX 88173 .......... ............ A Cytopath eval, fna, report ............................ 1.39 2.11 NA 0.07 3.57 NA XXX 88173 .......... 26 ....... A Cytopath eval, fna, report ............................ 1.39 0.58 0.58 0.05 2.02 2.02 XXX 88173 .......... TC ...... A Cytopath eval, fna, report ............................ 0.00 1.53 NA 0.02 1.55 NA XXX 88182 .......... ............ A Cell marker study ........................................ 0.77 2.00 NA 0.07 2.84 NA XXX 88182 .......... 26 ....... A Cell marker study ........................................ 0.77 0.32 0.32 0.03 1.12 1.12 XXX 88182 .......... TC ...... A Cell marker study ........................................ 0.00 1.67 NA 0.04 1.71 NA XXX 88184 .......... ............ A Flowcytometry/ tc, 1 marker ........................ 0.00 1.62 NA 0.02 1.64 NA XXX 88185 .......... ............ A Flowcytometry/tc, add-on ............................ 0.00 0.86 NA 0.02 0.88 NA ZZZ 88187 .......... ............ A Flowcytometry/read, 2-8 .............................. 1.36 0.42 0.42 0.01 1.79 1.79 XXX 88188 .......... ............ A Flowcytometry/read, 9-15 ............................ 1.69 0.53 0.53 0.01 2.23 2.23 XXX 88189 .......... ............ A Flowcytometry/read, 16 & > ........................ 2.23 0.69 0.69 0.01 2.94 2.94 XXX 88199 .......... ............ C Cytopathology procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88199 .......... 26 ....... C Cytopathology procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88199 .......... TC ...... C Cytopathology procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88291 .......... ............ A Cyto/molecular report .................................. 0.52 0.21 0.18 0.02 0.75 0.72 XXX 88299 .......... ............ C Cytogenetic study ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88300 .......... ............ A Surgical path, gross .................................... 0.08 0.45 NA 0.02 0.55 NA XXX 88300 .......... 26 ....... A Surgical path, gross .................................... 0.08 0.03 0.03 0.01 0.12 0.12 XXX 88300 .......... TC ...... A Surgical path, gross .................................... 0.00 0.42 NA 0.01 0.43 NA XXX 88302 .......... ............ A Tissue exam by pathologist ........................ 0.13 1.03 NA 0.03 1.19 NA XXX 88302 .......... 26 ....... A Tissue exam by pathologist ........................ 0.13 0.06 0.06 0.01 0.20 0.20 XXX 88302 .......... TC ...... A Tissue exam by pathologist ........................ 0.00 0.98 NA 0.02 1.00 NA XXX 88304 .......... ............ A Tissue exam by pathologist ........................ 0.22 1.43 NA 0.03 1.68 NA XXX 88304 .......... 26 ....... A Tissue exam by pathologist ........................ 0.22 0.09 0.09 0.01 0.32 0.32 XXX 88304 .......... TC ...... A Tissue exam by pathologist ........................ 0.00 1.34 NA 0.02 1.36 NA XXX 88305 .......... ............ A Tissue exam by pathologist ........................ 0.75 2.09 NA 0.07 2.91 NA XXX 88305 .......... 26 ....... A Tissue exam by pathologist ........................ 0.75 0.33 0.33 0.03 1.11 1.11 XXX 88305 .......... TC ...... A Tissue exam by pathologist ........................ 0.00 1.76 NA 0.04 1.80 NA XXX 88307 .......... ............ A Tissue exam by pathologist ........................ 1.59 3.27 NA 0.12 4.98 NA XXX 88307 .......... 26 ....... A Tissue exam by pathologist ........................ 1.59 0.66 0.66 0.06 2.32 2.32 XXX 88307 .......... TC ...... A Tissue exam by pathologist ........................ 0.00 2.60 NA 0.06 2.66 NA XXX 88309 .......... ............ A Tissue exam by pathologist ........................ 2.28 4.52 NA 0.14 6.95 NA XXX 88309 .......... 26 ....... A Tissue exam by pathologist ........................ 2.28 0.95 0.95 0.08 3.31 3.31 XXX 88309 .......... TC ...... A Tissue exam by pathologist ........................ 0.00 3.57 NA 0.06 3.63 NA XXX 88311 .......... ............ A Decalcify tissue ........................................... 0.24 0.23 NA 0.02 0.49 NA XXX 88311 .......... 26 ....... A Decalcify tissue ........................................... 0.24 0.10 0.10 0.01 0.35 0.35 XXX 88311 .......... TC ...... A Decalcify tissue ........................................... 0.00 0.13 NA 0.01 0.14 NA XXX 88312 .......... ............ A Special stains .............................................. 0.54 1.66 NA 0.03 2.23 NA XXX 88312 .......... 26 ....... A Special stains .............................................. 0.54 0.23 0.23 0.02 0.79 0.79 XXX 88312 .......... TC ...... A Special stains .............................................. 0.00 1.44 NA 0.01 1.45 NA XXX 88313 .......... ............ A Special stains .............................................. 0.24 1.35 NA 0.02 1.61 NA XXX 88313 .......... 26 ....... A Special stains .............................................. 0.24 0.10 0.10 0.01 0.35 0.35 XXX 88313 .......... TC ...... A Special stains .............................................. 0.00 1.25 NA 0.01 1.26 NA XXX
88314 .......... ............ A Histochemical stain ..................................... 0.45 2.06 NA 0.04 2.55 NA XXX
88314 .......... 26 ....... A Histochemical stain ..................................... 0.45 0.19 0.19 0.02 0.66 0.66 XXX 88314 .......... TC ...... A Histochemical stain ..................................... 0.00 1.88 NA 0.02 1.90 NA XXX 88318 .......... ............ A Chemical histochemistry ............................. 0.42 1.77 NA 0.03 2.22 NA XXX 88318 .......... 26 ....... A Chemical histochemistry ............................. 0.42 0.18 0.18 0.02 0.62 0.62 XXX 88318 .......... TC ...... A Chemical histochemistry ............................. 0.00 1.60 NA 0.01 1.61 NA XXX 88319 .......... ............ A Enzyme histochemistry ............................... 0.53 3.39 NA 0.04 3.96 NA XXX 88319 .......... 26 ....... A Enzyme histochemistry ............................... 0.53 0.22 0.22 0.02 0.77 0.77 XXX 88319 .......... TC ...... A Enzyme histochemistry ............................... 0.00 3.17 NA 0.02 3.19 NA XXX
88321 .......... ............ A Microslide consultation ................................ 1.30 0.80 0.55 0.05 2.15 1.90 XXX
88323 .......... ............ A Microslide consultation ................................ 1.35 1.84 NA 0.07 3.26 NA XXX
88323 .......... 26 ....... A Microslide consultation ................................ 1.35 0.56 0.56 0.05 1.96 1.96 XXX 88323 .......... TC ...... A Microslide consultation ................................ 0.00 1.28 NA 0.02 1.30 NA XXX 88325 .......... ............ A Comprehensive review of data ................... 2.22 2.87 0.93 0.07 5.16 3.22 XXX 88329 .......... ............ A Path consult introp ...................................... 0.67 0.64 0.28 0.02 1.34 0.97 XXX 88331 .......... ............ A Path consult intraop, 1 bloc ........................ 1.19 1.12 NA 0.08 2.40 NA XXX 88331 .......... 26 ....... A Path consult intraop, 1 bloc ........................ 1.19 0.50 0.50 0.04 1.73 1.73 XXX


## 45980

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

88331 .......... TC ...... A Path consult intraop, 1 bloc ........................ 0.00 0.63 NA 0.04 0.67 NA XXX 88332 .......... ............ A Path consult intraop, add ’ l ........................... 0.59 0.46 NA 0.04 1.09 NA XXX 88332 .......... 26 ....... A Path consult intraop, add ’ l ........................... 0.59 0.24 0.24 0.02 0.85 0.85 XXX 88332 .......... TC ...... A Path consult intraop, add ’ l ........................... 0.00 0.21 NA 0.02 0.23 NA XXX 88342 .......... ............ A Immunohistochemistry ................................. 0.85 1.52 NA 0.05 2.42 NA XXX 88342 .......... 26 ....... A Immunohistochemistry ................................. 0.85 0.35 0.35 0.03 1.23 1.23 XXX 88342 .......... TC ...... A Immunohistochemistry ................................. 0.00 1.16 NA 0.02 1.18 NA XXX 88346 .......... ............ A Immunofluorescent study ............................ 0.86 1.65 NA 0.05 2.56 NA XXX 88346 .......... 26 ....... A Immunofluorescent study ............................ 0.86 0.36 0.36 0.03 1.25 1.25 XXX 88346 .......... TC ...... A Immunofluorescent study ............................ 0.00 1.29 NA 0.02 1.31 NA XXX 88347 .......... ............ A Immunofluorescent study ............................ 0.86 1.31 NA 0.05 2.22 NA XXX 88347 .......... 26 ....... A Immunofluorescent study ............................ 0.86 0.34 0.34 0.03 1.23 1.23 XXX 88347 .......... TC ...... A Immunofluorescent study ............................ 0.00 0.97 NA 0.02 0.99 NA XXX 88348 .......... ............ A Electron microscopy .................................... 1.51 10.48 NA 0.13 12.12 NA XXX 88348 .......... 26 ....... A Electron microscopy .................................... 1.51 0.62 0.62 0.06 2.20 2.20 XXX 88348 .......... TC ...... A Electron microscopy .................................... 0.00 9.85 NA 0.07 9.92 NA XXX 88349 .......... ............ A Scanning electron microscopy .................... 0.76 4.10 NA 0.09 4.95 NA XXX 88349 .......... 26 ....... A Scanning electron microscopy .................... 0.76 0.32 0.32 0.03 1.11 1.11 XXX 88349 .......... TC ...... A Scanning electron microscopy .................... 0.00 3.78 NA 0.06 3.84 NA XXX 88355 .......... ............ A Analysis, skeletal muscle ............................ 1.85 8.06 NA 0.13 10.04 NA XXX 88355 .......... 26 ....... A Analysis, skeletal muscle ............................ 1.85 0.77 0.77 0.07 2.70 2.70 XXX 88355 .......... TC ...... A Analysis, skeletal muscle ............................ 0.00 7.29 NA 0.06 7.35 NA XXX 88356 .......... ............ A Analysis, nerve ............................................ 3.03 4.70 NA 0.19 7.91 NA XXX 88356 .......... 26 ....... A Analysis, nerve ............................................ 3.03 1.23 1.23 0.12 4.37 4.37 XXX 88356 .......... TC ...... A Analysis, nerve ............................................ 0.00 3.47 NA 0.07 3.54 NA XXX 88358 .......... ............ A Analysis, tumor ............................................ 0.95 0.92 NA 0.17 2.04 NA XXX 88358 .......... 26 ....... A Analysis, tumor ............................................ 0.95 0.39 0.39 0.10 1.44 1.44 XXX 88358 .......... TC ...... A Analysis, tumor ............................................ 0.00 0.53 NA 0.07 0.60 NA XXX 88360 .......... ............ A Tumor immunohistochem/manual ............... 1.10 1.81 NA 0.08 2.99 NA XXX 88360 .......... 26 ....... A Tumor immunohistochem/manual ............... 1.10 0.46 0.46 0.06 1.62 1.62 XXX 88360 .......... TC ...... A Tumor immunohistochem/manual ............... 0.00 1.35 NA 0.02 1.37 NA XXX 88361 .......... ............ A Tumor immunohistochem/comput ............... 1.18 3.07 NA 0.17 4.42 NA XXX 88361 .......... 26 ....... A Tumor immunohistochem/comput ............... 1.18 0.48 0.48 0.10 1.76 1.76 XXX 88361 .......... TC ...... A Tumor immunohistochem/comput ............... 0.00 2.59 NA 0.07 2.66 NA XXX 88362 .......... ............ A Nerve teasing preparations ......................... 2.17 4.63 NA 0.15 6.95 NA XXX 88362 .......... 26 ....... A Nerve teasing preparations ......................... 2.17 0.89 0.89 0.09 3.16 3.16 XXX 88362 .......... TC ...... A Nerve teasing preparations ......................... 0.00 3.73 NA 0.06 3.79 NA XXX 88365 .......... ............ A Insitu hybridization (fish) ............................. 1.20 2.32 NA 0.05 3.58 NA XXX 88365 .......... 26 ....... A Insitu hybridization (fish) ............................. 1.20 0.50 0.50 0.03 1.73 1.73 XXX 88365 .......... TC ...... A Insitu hybridization (fish) ............................. 0.00 1.83 NA 0.02 1.85 NA XXX 88367 .......... ............ A Insitu hybridization, auto ............................. 1.30 4.76 NA 0.12 6.18 NA XXX 88367 .......... 26 ....... A Insitu hybridization, auto ............................. 1.30 0.53 0.53 0.06 1.89 1.89 XXX 88367 .......... TC ...... A Insitu hybridization, auto ............................. 0.00 4.23 NA 0.06 4.29 NA XXX 88368 .......... ............ A Insitu hybridization, manual ......................... 1.40 3.95 NA 0.12 5.47 NA XXX 88368 .......... 26 ....... A Insitu hybridization, manual ......................... 1.40 0.58 0.58 0.06 2.05 2.05 XXX 88368 .......... TC ...... A Insitu hybridization, manual ......................... 0.00 3.37 NA 0.06 3.43 NA XXX 88371 .......... 26 ....... A Protein, western blot tissue ......................... 0.37 0.13 0.13 0.01 0.51 0.51 XXX 88372 .......... 26 ....... A Protein analysis w/probe ............................. 0.37 0.16 0.16 0.01 0.54 0.54 XXX 88380 .......... ............ C Microdissection ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88380 .......... 26 ....... C Microdissection ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88380 .......... TC ...... C Microdissection ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88399 .......... ............ C Surgical pathology procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88399 .......... 26 ....... C Surgical pathology procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88399 .......... TC ...... C Surgical pathology procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 89060 .......... 26 ....... A Exam,synovial fluid crystals ........................ 0.37 0.16 0.16 0.01 0.54 0.54 XXX 89100 .......... ............ A Sample intestinal contents .......................... 0.60 3.64 0.32 0.03 4.27 0.95 XXX 89105 .......... ............ A Sample intestinal contents .......................... 0.50 3.28 0.28 0.02 3.80 0.80 XXX 89130 .......... ............ A Sample stomach contents ........................... 0.45 3.07 0.19 0.02 3.54 0.66 XXX 89132 .......... ............ A Sample stomach contents ........................... 0.19 2.84 0.16 0.01 3.04 0.36 XXX 89135 .......... ............ A Sample stomach contents ........................... 0.79 3.96 0.32 0.04 4.79 1.15 XXX 89136 .......... ............ A Sample stomach contents ........................... 0.21 2.93 0.15 0.01 3.15 0.37 XXX 89140 .......... ............ A Sample stomach contents ........................... 0.94 3.28 0.36 0.04 4.26 1.35 XXX 89141 .......... ............ A Sample stomach contents ........................... 0.85 3.72 0.40 0.03 4.60 1.29 XXX 89220 .......... ............ A Sputum specimen collection ....................... 0.00 0.39 NA 0.02 0.41 NA XXX 89230 .......... ............ A Collect sweat for test ................................... 0.00 0.11 NA 0.02 0.13 NA XXX 89240 .......... ............ C Pathology lab procedure ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90281 .......... ............ I Human ig, im ............................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90283 .......... ............ I Human ig, iv ................................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90287 .......... ............ I Botulinum antitoxin ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90288 .......... ............ I Botulism ig, iv .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90291 .......... ............ I Cmv ig, iv .................................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90296 .......... ............ E Diphtheria antitoxin ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90371 .......... ............ E Hep b ig, im ................................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90375 .......... ............ E Rabies ig, im/sc ........................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX


## 45981

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

90376 .......... ............ E Rabies ig, heat treated ................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90379 .......... ............ I Rsv ig, iv ...................................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90384 .......... ............ I Rh ig, full-dose, im ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90385 .......... ............ E Rh ig, minidose, im ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90386 .......... ............ I Rh ig, iv ....................................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90389 .......... ............ I Tetanus ig, im .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90393 .......... ............ E Vaccina ig, im .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90396 .......... ............ E Varicella-zoster ig, im .................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90399 .......... ............ I Immune globulin .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90465 .......... ............ A Immune admin 1 inj, < 8 yrs ....................... 0.17 0.31 0.27 0.01 0.49 0.45 XXX 90466 .......... ............ A Immune admin addl inj, < 8 y ..................... 0.15 0.13 0.12 0.01 0.29 0.28 ZZZ 90467 .......... ............ R Immune admin o or n, < 8 yrs .................... 0.17 0.31 0.00 0.01 0.49 0.18 XXX 90468 .......... ............ R Immune admin o/n, addl < 8 y .................... 0.15 0.13 0.00 0.01 0.29 0.16 ZZZ
90471 .......... ............ A Immunization admin .................................... 0.17 0.31 NA 0.01 0.49 NA XXX 90472 .......... ............ A Immunization admin, each add ................... 0.15 0.13 NA 0.01 0.29 NA ZZZ 90473 .......... ............ R Immune admin oral/nasal ............................ 0.17 0.31 0.00 0.01 0.49 0.18 XXX 90474 .......... ............ R Immune admin oral/nasal addl .................... 0.15 0.13 0.00 0.01 0.29 0.16 ZZZ 90476 .......... ............ E Adenovirus vaccine, type 4 ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90477 .......... ............ E Adenovirus vaccine, type 7 ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90581 .......... ............ E Anthrax vaccine, sc ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90585 .......... ............ E Bcg vaccine, percut ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90586 .......... ............ E Bcg vaccine, intravesical ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90632 .......... ............ E Hep a vaccine, adult im .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90633 .......... ............ E Hep a vacc, ped/adol, 2 dose ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90634 .......... ............ E Hep a vacc, ped/adol, 3 dose ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90636 .......... ............ E Hep a/hep b vacc, adult im ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90645 .......... ............ E Hib vaccine, hboc, im .................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90646 .......... ............ E Hib vaccine, prp-d, im ................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90647 .......... ............ E Hib vaccine, prp-omp, im ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90648 .......... ............ E Hib vaccine, prp-t, im .................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90665 .......... ............ E Lyme disease vaccine, im ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90669 .......... ............ N Pneumococcal vacc, ped <5 ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90675 .......... ............ E Rabies vaccine, im ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90676 .......... ............ E Rabies vaccine, id ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90680 .......... ............ E Rotovirus vaccine, oral ................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90690 .......... ............ E Typhoid vaccine, oral .................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90691 .......... ............ E Typhoid vaccine, im .................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90692 .......... ............ E Typhoid vaccine, h-p, sc/id ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90693 .......... ............ E Typhoid vaccine, akd, sc ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90698 .......... ............ E Dtap-hib-ip vaccine, im ................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90700 .......... ............ E Dtap vaccine, < 7 yrs, im ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90701 .......... ............ E Dtp vaccine, im ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90702 .......... ............ E Dt vaccine < 7, im ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90703 .......... ............ E Tetanus vaccine, im .................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90704 .......... ............ E Mumps vaccine, sc ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90705 .......... ............ E Measles vaccine, sc .................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90706 .......... ............ E Rubella vaccine, sc ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90707 .......... ............ E Mmr vaccine, sc .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90708 .......... ............ E Measles-rubella vaccine, sc ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90710 .......... ............ E Mmrv vaccine, sc ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90712 .......... ............ E Oral poliovirus vaccine ................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90713 .......... ............ E Poliovirus, ipv, sc ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90715 .......... ............ E Tdap vaccine >7 im ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90716 .......... ............ E Chicken pox vaccine, sc ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90717 .......... ............ E Yellow fever vaccine, sc .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90718 .......... ............ E Td vaccine > 7, im ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90719 .......... ............ E Diphtheria vaccine, im ................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90720 .......... ............ E Dtp/hib vaccine, im ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90721 .......... ............ E Dtap/hib vaccine, im .................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90723 .......... ............ I Dtap-hep b-ipv vaccine, im ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90725 .......... ............ E Cholera vaccine, injectable ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90727 .......... ............ E Plague vaccine, im ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 XX 90733 .......... ............ E Meningococcal vaccine, sc ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90734 .......... ............ E Meningococcal vaccine, im ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90735 .......... ............ E Encephalitis vaccine, sc .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90748 .......... ............ I Hep b/hib vaccine, im .................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX
90749 .......... ............ E Vaccine toxoid ............................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90780 .......... ............ I IV infusion therapy, 1 hour .......................... 0.17 0.00 0.00 0.07 0.24 0.24 XXX 90781 .......... ............ I IV infusion, additional hour .......................... 0.17 0.00 0.00 0.04 0.21 0.21 ZZZ 90782 .......... ............ I Injection, sc/im ............................................. 0.17 0.00 0.00 0.01 0.18 0.18 XXX 90783 .......... ............ A Injection, ia .................................................. 0.17 0.31 NA 0.02 0.50 NA XXX 90784 .......... ............ I Injection, iv .................................................. 0.17 0.00 0.00 0.04 0.21 0.21 XXX 90788 .......... ............ A Injection of antibiotic .................................... 0.17 0.26 NA 0.01 0.44 NA XXX 90799 .......... ............ C Ther/prophylactic/dx inject ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX


## 45982

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

90801 .......... ............ A Psy dx interview .......................................... 2.81 1.19 0.91 0.06 4.05 3.77 XXX 90802 .......... ............ A Intac psy dx interview .................................. 3.02 1.23 0.96 0.07 4.32 4.05 XXX 90804 .......... ............ A Psytx, office, 20-30 min ............................... 1.21 0.49 0.37 0.03 1.74 1.61 XXX 90805 .......... ............ A Psytx, off, 20-30 min w/e&m ....................... 1.37 0.51 0.41 0.03 1.91 1.81 XXX 90806 .......... ............ A Psytx, off, 45-50 min ................................... 1.86 0.68 0.58 0.04 2.59 2.49 XXX 90807 .......... ............ A Psytx, off, 45-50 min w/e&m ....................... 2.02 0.70 0.61 0.05 2.78 2.69 XXX 90808 .......... ............ A Psytx, office, 75-80 min ............................... 2.80 1.00 0.87 0.06 3.85 3.73 XXX 90809 .......... ............ A Psytx, off, 75-80, w/e&m ............................. 2.96 0.99 0.90 0.07 4.02 3.92 XXX 90810 .......... ............ A Intac psytx, off, 20-30 min ........................... 1.32 0.51 0.41 0.04 1.87 1.77 XXX 90811 .......... ............ A Intac psytx, 20-30, w/e&m ........................... 1.48 0.58 0.45 0.04 2.10 1.97 XXX 90812 .......... ............ A Intac psytx, off, 45-50 min ........................... 1.97 0.77 0.62 0.04 2.79 2.64 XXX 90813 .......... ............ A Intac psytx, 45-50 min w/e&m ..................... 2.13 0.77 0.65 0.05 2.96 2.84 XXX 90814 .......... ............ A Intac psytx, off, 75-80 min ........................... 2.91 1.07 0.94 0.06 4.04 3.91 XXX 90815 .......... ............ A Intac psytx, 75-80 w/e&m ............................ 3.07 1.05 0.92 0.07 4.19 4.06 XXX 90816 .......... ............ A Psytx, hosp, 20-30 min ............................... 1.25 NA 0.45 0.03 NA 1.73 XXX 90817 .......... ............ A Psytx, hosp, 20-30 min w/e&m ................... 1.41 NA 0.45 0.03 NA 1.90 XXX 90818 .......... ............ A Psytx, hosp, 45-50 min ............................... 1.89 NA 0.67 0.04 NA 2.60 XXX 90819 .......... ............ A Psytx, hosp, 45-50 min w/e&m ................... 2.05 NA 0.64 0.05 NA 2.75 XXX 90821 .......... ............ A Psytx, hosp, 75-80 min ............................... 2.84 NA 0.97 0.06 NA 3.87 XXX 90822 .......... ............ A Psytx, hosp, 75-80 min w/e&m ................... 3.00 NA 0.93 0.08 NA 4.01 XXX 90823 .......... ............ A Intac psytx, hosp, 20-30 min ....................... 1.36 NA 0.47 0.03 NA 1.86 XXX 90824 .......... ............ A Intac psytx, hsp 20-30 w/e&m ..................... 1.52 NA 0.48 0.04 NA 2.05 XXX 90826 .......... ............ A Intac psytx, hosp, 45-50 min ....................... 2.01 NA 0.70 0.05 NA 2.76 XXX 90827 .......... ............ A Intac psytx, hsp 45-50 w/e&m ..................... 2.16 NA 0.67 0.05 NA 2.89 XXX 90828 .......... ............ A Intac psytx, hosp, 75-80 min ....................... 2.95 NA 1.02 0.06 NA 4.03 XXX 90829 .......... ............ A Intac psytx, hsp 75-80 w/e&m ..................... 3.11 NA 0.96 0.07 NA 4.14 XXX 90845 .......... ............ A Psychoanalysis ............................................ 1.79 0.57 0.54 0.04 2.40 2.37 XXX 90846 .......... ............ R Family psytx w/o patient .............................. 1.83 0.64 0.63 0.04 2.51 2.50 XXX 90847 .......... ............ R Family psytx w/patient ................................. 2.21 0.81 0.74 0.05 3.08 3.01 XXX 90849 .......... ............ R Multiple family group psytx .......................... 0.59 0.27 0.24 0.02 0.88 0.85 XXX 90853 .......... ............ A Group psychotherapy .................................. 0.59 0.25 0.23 0.01 0.85 0.83 XXX 90857 .......... ............ A Intac group psytx ......................................... 0.63 0.29 0.25 0.01 0.93 0.89 XXX 90862 .......... ............ A Medication management ............................. 0.95 0.42 0.32 0.02 1.39 1.29 XXX 90865 .......... ............ A Narcosynthesis ............................................ 2.85 1.35 0.89 0.12 4.31 3.86 XXX 90870 .......... ............ A Electroconvulsive therapy ........................... 1.88 1.82 0.58 0.04 3.74 2.50 000 90871 .......... ............ N Electroconvulsive therapy ........................... 2.73 NA 0.99 0.07 NA 3.78 000 90875 .......... ............ N Psychophysiological therapy ....................... 1.20 0.85 0.46 0.04 2.09 1.70 XXX 90876 .......... ............ N Psychophysiological therapy ....................... 1.90 1.11 0.72 0.05 3.06 2.68 XXX 90880 .......... ............ A Hypnotherapy .............................................. 2.19 0.98 0.67 0.05 3.22 2.92 XXX 90882 .......... ............ N Environmental manipulation ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90885 .......... ............ B Psy evaluation of records ............................ 0.97 0.37 0.37 0.02 1.36 1.36 XXX 90887 .......... ............ B Consultation with family .............................. 1.48 0.82 0.56 0.04 2.34 2.08 XXX 90889 .......... ............ B Preparation of report ................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90899 .......... ............ C Psychiatric service/therapy .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90901 .......... ............ A Biofeedback train, any meth ....................... 0.41 0.64 0.14 0.02 1.07 0.57 000 90911 .......... ............ A Biofeedback peri/uro/rectal .......................... 0.89 1.58 0.33 0.06 2.53 1.28 000 90918 .......... ............ I ESRD related services, month .................... 11.18 5.96 5.96 0.36 17.50 17.50 XXX 90919 .......... ............ I ESRD related services, month .................... 8.55 3.90 3.90 0.29 12.74 12.74 XXX 90920 .......... ............ I ESRD related services, month .................... 7.27 3.65 3.65 0.23 11.16 11.16 XXX 90921 .......... ............ I ESRD related services, month .................... 4.47 2.37 2.37 0.14 6.98 6.98 XXX 90922 .......... ............ I ESRD related services, day ........................ 0.37 0.21 0.21 0.01 0.59 0.59 XXX 90923 .......... ............ I Esrd related services, day ........................... 0.28 0.13 0.13 0.01 0.42 0.42 XXX 90924 .......... ............ I Esrd related services, day ........................... 0.24 0.12 0.12 0.01 0.37 0.37 XXX 90925 .......... ............ I Esrd related services, day ........................... 0.15 0.08 0.08 0.01 0.24 0.24 XXX 90935 .......... ............ A Hemodialysis, one evaluation ..................... 1.22 NA 0.65 0.04 NA 1.91 000 90937 .......... ............ A Hemodialysis, repeated eval ....................... 2.11 NA 0.95 0.07 NA 3.13 000 90945 .......... ............ A Dialysis, one evaluation .............................. 1.28 NA 0.67 0.04 NA 1.99 000 90947 .......... ............ A Dialysis, repeated eval ................................ 2.16 NA 0.97 0.07 NA 3.20 000 90997 .......... ............ A Hemoperfusion ............................................ 1.84 NA 0.65 0.06 NA 2.55 000 90999 .......... ............ C Dialysis procedure ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91000 .......... ............ A Esophageal intubation ................................. 0.73 0.84 NA 0.04 1.62 NA 000 91000 .......... 26 ....... A Esophageal intubation ................................. 0.73 0.25 0.25 0.03 1.01 1.01 000 91000 .......... TC ...... A Esophageal intubation ................................. 0.00 0.59 NA 0.01 0.60 NA 000 91010 .......... ............ A Esophagus motility study ............................ 1.25 4.76 NA 0.12 6.14 NA 000 91010 .......... 26 ....... A Esophagus motility study ............................ 1.25 0.47 0.47 0.06 1.78 1.78 000 91010 .......... TC ...... A Esophagus motility study ............................ 0.00 4.30 NA 0.06 4.36 NA 000 91011 .......... ............ A Esophagus motility study ............................ 1.50 5.79 NA 0.13 7.42 NA 000 91011 .......... 26 ....... A Esophagus motility study ............................ 1.50 0.57 0.57 0.07 2.15 2.15 000 91011 .......... TC ...... A Esophagus motility study ............................ 0.00 5.22 NA 0.06 5.28 NA 000 91012 .......... ............ A Esophagus motility study ............................ 1.46 5.76 NA 0.13 7.35 NA 000 91012 .......... 26 ....... A Esophagus motility study ............................ 1.46 0.55 0.55 0.06 2.07 2.07 000 91012 .......... TC ...... A Esophagus motility study ............................ 0.00 5.21 NA 0.07 5.28 NA 000 91020 .......... ............ A Gastric motility ............................................. 1.44 4.49 NA 0.13 6.07 NA 000 91020 .......... 26 ....... A Gastric motility ............................................. 1.44 0.51 0.51 0.07 2.02 2.02 000


## 45983

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

91020 .......... TC ...... A Gastric motility ............................................. 0.00 3.99 NA 0.06 4.05 NA 000 91030 .......... ............ A Acid perfusion of esophagus ....................... 0.91 2.67 NA 0.06 3.64 NA 000 91030 .......... 26 ....... A Acid perfusion of esophagus ....................... 0.91 0.35 0.35 0.04 1.30 1.30 000 91030 .......... TC ...... A Acid perfusion of esophagus ....................... 0.00 2.32 NA 0.02 2.34 NA 000 91034 .......... ............ A Gastroesophageal reflux test ...................... 0.97 5.70 NA 0.12 6.79 NA XXX 91034 .......... 26 ....... A Gastroesophageal reflux test ...................... 0.97 0.36 0.36 0.06 1.40 1.40 XXX 91034 .......... TC ...... A Gastroesophageal reflux test ...................... 0.00 5.33 NA 0.06 5.39 NA XXX 91035 .......... ............ A G-esoph reflx tst w/electrod ........................ 1.59 11.65 NA 0.12 13.36 NA XXX 91035 .......... 26 ....... A G-esoph reflx tst w/electrod ........................ 1.59 0.60 0.60 0.06 2.25 2.25 XXX 91035 .......... TC ...... A G-esoph reflx tst w/electrod ........................ 0.00 11.05 NA 0.06 11.11 NA XXX 91037 .......... ............ A Esoph imped function test ........................... 0.97 3.22 NA 0.12 4.32 NA XXX 91037 .......... 26 ....... A Esoph imped function test ........................... 0.97 0.36 0.36 0.06 1.40 1.40 XXX 91037 .......... TC ...... A Esoph imped function test ........................... 0.00 2.86 NA 0.06 2.92 NA XXX 91038 .......... ............ A Esoph imped funct test > 1h ....................... 1.10 2.47 NA 0.12 3.69 NA XXX 91038 .......... 26 ....... A Esoph imped funct test > 1h ....................... 1.10 0.42 0.42 0.06 1.58 1.58 XXX 91038 .......... TC ...... A Esoph imped funct test > 1h ....................... 0.00 2.05 NA 0.06 2.11 NA XXX 91040 .......... ............ A Esoph balloon distension tst ....................... 0.97 11.26 NA 0.12 12.35 NA XXX 91040 .......... 26 ....... A Esoph balloon distension tst ....................... 0.97 0.36 0.36 0.06 1.40 1.40 XXX 91040 .......... TC ...... A Esoph balloon distension tst ....................... 0.00 10.89 NA 0.06 10.95 NA XXX 91052 .......... ............ A Gastric analysis test .................................... 0.79 2.64 NA 0.05 3.48 NA 000 91052 .......... 26 ....... A Gastric analysis test .................................... 0.79 0.30 0.30 0.03 1.12 1.12 000 91052 .......... TC ...... A Gastric analysis test .................................... 0.00 2.34 NA 0.02 2.36 NA 000 91055 .......... ............ A Gastric intubation for smear ........................ 0.94 2.91 NA 0.07 3.92 NA 000 91055 .......... 26 ....... A Gastric intubation for smear ........................ 0.94 0.27 0.27 0.05 1.26 1.26 000 91055 .......... TC ...... A Gastric intubation for smear ........................ 0.00 2.64 NA 0.02 2.66 NA 000 91060 .......... ............ A Gastric saline load test ................................ 0.45 1.89 NA 0.05 2.39 NA 000 91060 .......... 26 ....... A Gastric saline load test ................................ 0.45 0.14 0.14 0.03 0.62 0.62 000 91060 .......... TC ...... A Gastric saline load test ................................ 0.00 1.75 NA 0.02 1.77 NA 000 91065 .......... ............ A Breath hydrogen test ................................... 0.20 1.62 NA 0.03 1.85 NA 000 91065 .......... 26 ....... A Breath hydrogen test ................................... 0.20 0.07 0.07 0.01 0.28 0.28 000 91065 .......... TC ...... A Breath hydrogen test ................................... 0.00 1.55 NA 0.02 1.57 NA 000 91100 .......... ............ A Pass intestine bleeding tube ....................... 1.08 2.70 0.28 0.07 3.85 1.43 000 91105 .......... ............ A Gastric intubation treatment ........................ 0.37 1.99 0.09 0.03 2.39 0.49 000 91110 .......... ............ A Gi tract capsule endoscopy ......................... 3.65 24.17 NA 0.16 27.98 NA XXX 91110 .......... 26 ....... A Gi tract capsule endoscopy ......................... 3.65 1.38 1.38 0.09 5.12 5.12 XXX 91110 .......... TC ...... A Gi tract capsule endoscopy ......................... 0.00 22.79 NA 0.07 22.86 NA XXX
91120 .......... ............ A Rectal sensation test ................................... 0.97 11.11 NA 0.11 12.19 NA XXX 91120 .......... 26 ....... A Rectal sensation test ................................... 0.97 0.36 0.36 0.07 1.41 1.41 XXX 91120 .......... TC ...... A Rectal sensation test ................................... 0.00 10.74 NA 0.04 10.78 NA XXX 91122 .......... ............ A Anal pressure record ................................... 1.77 5.15 NA 0.21 7.13 NA 000 91122 .......... 26 ....... A Anal pressure record ................................... 1.77 0.62 0.62 0.13 2.52 2.52 000 91122 .......... TC ...... A Anal pressure record ................................... 0.00 4.53 NA 0.08 4.61 NA 000 91123 .......... ............ B Irrigate fecal impaction ................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91132 .......... ............ C Electrogastrography .................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91132 .......... 26 ....... A Electrogastrography .................................... 0.52 0.20 0.20 0.02 0.74 0.74 XXX 91132 .......... TC ...... C Electrogastrography .................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91133 .......... ............ C Electrogastrography w/test .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91133 .......... 26 ....... A Electrogastrography w/test .......................... 0.66 0.25 0.25 0.03 0.94 0.94 XXX 91133 .......... TC ...... C Electrogastrography w/test .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91299 .......... ............ C Gastroenterology procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91299 .......... 26 ....... C Gastroenterology procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91299 .......... TC ...... C Gastroenterology procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92002 .......... ............ A Eye exam, new patient ................................ 0.88 0.97 0.33 0.02 1.87 1.23 XXX 92004 .......... ............ A Eye exam, new patient ................................ 1.67 1.68 0.66 0.04 3.40 2.38 XXX 92012 .......... ............ A Eye exam established pat ........................... 0.67 1.01 0.28 0.02 1.70 0.97 XXX 92014 .......... ............ A Eye exam & treatment ................................ 1.10 1.39 0.46 0.03 2.52 1.59 XXX 92015 .......... ............ N Refraction .................................................... 0.38 1.21 0.15 0.01 1.61 0.54 XXX 92018 .......... ............ A New eye exam & treatment ........................ 2.51 NA 1.05 0.07 NA 3.62 XXX 92019 .......... ............ A Eye exam & treatment ................................ 1.31 NA 0.55 0.03 NA 1.89 XXX 92020 .......... ............ A Special eye evaluation ................................ 0.37 0.33 0.16 0.01 0.71 0.54 XXX 92060 .......... ............ A Special eye evaluation ................................ 0.69 0.72 NA 0.03 1.45 NA XXX 92060 .......... 26 ....... A Special eye evaluation ................................ 0.69 0.28 0.28 0.02 0.99 0.99 XXX 92060 .......... TC ...... A Special eye evaluation ................................ 0.00 0.44 NA 0.01 0.45 NA XXX 92065 .......... ............ A Orthoptic/pleoptic training ............................ 0.37 0.57 NA 0.02 0.96 NA XXX 92065 .......... 26 ....... A Orthoptic/pleoptic training ............................ 0.37 0.15 0.15 0.01 0.53 0.53 XXX 92065 .......... TC ...... A Orthoptic/pleoptic training ............................ 0.00 0.43 NA 0.01 0.44 NA XXX 92070 .......... ............ A Fitting of contact lens .................................. 0.70 1.04 0.31 0.02 1.76 1.03 XXX 92081 .......... ............ A Visual field examination(s) .......................... 0.36 0.93 NA 0.02 1.31 NA XXX 92081 .......... 26 ....... A Visual field examination(s) .......................... 0.36 0.15 0.15 0.01 0.52 0.52 XXX 92081 .......... TC ...... A Visual field examination(s) .......................... 0.00 0.78 NA 0.01 0.79 NA XXX 92082 .......... ............ A Visual field examination(s) .......................... 0.44 1.22 NA 0.02 1.68 NA XXX 92082 .......... 26 ....... A Visual field examination(s) .......................... 0.44 0.19 0.19 0.01 0.64 0.64 XXX 92082 .......... TC ...... A Visual field examination(s) .......................... 0.00 1.03 NA 0.01 1.04 NA XXX 92083 .......... ............ A Visual field examination(s) .......................... 0.50 1.41 NA 0.02 1.93 NA XXX


## 45984

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

92083 .......... 26 ....... A Visual field examination(s) .......................... 0.50 0.22 0.22 0.01 0.73 0.73 XXX 92083 .......... TC ...... A Visual field examination(s) .......................... 0.00 1.19 NA 0.01 1.20 NA XXX 92100 .......... ............ A Serial tonometry exam(s) ............................ 0.92 1.34 0.35 0.02 2.28 1.30 XXX 92120 .......... ............ A Tonography & eye evaluation ..................... 0.81 1.06 0.31 0.02 1.89 1.14 XXX 92130 .......... ............ A Water provocation tonography .................... 0.81 1.26 0.36 0.02 2.09 1.19 XXX 92135 .......... ............ A Opthalmic dx imaging .................................. 0.35 0.77 NA 0.02 1.14 NA XXX 92135 .......... 26 ....... A Opthalmic dx imaging .................................. 0.35 0.15 0.15 0.01 0.51 0.51 XXX 92135 .......... TC ...... A Opthalmic dx imaging .................................. 0.00 0.63 NA 0.01 0.64 NA XXX 92136 .......... ............ A Ophthalmic biometry ................................... 0.54 1.58 NA 0.08 2.20 NA XXX 92136 .......... 26 ....... A Ophthalmic biometry ................................... 0.54 0.24 0.24 0.01 0.79 0.79 XXX 92136 .......... TC ...... A Ophthalmic biometry ................................... 0.00 1.35 NA 0.07 1.42 NA XXX 92140 .......... ............ A Glaucoma provocative tests ........................ 0.50 0.98 0.21 0.01 1.49 0.72 XXX 92225 .......... ............ A Special eye exam, initial ............................. 0.38 0.22 0.16 0.01 0.61 0.55 XXX 92226 .......... ............ A Special eye exam, subsequent ................... 0.33 0.21 0.14 0.01 0.55 0.48 XXX 92230 .......... ............ A Eye exam with photos ................................. 0.60 1.39 0.20 0.02 2.01 0.82 XXX 92235 .......... ............ A Eye exam with photos ................................. 0.81 2.50 NA 0.08 3.39 NA XXX 92235 .......... 26 ....... A Eye exam with photos ................................. 0.81 0.36 0.36 0.02 1.19 1.19 XXX 92235 .......... TC ...... A Eye exam with photos ................................. 0.00 2.14 NA 0.06 2.20 NA XXX 92240 .......... ............ A Icg angiography ........................................... 1.10 5.75 NA 0.09 6.94 NA XXX 92240 .......... 26 ....... A Icg angiography ........................................... 1.10 0.49 0.49 0.03 1.62 1.62 XXX 92240 .......... TC ...... A Icg angiography ........................................... 0.00 5.27 NA 0.06 5.33 NA XXX 92250 .......... ............ A Eye exam with photos ................................. 0.44 1.47 NA 0.02 1.93 NA XXX 92250 .......... 26 ....... A Eye exam with photos ................................. 0.44 0.19 0.19 0.01 0.64 0.64 XXX 92250 .......... TC ...... A Eye exam with photos ................................. 0.00 1.29 NA 0.01 1.30 NA XXX 92260 .......... ............ A Ophthalmoscopy/dynamometry ................... 0.20 0.25 0.09 0.01 0.46 0.30 XXX 92265 .......... ............ A Eye muscle evaluation ................................ 0.81 1.39 NA 0.06 2.26 NA XXX 92265 .......... 26 ....... A Eye muscle evaluation ................................ 0.81 0.28 0.28 0.04 1.13 1.13 XXX 92265 .......... TC ...... A Eye muscle evaluation ................................ 0.00 1.11 NA 0.02 1.13 NA XXX 92270 .......... ............ A Electro-oculography ..................................... 0.81 1.49 NA 0.05 2.35 NA XXX 92270 .......... 26 ....... A Electro-oculography ..................................... 0.81 0.32 0.32 0.03 1.16 1.16 XXX 92270 .......... TC ...... A Electro-oculography ..................................... 0.00 1.17 NA 0.02 1.19 NA XXX 92275 .......... ............ A Electroretinography ..................................... 1.01 1.92 NA 0.05 2.98 NA XXX 92275 .......... 26 ....... A Electroretinography ..................................... 1.01 0.42 0.42 0.03 1.46 1.46 XXX 92275 .......... TC ...... A Electroretinography ..................................... 0.00 1.50 NA 0.02 1.52 NA XXX 92283 .......... ............ A Color vision examination ............................. 0.17 0.84 NA 0.02 1.03 NA XXX 92283 .......... 26 ....... A Color vision examination ............................. 0.17 0.07 0.07 0.01 0.25 0.25 XXX 92283 .......... TC ...... A Color vision examination ............................. 0.00 0.77 NA 0.01 0.78 NA XXX 92284 .......... ............ A Dark adaptation eye exam .......................... 0.24 1.74 NA 0.02 2.00 NA XXX 92284 .......... 26 ....... A Dark adaptation eye exam .......................... 0.24 0.08 0.08 0.01 0.33 0.33 XXX 92284 .......... TC ...... A Dark adaptation eye exam .......................... 0.00 1.66 NA 0.01 1.67 NA XXX 92285 .......... ............ A Eye photography ......................................... 0.20 0.94 NA 0.02 1.16 NA XXX 92285 .......... 26 ....... A Eye photography ......................................... 0.20 0.09 0.09 0.01 0.30 0.30 XXX 92285 .......... TC ...... A Eye photography ......................................... 0.00 0.86 NA 0.01 0.87 NA XXX 92286 .......... ............ A Internal eye photography ............................ 0.66 2.88 NA 0.04 3.58 NA XXX 92286 .......... 26 ....... A Internal eye photography ............................ 0.66 0.29 0.29 0.02 0.97 0.97 XXX 92286 .......... TC ...... A Internal eye photography ............................ 0.00 2.59 NA 0.02 2.61 NA XXX 92287 .......... ............ A Internal eye photography ............................ 0.81 2.28 0.30 0.02 3.12 1.13 XXX 92310 .......... ............ N Contact lens fitting ....................................... 1.17 1.13 0.45 0.04 2.34 1.66 XXX 92311 .......... ............ A Contact lens fitting ....................................... 1.08 1.14 0.35 0.03 2.25 1.47 XXX 92312 .......... ............ A Contact lens fitting ....................................... 1.26 1.17 0.49 0.03 2.47 1.78 XXX 92313 .......... ............ A Contact lens fitting ....................................... 0.92 1.13 0.28 0.02 2.07 1.22 XXX 92314 .......... ............ N Prescription of contact lens ......................... 0.69 0.98 0.27 0.01 1.68 0.97 XXX 92315 .......... ............ A Prescription of contact lens ......................... 0.45 0.95 0.16 0.01 1.41 0.62 XXX 92316 .......... ............ A Prescription of contact lens ......................... 0.68 1.05 0.28 0.02 1.75 0.98 XXX 92317 .......... ............ A Prescription of contact lens ......................... 0.45 1.05 0.15 0.01 1.52 0.61 XXX 92325 .......... ............ A Modification of contact lens ......................... 0.00 0.49 NA 0.01 0.50 NA XXX 92326 .......... ............ A Replacement of contact lens ....................... 0.00 1.41 NA 0.06 1.47 NA XXX 92330 .......... ............ A Fitting of artificial eye .................................. 1.08 0.99 0.32 0.03 2.10 1.43 XXX 92335 .......... ............ A Fitting of artificial eye .................................. 0.45 0.88 0.16 0.01 1.34 0.62 XXX 92340 .......... ............ N Fitting of spectacles .................................... 0.37 0.66 NA 0.01 1.04 NA XXX 92341 .......... ............ N Fitting of spectacles .................................... 0.47 0.70 NA 0.01 1.18 NA XXX 92342 .......... ............ N Fitting of spectacles .................................... 0.53 0.72 NA 0.01 1.27 NA XXX 92352 .......... ............ B Special spectacles fitting ............................. 0.37 0.67 NA 0.01 1.05 NA XXX 92353 .......... ............ B Special spectacles fitting ............................. 0.50 0.72 NA 0.02 1.24 NA XXX 92354 .......... ............ B Special spectacles fitting ............................. 0.00 7.13 NA 0.10 7.23 NA XXX 92355 .......... ............ B Special spectacles fitting ............................. 0.00 3.53 NA 0.01 3.54 NA XXX 92358 .......... ............ B Eye prosthesis service ................................ 0.00 0.81 NA 0.05 0.86 NA XXX 92370 .......... ............ N Repair & adjust spectacles ......................... 0.32 0.53 NA 0.02 0.87 NA XXX 92371 .......... ............ B Repair & adjust spectacles ......................... 0.00 0.53 NA 0.02 0.55 NA XXX 92390 .......... ............ N Supply of spectacles ................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92391 .......... ............ N Supply of contact lenses ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92392 .......... ............ I Supply of low vision aids ............................. 0.00 0.00 0.00 0.02 0.02 0.02 XXX 92393 .......... ............ I Supply of artificial eye ................................. 0.00 0.00 0.00 0.57 0.57 0.57 XXX 92395 .......... ............ I Supply of spectacles ................................... 0.00 0.00 0.00 0.10 0.10 0.10 XXX


## 45985

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

92396 .......... ............ I Supply of contact lenses ............................. 0.00 0.00 0.00 0.07 0.07 0.07 XXX 92499 .......... ............ C Eye service or procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92499 .......... 26 ....... C Eye service or procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92499 .......... TC ...... C Eye service or procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
92502 .......... ............ A Ear and throat examination ......................... 1.51 NA 1.08 0.05 NA 2.65 000 92504 .......... ............ A Ear microscopy examination ....................... 0.18 0.50 0.09 0.01 0.69 0.28 XXX 92506 .......... ............ A Speech/hearing evaluation .......................... 0.86 2.68 0.38 0.03 3.57 1.27 XXX 92507 .......... ............ A Speech/hearing therapy .............................. 0.52 1.10 0.22 0.02 1.65 0.76 XXX 92508 .......... ............ A Speech/hearing therapy .............................. 0.26 0.51 0.12 0.01 0.78 0.39 XXX 92510 .......... ............ I Rehab for ear implant ................................. 1.50 0.00 0.00 0.07 1.57 1.57 XXX 92511 .......... ............ A Nasopharyngoscopy .................................... 0.84 3.23 0.76 0.03 4.10 1.64 000 92512 .......... ............ A Nasal function studies ................................. 0.55 1.13 0.18 0.02 1.70 0.75 XXX 92516 .......... ............ A Facial nerve function test ............................ 0.43 1.18 0.21 0.01 1.62 0.65 XXX 92520 .......... ............ A Laryngeal function studies .......................... 0.76 0.51 0.38 0.03 1.31 1.17 XXX 92526 .......... ............ A Oral function therapy ................................... 0.55 1.75 0.20 0.02 2.32 0.77 XXX 92531 .......... ............ B Spontaneous nystagmus study ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92532 .......... ............ B Positional nystagmus test ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92533 .......... ............ B Caloric vestibular test .................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92534 .......... ............ B Optokinetic nystagmus test ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92541 .......... ............ A Spontaneous nystagmus test ...................... 0.40 1.02 NA 0.04 1.47 NA XXX 92541 .......... 26 ....... A Spontaneous nystagmus test ...................... 0.40 0.18 0.18 0.02 0.60 0.60 XXX 92541 .......... TC ...... A Spontaneous nystagmus test ...................... 0.00 0.84 NA 0.02 0.86 NA XXX 92542 .......... ............ A Positional nystagmus test ........................... 0.33 1.13 NA 0.03 1.50 NA XXX 92542 .......... 26 ....... A Positional nystagmus test ........................... 0.33 0.15 0.15 0.01 0.49 0.49 XXX 92542 .......... TC ...... A Positional nystagmus test ........................... 0.00 0.98 NA 0.02 1.00 NA XXX 92543 .......... ............ A Caloric vestibular test .................................. 0.10 0.57 NA 0.02 0.69 NA XXX 92543 .......... 26 ....... A Caloric vestibular test .................................. 0.10 0.05 0.05 0.01 0.16 0.16 XXX 92543 .......... TC ...... A Caloric vestibular test .................................. 0.00 0.52 NA 0.01 0.53 NA XXX 92544 .......... ............ A Optokinetic nystagmus test ......................... 0.26 0.90 NA 0.03 1.19 NA XXX 92544 .......... 26 ....... A Optokinetic nystagmus test ......................... 0.26 0.12 0.12 0.01 0.39 0.39 XXX 92544 .......... TC ...... A Optokinetic nystagmus test ......................... 0.00 0.78 NA 0.02 0.80 NA XXX 92545 .......... ............ A Oscillating tracking test ............................... 0.23 0.81 NA 0.03 1.07 NA XXX 92545 .......... 26 ....... A Oscillating tracking test ............................... 0.23 0.11 0.11 0.01 0.35 0.35 XXX 92545 .......... TC ...... A Oscillating tracking test ............................... 0.00 0.71 NA 0.02 0.73 NA XXX 92546 .......... ............ A Sinusoidal rotational test ............................. 0.29 1.93 NA 0.03 2.25 NA XXX 92546 .......... 26 ....... A Sinusoidal rotational test ............................. 0.29 0.13 0.13 0.01 0.43 0.43 XXX 92546 .......... TC ...... A Sinusoidal rotational test ............................. 0.00 1.81 NA 0.02 1.83 NA XXX 92547 .......... ............ A Supplemental electrical test ........................ 0.00 0.08 NA 0.06 0.14 NA ZZZ 92548 .......... ............ A Posturography ............................................. 0.50 2.14 NA 0.15 2.79 NA XXX 92548 .......... 26 ....... A Posturography ............................................. 0.50 0.25 0.25 0.02 0.77 0.77 XXX 92548 .......... TC ...... A Posturography ............................................. 0.00 1.89 NA 0.13 2.02 NA XXX 92551 .......... ............ N Pure tone hearing test, air .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92552 .......... ............ A Pure tone audiometry, air ............................ 0.00 0.44 NA 0.04 0.48 NA XXX 92553 .......... ............ A Audiometry, air & bone ............................... 0.00 0.63 NA 0.06 0.69 NA XXX 92555 .......... ............ A Speech threshold audiometry ..................... 0.00 0.35 NA 0.04 0.39 NA XXX 92556 .......... ............ A Speech audiometry, complete ..................... 0.00 0.54 NA 0.06 0.60 NA XXX 92557 .......... ............ A Comprehensive hearing test ....................... 0.00 1.12 NA 0.12 1.24 NA XXX 92559 .......... ............ N Group audiometric testing ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92560 .......... ............ N Bekesy audiometry, screen ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92561 .......... ............ A Bekesy audiometry, diagnosis .................... 0.00 0.68 NA 0.06 0.74 NA XXX 92562 .......... ............ A Loudness balance test ................................ 0.00 0.42 NA 0.04 0.46 NA XXX 92563 .......... ............ A Tone decay hearing test ............................. 0.00 0.37 NA 0.04 0.41 NA XXX 92564 .......... ............ A Sisi hearing test ........................................... 0.00 0.45 NA 0.05 0.50 NA XXX 92565 .......... ............ A Stenger test, pure tone ............................... 0.00 0.36 NA 0.04 0.40 NA XXX 92567 .......... ............ A Tympanometry ............................................. 0.00 0.48 NA 0.06 0.54 NA XXX 92568 .......... ............ A Acoustic reflex testing ................................. 0.00 0.32 NA 0.04 0.36 NA XXX 92569 .......... ............ A Acoustic reflex decay test ........................... 0.00 0.34 NA 0.04 0.38 NA XXX 92571 .......... ............ A Filtered speech hearing test ........................ 0.00 0.36 NA 0.04 0.40 NA XXX 92572 .......... ............ A Staggered spondaic word test .................... 0.00 0.17 NA 0.01 0.18 NA XXX
92573 .......... ............ A Lombard test ............................................... 0.00 0.33 NA 0.04 0.37 NA XXX 92575 .......... ............ A Sensorineural acuity test ............................. 0.00 0.41 NA 0.02 0.43 NA XXX 92576 .......... ............ A Synthetic sentence test ............................... 0.00 0.42 NA 0.05 0.47 NA XXX 92577 .......... ............ A Stenger test, speech ................................... 0.00 0.60 NA 0.07 0.67 NA XXX 92579 .......... ............ A Visual audiometry (vra) ............................... 0.00 0.68 NA 0.06 0.74 NA XXX 92582 .......... ............ A Conditioning play audiometry ...................... 0.00 0.72 NA 0.06 0.78 NA XXX 92583 .......... ............ A Select picture audiometry ............................ 0.00 0.79 NA 0.08 0.87 NA XXX 92584 .......... ............ A Electrocochleography .................................. 0.00 2.15 NA 0.21 2.36 NA XXX 92585 .......... ............ A Auditor evoke potent, compre ..................... 0.50 1.97 NA 0.17 2.64 NA XXX 92585 .......... 26 ....... A Auditor evoke potent, compre ..................... 0.50 0.21 0.21 0.03 0.74 0.74 XXX 92585 .......... TC ...... A Auditor evoke potent, compre ..................... 0.00 1.77 NA 0.14 1.91 NA XXX 92586 .......... ............ A Auditor evoke potent, limit ........................... 0.00 1.67 NA 0.14 1.81 NA XXX 92587 .......... ............ A Evoked auditory test .................................... 0.13 1.15 NA 0.12 1.40 NA XXX 92587 .......... 26 ....... A Evoked auditory test .................................... 0.13 0.06 0.06 0.01 0.20 0.20 XXX 92587 .......... TC ...... A Evoked auditory test .................................... 0.00 1.09 NA 0.11 1.20 NA XXX


## 45986

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

92588 .......... ............ A Evoked auditory test .................................... 0.36 1.43 NA 0.14 1.93 NA XXX 92588 .......... 26 ....... A Evoked auditory test .................................... 0.36 0.15 0.15 0.01 0.52 0.52 XXX 92588 .......... TC ...... A Evoked auditory test .................................... 0.00 1.28 NA 0.13 1.41 NA XXX 92590 .......... ............ N Hearing aid exam, one ear ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92591 .......... ............ N Hearing aid exam, both ears ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92592 .......... ............ N Hearing aid check, one ear ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92593 .......... ............ N Hearing aid check, both ears ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92594 .......... ............ N Electro hearng aid test, one ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92595 .......... ............ N Electro hearng aid tst, both ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92596 .......... ............ A Ear protector evaluation .............................. 0.00 0.58 NA 0.06 0.64 NA XXX 92597 .......... ............ A Oral speech device eval .............................. 0.86 1.68 0.43 0.03 2.57 1.32 XXX 92601 .......... ............ A Cochlear implt f/up exam < 7 ...................... 0.00 3.54 NA 0.07 3.61 NA XXX 92602 .......... ............ A Reprogram cochlear implt < 7 ..................... 0.00 2.41 NA 0.07 2.48 NA XXX 92603 .......... ............ A Cochlear implt f/up exam 7 > ...................... 0.00 2.19 NA 0.07 2.26 NA XXX 92604 .......... ............ A Reprogram cochlear implt 7 > ..................... 0.00 1.39 NA 0.07 1.46 NA XXX 92605 .......... ............ B Eval for nonspeech device rx ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92606 .......... ............ B Non-speech device service ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92607 .......... ............ A Ex for speech device rx, 1hr ....................... 0.00 3.11 NA 0.05 3.16 NA XXX 92608 .......... ............ A Ex for speech device rx addl ...................... 0.00 0.56 NA 0.05 0.61 NA XXX 92609 .......... ............ A Use of speech device service ..................... 0.00 1.61 NA 0.04 1.65 NA XXX 92610 .......... ............ A Evaluate swallowing function ...................... 0.00 2.97 NA 0.08 3.05 NA XXX 92611 .......... ............ A Motion fluoroscopy/swallow ......................... 0.00 3.09 NA 0.08 3.17 NA XXX 92612 .......... ............ A Endoscopy swallow tst (fees) ...................... 1.27 2.74 0.63 0.04 4.06 1.95 XXX 92613 .......... ............ A Endoscopy swallow tst (fees) ...................... 0.71 0.38 0.38 0.05 1.14 1.14 XXX 92614 .......... ............ A Laryngoscopic sensory test ......................... 1.27 2.47 0.63 0.04 3.78 1.95 XXX 92615 .......... ............ A Eval laryngoscopy sense tst ....................... 0.63 0.34 0.34 0.05 1.02 1.02 XXX 92616 .......... ............ A Fees w/laryngeal sense test ....................... 1.88 3.31 0.95 0.06 5.26 2.90 XXX 92617 .......... ............ A Interprt fees/laryngeal test ........................... 0.79 0.42 0.42 0.05 1.26 1.26 XXX 92620 .......... ............ A Auditory function, 60 min ............................ 0.00 1.18 NA 0.06 1.24 NA XXX 92621 .......... ............ A Auditory function, + 15 min ......................... 0.00 0.26 NA 0.06 0.32 NA ZZZ
92625 .......... ............ A Tinnitus assessment .................................... 0.00 1.16 NA 0.06 1.22 NA XXX 92700 .......... ............ C Ent procedure/service ................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92950 .......... ............ A Heart/lung resuscitation cpr ........................ 3.80 3.97 0.95 0.28 8.04 5.03 000 92953 .......... ............ A Temporary external pacing ......................... 0.23 NA 0.07 0.02 NA 0.32 000 92960 .......... ............ A Cardioversion electric, ext ........................... 2.25 6.22 1.26 0.07 8.55 3.58 000 92961 .......... ............ A Cardioversion, electric, int ........................... 4.60 NA 2.19 0.29 NA 7.08 000 92970 .......... ............ A Cardioassist, internal ................................... 3.52 NA 1.06 0.16 NA 4.74 000 92971 .......... ............ A Cardioassist, external .................................. 1.77 NA 0.91 0.06 NA 2.74 000 92973 .......... ............ A Percut coronary thrombectomy ................... 3.29 NA 1.35 0.23 NA 4.86 ZZZ 92974 .......... ............ A Cath place, cardio brachytx ........................ 3.01 NA 1.24 0.21 NA 4.45 ZZZ 92975 .......... ............ A Dissolve clot, heart vessel .......................... 7.25 NA 2.94 0.50 NA 10.69 000 92977 .......... ............ A Dissolve clot, heart vessel .......................... 0.00 6.62 NA 0.46 7.08 NA XXX 92978 .......... ............ A Intravasc us, heart add-on .......................... 1.80 NA NA 0.30 NA NA ZZZ 92978 .......... 26 ....... A Intravasc us, heart add-on .......................... 1.80 0.74 0.74 0.06 2.61 2.61 ZZZ 92978 .......... TC ...... A Intravasc us, heart add-on .......................... 0.00 NA NA 0.24 NA NA ZZZ 92979 .......... ............ A Intravasc us, heart add-on .......................... 1.44 NA NA 0.19 NA NA ZZZ 92979 .......... 26 ....... A Intravasc us, heart add-on .......................... 1.44 0.59 0.59 0.06 2.09 2.09 ZZZ 92979 .......... TC ...... A Intravasc us, heart add-on .......................... 0.00 NA NA 0.13 NA NA ZZZ 92980 .......... ............ A Insert intracoronary stent ............................ 14.85 NA 6.36 1.03 NA 22.24 000 92981 .......... ............ A Insert intracoronary stent ............................ 4.17 NA 1.71 0.29 NA 6.17 ZZZ 92982 .......... ............ A Coronary artery dilation ............................... 10.98 NA 4.77 0.76 NA 16.52 000 92984 .......... ............ A Coronary artery dilation ............................... 2.98 NA 1.21 0.21 NA 4.40 ZZZ 92986 .......... ............ A Revision of aortic valve ............................... 21.81 NA 12.62 1.51 NA 35.94 090 92987 .......... ............ A Revision of mitral valve ............................... 22.72 NA 13.01 1.59 NA 37.32 090 92990 .......... ............ A Revision of pulmonary valve ....................... 17.34 NA 10.33 1.20 NA 28.87 090 92992 .......... ............ C Revision of heart chamber .......................... 0.00 0.00 0.00 0.00 0.00 0.00 090 92993 .......... ............ C Revision of heart chamber .......................... 0.00 0.00 0.00 0.00 0.00 0.00 090 92995 .......... ............ A Coronary atherectomy ................................. 12.09 NA 5.22 0.84 NA 18.16 000 92996 .......... ............ A Coronary atherectomy add-on .................... 3.27 NA 1.33 0.10 NA 4.70 ZZZ 92997 .......... ............ A Pul art balloon repr, percut ......................... 12.00 NA 5.04 0.40 NA 17.44 000 92998 .......... ............ A Pul art balloon repr, percut ......................... 6.00 NA 2.24 0.28 NA 8.53 ZZZ 93000 .......... ............ A Electrocardiogram, complete ....................... 0.17 0.47 NA 0.03 0.67 NA XXX 93005 .......... ............ A Electrocardiogram, tracing .......................... 0.00 0.41 NA 0.02 0.43 NA XXX 93010 .......... ............ A Electrocardiogram report ............................. 0.17 0.06 0.06 0.01 0.24 0.24 XXX 93012 .......... ............ A Transmission of ecg .................................... 0.00 4.81 NA 0.18 4.99 NA XXX 93014 .......... ............ A Report on transmitted ecg ........................... 0.52 0.19 0.19 0.02 0.73 0.73 XXX 93015 .......... ............ A Cardiovascular stress test ........................... 0.75 2.11 NA 0.14 3.00 NA XXX 93016 .......... ............ A Cardiovascular stress test ........................... 0.45 0.18 0.18 0.02 0.65 0.65 XXX 93017 .......... ............ A Cardiovascular stress test ........................... 0.00 1.82 NA 0.11 1.93 NA XXX 93018 .......... ............ A Cardiovascular stress test ........................... 0.30 0.12 0.12 0.01 0.43 0.43 XXX 93024 .......... ............ A Cardiac drug stress test .............................. 1.17 1.93 NA 0.12 3.22 NA XXX 93024 .......... 26 ....... A Cardiac drug stress test .............................. 1.17 0.47 0.47 0.04 1.68 1.68 XXX 93024 .......... TC ...... A Cardiac drug stress test .............................. 0.00 1.46 NA 0.08 1.54 NA XXX
93025 .......... ............ A Microvolt t-wave assess .............................. 0.75 7.06 NA 0.14 7.95 NA XXX


## 45987

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

93025 .......... 26 ....... A Microvolt t-wave assess .............................. 0.75 0.30 0.30 0.03 1.08 1.08 XXX 93025 .......... TC ...... A Microvolt t-wave assess .............................. 0.00 6.76 NA 0.11 6.87 NA XXX 93040 .......... ............ A Rhythm ECG with report ............................. 0.16 0.21 NA 0.02 0.39 NA XXX 93041 .......... ............ A Rhythm ECG, tracing .................................. 0.00 0.16 NA 0.01 0.17 NA XXX 93042 .......... ............ A Rhythm ECG, report .................................... 0.16 0.05 0.05 0.01 0.22 0.22 XXX 93224 .......... ............ A ECG monitor/report, 24 hrs ......................... 0.52 3.30 NA 0.24 4.07 NA XXX 93225 .......... ............ A ECG monitor/record, 24 hrs ........................ 0.00 1.20 NA 0.08 1.28 NA XXX 93226 .......... ............ A ECG monitor/report, 24 hrs ......................... 0.00 1.90 NA 0.14 2.04 NA XXX 93227 .......... ............ A ECG monitor/review, 24 hrs ........................ 0.52 0.20 0.20 0.02 0.74 0.74 XXX 93230 .......... ............ A ECG monitor/report, 24 hrs ......................... 0.52 3.42 NA 0.26 4.20 NA XXX 93231 .......... ............ A Ecg monitor/record, 24 hrs .......................... 0.00 1.38 NA 0.11 1.49 NA XXX 93232 .......... ............ A ECG monitor/report, 24 hrs ......................... 0.00 1.85 NA 0.13 1.98 NA XXX 93233 .......... ............ A ECG monitor/review, 24 hrs ........................ 0.52 0.20 0.20 0.02 0.74 0.74 XXX 93235 .......... ............ A ECG monitor/report, 24 hrs ......................... 0.45 2.79 NA 0.16 3.40 NA XXX 93236 .......... ............ A ECG monitor/report, 24 hrs ......................... 0.00 2.63 NA 0.14 2.77 NA XXX 93237 .......... ............ A ECG monitor/review, 24 hrs ........................ 0.45 0.17 0.17 0.02 0.64 0.64 XXX 93268 .......... ............ A ECG record/review ...................................... 0.52 5.84 NA 0.28 6.65 NA XXX 93270 .......... ............ A ECG recording ............................................. 0.00 1.04 NA 0.08 1.12 NA XXX 93271 .......... ............ A Ecg/monitoring and analysis ....................... 0.00 4.60 NA 0.18 4.78 NA XXX 93272 .......... ............ A Ecg/review, interpret only ............................ 0.52 0.19 0.19 0.02 0.73 0.73 XXX 93278 .......... ............ A ECG/signal-averaged .................................. 0.25 1.10 NA 0.12 1.47 NA XXX 93278 .......... 26 ....... A ECG/signal-averaged .................................. 0.25 0.10 0.10 0.01 0.36 0.36 XXX 93278 .......... TC ...... A ECG/signal-averaged .................................. 0.00 1.00 NA 0.11 1.11 NA XXX
93303 .......... ............ A Echo transthoracic ....................................... 1.30 4.74 NA 0.27 6.32 NA XXX 93303 .......... 26 ....... A Echo transthoracic ....................................... 1.30 0.50 0.50 0.04 1.84 1.84 XXX 93303 .......... TC ...... A Echo transthoracic ....................................... 0.00 4.25 NA 0.23 4.48 NA XXX
93304 .......... ............ A Echo transthoracic ....................................... 0.75 2.71 NA 0.15 3.61 NA XXX 93304 .......... 26 ....... A Echo transthoracic ....................................... 0.75 0.29 0.29 0.02 1.06 1.06 XXX 93304 .......... TC ...... A Echo transthoracic ....................................... 0.00 2.42 NA 0.13 2.55 NA XXX 93307 .......... ............ A Echo exam of heart ..................................... 0.92 4.30 NA 0.26 5.48 NA XXX 93307 .......... 26 ....... A Echo exam of heart ..................................... 0.92 0.36 0.36 0.03 1.32 1.32 XXX 93307 .......... TC ...... A Echo exam of heart ..................................... 0.00 3.94 NA 0.23 4.17 NA XXX 93308 .......... ............ A Echo exam of heart ..................................... 0.53 2.39 NA 0.15 3.08 NA XXX 93308 .......... 26 ....... A Echo exam of heart ..................................... 0.53 0.21 0.21 0.02 0.76 0.76 XXX 93308 .......... TC ...... A Echo exam of heart ..................................... 0.00 2.19 NA 0.13 2.32 NA XXX 93312 .......... ............ A Echo transesophageal ................................. 2.20 5.88 NA 0.37 8.45 NA XXX 93312 .......... 26 ....... A Echo transesophageal ................................. 2.20 0.82 0.82 0.08 3.10 3.10 XXX 93312 .......... TC ...... A Echo transesophageal ................................. 0.00 5.06 NA 0.29 5.35 NA XXX 93313 .......... ............ A Echo transesophageal ................................. 0.95 0.00 0.21 0.06 1.01 1.22 XXX 93314 .......... ............ A Echo transesophageal ................................. 1.25 5.32 NA 0.33 6.91 NA XXX 93314 .......... 26 ....... A Echo transesophageal ................................. 1.25 0.49 0.49 0.04 1.78 1.78 XXX 93314 .......... TC ...... A Echo transesophageal ................................. 0.00 4.84 NA 0.29 5.13 NA XXX 93315 .......... ............ C Echo transesophageal ................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93315 .......... 26 ....... A Echo transesophageal ................................. 2.79 1.04 1.04 0.09 3.92 3.92 XXX 93315 .......... TC ...... C Echo transesophageal ................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93316 .......... ............ A Echo transesophageal ................................. 0.95 NA 0.24 0.05 NA 1.24 XXX 93317 .......... ............ C Echo transesophageal ................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93317 .......... 26 ....... A Echo transesophageal ................................. 1.83 0.69 0.69 0.08 2.60 2.60 XXX 93317 .......... TC ...... C Echo transesophageal ................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93318 .......... ............ C Echo transesophageal intraop .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93318 .......... 26 ....... A Echo transesophageal intraop .................... 2.20 0.47 0.47 0.14 2.82 2.82 XXX 93318 .......... TC ...... C Echo transesophageal intraop .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93320 .......... ............ A Doppler echo exam, heart ........................... 0.38 1.92 NA 0.13 2.43 NA ZZZ 93320 .......... 26 ....... A Doppler echo exam, heart ........................... 0.38 0.16 0.16 0.01 0.55 0.55 ZZZ 93320 .......... TC ...... A Doppler echo exam, heart ........................... 0.00 1.76 NA 0.12 1.88 NA ZZZ 93321 .......... ............ A Doppler echo exam, heart ........................... 0.15 1.07 NA 0.09 1.31 NA ZZZ 93321 .......... 26 ....... A Doppler echo exam, heart ........................... 0.15 0.06 0.06 0.01 0.22 0.22 ZZZ 93321 .......... TC ...... A Doppler echo exam, heart ........................... 0.00 1.01 NA 0.08 1.09 NA ZZZ 93325 .......... ............ A Doppler color flow add-on ........................... 0.07 2.41 NA 0.22 2.70 NA ZZZ 93325 .......... 26 ....... A Doppler color flow add-on ........................... 0.07 0.03 0.03 0.01 0.11 0.11 ZZZ 93325 .......... TC ...... A Doppler color flow add-on ........................... 0.00 2.38 NA 0.21 2.59 NA ZZZ
93350 .......... ............ A Echo transthoracic ....................................... 1.48 3.36 NA 0.18 5.02 NA XXX
93350 .......... 26 ....... A Echo transthoracic ....................................... 1.48 0.59 0.59 0.05 2.12 2.12 XXX 93350 .......... TC ...... A Echo transthoracic ....................................... 0.00 2.77 NA 0.13 2.90 NA XXX 93501 .......... ............ A Right heart catheterization .......................... 3.03 21.04 NA 1.26 25.33 NA 000 93501 .......... 26 ....... A Right heart catheterization .......................... 3.03 1.19 1.19 0.21 4.43 4.43 000 93501 .......... TC ...... A Right heart catheterization .......................... 0.00 19.84 NA 1.05 20.89 NA 000 93503 .......... ............ A Insert/place heart catheter .......................... 2.92 NA 0.67 0.20 NA 3.79 000 93505 .......... ............ A Biopsy of heart lining ................................... 4.38 10.54 NA 0.46 15.38 NA 000 93505 .......... 26 ....... A Biopsy of heart lining ................................... 4.38 1.75 1.75 0.30 6.42 6.42 000 93505 .......... TC ...... A Biopsy of heart lining ................................... 0.00 8.79 NA 0.16 8.95 NA 000 93508 .......... ............ A Cath placement, angiography ..................... 4.10 15.76 NA 0.93 20.78 NA 000 93508 .......... 26 ....... A Cath placement, angiography ..................... 4.10 2.23 2.23 0.28 6.61 6.61 000 93508 .......... TC ...... A Cath placement, angiography ..................... 0.00 13.52 NA 0.65 14.17 NA 000


## 45988

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

93510 .......... ............ A Left heart catheterization ............................. 4.33 35.48 NA 2.61 42.42 NA 000 93510 .......... 26 ....... A Left heart catheterization ............................. 4.33 2.34 2.34 0.30 6.97 6.97 000 93510 .......... TC ...... A Left heart catheterization ............................. 0.00 33.14 NA 2.31 35.45 NA 000 93511 .......... ............ A Left heart catheterization ............................. 5.03 NA NA 2.59 NA NA 000 93511 .......... 26 ....... A Left heart catheterization ............................. 5.03 2.62 2.62 0.35 8.00 8.00 000 93511 .......... TC ...... A Left heart catheterization ............................. 0.00 NA NA 2.24 NA NA 000 93514 .......... ............ A Left heart catheterization ............................. 7.05 NA NA 2.74 NA NA 000 93514 .......... 26 ....... A Left heart catheterization ............................. 7.05 3.31 3.31 0.49 10.85 10.85 000 93514 .......... TC ...... A Left heart catheterization ............................. 0.00 NA NA 2.24 NA NA 000 93524 .......... ............ A Left heart catheterization ............................. 6.95 NA NA 3.43 NA NA 000 93524 .......... 26 ....... A Left heart catheterization ............................. 6.95 3.38 3.38 0.48 10.81 10.81 000 93524 .......... TC ...... A Left heart catheterization ............................. 0.00 NA NA 2.95 NA NA 000
93526 .......... ............ A Rt & Lt heart catheters ................................ 5.99 49.26 NA 3.46 58.71 NA 000 93526 .......... 26 ....... A Rt & Lt heart catheters ................................ 5.99 3.00 3.00 0.42 9.42 9.42 000 93526 .......... TC ...... A Rt & Lt heart catheters ................................ 0.00 46.25 NA 3.04 49.29 NA 000
93527 .......... ............ A Rt & Lt heart catheters ................................ 7.28 NA NA 3.46 NA NA 000 93527 .......... 26 ....... A Rt & Lt heart catheters ................................ 7.28 3.52 3.52 0.51 11.32 11.32 000 93527 .......... TC ...... A Rt & Lt heart catheters ................................ 0.00 NA NA 2.95 NA NA 000
93528 .......... ............ A Rt & Lt heart catheters ................................ 9.01 NA NA 3.57 NA NA 000 93528 .......... 26 ....... A Rt & Lt heart catheters ................................ 9.01 4.30 4.30 0.62 13.93 13.93 000 93528 .......... TC ...... A Rt & Lt heart catheters ................................ 0.00 NA NA 2.95 NA NA 000 93529 .......... ............ A Rt, lt heart catheterization ........................... 4.80 NA NA 3.28 NA NA 000 93529 .......... 26 ....... A Rt, lt heart catheterization ........................... 4.80 2.42 2.42 0.33 7.55 7.55 000 93529 .......... TC ...... A Rt, lt heart catheterization ........................... 0.00 NA NA 2.95 NA NA 000 93530 .......... ............ A Rt heart cath, congenital ............................. 4.23 NA NA 1.34 NA NA 000 93530 .......... 26 ....... A Rt heart cath, congenital ............................. 4.23 2.02 2.02 0.29 6.54 6.54 000 93530 .......... TC ...... A Rt heart cath, congenital ............................. 0.00 NA NA 1.05 NA NA 000 93531 .......... ............ A R & l heart cath, congenital ........................ 8.36 NA NA 3.62 NA NA 000 93531 .......... 26 ....... A R & l heart cath, congenital ........................ 8.36 3.74 3.74 0.58 12.68 12.68 000 93531 .......... TC ...... A R & l heart cath, congenital ........................ 0.00 NA NA 3.04 NA NA 000 93532 .......... ............ A R & l heart cath, congenital ........................ 10.01 NA NA 3.64 NA NA 000 93532 .......... 26 ....... A R & l heart cath, congenital ........................ 10.01 4.44 4.44 0.69 15.14 15.14 000 93532 .......... TC ...... A R & l heart cath, congenital ........................ 0.00 NA NA 2.95 NA NA 000 93533 .......... ............ A R & l heart cath, congenital ........................ 6.70 NA NA 3.42 NA NA 000 93533 .......... 26 ....... A R & l heart cath, congenital ........................ 6.70 2.87 2.87 0.47 10.04 10.04 000 93533 .......... TC ...... A R & l heart cath, congenital ........................ 0.00 NA NA 2.95 NA NA 000 93539 .......... ............ A Injection, cardiac cath ................................. 0.40 NA 0.17 0.01 NA 0.58 000 93540 .......... ............ A Injection, cardiac cath ................................. 0.43 NA 0.18 0.01 NA 0.62 000 93541 .......... ............ A Injection for lung angiogram ........................ 0.29 NA 0.12 0.01 NA 0.42 000 93542 .......... ............ A Injection for heart x-rays ............................. 0.29 NA 0.12 0.01 NA 0.42 000 93543 .......... ............ A Injection for heart x-rays ............................. 0.29 NA 0.12 0.01 NA 0.42 000 93544 .......... ............ A Injection for aortography ............................. 0.25 NA 0.10 0.01 NA 0.36 000 93545 .......... ............ A Inject for coronary x-rays ............................ 0.40 NA 0.17 0.01 NA 0.58 000 93555 .......... ............ A Imaging, cardiac cath .................................. 0.81 5.12 NA 0.37 6.30 NA XXX 93555 .......... 26 ....... A Imaging, cardiac cath .................................. 0.81 0.33 0.33 0.03 1.17 1.17 XXX 93555 .......... TC ...... A Imaging, cardiac cath .................................. 0.00 4.79 NA 0.34 5.13 NA XXX 93556 .......... ............ A Imaging, cardiac cath .................................. 0.83 7.95 NA 0.54 9.32 NA XXX 93556 .......... 26 ....... A Imaging, cardiac cath .................................. 0.83 0.34 0.34 0.03 1.20 1.20 XXX 93556 .......... TC ...... A Imaging, cardiac cath .................................. 0.00 7.61 NA 0.51 8.12 NA XXX 93561 .......... ............ A Cardiac output measurement ...................... 0.50 NA NA 0.08 NA NA 000 93561 .......... 26 ....... A Cardiac output measurement ...................... 0.50 0.16 0.16 0.02 0.68 0.68 000 93561 .......... TC ...... A Cardiac output measurement ...................... 0.00 NA NA 0.06 NA NA 000 93562 .......... ............ A Cardiac output measurement ...................... 0.16 NA NA 0.05 NA NA 000 93562 .......... 26 ....... A Cardiac output measurement ...................... 0.16 0.05 0.05 0.01 0.22 0.22 000 93562 .......... TC ...... A Cardiac output measurement ...................... 0.00 NA NA 0.04 NA NA 000
93571 .......... ............ A Heart flow reserve measure ........................ 1.80 NA NA 0.30 NA NA ZZZ 93571 .......... 26 ....... A Heart flow reserve measure ........................ 1.80 0.70 0.70 0.06 2.57 2.57 ZZZ 93571 .......... TC ...... A Heart flow reserve measure ........................ 0.00 NA NA 0.24 NA NA ZZZ
93572 .......... ............ A Heart flow reserve measure ........................ 1.44 NA NA 0.17 NA NA ZZZ 93572 .......... 26 ....... A Heart flow reserve measure ........................ 1.44 0.50 0.50 0.04 1.98 1.98 ZZZ 93572 .......... TC ...... A Heart flow reserve measure ........................ 0.00 NA NA 0.13 NA NA ZZZ
93580 .......... ............ A Transcath closure of asd ............................. 18.01 NA 7.75 1.25 NA 27.00 000 93581 .......... ............ A Transcath closure of vsd ............................. 24.44 NA 9.69 1.71 NA 35.84 000 93600 .......... ............ A Bundle of His recording ............................... 2.12 NA NA 0.29 NA NA 000 93600 .......... 26 ....... A Bundle of His recording ............................... 2.12 0.87 0.87 0.16 3.15 3.15 000 93600 .......... TC ...... A Bundle of His recording ............................... 0.00 NA NA 0.13 NA NA 000 93602 .......... ............ A Intra-atrial recording .................................... 2.12 NA NA 0.24 NA NA 000 93602 .......... 26 ....... A Intra-atrial recording .................................... 2.12 0.86 0.86 0.17 3.15 3.15 000 93602 .......... TC ...... A Intra-atrial recording .................................... 0.00 NA NA 0.07 NA NA 000 93603 .......... ............ A Right ventricular recording .......................... 2.12 NA NA 0.29 NA NA 000 93603 .......... 26 ....... A Right ventricular recording .......................... 2.12 0.84 0.84 0.18 3.15 3.15 000 93603 .......... TC ...... A Right ventricular recording .......................... 0.00 NA NA 0.11 NA NA 000 93609 .......... ............ A Map tachycardia, add-on ............................. 5.00 NA NA 0.52 NA NA ZZZ 93609 .......... 26 ....... A Map tachycardia, add-on ............................. 5.00 2.03 2.03 0.35 7.38 7.38 ZZZ


## 45989

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

93609 .......... TC ...... A Map tachycardia, add-on ............................. 0.00 NA NA 0.17 NA NA ZZZ 93610 .......... ............ A Intra-atrial pacing ......................................... 3.03 NA NA 0.34 NA NA 000 93610 .......... 26 ....... A Intra-atrial pacing ......................................... 3.03 1.21 1.21 0.24 4.47 4.47 000 93610 .......... TC ...... A Intra-atrial pacing ......................................... 0.00 NA NA 0.10 NA NA 000 93612 .......... ............ A Intraventricular pacing ................................. 3.03 NA NA 0.36 NA NA 000 93612 .......... 26 ....... A Intraventricular pacing ................................. 3.03 1.20 1.20 0.25 4.48 4.48 000 93612 .......... TC ...... A Intraventricular pacing ................................. 0.00 NA NA 0.11 NA NA 000 93613 .......... ............ A Electrophys map 3d, add-on ....................... 7.00 NA 2.90 0.49 NA 10.39 ZZZ 93615 .......... ............ A Esophageal recording ................................. 0.99 NA NA 0.05 NA NA 000 93615 .......... 26 ....... A Esophageal recording ................................. 0.99 0.27 0.27 0.03 1.30 1.30 000 93615 .......... TC ...... A Esophageal recording ................................. 0.00 NA NA 0.02 NA NA 000 93616 .......... ............ A Esophageal recording ................................. 1.49 NA NA 0.11 NA NA 000 93616 .......... 26 ....... A Esophageal recording ................................. 1.49 0.44 0.44 0.09 2.02 2.02 000 93616 .......... TC ...... A Esophageal recording ................................. 0.00 NA NA 0.02 NA NA 000 93618 .......... ............ A Heart rhythm pacing .................................... 4.26 NA NA 0.54 NA NA 000 93618 .......... 26 ....... A Heart rhythm pacing .................................... 4.26 1.75 1.75 0.30 6.30 6.30 000 93618 .......... TC ...... A Heart rhythm pacing .................................... 0.00 NA NA 0.24 NA NA 000 93619 .......... ............ A Electrophysiology evaluation ....................... 7.32 NA NA 0.98 NA NA 000 93619 .......... 26 ....... A Electrophysiology evaluation ....................... 7.32 3.37 3.37 0.51 11.21 11.21 000 93619 .......... TC ...... A Electrophysiology evaluation ....................... 0.00 NA NA 0.47 NA NA 000 93620 .......... ............ C Electrophysiology evaluation ....................... 0.00 0.00 0.00 0.00 0.00 0.00 000 93620 .......... 26 ....... A Electrophysiology evaluation ....................... 11.59 5.11 5.11 0.80 17.50 17.50 000 93620 .......... TC ...... C Electrophysiology evaluation ....................... 0.00 0.00 0.00 0.00 0.00 0.00 000 93621 .......... ............ C Electrophysiology evaluation ....................... 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93621 .......... 26 ....... A Electrophysiology evaluation ....................... 2.10 0.86 0.86 0.15 3.11 3.11 ZZZ 93621 .......... TC ...... C Electrophysiology evaluation ....................... 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93622 .......... ............ C Electrophysiology evaluation ....................... 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93622 .......... 26 ....... A Electrophysiology evaluation ....................... 3.11 1.26 1.26 0.22 4.59 4.59 ZZZ 93622 .......... TC ...... C Electrophysiology evaluation ....................... 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93623 .......... ............ C Stimulation, pacing heart ............................. 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93623 .......... 26 ....... A Stimulation, pacing heart ............................. 2.86 1.16 1.16 0.20 4.21 4.21 ZZZ 93623 .......... TC ...... C Stimulation, pacing heart ............................. 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93624 .......... ............ A Electrophysiologic study .............................. 4.81 NA NA 0.46 NA NA 000 93624 .......... 26 ....... A Electrophysiologic study .............................. 4.81 2.33 2.33 0.33 7.47 7.47 000 93624 .......... TC ...... A Electrophysiologic study .............................. 0.00 NA NA 0.13 NA NA 000 93631 .......... ............ A Heart pacing, mapping ................................ 7.61 NA NA 1.60 NA NA 000 93631 .......... 26 ....... A Heart pacing, mapping ................................ 7.61 2.83 2.83 0.97 11.41 11.41 000 93631 .......... TC ...... A Heart pacing, mapping ................................ 0.00 NA NA 0.62 NA NA 000
93640 .......... ............ A Evaluation heart device ............................... 3.52 NA NA 0.66 NA NA 000 93640 .......... 26 ....... A Evaluation heart device ............................... 3.52 1.42 1.42 0.24 5.18 5.18 000 93640 .......... TC ...... A Evaluation heart device ............................... 0.00 NA NA 0.42 NA NA 000 93641 .......... ............ A Electrophysiology evaluation ....................... 5.93 NA NA 0.83 NA NA 000 93641 .......... 26 ....... A Electrophysiology evaluation ....................... 5.93 2.41 2.41 0.41 8.75 8.75 000 93641 .......... TC ...... A Electrophysiology evaluation ....................... 0.00 NA NA 0.42 NA NA 000 93642 .......... ............ A Electrophysiology evaluation ....................... 4.89 8.17 NA 0.57 13.63 NA 000 93642 .......... 26 ....... A Electrophysiology evaluation ....................... 4.89 2.35 2.35 0.15 7.39 7.39 000 93642 .......... TC ...... A Electrophysiology evaluation ....................... 0.00 5.81 NA 0.42 6.23 NA 000 93650 .......... ............ A Ablate heart dysrhythm focus ..................... 10.51 NA 4.68 0.73 NA 15.92 000 93651 .......... ............ A Ablate heart dysrhythm focus ..................... 16.26 NA 6.61 1.13 NA 24.00 000 93652 .......... ............ A Ablate heart dysrhythm focus ..................... 17.69 NA 7.17 1.23 NA 26.08 000
93660 .......... ............ A Tilt table evaluation ..................................... 1.89 2.58 NA 0.08 4.55 NA 000 93660 .......... 26 ....... A Tilt table evaluation ..................................... 1.89 0.77 0.77 0.06 2.73 2.73 000 93660 .......... TC ...... A Tilt table evaluation ..................................... 0.00 1.81 NA 0.02 1.83 NA 000 93662 .......... ............ C Intracardiac ecg (ice) ................................... 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93662 .......... 26 ....... A Intracardiac ecg (ice) ................................... 2.81 1.16 1.16 0.09 4.06 4.06 ZZZ 93662 .......... TC ...... C Intracardiac ecg (ice) ................................... 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93668 .......... ............ N Peripheral vascular rehab ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93701 .......... ............ A Bioimpedance, thoracic ............................... 0.17 0.94 NA 0.02 1.13 NA XXX 93701 .......... 26 ....... A Bioimpedance, thoracic ............................... 0.17 0.07 0.07 0.01 0.25 0.25 XXX 93701 .......... TC ...... A Bioimpedance, thoracic ............................... 0.00 0.87 NA 0.01 0.88 NA XXX 93720 .......... ............ A Total body plethysmography ....................... 0.17 0.92 NA 0.07 1.16 NA XXX 93721 .......... ............ A Plethysmography tracing ............................. 0.00 0.87 NA 0.06 0.93 NA XXX 93722 .......... ............ A Plethysmography report .............................. 0.17 0.05 0.05 0.01 0.23 0.23 XXX 93724 .......... ............ A Analyze pacemaker system ........................ 4.89 5.22 NA 0.39 10.50 NA 000 93724 .......... 26 ....... A Analyze pacemaker system ........................ 4.89 2.00 2.00 0.15 7.04 7.04 000 93724 .......... TC ...... A Analyze pacemaker system ........................ 0.00 3.22 NA 0.24 3.46 NA 000 93727 .......... ............ A Analyze ilr system ....................................... 0.52 0.37 0.20 0.02 0.91 0.74 XXX 93731 .......... ............ A Analyze pacemaker system ........................ 0.45 0.74 NA 0.05 1.24 NA XXX 93731 .......... 26 ....... A Analyze pacemaker system ........................ 0.45 0.18 0.18 0.01 0.64 0.64 XXX 93731 .......... TC ...... A Analyze pacemaker system ........................ 0.00 0.56 NA 0.04 0.60 NA XXX 93732 .......... ............ A Analyze pacemaker system ........................ 0.92 0.98 NA 0.07 1.97 NA XXX 93732 .......... 26 ....... A Analyze pacemaker system ........................ 0.92 0.37 0.37 0.03 1.32 1.32 XXX 93732 .......... TC ...... A Analyze pacemaker system ........................ 0.00 0.62 NA 0.04 0.66 NA XXX 93733 .......... ............ A Telephone analy, pacemaker ...................... 0.17 0.69 NA 0.07 0.93 NA XXX


## 45990

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

93733 .......... 26 ....... A Telephone analy, pacemaker ...................... 0.17 0.07 0.07 0.01 0.25 0.25 XXX 93733 .......... TC ...... A Telephone analy, pacemaker ...................... 0.00 0.62 NA 0.06 0.68 NA XXX 93734 .......... ............ A Analyze pacemaker system ........................ 0.38 0.59 NA 0.03 1.00 NA XXX 93734 .......... 26 ....... A Analyze pacemaker system ........................ 0.38 0.16 0.16 0.01 0.55 0.55 XXX 93734 .......... TC ...... A Analyze pacemaker system ........................ 0.00 0.43 NA 0.02 0.45 NA XXX 93735 .......... ............ A Analyze pacemaker system ........................ 0.74 0.82 NA 0.06 1.62 NA XXX 93735 .......... 26 ....... A Analyze pacemaker system ........................ 0.74 0.29 0.29 0.02 1.05 1.05 XXX 93735 .......... TC ...... A Analyze pacemaker system ........................ 0.00 0.53 NA 0.04 0.57 NA XXX 93736 .......... ............ A Telephonic analy, pacemaker ..................... 0.15 0.60 NA 0.07 0.82 NA XXX 93736 .......... 26 ....... A Telephonic analy, pacemaker ..................... 0.15 0.06 0.06 0.01 0.22 0.22 XXX 93736 .......... TC ...... A Telephonic analy, pacemaker ..................... 0.00 0.54 NA 0.06 0.60 NA XXX 93740 .......... ............ B Temperature gradient studies ..................... 0.16 0.16 NA 0.02 0.34 NA XXX 93740 .......... 26 ....... B Temperature gradient studies ..................... 0.16 0.04 0.04 0.01 0.21 0.21 XXX 93740 .......... TC ...... B Temperature gradient studies ..................... 0.00 0.12 NA 0.01 0.13 NA XXX 93741 .......... ............ A Analyze ht pace device sngl ....................... 0.80 1.04 NA 0.07 1.91 NA XXX 93741 .......... 26 ....... A Analyze ht pace device sngl ....................... 0.80 0.32 0.32 0.03 1.15 1.15 XXX 93741 .......... TC ...... A Analyze ht pace device sngl ....................... 0.00 0.72 NA 0.04 0.76 NA XXX 93742 .......... ............ A Analyze ht pace device sngl ....................... 0.91 1.11 NA 0.07 2.09 NA XXX 93742 .......... 26 ....... A Analyze ht pace device sngl ....................... 0.91 0.38 0.38 0.03 1.32 1.32 XXX 93742 .......... TC ...... A Analyze ht pace device sngl ....................... 0.00 0.73 NA 0.04 0.77 NA XXX 93743 .......... ............ A Analyze ht pace device dual ....................... 1.03 1.20 NA 0.07 2.30 NA XXX 93743 .......... 26 ....... A Analyze ht pace device dual ....................... 1.03 0.42 0.42 0.03 1.48 1.48 XXX 93743 .......... TC ...... A Analyze ht pace device dual ....................... 0.00 0.78 NA 0.04 0.82 NA XXX 93744 .......... ............ A Analyze ht pace device dual ....................... 1.18 1.23 NA 0.08 2.50 NA XXX 93744 .......... 26 ....... A Analyze ht pace device dual ....................... 1.18 0.48 0.48 0.04 1.70 1.70 XXX 93744 .......... TC ...... A Analyze ht pace device dual ....................... 0.00 0.75 NA 0.04 0.79 NA XXX 93745 .......... ............ C Set-up cardiovert-defibrill ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93745 .......... 26 ....... C Set-up cardiovert-defibrill ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93745 .......... TC ...... C Set-up cardiovert-defibrill ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93760 .......... ............ N Cephalic thermogram .................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93762 .......... ............ N Peripheral thermogram ................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93770 .......... ............ B Measure venous pressure ........................... 0.16 0.07 NA 0.02 0.25 NA XXX 93770 .......... 26 ....... B Measure venous pressure ........................... 0.16 0.05 0.05 0.01 0.22 0.22 XXX 93770 .......... TC ...... B Measure venous pressure ........................... 0.00 0.02 NA 0.01 0.03 NA XXX 93784 .......... ............ A Ambulatory BP monitoring .......................... 0.38 1.66 NA 0.03 2.07 NA XXX 93786 .......... ............ A Ambulatory BP recording ............................ 0.00 0.99 NA 0.01 1.00 NA XXX 93788 .......... ............ A Ambulatory BP analysis .............................. 0.00 0.55 NA 0.01 0.56 NA XXX 93790 .......... ............ A Review/report BP recording ........................ 0.38 0.13 0.13 0.01 0.52 0.52 XXX 93797 .......... ............ A Cardiac rehab .............................................. 0.18 0.34 0.07 0.01 0.53 0.26 000 93798 .......... ............ A Cardiac rehab/monitor ................................. 0.28 0.50 0.11 0.01 0.79 0.40 000 93799 .......... ............ C Cardiovascular procedure ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93799 .......... 26 ....... C Cardiovascular procedure ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93799 .......... TC ...... C Cardiovascular procedure ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93875 .......... ............ A Extracranial study ........................................ 0.22 2.40 NA 0.12 2.75 NA XXX 93875 .......... 26 ....... A Extracranial study ........................................ 0.22 0.08 0.08 0.01 0.31 0.31 XXX 93875 .......... TC ...... A Extracranial study ........................................ 0.00 2.32 NA 0.11 2.43 NA XXX 93880 .......... ............ A Extracranial study ........................................ 0.60 5.78 NA 0.39 6.78 NA XXX 93880 .......... 26 ....... A Extracranial study ........................................ 0.60 0.21 0.21 0.04 0.85 0.85 XXX 93880 .......... TC ...... A Extracranial study ........................................ 0.00 5.58 NA 0.35 5.93 NA XXX 93882 .......... ............ A Extracranial study ........................................ 0.40 3.57 NA 0.26 4.23 NA XXX 93882 .......... 26 ....... A Extracranial study ........................................ 0.40 0.14 0.14 0.04 0.58 0.58 XXX 93882 .......... TC ...... A Extracranial study ........................................ 0.00 3.43 NA 0.22 3.65 NA XXX 93886 .......... ............ A Intracranial study ......................................... 0.94 6.78 NA 0.45 8.17 NA XXX 93886 .......... 26 ....... A Intracranial study ......................................... 0.94 0.36 0.36 0.06 1.37 1.37 XXX 93886 .......... TC ...... A Intracranial study ......................................... 0.00 6.42 NA 0.39 6.81 NA XXX 93888 .......... ............ A Intracranial study ......................................... 0.62 4.33 NA 0.32 5.27 NA XXX 93888 .......... 26 ....... A Intracranial study ......................................... 0.62 0.23 0.23 0.05 0.90 0.90 XXX 93888 .......... TC ...... A Intracranial study ......................................... 0.00 4.11 NA 0.27 4.38 NA XXX 93890 .......... ............ A Tcd, vasoreactivity study ............................. 1.00 5.09 NA 0.45 6.54 NA XXX 93890 .......... 26 ....... A Tcd, vasoreactivity study ............................. 1.00 0.39 0.39 0.06 1.45 1.45 XXX 93890 .......... TC ...... A Tcd, vasoreactivity study ............................. 0.00 4.70 NA 0.39 5.09 NA XXX 93892 .......... ............ A Tcd, emboli detect w/o inj ........................... 1.15 5.40 NA 0.45 7.00 NA XXX 93892 .......... 26 ....... A Tcd, emboli detect w/o inj ........................... 1.15 0.45 0.45 0.06 1.66 1.66 XXX 93892 .......... TC ...... A Tcd, emboli detect w/o inj ........................... 0.00 4.95 NA 0.39 5.34 NA XXX 93893 .......... ............ A Tcd, emboli detect w/inj .............................. 1.15 5.23 NA 0.45 6.83 NA XXX 93893 .......... 26 ....... A Tcd, emboli detect w/inj .............................. 1.15 0.45 0.45 0.06 1.66 1.66 XXX 93893 .......... TC ...... A Tcd, emboli detect w/inj .............................. 0.00 4.78 NA 0.39 5.17 NA XXX 93922 .......... ............ A Extremity study ............................................ 0.25 2.74 NA 0.15 3.14 NA XXX 93922 .......... 26 ....... A Extremity study ............................................ 0.25 0.08 0.08 0.02 0.35 0.35 XXX 93922 .......... TC ...... A Extremity study ............................................ 0.00 2.65 NA 0.13 2.78 NA XXX 93923 .......... ............ A Extremity study ............................................ 0.45 4.15 NA 0.26 4.86 NA XXX 93923 .......... 26 ....... A Extremity study ............................................ 0.45 0.15 0.15 0.04 0.64 0.64 XXX 93923 .......... TC ...... A Extremity study ............................................ 0.00 4.00 NA 0.22 4.22 NA XXX 93924 .......... ............ A Extremity study ............................................ 0.50 5.02 NA 0.30 5.82 NA XXX


## 45991

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

93924 .......... 26 ....... A Extremity study ............................................ 0.50 0.17 0.17 0.05 0.72 0.72 XXX 93924 .......... TC ...... A Extremity study ............................................ 0.00 4.85 NA 0.25 5.10 NA XXX 93925 .......... ............ A Lower extremity study ................................. 0.58 7.09 NA 0.39 8.06 NA XXX 93925 .......... 26 ....... A Lower extremity study ................................. 0.58 0.20 0.20 0.04 0.82 0.82 XXX 93925 .......... TC ...... A Lower extremity study ................................. 0.00 6.89 NA 0.35 7.24 NA XXX 93926 .......... ............ A Lower extremity study ................................. 0.39 4.21 NA 0.27 4.87 NA XXX 93926 .......... 26 ....... A Lower extremity study ................................. 0.39 0.13 0.13 0.04 0.56 0.56 XXX 93926 .......... TC ...... A Lower extremity study ................................. 0.00 4.08 NA 0.23 4.31 NA XXX 93930 .......... ............ A Upper extremity study ................................. 0.46 5.52 NA 0.41 6.39 NA XXX 93930 .......... 26 ....... A Upper extremity study ................................. 0.46 0.16 0.16 0.04 0.66 0.66 XXX 93930 .......... TC ...... A Upper extremity study ................................. 0.00 5.35 NA 0.37 5.72 NA XXX 93931 .......... ............ A Upper extremity study ................................. 0.31 3.65 NA 0.27 4.24 NA XXX 93931 .......... 26 ....... A Upper extremity study ................................. 0.31 0.10 0.10 0.03 0.44 0.44 XXX 93931 .......... TC ...... A Upper extremity study ................................. 0.00 3.55 NA 0.24 3.79 NA XXX 93965 .......... ............ A Extremity study ............................................ 0.35 2.85 NA 0.14 3.34 NA XXX 93965 .......... 26 ....... A Extremity study ............................................ 0.35 0.12 0.12 0.02 0.49 0.49 XXX 93965 .......... TC ...... A Extremity study ............................................ 0.00 2.73 NA 0.12 2.85 NA XXX 93970 .......... ............ A Extremity study ............................................ 0.68 5.46 NA 0.46 6.60 NA XXX 93970 .......... 26 ....... A Extremity study ............................................ 0.68 0.23 0.23 0.06 0.97 0.97 XXX 93970 .......... TC ...... A Extremity study ............................................ 0.00 5.22 NA 0.40 5.62 NA XXX 93971 .......... ............ A Extremity study ............................................ 0.45 3.69 NA 0.30 4.44 NA XXX 93971 .......... 26 ....... A Extremity study ............................................ 0.45 0.16 0.16 0.03 0.64 0.64 XXX 93971 .......... TC ...... A Extremity study ............................................ 0.00 3.53 NA 0.27 3.80 NA XXX 93975 .......... ............ A Vascular study ............................................. 1.80 8.00 NA 0.56 10.36 NA XXX 93975 .......... 26 ....... A Vascular study ............................................. 1.80 0.62 0.62 0.13 2.55 2.55 XXX 93975 .......... TC ...... A Vascular study ............................................. 0.00 7.38 NA 0.43 7.81 NA XXX 93976 .......... ............ A Vascular study ............................................. 1.21 4.46 NA 0.35 6.02 NA XXX 93976 .......... 26 ....... A Vascular study ............................................. 1.21 0.42 0.42 0.05 1.68 1.68 XXX 93976 .......... TC ...... A Vascular study ............................................. 0.00 4.04 NA 0.30 4.34 NA XXX 93978 .......... ............ A Vascular study ............................................. 0.65 4.79 NA 0.43 5.88 NA XXX 93978 .......... 26 ....... A Vascular study ............................................. 0.65 0.22 0.22 0.06 0.93 0.93 XXX 93978 .......... TC ...... A Vascular study ............................................. 0.00 4.57 NA 0.37 4.94 NA XXX 93979 .......... ............ A Vascular study ............................................. 0.44 3.39 NA 0.27 4.10 NA XXX 93979 .......... 26 ....... A Vascular study ............................................. 0.44 0.15 0.15 0.03 0.62 0.62 XXX 93979 .......... TC ...... A Vascular study ............................................. 0.00 3.24 NA 0.24 3.48 NA XXX 93980 .......... ............ A Penile vascular study .................................. 1.25 3.13 NA 0.42 4.80 NA XXX 93980 .......... 26 ....... A Penile vascular study .................................. 1.25 0.44 0.44 0.08 1.78 1.78 XXX 93980 .......... TC ...... A Penile vascular study .................................. 0.00 2.69 NA 0.34 3.03 NA XXX 93981 .......... ............ A Penile vascular study .................................. 0.44 2.85 NA 0.33 3.62 NA XXX 93981 .......... 26 ....... A Penile vascular study .................................. 0.44 0.15 0.15 0.02 0.61 0.61 XXX 93981 .......... TC ...... A Penile vascular study .................................. 0.00 2.71 NA 0.31 3.02 NA XXX 93990 .......... ............ A Doppler flow testing ..................................... 0.25 4.13 NA 0.26 4.64 NA XXX 93990 .......... 26 ....... A Doppler flow testing ..................................... 0.25 0.09 0.09 0.03 0.37 0.37 XXX 93990 .......... TC ...... A Doppler flow testing ..................................... 0.00 4.03 NA 0.23 4.26 NA XXX 94010 .......... ............ A Breathing capacity test ................................ 0.17 0.67 NA 0.03 0.87 NA XXX 94010 .......... 26 ....... A Breathing capacity test ................................ 0.17 0.05 0.05 0.01 0.23 0.23 XXX 94010 .......... TC ...... A Breathing capacity test ................................ 0.00 0.62 NA 0.02 0.64 NA XXX 94014 .......... ............ A Patient recorded spirometry ........................ 0.52 0.77 NA 0.03 1.32 NA XXX 94015 .......... ............ A Patient recorded spirometry ........................ 0.00 0.60 NA 0.01 0.61 NA XXX 94016 .......... ............ A Review patient spirometry ........................... 0.52 0.17 0.17 0.02 0.71 0.71 XXX 94060 .......... ............ A Evaluation of wheezing ............................... 0.31 1.08 NA 0.07 1.46 NA XXX 94060 .......... 26 ....... A Evaluation of wheezing ............................... 0.31 0.09 0.09 0.01 0.41 0.41 XXX 94060 .......... TC ...... A Evaluation of wheezing ............................... 0.00 0.99 NA 0.06 1.05 NA XXX 94070 .......... ............ A Evaluation of wheezing ............................... 0.60 0.83 NA 0.13 1.57 NA XXX 94070 .......... 26 ....... A Evaluation of wheezing ............................... 0.60 0.18 0.18 0.03 0.81 0.81 XXX 94070 .......... TC ...... A Evaluation of wheezing ............................... 0.00 0.66 NA 0.10 0.76 NA XXX 94150 .......... ............ B Vital capacity test ........................................ 0.07 0.47 NA 0.02 0.56 NA XXX 94150 .......... 26 ....... B Vital capacity test ........................................ 0.07 0.03 0.03 0.01 0.11 0.11 XXX 94150 .......... TC ...... B Vital capacity test ........................................ 0.00 0.44 NA 0.01 0.45 NA XXX 94200 .......... ............ A Lung function test (MBC/MVV) ................... 0.11 0.44 NA 0.03 0.58 NA XXX 94200 .......... 26 ....... A Lung function test (MBC/MVV) ................... 0.11 0.03 0.03 0.01 0.15 0.15 XXX 94200 .......... TC ...... A Lung function test (MBC/MVV) ................... 0.00 0.41 NA 0.02 0.43 NA XXX 94240 .......... ............ A Residual lung capacity ................................ 0.26 0.66 NA 0.06 0.98 NA XXX 94240 .......... 26 ....... A Residual lung capacity ................................ 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94240 .......... TC ...... A Residual lung capacity ................................ 0.00 0.58 NA 0.05 0.63 NA XXX 94250 .......... ............ A Expired gas collection ................................. 0.11 0.61 NA 0.02 0.74 NA XXX 94250 .......... 26 ....... A Expired gas collection ................................. 0.11 0.03 0.03 0.01 0.15 0.15 XXX 94250 .......... TC ...... A Expired gas collection ................................. 0.00 0.58 NA 0.01 0.59 NA XXX 94260 .......... ............ A Thoracic gas volume ................................... 0.13 0.58 NA 0.05 0.76 NA XXX 94260 .......... 26 ....... A Thoracic gas volume ................................... 0.13 0.04 0.04 0.01 0.18 0.18 XXX 94260 .......... TC ...... A Thoracic gas volume ................................... 0.00 0.54 NA 0.04 0.58 NA XXX 94350 .......... ............ A Lung nitrogen washout curve ...................... 0.26 0.72 NA 0.05 1.03 NA XXX 94350 .......... 26 ....... A Lung nitrogen washout curve ...................... 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94350 .......... TC ...... A Lung nitrogen washout curve ...................... 0.00 0.64 NA 0.04 0.68 NA XXX


## 45992

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

94360 .......... ............ A Measure airflow resistance ......................... 0.26 0.71 NA 0.07 1.04 NA XXX 94360 .......... 26 ....... A Measure airflow resistance ......................... 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94360 .......... TC ...... A Measure airflow resistance ......................... 0.00 0.63 NA 0.06 0.69 NA XXX 94370 .......... ............ A Breath airway closing volume ..................... 0.26 0.69 NA 0.03 0.98 NA XXX 94370 .......... 26 ....... A Breath airway closing volume ..................... 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94370 .......... TC ...... A Breath airway closing volume ..................... 0.00 0.61 NA 0.02 0.63 NA XXX 94375 .......... ............ A Respiratory flow volume loop ...................... 0.31 0.60 NA 0.03 0.94 NA XXX 94375 .......... 26 ....... A Respiratory flow volume loop ...................... 0.31 0.09 0.09 0.01 0.41 0.41 XXX 94375 .......... TC ...... A Respiratory flow volume loop ...................... 0.00 0.51 NA 0.02 0.53 NA XXX 94400 .......... ............ A CO2 breathing response curve ................... 0.40 0.86 NA 0.09 1.35 NA XXX 94400 .......... 26 ....... A CO2 breathing response curve ................... 0.40 0.12 0.12 0.03 0.55 0.55 XXX 94400 .......... TC ...... A CO2 breathing response curve ................... 0.00 0.74 NA 0.06 0.80 NA XXX 94450 .......... ............ A Hypoxia response curve .............................. 0.40 0.86 NA 0.04 1.30 NA XXX 94450 .......... 26 ....... A Hypoxia response curve .............................. 0.40 0.12 0.12 0.02 0.54 0.54 XXX 94450 .......... TC ...... A Hypoxia response curve .............................. 0.00 0.74 NA 0.02 0.76 NA XXX 94452 .......... ............ A Hast w/report ............................................... 0.31 1.00 NA 0.04 1.35 NA XXX 94452 .......... 26 ....... A Hast w/report ............................................... 0.31 0.09 0.09 0.02 0.42 0.42 XXX 94452 .......... TC ...... A Hast w/report ............................................... 0.00 0.92 NA 0.02 0.94 NA XXX 94453 .......... ............ A Hast w/oxygen titrate ................................... 0.40 1.47 NA 0.04 1.91 NA XXX 94453 .......... 26 ....... A Hast w/oxygen titrate ................................... 0.40 0.12 0.12 0.02 0.54 0.54 XXX 94453 .......... TC ...... A Hast w/oxygen titrate ................................... 0.00 1.36 NA 0.02 1.38 NA XXX 94620 .......... ............ A Pulmonary stress test/simple ...................... 0.64 2.17 NA 0.13 2.94 NA XXX 94620 .......... 26 ....... A Pulmonary stress test/simple ...................... 0.64 0.20 0.20 0.03 0.87 0.87 XXX 94620 .......... TC ...... A Pulmonary stress test/simple ...................... 0.00 1.98 NA 0.10 2.08 NA XXX 94621 .......... ............ A Pulm stress test/complex ............................ 1.42 2.21 NA 0.16 3.79 NA XXX 94621 .......... 26 ....... A Pulm stress test/complex ............................ 1.42 0.43 0.43 0.06 1.91 1.91 XXX 94621 .......... TC ...... A Pulm stress test/complex ............................ 0.00 1.78 NA 0.10 1.88 NA XXX 94640 .......... ............ A Airway inhalation treatment ......................... 0.00 0.30 NA 0.02 0.32 NA XXX 94642 .......... ............ C Aerosol inhalation treatment ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94656 .......... ............ A Initial ventilator mgmt .................................. 1.22 1.16 0.31 0.06 2.44 1.59 XXX 94657 .......... ............ A Continued ventilator mgmt .......................... 0.83 0.98 0.24 0.04 1.85 1.11 XXX 94660 .......... ............ A Pos airway pressure, CPAP ........................ 0.76 0.62 0.23 0.04 1.42 1.03 XXX 94662 .......... ............ A Neg press ventilation, cnp ........................... 0.76 NA 0.23 0.03 NA 1.02 XXX 94664 .......... ............ A Evaluate pt use of inhaler ........................... 0.00 0.31 NA 0.04 0.35 NA XXX 94667 .......... ............ A Chest wall manipulation .............................. 0.00 0.51 NA 0.05 0.56 NA XXX 94668 .......... ............ A Chest wall manipulation .............................. 0.00 0.44 NA 0.02 0.46 NA XXX 94680 .......... ............ A Exhaled air analysis, o2 .............................. 0.26 1.70 NA 0.07 2.03 NA XXX 94680 .......... 26 ....... A Exhaled air analysis, o2 .............................. 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94680 .......... TC ...... A Exhaled air analysis, o2 .............................. 0.00 1.62 NA 0.06 1.68 NA XXX 94681 .......... ............ A Exhaled air analysis, o2/co2 ....................... 0.20 2.27 NA 0.13 2.60 NA XXX 94681 .......... 26 ....... A Exhaled air analysis, o2/co2 ....................... 0.20 0.06 0.06 0.01 0.27 0.27 XXX 94681 .......... TC ...... A Exhaled air analysis, o2/co2 ....................... 0.00 2.21 NA 0.12 2.33 NA XXX 94690 .......... ............ A Exhaled air analysis .................................... 0.07 1.76 NA 0.05 1.88 NA XXX 94690 .......... 26 ....... A Exhaled air analysis .................................... 0.07 0.02 0.02 0.01 0.10 0.10 XXX 94690 .......... TC ...... A Exhaled air analysis .................................... 0.00 1.74 NA 0.04 1.78 NA XXX 94720 .......... ............ A Monoxide diffusing capacity ........................ 0.26 0.98 NA 0.07 1.31 NA XXX 94720 .......... 26 ....... A Monoxide diffusing capacity ........................ 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94720 .......... TC ...... A Monoxide diffusing capacity ........................ 0.00 0.90 NA 0.06 0.96 NA XXX 94725 .......... ............ A Membrane diffusion capacity ...................... 0.26 2.55 NA 0.13 2.94 NA XXX 94725 .......... 26 ....... A Membrane diffusion capacity ...................... 0.26 0.08 0.08 0.01 0.35 0.35 XXX 94725 .......... TC ...... A Membrane diffusion capacity ...................... 0.00 2.47 NA 0.12 2.59 NA XXX 94750 .......... ............ A Pulmonary compliance study ...................... 0.23 1.37 NA 0.05 1.65 NA XXX 94750 .......... 26 ....... A Pulmonary compliance study ...................... 0.23 0.07 0.07 0.01 0.31 0.31 XXX 94750 .......... TC ...... A Pulmonary compliance study ...................... 0.00 1.30 NA 0.04 1.34 NA XXX 94760 .......... ............ T Measure blood oxygen level ....................... 0.00 0.04 NA 0.02 0.06 NA XXX 94761 .......... ............ T Measure blood oxygen level ....................... 0.00 0.07 NA 0.06 0.13 NA XXX 94762 .......... ............ A Measure blood oxygen level ....................... 0.00 0.52 NA 0.10 0.62 NA XXX
94770 .......... ............ A Exhaled carbon dioxide test ........................ 0.15 0.76 NA 0.08 0.99 NA XXX
94770 .......... 26 ....... A Exhaled carbon dioxide test ........................ 0.15 0.04 0.04 0.01 0.20 0.20 XXX 94770 .......... TC ...... A Exhaled carbon dioxide test ........................ 0.00 0.72 NA 0.07 0.79 NA XXX 94772 .......... ............ C Breath recording, infant ............................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94772 .......... 26 ....... C Breath recording, infant ............................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94772 .......... TC ...... C Breath recording, infant ............................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94799 .......... ............ C Pulmonary service/procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94799 .......... 26 ....... C Pulmonary service/procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94799 .......... TC ...... C Pulmonary service/procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95004 .......... ............ A Percut allergy skin tests .............................. 0.00 0.11 NA 0.01 0.12 NA XXX 95010 .......... ............ A Percut allergy titrate test ............................. 0.15 0.33 0.07 0.01 0.49 0.23 XXX 95015 .......... ............ A Id allergy titrate-drug/bug ............................ 0.15 0.16 0.06 0.01 0.32 0.22 XXX 95024 .......... ............ A Id allergy test, drug/bug .............................. 0.00 0.16 NA 0.01 0.17 NA XXX 95027 .......... ............ A Id allergy titrate-airborne ............................. 0.00 0.16 NA 0.01 0.17 NA XXX 95028 .......... ............ A Id allergy test-delayed type ......................... 0.00 0.23 NA 0.01 0.24 NA XXX 95044 .......... ............ A Allergy patch tests ....................................... 0.00 0.19 NA 0.01 0.20 NA XXX 95052 .......... ............ A Photo patch test .......................................... 0.00 0.23 NA 0.01 0.24 NA XXX


## 45993

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

95056 .......... ............ A Photosensitivity tests ................................... 0.00 0.34 NA 0.01 0.35 NA XXX 95060 .......... ............ A Eye allergy tests .......................................... 0.00 0.42 NA 0.02 0.44 NA XXX 95065 .......... ............ A Nose allergy test ......................................... 0.00 0.31 NA 0.01 0.32 NA XXX 95070 .......... ............ A Bronchial allergy tests ................................. 0.00 1.91 NA 0.02 1.93 NA XXX 95071 .......... ............ A Bronchial allergy tests ................................. 0.00 2.50 NA 0.02 2.52 NA XXX 95075 .......... ............ A Ingestion challenge test .............................. 0.95 0.83 0.40 0.03 1.81 1.38 XXX 95078 .......... ............ A Provocative testing ...................................... 0.00 0.27 NA 0.02 0.29 NA XXX 95115 .......... ............ A Immunotherapy, one injection ..................... 0.00 0.35 NA 0.02 0.37 NA 000 95117 .......... ............ A Immunotherapy injections ........................... 0.00 0.45 NA 0.02 0.47 NA 000 95120 .......... ............ I Immunotherapy, one injection ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95125 .......... ............ I Immunotherapy, many antigens .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95130 .......... ............ I Immunotherapy, insect venom .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95131 .......... ............ I Immunotherapy, insect venoms .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95132 .......... ............ I Immunotherapy, insect venoms .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95133 .......... ............ I Immunotherapy, insect venoms .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95134 .......... ............ I Immunotherapy, insect venoms .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95144 .......... ............ A Antigen therapy services ............................. 0.06 0.21 0.02 0.01 0.28 0.09 000 95145 .......... ............ A Antigen therapy services ............................. 0.06 0.33 0.02 0.01 0.40 0.09 000 95146 .......... ............ A Antigen therapy services ............................. 0.06 0.48 0.03 0.01 0.55 0.10 000 95147 .......... ............ A Antigen therapy services ............................. 0.06 0.46 0.02 0.01 0.53 0.09 000 95148 .......... ............ A Antigen therapy services ............................. 0.06 0.65 0.03 0.01 0.72 0.10 000 95149 .......... ............ A Antigen therapy services ............................. 0.06 0.89 0.03 0.01 0.96 0.10 000 95165 .......... ............ A Antigen therapy services ............................. 0.06 0.20 0.02 0.01 0.27 0.09 000 95170 .......... ............ A Antigen therapy services ............................. 0.06 0.15 0.03 0.01 0.22 0.10 000 95180 .......... ............ A Rapid desensitization .................................. 2.01 2.07 0.97 0.04 4.13 3.03 000 95199 .......... ............ C Allergy immunology services ....................... 0.00 0.00 0.00 0.00 0.00 0.00 000 95250 .......... ............ A Glucose monitoring, cont ............................ 0.00 3.91 NA 0.01 3.92 NA XXX 95805 .......... ............ A Multiple sleep latency test ........................... 1.88 15.27 NA 0.43 17.58 NA XXX 95805 .......... 26 ....... A Multiple sleep latency test ........................... 1.88 0.64 0.64 0.09 2.62 2.62 XXX 95805 .......... TC ...... A Multiple sleep latency test ........................... 0.00 14.62 NA 0.34 14.96 NA XXX 95806 .......... ............ A Sleep study, unattended ............................. 1.66 3.31 NA 0.39 5.36 NA XXX 95806 .......... 26 ....... A Sleep study, unattended ............................. 1.66 0.53 0.53 0.08 2.27 2.27 XXX 95806 .......... TC ...... A Sleep study, unattended ............................. 0.00 2.78 NA 0.31 3.09 NA XXX 95807 .......... ............ A Sleep study, attended ................................. 1.66 11.70 NA 0.50 13.86 NA XXX 95807 .......... 26 ....... A Sleep study, attended ................................. 1.66 0.52 0.52 0.08 2.26 2.26 XXX 95807 .......... TC ...... A Sleep study, attended ................................. 0.00 11.18 NA 0.42 11.60 NA XXX 95808 .......... ............ A Polysomnography, 1-3 ................................ 2.66 12.98 NA 0.55 16.18 NA XXX 95808 .......... 26 ....... A Polysomnography, 1-3 ................................ 2.66 0.90 0.90 0.13 3.68 3.68 XXX 95808 .......... TC ...... A Polysomnography, 1-3 ................................ 0.00 12.08 NA 0.42 12.50 NA XXX 95810 .......... ............ A Polysomnography, 4 or more ...................... 3.53 17.14 NA 0.59 21.26 NA XXX 95810 .......... 26 ....... A Polysomnography, 4 or more ...................... 3.53 1.15 1.15 0.17 4.85 4.85 XXX 95810 .......... TC ...... A Polysomnography, 4 or more ...................... 0.00 15.99 NA 0.42 16.41 NA XXX 95811 .......... ............ A Polysomnography w/cpap ........................... 3.80 18.83 NA 0.61 23.24 NA XXX 95811 .......... 26 ....... A Polysomnography w/cpap ........................... 3.80 1.24 1.24 0.18 5.22 5.22 XXX 95811 .......... TC ...... A Polysomnography w/cpap ........................... 0.00 17.59 NA 0.43 18.02 NA XXX 95812 .......... ............ A Eeg, 41-60 minutes ..................................... 1.08 3.85 NA 0.17 5.10 NA XXX 95812 .......... 26 ....... A Eeg, 41-60 minutes ..................................... 1.08 0.44 0.44 0.06 1.58 1.58 XXX 95812 .......... TC ...... A Eeg, 41-60 minutes ..................................... 0.00 3.40 NA 0.11 3.51 NA XXX 95813 .......... ............ A Eeg, over 1 hour ......................................... 1.73 4.77 NA 0.20 6.71 NA XXX 95813 .......... 26 ....... A Eeg, over 1 hour ......................................... 1.73 0.68 0.68 0.09 2.50 2.50 XXX 95813 .......... TC ...... A Eeg, over 1 hour ......................................... 0.00 4.09 NA 0.11 4.20 NA XXX 95816 .......... ............ A Eeg, awake and drowsy .............................. 1.08 3.52 NA 0.16 4.77 NA XXX 95816 .......... 26 ....... A Eeg, awake and drowsy .............................. 1.08 0.45 0.45 0.06 1.59 1.59 XXX 95816 .......... TC ...... A Eeg, awake and drowsy .............................. 0.00 3.08 NA 0.10 3.18 NA XXX 95819 .......... ............ A Eeg, awake and asleep ............................... 1.08 3.00 NA 0.16 4.24 NA XXX 95819 .......... 26 ....... A Eeg, awake and asleep ............................... 1.08 0.45 0.45 0.06 1.59 1.59 XXX 95819 .......... TC ...... A Eeg, awake and asleep ............................... 0.00 2.55 NA 0.10 2.65 NA XXX 95822 .......... ............ A Eeg, coma or sleep only ............................. 1.08 4.29 NA 0.19 5.56 NA XXX 95822 .......... 26 ....... A Eeg, coma or sleep only ............................. 1.08 0.45 0.45 0.06 1.59 1.59 XXX 95822 .......... TC ...... A Eeg, coma or sleep only ............................. 0.00 3.84 NA 0.13 3.97 NA XXX 95824 .......... ............ C Eeg, cerebral death only ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95824 .......... 26 ....... A Eeg, cerebral death only ............................. 0.74 0.30 0.30 0.04 1.08 1.08 XXX 95824 .......... TC ...... C Eeg, cerebral death only ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95827 .......... ............ A Eeg, all night recording ............................... 1.08 5.15 NA 0.19 6.42 NA XXX 95827 .......... 26 ....... A Eeg, all night recording ............................... 1.08 0.40 0.40 0.05 1.53 1.53 XXX 95827 .......... TC ...... A Eeg, all night recording ............................... 0.00 4.75 NA 0.14 4.89 NA XXX 95829 .......... ............ A Surgery electrocorticogram ......................... 6.21 28.77 NA 0.50 35.49 NA XXX 95829 .......... 26 ....... A Surgery electrocorticogram ......................... 6.21 2.25 2.25 0.48 8.94 8.94 XXX 95829 .......... TC ...... A Surgery electrocorticogram ......................... 0.00 26.53 NA 0.02 26.55 NA XXX 95830 .......... ............ A Insert electrodes for EEG ............................ 1.70 3.14 0.71 0.11 4.95 2.52 XXX 95831 .......... ............ A Limb muscle testing, manual ...................... 0.28 0.44 NA 0.01 0.73 NA XXX 95832 .......... ............ A Hand muscle testing, manual ...................... 0.29 0.33 NA 0.02 0.64 NA XXX 95833 .......... ............ A Body muscle testing, manual ...................... 0.47 0.56 NA 0.02 1.05 NA XXX 95834 .......... ............ A Body muscle testing, manual ...................... 0.60 0.62 NA 0.03 1.25 NA XXX


## 45994

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

95851 .......... ............ A Range of motion measurements ................. 0.16 0.35 NA 0.01 0.52 NA XXX 95852 .......... ............ A Range of motion measurements ................. 0.11 0.25 NA 0.01 0.37 NA XXX
95857 .......... ............ A Tensilon test ................................................ 0.53 0.59 0.22 0.02 1.14 0.77 XXX 95858 .......... ............ A Tensilon test & myogram ............................ 1.56 NA NA 0.12 NA NA XXX 95858 .......... 26 ....... A Tensilon test & myogram ............................ 1.56 0.65 0.65 0.08 2.30 2.30 XXX 95858 .......... TC ...... A Tensilon test & myogram ............................ 0.00 NA NA 0.04 NA NA XXX 95860 .......... ............ A Muscle test, one limb .................................. 0.96 1.35 NA 0.07 2.38 NA XXX 95860 .......... 26 ....... A Muscle test, one limb .................................. 0.96 0.41 0.41 0.05 1.42 1.42 XXX 95860 .......... TC ...... A Muscle test, one limb .................................. 0.00 0.94 NA 0.02 0.96 NA XXX 95861 .......... ............ A Muscle test, 2 limbs .................................... 1.54 1.47 NA 0.13 3.15 NA XXX 95861 .......... 26 ....... A Muscle test, 2 limbs .................................... 1.54 0.66 0.66 0.07 2.27 2.27 XXX 95861 .......... TC ...... A Muscle test, 2 limbs .................................... 0.00 0.81 NA 0.06 0.87 NA XXX 95863 .......... ............ A Muscle test, 3 limbs .................................... 1.87 1.78 NA 0.15 3.80 NA XXX 95863 .......... 26 ....... A Muscle test, 3 limbs .................................... 1.87 0.78 0.78 0.09 2.74 2.74 XXX 95863 .......... TC ...... A Muscle test, 3 limbs .................................... 0.00 0.99 NA 0.06 1.05 NA XXX 95864 .......... ............ A Muscle test, 4 limbs .................................... 1.99 2.53 NA 0.21 4.73 NA XXX 95864 .......... 26 ....... A Muscle test, 4 limbs .................................... 1.99 0.85 0.85 0.09 2.93 2.93 XXX 95864 .......... TC ...... A Muscle test, 4 limbs .................................... 0.00 1.68 NA 0.12 1.80 NA XXX
95867 .......... ............ A Muscle test cran nerv unilat ........................ 0.79 0.96 NA 0.07 1.82 NA XXX 95867 .......... 26 ....... A Muscle test cran nerv unilat ........................ 0.79 0.34 0.34 0.03 1.16 1.16 XXX 95867 .......... TC ...... A Muscle test cran nerv unilat ........................ 0.00 0.62 NA 0.04 0.66 NA XXX
95868 .......... ............ A Muscle test cran nerve bilat ........................ 1.18 1.26 NA 0.10 2.54 NA XXX 95868 .......... 26 ....... A Muscle test cran nerve bilat ........................ 1.18 0.49 0.49 0.05 1.73 1.73 XXX 95868 .......... TC ...... A Muscle test cran nerve bilat ........................ 0.00 0.77 NA 0.05 0.82 NA XXX 95869 .......... ............ A Muscle test, thor paraspinal ........................ 0.37 0.52 NA 0.04 0.93 NA XXX 95869 .......... 26 ....... A Muscle test, thor paraspinal ........................ 0.37 0.16 0.16 0.02 0.55 0.55 XXX 95869 .......... TC ...... A Muscle test, thor paraspinal ........................ 0.00 0.37 NA 0.02 0.39 NA XXX 95870 .......... ............ A Muscle test, nonparaspinal ......................... 0.37 0.51 NA 0.04 0.92 NA XXX 95870 .......... 26 ....... A Muscle test, nonparaspinal ......................... 0.37 0.16 0.16 0.02 0.55 0.55 XXX 95870 .......... TC ...... A Muscle test, nonparaspinal ......................... 0.00 0.35 NA 0.02 0.37 NA XXX 95872 .......... ............ A Muscle test, one fiber .................................. 1.50 1.28 NA 0.13 2.91 NA XXX 95872 .......... 26 ....... A Muscle test, one fiber .................................. 1.50 0.61 0.61 0.08 2.20 2.20 XXX 95872 .......... TC ...... A Muscle test, one fiber .................................. 0.00 0.66 NA 0.05 0.71 NA XXX
95875 .......... ............ A Limb exercise test ....................................... 1.10 1.40 NA 0.11 2.61 NA XXX 95875 .......... 26 ....... A Limb exercise test ....................................... 1.10 0.46 0.46 0.05 1.61 1.61 XXX 95875 .......... TC ...... A Limb exercise test ....................................... 0.00 0.94 NA 0.06 1.00 NA XXX
95900 .......... ............ A Motor nerve conduction test ........................ 0.42 1.18 NA 0.04 1.64 NA XXX 95900 .......... 26 ....... A Motor nerve conduction test ........................ 0.42 0.18 0.18 0.02 0.62 0.62 XXX 95900 .......... TC ...... A Motor nerve conduction test ........................ 0.00 1.00 NA 0.02 1.02 NA XXX
95903 .......... ............ A Motor nerve conduction test ........................ 0.60 1.14 NA 0.05 1.79 NA XXX 95903 .......... 26 ....... A Motor nerve conduction test ........................ 0.60 0.25 0.25 0.03 0.88 0.88 XXX 95903 .......... TC ...... A Motor nerve conduction test ........................ 0.00 0.89 NA 0.02 0.91 NA XXX 95904 .......... ............ A Sense nerve conduction test ....................... 0.34 1.03 NA 0.04 1.41 NA XXX 95904 .......... 26 ....... A Sense nerve conduction test ....................... 0.34 0.15 0.15 0.02 0.51 0.51 XXX 95904 .......... TC ...... A Sense nerve conduction test ....................... 0.00 0.88 NA 0.02 0.90 NA XXX 95920 .......... ............ A Intraop nerve test add-on ............................ 2.11 2.06 NA 0.23 4.40 NA ZZZ 95920 .......... 26 ....... A Intraop nerve test add-on ............................ 2.11 0.90 0.90 0.16 3.18 3.18 ZZZ 95920 .......... TC ...... A Intraop nerve test add-on ............................ 0.00 1.15 NA 0.07 1.22 NA ZZZ 95921 .......... ............ A Autonomic nerv function test ....................... 0.90 0.79 NA 0.06 1.75 NA XXX 95921 .......... 26 ....... A Autonomic nerv function test ....................... 0.90 0.32 0.32 0.04 1.26 1.26 XXX 95921 .......... TC ...... A Autonomic nerv function test ....................... 0.00 0.47 NA 0.02 0.49 NA XXX 95922 .......... ............ A Autonomic nerv function test ....................... 0.96 0.89 NA 0.07 1.92 NA XXX 95922 .......... 26 ....... A Autonomic nerv function test ....................... 0.96 0.40 0.40 0.05 1.41 1.41 XXX 95922 .......... TC ...... A Autonomic nerv function test ....................... 0.00 0.50 NA 0.02 0.52 NA XXX
95923 .......... ............ A Autonomic nerv function test ....................... 0.90 1.87 NA 0.07 2.84 NA XXX 95923 .......... 26 ....... A Autonomic nerv function test ....................... 0.90 0.37 0.37 0.05 1.32 1.32 XXX 95923 .......... TC ...... A Autonomic nerv function test ....................... 0.00 1.50 NA 0.02 1.52 NA XXX 95925 .......... ............ A *Somatosensory testing .............................. 0.54 1.57 NA 0.10 2.21 NA XXX 95925 .......... 26 ....... A Somatosensory testing ................................ 0.54 0.22 0.22 0.04 0.80 0.80 XXX 95925 .......... TC ...... A Somatosensory testing ................................ 0.00 1.35 NA 0.06 1.41 NA XXX 95926 .......... ............ A *Somatosensory testing .............................. 0.54 1.52 NA 0.09 2.15 NA XXX 95926 .......... 26 ....... A Somatosensory testing ................................ 0.54 0.23 0.23 0.03 0.80 0.80 XXX 95926 .......... TC ...... A Somatosensory testing ................................ 0.00 1.30 NA 0.06 1.36 NA XXX 95927 .......... ............ A Somatosensory testing ................................ 0.54 1.63 NA 0.10 2.27 NA XXX 95927 .......... 26 ....... A Somatosensory testing ................................ 0.54 0.24 0.24 0.04 0.82 0.82 XXX 95927 .......... TC ...... A Somatosensory testing ................................ 0.00 1.39 NA 0.06 1.45 NA XXX 95928 .......... ............ A C motor evoked, uppr limbs ........................ 1.50 3.03 NA 0.09 4.63 NA XXX 95928 .......... 26 ....... A C motor evoked, uppr limbs ........................ 1.50 0.63 0.63 0.06 2.19 2.19 XXX 95928 .......... TC ...... A C motor evoked, uppr limbs ........................ 0.00 2.40 NA 0.03 2.43 NA XXX 95929 .......... ............ A Cmotor evoked, lwr limbs ............................ 1.50 3.23 NA 0.09 4.82 NA XXX 95929 .......... 26 ....... A C motor evoked, lwr limbs .......................... 1.50 0.63 0.63 0.06 2.19 2.19 XXX 95929 .......... TC ...... A C motor evoked, lwr limbs .......................... 0.00 2.60 NA 0.03 2.63 NA XXX 95930 .......... ............ A Visual evoked potential test ........................ 0.35 2.20 NA 0.03 2.59 NA XXX 95930 .......... 26 ....... A Visual evoked potential test ........................ 0.35 0.15 0.15 0.02 0.52 0.52 XXX


## 45995

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

95930 .......... TC ...... A Visual evoked potential test ........................ 0.00 2.06 NA 0.01 2.07 NA XXX 95933 .......... ............ A Blink reflex test ............................................ 0.59 1.02 NA 0.10 1.71 NA XXX 95933 .......... 26 ....... A Blink reflex test ............................................ 0.59 0.23 0.23 0.04 0.86 0.86 XXX 95933 .......... TC ...... A Blink reflex test ............................................ 0.00 0.78 NA 0.06 0.84 NA XXX 95934 .......... ............ A H-reflex test ................................................. 0.51 0.55 NA 0.04 1.10 NA XXX 95934 .......... 26 ....... A H-reflex test ................................................. 0.51 0.22 0.22 0.02 0.75 0.75 XXX 95934 .......... TC ...... A H-reflex test ................................................. 0.00 0.34 NA 0.02 0.36 NA XXX 95936 .......... ............ A H-reflex test ................................................. 0.55 0.48 NA 0.05 1.08 NA XXX 95936 .......... 26 ....... A H-reflex test ................................................. 0.55 0.23 0.23 0.03 0.81 0.81 XXX 95936 .......... TC ...... A H-reflex test ................................................. 0.00 0.25 NA 0.02 0.27 NA XXX 95937 .......... ............ A Neuromuscular junction test ........................ 0.65 0.65 NA 0.10 1.41 NA XXX 95937 .......... 26 ....... A Neuromuscular junction test ........................ 0.65 0.26 0.26 0.08 0.99 0.99 XXX 95937 .......... TC ...... A Neuromuscular junction test ........................ 0.00 0.39 NA 0.02 0.41 NA XXX 95950 .......... ............ A Ambulatory eeg monitoring ......................... 1.51 3.77 NA 0.51 5.79 NA XXX 95950 .......... 26 ....... A Ambulatory eeg monitoring ......................... 1.51 0.62 0.62 0.08 2.22 2.22 XXX 95950 .......... TC ...... A Ambulatory eeg monitoring ......................... 0.00 3.15 NA 0.43 3.58 NA XXX 95951 .......... TC ...... C EEG monitoring/videorecord ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95951 .......... 26 ....... A EEG monitoring/videorecord ....................... 6.00 2.48 2.48 0.32 8.81 8.81 XXX 95951 .......... TC ...... C EEG monitoring/videorecord ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95953 .......... ............ A EEG monitoring/computer ........................... 3.09 7.05 NA 0.60 10.73 NA XXX 95953 .......... 26 ....... A EEG monitoring/computer ........................... 3.09 1.25 1.25 0.17 4.51 4.51 XXX 95953 .......... TC ...... A EEG monitoring/computer ........................... 0.00 5.79 NA 0.43 6.22 NA XXX 95954 .......... ............ A EEG monitoring/giving drugs ...................... 2.45 4.19 NA 0.19 6.83 NA XXX 95954 .......... 26 ....... A EEG monitoring/giving drugs ...................... 2.45 1.01 1.01 0.13 3.60 3.60 XXX 95954 .......... TC ...... A EEG monitoring/giving drugs ...................... 0.00 3.17 NA 0.06 3.23 NA XXX 95955 .......... ............ A EEG during surgery ..................................... 1.01 2.70 NA 0.22 3.93 NA XXX 95955 .......... 26 ....... A EEG during surgery ..................................... 1.01 0.35 0.35 0.05 1.41 1.41 XXX 95955 .......... TC ...... A EEG during surgery ..................................... 0.00 2.34 NA 0.17 2.51 NA XXX 95956 .......... TC ...... A Eeg monitoring, cable/radio ........................ 3.09 14.65 NA 0.59 18.33 NA XXX 95956 .......... 26 ....... A Eeg monitoring, cable/radio ........................ 3.09 1.27 1.27 0.16 4.51 4.51 XXX 95956 .......... TC ...... A Eeg monitoring, cable/radio ........................ 0.00 13.38 NA 0.43 13.81 NA XXX 95957 .......... ............ A EEG digital analysis .................................... 1.98 3.19 NA 0.23 5.41 NA XXX 95957 .......... 26 ....... A EEG digital analysis .................................... 1.98 0.83 0.83 0.11 2.92 2.92 XXX 95957 .......... TC ...... A EEG digital analysis .................................... 0.00 2.36 NA 0.12 2.48 NA XXX 95958 .......... ............ A EEG monitoring/function test ...................... 4.25 3.95 NA 0.34 8.54 NA XXX 95958 .......... 26 ....... A EEG monitoring/function test ...................... 4.25 1.71 1.71 0.21 6.17 6.17 XXX 95958 .......... TC ...... A EEG monitoring/function test ...................... 0.00 2.24 NA 0.13 2.37 NA XXX 95961 .......... ............ A Electrode stimulation, brain ......................... 2.98 2.76 NA 0.55 6.28 NA XXX 95961 .......... 26 ....... A Electrode stimulation, brain ......................... 2.98 1.29 1.29 0.48 4.74 4.74 XXX 95961 .......... TC ...... A Electrode stimulation, brain ......................... 0.00 1.47 NA 0.07 1.54 NA XXX 95962 .......... ............ A Electrode stim, brain add-on ....................... 3.22 2.58 NA 0.39 6.18 NA ZZZ 95962 .......... 26 ....... A Electrode stim, brain add-on ....................... 3.22 1.36 1.36 0.32 4.89 4.89 ZZZ 95962 .......... TC ...... A Electrode stim, brain add-on ....................... 0.00 1.22 NA 0.07 1.29 NA ZZZ 95965 .......... ............ C Meg, spontaneous ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95965 .......... 26 ....... A Meg, spontaneous ....................................... 8.01 3.36 3.36 0.46 11.83 11.83 XXX 95965 .......... TC ...... C Meg, spontaneous ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95966 .......... ............ C Meg, evoked, single .................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95966 .......... 26 ....... A Meg, evoked, single .................................... 4.00 1.67 1.67 0.19 5.85 5.85 XXX 95966 .......... TC ...... C Meg, evoked, single .................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95967 .......... ............ C Meg, evoked, each add ’ l ............................. 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 95967 .......... 26 ....... A Meg, evoked, each add ’ l ............................. 3.50 1.23 1.23 0.16 4.89 4.89 ZZZ 95967 .......... TC ...... C Meg, evoked, each add ’ l ............................. 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 95970 .......... ............ A Analyze neurostim, no prog ........................ 0.45 0.84 0.14 0.03 1.32 0.62 XXX 95971 .......... ............ A Analyze neurostim, simple .......................... 0.78 0.67 0.22 0.07 1.53 1.07 XXX 95972 .......... ............ A Analyze neurostim, complex ....................... 1.50 1.21 0.48 0.14 2.85 2.13 XXX 95973 .......... ............ A Analyze neurostim, complex ....................... 0.92 0.62 0.33 0.07 1.61 1.32 ZZZ 95974 .......... ............ A Cranial neurostim, complex ......................... 3.01 1.68 1.27 0.16 4.85 4.43 XXX 95975 .......... ............ A Cranial neurostim, complex ......................... 1.70 0.88 0.71 0.12 2.70 2.53 ZZZ 95978 .......... ............ A Analyze neurostim brain/1h ......................... 3.51 1.96 1.32 0.18 5.65 5.00 XXX 95979 .......... ............ A Analyz neurostim brain add-on ................... 1.64 0.86 0.67 0.08 2.58 2.39 ZZZ 95990 .......... ............ A Spin/brain pump refil & main ....................... 0.00 1.53 NA 0.06 1.59 NA XXX 95991 .......... ............ A Spin/brain pump refil & main ....................... 0.77 1.38 NA 0.06 2.21 NA XXX 95999 .......... ............ C Neurological procedure ............................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 96000 .......... ............ A Motion analysis, video/3d ............................ 1.80 NA 0.52 0.11 NA 2.43 XXX 96001 .......... ............ A Motion test w/ft press meas ........................ 2.15 NA 0.64 0.10 NA 2.90 XXX 96002 .......... ............ A Dynamic surface emg ................................. 0.41 NA 0.15 0.02 NA 0.58 XXX 96003 .......... ............ A Dynamic fine wire emg ................................ 0.37 NA 0.13 0.02 NA 0.52 XXX 96004 .......... ............ A Phys review of motion tests ........................ 2.14 0.96 0.89 0.11 3.21 3.15 XXX 96100 .......... ............ A Psychological testing ................................... 0.00 1.74 NA 0.18 1.92 NA XXX 96105 .......... ............ A Assessment of aphasia ............................... 0.00 1.64 NA 0.18 1.82 NA XXX 96110 .......... ............ A Developmental test, lim ............................... 0.00 0.17 NA 0.18 0.35 NA XXX 96111 .......... ............ A Developmental test, extend ......................... 2.61 1.01 0.99 0.18 3.79 3.78 XXX
96115 .......... ............ A Neurobehavior status exam ........................ 0.00 1.82 NA 0.18 2.00 NA XXX 96117 .......... ............ A Neuropsych test battery .............................. 0.00 1.78 NA 0.18 1.96 NA XXX


## 45996

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

96150 .......... ............ A Assess hlth/behave, init .............................. 0.50 0.17 0.17 0.01 0.68 0.68 XXX 96151 .......... ............ A Assess hlth/behave, subseq ....................... 0.48 0.17 0.16 0.01 0.66 0.65 XXX 96152 .......... ............ A Intervene hlth/behave, indiv ........................ 0.46 0.16 0.15 0.01 0.63 0.62 XXX 96153 .......... ............ A Intervene hlth/behave, group ...................... 0.10 0.04 0.03 0.01 0.15 0.14 XXX 96154 .......... ............ A Interv hlth/behav, fam w/pt .......................... 0.45 0.16 0.15 0.01 0.62 0.61 XXX 96155 .......... ............ N Interv hlth/behav fam no pt ......................... 0.44 0.17 0.16 0.02 0.63 0.62 XXX 96400 .......... ............ I Chemotherapy, sc/im .................................. 0.17 0.00 0.00 0.01 0.18 0.18 XXX
96405 .......... ............ A Intralesional chemo admin .......................... 0.52 2.58 0.24 0.03 3.13 0.79 000 96406 .......... ............ A Intralesional chemo admin .......................... 0.80 3.20 0.29 0.03 4.03 1.12 000 96408 .......... ............ I Chemotherapy, push technique .................. 0.17 0.00 0.00 0.06 0.23 0.23 XXX 96410 .......... ............ I Chemotherapy,infusion method .................. 0.17 0.00 0.00 0.08 0.25 0.25 XXX 96412 .......... ............ I Chemo, infuse method add-on .................... 0.17 0.00 0.00 0.07 0.24 0.24 ZZZ 96414 .......... ............ I Chemo, infuse method add-on .................... 0.17 0.00 0.00 0.08 0.25 0.25 XXX 96420 .......... ............ A Chemotherapy, push technique .................. 0.17 2.67 NA 0.08 2.92 NA XXX 96422 .......... ............ A Chemotherapy,infusion method .................. 0.17 4.87 NA 0.08 5.12 NA XXX 96423 .......... ............ A Chemo, infuse method add-on .................... 0.17 1.89 NA 0.02 2.08 NA ZZZ 96425 .......... ............ A Chemotherapy,infusion method .................. 0.17 4.50 NA 0.08 4.75 NA XXX 96440 .......... ............ A Chemotherapy, intracavitary ....................... 2.37 7.56 1.20 0.17 10.10 3.74 000 96445 .......... ............ A Chemotherapy, intracavitary ....................... 2.20 7.64 1.15 0.14 9.99 3.50 000 96450 .......... ............ A Chemotherapy, into CNS ............................ 1.89 6.62 1.07 0.08 8.59 3.04 000 96520 .......... ............ A Port pump refill & main ............................... 0.21 3.79 NA 0.06 4.06 NA XXX 96530 .......... ............ A Syst pump refill & main ............................... 0.21 2.66 NA 0.06 2.93 NA XXX 96542 .......... ............ A Chemotherapy injection ............................... 1.42 4.09 0.64 0.06 5.57 2.12 XXX 96545 .......... ............ B Provide chemotherapy agent ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 96549 .......... ............ C Chemotherapy, unspecified ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 96567 .......... ............ A Photodynamic tx, skin ................................. 0.00 1.45 NA 0.04 1.49 NA XXX 96570 .......... ............ A Photodynamic tx, 30 min ............................. 1.10 0.00 0.37 0.11 1.21 1.58 ZZZ 96571 .......... ............ A Photodynamic tx, addl 15 min ..................... 0.55 0.00 0.20 0.03 0.58 0.78 ZZZ 96900 .......... ............ A Ultraviolet light therapy ................................ 0.00 0.45 NA 0.02 0.47 NA XXX 96902 .......... ............ B Trichogram .................................................. 0.41 0.18 0.16 0.01 0.60 0.58 XXX 96910 .......... ............ A Photochemotherapy with UV-B ................... 0.00 1.13 NA 0.04 1.17 NA XXX 96912 .......... ............ A Photochemotherapy with UV-A ................... 0.00 1.45 NA 0.05 1.50 NA XXX 96913 .......... ............ A Photochemotherapy, UV-A or B .................. 0.00 1.97 NA 0.10 2.07 NA XXX 96920 .......... ............ A Laser tx, skin < 250 sq cm .......................... 1.15 2.91 0.61 0.02 4.08 1.78 000 96921 .......... ............ A Laser tx, skin 250-500 sq cm ...................... 1.17 3.00 0.63 0.03 4.21 1.83 000 96922 .......... ............ A Laser tx, skin > 500 sq cm .......................... 2.10 3.96 0.60 0.04 6.10 2.75 000 96999 .......... ............ C Dermatological procedure ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
97001 .......... ............ A Pt evaluation ................................................ 1.20 0.75 NA 0.05 2.00 NA XXX 97002 .......... ............ A Pt re-evaluation ........................................... 0.60 0.44 NA 0.02 1.06 NA XXX 97003 .......... ............ A Ot evaluation ............................................... 1.20 0.86 NA 0.06 2.12 NA XXX 97004 .......... ............ A Ot re-evaluation ........................................... 0.60 0.64 NA 0.02 1.26 NA XXX
97005 .......... ............ I Athletic train eval ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97006 .......... ............ I Athletic train reeval ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97010 .......... ............ B Hot or cold packs therapy ........................... 0.06 0.06 NA 0.01 0.13 NA XXX 97012 .......... ............ A Mechanical traction therapy ........................ 0.25 0.14 NA 0.01 0.40 NA XXX 97014 .......... ............ I Electric stimulation therapy ......................... 0.18 0.19 NA 0.01 0.38 NA XXX 97016 .......... ............ A Vasopneumatic device therapy ................... 0.18 0.19 NA 0.01 0.38 NA XXX 97018 .......... ............ A Paraffin bath therapy ................................... 0.06 0.11 NA 0.01 0.18 NA XXX 97020 .......... ............ A Microwave therapy ...................................... 0.06 0.06 NA 0.01 0.13 NA XXX 97022 .......... ............ A Whirlpool therapy ........................................ 0.17 0.23 NA 0.01 0.41 NA XXX 97024 .......... ............ A Diathermy treatment .................................... 0.06 0.07 NA 0.01 0.14 NA XXX 97026 .......... ............ A Infrared therapy ........................................... 0.06 0.06 NA 0.01 0.13 NA XXX 97028 .......... ............ A Ultraviolet therapy ....................................... 0.08 0.07 NA 0.01 0.16 NA XXX
97032 .......... ............ A Electrical stimulation .................................... 0.25 0.17 NA 0.01 0.43 NA XXX 97033 .......... ............ A Electric current therapy ............................... 0.26 0.30 NA 0.01 0.57 NA XXX 97034 .......... ............ A Contrast bath therapy .................................. 0.21 0.16 NA 0.01 0.38 NA XXX 97035 .......... ............ A Ultrasound therapy ...................................... 0.21 0.10 NA 0.01 0.32 NA XXX 97036 .......... ............ A Hydrotherapy ............................................... 0.28 0.34 NA 0.01 0.63 NA XXX 97039 .......... ............ C Physical therapy treatment .......................... 0.20 0.10 NA 0.01 0.31 NA XXX 97110 .......... ............ A Therapeutic exercises ................................. 0.45 0.28 NA 0.02 0.75 NA XXX
97112 .......... ............ A Neuromuscular reeducation ........................ 0.45 0.32 NA 0.01 0.78 NA XXX 97113 .......... ............ A Aquatic therapy/exercises ........................... 0.44 0.42 NA 0.01 0.87 NA XXX 97116 .......... ............ A Gait training therapy .................................... 0.40 0.25 NA 0.01 0.66 NA XXX 97124 .......... ............ A Massage therapy ......................................... 0.35 0.24 NA 0.01 0.60 NA XXX 97139 .......... ............ C Physical medicine procedure ...................... 0.21 0.21 NA 0.01 0.43 NA XXX 97140 .......... ............ A Manual therapy ............................................ 0.43 0.26 NA 0.01 0.70 NA XXX 97150 .......... ............ A Group therapeutic procedures .................... 0.27 0.19 NA 0.01 0.47 NA XXX 97504 .......... ............ A Orthotic training ........................................... 0.45 0.35 NA 0.03 0.83 NA XXX 97520 .......... ............ A Prosthetic training ........................................ 0.45 0.28 NA 0.01 0.74 NA XXX 97530 .......... ............ A Therapeutic activities ................................... 0.44 0.33 NA 0.01 0.78 NA XXX 97532 .......... ............ A Cognitive skills development ....................... 0.44 0.21 NA 0.01 0.66 NA XXX 97533 .......... ............ A Sensory integration ..................................... 0.44 0.25 NA 0.01 0.70 NA XXX 97535 .......... ............ A Self care mngment training ......................... 0.45 0.34 NA 0.01 0.80 NA XXX 97537 .......... ............ A Community/work reintegration ..................... 0.45 0.27 NA 0.01 0.73 NA XXX


## 45997

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

97542 .......... ............ A Wheelchair mngment training ..................... 0.45 0.29 NA 0.01 0.75 NA XXX 97545 .......... ............ R Work hardening ........................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97546 .......... ............ R Work hardening add-on ............................... 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 97597 .......... ............ A Active wound care/20 cm or < .................... 0.58 0.74 NA 0.05 1.37 NA XXX
97598 .......... ............ A Active wound care > 20 cm ........................ 0.80 0.88 NA 0.05 1.73 NA XXX 97602 .......... ............ B Wound(s) care non-selective ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97605 .......... ............ B Neg press wound tx, < 50 cm ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97606 .......... ............ B Neg press wound tx, > 50 cm ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97703 .......... ............ A Prosthetic checkout ..................................... 0.25 0.47 NA 0.02 0.74 NA XXX 97750 .......... ............ A Physical performance test ........................... 0.45 0.33 NA 0.02 0.80 NA XXX 97755 .......... ............ A Assistive technology assess ....................... 0.62 0.29 NA 0.02 0.93 NA XXX 97799 .......... ............ C Physical medicine procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97802 .......... ............ A Medical nutrition, indiv, in ............................ 0.00 0.43 NA 0.01 0.44 NA XXX 97803 .......... ............ A Med nutrition, indiv, subseq ........................ 0.00 0.42 NA 0.01 0.43 NA XXX 97804 .......... ............ A Medical nutrition, group ............................... 0.00 0.16 NA 0.01 0.17 NA XXX 97810 .......... ............ N Acupunct w/o stimul 15 min ........................ 0.60 0.09 0.06 0.03 0.72 0.69 XXX 97811 .......... ............ N Acupunct w/o stimul addl 15m .................... 0.50 0.06 0.05 0.03 0.59 0.58 ZZZ 97813 .......... ............ N Acupunct w/stimul 15 min ........................... 0.65 0.09 0.06 0.03 0.77 0.74 XXX 97814 .......... ............ N Acupunct w/stimul addl 15m ....................... 0.55 0.07 0.05 0.03 0.65 0.63 ZZZ 98925 .......... ............ A Osteopathic manipulation ............................ 0.45 0.31 0.14 0.02 0.78 0.61 000 98926 .......... ............ A Osteopathic manipulation ............................ 0.65 0.40 0.24 0.03 1.08 0.92 000 98927 .......... ............ A Osteopathic manipulation ............................ 0.87 0.49 0.28 0.03 1.40 1.18 000 98928 .......... ............ A Osteopathic manipulation ............................ 1.03 0.58 0.33 0.04 1.65 1.41 000 98929 .......... ............ A Osteopathic manipulation ............................ 1.19 0.66 0.36 0.05 1.90 1.60 000 98940 .......... ............ A Chiropractic manipulation ............................ 0.45 0.22 0.12 0.01 0.68 0.58 000 98941 .......... ............ A Chiropractic manipulation ............................ 0.65 0.29 0.17 0.01 0.95 0.83 000 98942 .......... ............ A Chiropractic manipulation ............................ 0.87 0.35 0.23 0.02 1.24 1.12 000 98943 .......... ............ N Chiropractic manipulation ............................ 0.40 0.24 0.16 0.01 0.65 0.57 XXX 99000 .......... ............ B Specimen handling ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99001 .......... ............ B Specimen handling ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99002 .......... ............ B Device handling ........................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99024 .......... ............ B Postop follow-up visit .................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99026 .......... ............ N In-hospital on call service ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99027 .......... ............ N Out-of-hosp on call service ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99050 .......... ............ B Medical services after hrs ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99052 .......... ............ B Medical services at night ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99054 .......... ............ B Medical servcs, unusual hrs ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99056 .......... ............ B Non-office medical services ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99058 .......... ............ B Office emergency care ................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99070 .......... ............ B Special supplies .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99071 .......... ............ B Patient education materials ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99075 .......... ............ N Medical testimony ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99078 .......... ............ B Group health education ............................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99080 .......... ............ B Special reports or forms .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99082 .......... ............ C Unusual physician travel ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99090 .......... ............ B Computer data analysis .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99091 .......... ............ B Collect/review data from pt ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99100 .......... ............ B Special anesthesia service .......................... 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99116 .......... ............ B Anesthesia with hypothermia ...................... 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99135 .......... ............ B Special anesthesia procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99140 .......... ............ B Emergency anesthesia ................................ 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99141 .......... ............ B Sedation, iv/im or inhalant ........................... 0.80 1.84 0.38 0.05 2.69 1.23 XXX 99142 .......... ............ B Sedation, oral/rectal/nasal ........................... 0.60 0.94 0.30 0.04 1.59 0.94 XXX 99170 .......... ............ A Anogenitalexam, child ................................. 1.75 1.71 0.55 0.08 3.55 2.38 000 99172 .......... ............ N Ocular function screen ................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99173 .......... ............ N Visual acuity screen .................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99175 .......... ............ A Induction of vomiting ................................... 0.00 1.16 NA 0.10 1.26 NA XXX 99183 .......... ............ A Hyperbaric oxygen therapy ......................... 2.34 3.09 0.70 0.16 5.60 3.21 XXX 99185 .......... ............ A Regional hypothermia ................................. 0.00 0.82 NA 0.04 0.86 NA XXX 99186 .......... ............ A Total body hypothermia ............................... 0.00 1.62 NA 0.45 2.07 NA XXX 99195 .......... ............ A Phlebotomy .................................................. 0.00 0.88 NA 0.02 0.90 NA XXX 99199 .......... ............ C Special service/proc/report .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99201 .......... ............ A Office/outpatient visit, new .......................... 0.45 0.51 0.15 0.03 0.99 0.63 XXX 99202 .......... ............ A Office/outpatient visit, new .......................... 0.88 0.81 0.31 0.05 1.74 1.24 XXX 99203 .......... ............ A Office/outpatient visit, new .......................... 1.34 1.14 0.47 0.09 2.57 1.91 XXX 99204 .......... ............ A Office/outpatient visit, new .......................... 2.00 1.51 0.70 0.12 3.63 2.82 XXX 99205 .......... ............ A Office/outpatient visit, new .......................... 2.68 1.78 0.93 0.15 4.61 3.76 XXX 99211 .......... ............ A Office/outpatient visit, est ............................ 0.17 0.38 0.06 0.01 0.56 0.24 XXX 99212 .......... ............ A Office/outpatient visit, est ............................ 0.45 0.55 0.16 0.03 1.03 0.64 XXX 99213 .......... ............ A Office/outpatient visit, est ............................ 0.67 0.70 0.24 0.03 1.40 0.94 XXX 99214 .......... ............ A Office/outpatient visit, est ............................ 1.10 1.04 0.40 0.05 2.20 1.55 XXX 99215 .......... ............ A Office/outpatient visit, est ............................ 1.77 1.33 0.64 0.08 3.18 2.49 XXX 99217 .......... ............ A Observation care discharge ........................ 1.28 NA 0.54 0.06 NA 1.88 XXX 99218 .......... ............ A Observation care ......................................... 1.28 NA 0.43 0.06 NA 1.78 XXX


## 45998

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

99219 .......... ............ A Observation care ......................................... 2.14 NA 0.71 0.10 NA 2.95 XXX 99220 .......... ............ A Observation care ......................................... 3.00 NA 1.02 0.14 NA 4.16 XXX 99221 .......... ............ A Initial hospital care ...................................... 1.28 NA 0.44 0.07 NA 1.80 XXX 99222 .......... ............ A Initial hospital care ...................................... 2.14 NA 0.73 0.10 NA 2.97 XXX 99223 .......... ............ A Initial hospital care ...................................... 3.00 NA 1.02 0.13 NA 4.15 XXX 99231 .......... ............ A Subsequent hospital care ............................ 0.64 NA 0.23 0.03 NA 0.90 XXX 99232 .......... ............ A Subsequent hospital care ............................ 1.06 NA 0.37 0.04 NA 1.47 XXX 99233 .......... ............ A Subsequent hospital care ............................ 1.51 NA 0.52 0.06 NA 2.09 XXX 99234 .......... ............ A Observ/hosp same date .............................. 2.57 NA 0.88 0.13 NA 3.58 XXX 99235 .......... ............ A Observ/hosp same date .............................. 3.42 NA 1.14 0.16 NA 4.71 XXX 99236 .......... ............ A Observ/hosp same date .............................. 4.27 NA 1.43 0.19 NA 5.89 XXX 99238 .......... ............ A Hospital discharge day ................................ 1.28 NA 0.54 0.05 NA 1.87 XXX 99239 .......... ............ A Hospital discharge day ................................ 1.75 NA 0.73 0.07 NA 2.55 XXX 99241 .......... ............ A Office consultation ....................................... 0.64 0.65 NA 0.05 1.34 NA XXX 99242 .......... ............ A Office consultation ....................................... 1.29 1.07 NA 0.10 2.46 NA XXX 99243 .......... ............ A Office consultation ....................................... 1.72 1.42 NA 0.13 3.27 NA XXX 99244 .......... ............ A Office consultation ....................................... 2.59 1.85 NA 0.16 4.60 NA XXX 99245 .......... ............ A Office consultation ....................................... 3.43 2.29 NA 0.21 5.93 NA XXX 99251 .......... ............ A Initial inpatient consult ................................. 0.66 NA 0.24 0.05 NA 0.95 XXX 99252 .......... ............ A Initial inpatient consult ................................. 1.32 NA 0.50 0.09 NA 1.92 XXX 99253 .......... ............ A Initial inpatient consult ................................. 1.82 NA 0.69 0.11 NA 2.62 XXX 99254 .......... ............ A Initial inpatient consult ................................. 2.65 NA 0.98 0.13 NA 3.76 XXX 99255 .......... ............ A Initial inpatient consult ................................. 3.65 NA 1.35 0.18 NA 5.17 XXX 99261 .......... ............ A Follow-up inpatient consult .......................... 0.42 NA 0.15 0.02 NA 0.59 XXX 99262 .......... ............ A Follow-up inpatient consult .......................... 0.85 NA 0.31 0.04 NA 1.20 XXX 99263 .......... ............ A Follow-up inpatient consult .......................... 1.27 NA 0.45 0.06 NA 1.78 XXX 99271 .......... ............ A Confirmatory consultation ............................ 0.45 0.55 0.16 0.03 1.03 0.64 XXX 99272 .......... ............ A Confirmatory consultation ............................ 0.84 0.84 0.31 0.06 1.74 1.21 XXX 99273 .......... ............ A Confirmatory consultation ............................ 1.19 1.11 0.45 0.10 2.40 1.74 XXX 99274 .......... ............ A Confirmatory consultation ............................ 1.73 1.37 0.64 0.12 3.22 2.49 XXX 99275 .......... ............ A Confirmatory consultation ............................ 2.31 1.65 0.83 0.15 4.12 3.30 XXX 99281 .......... ............ A Emergency dept visit ................................... 0.33 NA 0.09 0.02 NA 0.44 XXX 99282 .......... ............ A Emergency dept visit ................................... 0.55 NA 0.14 0.04 NA 0.73 XXX 99283 .......... ............ A Emergency dept visit ................................... 1.24 NA 0.30 0.09 NA 1.64 XXX 99284 .......... ............ A Emergency dept visit ................................... 1.95 NA 0.46 0.14 NA 2.55 XXX 99285 .......... ............ A Emergency dept visit ................................... 3.07 NA 0.70 0.23 NA 4.00 XXX 99288 .......... ............ B Direct advanced life support ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99289 .......... ............ A Ped crit care transport ................................. 4.80 NA 1.42 0.24 NA 6.45 XXX 99290 .......... ............ A Ped crit care transport addl ......................... 2.40 NA 0.81 0.12 NA 3.34 ZZZ 99291 .......... ............ A Critical care, first hour ................................. 4.00 2.52 1.26 0.21 6.73 5.47 XXX 99292 .......... ............ A Critical care, addl 30 min ............................ 2.00 0.89 0.63 0.11 3.01 2.75 ZZZ 99293 .......... ............ A Ped critical care, initial ................................ 16.01 NA 4.66 1.12 NA 21.80 XXX 99294 .......... ............ A Ped critical care, subseq ............................. 8.01 NA 2.35 0.45 NA 10.81 XXX 99295 .......... ............ A Neonate crit care, initial .............................. 18.50 NA 5.27 1.16 NA 24.93 XXX 99296 .......... ............ A Neonate critical care subseq ....................... 8.01 NA 2.47 0.32 NA 10.80 XXX 99298 .......... ............ A Ic for lbw infant < 1500 gm ......................... 2.76 NA 0.92 0.17 NA 3.85 XXX 99299 .......... ............ A Ic, lbw infant 1500-2500 gm ........................ 2.51 NA 0.84 0.16 NA 3.51 XXX 99301 .......... ............ A Nursing facility care ..................................... 1.20 0.50 0.50 0.05 1.75 1.75 XXX 99302 .......... ............ A Nursing facility care ..................................... 1.61 0.63 0.63 0.07 2.32 2.32 XXX 99303 .......... ............ A Nursing facility care ..................................... 2.01 0.75 0.75 0.08 2.84 2.84 XXX 99311 .......... ............ A Nursing fac care, subseq ............................ 0.60 0.27 0.27 0.03 0.90 0.90 XXX 99312 .......... ............ A Nursing fac care, subseq ............................ 1.00 0.45 0.45 0.04 1.49 1.49 XXX 99313 .......... ............ A Nursing fac care, subseq ............................ 1.42 0.62 0.62 0.06 2.10 2.10 XXX 99315 .......... ............ A Nursing fac discharge day .......................... 1.13 0.45 0.45 0.05 1.63 1.63 XXX 99316 .......... ............ A Nursing fac discharge day .......................... 1.50 0.58 0.58 0.06 2.14 2.14 XXX 99321 .......... ............ A Rest home visit, new patient ....................... 0.71 0.34 0.32 0.03 1.08 1.06 XXX 99322 .......... ............ A Rest home visit, new patient ....................... 1.01 0.45 0.44 0.05 1.52 1.50 XXX 99323 .......... ............ A Rest home visit, new patient ....................... 1.28 0.54 0.52 0.05 1.87 1.85 XXX 99331 .......... ............ A Rest home visit, est pat .............................. 0.60 0.31 0.29 0.03 0.94 0.92 XXX 99332 .......... ............ A Rest home visit, est pat .............................. 0.80 0.37 0.35 0.03 1.20 1.18 XXX 99333 .......... ............ A Rest home visit, est pat .............................. 1.00 0.45 0.43 0.04 1.49 1.47 XXX 99341 .......... ............ A Home visit, new patient ............................... 1.01 0.48 0.45 0.05 1.54 1.52 XXX 99342 .......... ............ A Home visit, new patient ............................... 1.52 0.67 0.65 0.07 2.27 2.24 XXX 99343 .......... ............ A Home visit, new patient ............................... 2.27 0.92 0.90 0.10 3.30 3.27 XXX 99344 .......... ............ A Home visit, new patient ............................... 3.04 1.15 1.13 0.13 4.32 4.29 XXX 99345 .......... ............ A Home visit, new patient ............................... 3.79 1.40 1.37 0.16 5.34 5.32 XXX 99347 .......... ............ A Home visit, est patient ................................. 0.76 0.40 0.37 0.04 1.20 1.17 XXX 99348 .......... ............ A Home visit, est patient ................................. 1.26 0.57 0.54 0.06 1.89 1.87 XXX 99349 .......... ............ A Home visit, est patient ................................. 2.02 0.81 0.79 0.09 2.93 2.90 XXX 99350 .......... ............ A Home visit, est patient ................................. 3.04 1.15 1.12 0.13 4.32 4.29 XXX 99354 .......... ............ A Prolonged service, office ............................. 1.77 0.77 0.65 0.08 2.63 2.50 ZZZ 99355 .......... ............ A Prolonged service, office ............................. 1.77 0.75 0.61 0.07 2.59 2.45 ZZZ 99356 .......... ............ A Prolonged service, inpatient ........................ 1.71 NA 0.61 0.07 NA 2.39 ZZZ 99357 .......... ............ A Prolonged service, inpatient ........................ 1.71 NA 0.62 0.08 NA 2.42 ZZZ


## 45999

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

99358 .......... ............ B Prolonged serv, w/o contact ........................ 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99359 .......... ............ B Prolonged serv, w/o contact ........................ 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99361 .......... ............ B Physician/team conference ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99362 .......... ............ B Physician/team conference ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99371 .......... ............ B Physician phone consultation ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99372 .......... ............ B Physician phone consultation ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99373 .......... ............ B Physician phone consultation ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99374 .......... ............ B Home health care supervision .................... 1.10 0.70 0.42 0.05 1.85 1.57 XXX 99375 .......... ............ I Home health care supervision .................... 1.73 0.00 0.00 0.07 1.80 1.80 XXX 99377 .......... ............ B Hospice care supervision ............................ 1.10 0.70 0.42 0.05 1.85 1.57 XXX 99378 .......... ............ I Hospice care supervision ............................ 1.73 0.00 0.00 0.07 1.80 1.80 XXX 99379 .......... ............ B Nursing fac care supervision ....................... 1.10 0.70 0.42 0.04 1.84 1.56 XXX 99380 .......... ............ B Nursing fac care supervision ....................... 1.73 0.99 0.66 0.06 2.79 2.45 XXX 99381 .......... ............ N Prev visit, new, infant .................................. 1.19 1.42 0.45 0.05 2.67 1.69 XXX 99382 .......... ............ N Prev visit, new, age 1-4 .............................. 1.36 1.47 0.52 0.05 2.88 1.93 XXX 99383 .......... ............ N Prev visit, new, age 5-11 ............................ 1.36 1.42 0.52 0.05 2.83 1.93 XXX 99384 .......... ............ N Prev visit, new, age 12-17 .......................... 1.53 1.49 0.59 0.06 3.08 2.18 XXX 99385 .......... ............ N Prev visit, new, age 18-39 .......................... 1.53 1.49 0.59 0.06 3.08 2.18 XXX 99386 .......... ............ N Prev visit, new, age 40-64 .......................... 1.88 1.66 0.72 0.07 3.62 2.67 XXX 99387 .......... ............ N Prev visit, new, 65 & over ........................... 2.06 1.80 0.78 0.07 3.94 2.92 XXX 99391 .......... ............ N Prev visit, est, infant .................................... 1.02 1.02 0.39 0.04 2.08 1.45 XXX 99392 .......... ............ N Prev visit, est, age 1-4 ................................ 1.19 1.09 0.45 0.05 2.33 1.69 XXX 99393 .......... ............ N Prev visit, est, age 5-11 .............................. 1.19 1.07 0.45 0.05 2.31 1.69 XXX 99394 .......... ............ N Prev visit, est, age 12-17 ............................ 1.36 1.13 0.52 0.05 2.55 1.93 XXX 99395 .......... ............ N Prev visit, est, age 18-39 ............................ 1.36 1.16 0.52 0.05 2.57 1.93 XXX 99396 .......... ............ N Prev visit, est, age 40-64 ............................ 1.53 1.24 0.59 0.06 2.83 2.18 XXX 99397 .......... ............ N Prev visit, est, 65 & over ............................. 1.71 1.37 0.65 0.06 3.14 2.43 XXX 99401 .......... ............ N Preventive counseling, indiv ........................ 0.48 0.58 0.19 0.01 1.07 0.68 XXX 99402 .......... ............ N Preventive counseling, indiv ........................ 0.98 0.81 0.37 0.02 1.81 1.37 XXX 99403 .......... ............ N Preventive counseling, indiv ........................ 1.46 1.02 0.56 0.04 2.52 2.06 XXX 99404 .......... ............ N Preventive counseling, indiv ........................ 1.95 1.24 0.74 0.05 3.24 2.75 XXX 99411 .......... ............ N Preventive counseling, group ...................... 0.15 0.20 0.06 0.01 0.36 0.22 XXX 99412 .......... ............ N Preventive counseling, group ...................... 0.25 0.26 0.10 0.01 0.52 0.36 XXX 99420 .......... ............ N Health risk assessment test ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99429 .......... ............ N Unlisted preventive service ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99431 .......... ............ A Initial care, normal newborn ........................ 1.17 0.00 0.37 0.05 1.22 1.59 XXX 99432 .......... ............ A Newborn care, not in hosp .......................... 1.26 1.01 NA 0.07 2.34 NA XXX 99433 .......... ............ A Normal newborn care/hospital .................... 0.62 NA 0.19 0.02 NA 0.83 XXX 99435 .......... ............ A Newborn discharge day hosp ..................... 1.50 NA 0.59 0.06 NA 2.15 XXX 99436 .......... ............ A Attendance, birth ......................................... 1.50 NA 0.46 0.06 NA 2.02 XXX 99440 .......... ............ A Newborn resuscitation ................................. 2.94 NA 0.91 0.12 NA 3.96 XXX 99450 .......... ............ N Life/disability evaluation .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99455 .......... ............ R Disability examination .................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99456 .......... ............ R Disability examination .................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99499 .......... ............ C Unlisted e&m service .................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99500 .......... ............ I Home visit, prenatal .................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99501 .......... ............ I Home visit, postnatal ................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99502 .......... ............ I Home visit, nb care ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99503 .......... ............ I Home visit, resp therapy ............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99504 .......... ............ I Home visit mech ventilator .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99505 .......... ............ I Home visit, stoma care ............................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99506 .......... ............ I Home visit, im injection ............................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99507 .......... ............ I Home visit, cath maintain ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99509 .......... ............ I Home visit day life activity ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99510 .......... ............ I Home visit, sing/m/fam couns ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99511 .......... ............ I Home visit, fecal/enema mgmt .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99512 .......... ............ I Home visit for hemodialysis ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX
99600 .......... ............ I Home visit nos ............................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99601 .......... ............ I Home infusion/visit, 2 hrs ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99602 .......... ............ I Home infusion, each addtl hr ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX A4890 ......... ............ R Repair/maint cont hemo equip .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0150 ......... ............ R Comprehensve oral evaluation ................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D0240 ......... ............ R Intraoral occlusal film .................................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0250 ......... ............ R Extraoral first film ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0260 ......... ............ R Extraoral ea additional film .......................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0270 ......... ............ R Dental bitewing single film .......................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0272 ......... ............ R Dental bitewings two films ........................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0274 ......... ............ R Dental bitewings four films .......................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0277 ......... ............ R Vert bitewings-sev to eight .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D0416 ......... ............ R Viral culture ................................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0421 ......... ............ R Gen tst suscept oral disease ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0431 ......... ............ R Diag tst detect mucos abnorm .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0460 ......... ............ R Pulp vitality test ........................................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0472 ......... ............ R Gross exam, prep & report ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX


## 46000

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

D0473 ......... ............ R Micro exam, prep & report .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0474 ......... ............ R Micro w exam of surg margins .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0475 ......... ............ R Decalcification procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0476 ......... ............ R Spec stains for microorganis ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0477 ......... ............ R Spec stains not for microorg ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX
D0478 ......... ............ R Immunohistochemical stains ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0479 ......... ............ R Tissue in-situ hybridization .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0480 ......... ............ R Cytopath smear prep & report .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0481 ......... ............ R Electron microscopy diagnost ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0482 ......... ............ R Direct immunofluorescence ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0483 ......... ............ R Indirect immunofluorescence ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0484 ......... ............ R Consult slides prep elsewher ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0485 ......... ............ R Consult inc prep of slides ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX D0502 ......... ............ R Other oral pathology procedu ..................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D0999 ......... ............ R Unspecified diagnostic proce ...................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1510 ......... ............ R Space maintainer fxd unilat ......................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1515 ......... ............ R Fixed bilat space maintainer ....................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1520 ......... ............ R Remove unilat space maintain .................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1525 ......... ............ R Remove bilat space maintain ...................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D1550 ......... ............ R Recement space maintainer ....................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D2999 ......... ............ R Dental unspec restorative pr ....................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D3460 ......... ............ R Endodontic endosseous implan .................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY D3999 ......... ............ R Endodontic procedure ................................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4260 ......... ............ R Osseous surgery per quadrant ................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4263 ......... ............ R Bone replce graft first site ........................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4264 ......... ............ R Bone replce graft each add ......................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4268 ......... ............ R Surgical revision procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D4270 ......... ............ R Pedicle soft tissue graft pr .......................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4271 ......... ............ R Free soft tissue graft proc ........................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4273 ......... ............ R Subepithelial tissue graft ............................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D4355 ......... ............ R Full mouth debridement .............................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY D4381 ......... ............ R Localized delivery antimicro ........................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5911 ......... ............ R Facial moulage sectional ............................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5912 ......... ............ R Facial moulage complete ............................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5951 ......... ............ R Feeding aid .................................................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5983 ......... ............ R Radiation applicator ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5984 ......... ............ R Radiation shield ........................................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5985 ......... ............ R Radiation cone locator ................................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY D5987 ......... ............ R Commissure splint ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D6920 ......... ............ R Dental connector bar ................................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7111 ......... ............ R Extraction coronal remnants ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7140 ......... ............ R Extraction erupted tooth/exr ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7210 ......... ............ R Rem imp tooth w mucoper flp ..................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7220 ......... ............ R Impact tooth remov soft tiss ........................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7230 ......... ............ R Impact tooth remov part bony ..................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7240 ......... ............ R Impact tooth remov comp bony .................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7241 ......... ............ R Impact tooth rem bony w/comp ................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY
D7250 ......... ............ R Tooth root removal ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7260 ......... ............ R Oral antral fistula closure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7261 ......... ............ R Primary closure sinus perf .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7283 ......... ............ R Place device impacted tooth ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7288 ......... ............ R Brush biopsy ................................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7291 ......... ............ R Transseptal fiberotomy ................................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY D7321 ......... ............ R Alveoloplasty not w/extracts ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7511 ......... ............ R Incision/drain abscess intra ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7521 ......... ............ R Incision/drain abscess extra ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX D7940 ......... ............ R Reshaping bone orthognathic ..................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9110 ......... ............ R Tx dental pain minor proc ........................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9230 ......... ............ R Analgesia ..................................................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9248 ......... ............ R Sedation (non-iv) ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX D9630 ......... ............ R Other drugs/medicaments ........................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9930 ......... ............ R Treatment of complications ......................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9940 ......... ............ R Dental occlusal guard .................................. 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9950 ......... ............ R Occlusion analysis ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9951 ......... ............ R Limited occlusal adjustment ........................ 0.00 0.00 0.00 0.00 0.00 0.00 YYY D9952 ......... ............ R Complete occlusal adjustment .................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY G0008 ......... ............ X Admin influenza virus vac ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0009 ......... ............ X Admin pneumococcal vaccine ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0010 ......... ............ X Admin hepatitis b vaccine ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0030 ......... ............ I PET imaging prev PET single ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0030 ......... 26 ....... I PET imaging prev PET single ..................... 1.50 0.61 0.61 0.06 2.17 2.17 XXX G0030 ......... TC ...... I PET imaging prev PET single ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0031 ......... ............ I PET imaging prev PET multple ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0031 ......... 26 ....... I PET imaging prev PET multple ................... 1.87 0.76 0.76 0.07 2.70 2.70 XXX


## 46001

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

G0031 ......... TC ...... I PET imaging prev PET multple ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0032 ......... ............ I PET follow SPECT 78464 singl .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0032 ......... 26 ....... I PET follow SPECT 78464 singl .................. 1.50 0.57 0.57 0.06 2.13 2.13 XXX G0032 ......... TC ...... I PET follow SPECT 78464 singl .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0033 ......... ............ I PET follow SPECT 78464 mult ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0033 ......... 26 ....... I PET follow SPECT 78464 mult ................... 1.87 0.78 0.78 0.07 2.72 2.72 XXX G0033 ......... TC ...... I PET follow SPECT 78464 mult ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0034 ......... ............ I PET follow SPECT 76865 singl .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0034 ......... 26 ....... I PET follow SPECT 76865 singl .................. 1.50 0.60 0.60 0.05 2.15 2.15 XXX G0034 ......... TC ...... I PET follow SPECT 76865 singl .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0035 ......... ............ I PET follow SPECT 78465 mult ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0035 ......... 26 ....... I PET follow SPECT 78465 mult ................... 1.87 0.76 0.76 0.06 2.70 2.70 XXX G0035 ......... TC ...... I PET follow SPECT 78465 mult ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0036 ......... ............ I PET follow cornry angio sing ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0036 ......... 26 ....... I PET follow cornry angio sing ...................... 1.50 0.59 0.59 0.05 2.14 2.14 XXX G0036 ......... TC ...... I PET follow cornry angio sing ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0037 ......... ............ I PET follow cornry angio mult ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0037 ......... 26 ....... I PET follow cornry angio mult ...................... 1.87 0.74 0.74 0.06 2.67 2.67 XXX G0037 ......... TC ...... I PET follow cornry angio mult ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0038 ......... ............ I PET follow myocard perf sing ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0038 ......... 26 ....... I PET follow myocard perf sing ..................... 1.50 0.51 0.51 0.07 2.09 2.09 XXX G0038 ......... TC ...... I PET follow myocard perf sing ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0039 ......... ............ I PET follow myocard perf mult ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0039 ......... 26 ....... I PET follow myocard perf mult ..................... 1.87 0.74 0.74 0.07 2.69 2.69 XXX G0039 ......... TC ...... I PET follow myocard perf mult ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0040 ......... ............ I PET follow stress echo singl ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0040 ......... 26 ....... I PET follow stress echo singl ....................... 1.50 0.61 0.61 0.06 2.18 2.18 XXX G0040 ......... TC ...... I PET follow stress echo singl ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0041 ......... ............ I PET follow stress echo mult ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0041 ......... 26 ....... I PET follow stress echo mult ....................... 1.87 0.76 0.76 0.06 2.70 2.70 XXX G0041 ......... TC ...... I PET follow stress echo mult ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0042 ......... ............ I PET follow ventriculogm sing ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0042 ......... 26 ....... I PET follow ventriculogm sing ...................... 1.50 0.63 0.63 0.05 2.18 2.18 XXX G0042 ......... TC ...... I PET follow ventriculogm sing ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0043 ......... ............ I PET follow ventriculogm mult ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0043 ......... 26 ....... I PET follow ventriculogm mult ...................... 1.87 0.79 0.79 0.07 2.73 2.73 XXX G0043 ......... TC ...... I PET follow ventriculogm mult ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0044 ......... ............ I PET following rest ECG singl ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0044 ......... 26 ....... I PET following rest ECG singl ...................... 1.50 0.62 0.62 0.05 2.17 2.17 XXX G0044 ......... TC ...... I PET following rest ECG singl ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0045 ......... ............ I PET following rest ECG mult ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0045 ......... 26 ....... I PET following rest ECG mult ...................... 1.87 0.75 0.75 0.06 2.69 2.69 XXX G0045 ......... TC ...... I PET following rest ECG mult ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0046 ......... ............ I PET follow stress ECG singl ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0046 ......... 26 ....... I PET follow stress ECG singl ....................... 1.50 0.62 0.62 0.05 2.17 2.17 XXX G0046 ......... TC ...... I PET follow stress ECG singl ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0047 ......... ............ I PET follow stress ECG mult ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0047 ......... 26 ....... I PET follow stress ECG mult ....................... 1.87 0.76 0.76 0.06 2.70 2.70 XXX G0047 ......... TC ...... I PET follow stress ECG mult ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0101 ......... ............ A CA screen;pelvic/breast exam .................... 0.45 0.51 0.17 0.02 0.98 0.64 XXX G0102 ......... ............ A Prostate ca screening; dre .......................... 0.17 0.38 0.06 0.01 0.56 0.24 XXX G0104 ......... ............ A CA screen;flexi sigmoidscope ..................... 0.96 2.33 0.55 0.08 3.37 1.59 000 G0105 ......... ............ A Colorectal scrn; hi risk ind ........................... 3.70 6.60 1.58 0.30 10.59 5.57 000 G0105 ......... 53 ....... A Colorectal scrn; hi risk ind ........................... 0.96 2.33 0.55 0.08 3.37 1.59 000 G0106 ......... ............ A Colon CA screen;barium enema ................. 0.99 3.35 NA 0.17 4.51 NA XXX G0106 ......... 26 ....... A Colon CA screen;barium enema ................. 0.99 0.34 0.34 0.04 1.37 1.37 XXX G0106 ......... TC ...... A Colon CA screen;barium enema ................. 0.00 3.02 NA 0.13 3.15 NA XXX G0108 ......... ............ A Diab manage trn per indiv ........................... 0.00 0.83 NA 0.01 0.84 NA XXX G0109 ......... ............ A Diab manage trn ind/group ......................... 0.00 0.48 NA 0.01 0.49 NA XXX G0110 ......... ............ R Nett pulm-rehab educ; ind ........................... 0.90 0.68 NA 0.04 1.62 NA XXX G0111 ......... ............ R Nett pulm-rehab educ; group ...................... 0.27 0.30 NA 0.01 0.58 NA XXX G0112 ......... ............ R Nett;nutrition guid, initial .............................. 1.72 1.26 0.65 0.04 3.02 2.41 XXX G0113 ......... ............ R Nett;nutrition guid,subseqnt ......................... 1.29 0.81 0.40 0.05 2.15 1.74 XXX G0114 ......... ............ R Nett; psychosocial consult ........................... 1.20 0.46 NA 0.05 1.71 NA XXX G0115 ......... ............ R Nett; psychological testing .......................... 1.20 0.78 NA 0.03 2.01 NA XXX G0116 ......... ............ R Nett; psychosocial counsel .......................... 1.11 0.94 0.32 0.05 2.10 1.49 XXX G0117 ......... ............ T Glaucoma scrn hgh risk direc ..................... 0.45 0.73 0.19 0.01 1.19 0.65 XXX G0118 ......... ............ T Glaucoma scrn hgh risk direc ..................... 0.17 0.55 0.06 0.01 0.73 0.24 XXX G0120 ......... ............ A Colon ca scrn; barium enema ..................... 0.99 3.35 NA 0.17 4.51 NA XXX G0120 ......... 26 ....... A Colon ca scrn; barium enema ..................... 0.99 0.34 0.34 0.04 1.37 1.37 XXX G0120 ......... TC ...... A Colon ca scrn; barium enema ..................... 0.00 3.02 NA 0.13 3.15 NA XXX G0121 ......... ............ A Colon ca scrn not hi rsk ind ........................ 3.70 6.60 1.58 0.30 10.59 5.57 000 G0121 ......... 53 ....... A Colon ca scrn not hi rsk ind ........................ 0.96 2.33 0.55 0.08 3.37 1.59 000 G0122 ......... ............ N Colon ca scrn; barium enema ..................... 0.99 3.51 NA 0.18 4.68 NA XXX


## 46002

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

G0122 ......... 26 ....... N Colon ca scrn; barium enema ..................... 0.99 0.38 0.38 0.05 1.42 1.42 XXX G0122 ......... TC ...... N Colon ca scrn; barium enema ..................... 0.00 3.13 NA 0.13 3.26 NA XXX G0124 ......... ............ A Screen c/v thin layer by MD ........................ 0.42 0.23 0.15 0.02 0.67 0.59 XXX G0125 ......... ............ I PET image pulmonary nodule ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0125 ......... 26 ....... I PET image pulmonary nodule ..................... 1.50 0.54 0.54 0.06 2.11 2.11 XXX G0125 ......... TC ...... I PET image pulmonary nodule ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0127 ......... ............ R Trim nail(s) .................................................. 0.17 0.27 0.07 0.01 0.45 0.25 000 G0128 ......... ............ R CORF skilled nursing service ...................... 0.08 0.03 0.03 0.01 0.12 0.12 XXX G0130 ......... ............ A Single energy x-ray study ........................... 0.22 0.88 NA 0.06 1.16 NA XXX G0130 ......... 26 ....... A Single energy x-ray study ........................... 0.22 0.08 0.08 0.01 0.31 0.31 XXX G0130 ......... TC ...... A Single energy x-ray study ........................... 0.00 0.80 NA 0.05 0.85 NA XXX G0141 ......... ............ A Scr c/v cyto,autosys and md ....................... 0.42 0.23 0.15 0.02 0.67 0.59 XXX G0166 ......... ............ A Extrnl counterpulse, per tx .......................... 0.07 3.93 0.03 0.01 4.01 0.11 XXX G0168 ......... ............ A Wound closure by adhesive ........................ 0.45 1.80 0.21 0.03 2.28 0.69 000 G0179 ......... ............ A MD recertification HHA PT .......................... 0.45 0.94 0.87 0.02 1.41 1.35 XXX G0180 ......... ............ A MD certification HHA patient ....................... 0.67 1.15 1.08 0.03 1.85 1.78 XXX G0181 ......... ............ A Home health care supervision .................... 1.73 1.38 1.31 0.07 3.18 3.12 XXX G0182 ......... ............ A Hospice care supervision ............................ 1.73 1.54 1.47 0.07 3.34 3.27 XXX G0186 ......... ............ C Dstry eye lesn,fdr vssl tech ......................... 0.00 0.00 0.00 0.00 0.00 0.00 YYY G0202 ......... ............ A Screeningmammographydigital ................... 0.70 2.78 NA 0.10 3.58 NA XXX G0202 ......... 26 ....... A Screeningmammographydigital ................... 0.70 0.23 0.23 0.03 0.96 0.96 XXX G0202 ......... TC ...... A Screeningmammographydigital ................... 0.00 2.55 NA 0.07 2.62 NA XXX G0204 ......... ............ A Diagnosticmammographydigital .................. 0.87 2.79 NA 0.11 3.77 NA XXX G0204 ......... 26 ....... A Diagnosticmammographydigital .................. 0.87 0.28 0.28 0.04 1.19 1.19 XXX G0204 ......... TC ...... A Diagnosticmammographydigital .................. 0.00 2.51 NA 0.07 2.58 NA XXX G0206 ......... ............ A Diagnosticmammographydigital .................. 0.70 2.25 NA 0.09 3.05 NA XXX G0206 ......... 26 ....... A Diagnosticmammographydigital .................. 0.70 0.23 0.23 0.03 0.96 0.96 XXX G0206 ......... TC ...... A Diagnosticmammographydigital .................. 0.00 2.02 NA 0.06 2.08 NA XXX G0210 ......... ............ I PET img wholebody dxlung ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0210 ......... 26 ....... I PET img wholebody dxlung ........................ 1.50 0.54 0.54 0.06 2.10 2.10 XXX G0210 ......... TC ...... I PET img wholebody dxlung ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0211 ......... ............ I PET img wholbody init lung ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0211 ......... 26 ....... I PET img wholbody init lung ........................ 1.50 0.53 0.53 0.06 2.10 2.10 XXX G0211 ......... TC ...... I PET img wholbody init lung ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0212 ......... ............ I PET img wholebod restag lung ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0212 ......... 26 ....... I PET img wholebod restag lung ................... 1.50 0.54 0.54 0.06 2.10 2.10 XXX G0212 ......... TC ...... I PET img wholebod restag lung ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0213 ......... ............ I PET img wholbody dx ................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0213 ......... 26 ....... I PET img wholbody dx ................................. 1.50 0.53 0.53 0.06 2.10 2.10 XXX G0213 ......... TC ...... I PET img wholbody dx ................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0214 ......... ............ I PET img wholebod init ................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0214 ......... 26 ....... I PET img wholebod init ................................ 1.50 0.53 0.53 0.06 2.10 2.10 XXX G0214 ......... TC ...... I PET img wholebod init ................................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0215 ......... ............ I PETimg wholebod restag ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0215 ......... 26 ....... I PETimg wholebod restag ............................ 1.50 0.54 0.54 0.06 2.10 2.10 XXX G0215 ......... TC ...... I PETimg wholebod restag ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0216 ......... ............ I PET img wholebod dx melanoma ............... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0216 ......... 26 ....... I PET img wholebod dx melanoma ............... 1.50 0.54 0.54 0.06 2.10 2.10 XXX G0216 ......... TC ...... I PET img wholebod dx melanoma ............... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0217 ......... ............ I PET img wholebod init melan ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0217 ......... 26 ....... I PET img wholebod init melan ..................... 1.50 0.54 0.54 0.06 2.10 2.10 XXX G0217 ......... TC ...... I PET img wholebod init melan ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0218 ......... ............ I PET img wholebod restag mela .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0218 ......... 26 ....... I PET img wholebod restag mela .................. 1.50 0.54 0.54 0.06 2.11 2.11 XXX G0218 ......... TC ...... I PET img wholebod restag mela .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0219 ......... ............ N PET img wholbod melano nonco ................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0219 ......... 26 ....... N PET img wholbod melano nonco ................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0219 ......... TC ...... N PET img wholbod melano nonco ................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0220 ......... ............ I PET img wholebod dx lymphoma ............... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0220 ......... 26 ....... I PET img wholebod dx lymphoma ............... 1.50 0.54 0.54 0.06 2.10 2.10 XXX G0220 ......... TC ...... I PET img wholebod dx lymphoma ............... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0221 ......... ............ I PET imag wholbod init lympho ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0221 ......... 26 ....... I PET imag wholbod init lympho ................... 1.50 0.54 0.54 0.06 2.10 2.10 XXX G0221 ......... TC ...... I PET imag wholbod init lympho ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0222 ......... ............ I PET imag wholbod resta lymph .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0222 ......... 26 ....... I PET imag wholbod resta lymph .................. 1.50 0.54 0.54 0.06 2.11 2.11 XXX G0222 ......... TC ...... I PET imag wholbod resta lymph .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0223 ......... ............ I PET imag wholbod reg dx head ................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0223 ......... 26 ....... I PET imag wholbod reg dx head ................. 1.50 0.54 0.54 0.06 2.10 2.10 XXX G0223 ......... TC ...... I PET imag wholbod reg dx head ................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0224 ......... ............ I PET imag wholbod reg ini hea .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0224 ......... 26 ....... I PET imag wholbod reg ini hea .................... 1.50 0.54 0.54 0.06 2.10 2.10 XXX G0224 ......... TC ...... I PET imag wholbod reg ini hea .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0225 ......... ............ I PET whol restag headneckonly .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX


## 46003

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

G0225 ......... 26 ....... I PET whol restag headneckonly .................. 1.50 0.54 0.54 0.06 2.11 2.11 XXX G0225 ......... TC ...... I PET whol restag headneckonly .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0226 ......... ............ I PET img wholbody dx esophagl ................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0226 ......... 26 ....... I PET img wholbody dx esophagl ................. 1.50 0.55 0.55 0.06 2.12 2.12 XXX G0226 ......... TC ...... I PET img wholbody dx esophagl ................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0227 ......... ............ I PET img wholbod ini esophage .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0227 ......... 26 ....... I PET img wholbod ini esophage .................. 1.50 0.55 0.55 0.06 2.11 2.11 XXX G0227 ......... TC ...... I PET img wholbod ini esophage .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0228 ......... ............ I PET img wholbod restg esopha .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0228 ......... 26 ....... I PET img wholbod restg esopha .................. 1.50 0.54 0.54 0.06 2.10 2.10 XXX G0228 ......... TC ...... I PET img wholbod restg esopha .................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0229 ......... ............ I PET img metaboloc brain pres ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0229 ......... 26 ....... I PET img metaboloc brain pres ................... 1.50 0.54 0.54 0.06 2.10 2.10 XXX G0229 ......... TC ...... I PET img metaboloc brain pres ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0230 ......... ............ I PET myocard viability post .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0230 ......... 26 ....... I PET myocard viability post .......................... 1.50 0.55 0.55 0.06 2.12 2.12 XXX G0230 ......... TC ...... I PET myocard viability post .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0231 ......... ............ I PET WhBD colorec; gamma cam ............... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0231 ......... 26 ....... I PET WhBD colorec; gamma cam ............... 1.50 0.54 0.54 0.06 2.10 2.10 XXX G0231 ......... TC ...... I PET WhBD colorec; gamma cam ............... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0232 ......... ............ I PET whbd lymphoma; gamma cam ............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0232 ......... 26 ....... I PET whbd lymphoma; gamma cam ............ 1.50 0.55 0.55 0.06 2.11 2.11 XXX G0232 ......... TC ...... I PET whbd lymphoma; gamma cam ............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0233 ......... ............ I PET whbd melanoma; gamma cam ............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0233 ......... 26 ....... I PET whbd melanoma; gamma cam ............ 1.50 0.55 0.55 0.06 2.11 2.11 XXX G0233 ......... TC ...... I PET whbd melanoma; gamma cam ............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0234 ......... ............ I PET WhBD pulm nod; gamma cam ............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0234 ......... 26 ....... I PET WhBD pulm nod; gamma cam ............ 1.50 0.54 0.54 0.06 2.11 2.11 XXX G0234 ......... TC ...... I PET WhBD pulm nod; gamma cam ............ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0235 ......... ............ N PET not otherwise specified ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0235 ......... 26 ....... N PET not otherwise specified ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0235 ......... TC ...... N PET not otherwise specified ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0237 ......... ............ A Therapeutic procd strg endur ...................... 0.00 0.40 NA 0.02 0.42 NA XXX G0238 ......... ............ A Oth resp proc, indiv ..................................... 0.00 0.49 NA 0.00 0.49 NA XXX G0239 ......... ............ A Oth resp proc, group ................................... 0.00 0.33 NA 0.00 0.33 NA XXX G0244 ......... ............ E Observ care by facility topt ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0245 ......... ............ R Initial foot exam pt lops ............................... 0.88 0.81 0.31 0.04 1.73 1.23 XXX G0246 ......... ............ R Followup eval of foot pt lop ......................... 0.45 0.55 0.16 0.02 1.02 0.63 XXX G0247 ......... ............ R Routine footcare pt w lops .......................... 0.50 0.55 0.21 0.02 1.07 0.73 ZZZ G0248 ......... ............ R Demonstrate use home inr mon ................. 0.00 6.05 NA 0.01 6.06 NA XXX G0249 ......... ............ R Provide test material,equipm ....................... 0.00 3.64 NA 0.01 3.65 NA XXX G0250 ......... ............ R MD review interpret of test .......................... 0.18 0.06 0.06 0.01 0.25 0.25 XXX G0251 ......... ............ E Linear acc based stero radio ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0252 ......... ............ N PET imaging initial dx ................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0252 ......... 26 ....... N PET imaging initial dx ................................. 1.50 0.59 0.59 0.04 2.13 2.13 XXX G0252 ......... TC ...... N PET imaging initial dx ................................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0253 ......... ............ I PET image brst dection recur ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0253 ......... 26 ....... I PET image brst dection recur ..................... 1.87 0.66 0.66 0.08 2.62 2.62 XXX G0253 ......... TC ...... I PET image brst dection recur ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0254 ......... ............ I PET image brst eval to tx ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0254 ......... 26 ....... I PET image brst eval to tx ........................... 1.87 0.68 0.68 0.08 2.64 2.64 XXX G0254 ......... TC ...... I PET image brst eval to tx ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0255 ......... ............ N Current percep threshold tst ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0255 ......... 26 ....... N Current percep threshold tst ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0255 ......... TC ...... N Current percep threshold tst ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0257 ......... ............ E Unsched dialysis ESRD pt hos ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0258 ......... ............ E IV infusion during obs stay .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0259 ......... ............ E Inject for sacroiliac joint ............................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0260 ......... ............ E Inj for sacroiliac jt anesth ............................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0263 ......... ............ E Adm with CHF, CP, asthma ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0264 ......... ............ E Assmt otr CHF, CP, asthma ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0268 ......... ............ A Removal of impacted wax md ..................... 0.61 0.62 0.23 0.02 1.25 0.86 000 G0269 ......... ............ B Occlusive device in vein art ........................ 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0270 ......... ............ A MNT subs tx for change dx ......................... 0.00 0.42 NA 0.01 0.43 NA XXX G0271 ......... ............ A Group MNT 2 or more 30 mins ................... 0.00 0.16 NA 0.01 0.17 NA XXX G0275 ......... ............ A Renal angio, cardiac cath ........................... 0.25 NA 0.11 0.01 NA 0.37 ZZZ G0278 ......... ............ A Iliac art angio,cardiac cath .......................... 0.25 NA 0.11 0.01 NA 0.37 ZZZ G0279 ......... ............ C Excorp shock tx, elbow epi ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0280 ......... ............ C Excorp shock tx other than ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0281 ......... ............ A Elec stim unattend for press ....................... 0.18 0.12 NA 0.01 0.31 NA XXX G0282 ......... ............ N Elect stim wound care not pd ..................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0283 ......... ............ A Elec stim other than wound ........................ 0.18 0.12 NA 0.01 0.31 NA XXX G0288 ......... ............ A Recon, CTA for surg plan ........................... 0.00 10.63 NA 0.18 10.81 NA XXX G0289 ......... ............ A Arthro, loose body + chondro ...................... 1.48 NA 0.78 0.26 NA 2.52 ZZZ


## 46004

——————————

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### B.

— R ELATIVE 

### VALUE 

### U NITS 

### (RVU S 

### ) AND 

### R ELATED 

### I NFORMATION



### —Continued

CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

G0290 ......... ............ E Drug-eluting stents, single ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0291 ......... ............ E Drug-eluting stents,each add ...................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0293 ......... ............ E Non-cov surg proc,clin trial ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0294 ......... ............ E Non-cov proc, clinical trial ........................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0295 ......... ............ N Electromagnetic therapy onc ....................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0308 ......... ............ A ESRD related svc 4+mo < 2yrs .................. 12.77 8.56 8.56 0.42 21.74 21.74 XXX G0309 ......... ............ A ESRD related svc 2-3mo <2yrs .................. 10.63 7.11 7.11 0.36 18.11 18.11 XXX G0310 ......... ............ A ESRD related svc 1 vst <2yrs ..................... 8.51 5.69 5.69 0.28 14.48 14.48 XXX G0311 ......... ............ A ESRD related svs 4+mo 2-11yr .................. 9.75 4.73 4.73 0.34 14.82 14.82 XXX G0312 ......... ............ A ESRD relate svs 2-3 mo 2-11y ................... 8.13 3.93 3.93 0.29 12.34 12.34 XXX G0313 ......... ............ A ESRD related svs 1 mon 2-11y .................. 6.50 3.15 3.15 0.22 9.87 9.87 XXX G0314 ......... ............ A ESRD related svs 4+ mo 12-19 .................. 8.30 4.43 4.43 0.27 13.00 13.00 XXX G0315 ......... ............ A ESRD related svs 2-3mo/12-19 .................. 6.91 3.68 3.68 0.23 10.82 10.82 XXX G0316 ......... ............ A ESRD related svs 1vis/12-19y .................... 5.53 2.95 2.95 0.17 8.65 8.65 XXX G0317 ......... ............ A ESRD related svs 4+mo 20+yrs ................. 5.10 2.87 2.87 0.17 8.14 8.14 XXX G0318 ......... ............ A ESRD related svs 2-3 mo 20+y .................. 4.25 2.38 2.38 0.14 6.77 6.77 XXX G0319 ......... ............ A ESRD related svs 1visit 20+y ..................... 3.40 1.90 1.90 0.11 5.41 5.41 XXX G0320 ......... ............ A ESD related svs home undr 2 ..................... 10.63 7.11 7.11 0.36 18.11 18.11 XXX G0321 ......... ............ A ESRDrelatedsvs home mo 2-11y ................ 8.13 3.93 3.93 0.29 12.34 12.34 XXX G0322 ......... ............ A ESRD related svs hom mo12-19 ................ 6.91 3.68 3.68 0.23 10.82 10.82 XXX G0323 ......... ............ A ESRD related svs home mo 20+ ................ 4.25 2.38 2.38 0.14 6.77 6.77 XXX G0324 ......... ............ A ESRD related serv/dy,2y ............................. 0.35 0.24 0.24 0.01 0.60 0.60 XXX G0325 ......... ............ A ESRD relate serv/dy 2-11yr ........................ 0.23 0.12 0.12 0.01 0.36 0.36 XXX G0326 ......... ............ A ESRD relate serv/dy 12-19y ....................... 0.27 0.13 0.13 0.01 0.41 0.41 XXX G0327 ......... ............ A ESRD relate serv/dy 20+yrs ........................ 0.14 0.08 0.08 0.01 0.23 0.23 XXX G0329 ......... ............ A Electromagntic tx for ulcers ......................... 0.06 0.14 NA 0.01 0.21 NA XXX G0336 ......... ............ I PET imaging brain alzheimers .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0336 ......... 26 ....... I PET imaging brain alzheimers .................... 1.50 0.52 0.52 0.05 2.07 2.07 XXX G0336 ......... TC ...... I PET imaging brain alzheimers .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0337 ......... ............ X Hospice evaluation preelecti ....................... 1.34 0.51 0.51 0.09 1.94 1.94 XXX G0341 ......... ............ A Percutaneous islet celltrans ........................ 6.99 NA 2.68 0.48 NA 10.15 000 G0342 ......... ............ A Laparoscopy islet cell trans ......................... 11.94 NA 5.24 1.46 NA 18.64 090 G0343 ......... ............ A Laparotomy islet cell transp ........................ 19.89 NA 8.62 2.06 NA 30.57 090 G0344 ......... ............ A Initial preventive exam ................................ 1.34 1.14 0.47 0.10 2.58 1.92 XXX G0345 ......... ............ A IV infuse hydration, initial ............................ 0.17 1.43 NA 0.07 1.67 NA XXX G0346 ......... ............ A Each additional infuse hour ......................... 0.09 0.40 NA 0.04 0.53 NA ZZZ G0347 ......... ............ A IV infusion therapy/diagnost ........................ 0.21 1.76 NA 0.07 2.04 NA XXX G0348 ......... ............ A Each additional hr up to 8hr ........................ 0.18 0.46 NA 0.04 0.68 NA ZZZ G0349 ......... ............ A Additional sequential infuse ........................ 0.19 0.90 NA 0.04 1.13 NA ZZZ G0350 ......... ............ A Concurrent infusion ..................................... 0.17 0.44 NA 0.04 0.65 NA ZZZ G0351 ......... ............ A Therapeutic/diagnostic injec ........................ 0.17 0.31 NA 0.01 0.49 NA XXX G0353 ......... ............ A IV push,single orinitial dru ........................... 0.18 1.30 NA 0.04 1.52 NA XXX G0354 ......... ............ A Each addition sequential IV ........................ 0.10 0.57 NA 0.04 0.71 NA ZZZ G0355 ......... ............ A Chemo adminisrate subcut/IM .................... 0.21 1.15 NA 0.01 1.37 NA XXX G0356 ......... ............ A Hormonal anti-neoplastic ............................. 0.19 0.75 NA 0.01 0.95 NA XXX G0357 ......... ............ A IV push single/initial subst ........................... 0.24 2.94 NA 0.06 3.24 NA XXX G0358 ......... ............ A IV push each additional drug ...................... 0.20 1.62 NA 0.06 1.88 NA ZZZ G0359 ......... ............ A Chemotherapy IV one hr initi ...................... 0.28 4.22 NA 0.08 4.58 NA XXX G0360 ......... ............ A Each additional hr 1-8 hrs ........................... 0.19 0.78 NA 0.07 1.04 NA ZZZ G0361 ......... ............ A Prolong chemo infuse>8hrs pu ................... 0.21 4.63 NA 0.08 4.92 NA XXX G0362 ......... ............ A Each add sequential infusion ...................... 0.21 1.95 NA 0.07 2.23 NA ZZZ G0363 ......... ............ T Irrigate implanted venous de ....................... 0.04 0.70 NA 0.01 0.75 NA XXX G0364 ......... ............ A Bone marrow aspirate &biopsy ................... 0.16 0.14 0.06 0.04 0.34 0.26 ZZZ G0365 ......... ............ A Vessel mapping hemo access .................... 0.25 4.13 NA 0.25 4.63 NA XXX G0365 ......... 26 ....... A Vessel mapping hemo access .................... 0.25 0.09 0.09 0.02 0.36 0.36 XXX G0365 ......... TC ...... A Vessel mapping hemo access .................... 0.00 4.03 NA 0.23 4.26 NA XXX G0366 ......... ............ A EKG for initial prevent exam ....................... 0.17 0.47 0.00 0.03 0.67 0.20 XXX G0367 ......... ............ A EKG tracing for initial prev .......................... 0.00 0.41 NA 0.02 0.43 NA XXX G0368 ......... ............ A EKG interpret & report preve ...................... 0.17 0.06 0.06 0.01 0.24 0.24 XXX G0375 ......... ............ A Smoke/Tobacco counseling3-10 ................. 0.24 0.00 0.00 0.01 0.25 0.25 XXX G0376 ......... ............ A Smoke/Tobacco counseling >10 ................. 0.48 0.00 0.00 0.01 0.49 0.49 XXX G9013 ......... ............ N ESRD demo bundle level I .......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9014 ......... ............ N ESRD demo bundle-level II ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX G9016 ......... ............ N Demo-smoking cessation coun ................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX M0064 ......... ............ A Visit for drug monitoring .............................. 0.37 0.38 0.12 0.01 0.76 0.50 XXX P3001 ......... ............ A Screening pap smear by phys .................... 0.42 0.23 0.15 0.02 0.67 0.59 XXX Q0035 ......... ............ A Cardiokymography ...................................... 0.17 0.41 NA 0.03 0.61 NA XXX Q0035 ......... 26 ....... A Cardiokymography ...................................... 0.17 0.06 0.06 0.01 0.24 0.24 XXX Q0035 ......... TC ...... A Cardiokymography ...................................... 0.00 0.35 NA 0.02 0.37 NA XXX Q0091 ......... ............ A Obtaining screen pap smear ....................... 0.37 0.68 NA 0.02 1.07 NA XXX Q0092 ......... ............ A Set up port xray equipment ......................... 0.00 0.33 NA 0.01 0.34 NA XXX Q3001 ......... ............ C Brachytherapy Radioelements .................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX R0070 ......... ............ C Transport portable x-ray .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX R0075 ......... ............ C Transport port x-ray multipl ......................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX


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CPT 1 HCPCS 2 Mod Status Description Physician work RVUs 3 Nonfacility

PE RVUs Facility PE RVUs Malpractice RVUs Nonfacility total Facility total Global

R0076 ......... ............ B Transport portable EKG .............................. 0.00 0.00 0.00 0.00 0.00 0.00 XXX V5299 ......... ............ R Hearing service ........................................... 0.00 0.00 0.00 0.00 0.00 0.00 XXX

1 CPT codes and descriptions only are copyright 2005 American Medical Associaiton. All rights reserved. Applicable FARS/DFARS app ly.

2 Copyright 2005 American Dental Association. All rights reserved.

3 +Indicates RVUs are not used for Medicare payment. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules


## 46006 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

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CPT Code Short descriptors

00104 .. Anesth, electroshock 00124 .. Anesth, ear exam 11100 .. Biopsy, skin lesion 11101 .. Biopsy, skin add-on 11950 .. Therapy for contour defects 11951 .. Therapy for contour defects 11952 .. Therapy for contour defects 11954 .. Therapy for contour defects 11975 .. Insert contraceptive cap 11976 .. Removal of contraceptive cap 11977 .. Removal/reinsert contra cap 12031 .. Layer closure of wound(s) 12034 .. Layer closure of wound(s) 12041 .. Layer closure of wound(s) 12042 .. Layer closure of wound(s) 12044 .. Layer closure of wound(s) 12051 .. Layer closure of wound(s) 12052 .. Layer closure of wound(s) 12053 .. Layer closure of wound(s) 12054 .. Layer closure of wound(s) 12055 .. Layer closure of wound(s) 12056 .. Layer closure of wound(s) 12057 .. Layer closure of wound(s) 13152 .. Repair of wound or lesion 15775 .. Hair transplant punch grafts 15776 .. Hair transplant punch grafts 15851 .. Removal of sutures 15852 .. Dressing change not for burn 17250 .. Chemical cautery, tissue 17304 .. 1 stage mohs, up to 5 spec 17305 .. 2 stage mohs, up to 5 spec 17306 .. 3 stage mohs, up to 5 spec 17307 .. Mohs addl stage up to 5 spec 17310 .. Mohs any stage > 5 spec each 17360 .. Skin peel therapy 19000 .. Drainage of breast lesion 19396 .. Design custom breast implant 20500 .. Injection of sinus tract 21300 .. Treatment of skull fracture 21310 .. Treatment of nose fracture 21480 .. Reset dislocated jaw 31700 .. Insertion of airway catheter 31730 .. Intro, windpipe wire/tube 32960 .. Therapeutic pneumothorax 33960 .. External circulation assist 33961 .. External circulation assist 36522 .. Photopheresis 36860 .. External cannula declotting 38230 .. Bone marrow collection 38794 .. Access thoracic lymph duct 40490 .. Biopsy of lip 41250 .. Repair tongue laceration 41251 .. Repair tongue laceration 41252 .. Repair tongue laceration 41800 .. Drainage of gum lesion 41805 .. Removal foreign body, gum 41806 .. Removal foreign body,jawbone 41822 .. Excision of gum lesion 41825 .. Excision of gum lesion 41826 .. Excision of gum lesion 41828 .. Excision of gum lesion 41830 .. Removal of gum tissue 42100 .. Biopsy roof of mouth 42104 .. Excision lesion, mouth roof 

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CPT Code Short descriptors

42106 .. Excision lesion, mouth roof 42107 .. Excision lesion, mouth roof 42160 .. Treatment mouth roof lesion 42280 .. Preparation, palate mold 43750 .. Place gastrostomy tube 43760 .. Change gastrostomy tube 47000 .. Needle biopsy of liver 48102 .. Needle biopsy, pancreas 49080 .. Puncture, peritoneal cavity 49081 .. Removal of abdominal fluid 49428 .. Ligation of shunt 51000 .. Drainage of bladder 51005 .. Drainage of bladder 54450 .. Preputial stretching 56420 .. Drainage of gland abscess 57150 .. Treat vagina infection 57170 .. Fitting of diaphragm/cap 57180 .. Treat vaginal bleeding 58300 .. Insert intrauterine device 58323 .. Sperm washing 59160 .. D & c after delivery 59300 .. Episiotomy or vaginal repair 60000 .. Drain thyroid/tongue cyst 60001 .. Aspirate/inject thyriod cyst 61888 .. Revise/remove neuroreceiver 62194 .. Replace/irrigate catheter 67221 .. Ocular photodynamic ther 67225 .. Eye photodynamic ther add-on 68400 .. Incise/drain tear gland 68420 .. Incise/drain tear sac 68510 .. Biopsy of tear gland 68530 .. Clearance of tear duct 69100 .. Biopsy of external ear
69300 .. Revise external ear 76120 .. Cine/video x-rays 76940 .. Us guide, tissue ablation 76942 .. Echo guide for biopsy 76975 .. GI endoscopic ultrasound
78160 .. Plasma iron turnover 78162 .. Radioiron absorption exam 78170 .. Red cell iron utilization 78172 .. Total body iron estimation 78282 .. GI protein loss exam 78350 .. Bone mineral, single photon 78351 .. Bone mineral, dual photon 78455 .. Venous thrombosis study 79200 .. Nuclear rx, intracav admin 79300 .. Nuclr rx, interstit colloid 79440 .. Nuclear rx, intra-articular 86585 .. TB tine test 88355 .. Analysis, skeletal muscle 88356 .. Analysis, nerve 89100 .. Sample intestinal contents 89105 .. Sample intestinal contents 89130 .. Sample stomach contents 89132 .. Sample stomach contents 89135 .. Sample stomach contents 89136 .. Sample stomach contents 89140 .. Sample stomach contents 89141 .. Sample stomach contents 90465 .. Immune admin 1 inj, < 8 yrs 90466 .. Immune admin addl inj, < 8 y 90467 .. Immune admin o or n, < 8 yrs 

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CPT Code Short descriptors

90468 .. Immune admin o/n, addl < 8 y 90880 .. Hypnotherapy 90997 .. Hemoperfusion 92015 .. Refraction 92230 .. Eye exam with photos 92260 .. Ophthalmoscopy/dynamometry 92265 .. Eye muscle evaluation 92284 .. Dark adaptation eye exam 92287 .. Internal eye photography 92310 .. Contact lens fitting 92311 .. Contact lens fitting 92312 .. Contact lens fitting 92313 .. Contact lens fitting 92314 .. Prescription of contact lens 92315 .. Prescription of contact lens 92316 .. Prescription of contact lens 92317 .. Prescription of contact lens 92340 .. Fitting of spectacles 92341 .. Fitting of spectacles 92342 .. Fitting of spectacles 92370 .. Repair & adjust spectacles 92510 .. Rehab for ear implant 92551 .. Pure tone hearing test, air 93012 .. Transmission of ecg 93271 .. Ecg/monitoring and analysis 93561 .. Cardiac output measurement 93562 .. Cardiac output measurement 94014 .. Patient recorded spirometry 94015 .. Patient recorded spirometry 94016 .. Review patient spirometry 94200 .. Lung function test (MBC/MVV) 94250 .. Expired gas collection 94350 .. Lung nitrogen washout curve 94370 .. Breath airway closing volume 94400 .. CO2 breathing response curve 94620 .. Pulmonary stress test/simple 94660 .. Pos airway pressure, CPAP 94667 .. Chest wall manipulation 94668 .. Chest wall manipulation 94680 .. Exhaled air analysis, o2 94681 .. Exhaled air analysis, o2/co2 94690 .. Exhaled air analysis 94725 .. Membrane diffusion capacity 94750 .. Pulmonary compliance study 95060 .. Eye allergy tests 95065 .. Nose allergy test 95071 .. Bronchial allergy tests 95075 .. Ingestion challenge test 95078 .. Provocative testing 95805 .. Multiple sleep latency test 95812 .. Eeg, 41-60 minutes 95813 .. Eeg, over 1 hour 95816 .. Eeg, awake and drowsy 95819 .. Eeg, awake and asleep 95822 .. Eeg, coma or sleep only 95950 .. Ambulatory eeg monitoring 95954 .. EEG monitoring/giving drugs 95956 .. Eeg monitoring, cable/radio 96900 .. Ultraviolet light therapy 96105 .. Assessment of aphasia 99185 .. Regional hypothermia 99186 .. Total body hypothermia


## 46007 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

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00510 ....... 00 ............. Alabama ............................................................................................. ................................. 1.000 0.846 0.752 00831 ....... 01 ............. Alaska .............................................................................................. .................................... 1.017 1.103 1.029 00832 ....... 00 ............. Arizona ............................................................................................. ................................... 1.000 0.992 1.069 00520 ....... 13 ............. Arkansas ............................................................................................ .................................. 1.000 0.831 0.438 31140 ....... 03 ............. Marin/Napa/Solano, CA ............................................................................... ........................ 1.035 1.340 0.651 31140 ....... 05 ............. San Francisco, CA ................................................................................... ........................... 1.060 1.543 0.651 31140 ....... 06 ............. San Mateo, CA ....................................................................................... ............................. 1.073 1.536 0.639 31140 ....... 07 ............. Oakland/Berkley, CA ................................................................................. .......................... 1.054 1.371 0.651 31140 ....... 09 ............. Santa Clara, CA ..................................................................................... ............................. 1.083 1.540 0.604 31140 ....... TBD** ....... Santa Cruz, CA ......................................................................................... .......................... 1.014 1.218 0.717 31140 ....... 99 ............. Rest of California* ................................................................................. .............................. 1.010 1.042 0.717 31146 ....... 17 ............. Ventura, CA ......................................................................................... ................................ 1.028 1.179 0.744 31146 ....... 18 ............. Los Angeles, CA ..................................................................................... ............................ 1.041 1.156 0.954 31146 ....... 26 ............. Anaheim/Santa Ana, CA ............................................................................... ...................... 1.034 1.236 0.954 31140 ....... TBD** ....... Sonoma, CA ............................................................................................. ........................... 1.017 1.230 0.717 31146 ....... 99 ............. Rest of California* ................................................................................. .............................. 1.010 1.042 0.717 00824 ....... 01 ............. Colorado ............................................................................................ .................................. 1.000 1.014 0.803 00591 ....... 00 ............. Connecticut ......................................................................................... ................................. 1.038 1.170 0.900 00903 ....... 01 ............. DC + MD/VA Suburbs .................................................................................. ....................... 1.048 1.250 0.926 00902 ....... 01 ............. Delaware ............................................................................................ ................................. 1.012 1.018 0.892 00590 ....... 03 ............. Fort Lauderdale, FL ................................................................................. ............................ 1.000 0.988 1.703 00590 ....... 04 ............. Miami, FL ........................................................................................... .................................. 1.000 1.046 2.269 00590 ....... 99 ............. Rest of Florida ..................................................................................... ................................ 1.000 0.934 1.272 00511 ....... 01 ............. Atlanta, GA ......................................................................................... ................................. 1.010 1.089 0.966 00511 ....... 99 ............. Rest of Georgia ..................................................................................... .............................. 1.000 0.872 0.966 00833 ....... 01 ............. Hawaii/Guam ......................................................................................... .............................. 1.005 1.111 0.800 05130 ....... 00 ............. Idaho ............................................................................................... ..................................... 1.000 0.868 0.459 00952 ....... 12 ............. East St. Louis, IL .................................................................................. ............................... 1.000 0.939 1.750 00952 ....... 15 ............. Suburban Chicago, IL ................................................................................ ......................... 1.018 1.115 1.652 00952 ....... 16 ............. Chicago, IL ......................................................................................... ................................. 1.025 1.126 1.867 00952 ....... 99 ............. Rest of Illinois .................................................................................... .................................. 1.000 0.872 1.193 00630 ....... 00 ............. Indiana ............................................................................................. .................................... 1.000 0.906 0.436 00826 ....... 00 ............. Iowa ................................................................................................ ..................................... 1.000 0.868 0.589 00650 ....... 00 ............. Kansas* ............................................................................................. .................................. 1.000 0.878 0.721 00740 ....... 04 ............. Kansas* ............................................................................................. .................................. 1.000 0.878 0.721 00660 ....... 00 ............. Kentucky ............................................................................................ .................................. 1.000 0.854 0.873 00528 ....... 01 ............. New Orleans, LA ..................................................................................... ............................ 1.000 0.946 1.197 00528 ....... 99 ............. Rest of Louisiana ................................................................................... ............................. 1.000 0.847 1.058 31142 ....... 03 ............. Southern Maine ...................................................................................... ............................. 1.000 1.013 0.637 31142 ....... 99 ............. Rest of Maine ....................................................................................... ............................... 1.000 0.886 0.637 00901 ....... 01 ............. Baltimore/Surr. Cntys, MD ........................................................................... ....................... 1.012 1.078 0.947 00901 ....... 99 ............. Rest of Maryland .................................................................................... ............................. 1.000 0.980 0.760 31143 ....... 01 ............. Metropolitan Boston ................................................................................. ........................... 1.030 1.329 0.823 31143 ....... 99 ............. Rest of Massachusetts ............................................................................... ......................... 1.007 1.103 0.823 00953 ....... 01 ............. Detroit, MI ......................................................................................... ................................... 1.037 1.054 2.744 00953 ....... 99 ............. Rest of Michigan .................................................................................... ............................. 1.000 0.921 1.518 00954 ....... 00 ............. Minnesota ........................................................................................... ................................. 1.000 1.005 0.410 00512 ....... 00 ............. Mississippi ......................................................................................... .................................. 1.000 0.839 0.722 00740 ....... 02 ............. Metropolitan Kansas City, MO ........................................................................ .................... 1.000 0.975 0.946 00523 ....... 01 ............. Metropolitan St. Louis, MO .......................................................................... ....................... 1.000 0.955 0.941 00523 ....... 99 ............. Rest of Missouri* ................................................................................... .............................. 1.000 0.802 0.892 00740 ....... 99 ............. Rest of Missouri* ................................................................................... .............................. 1.000 0.802 0.892 00751 ....... 01 ............. Montana ............................................................................................. .................................. 1.000 0.844 0.904 00655 ....... 00 ............. Nebraska ............................................................................................ ................................. 1.000 0.875 0.454 00834 ....... 00 ............. Nevada .............................................................................................. .................................. 1.003 1.043 1.068 31144 ....... 40 ............. New Hampshire ....................................................................................... ............................ 1.000 1.027 0.942 00805 ....... 01 ............. Northern NJ ......................................................................................... ................................ 1.058 1.220 0.973 00805 ....... 99 ............. Rest of New Jersey .................................................................................. ........................... 1.043 1.119 0.973 00521 ....... 05 ............. New Mexico .......................................................................................... ............................... 1.000 0.887 0.895 00801 ....... 99 ............. Rest of New York .................................................................................... ............................ 1.000 0.917 0.677 00803 ....... 01 ............. Manhattan, NY ....................................................................................... ............................. 1.065 1.298 1.504 00803 ....... 02 ............. NYC Suburbs/Long I., NY ............................................................................. ...................... 1.052 1.280 1.785 00803 ....... 03 ............. Poughkpsie/N NYC Suburbs, NY ........................................................................ ................ 1.014 1.074 1.167 14330 ....... 04 ............. Queens, NY .......................................................................................... ............................... 1.032 1.228 1.710 05535 ....... 00 ............. North Carolina ...................................................................................... ............................... 1.000 0.920 0.640 00820 ....... 01 ............. North Dakota ........................................................................................ ............................... 1.000 0.860 0.602 00883 ....... 00 ............. Ohio ................................................................................................ ..................................... 1.000 0.933 0.976 00522 ....... 00 ............. Oklahoma ............................................................................................ ................................ 1.000 0.854 0.382 00835 ....... 01 ............. Portland, OR ........................................................................................ ................................ 1.002 1.057 0.441 00835 ....... 99 ............. Rest of Oregon ...................................................................................... .............................. 1.000 0.925 0.441 00865 ....... 01 ............. Metropolitan Philadelphia, PA ....................................................................... ...................... 1.016 1.104 1.386


## 46008 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

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### —Continued

Carrier Locality Locality name Work GPCI PE GPCI MP GPCI

00865 ....... 99 ............. Rest of Pennsylvania ................................................................................ .......................... 1.000 0.902 0.806 00973 ....... 20 ............. Puerto Rico ......................................................................................... ................................. 1.000 0.698 0.261 00870 ....... 01 ............. Rhode Island ........................................................................................ ............................... 1.045 0.989 0.909 00880 ....... 01 ............. South Carolina ...................................................................................... ............................... 1.000 0.893 0.394 00820 ....... 02 ............. South Dakota ........................................................................................ ............................... 1.000 0.876 0.365 05440 ....... 35 ............. Tennessee ........................................................................................... ................................ 1.000 0.879 0.631 00900 ....... 09 ............. Brazoria, TX ........................................................................................ ................................ 1.020 0.961 1.298 00900 ....... 11 ............. Dallas, TX .......................................................................................... .................................. 1.009 1.062 1.061 00900 ....... 15 ............. Galveston, TX ....................................................................................... ............................... 1.000 0.952 1.298 00900 ....... 18 ............. Houston, TX ......................................................................................... ............................... 1.016 1.014 1.297 00900 ....... 20 ............. Beaumont, TX ........................................................................................ ............................. 1.000 0.860 1.298 00900 ....... 28 ............. Fort Worth, TX ...................................................................................... ............................... 1.000 0.989 1.061 00900 ....... 31 ............. Austin, TX .......................................................................................... .................................. 1.000 1.046 0.986 00900 ....... 99 ............. Rest of Texas ....................................................................................... ............................... 1.000 0.865 1.138 00910 ....... 09 ............. Utah ................................................................................................ ..................................... 1.000 0.937 0.662 31145 ....... 50 ............. Vermont ............................................................................................. .................................. 1.000 0.968 0.514 00973 ....... 50 ............. Virgin Islands ...................................................................................... ................................. 1.000 1.014 1.003 00904 ....... 00 ............. Virginia ............................................................................................ ..................................... 1.000 0.940 0.579 00836 ....... 02 ............. Seattle (King Cnty), WA ............................................................................. ......................... 1.014 1.131 0.819 00836 ....... 99 ............. Rest of Washington .................................................................................. ........................... 1.000 0.978 0.819 00884 ....... 16 ............. West Virginia ....................................................................................... ................................ 1.000 0.819 1.547 00951 ....... 00 ............. Wisconsin ........................................................................................... ................................. 1.000 0.918 0.790 00825 ....... 21 ............. Wyoming ............................................................................................. ................................. 1.000 0.853 0.935

For 2005 and 2006, if the work GPCI falls below a 1.0 work index, then the work GPCI equals 1.0. For 2005, if the Work, PE and MP GPCI for Alaska falls below 1.67, then the Work, PE and MP GPCIs equal 1.67. * states are served by more than one carrier ** locality numbers not assigned to proposed localities



### A DDENDUM 

### E.

— P ROPOSED 

### 2006 G EOGRAPHIC 

### A DJUSTMENT 

### FACTORS 

### (GAF S 

### )

Carrier Locality Locality name 2006 GAF

31140 ....... 06 ............. San Mateo, CA ....................................................................................... ............................................................. 1.259 31140 ....... 05 ............. San Francisco, CA ................................................................................... ............................................................ 1.256 31140 ....... 09 ............. Santa Clara, CA ..................................................................................... .............................................................. 1.256 00803 ....... 01 ............. Manhattan, NY ....................................................................................... .............................................................. 1.184 00803 ....... 02 ............. NYC Suburbs/Long I., NY ............................................................................. ...................................................... 1.180 31140 ....... 07 ............. Oakland/Berkley, CA ................................................................................. .......................................................... 1.177 31140 ....... 03 ............. Marin/Napa/Solano, CA ............................................................................... ........................................................ 1.154 31143 ....... 01 ............. Metropolitan Boston ................................................................................. ............................................................ 1.153 14330 ....... 04 ............. Queens, NY .......................................................................................... ............................................................... 1.144 00903 ....... 01 ............. DC + MD/VA Suburbs .................................................................................. ....................................................... 1.132 00805 ....... 01 ............. Northern NJ ......................................................................................... ................................................................ 1.126 31146 ....... 26 ............. Anaheim/Santa Ana, CA ............................................................................... ....................................................... 1.119 31140 ....... TBD* * ...... Santa Cruz, CA .......................................................................................... .......................................................... 1.119 00953 ....... 01 ............. Detroit, MI ......................................................................................... ................................................................... 1.111 00952 ....... 16 ............. Chicago, IL ......................................................................................... .................................................................. 1.102 31140 ....... TBD* * ...... Sonoma, CA .............................................................................................. .......................................................... 1.098 00591 ....... 00 ............. Connecticut ......................................................................................... ................................................................. 1.091 31146 ....... 18 ............. Los Angeles, CA ..................................................................................... ............................................................. 1.088 00952 ....... 15 ............. Suburban Chicago, IL ................................................................................ .......................................................... 1.085 31146 ....... 17 ............. Ventura, CA ......................................................................................... ................................................................ 1.083 00805 ....... 99 ............. Rest of New Jersey .................................................................................. ........................................................... 1.074 00865 ....... 01 ............. Metropolitan Philadelphia, PA ....................................................................... ...................................................... 1.069 00590 ....... 04 ............. Miami, FL ........................................................................................... .................................................................. 1.069 00836 ....... 02 ............. Seattle (King Cnty), WA ............................................................................. ......................................................... 1.058 00831 ....... 01 ............. Alaska .............................................................................................. .................................................................... 1.055 00803 ....... 03 ............. Poughkpsie/N NYC Suburbs, NY ........................................................................ ................................................ 1.046 00833 ....... 01 ............. Hawaii/Guam ......................................................................................... .............................................................. 1.044 00511 ....... 01 ............. Atlanta, GA ......................................................................................... ................................................................. 1.043 31143 ....... 99 ............. Rest of Massachusetts ............................................................................... ......................................................... 1.042 00901 ....... 01 ............. Baltimore/Surr. Cntys, MD ........................................................................... ........................................................ 1.039 00900 ....... 11 ............. Dallas, TX .......................................................................................... .................................................................. 1.034 00900 ....... 18 ............. Houston, TX ......................................................................................... ................................................................ 1.026 00834 ....... 00 ............. Nevada .............................................................................................. ................................................................... 1.023 00590 ....... 03 ............. Fort Lauderdale, FL ................................................................................. ............................................................ 1.022 00900 ....... 31 ............. Austin, TX .......................................................................................... .................................................................. 1.020 31146 ....... 99 ............. Rest of California * ................................................................................. .............................................................. 1.014 31140 ....... 99 ............. Rest of California * ................................................................................. .............................................................. 1.014 31144 ....... 40 ............. New Hampshire ....................................................................................... ............................................................ 1.010


## 46009 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### E.

— P ROPOSED 

### 2006 G EOGRAPHIC 

### A DJUSTMENT 

### FACTORS 

### (GAF S 

### )

—Continued

Carrier Locality Locality name 2006 GAF

00902 ....... 01 ............. Delaware ............................................................................................ .................................................................. 1.010 00973 ....... 50 ............. Virgin Islands ...................................................................................... ................................................................. 1.007 00900 ....... 09 ............. Brazoria, TX ........................................................................................ ................................................................. 1.005 00835 ....... 01 ............. Portland, OR ........................................................................................ ................................................................ 1.005 00952 ....... 12 ............. East St. Louis, IL .................................................................................. ............................................................... 1.003 00832 ....... 00 ............. Arizona ............................................................................................. .................................................................... 0.999 00824 ....... 01 ............. Colorado ............................................................................................ .................................................................. 0.999 00900 ....... 28 ............. Fort Worth, TX ...................................................................................... ............................................................... 0.998 31142 ....... 03 ............. Southern Maine ...................................................................................... ............................................................. 0.992 00900 ....... 15 ............. Galveston, TX ....................................................................................... ............................................................... 0.991 00740 ....... 02 ............. Metropolitan Kansas City, MO ........................................................................ ..................................................... 0.987 00953 ....... 99 ............. Rest of Michigan .................................................................................... .............................................................. 0.986 00836 ....... 99 ............. Rest of Washington .................................................................................. ........................................................... 0.984 00528 ....... 01 ............. New Orleans, LA ..................................................................................... ............................................................ 0.984 00901 ....... 99 ............. Rest of Maryland .................................................................................... ............................................................. 0.982 00590 ....... 99 ............. Rest of Florida ..................................................................................... ................................................................ 0.982 00954 ....... 00 ............. Minnesota ........................................................................................... ................................................................. 0.980 00523 ....... 01 ............. Metropolitan St. Louis, MO .......................................................................... ........................................................ 0.978 00883 ....... 00 ............. Ohio ................................................................................................ ..................................................................... 0.970 31145 ....... 50 ............. Vermont ............................................................................................. .................................................................. 0.968 00910 ....... 09 ............. Utah ................................................................................................ ..................................................................... 0.960 00904 ....... 00 ............. Virginia ............................................................................................ ..................................................................... 0.958 00951 ....... 00 ............. Wisconsin ........................................................................................... .................................................................. 0.956 00952 ....... 99 ............. Rest of Illinois .................................................................................... .................................................................. 0.952 00801 ....... 99 ............. Rest of New York .................................................................................... ............................................................ 0.952 05535 ....... 00 ............. North Carolina ...................................................................................... ................................................................ 0.951 00900 ....... 20 ............. Beaumont, TX ........................................................................................ .............................................................. 0.951 00865 ....... 99 ............. Rest of Pennsylvania ................................................................................ ........................................................... 0.950 00900 ....... 99 ............. Rest of Texas ....................................................................................... ............................................................... 0.947 00521 ....... 05 ............. New Mexico .......................................................................................... ............................................................... 0.947 00835 ....... 99 ............. Rest of Oregon ...................................................................................... .............................................................. 0.946 00511 ....... 99 ............. Rest of Georgia ..................................................................................... .............................................................. 0.943 00884 ....... 16 ............. West Virginia ....................................................................................... ................................................................. 0.942 00630 ....... 00 ............. Indiana ............................................................................................. .................................................................... 0.937 31142 ....... 99 ............. Rest of Maine ....................................................................................... ............................................................... 0.936 00740 ....... 04 ............. Kansas * ............................................................................................. .................................................................. 0.936 00650 ....... 00 ............. Kansas * ............................................................................................. .................................................................. 0.936 00528 ....... 99 ............. Rest of Louisiana ................................................................................... .............................................................. 0.936 00825 ....... 21 ............. Wyoming ............................................................................................. ................................................................. 0.934 05440 ....... 35 ............. Tennessee ........................................................................................... ................................................................ 0.933 00660 ....... 00 ............. Kentucky ............................................................................................ .................................................................. 0.932 00880 ....... 01 ............. South Carolina ...................................................................................... ............................................................... 0.930 00870 ....... 01 ............. Rhode Island ........................................................................................ ................................................................ 0.930 00751 ....... 01 ............. Montana ............................................................................................. .................................................................. 0.928 00826 ....... 00 ............. Iowa ................................................................................................ ..................................................................... 0.927 00655 ....... 00 ............. Nebraska ............................................................................................ .................................................................. 0.925 00820 ....... 01 ............. North Dakota ........................................................................................ ................................................................ 0.924 00510 ....... 00 ............. Alabama ............................................................................................. .................................................................. 0.923 05130 ....... 00 ............. Idaho ............................................................................................... ..................................................................... 0.922 00820 ....... 02 ............. South Dakota ........................................................................................ ............................................................... 0.922 00512 ....... 00 ............. Mississippi ......................................................................................... ................................................................... 0.919 00522 ....... 00 ............. Oklahoma ............................................................................................ ................................................................. 0.913 00740 ....... 99 ............. Rest of Missouri * ................................................................................... .............................................................. 0.910 00523 ....... 99 ............. Rest of Missouri * ................................................................................... .............................................................. 0.910 00520 ....... 13 ............. Arkansas ............................................................................................ .................................................................. 0.905 00973 ....... 20 ............. Puerto Rico ......................................................................................... ................................................................. 0.840

For 2005 and 2006, if the work GPCI falls below a 1.0 work index, the work GPCI equals 1.0. * states are served by more than one carrier ** locality numbers not assigned to proposed localities



### A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK

SSA state/county code County and state name ESRD MSA No. CBSA No.

01000 ......................... Autauga County, Alabama .......................................................................... ........................ 5240 33860 01010 ......................... Baldwin County, Alabama .......................................................................... ......................... 5160 01 01020 ......................... Barbour County, Alabama .......................................................................... ......................... 01 01 01030 ......................... Bibb County, Alabama ............................................................................. ........................... 01 13820


## 46010 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

01040 ......................... Blount County, Alabama ........................................................................... .......................... 1000 13820 01050 ......................... Bullock County, Alabama .......................................................................... .......................... 01 01 01060 ......................... Butler County, Alabama ........................................................................... ........................... 01 01 01070 ......................... Calhoun County, Alabama .......................................................................... ........................ 0450 11500 01080 ......................... Chambers County, Alabama ......................................................................... ...................... 01 01 01090 ......................... Cherokee County, Alabama ......................................................................... ....................... 01 01 01100 ......................... Chilton County, Alabama .......................................................................... .......................... 01 13820 01110 ......................... Choctaw County, Alabama .......................................................................... ........................ 01 01 01120 ......................... Clarke County, Alabama ........................................................................... .......................... 01 01 01130 ......................... Clay County, Alabama ............................................................................. ........................... 01 01 01140 ......................... Cleburne County, Alabama ......................................................................... ........................ 01 01 01150 ......................... Coffee County, Alabama ........................................................................... .......................... 01 01 01160 ......................... Colbert County, Alabama .......................................................................... .......................... 2650 22520 01170 ......................... Conecuh County, Alabama .......................................................................... ....................... 01 01 01180 ......................... Coosa County, Alabama ............................................................................ ......................... 01 01 01190 ......................... Covington County, Alabama ........................................................................ ....................... 01 01 01200 ......................... Crenshaw County, Alabama ......................................................................... ...................... 01 01 01210 ......................... Cullman County, Alabama .......................................................................... ........................ 01 01 01220 ......................... Dale County, Alabama ............................................................................. ........................... 2180 01 01230 ......................... Dallas County, Alabama ........................................................................... ........................... 01 01 01240 ......................... De Kalb County, Alabama .......................................................................... ......................... 01 01 01250 ......................... Elmore County, Alabama ........................................................................... ......................... 5240 33860 01260 ......................... Escambia County, Alabama ......................................................................... ....................... 01 01 01270 ......................... Etowah County, Alabama ........................................................................... ......................... 2880 23460 01280 ......................... Fayette County, Alabama .......................................................................... .......................... 01 01 01290 ......................... Franklin County, Alabama ......................................................................... .......................... 01 01 01300 ......................... Geneva County, Alabama ........................................................................... ........................ 01 20020 01310 ......................... Greene County, Alabama ........................................................................... ......................... 01 46220 01320 ......................... Hale County, Alabama ............................................................................. ........................... 01 46220 01330 ......................... Henry County, Alabama ............................................................................ .......................... 01 20020 01340 ......................... Houston County, Alabama .......................................................................... ........................ 2180 20020 01350 ......................... Jackson County, Alabama .......................................................................... ........................ 01 01 01360 ......................... Jefferson County, Alabama ........................................................................ ......................... 1000 13820 01370 ......................... Lamar County, Alabama ............................................................................ ......................... 01 01 01380 ......................... Lauderdale County, Alabama ....................................................................... ....................... 2650 22520 01390 ......................... Lawrence County, Alabama ......................................................................... ....................... 01 19460 01400 ......................... Lee County, Alabama .............................................................................. ............................ 01 12220 01410 ......................... Limestone County, Alabama ........................................................................ ....................... 01 26620 01420 ......................... Lowndes County, Alabama .......................................................................... ....................... 01 33860 01430 ......................... Macon County, Alabama ............................................................................ ......................... 01 01 01440 ......................... Madison County, Alabama .......................................................................... ........................ 3440 26620 01450 ......................... Marengo County, Alabama .......................................................................... ....................... 01 01 01460 ......................... Marion County, Alabama ........................................................................... .......................... 01 01 01470 ......................... Marshall County, Alabama ......................................................................... ......................... 01 01 01480 ......................... Mobile County, Alabama ........................................................................... .......................... 5160 33660 01490 ......................... Monroe County, Alabama ........................................................................... ........................ 01 01 01500 ......................... Montgomery County, Alabama ....................................................................... ..................... 5240 33860 01510 ......................... Morgan County, Alabama ........................................................................... ........................ 01 19460 01520 ......................... Perry County, Alabama ............................................................................ ........................... 01 01 01530 ......................... Pickens County, Alabama .......................................................................... ......................... 01 01 01540 ......................... Pike County, Alabama ............................................................................. ............................ 01 01 01550 ......................... Randolph County, Alabama ......................................................................... ....................... 01 01 01560 ......................... Russell County, Alabama .......................................................................... .......................... 1800 17980 01570 ......................... St Clair County, Alabama ......................................................................... ........................... 1000 13820 01580 ......................... Shelby County, Alabama ........................................................................... .......................... 1000 13820 01590 ......................... Sumter County, Alabama ........................................................................... ......................... 01 01 01600 ......................... Talladega County, Alabama ........................................................................ ........................ 01 01 01610 ......................... Tallapoosa County, Alabama ....................................................................... ....................... 01 01 01620 ......................... Tuscaloosa County, Alabama ....................................................................... ...................... 8600 46220 01630 ......................... Walker County, Alabama ........................................................................... ......................... 1000 13820 01640 ......................... Washington County, Alabama ....................................................................... ...................... 01 01 01650 ......................... Wilcox County, Alabama ........................................................................... .......................... 01 01 01660 ......................... Winston County, Alabama .......................................................................... ......................... 01 01 02013 ......................... Aleutians County East, Alaska .................................................................... ........................ 02 02 02016 ......................... Aleutians County West, Alaska .................................................................... ....................... 02 02 02020 ......................... Anchorage County, Alaska ......................................................................... ......................... 0380 11260 02030 ......................... Angoon County, Alaska ............................................................................ ........................... 02 02 02040 ......................... Barrow-North Slope County, Alaska ................................................................ ................... 02 02 02050 ......................... Bethel County, Alaska ............................................................................ ............................. 02 02 02060 ......................... Bristol Bay Borough County, Alaska ............................................................... .................... 02 02


## 46011 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

02068 ......................... Denali County, Alaska ............................................................................ ............................. 02 02 02070 ......................... Bristol Bay County, Alaska ....................................................................... ........................... 02 02 02080 ......................... Cordova-Mc Carthy County, Alaska ................................................................. ................... 02 02 02090 ......................... Fairbanks County, Alaska ......................................................................... .......................... 02 21820 02100 ......................... Haines County, Alaska ............................................................................ ............................ 02 02 02110 ......................... Juneau County, Alaska ............................................................................ ........................... 02 02 02120 ......................... Kenai-Cook Inlet County, Alaska .................................................................. ...................... 02 02 02122 ......................... Kenai Peninsula Borough, Alaska .................................................................. ..................... 02 02 02130 ......................... Ketchikan County, Alaska ......................................................................... .......................... 02 02 02140 ......................... Kobuk County, Alaska ............................................................................. ............................ 02 02 02150 ......................... Kodiak County, Alaska ............................................................................ ............................ 02 02 02160 ......................... Kuskokwin County, Alaska ......................................................................... ......................... 02 02 02164 ......................... Lake and Peninsula Borough, Alaska ............................................................... .................. 02 02 02170 ......................... Matanuska County, Alaska ......................................................................... ........................ 02 11260 02180 ......................... Nome County, Alaska .............................................................................. ........................... 02 02 02185 ......................... North Slope Borough, Alaska ...................................................................... ........................ 02 02 02188 ......................... Northwest Arctic Borough, Alaska ................................................................. ..................... 02 02 02190 ......................... Outer Ketchikan County, Alaska ................................................................... ...................... 02 02 02200 ......................... Prince Of Wales County, Alaska ................................................................... ...................... 02 02 02201 ......................... Prince of Wales-Outer Ketchikan Census Area, Alaska .............................................. ....... 02 02 02210 ......................... Seward County, Alaska ............................................................................ ........................... 02 02 02220 ......................... Sitka County, Alaska ............................................................................. .............................. 02 02 02230 ......................... Skagway-Yakutat County, Alaska ................................................................... .................... 02 02 02231 ......................... Skagway-Yakutat-Angoon Census Area, Alaska ....................................................... ......... 02 02 02232 ......................... Skagway-Hoonah-Angoon Census Area, Alaska ........................................................ ....... 02 02 02240 ......................... Southeast Fairbanks County, Alaska ............................................................... ................... 02 02 02250 ......................... Upper Yukon County, Alaska ....................................................................... ....................... 02 02 02260 ......................... Valdz-Chitna-Whitier County, Alaska .............................................................. .................... 02 02 02261 ......................... Valdex-Cordove Census Area, Alaska ............................................................... ................. 02 02 02270 ......................... Wade Hampton County, Alaska ...................................................................... .................... 02 02 02280 ......................... Wrangell-Petersburg County, Alaska ............................................................... ................... 02 02 02282 ......................... Yakutat Borough, Alaska .......................................................................... ........................... 02 02 02290 ......................... Yukon-Koyukuk County, Alaska ..................................................................... ..................... 02 02 03000 ......................... Apache County, Arizona ........................................................................... .......................... 03 03 03010 ......................... Cochise County, Arizona .......................................................................... ........................... 03 03 03020 ......................... Coconino County, Arizona ......................................................................... ......................... 03 22380 03030 ......................... Gila County, Arizona ............................................................................. .............................. 03 03 03040 ......................... Graham County, Arizona ........................................................................... .......................... 03 03 03050 ......................... Greenlee County, Arizona ......................................................................... .......................... 03 03 03055 ......................... La Paz County, Arizona ........................................................................... ........................... 03 03 03060 ......................... Maricopa County, Arizona ......................................................................... .......................... 6200 38060 03070 ......................... Mohave County, Arizona ........................................................................... .......................... 03 03 03080 ......................... Navajo County, Arizona ........................................................................... ........................... 03 03 03090 ......................... Pima County, Arizona ............................................................................. ............................ 8520 46060 03100 ......................... Pinal County, Arizona ............................................................................ .............................. 03 38060 03110 ......................... Santa Cruz County, Arizona ....................................................................... ........................ 03 03 03120 ......................... Yavapai County, Arizona .......................................................................... ........................... 03 39140 03130 ......................... Yuma County, Arizona ............................................................................. ........................... 03 49740 04000 ......................... Arkansas County, Arkansas ........................................................................ ........................ 04 04 04010 ......................... Ashley County, Arkansas .......................................................................... .......................... 04 04 04020 ......................... Baxter County, Arkansas .......................................................................... .......................... 04 04 04030 ......................... Benton County, Arkansas .......................................................................... ......................... 04 22220 04040 ......................... Boone County, Arkansas ........................................................................... ......................... 04 04 04050 ......................... Bradley County, Arkansas ......................................................................... .......................... 04 04 04060 ......................... Calhoun County, Arkansas ......................................................................... ........................ 04 04 04070 ......................... Carroll County, Arkansas ......................................................................... ........................... 04 04 04080 ......................... Chicot County, Arkansas .......................................................................... ........................... 04 04 04090 ......................... Clark County, Arkansas ........................................................................... ........................... 04 04 04100 ......................... Clay County, Arkansas ............................................................................ ............................ 04 04 04110 ......................... Cleburne County, Arkansas ........................................................................ ........................ 04 04 04120 ......................... Cleveland County, Arkansas ....................................................................... ........................ 04 38220 04130 ......................... Columbia County, Arkansas ........................................................................ ........................ 04 04 04140 ......................... Conway County, Arkansas .......................................................................... ........................ 04 04 04150 ......................... Craighead County, Arkansas ....................................................................... ....................... 04 27860 04160 ......................... Crawford County, Arkansas ........................................................................ ........................ 2720 22900 04170 ......................... Crittenden County, Arkansas ...................................................................... ........................ 4920 32820 04180 ......................... Cross County, Arkansas ........................................................................... .......................... 04 04 04190 ......................... Dallas County, Arkansas .......................................................................... ........................... 04 04 04200 ......................... Desha County, Arkansas ........................................................................... ......................... 04 04 04210 ......................... Drew County, Arkansas ............................................................................ .......................... 04 04


## 46012 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

04220 ......................... Faulkner County, Arkansas ........................................................................ ......................... 4400 30780 04230 ......................... Franklin County, Arkansas ........................................................................ .......................... 04 22900 04240 ......................... Fulton County, Arkansas .......................................................................... ........................... 04 04 04250 ......................... Garland County, Arkansas ......................................................................... ......................... 04 26300 04260 ......................... Grant County, Arkansas ........................................................................... ........................... 04 30780 04270 ......................... Greene County, Arkansas .......................................................................... ......................... 04 04 04280 ......................... Hempstead County, Arkansas ....................................................................... ..................... 04 04 04290 ......................... Hot Spring County, Arkansas ...................................................................... ........................ 04 04 04300 ......................... Howard County, Arkansas .......................................................................... ........................ 04 04 04310 ......................... Independence County, Arkansas .................................................................... .................... 04 04 04320 ......................... Izard County, Arkansas ........................................................................... ............................ 04 04 04330 ......................... Jackson County, Arkansas ......................................................................... ......................... 04 04 04340 ......................... Jefferson County, Arkansas ....................................................................... ......................... 6240 38220 04350 ......................... Johnson County, Arkansas ......................................................................... ........................ 04 04 04360 ......................... Lafayette County, Arkansas ....................................................................... ......................... 04 04 04370 ......................... Lawrence County, Arkansas ........................................................................ ....................... 04 04 04380 ......................... Lee County, Arkansas ............................................................................. ............................ 04 04 04390 ......................... Lincoln County, Arkansas ......................................................................... .......................... 04 38220 04400 ......................... Little River County, Arkansas .................................................................... .......................... 04 04 04410 ......................... Logan County, Arkansas ........................................................................... .......................... 04 04 04420 ......................... Lonoke County, Arkansas .......................................................................... ......................... 4400 30780 04430 ......................... Madison County, Arkansas ......................................................................... ........................ 04 22220 04440 ......................... Marion County, Arkansas .......................................................................... .......................... 04 04 04450 ......................... Miller County, Arkansas .......................................................................... ............................ 8360 45500 04460 ......................... Mississippi County, Arkansas ..................................................................... ........................ 04 04 04470 ......................... Monroe County, Arkansas .......................................................................... ......................... 04 04 04480 ......................... Montgomery County, Arkansas ...................................................................... ..................... 04 04 04490 ......................... Nevada County, Arkansas .......................................................................... ........................ 04 04 04500 ......................... Newton County, Arkansas .......................................................................... ......................... 04 04 04510 ......................... Ouachita County, Arkansas ........................................................................ ........................ 04 04 04520 ......................... Perry County, Arkansas ........................................................................... ........................... 04 30780 04530 ......................... Phillips County, Arkansas ........................................................................ ........................... 04 04 04540 ......................... Pike County, Arkansas ............................................................................ ............................ 04 04 04550 ......................... Poinsett County, Arkansas ........................................................................ .......................... 04 27860 04560 ......................... Polk County, Arkansas ............................................................................ ............................ 04 04 04570 ......................... Pope County, Arkansas ............................................................................ .......................... 04 04 04580 ......................... Prairie County, Arkansas ......................................................................... ........................... 04 04 04590 ......................... Pulaski County, Arkansas ......................................................................... .......................... 4400 30780 04600 ......................... Randolph County, Arkansas ........................................................................ ....................... 04 04 04610 ......................... St Francis County, Arkansas ...................................................................... ........................ 04 04 04620 ......................... Saline County, Arkansas .......................................................................... ........................... 4400 30780 04630 ......................... Scott County, Arkansas ........................................................................... ............................ 04 04 04640 ......................... Searcy County, Arkansas .......................................................................... .......................... 04 04 04650 ......................... Sebastian County, Arkansas ....................................................................... ........................ 2720 22900 04660 ......................... Sevier County, Arkansas .......................................................................... ........................... 04 04 04670 ......................... Sharp County, Arkansas ........................................................................... .......................... 04 04 04680 ......................... Stone County, Arkansas ........................................................................... .......................... 04 04 04690 ......................... Union County, Arkansas ........................................................................... .......................... 04 04 04700 ......................... Van Buren County, Arkansas ....................................................................... ....................... 04 04 04710 ......................... Washington County, Arkansas ...................................................................... ...................... 2580 22220 04720 ......................... White County, Arkansas ........................................................................... ........................... 04 04 04730 ......................... Woodruff County, Arkansas ........................................................................ ........................ 04 04 04740 ......................... Yell County, Arkansas ............................................................................ ............................. 04 04 05000 ......................... Alameda County, California ....................................................................... ......................... 5775 36084 05010 ......................... Alpine County, California ........................................................................ ............................. 05 05 05020 ......................... Amador County, California ........................................................................ .......................... 05 05 05030 ......................... Butte County, California ......................................................................... ............................. 1620 17020 05040 ......................... Calaveras County, California ..................................................................... ......................... 05 05 05050 ......................... Colusa County, California ........................................................................ ........................... 05 05 05060 ......................... Contra Costa County, California .................................................................. ....................... 5775 36084 05070 ......................... Del Norte County, California ..................................................................... .......................... 05 05 05080 ......................... Eldorado County, California ...................................................................... .......................... 6920 40900 05090 ......................... Fresno County, California ........................................................................ ........................... 2840 23420 05100 ......................... Glenn County, California ......................................................................... ............................ 05 05 05110 ......................... Humboldt County, California ...................................................................... ......................... 05 05 05120 ......................... Imperial County, California ...................................................................... ............................ 05 20940 05130 ......................... Inyo County, California .......................................................................... .............................. 05 05 05140 ......................... Kern County, California .......................................................................... ............................. 0680 12540 05150 ......................... Kings County, California ......................................................................... ............................. 05 25260 05160 ......................... Lake County, California .......................................................................... ............................. 05 05


## 46013 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

05170 ......................... Lassen County, California ........................................................................ ........................... 05 05 05200 ......................... Los Angeles County, California ................................................................... ........................ 4480 31084 05210 ......................... Los Angeles County, California ................................................................... ........................ 4480 31084 05300 ......................... Madera County, California ........................................................................ .......................... 05 31460 05310 ......................... Marin County, California ......................................................................... ............................. 7360 41884 05320 ......................... Mariposa County, California ...................................................................... .......................... 05 05 05330 ......................... Mendocino County, California ..................................................................... ........................ 05 05 05340 ......................... Merced County, California ........................................................................ ........................... 4940 32900 05350 ......................... Modoc County, California ......................................................................... ........................... 05 05 05360 ......................... Mono County, California .......................................................................... ............................ 05 05 05370 ......................... Monterey County, California ...................................................................... .......................... 7120 41500 05380 ......................... Napa County, California .......................................................................... ............................ 8720 34900 05390 ......................... Nevada County, California ........................................................................ .......................... 05 05 05400 ......................... Orange County, California ........................................................................ ........................... 0360 42044 05410 ......................... Placer County, California ........................................................................ ............................ 6920 40900 05420 ......................... Plumas County, California ........................................................................ ........................... 05 05 05430 ......................... Riverside County, California ..................................................................... ........................... 6780 40140 05440 ......................... Sacramento County, California .................................................................... ....................... 6920 40900 05450 ......................... San Benito County, California .................................................................... ......................... 05 41940 05460 ......................... San Bernardino County, California ................................................................ ..................... 6780 40140 05470 ......................... San Diego County, California ..................................................................... ......................... 7320 41740 05480 ......................... San Francisco County, California ................................................................. ...................... 7360 41884 05490 ......................... San Joaquin County, California ................................................................... ....................... 8120 44700 05500 ......................... San Luis Obispo County, California ............................................................... ..................... 05 42020 05510 ......................... San Mateo County, California ..................................................................... ........................ 7360 41884 05520 ......................... Santa Barbara County, California ................................................................. ...................... 7480 42060 05530 ......................... Santa Clara County, California ................................................................... ........................ 7400 41940 05540 ......................... Santa Cruz County, California .................................................................... ........................ 7485 42100 05550 ......................... Shasta County, California ........................................................................ ........................... 6690 39820 05560 ......................... Sierra County, California ........................................................................ ............................. 05 05 05570 ......................... Siskiyou County, California ...................................................................... ........................... 05 05 05580 ......................... Solano County, California ........................................................................ ........................... 8720 46700 05590 ......................... Sonoma County, California ........................................................................ ......................... 7500 42220 05600 ......................... Stanislaus County, California .................................................................... .......................... 5170 33700 05610 ......................... Sutter County, California ........................................................................ ............................. 9340 49700 05620 ......................... Tehama County, California ........................................................................ ......................... 05 05 05630 ......................... Trinity County, California ....................................................................... .............................. 05 05 05640 ......................... Tulare County, California ........................................................................ ............................ 8780 47300 05650 ......................... Tuolumne County, California ...................................................................... ......................... 05 05 05660 ......................... Ventura County, California ....................................................................... ........................... 6000 37100 05670 ......................... Yolo County, California .......................................................................... ............................. 6920 40900 05680 ......................... Yuba County, California .......................................................................... ............................ 9340 49700 06000 ......................... Adams County, Colorado ........................................................................... ......................... 2080 19740 06010 ......................... Alamosa County, Colorado ......................................................................... ........................ 06 06 06020 ......................... Arapahoe County, Colorado ........................................................................ ........................ 2080 19740 06030 ......................... Archuleta County, Colorado ....................................................................... ......................... 06 06 06040 ......................... Baca County, Colorado ............................................................................ ........................... 06 06 06050 ......................... Bent County, Colorado ............................................................................ ............................ 06 06 06060 ......................... Boulder County, Colorado ......................................................................... .......................... 1125 14500 06070 ......................... Chaffee County, Colorado ......................................................................... .......................... 06 06 06080 ......................... Cheyenne County, Colorado ........................................................................ ....................... 06 06 06090 ......................... Clear Creek County, Colorado ..................................................................... ....................... 06 19740 06100 ......................... Conejos County, Colorado ......................................................................... ......................... 06 06 06110 ......................... Costilla County, Colorado ........................................................................ ........................... 06 06 06120 ......................... Crowley County, Colorado ......................................................................... ......................... 06 06 06130 ......................... Custer County, Colorado .......................................................................... ........................... 06 06 06140 ......................... Delta County, Colorado ........................................................................... ............................ 06 06 06150 ......................... Denver County, Colorado .......................................................................... .......................... 2080 19740 06160 ......................... Dolores County, Colorado ......................................................................... .......................... 06 06 06170 ......................... Douglas County, Colorado ......................................................................... ......................... 2080 19740 06180 ......................... Eagle County, Colorado ........................................................................... ........................... 06 06 06190 ......................... Elbert County, Colorado .......................................................................... ............................ 06 19740 06200 ......................... El Paso County, Colorado ......................................................................... .......................... 1720 17820 06210 ......................... Fremont County, Colorado ......................................................................... ......................... 06 06 06220 ......................... Garfield County, Colorado ........................................................................ ........................... 06 06 06230 ......................... Gilpin County, Colorado .......................................................................... ............................ 06 19740 06240 ......................... Grand County, Colorado ........................................................................... .......................... 06 06 06250 ......................... Gunnison County, Colorado ........................................................................ ........................ 06 06 06260 ......................... Hinsdale County, Colorado ........................................................................ ......................... 06 06 06270 ......................... Huerfano County, Colorado ........................................................................ ........................ 06 06


## 46014 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

06280 ......................... Jackson County, Colorado ......................................................................... ......................... 06 06 06290 ......................... Jefferson County, Colorado ....................................................................... ......................... 2080 19740 06300 ......................... Kiowa County, Colorado ........................................................................... .......................... 06 06 06310 ......................... Kit Carson County, Colorado ...................................................................... ........................ 06 06 06320 ......................... Lake County, Colorado ............................................................................ ........................... 06 06 06330 ......................... La Plata County, Colorado ........................................................................ .......................... 06 06 06340 ......................... Larimer County, Colorado ......................................................................... .......................... 2670 22660 06350 ......................... Las Animas County, Colorado ...................................................................... ...................... 06 06 06360 ......................... Lincoln County, Colorado ......................................................................... ........................... 06 06 06370 ......................... Logan County, Colorado ........................................................................... .......................... 06 06 06380 ......................... Mesa County, Colorado ............................................................................ .......................... 06 24300 06390 ......................... Mineral County, Colorado ......................................................................... .......................... 06 06 06400 ......................... Moffat County, Colorado .......................................................................... ........................... 06 06 06410 ......................... Montezuma County, Colorado ....................................................................... ..................... 06 06 06420 ......................... Montrose County, Colorado ........................................................................ ........................ 06 06 06430 ......................... Morgan County, Colorado .......................................................................... ......................... 06 06 06440 ......................... Otero County, Colorado ........................................................................... ........................... 06 06 06450 ......................... Ouray County, Colorado ........................................................................... .......................... 06 06 06460 ......................... Park County, Colorado ............................................................................ ............................ 06 19740 06470 ......................... Phillips County, Colorado ........................................................................ ............................ 06 06 06480 ......................... Pitkin County, Colorado .......................................................................... ............................ 06 06 06490 ......................... Prowers County, Colorado ......................................................................... ......................... 06 06 06500 ......................... Pueblo County, Colorado .......................................................................... .......................... 6560 39380 06510 ......................... Rio Blanco County, Colorado ...................................................................... ........................ 06 06 06520 ......................... Rio Grande County, Colorado ...................................................................... ....................... 06 06 06530 ......................... Routt County, Colorado ........................................................................... ............................ 06 06 06540 ......................... Saguache County, Colorado ........................................................................ ....................... 06 06 06550 ......................... San Juan County, Colorado ........................................................................ ........................ 06 06 06560 ......................... San Miguel County, Colorado ...................................................................... ....................... 06 06 06570 ......................... Sedgwick County, Colorado ........................................................................ ........................ 06 06 06580 ......................... Summit County, Colorado .......................................................................... ......................... 06 06 06590 ......................... Teller County, Colorado .......................................................................... ............................ 06 17820 06600 ......................... Washington County, Colorado ...................................................................... ...................... 06 06 06610 ......................... Weld County, Colorado ............................................................................ ........................... 3060 24540 06620 ......................... Yuma County, Colorado ............................................................................ .......................... 06 06 06630 ......................... Broomfield County, Colorado ...................................................................... ........................ 06 19740 07000 ......................... Fairfield County, Connecticut .................................................................... .......................... 1163 14860 07010 ......................... Hartford County, Connecticut ..................................................................... ......................... 3283 25540 07020 ......................... Litchfield County, Connecticut ................................................................... .......................... 3283 25540 07030 ......................... Middlesex County, Connecticut .................................................................... ....................... 3283 25540 07040 ......................... New Haven County, Connecticut .................................................................... .................... 5483 35300 07050 ......................... New London County, Connecticut ................................................................... ................... 5523 35980 07060 ......................... Tolland County, Connecticut ...................................................................... ......................... 3283 25540 07070 ......................... Windham County, Connecticut ...................................................................... ...................... 07 07 08000 ......................... Kent County, Delaware ............................................................................ ........................... 07 20100 08010 ......................... New Castle County, Delaware ...................................................................... ...................... 9160 48864 08020 ......................... Sussex County, Delaware .......................................................................... ......................... 08 08 09000 ......................... Washington DC County, Dist Of Col ................................................................ ................... 8840 47894 10000 ......................... Alachua County, Florida .......................................................................... ............................ 2900 23540 10010 ......................... Baker County, Florida ............................................................................ ............................. 10 27260 10020 ......................... Bay County, Florida .............................................................................. ............................... 6015 37460 10030 ......................... Bradford County, Florida ......................................................................... ............................ 10 10 10040 ......................... Brevard County, Florida .......................................................................... ............................ 4900 37340 10050 ......................... Broward County, Florida .......................................................................... ........................... 2680 22744 10060 ......................... Calhoun County, Florida .......................................................................... ........................... 10 10 10070 ......................... Charlotte County, Florida ........................................................................ ............................ 10 39460 10080 ......................... Citrus County, Florida ........................................................................... .............................. 10 10 10090 ......................... Clay County, Florida ............................................................................. ............................... 3600 27260 10100 ......................... Collier County, Florida .......................................................................... ............................... 5345 34940 10110 ......................... Columbia County, Florida ......................................................................... ........................... 10 10 10120 ......................... Dade County, Florida ............................................................................. ............................. 5000 33124 10130 ......................... De Soto County, Florida .......................................................................... ............................ 10 10 10140 ......................... Dixie County, Florida ............................................................................ ............................... 10 10 10150 ......................... Duval County, Florida ............................................................................ .............................. 3600 27260 10160 ......................... Escambia County, Florida ......................................................................... .......................... 6080 37860 10170 ......................... Flagler County, Florida .......................................................................... .............................. 10 10 10180 ......................... Franklin County, Florida ......................................................................... ............................. 10 10 10190 ......................... Gadsden County, Florida .......................................................................... .......................... 8240 45220 10200 ......................... Gilchrist County, Florida ........................................................................ .............................. 10 23540 10210 ......................... Glades County, Florida ........................................................................... ............................ 10 10


## 46015 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

10220 ......................... Gulf County, Florida ............................................................................. ............................... 10 10 10230 ......................... Hamilton County, Florida ......................................................................... ............................ 10 10 10240 ......................... Hardee County, Florida ........................................................................... ............................ 10 10 10250 ......................... Hendry County, Florida ........................................................................... ............................ 10 10 10260 ......................... Hernando County, Florida ......................................................................... .......................... 8280 45300 10270 ......................... Highlands County, Florida ........................................................................ ........................... 10 10 10280 ......................... Hillsborough County, Florida ..................................................................... .......................... 8280 45300 10290 ......................... Holmes County, Florida ........................................................................... ............................ 10 10 10300 ......................... Indian River County, Florida ..................................................................... .......................... 10 46940 10310 ......................... Jackson County, Florida .......................................................................... ............................ 10 10 10320 ......................... Jefferson County, Florida ........................................................................ ............................ 10 45220 10330 ......................... Lafayette County, Florida ........................................................................ ............................ 10 10 10340 ......................... Lake County, Florida ............................................................................. .............................. 10 36740 10350 ......................... Lee County, Florida .............................................................................. ............................... 2700 15980 10360 ......................... Leon County, Florida ............................................................................. .............................. 8240 45220 10370 ......................... Levy County, Florida ............................................................................. .............................. 10 10 10380 ......................... Liberty County, Florida .......................................................................... .............................. 10 10 10390 ......................... Madison County, Florida .......................................................................... ........................... 10 10 10400 ......................... Manatee County, Florida .......................................................................... ........................... 1140 42260 10410 ......................... Marion County, Florida ........................................................................... ............................. 5790 36100 10420 ......................... Martin County, Florida ........................................................................... .............................. 2710 38940 10430 ......................... Monroe County, Florida ........................................................................... ............................ 10 10 10440 ......................... Nassau County, Florida ........................................................................... ............................ 3600 27260 10450 ......................... Okaloosa County, Florida ......................................................................... ........................... 2750 23020 10460 ......................... Okeechobee County, Florida ....................................................................... ....................... 10 10 10470 ......................... Orange County, Florida ........................................................................... ............................ 5960 36740 10480 ......................... Osceola County, Florida .......................................................................... ............................ 5960 36740 10490 ......................... Palm Beach County, Florida ....................................................................... ........................ 8960 48424 10500 ......................... Pasco County, Florida ............................................................................ ............................. 8280 45300 10510 ......................... Pinellas County, Florida ......................................................................... ............................. 8280 45300 10520 ......................... Polk County, Florida ............................................................................. ............................... 3980 29460 10530 ......................... Putnam County, Florida ........................................................................... ........................... 10 10 10540 ......................... St. Johns County, Florida ........................................................................ ............................ 3600 27260 10550 ......................... St Lucie County, Florida ......................................................................... ............................. 2710 38940 10560 ......................... Santa Rosa County, Florida ....................................................................... ......................... 6080 37860 10570 ......................... Sarasota County, Florida ......................................................................... ........................... 7510 42260 10580 ......................... Seminole County, Florida ......................................................................... ........................... 5960 36740 10590 ......................... Sumter County, Florida ........................................................................... ............................ 10 10 10600 ......................... Suwannee County, Florida ......................................................................... ......................... 10 10 10610 ......................... Taylor County, Florida ........................................................................... .............................. 10 10 10620 ......................... Union County, Florida ............................................................................ ............................. 10 10 10630 ......................... Volusia County, Florida .......................................................................... ............................. 2020 19660 10640 ......................... Wakulla County, Florida .......................................................................... ............................ 10 45220 10650 ......................... Walton County, Florida ........................................................................... ............................. 10 10 10660 ......................... Washington County, Florida ....................................................................... ......................... 10 10 11000 ......................... Appling County, Georgia .......................................................................... ........................... 11 11 11010 ......................... Atkinson County, Georgia ......................................................................... .......................... 11 11 11011 ......................... Bacon County, Georgia ............................................................................ ........................... 11 11 11020 ......................... Baker County, Georgia ............................................................................ ............................ 11 10500 11030 ......................... Baldwin County, Georgia .......................................................................... .......................... 11 11 11040 ......................... Banks County, Georgia ............................................................................ ........................... 11 11 11050 ......................... Barrow County, Georgia ........................................................................... ........................... 0520 12060 11060 ......................... Bartow County, Georgia ........................................................................... ........................... 11 12060 11070 ......................... Ben Hill County, Georgia ......................................................................... ........................... 11 11 11080 ......................... Berrien County, Georgia .......................................................................... ........................... 11 11 11090 ......................... Bibb County, Georgia ............................................................................. ............................. 4680 31420 11100 ......................... Bleckley County, Georgia ......................................................................... ........................... 11 11 11110 ......................... Brantley County, Georgia ......................................................................... ........................... 11 15260 11120 ......................... Brooks County, Georgia ........................................................................... ........................... 11 46660 11130 ......................... Bryan County, Georgia ............................................................................ ............................ 11 42340 11140 ......................... Bulloch County, Georgia .......................................................................... ........................... 11 11 11150 ......................... Burke County, Georgia ............................................................................ ............................ 11 12260 11160 ......................... Butts County, Georgia ............................................................................ ............................. 0520 12060 11161 ......................... Calhoun County, Georgia .......................................................................... .......................... 11 11 11170 ......................... Camden County, Georgia ........................................................................... ........................ 11 11 11180 ......................... Candler County, Georgia .......................................................................... .......................... 11 11 11190 ......................... Carroll County, Georgia .......................................................................... ............................ 11 12060 11200 ......................... Catoosa County, Georgia .......................................................................... .......................... 1560 16860 11210 ......................... Charlton County, Georgia ......................................................................... .......................... 11 11 11220 ......................... Chatham County, Georgia .......................................................................... ........................ 7520 42340


## 46016 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

11230 ......................... Chattahoochee County, Georgia .................................................................... ..................... 1800 17980 11240 ......................... Chattooga County, Georgia ........................................................................ ........................ 11 11 11250 ......................... Cherokee County, Georgia ......................................................................... ........................ 0520 12060 11260 ......................... Clarke County, Georgia ........................................................................... ............................ 0500 12020 11270 ......................... Clay County, Georgia ............................................................................. ............................. 11 11 11280 ......................... Clayton County, Georgia .......................................................................... ........................... 0520 12060 11281 ......................... Clinch County, Georgia ........................................................................... ............................ 11 11 11290 ......................... Cobb County, Georgia ............................................................................. ........................... 0520 12060 11291 ......................... Coffee County, Georgia ........................................................................... ........................... 11 11 11300 ......................... Colquitt County, Georgia ......................................................................... ............................ 11 11 11310 ......................... Columbia County, Georgia ......................................................................... ......................... 0600 12260 11311 ......................... Cook County, Georgia ............................................................................. ............................ 11 11 11320 ......................... Coweta County, Georgia ........................................................................... .......................... 0520 12060 11330 ......................... Crawford County, Georgia ......................................................................... ......................... 11 31420 11340 ......................... Crisp County, Georgia ............................................................................ ............................. 11 11 11341 ......................... Dade County, Georgia ............................................................................. ........................... 1560 16860 11350 ......................... Dawson County, Georgia ........................................................................... ......................... 11 12060 11360 ......................... Decatur County, Georgia .......................................................................... .......................... 11 11 11370 ......................... De Kalb County, Georgia .......................................................................... .......................... 0520 12060 11380 ......................... Dodge County, Georgia ............................................................................ .......................... 11 11 11381 ......................... Dooly County, Georgia ............................................................................ ............................ 11 11 11390 ......................... Dougherty County, Georgia ........................................................................ ........................ 0120 10500 11400 ......................... Douglas County, Georgia .......................................................................... .......................... 0520 12060 11410 ......................... Early County, Georgia ............................................................................ ............................. 11 11 11420 ......................... Echols County, Georgia ........................................................................... ........................... 11 46660 11421 ......................... Effingham County, Georgia ........................................................................ ......................... 7520 42340 11430 ......................... Elbert County, Georgia ........................................................................... ............................. 11 11 11440 ......................... Emanuel County, Georgia .......................................................................... ......................... 11 11 11441 ......................... Evans County, Georgia ............................................................................ ........................... 11 11 11450 ......................... Fannin County, Georgia ........................................................................... ........................... 11 11 11451 ......................... Fayette County, Georgia .......................................................................... ........................... 0520 12060 11460 ......................... Floyd County, Georgia ............................................................................ ............................ 11 40660 11461 ......................... Forsyth County, Georgia .......................................................................... ........................... 0520 12060 11462 ......................... Franklin County, Georgia ......................................................................... ........................... 11 11 11470 ......................... Fulton County, Georgia ........................................................................... ............................ 0520 12060 11471 ......................... Gilmer County, Georgia ........................................................................... ........................... 11 11 11480 ......................... Glascock County, Georgia ......................................................................... ......................... 11 11 11490 ......................... Glynn County, Georgia ............................................................................ ............................ 11 15260 11500 ......................... Gordon County, Georgia ........................................................................... .......................... 11 11 11510 ......................... Grady County, Georgia ............................................................................ ........................... 11 11 11520 ......................... Greene County, Georgia ........................................................................... .......................... 11 11 11530 ......................... Gwinnett County, Georgia ......................................................................... .......................... 0520 12060 11540 ......................... Habersham County, Georgia ........................................................................ ...................... 11 11 11550 ......................... Hall County, Georgia ............................................................................. .............................. 11 23580 11560 ......................... Hancock County, Georgia .......................................................................... ......................... 11 11 11570 ......................... Haralson County, Georgia ......................................................................... .......................... 11 12060 11580 ......................... Harris County, Georgia ........................................................................... ............................ 11 17980 11581 ......................... Hart County, Georgia ............................................................................. ............................. 11 11 11590 ......................... Heard County, Georgia ............................................................................ ........................... 11 12060 11591 ......................... Henry County, Georgia ............................................................................ ........................... 0520 12060 11600 ......................... Houston County, Georgia .......................................................................... .......................... 4680 47580 11601 ......................... Irwin County, Georgia ............................................................................ ............................. 11 11 11610 ......................... Jackson County, Georgia .......................................................................... .......................... 0500 11 11611 ......................... Jasper County, Georgia ........................................................................... ........................... 11 12060 11612 ......................... Jeff Davis County, Georgia ....................................................................... .......................... 11 11 11620 ......................... Jefferson County, Georgia ........................................................................ .......................... 11 11 11630 ......................... Jenkins County, Georgia .......................................................................... ........................... 11 11 11640 ......................... Johnson County, Georgia .......................................................................... ......................... 11 11 11650 ......................... Jones County, Georgia ............................................................................ ........................... 4680 31420 11651 ......................... Lamar County, Georgia ............................................................................ ........................... 11 12060 11652 ......................... Lanier County, Georgia ........................................................................... ............................ 11 46660 11660 ......................... Laurens County, Georgia .......................................................................... .......................... 11 11 11670 ......................... Lee County, Georgia .............................................................................. ............................. 0120 10500 11680 ......................... Liberty County, Georgia .......................................................................... ............................ 11 25980 11690 ......................... Lincoln County, Georgia .......................................................................... ............................ 11 11 11691 ......................... Long County, Georgia ............................................................................. ............................ 11 25980 11700 ......................... Lowndes County, Georgia .......................................................................... ......................... 11 46660 11701 ......................... Lumpkin County, Georgia .......................................................................... ......................... 11 11 11702 ......................... Mc Duffie County, Georgia ........................................................................ .......................... 0600 12260 11703 ......................... Mc Intosh County, Georgia ........................................................................ ......................... 11 15260


## 46017 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

11710 ......................... Macon County, Georgia ............................................................................ .......................... 11 11 11720 ......................... Madison County, Georgia .......................................................................... ......................... 0500 12020 11730 ......................... Marion County, Georgia ........................................................................... ........................... 11 17980 11740 ......................... Meriwether County, Georgia ....................................................................... ........................ 11 12060 11741 ......................... Miller County, Georgia ........................................................................... ............................. 11 11 11750 ......................... Mitchell County, Georgia ......................................................................... ............................ 11 11 11760 ......................... Monroe County, Georgia ........................................................................... .......................... 11 31420 11770 ......................... Montgomery County, Georgia ....................................................................... ...................... 11 11 11771 ......................... Morgan County, Georgia ........................................................................... .......................... 11 11 11772 ......................... Murray County, Georgia ........................................................................... ........................... 11 19140 11780 ......................... Muscogee County, Georgia ......................................................................... ....................... 1800 17980 11790 ......................... Newton County, Georgia ........................................................................... .......................... 0520 12060 11800 ......................... Oconee County, Georgia ........................................................................... ......................... 0500 12020 11801 ......................... Oglethorpe County, Georgia ....................................................................... ........................ 11 12020 11810 ......................... Paulding County, Georgia ......................................................................... .......................... 0520 12060 11811 ......................... Peach County, Georgia ............................................................................ ........................... 4680 11 11812 ......................... Pickens County, Georgia .......................................................................... .......................... 11 12060 11820 ......................... Pierce County, Georgia ........................................................................... ............................ 11 11 11821 ......................... Pike County, Georgia ............................................................................. ............................. 11 12060 11830 ......................... Polk County, Georgia ............................................................................. ............................. 11 11 11831 ......................... Pulaski County, Georgia .......................................................................... ........................... 11 11 11832 ......................... Putnam County, Georgia ........................................................................... .......................... 11 11 11833 ......................... Quitman County, Georgia .......................................................................... ......................... 11 11 11834 ......................... Rabun County, Georgia ............................................................................ .......................... 11 11 11835 ......................... Randolph County, Georgia ......................................................................... ......................... 11 11 11840 ......................... Richmond County, Georgia ......................................................................... ........................ 0600 12260 11841 ......................... Rockdale County, Georgia ......................................................................... ......................... 0520 12060 11842 ......................... Schley County, Georgia ........................................................................... ........................... 11 11 11850 ......................... Screven County, Georgia .......................................................................... .......................... 11 11 11851 ......................... Seminole County, Georgia ......................................................................... ......................... 11 11 11860 ......................... Spalding County, Georgia ......................................................................... .......................... 0520 12060 11861 ......................... Stephens County, Georgia ......................................................................... ......................... 11 11 11862 ......................... Stewart County, Georgia .......................................................................... ........................... 11 11 11870 ......................... Sumter County, Georgia ........................................................................... .......................... 11 11 11880 ......................... Talbot County, Georgia ........................................................................... ............................ 11 11 11881 ......................... Taliaferro County, Georgia ....................................................................... ........................... 11 11 11882 ......................... Tattnall County, Georgia ......................................................................... ............................ 11 11 11883 ......................... Taylor County, Georgia ........................................................................... ............................ 11 11 11884 ......................... Telfair County, Georgia .......................................................................... ............................. 11 11 11885 ......................... Terrell County, Georgia .......................................................................... ............................. 11 10500 11890 ......................... Thomas County, Georgia ........................................................................... ......................... 11 11 11900 ......................... Tift County, Georgia ............................................................................. ............................... 11 11 11901 ......................... Toombs County, Georgia ........................................................................... ......................... 11 11 11902 ......................... Towns County, Georgia ............................................................................ .......................... 11 11 11903 ......................... Treutlen County, Georgia ......................................................................... ........................... 11 11 11910 ......................... Troup County, Georgia ............................................................................ ............................ 11 11 11911 ......................... Turner County, Georgia ........................................................................... ........................... 11 11 11912 ......................... Twiggs County, Georgia ........................................................................... ........................... 11 31420 11913 ......................... Union County, Georgia ............................................................................ ............................ 11 11 11920 ......................... Upson County, Georgia ............................................................................ ........................... 11 11 11921 ......................... Walker County, Georgia ........................................................................... ........................... 1560 16860 11930 ......................... Walton County, Georgia ........................................................................... ........................... 0520 12060 11940 ......................... Ware County, Georgia ............................................................................. ........................... 11 11 11941 ......................... Warren County, Georgia ........................................................................... .......................... 11 11 11950 ......................... Washington County, Georgia ....................................................................... ....................... 11 11 11960 ......................... Wayne County, Georgia ............................................................................ .......................... 11 11 11961 ......................... Webster County, Georgia .......................................................................... .......................... 11 11 11962 ......................... Wheeler County, Georgia .......................................................................... .......................... 11 11 11963 ......................... White County, Georgia ............................................................................ ............................ 11 11 11970 ......................... Whitfield County, Georgia ........................................................................ ........................... 11 19140 11971 ......................... Wilcox County, Georgia ........................................................................... ........................... 11 11 11972 ......................... Wilkes County, Georgia ........................................................................... ........................... 11 11 11973 ......................... Wilkinson County, Georgia ........................................................................ .......................... 11 11 11980 ......................... Worth County, Georgia ............................................................................ ........................... 11 10500 12005 ......................... Kalawao County, Hawaii ........................................................................... .......................... 12 12 12010 ......................... Hawaii County, Hawaii ............................................................................ ............................ 12 12 12020 ......................... Honolulu County, Hawaii .......................................................................... ........................... 3320 26180 12040 ......................... Kauai County, Hawaii ............................................................................. ............................. 12 12 12050 ......................... Maui County, Hawaii .............................................................................. ............................. 12 12 13000 ......................... Ada County, Idaho ................................................................................ .............................. 1080 14260


## 46018 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

13010 ......................... Adams County, Idaho .............................................................................. ............................ 13 13 13020 ......................... Bannock County, Idaho ............................................................................ ........................... 13 38540 13030 ......................... Bear Lake County, Idaho .......................................................................... .......................... 13 13 13040 ......................... Benewah County, Idaho ............................................................................ .......................... 13 13 13050 ......................... Bingham County, Idaho ............................................................................ ........................... 13 13 13060 ......................... Blaine County, Idaho ............................................................................. .............................. 13 13 13070 ......................... Boise County, Idaho .............................................................................. .............................. 13 14260 13080 ......................... Bonner County, Idaho ............................................................................. ............................ 13 13 13090 ......................... Bonneville County, Idaho ......................................................................... ........................... 13 26820 13100 ......................... Boundary County, Idaho ........................................................................... .......................... 13 13 13110 ......................... Butte County, Idaho .............................................................................. .............................. 13 13 13120 ......................... Camas County, Idaho .............................................................................. ........................... 13 13 13130 ......................... Canyon County, Idaho ............................................................................. ........................... 13 14260 13140 ......................... Caribou County, Idaho ............................................................................ ............................ 13 13 13150 ......................... Cassia County, Idaho ............................................................................. ............................. 13 13 13160 ......................... Clark County, Idaho .............................................................................. .............................. 13 13 13170 ......................... Clearwater County, Idaho ......................................................................... .......................... 13 13 13180 ......................... Custer County, Idaho ............................................................................. ............................. 13 13 13190 ......................... Elmore County, Idaho ............................................................................. ............................ 13 13 13200 ......................... Franklin County, Idaho ........................................................................... ............................. 13 30860 13210 ......................... Fremont County, Idaho ............................................................................ ........................... 13 13 13220 ......................... Gem County, Idaho ................................................................................ ............................. 13 14260 13230 ......................... Gooding County, Idaho ............................................................................ ........................... 13 13 13240 ......................... Idaho County, Idaho .............................................................................. .............................. 13 13 13250 ......................... Jefferson County, Idaho .......................................................................... ............................ 13 26820 13260 ......................... Jerome County, Idaho ............................................................................. ............................ 13 13 13270 ......................... Kootenai County, Idaho ........................................................................... ............................ 13 17660 13280 ......................... Latah County, Idaho .............................................................................. .............................. 13 13 13290 ......................... Lemhi County, Idaho .............................................................................. ............................. 13 13 13300 ......................... Lewis County, Idaho .............................................................................. .............................. 13 13 13310 ......................... Lincoln County, Idaho ............................................................................ ............................. 13 13 13320 ......................... Madison County, Idaho ............................................................................ ........................... 13 13 13330 ......................... Minidoka County, Idaho ........................................................................... ........................... 13 13 13340 ......................... Nez Perce County, Idaho .......................................................................... .......................... 13 30300 13350 ......................... Oneida County, Idaho ............................................................................. ............................ 13 13 13360 ......................... Owyhee County, Idaho ............................................................................. ........................... 13 14260 13370 ......................... Payette County, Idaho ............................................................................ ............................. 13 13 13380 ......................... Power County, Idaho .............................................................................. ............................. 13 38540 13390 ......................... Shoshone County, Idaho ........................................................................... .......................... 13 13 13400 ......................... Teton County, Idaho .............................................................................. .............................. 13 13 13410 ......................... Twin Falls County, Idaho ......................................................................... ........................... 13 13 13420 ......................... Valley County, Idaho ............................................................................. .............................. 13 13 13430 ......................... Washington County, Idaho ......................................................................... ......................... 13 13 14000 ......................... Adams County, Illinois ........................................................................... .............................. 14 14 14010 ......................... Alexander County, Illinois ....................................................................... ............................. 14 14 14020 ......................... Bond County, Illinois ............................................................................ ............................... 14 41180 14030 ......................... Boone County, Illinois ........................................................................... .............................. 6880 40420 14040 ......................... Brown County, Illinois ........................................................................... ............................... 14 14 14050 ......................... Bureau County, Illinois .......................................................................... .............................. 14 14 14060 ......................... Calhoun County, Illinois ......................................................................... ............................. 14 41180 14070 ......................... Carroll County, Illinois ......................................................................... ................................ 14 14 14080 ......................... Cass County, Illinois ............................................................................ ................................ 14 14 14090 ......................... Champaign County, Illinois ....................................................................... .......................... 1400 16580 14100 ......................... Christian County, Illinois ....................................................................... ............................... 14 14 14110 ......................... Clark County, Illinois ........................................................................... ................................ 14 14 14120 ......................... Clay County, Illinois ............................................................................ ................................. 14 14 14130 ......................... Clinton County, Illinois ......................................................................... ................................ 7040 41180 14140 ......................... Coles County, Illinois ........................................................................... ................................ 14 14 14141 ......................... Cook County, Illinois ............................................................................ ............................... 1600 16974 14150 ......................... Crawford County, Illinois ........................................................................ ............................. 14 14 14160 ......................... Cumberland County, Illinois ...................................................................... .......................... 14 14 14170 ......................... De Kalb County, Illinois ......................................................................... .............................. 14 16974 14180 ......................... De Witt County, Illinois ......................................................................... ............................... 14 14 14190 ......................... Douglas County, Illinois ......................................................................... .............................. 14 14 14250 ......................... Du Page County, Illinois ......................................................................... ............................. 1600 16974 14310 ......................... Edgar County, Illinois ........................................................................... ............................... 14 14 14320 ......................... Edwards County, Illinois ......................................................................... ............................. 14 14 14330 ......................... Effingham County, Illinois ....................................................................... ............................. 14 14 14340 ......................... Fayette County, Illinois ......................................................................... ............................... 14 14 14350 ......................... Ford County, Illinois ............................................................................ ................................ 14 16580


## 46019 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

14360 ......................... Franklin County, Illinois ........................................................................ ............................... 14 14 14370 ......................... Fulton County, Illinois .......................................................................... ................................ 14 14 14380 ......................... Gallatin County, Illinois ........................................................................ ................................ 14 14 14390 ......................... Greene County, Illinois .......................................................................... .............................. 14 14 14400 ......................... Grundy County, Illinois .......................................................................... .............................. 3690 16974 14410 ......................... Hamilton County, Illinois ........................................................................ .............................. 14 14 14420 ......................... Hancock County, Illinois ......................................................................... ............................. 14 14 14421 ......................... Hardin County, Illinois .......................................................................... ............................... 14 14 14440 ......................... Henderson County, Illinois ....................................................................... ........................... 14 14 14450 ......................... Henry County, Illinois ........................................................................... ............................... 1960 19340 14460 ......................... Iroquois County, Illinois ........................................................................ ............................... 14 14 14470 ......................... Jackson County, Illinois ......................................................................... .............................. 14 14 14480 ......................... Jasper County, Illinois .......................................................................... ............................... 14 14 14490 ......................... Jefferson County, Illinois ....................................................................... .............................. 14 14 14500 ......................... Jersey County, Illinois .......................................................................... ............................... 7040 41180 14510 ......................... Jo Daviess County, Illinois ...................................................................... ............................ 14 14 14520 ......................... Johnson County, Illinois ......................................................................... ............................. 14 14 14530 ......................... Kane County, Illinois ............................................................................ ............................... 0620 16974 14540 ......................... Kankakee County, Illinois ........................................................................ ............................ 3740 28100 14550 ......................... Kendall County, Illinois ......................................................................... ............................... 0620 16974 14560 ......................... Knox County, Illinois ............................................................................ ................................ 14 14 14570 ......................... Lake County, Illinois ............................................................................ ................................ 3965 29404 14580 ......................... La Salle County, Illinois ........................................................................ ............................... 14 14 14590 ......................... Lawrence County, Illinois ........................................................................ ............................ 14 14 14600 ......................... Lee County, Illinois ............................................................................. ................................. 14 14 14610 ......................... Livingston County, Illinois ...................................................................... .............................. 14 14 14620 ......................... Logan County, Illinois ........................................................................... ............................... 14 14 14630 ......................... Mc Donough County, Illinois ...................................................................... ......................... 14 14 14640 ......................... Mc Henry County, Illinois ........................................................................ ............................ 1600 16974 14650 ......................... Mclean County, Illinois .......................................................................... .............................. 1040 14060 14660 ......................... Macon County, Illinois ........................................................................... .............................. 2040 19500 14670 ......................... Macoupin County, Illinois ........................................................................ ............................ 14 41180 14680 ......................... Madison County, Illinois ......................................................................... ............................. 7040 41180 14690 ......................... Marion County, Illinois .......................................................................... ............................... 14 14 14700 ......................... Marshall County, Illinois ........................................................................ .............................. 14 37900 14710 ......................... Mason County, Illinois ........................................................................... .............................. 14 14 14720 ......................... Massac County, Illinois .......................................................................... ............................. 14 14 14730 ......................... Menard County, Illinois .......................................................................... .............................. 7880 44100 14740 ......................... Mercer County, Illinois .......................................................................... ............................... 14 19340 14750 ......................... Monroe County, Illinois .......................................................................... .............................. 7040 41180 14760 ......................... Montgomery County, Illinois ...................................................................... .......................... 14 14 14770 ......................... Morgan County, Illinois .......................................................................... .............................. 14 14 14780 ......................... Moultrie County, Illinois ........................................................................ ............................... 14 14 14790 ......................... Ogle County, Illinois ............................................................................ ................................ 14 14 14800 ......................... Peoria County, Illinois .......................................................................... ............................... 6120 37900 14810 ......................... Perry County, Illinois ........................................................................... ................................ 14 14 14820 ......................... Piatt County, Illinois ........................................................................... .................................. 14 16580 14830 ......................... Pike County, Illinois ............................................................................ ................................. 14 14 14831 ......................... Pope County, Illinois ............................................................................ ............................... 14 14 14850 ......................... Pulaski County, Illinois ......................................................................... ............................... 14 14 14860 ......................... Putnam County, Illinois .......................................................................... ............................. 14 14 14870 ......................... Randolph County, Illinois ........................................................................ ............................ 14 14 14880 ......................... Richland County, Illinois ........................................................................ .............................. 14 14 14890 ......................... Rock Island County, Illinois ..................................................................... ............................ 1960 19340 14900 ......................... St Clair County, Illinois ........................................................................ ................................ 7040 41180 14910 ......................... Saline County, Illinois .......................................................................... ................................ 14 14 14920 ......................... Sangamon County, Illinois ........................................................................ .......................... 7880 44100 14921 ......................... Schuyler County, Illinois ........................................................................ .............................. 14 14 14940 ......................... Scott County, Illinois ........................................................................... ................................. 14 14 14950 ......................... Shelby County, Illinois .......................................................................... ............................... 14 14 14960 ......................... Stark County, Illinois ........................................................................... ................................ 14 37900 14970 ......................... Stephenson County, Illinois ...................................................................... ........................... 14 14 14980 ......................... Tazewell County, Illinois ........................................................................ .............................. 6120 37900 14981 ......................... Union County, Illinois ........................................................................... ............................... 14 14 14982 ......................... Vermilion County, Illinois ....................................................................... .............................. 14 19180 14983 ......................... Wabash County, Illinois .......................................................................... ............................. 14 14 14984 ......................... Warren County, Illinois .......................................................................... .............................. 14 14 14985 ......................... Washington County, Illinois ...................................................................... ........................... 14 14 14986 ......................... Wayne County, Illinois ........................................................................... .............................. 14 14 14987 ......................... White County, Illinois ........................................................................... ................................ 14 14


## 46020 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

14988 ......................... Whiteside County, Illinois ....................................................................... ............................. 14 14 14989 ......................... Will County, Illinois ............................................................................ .................................. 3690 16974 14990 ......................... Williamson County, Illinois ...................................................................... ............................ 14 14 14991 ......................... Winnebago County, Illinois ....................................................................... ........................... 6880 40420 14992 ......................... Woodford County, Illinois ........................................................................ ............................ 6120 37900 15000 ......................... Adams County, Indiana ............................................................................ ........................... 15 15 15010 ......................... Allen County, Indiana ............................................................................ .............................. 2760 23060 15020 ......................... Bartholomew County, Indiana ...................................................................... ....................... 15 18020 15030 ......................... Benton County, Indiana ........................................................................... ............................ 15 29140 15040 ......................... Blackford County, Indiana ........................................................................ ........................... 15 15 15050 ......................... Boone County, Indiana ............................................................................ ............................ 3480 26900 15060 ......................... Brown County, Indiana ............................................................................ ............................ 15 26900 15070 ......................... Carroll County, Indiana .......................................................................... ............................. 15 29140 15080 ......................... Cass County, Indiana ............................................................................. ............................. 15 15 15090 ......................... Clark County, Indiana ............................................................................ .............................. 4520 31140 15100 ......................... Clay County, Indiana ............................................................................. .............................. 8320 45460 15110 ......................... Clinton County, Indiana .......................................................................... ............................. 15 15 15120 ......................... Crawford County, Indiana ......................................................................... .......................... 15 15 15130 ......................... Daviess County, Indiana .......................................................................... ........................... 15 15 15140 ......................... Dearborn County, Indiana ......................................................................... .......................... 1640 17140 15150 ......................... Decatur County, Indiana .......................................................................... ........................... 15 15 15160 ......................... De Kalb County, Indiana .......................................................................... ........................... 2760 15 15170 ......................... Delaware County, Indiana ......................................................................... .......................... 5280 34620 15180 ......................... Dubois County, Indiana ........................................................................... ............................ 15 15 15190 ......................... Elkhart County, Indiana .......................................................................... ............................. 2330 21140 15200 ......................... Fayette County, Indiana .......................................................................... ............................ 15 15 15210 ......................... Floyd County, Indiana ............................................................................ ............................. 4520 31140 15220 ......................... Fountain County, Indiana ......................................................................... ........................... 15 15 15230 ......................... Franklin County, Indiana ......................................................................... ............................ 15 17140 15240 ......................... Fulton County, Indiana ........................................................................... ............................. 15 15 15250 ......................... Gibson County, Indiana ........................................................................... ............................ 15 21780 15260 ......................... Grant County, Indiana ............................................................................ ............................. 15 15 15270 ......................... Greene County, Indiana ........................................................................... ........................... 15 14020 15280 ......................... Hamilton County, Indiana ......................................................................... ........................... 3480 26900 15290 ......................... Hancock County, Indiana .......................................................................... .......................... 3480 26900 15300 ......................... Harrison County, Indiana ......................................................................... ........................... 4520 31140 15310 ......................... Hendricks County, Indiana ........................................................................ .......................... 3480 26900 15320 ......................... Henry County, Indiana ............................................................................ ............................ 15 15 15330 ......................... Howard County, Indiana ........................................................................... ........................... 3850 29020 15340 ......................... Huntington County, Indiana ....................................................................... .......................... 15 15 15350 ......................... Jackson County, Indiana .......................................................................... ........................... 15 15 15360 ......................... Jasper County, Indiana ........................................................................... ............................ 15 23844 15370 ......................... Jay County, Indiana .............................................................................. .............................. 15 15 15380 ......................... Jefferson County, Indiana ........................................................................ ........................... 15 15 15390 ......................... Jennings County, Indiana ......................................................................... ........................... 15 15 15400 ......................... Johnson County, Indiana .......................................................................... .......................... 3480 26900 15410 ......................... Knox County, Indiana ............................................................................. ............................. 15 15 15420 ......................... Kosciusko County, Indiana ........................................................................ .......................... 15 15 15430 ......................... Lagrange County, Indiana ......................................................................... .......................... 15 15 15440 ......................... Lake County, Indiana ............................................................................. ............................. 2960 23844 15450 ......................... La Porte County, Indiana ......................................................................... ........................... 15 33140 15460 ......................... Lawrence County, Indiana ......................................................................... ......................... 15 15 15470 ......................... Madison County, Indiana .......................................................................... .......................... 0400 11300 15480 ......................... Marion County, Indiana ........................................................................... ............................ 3480 26900 15490 ......................... Marshall County, Indiana ......................................................................... ........................... 15 15 15500 ......................... Martin County, Indiana ........................................................................... ............................. 15 15 15510 ......................... Miami County, Indiana ............................................................................ ............................ 15 15 15520 ......................... Monroe County, Indiana ........................................................................... ........................... 1020 14020 15530 ......................... Montgomery County, Indiana ....................................................................... ....................... 15 15 15540 ......................... Morgan County, Indiana ........................................................................... ........................... 3480 26900 15550 ......................... Newton County, Indiana ........................................................................... ........................... 15 23844 15560 ......................... Noble County, Indiana ............................................................................ ............................. 15 15 15570 ......................... Ohio County, Indiana ............................................................................. ............................. 15 17140 15580 ......................... Orange County, Indiana ........................................................................... ........................... 15 15 15590 ......................... Owen County, Indiana ............................................................................. ............................ 15 14020 15600 ......................... Parke County, Indiana ............................................................................ ............................. 15 15 15610 ......................... Perry County, Indiana ............................................................................ ............................. 15 15 15620 ......................... Pike County, Indiana ............................................................................. .............................. 15 15 15630 ......................... Porter County, Indiana ........................................................................... ............................. 2960 23844 15640 ......................... Posey County, Indiana ............................................................................ ............................ 2440 21780


## 46021 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

15650 ......................... Pulaski County, Indiana .......................................................................... ............................ 15 15 15660 ......................... Putnam County, Indiana ........................................................................... ........................... 15 26900 15670 ......................... Randolph County, Indiana ......................................................................... .......................... 15 15 15680 ......................... Ripley County, Indiana ........................................................................... ............................. 15 15 15690 ......................... Rush County, Indiana ............................................................................. ............................. 15 15 15700 ......................... St Joseph County, Indiana ........................................................................ .......................... 7800 43780 15710 ......................... Scott County, Indiana ............................................................................ .............................. 15 15 15720 ......................... Shelby County, Indiana ........................................................................... ............................ 3480 26900 15730 ......................... Spencer County, Indiana .......................................................................... ........................... 15 15 15740 ......................... Starke County, Indiana ........................................................................... ............................. 15 15 15750 ......................... Steuben County, Indiana .......................................................................... ........................... 15 15 15760 ......................... Sullivan County, Indiana ......................................................................... ............................ 15 45460 15770 ......................... Switzerland County, Indiana ...................................................................... ......................... 15 15 15780 ......................... Tippecanoe County, Indiana ....................................................................... ........................ 3920 29140 15790 ......................... Tipton County, Indiana ........................................................................... ............................. 3850 29020 15800 ......................... Union County, Indiana ............................................................................ ............................. 15 15 15810 ......................... Vanderburgh County, Indiana ...................................................................... ....................... 2440 21780 15820 ......................... Vermillion County, Indiana ....................................................................... ........................... 15 45460 15830 ......................... Vigo County, Indiana ............................................................................. .............................. 8320 45460 15840 ......................... Wabash County, Indiana ........................................................................... .......................... 15 15 15850 ......................... Warren County, Indiana ........................................................................... ........................... 15 15 15860 ......................... Warrick County, Indiana .......................................................................... ............................ 2440 21780 15870 ......................... Washington County, Indiana ....................................................................... ........................ 15 31140 15880 ......................... Wayne County, Indiana ............................................................................ ........................... 15 15 15890 ......................... Wells County, Indiana ............................................................................ ............................. 15 23060 15900 ......................... White County, Indiana ............................................................................ ............................. 15 15 15910 ......................... Whitley County, Indiana .......................................................................... ............................ 2760 23060 16000 ......................... Adair County, Iowa ............................................................................... ............................... 16 16 16010 ......................... Adams County, Iowa ............................................................................... ............................ 16 16 16020 ......................... Allamakee County, Iowa ........................................................................... .......................... 16 16 16030 ......................... Appanoose County, Iowa ........................................................................... ......................... 16 16 16040 ......................... Audubon County, Iowa ............................................................................. ........................... 16 16 16050 ......................... Benton County, Iowa .............................................................................. ............................. 16 16300 16060 ......................... Black Hawk County, Iowa .......................................................................... ......................... 8920 47940 16070 ......................... Boone County, Iowa ............................................................................... ............................. 16 16 16080 ......................... Bremer County, Iowa .............................................................................. ............................ 8920 47940 16090 ......................... Buchanan County, Iowa ............................................................................ .......................... 16 16 16100 ......................... Buena Vista County, Iowa ......................................................................... .......................... 16 16 16110 ......................... Butler County, Iowa .............................................................................. ............................... 16 16 16120 ......................... Calhoun County, Iowa ............................................................................. ............................ 16 16 16130 ......................... Carroll County, Iowa ............................................................................. ............................... 16 16 16140 ......................... Cass County, Iowa ................................................................................ .............................. 16 16 16150 ......................... Cedar County, Iowa ............................................................................... ............................. 16 16 16160 ......................... Cerro Gordo County, Iowa ......................................................................... ......................... 16 16 16170 ......................... Cherokee County, Iowa ............................................................................ ........................... 16 16 16180 ......................... Chickasaw County, Iowa ........................................................................... .......................... 16 16 16190 ......................... Clarke County, Iowa .............................................................................. .............................. 16 16 16200 ......................... Clay County, Iowa ................................................................................ ............................... 16 16 16210 ......................... Clayton County, Iowa ............................................................................. ............................. 16 16 16220 ......................... Clinton County, Iowa ............................................................................. .............................. 16 16 16230 ......................... Crawford County, Iowa ............................................................................ ............................ 16 16 16240 ......................... Dallas County, Iowa .............................................................................. .............................. 2120 19780 16250 ......................... Davis County, Iowa ............................................................................... .............................. 16 16 16260 ......................... Decatur County, Iowa ............................................................................. ............................. 16 16 16270 ......................... Delaware County, Iowa ............................................................................ ........................... 16 16 16280 ......................... Des Moines County, Iowa .......................................................................... ......................... 16 16 16290 ......................... Dickinson County, Iowa ........................................................................... ............................ 16 16 16300 ......................... Dubuque County, Iowa ............................................................................. ........................... 2200 20220 16310 ......................... Emmet County, Iowa ............................................................................... ............................ 16 16 16320 ......................... Fayette County, Iowa ............................................................................. ............................. 16 16 16330 ......................... Floyd County, Iowa ............................................................................... .............................. 16 16 16340 ......................... Franklin County, Iowa ............................................................................ ............................. 16 16 16350 ......................... Fremont County, Iowa ............................................................................. ............................ 16 16 16360 ......................... Greene County, Iowa .............................................................................. ............................ 16 16 16370 ......................... Grundy County, Iowa .............................................................................. ............................ 16 47940 16380 ......................... Guthrie County, Iowa ............................................................................. ............................. 16 19780 16390 ......................... Hamilton County, Iowa ............................................................................ ............................ 16 16 16400 ......................... Hancock County, Iowa ............................................................................. ........................... 16 16 16410 ......................... Hardin County, Iowa .............................................................................. .............................. 16 16 16420 ......................... Harrison County, Iowa ............................................................................ ............................. 16 36540


## 46022 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

16430 ......................... Henry County, Iowa ............................................................................... .............................. 16 16 16440 ......................... Howard County, Iowa .............................................................................. ............................ 16 16 16450 ......................... Humboldt County, Iowa ............................................................................ ........................... 16 16 16460 ......................... Ida County, Iowa ................................................................................. ................................ 16 16 16470 ......................... Iowa County, Iowa ................................................................................ ............................... 16 16 16480 ......................... Jackson County, Iowa ............................................................................. ............................ 16 16 16490 ......................... Jasper County, Iowa .............................................................................. ............................. 16 16 16500 ......................... Jefferson County, Iowa ........................................................................... ............................ 16 16 16510 ......................... Johnson County, Iowa ............................................................................. ............................ 3500 26980 16520 ......................... Jones County, Iowa ............................................................................... .............................. 16 16300 16530 ......................... Keokuk County, Iowa .............................................................................. ............................ 16 16 16540 ......................... Kossuth County, Iowa ............................................................................. ............................ 16 16 16550 ......................... Lee County, Iowa ................................................................................. ............................... 16 16 16560 ......................... Linn County, Iowa ................................................................................ ............................... 1360 16300 16570 ......................... Louisa County, Iowa .............................................................................. .............................. 16 16 16580 ......................... Lucas County, Iowa ............................................................................... .............................. 16 16 16590 ......................... Lyon County, Iowa ................................................................................ .............................. 16 16 16600 ......................... Madison County, Iowa ............................................................................. ............................ 16 19780 16610 ......................... Mahaska County, Iowa ............................................................................. ........................... 16 16 16620 ......................... Marion County, Iowa .............................................................................. ............................. 16 16 16630 ......................... Marshall County, Iowa ............................................................................ ............................. 16 16 16640 ......................... Mills County, Iowa ............................................................................... ................................ 16 36540 16650 ......................... Mitchell County, Iowa ............................................................................ .............................. 16 16 16660 ......................... Monona County, Iowa .............................................................................. ........................... 16 16 16670 ......................... Monroe County, Iowa .............................................................................. ............................ 16 16 16680 ......................... Montgomery County, Iowa .......................................................................... ........................ 16 16 16690 ......................... Muscatine County, Iowa ........................................................................... ........................... 16 16 16700 ......................... O Brien County, Iowa ............................................................................. ............................. 16 16 16710 ......................... Osceola County, Iowa ............................................................................. ............................ 16 16 16720 ......................... Page County, Iowa ................................................................................ .............................. 16 16 16730 ......................... Palo Alto County, Iowa ........................................................................... ............................. 16 16 16740 ......................... Plymouth County, Iowa ............................................................................ ........................... 16 16 16750 ......................... Pocahontas County, Iowa .......................................................................... ......................... 16 16 16760 ......................... Polk County, Iowa ................................................................................ ............................... 2120 19780 16770 ......................... Pottawattamie County, Iowa ....................................................................... ........................ 5920 36540 16780 ......................... Poweshiek County, Iowa ........................................................................... .......................... 16 16 16790 ......................... Ringgold County, Iowa ............................................................................ ............................ 16 16 16800 ......................... Sac County, Iowa ................................................................................. ............................... 16 16 16810 ......................... Scott County, Iowa ............................................................................... ............................... 1960 19340 16820 ......................... Shelby County, Iowa .............................................................................. ............................. 16 16 16830 ......................... Sioux County, Iowa ............................................................................... .............................. 16 16 16840 ......................... Story County, Iowa ............................................................................... ............................... 16 11180 16850 ......................... Tama County, Iowa ................................................................................ ............................. 16 16 16860 ......................... Taylor County, Iowa .............................................................................. .............................. 16 16 16870 ......................... Union County, Iowa ............................................................................... .............................. 16 16 16880 ......................... Van Buren County, Iowa ........................................................................... .......................... 16 16 16890 ......................... Wapello County, Iowa ............................................................................. ............................ 16 16 16900 ......................... Warren County, Iowa .............................................................................. ............................ 2120 19780 16910 ......................... Washington County, Iowa .......................................................................... ......................... 16 26980 16920 ......................... Wayne County, Iowa ............................................................................... ............................ 16 16 16930 ......................... Webster County, Iowa ............................................................................. ............................ 16 16 16940 ......................... Winnebago County, Iowa ........................................................................... ......................... 16 16 16950 ......................... Winneshiek County, Iowa .......................................................................... .......................... 16 16 16960 ......................... Woodbury County, Iowa ............................................................................ .......................... 7720 43580 16970 ......................... Worth County, Iowa ............................................................................... .............................. 16 16 16980 ......................... Wright County, Iowa .............................................................................. .............................. 16 16 17000 ......................... Allen County, Kansas ............................................................................. ............................. 17 17 17010 ......................... Anderson County, Kansas .......................................................................... ........................ 17 17 17020 ......................... Atchison County, Kansas .......................................................................... .......................... 17 17 17030 ......................... Barber County, Kansas ............................................................................ ........................... 17 17 17040 ......................... Barton County, Kansas ............................................................................ ........................... 17 17 17050 ......................... Bourbon County, Kansas ........................................................................... ......................... 17 17 17060 ......................... Brown County, Kansas ............................................................................. ........................... 17 17 17070 ......................... Butler County, Kansas ............................................................................ ............................ 9040 48620 17080 ......................... Chase County, Kansas ............................................................................. .......................... 17 17 17090 ......................... Chautauqua County, Kansas ........................................................................ ...................... 17 17 17100 ......................... Cherokee County, Kansas .......................................................................... ........................ 17 17 17110 ......................... Cheyenne County, Kansas .......................................................................... ....................... 17 17 17120 ......................... Clark County, Kansas ............................................................................. ............................ 17 17 17130 ......................... Clay County, Kansas .............................................................................. ............................. 17 17


## 46023 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

17140 ......................... Cloud County, Kansas ............................................................................. ........................... 17 17 17150 ......................... Coffey County, Kansas ............................................................................ ........................... 17 17 17160 ......................... Comanche County, Kansas .......................................................................... ...................... 17 17 17170 ......................... Cowley County, Kansas ............................................................................ .......................... 17 17 17180 ......................... Crawford County, Kansas .......................................................................... ......................... 17 17 17190 ......................... Decatur County, Kansas ........................................................................... .......................... 17 17 17200 ......................... Dickinson County, Kansas ......................................................................... ......................... 17 17 17210 ......................... Doniphan County, Kansas .......................................................................... ........................ 17 41140 17220 ......................... Douglas County, Kansas ........................................................................... .......................... 4150 29940 17230 ......................... Edwards County, Kansas ........................................................................... ......................... 17 17 17240 ......................... Elk County, Kansas ............................................................................... .............................. 17 17 17250 ......................... Ellis County, Kansas ............................................................................. .............................. 17 17 17260 ......................... Ellsworth County, Kansas ......................................................................... .......................... 17 17 17270 ......................... Finney County, Kansas ............................................................................ ........................... 17 17 17280 ......................... Ford County, Kansas .............................................................................. ............................ 17 17 17290 ......................... Franklin County, Kansas .......................................................................... ........................... 17 28140 17300 ......................... Geary County, Kansas ............................................................................. ........................... 17 17 17310 ......................... Gove County, Kansas .............................................................................. ........................... 17 17 17320 ......................... Graham County, Kansas ............................................................................ ......................... 17 17 17330 ......................... Grant County, Kansas ............................................................................. ............................ 17 17 17340 ......................... Gray County, Kansas .............................................................................. ............................ 17 17 17350 ......................... Greeley County, Kansas ........................................................................... .......................... 17 17 17360 ......................... Greenwood County, Kansas ......................................................................... ...................... 17 17 17370 ......................... Hamilton County, Kansas .......................................................................... .......................... 17 17 17380 ......................... Harper County, Kansas ............................................................................ ........................... 17 17 17390 ......................... Harvey County, Kansas ............................................................................ .......................... 17 48620 17391 ......................... Haskell County, Kansas ........................................................................... ........................... 17 17 17410 ......................... Hodgeman County, Kansas .......................................................................... ...................... 17 17 17420 ......................... Jackson County, Kansas ........................................................................... .......................... 17 45820 17430 ......................... Jefferson County, Kansas ......................................................................... .......................... 17 45820 17440 ......................... Jewell County, Kansas ............................................................................ ............................ 17 17 17450 ......................... Johnson County, Kansas ........................................................................... ......................... 3760 28140 17451 ......................... Kearny County, Kansas ............................................................................ .......................... 17 17 17470 ......................... Kingman County, Kansas ........................................................................... ......................... 17 17 17480 ......................... Kiowa County, Kansas ............................................................................. ........................... 17 17 17490 ......................... Labette County, Kansas ........................................................................... ........................... 17 17 17500 ......................... Lane County, Kansas .............................................................................. ............................ 17 17 17510 ......................... Leavenworth County, Kansas ....................................................................... ...................... 3760 28140 17520 ......................... Lincoln County, Kansas ........................................................................... ........................... 17 17 17530 ......................... Linn County, Kansas .............................................................................. ............................. 17 28140 17540 ......................... Logan County, Kansas ............................................................................. ........................... 17 17 17550 ......................... Lyon County, Kansas .............................................................................. ............................ 17 17 17560 ......................... Mc Pherson County, Kansas ........................................................................ ...................... 17 17 17570 ......................... Marion County, Kansas ............................................................................ ........................... 17 17 17580 ......................... Marshall County, Kansas .......................................................................... .......................... 17 17 17590 ......................... Meade County, Kansas ............................................................................. .......................... 17 17 17600 ......................... Miami County, Kansas ............................................................................. ........................... 3760 28140 17610 ......................... Mitchell County, Kansas .......................................................................... ............................ 17 17 17620 ......................... Montgomery County, Kansas ........................................................................ ...................... 17 17 17630 ......................... Morris County, Kansas ............................................................................ ............................ 17 17 17640 ......................... Morton County, Kansas ............................................................................ ........................... 17 17 17650 ......................... Nemaha County, Kansas ............................................................................ ........................ 17 17 17660 ......................... Neosho County, Kansas ............................................................................ ......................... 17 17 17670 ......................... Ness County, Kansas .............................................................................. ............................ 17 17 17680 ......................... Norton County, Kansas ............................................................................ ........................... 17 17 17690 ......................... Osage County, Kansas ............................................................................. .......................... 17 45820 17700 ......................... Osborne County, Kansas ........................................................................... ......................... 17 17 17710 ......................... Ottawa County, Kansas ............................................................................ .......................... 17 17 17720 ......................... Pawnee County, Kansas ............................................................................ ......................... 17 17 17730 ......................... Phillips County, Kansas .......................................................................... ............................ 17 17 17740 ......................... Pottawatomie County, Kansas ...................................................................... ...................... 17 17 17750 ......................... Pratt County, Kansas ............................................................................. ............................. 17 17 17760 ......................... Rawlins County, Kansas ........................................................................... .......................... 17 17 17770 ......................... Reno County, Kansas .............................................................................. ........................... 17 17 17780 ......................... Republic County, Kansas .......................................................................... .......................... 17 17 17790 ......................... Rice County, Kansas .............................................................................. ............................. 17 17 17800 ......................... Riley County, Kansas ............................................................................. ............................. 17 17 17810 ......................... Rooks County, Kansas ............................................................................. ........................... 17 17 17820 ......................... Rush County, Kansas .............................................................................. ........................... 17 17 17830 ......................... Russell County, Kansas ........................................................................... ........................... 17 17


## 46024 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

17840 ......................... Saline County, Kansas ............................................................................ ............................ 17 17 17841 ......................... Scott County, Kansas ............................................................................. ............................. 17 17 17860 ......................... Sedgwick County, Kansas .......................................................................... ........................ 9040 48620 17870 ......................... Seward County, Kansas ............................................................................ .......................... 17 17 17880 ......................... Shawnee County, Kansas ........................................................................... ........................ 8440 45820 17890 ......................... Sheridan County, Kansas .......................................................................... ......................... 17 17 17900 ......................... Sherman County, Kansas ........................................................................... ........................ 17 17 17910 ......................... Smith County, Kansas ............................................................................. ............................ 17 17 17920 ......................... Stafford County, Kansas .......................................................................... ........................... 17 17 17921 ......................... Stanton County, Kansas ........................................................................... .......................... 17 17 17940 ......................... Stevens County, Kansas ........................................................................... .......................... 17 17 17950 ......................... Sumner County, Kansas ............................................................................ ......................... 17 48620 17960 ......................... Thomas County, Kansas ............................................................................ ......................... 17 17 17970 ......................... Trego County, Kansas ............................................................................. ........................... 17 17 17980 ......................... Wabaunsee County, Kansas ......................................................................... ...................... 17 17 17981 ......................... Wallace County, Kansas ........................................................................... .......................... 17 17 17982 ......................... Washington County, Kansas ........................................................................ ....................... 17 17 17983 ......................... Wichita County, Kansas ........................................................................... ........................... 17 17 17984 ......................... Wilson County, Kansas ............................................................................ ........................... 17 17 17985 ......................... Woodson County, Kansas ........................................................................... ........................ 17 17 17986 ......................... Wyandotte County, Kansas ......................................................................... ........................ 3760 28140 18000 ......................... Adair County, Kentucky ........................................................................... ............................ 18 18 18010 ......................... Allen County, Kentucky ........................................................................... ............................ 18 18 18020 ......................... Anderson County, Kentucky ........................................................................ ........................ 18 18 18030 ......................... Ballard County, Kentucky ......................................................................... ........................... 18 18 18040 ......................... Barren County, Kentucky .......................................................................... .......................... 18 18 18050 ......................... Bath County, Kentucky ............................................................................ ............................ 18 18 18060 ......................... Bell County, Kentucky ............................................................................ ............................. 18 18 18070 ......................... Boone County, Kentucky ........................................................................... .......................... 1640 17140 18080 ......................... Bourbon County, Kentucky ......................................................................... ........................ 4280 30460 18090 ......................... Boyd County, Kentucky ............................................................................ ........................... 3400 26580 18100 ......................... Boyle County, Kentucky ........................................................................... ........................... 18 18 18110 ......................... Bracken County, Kentucky ......................................................................... ......................... 18 17140 18120 ......................... Breathitt County, Kentucky ....................................................................... ........................... 18 18 18130 ......................... Breckinridge County, Kentucky .................................................................... ....................... 18 18 18140 ......................... Bullitt County, Kentucky ......................................................................... ............................. 4520 31140 18150 ......................... Butler County, Kentucky .......................................................................... ............................ 18 18 18160 ......................... Caldwell County, Kentucky ........................................................................ ......................... 18 18 18170 ......................... Calloway County, Kentucky ........................................................................ ........................ 18 18 18180 ......................... Campbell County, Kentucky ........................................................................ ........................ 1640 17140 18190 ......................... Carlisle County, Kentucky ........................................................................ ........................... 18 18 18191 ......................... Carroll County, Kentucky ......................................................................... ........................... 18 18 18210 ......................... Carter County, Kentucky .......................................................................... ........................... 3400 18 18220 ......................... Casey County, Kentucky ........................................................................... .......................... 18 18 18230 ......................... Christian County, Kentucky ....................................................................... .......................... 1660 17300 18240 ......................... Clark County, Kentucky ........................................................................... ............................ 4280 30460 18250 ......................... Clay County, Kentucky ............................................................................ ............................ 18 18 18260 ......................... Clinton County, Kentucky ......................................................................... ........................... 18 18 18270 ......................... Crittenden County, Kentucky ...................................................................... ........................ 18 18 18271 ......................... Cumberland County, Kentucky ...................................................................... ..................... 18 18 18290 ......................... Daviess County, Kentucky ......................................................................... ......................... 5990 36980 18291 ......................... Edmonson County, Kentucky ........................................................................ ...................... 18 14540 18310 ......................... Elliott County, Kentucky ......................................................................... ............................. 18 18 18320 ......................... Estill County, Kentucky .......................................................................... ............................. 18 18 18330 ......................... Fayette County, Kentucky ......................................................................... .......................... 4280 30460 18340 ......................... Fleming County, Kentucky ......................................................................... ......................... 18 18 18350 ......................... Floyd County, Kentucky ........................................................................... ........................... 18 18 18360 ......................... Franklin County, Kentucky ........................................................................ .......................... 18 18 18361 ......................... Fulton County, Kentucky .......................................................................... ........................... 18 18 18362 ......................... Gallatin County, Kentucky ........................................................................ ........................... 18 17140 18390 ......................... Garrard County, Kentucky ......................................................................... .......................... 18 18 18400 ......................... Grant County, Kentucky ........................................................................... ........................... 18 17140 18410 ......................... Graves County, Kentucky .......................................................................... ......................... 18 18 18420 ......................... Grayson County, Kentucky ......................................................................... ........................ 18 18 18421 ......................... Green County, Kentucky ........................................................................... .......................... 18 18 18440 ......................... Greenup County, Kentucky ......................................................................... ........................ 3400 26580 18450 ......................... Hancock County, Kentucky ......................................................................... ........................ 18 36980 18460 ......................... Hardin County, Kentucky .......................................................................... .......................... 18 21060 18470 ......................... Harlan County, Kentucky .......................................................................... .......................... 18 18 18480 ......................... Harrison County, Kentucky ........................................................................ ......................... 18 18


## 46025 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

18490 ......................... Hart County, Kentucky ............................................................................ ............................ 18 18 18500 ......................... Henderson County, Kentucky ....................................................................... ...................... 2440 21780 18510 ......................... Henry County, Kentucky ........................................................................... .......................... 18 31140 18511 ......................... Hickman County, Kentucky ......................................................................... ........................ 18 18 18530 ......................... Hopkins County, Kentucky ......................................................................... ......................... 18 18 18540 ......................... Jackson County, Kentucky ......................................................................... ......................... 18 18 18550 ......................... Jefferson County, Kentucky ....................................................................... ......................... 4520 31140 18560 ......................... Jessamine County, Kentucky ....................................................................... ....................... 4280 30460 18570 ......................... Johnson County, Kentucky ......................................................................... ........................ 18 18 18580 ......................... Kenton County, Kentucky .......................................................................... .......................... 1640 17140 18590 ......................... Knott County, Kentucky ........................................................................... ............................ 18 18 18600 ......................... Knox County, Kentucky ............................................................................ ........................... 18 18 18610 ......................... Larue County, Kentucky ........................................................................... ........................... 18 21060 18620 ......................... Laurel County, Kentucky .......................................................................... ........................... 18 18 18630 ......................... Lawrence County, Kentucky ........................................................................ ....................... 18 18 18640 ......................... Lee County, Kentucky ............................................................................. ............................ 18 18 18650 ......................... Leslie County, Kentucky .......................................................................... ............................ 18 18 18660 ......................... Letcher County, Kentucky ......................................................................... .......................... 18 18 18670 ......................... Lewis County, Kentucky ........................................................................... ........................... 18 18 18680 ......................... Lincoln County, Kentucky ......................................................................... ........................... 18 18 18690 ......................... Livingston County, Kentucky ...................................................................... ......................... 18 18 18700 ......................... Logan County, Kentucky ........................................................................... .......................... 18 18 18710 ......................... Lyon County, Kentucky ............................................................................ ........................... 18 18 18720 ......................... Mc Cracken County, Kentucky ...................................................................... ...................... 18 18 18730 ......................... Mc Creary County, Kentucky ....................................................................... ....................... 18 18 18740 ......................... Mc Lean County, Kentucky ......................................................................... ........................ 18 18 18750 ......................... Madison County, Kentucky ......................................................................... ........................ 18 18 18760 ......................... Magoffin County, Kentucky ........................................................................ ......................... 18 18 18770 ......................... Marion County, Kentucky .......................................................................... .......................... 18 18 18780 ......................... Marshall County, Kentucky ........................................................................ ......................... 18 18 18790 ......................... Martin County, Kentucky .......................................................................... ........................... 18 18 18800 ......................... Mason County, Kentucky ........................................................................... ......................... 18 18 18801 ......................... Meade County, Kentucky ........................................................................... ......................... 18 31140 18802 ......................... Menifee County, Kentucky ......................................................................... ......................... 18 18 18830 ......................... Mercer County, Kentucky .......................................................................... .......................... 18 18 18831 ......................... Metcalfe County, Kentucky ........................................................................ ......................... 18 18 18850 ......................... Monroe County, Kentucky .......................................................................... ......................... 18 18 18860 ......................... Montgomery County, Kentucky ...................................................................... ..................... 18 18 18861 ......................... Morgan County, Kentucky .......................................................................... ......................... 18 18 18880 ......................... Muhlenberg County, Kentucky ...................................................................... ...................... 18 18 18890 ......................... Nelson County, Kentucky .......................................................................... .......................... 18 31140 18900 ......................... Nicholas County, Kentucky ........................................................................ ......................... 18 18 18910 ......................... Ohio County, Kentucky ............................................................................ ........................... 18 18 18920 ......................... Oldham County, Kentucky .......................................................................... ........................ 4520 31140 18930 ......................... Owen County, Kentucky ............................................................................ .......................... 18 18 18931 ......................... Owsley County, Kentucky .......................................................................... ......................... 18 18 18932 ......................... Pendleton County, Kentucky ....................................................................... ........................ 18 17140 18960 ......................... Perry County, Kentucky ........................................................................... ........................... 18 18 18970 ......................... Pike County, Kentucky ............................................................................ ............................ 18 18 18971 ......................... Powell County, Kentucky .......................................................................... .......................... 18 18 18972 ......................... Pulaski County, Kentucky ......................................................................... .......................... 18 18 18973 ......................... Robertson County, Kentucky ....................................................................... ....................... 18 18 18974 ......................... Rockcastle County, Kentucky ...................................................................... ....................... 18 18 18975 ......................... Rowan County, Kentucky ........................................................................... ......................... 18 18 18976 ......................... Russell County, Kentucky ......................................................................... .......................... 18 18 18977 ......................... Scott County, Kentucky ........................................................................... ............................ 4280 30460 18978 ......................... Shelby County, Kentucky .......................................................................... .......................... 4520 31140 18979 ......................... Simpson County, Kentucky ......................................................................... ........................ 18 18 18980 ......................... Spencer County, Kentucky ......................................................................... ......................... 18 31140 18981 ......................... Taylor County, Kentucky .......................................................................... ........................... 18 18 18982 ......................... Todd County, Kentucky ............................................................................ ........................... 18 18 18983 ......................... Trigg County, Kentucky ........................................................................... ............................ 18 17300 18984 ......................... Trimble County, Kentucky ......................................................................... .......................... 18 31140 18985 ......................... Union County, Kentucky ........................................................................... ........................... 18 18 18986 ......................... Warren County, Kentucky .......................................................................... ......................... 18 14540 18987 ......................... Washington County, Kentucky ...................................................................... ...................... 18 18 18988 ......................... Wayne County, Kentucky ........................................................................... ......................... 18 18 18989 ......................... Webster County, Kentucky ......................................................................... ......................... 18 21780 18990 ......................... Whitley County, Kentucky ......................................................................... .......................... 18 18 18991 ......................... Wolfe County, Kentucky ........................................................................... ........................... 18 18


## 46026 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

18992 ......................... Woodford County, Kentucky ........................................................................ ....................... 4280 30460 19000 ......................... Acadia County, Louisiana ......................................................................... .......................... 19 19 19010 ......................... Allen County, Louisiana .......................................................................... ............................ 19 19 19020 ......................... Ascension County, Louisiana ...................................................................... ........................ 0760 12940 19030 ......................... Assumption County, Louisiana ..................................................................... ....................... 19 19 19040 ......................... Avoyelles County, Louisiana ...................................................................... ......................... 19 19 19050 ......................... Beauregard County, Louisiana ..................................................................... ....................... 19 19 19060 ......................... Bienville County, Louisiana ...................................................................... ........................... 19 19 19070 ......................... Bossier County, Louisiana ........................................................................ .......................... 7680 43340 19080 ......................... Caddo County, Louisiana .......................................................................... .......................... 7680 43340 19090 ......................... Calcasieu County, Louisiana ...................................................................... ......................... 3960 29340 19100 ......................... Caldwell County, Louisiana ....................................................................... .......................... 19 19 19110 ......................... Cameron County, Louisiana ........................................................................ ........................ 19 29340 19120 ......................... Catahoula County, Louisiana ...................................................................... ........................ 19 19 19130 ......................... Claiborne County, Louisiana ...................................................................... ......................... 19 19 19140 ......................... Concordia County, Louisiana ...................................................................... ........................ 19 19 19150 ......................... De Soto County, Louisiana ........................................................................ ......................... 19 43340 19160 ......................... East Baton Rouge County, Louisiana ............................................................... .................. 0760 12940 19170 ......................... East Carroll County, Louisiana ................................................................... ........................ 19 19 19180 ......................... East Feliciana County, Louisiana ................................................................. ....................... 19 12940 19190 ......................... Evangeline County, Louisiana ..................................................................... ........................ 19 19 19200 ......................... Franklin County, Louisiana ....................................................................... ........................... 19 19 19210 ......................... Grant County, Louisiana .......................................................................... ........................... 19 10780 19220 ......................... Iberia County, Louisiana ......................................................................... ............................ 19 19 19230 ......................... Iberville County, Louisiana ...................................................................... ............................ 19 12940 19240 ......................... Jackson County, Louisiana ........................................................................ ......................... 19 19 19250 ......................... Jefferson County, Louisiana ...................................................................... .......................... 5560 35380 19260 ......................... Jefferson Davis County, Louisiana ................................................................ ..................... 19 19 19270 ......................... Lafayette County, Louisiana ...................................................................... .......................... 3880 29180 19280 ......................... Lafourche County, Louisiana ...................................................................... ........................ 3350 26380 19290 ......................... La Salle County, Louisiana ....................................................................... .......................... 19 19 19300 ......................... Lincoln County, Louisiana ........................................................................ ........................... 19 19 19310 ......................... Livingston County, Louisiana ..................................................................... ......................... 0760 12940 19320 ......................... Madison County, Louisiana ........................................................................ ......................... 19 19 19330 ......................... Morehouse County, Louisiana ...................................................................... ...................... 19 19 19340 ......................... Natchitoches County, Louisiana ................................................................... ....................... 19 19 19350 ......................... Orleans County, Louisiana ........................................................................ .......................... 5560 35380 19360 ......................... Ouachita County, Louisiana ....................................................................... ......................... 5200 33740 19370 ......................... Plaquemines County, Louisiana .................................................................... ...................... 19 35380 19380 ......................... Pointe Coupee County, Louisiana .................................................................. .................... 19 12940 19390 ......................... Rapides County, Louisiana ........................................................................ ......................... 0220 10780 19400 ......................... Red River County, Louisiana ...................................................................... ........................ 19 19 19410 ......................... Richland County, Louisiana ....................................................................... ......................... 19 19 19420 ......................... Sabine County, Louisiana ......................................................................... .......................... 19 19 19430 ......................... St Bernard County, Louisiana ..................................................................... ........................ 5560 35380 19440 ......................... St Charles County, Louisiana ..................................................................... ........................ 5560 35380 19450 ......................... St Helena County, Louisiana ...................................................................... ........................ 19 12940 19460 ......................... St James County, Louisiana ....................................................................... ........................ 19 19 19470 ......................... St John Baptist County, Louisiana ................................................................ ...................... 5560 35380 19480 ......................... St Landry County, Louisiana ...................................................................... ......................... .19 19 19490 ......................... St Martin County, Louisiana ...................................................................... .......................... 3880 29180 19500 ......................... St Mary County, Louisiana ........................................................................ .......................... 19 19 19510 ......................... St Tammany County, Louisiana ..................................................................... ..................... 5560 35380 19520 ......................... Tangipahoa County, Louisiana ..................................................................... ...................... 19 19 19530 ......................... Tensas County, Louisiana ......................................................................... .......................... 19 19 19540 ......................... Terrebonne County, Louisiana ..................................................................... ....................... 3350 26380 19550 ......................... Union County, Louisiana .......................................................................... ........................... 19 33740 19560 ......................... Vermilion County, Louisiana ...................................................................... ......................... 19 19 19570 ......................... Vernon County, Louisiana ......................................................................... .......................... 19 19 19580 ......................... Washington County, Louisiana ..................................................................... ...................... 19 19 19590 ......................... Webster County, Louisiana ........................................................................ ......................... 19 19 19600 ......................... West Baton Rouge County, Louisiana ............................................................... ................. 0760 12940 19610 ......................... West Carroll County, Louisiana ................................................................... ....................... 19 19 19620 ......................... West Feliciana County, Louisiana ................................................................. ...................... 19 12940 19630 ......................... Winn County, Louisiana ........................................................................... ........................... 19 19 20000 ......................... Androscoggin County, Maine ....................................................................... ....................... 4243 30340 20010 ......................... Aroostook County, Maine .......................................................................... .......................... 20 20 20020 ......................... Cumberland County, Maine ......................................................................... ....................... 6403 38860 20030 ......................... Franklin County, Maine ........................................................................... ............................ 20 20 20040 ......................... Hancock County, Maine ............................................................................ .......................... 20 20


## 46027 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

20050 ......................... Kennebec County, Maine ........................................................................... ......................... 20 20 20060 ......................... Knox County, Maine ............................................................................... ............................. 20 20 20070 ......................... Lincoln County, Maine ............................................................................ ............................. 20 20 20080 ......................... Oxford County, Maine ............................................................................. ............................ 20 20 20090 ......................... Penobscot County, Maine .......................................................................... ......................... 0733 12620 20100 ......................... Piscataquis County, Maine ........................................................................ .......................... 20 20 20110 ......................... Sagadahoc County, Maine .......................................................................... ........................ 6403 38860 20120 ......................... Somerset County, Maine ........................................................................... .......................... 20 20 20130 ......................... Waldo County, Maine .............................................................................. ............................ 20 20 20140 ......................... Washington County, Maine ......................................................................... ........................ 20 20 20150 ......................... York County, Maine ............................................................................... .............................. 6403 38860 21000 ......................... Allegany County, Maryland ........................................................................ ......................... 1900 19060 21010 ......................... Anne Arundel County, Maryland .................................................................... ..................... 0720 12580 21020 ......................... Baltimore County, Maryland ....................................................................... ......................... 0720 12580 21030 ......................... Baltimore City County, Maryland .................................................................. ...................... 0720 12580 21040 ......................... Calvert County, Maryland ......................................................................... ........................... 8840 47894 21050 ......................... Caroline County, Maryland ........................................................................ .......................... 21 21 21060 ......................... Carroll County, Maryland ......................................................................... ........................... 0720 12580 21070 ......................... Cecil County, Maryland ........................................................................... ............................ 9160 48864 21080 ......................... Charles County, Maryland ......................................................................... .......................... 8840 47894 21090 ......................... Dorchester County, Maryland ...................................................................... ....................... 21 21 21100 ......................... Frederick County, Maryland ....................................................................... ......................... 8840 13644 21110 ......................... Garrett County, Maryland ......................................................................... ........................... 21 21 21120 ......................... Harford County, Maryland ......................................................................... .......................... 0720 12580 21130 ......................... Howard County, Maryland .......................................................................... ......................... 0720 12580 21140 ......................... Kent County, Maryland ............................................................................ ............................ 21 21 21150 ......................... Montgomery County, Maryland ...................................................................... ..................... 8840 13644 21160 ......................... Prince Georges County, Maryland .................................................................. .................... 8840 47894 21170 ......................... Queen Annes County, Maryland ..................................................................... .................... 0720 12580 21180 ......................... St Marys County, Maryland ........................................................................ ......................... 21 21 21190 ......................... Somerset County, Maryland ........................................................................ ........................ 21 41540 21200 ......................... Talbot County, Maryland .......................................................................... ........................... 21 21 21210 ......................... Washington County, Maryland ...................................................................... ...................... 3180 25180 21220 ......................... Wicomico County, Maryland ........................................................................ ....................... 21 41540 21230 ......................... Worcester County, Maryland ....................................................................... ........................ 21 21 22000 ......................... Barnstable County, Massachusetts ................................................................. .................... 0743 12700 22010 ......................... Berkshire County, Massachusetts .................................................................. ..................... 6323 38340 22020 ......................... Bristol County, Massachusetts .................................................................... ........................ 5403 39300 22030 ......................... Dukes County, Massachusetts ...................................................................... ...................... 22 22 22040 ......................... Essex County, Massachusetts ...................................................................... ...................... 1123 21604 22060 ......................... Franklin County, Massachusetts ................................................................... ...................... 22 44140 22070 ......................... Hampden County, Massachusetts .................................................................... .................. 8003 44140 22080 ......................... Hampshire County, Massachusetts .................................................................. .................. 8003 44140 22090 ......................... Middlesex County, Massachusetts .................................................................. .................... 1123 15764 22120 ......................... Nantucket County, Massachusetts .................................................................. .................... 22 22 22130 ......................... Norfolk County, Massachusetts .................................................................... ...................... 1123 14484 22150 ......................... Plymouth County, Massachusetts ................................................................... .................... 1123 14484 22160 ......................... Suffolk County, Massachusetts .................................................................... ....................... 1123 14484 22170 ......................... Worcester County, Massachusetts .................................................................. ................... 9243 49340 23000 ......................... Alcona County, Michigan .......................................................................... .......................... 23 23 23010 ......................... Alger County, Michigan ........................................................................... ............................ 23 23 23020 ......................... Allegan County, Michigan ......................................................................... .......................... 23 23 23030 ......................... Alpena County, Michigan .......................................................................... .......................... 23 23 23040 ......................... Antrim County, Michigan .......................................................................... ........................... 23 23 23050 ......................... Arenac County, Michigan .......................................................................... .......................... 23 23 23060 ......................... Baraga County, Michigan .......................................................................... .......................... 23 23 23070 ......................... Barry County, Michigan ........................................................................... ............................ 23 24340 23080 ......................... Bay County, Michigan ............................................................................. ............................ 6960 13020 23090 ......................... Benzie County, Michigan .......................................................................... .......................... 23 23 23100 ......................... Berrien County, Michigan ......................................................................... ........................... 0870 35660 23110 ......................... Branch County, Michigan .......................................................................... .......................... 23 23 23120 ......................... Calhoun County, Michigan ......................................................................... ......................... 0780 12980 23130 ......................... Cass County, Michigan ............................................................................ ........................... 23 43780 23140 ......................... Charlevoix County, Michigan ...................................................................... ........................ 23 23 23150 ......................... Cheboygan County, Michigan ....................................................................... ...................... 23 23 23160 ......................... Chippewa County, Michigan ........................................................................ ....................... 23 23 23170 ......................... Clare County, Michigan ........................................................................... ............................ 23 23 23180 ......................... Clinton County, Michigan ......................................................................... ........................... 4040 29620 23190 ......................... Crawford County, Michigan ........................................................................ ......................... 23 23 23200 ......................... Delta County, Michigan ........................................................................... ............................ 23 23


## 46028 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

23210 ......................... Dickinson County, Michigan ....................................................................... ......................... 23 23 23220 ......................... Eaton County, Michigan ........................................................................... ........................... 4040 29620 23230 ......................... Emmet County, Michigan ........................................................................... ......................... 23 23 23240 ......................... Genesee County, Michigan ......................................................................... ........................ 2640 22420 23250 ......................... Gladwin County, Michigan ......................................................................... ......................... 23 23 23260 ......................... Gogebic County, Michigan ......................................................................... ......................... 23 23 23270 ......................... Grand Traverse County, Michigan .................................................................. .................... 23 23 23280 ......................... Gratiot County, Michigan ......................................................................... ............................ 23 23 23290 ......................... Hillsdale County, Michigan ....................................................................... ........................... 23 23 23300 ......................... Houghton County, Michigan ........................................................................ ........................ 23 23 23310 ......................... Huron County, Michigan ........................................................................... ........................... 23 23 23320 ......................... Ingham County, Michigan .......................................................................... ......................... 4040 29620 23330 ......................... Ionia County, Michigan ........................................................................... ............................. 23 24340 23340 ......................... Iosco County, Michigan ........................................................................... ............................ 23 23 23350 ......................... Iron County, Michigan ............................................................................ ............................. 23 23 23360 ......................... Isabella County, Michigan ........................................................................ ........................... 23 23 23370 ......................... Jackson County, Michigan ......................................................................... ......................... 3520 27100 23380 ......................... Kalamazoo County, Michigan ....................................................................... ...................... 3720 28020 23390 ......................... Kalkaska County, Michigan ........................................................................ ......................... 23 23 23400 ......................... Kent County, Michigan ............................................................................ ............................ 3000 24340 23410 ......................... Keweenaw County, Michigan ........................................................................ ...................... 23 23 23420 ......................... Lake County, Michigan ............................................................................ ............................ 23 23 23430 ......................... Lapeer County, Michigan .......................................................................... .......................... 2160 47644 23440 ......................... Leelanau County, Michigan ........................................................................ ......................... 23 23 23450 ......................... Lenawee County, Michigan ......................................................................... ........................ 23 23 23460 ......................... Livingston County, Michigan ...................................................................... ......................... 2160 47644 23470 ......................... Luce County, Michigan ............................................................................ ............................ 23 23 23480 ......................... Mackinac County, Michigan ........................................................................ ........................ 23 23 23490 ......................... Macomb County, Michigan .......................................................................... ........................ 2160 47644 23500 ......................... Manistee County, Michigan ........................................................................ ......................... 23 23 23510 ......................... Marquette County, Michigan ....................................................................... ........................ 23 23 23520 ......................... Mason County, Michigan ........................................................................... .......................... 23 23 23530 ......................... Mecosta County, Michigan ......................................................................... ......................... 23 23 23540 ......................... Menominee County, Michigan ....................................................................... ...................... 23 23 23550 ......................... Midland County, Michigan ......................................................................... .......................... 6960 23 23560 ......................... Missaukee County, Michigan ....................................................................... ....................... 23 23 23570 ......................... Monroe County, Michigan .......................................................................... ......................... 2160 33780 23580 ......................... Montcalm County, Michigan ........................................................................ ........................ 23 23 23590 ......................... Montmorency County, Michigan ..................................................................... ..................... 23 23 23600 ......................... Muskegon County, Michigan ........................................................................ ....................... 5320 34740 23610 ......................... Newaygo County, Michigan ......................................................................... ....................... 23 24340 23620 ......................... Oakland County, Michigan ......................................................................... ......................... 2160 47644 23630 ......................... Oceana County, Michigan .......................................................................... ......................... 23 23 23640 ......................... Ogemaw County, Michigan .......................................................................... ....................... 23 23 23650 ......................... Ontonagon County, Michigan ....................................................................... ....................... 23 23 23660 ......................... Osceola County, Michigan ......................................................................... ......................... 23 23 23670 ......................... Oscoda County, Michigan .......................................................................... ......................... 23 23 23680 ......................... Otsego County, Michigan .......................................................................... .......................... 23 23 23690 ......................... Ottawa County, Michigan .......................................................................... .......................... 3000 26100 23700 ......................... Presque Isle County, Michigan .................................................................... ....................... 23 23 23710 ......................... Roscommon County, Michigan ....................................................................... .................... 23 23 23720 ......................... Saginaw County, Michigan ......................................................................... ......................... 6960 40980 23730 ......................... St Clair County, Michigan ........................................................................ ........................... 2160 47644 23740 ......................... St Joseph County, Michigan ....................................................................... ........................ 23 23 23750 ......................... Sanilac County, Michigan ......................................................................... ........................... 23 23 23760 ......................... Schoolcraft County, Michigan ..................................................................... ........................ 23 23 23770 ......................... Shiawassee County, Michigan ...................................................................... ...................... 23 23 23780 ......................... Tuscola County, Michigan ......................................................................... .......................... 23 23 23790 ......................... Van Buren County, Michigan ....................................................................... ....................... 23 28020 23800 ......................... Washtenaw County, Michigan ....................................................................... ...................... 0440 11460 23810 ......................... Wayne County, Michigan ........................................................................... ......................... 2160 19804 23830 ......................... Wexford County, Michigan ......................................................................... ......................... 23 23 24000 ......................... Aitkin County, Minnesota ......................................................................... ........................... 24 24 24010 ......................... Anoka County, Minnesota .......................................................................... ......................... 5120 33460 24020 ......................... Becker County, Minnesota ......................................................................... ......................... 24 24 24030 ......................... Beltrami County, Minnesota ....................................................................... ......................... 24 24 24040 ......................... Benton County, Minnesota ......................................................................... ......................... 6980 41060 24050 ......................... Big Stone County, Minnesota ...................................................................... ....................... 24 24 24060 ......................... Blue Earth County, Minnesota ..................................................................... ....................... 24 24 24070 ......................... Brown County, Minnesota .......................................................................... ......................... 24 24


## 46029 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

24080 ......................... Carlton County, Minnesota ........................................................................ .......................... 24 20260 24090 ......................... Carver County, Minnesota ......................................................................... ......................... 5120 33460 24100 ......................... Cass County, Minnesota ........................................................................... .......................... 24 24 24110 ......................... Chippewa County, Minnesota ....................................................................... ...................... 24 24 24120 ......................... Chisago County, Minnesota ........................................................................ ........................ 5120 33460 24130 ......................... Clay County, Minnesota ........................................................................... ........................... 2520 22020 24140 ......................... Clearwater County, Minnesota ..................................................................... ....................... 24 24 24150 ......................... Cook County, Minnesota ........................................................................... .......................... 24 24 24160 ......................... Cottonwood County, Minnesota ..................................................................... ..................... 24 24 24170 ......................... Crow Wing County, Minnesota ...................................................................... ..................... 24 24 24180 ......................... Dakota County, Minnesota ......................................................................... ......................... 5120 33460 24190 ......................... Dodge County, Minnesota .......................................................................... ......................... 24 40340 24200 ......................... Douglas County, Minnesota ........................................................................ ........................ 24 24 24210 ......................... Faribault County, Minnesota ...................................................................... ......................... 24 24 24220 ......................... Fillmore County, Minnesota ....................................................................... ......................... 24 24 24230 ......................... Freeborn County, Minnesota ....................................................................... ........................ 24 24 24240 ......................... Goodhue County, Minnesota ........................................................................ ...................... 24 24 24250 ......................... Grant County, Minnesota .......................................................................... .......................... 24 24 24260 ......................... Hennepin County, Minnesota ....................................................................... ....................... 5120 33460 24270 ......................... Houston County, Minnesota ........................................................................ ........................ 24 29100 24280 ......................... Hubbard County, Minnesota ........................................................................ ....................... 24 24 24290 ......................... Isanti County, Minnesota ......................................................................... ............................ 5120 33460 24300 ......................... Itasca County, Minnesota ......................................................................... ........................... 24 24 24310 ......................... Jackson County, Minnesota ........................................................................ ........................ 24 24 24320 ......................... Kanabec County, Minnesota ........................................................................ ....................... 24 24 24330 ......................... Kandiyohi County, Minnesota ...................................................................... ....................... 24 24 24340 ......................... Kittson County, Minnesota ........................................................................ .......................... 24 24 24350 ......................... Koochiching County, Minnesota .................................................................... ...................... 24 24 24360 ......................... Lac Qui Parle County, Minnesota .................................................................. ..................... 24 24 24370 ......................... Lake County, Minnesota ........................................................................... .......................... 24 24 24380 ......................... Lake Of Woods County, Minnesota .................................................................. .................. 24 24 24390 ......................... Le Sueur County, Minnesota ....................................................................... ....................... 24 24 24400 ......................... Lincoln County, Minnesota ........................................................................ .......................... 24 24 24410 ......................... Lyon County, Minnesota ........................................................................... .......................... 24 24 24420 ......................... Mc Leod County, Minnesota ........................................................................ ....................... 24 24 24430 ......................... Mahnomen County, Minnesota ....................................................................... .................... 24 24 24440 ......................... Marshall County, Minnesota ....................................................................... ......................... 24 24 24450 ......................... Martin County, Minnesota ......................................................................... .......................... 24 24 24460 ......................... Meeker County, Minnesota ......................................................................... ........................ 24 24 24470 ......................... Mille Lacs County, Minnesota ..................................................................... ........................ 24 24 24480 ......................... Morrison County, Minnesota ....................................................................... ........................ 24 24 24490 ......................... Mower County, Minnesota .......................................................................... ........................ 24 24 24500 ......................... Murray County, Minnesota ......................................................................... ......................... 24 24 24510 ......................... Nicollet County, Minnesota ....................................................................... .......................... 24 24 24520 ......................... Nobles County, Minnesota ......................................................................... ......................... 24 24 24530 ......................... Norman County, Minnesota ......................................................................... ....................... 24 24 24540 ......................... Olmsted County, Minnesota ........................................................................ ........................ 6820 40340 24550 ......................... Otter Tail County, Minnesota ..................................................................... ......................... 24 24 24560 ......................... Pennington County, Minnesota ..................................................................... ...................... 24 24 24570 ......................... Pine County, Minnesota ........................................................................... ........................... 24 24 24580 ......................... Pipestone County, Minnesota ...................................................................... ....................... 24 24 24590 ......................... Polk County, Minnesota ........................................................................... ........................... 24 24220 24600 ......................... Pope County, Minnesota ........................................................................... .......................... 24 24 24610 ......................... Ramsey County, Minnesota ......................................................................... ....................... 5120 33460 24620 ......................... Red Lake County, Minnesota ....................................................................... ....................... 24 24 24630 ......................... Redwood County, Minnesota ........................................................................ ...................... 24 24 24640 ......................... Renville County, Minnesota ....................................................................... ......................... 24 24 24650 ......................... Rice County, Minnesota ........................................................................... ........................... 24 24 24660 ......................... Rock County, Minnesota ........................................................................... .......................... 24 24 24670 ......................... Roseau County, Minnesota ......................................................................... ........................ 24 24 24680 ......................... St Louis County, Minnesota ....................................................................... ......................... 2240 20260 24690 ......................... Scott County, Minnesota .......................................................................... ........................... 5120 33460 24700 ......................... Sherburne County, Minnesota ...................................................................... ...................... 6980 33460 24710 ......................... Sibley County, Minnesota ......................................................................... .......................... 24 24 24720 ......................... Stearns County, Minnesota ........................................................................ ......................... 6980 41060 24730 ......................... Steele County, Minnesota ......................................................................... .......................... 24 24 24740 ......................... Stevens County, Minnesota ........................................................................ ........................ 24 24 24750 ......................... Swift County, Minnesota .......................................................................... ........................... 24 24 24760 ......................... Todd County, Minnesota ........................................................................... .......................... 24 24 24770 ......................... Traverse County, Minnesota ....................................................................... ........................ 24 24


## 46030 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

24780 ......................... Wabasha County, Minnesota ........................................................................ ...................... 24 40340 24790 ......................... Wadena County, Minnesota ......................................................................... ....................... 24 24 24800 ......................... Waseca County, Minnesota ......................................................................... ....................... 24 24 24810 ......................... Washington County, Minnesota ..................................................................... ..................... 5120 33460 24820 ......................... Watonwan County, Minnesota ....................................................................... ..................... 24 24 24830 ......................... Wilkin County, Minnesota ......................................................................... ........................... 24 24 24840 ......................... Winona County, Minnesota ......................................................................... ........................ 24 24 24850 ......................... Wright County, Minnesota ......................................................................... .......................... 5120 33460 24860 ......................... Yellow Medicine County, Minnesota ................................................................ ................... 24 24 25000 ......................... Adams County, Mississippi ........................................................................ ......................... 25 25 25010 ......................... Alcorn County, Mississippi ....................................................................... ........................... 25 25 25020 ......................... Amite County, Mississippi ........................................................................ ........................... 25 25 25030 ......................... Attala County, Mississippi ....................................................................... ............................ 25 25 25040 ......................... Benton County, Mississippi ....................................................................... .......................... 25 25 25050 ......................... Bolivar County, Mississippi ...................................................................... ........................... 25 25 25060 ......................... Calhoun County, Mississippi ...................................................................... ......................... 25 25 25070 ......................... Carroll County, Mississippi ...................................................................... ............................ 25 25 25080 ......................... Chickasaw County, Mississippi .................................................................... ....................... 25 25 25090 ......................... Choctaw County, Mississippi ...................................................................... ........................ 25 25 25100 ......................... Claiborne County, Mississippi .................................................................... ......................... 25 25 25110 ......................... Clarke County, Mississippi ....................................................................... ........................... 25 25 25120 ......................... Clay County, Mississippi ......................................................................... ............................ 25 25 25130 ......................... Coahoma County, Mississippi ...................................................................... ....................... 25 25 25140 ......................... Copiah County, Mississippi ....................................................................... .......................... 25 27140 25150 ......................... Covington County, Mississippi .................................................................... ........................ 25 25 25160 ......................... Desoto County, Mississippi ....................................................................... .......................... 4920 32820 25170 ......................... Forrest County, Mississippi ...................................................................... ........................... 25 25620 25180 ......................... Franklin County, Mississippi ..................................................................... ........................... 25 25 25190 ......................... George County, Mississippi ....................................................................... ......................... 25 37700 25200 ......................... Greene County, Mississippi ....................................................................... ......................... 25 25 25210 ......................... Grenada County, Mississippi ...................................................................... ........................ 25 25 25220 ......................... Hancock County, Mississippi ...................................................................... ........................ 0920 25060 25230 ......................... Harrison County, Mississippi ..................................................................... .......................... 0920 25060 25240 ......................... Hinds County, Mississippi ........................................................................ ........................... 3560 27140 25250 ......................... Holmes County, Mississippi ....................................................................... ......................... 25 25 25260 ......................... Humphreys County, Mississippi .................................................................... ...................... 25 25 25270 ......................... Issaquena County, Mississippi .................................................................... ........................ 25 25 25280 ......................... Itawamba County, Mississippi ..................................................................... ........................ 25 25 25290 ......................... Jackson County, Mississippi ...................................................................... ......................... 6025 37700 25300 ......................... Jasper County, Mississippi ....................................................................... ........................... 25 25 25310 ......................... Jefferson County, Mississippi .................................................................... .......................... 25 25 25320 ......................... Jefferson Davis County, Mississippi .............................................................. ..................... 25 25 25330 ......................... Jones County, Mississippi ........................................................................ ........................... 25 25 25340 ......................... Kemper County, Mississippi ....................................................................... ......................... 25 25 25350 ......................... Lafayette County, Mississippi .................................................................... .......................... 25 25 25360 ......................... Lamar County, Mississippi ........................................................................ .......................... 25 25620 25370 ......................... Lauderdale County, Mississippi ................................................................... ....................... 25 25 25380 ......................... Lawrence County, Mississippi ..................................................................... ........................ 25 25 25390 ......................... Leake County, Mississippi ........................................................................ ........................... 25 25 25400 ......................... Lee County, Mississippi .......................................................................... ............................ 25 25 25410 ......................... Leflore County, Mississippi ...................................................................... ........................... 25 25 25420 ......................... Lincoln County, Mississippi ...................................................................... ........................... 25 25 25430 ......................... Lowndes County, Mississippi ...................................................................... ........................ 25 25 25440 ......................... Madison County, Mississippi ...................................................................... ......................... 3560 27140 25450 ......................... Marion County, Mississippi ....................................................................... .......................... 25 25 25460 ......................... Marshall County, Mississippi ..................................................................... .......................... 25 32820 25470 ......................... Monroe County, Mississippi ....................................................................... ......................... 25 25 25480 ......................... Montgomery County, Mississippi ................................................................... ..................... 25 25 25490 ......................... Neshoba County, Mississippi ...................................................................... ........................ 25 25 25500 ......................... Newton County, Mississippi ....................................................................... ......................... 25 25 25510 ......................... Noxubee County, Mississippi ...................................................................... ........................ 25 25 25520 ......................... Oktibbeha County, Mississippi .................................................................... ........................ 25 25 25530 ......................... Panola County, Mississippi ....................................................................... .......................... 25 25 25540 ......................... Pearl River County, Mississippi .................................................................. ........................ 25 25 25550 ......................... Perry County, Mississippi ........................................................................ ............................ 25 25620 25560 ......................... Pike County, Mississippi ......................................................................... ............................ 25 25 25570 ......................... Pontotoc County, Mississippi ..................................................................... ......................... 25 25 25580 ......................... Prentiss County, Mississippi ..................................................................... .......................... 25 25 25590 ......................... Quitman County, Mississippi ...................................................................... ......................... 25 25 25600 ......................... Rankin County, Mississippi ....................................................................... .......................... 3560 27140


## 46031 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

25610 ......................... Scott County, Mississippi ........................................................................ ............................ 25 25 25620 ......................... Sharkey County, Mississippi ...................................................................... ......................... 25 25 25630 ......................... Simpson County, Mississippi ...................................................................... ........................ 25 27140 25640 ......................... Smith County, Mississippi ........................................................................ ........................... 25 25 25650 ......................... Stone County, Mississippi ........................................................................ ........................... 25 25060 25660 ......................... Sunflower County, Mississippi .................................................................... ........................ 25 25 25670 ......................... Tallahatchie County, Mississippi ................................................................. ........................ 25 25 25680 ......................... Tate County, Mississippi ......................................................................... ............................ 25 32820 25690 ......................... Tippah County, Mississippi ....................................................................... .......................... 25 25 25700 ......................... Tishomingo County, Mississippi ................................................................... ....................... 25 25 25710 ......................... Tunica County, Mississippi ....................................................................... ........................... 25 32820 25720 ......................... Union County, Mississippi ........................................................................ ........................... 25 25 25730 ......................... Walthall County, Mississippi ..................................................................... ........................... 25 25 25740 ......................... Warren County, Mississippi ....................................................................... .......................... 25 25 25750 ......................... Washington County, Mississippi ................................................................... ...................... 25 25 25760 ......................... Wayne County, Mississippi ........................................................................ ......................... 25 25 25770 ......................... Webster County, Mississippi ...................................................................... ......................... 25 25 25780 ......................... Wilkinson County, Mississippi .................................................................... ......................... 25 25 25790 ......................... Winston County, Mississippi ...................................................................... ......................... 25 25 25800 ......................... Yalobusha County, Mississippi .................................................................... ....................... 25 25 25810 ......................... Yazoo County, Mississippi ........................................................................ .......................... 25 25 26000 ......................... Adair County, Missouri ........................................................................... ............................. 26 26 26010 ......................... Andrew County, Missouri .......................................................................... .......................... 26 41140 26020 ......................... Atchison County, Missouri ........................................................................ ........................... 26 26 26030 ......................... Audrain County, Missouri ......................................................................... ........................... 26 26 26040 ......................... Barry County, Missouri ........................................................................... ............................. 26 26 26050 ......................... Barton County, Missouri .......................................................................... ............................ 26 26 26060 ......................... Bates County, Missouri ........................................................................... ............................ 26 28140 26070 ......................... Benton County, Missouri .......................................................................... ........................... 26 26 26080 ......................... Bollinger County, Missouri ....................................................................... ........................... 26 26 26090 ......................... Boone County, Missouri ........................................................................... ........................... 1740 17860 26100 ......................... Buchanan County, Missouri ........................................................................ ........................ 7000 41140 26110 ......................... Butler County, Missouri .......................................................................... ............................. 26 26 26120 ......................... Caldwell County, Missouri ........................................................................ ........................... 26 28140 26130 ......................... Callaway County, Missouri ........................................................................ .......................... 26 27620 26140 ......................... Camden County, Missouri .......................................................................... ......................... 26 26 26150 ......................... Cape Girardeau County, Missouri .................................................................. ..................... 26 26 26160 ......................... Carroll County, Missouri ......................................................................... ............................. 26 26 26170 ......................... Carter County, Missouri .......................................................................... ............................ 26 26 26180 ......................... Cass County, Missouri ............................................................................ ............................ 3760 28140 26190 ......................... Cedar County, Missouri ........................................................................... ............................ 26 26 26200 ......................... Chariton County, Missouri ........................................................................ ........................... 26 26 26210 ......................... Christian County, Missouri ....................................................................... ........................... 7920 44180 26220 ......................... Clark County, Missouri ........................................................................... ............................. 26 26 26230 ......................... Clay County, Missouri ............................................................................ ............................. 3760 28140 26240 ......................... Clinton County, Missouri ......................................................................... ............................ 26 28140 26250 ......................... Cole County, Missouri ............................................................................ ............................. 26 27620 26260 ......................... Cooper County, Missouri .......................................................................... ........................... 26 26 26270 ......................... Crawford County, Missouri ........................................................................ .......................... 26 41180 26280 ......................... Dade County, Missouri ............................................................................ ............................ 26 26 26290 ......................... Dallas County, Missouri .......................................................................... ............................ 26 44180 26300 ......................... Daviess County, Missouri ......................................................................... ........................... 26 26 26310 ......................... De Kalb County, Missouri ......................................................................... .......................... 26 41140 26320 ......................... Dent County, Missouri ............................................................................ ............................. 26 26 26330 ......................... Douglas County, Missouri ......................................................................... .......................... 26 26 26340 ......................... Dunklin County, Missouri ......................................................................... ........................... 26 26 26350 ......................... Franklin County, Missouri ........................................................................ ............................ 7040 41180 26360 ......................... Gasconade County, Missouri ....................................................................... ....................... 26 26 26370 ......................... Gentry County, Missouri .......................................................................... ............................ 26 26 26380 ......................... Greene County, Missouri .......................................................................... .......................... 7920 44180 26390 ......................... Grundy County, Missouri .......................................................................... ........................... 26 26 26400 ......................... Harrison County, Missouri ........................................................................ ........................... 26 26 26410 ......................... Henry County, Missouri ........................................................................... ............................ 26 26 26411 ......................... Hickory County, Missouri ......................................................................... ........................... 26 26 26412 ......................... Holt County, Missouri ............................................................................ .............................. 26 26 26440 ......................... Howard County, Missouri .......................................................................... .......................... 26 17860 26450 ......................... Howell County, Missouri .......................................................................... ............................ 26 26 26460 ......................... Iron County, Missouri ............................................................................ .............................. 26 26 26470 ......................... Jackson County, Missouri ......................................................................... .......................... 3760 28140 26480 ......................... Jasper County, Missouri .......................................................................... ............................ 3710 27900


## 46032 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

26490 ......................... Jefferson County, Missouri ....................................................................... ........................... 7040 41180 26500 ......................... Johnson County, Missouri ......................................................................... .......................... 26 26 26510 ......................... Knox County, Missouri ............................................................................ ............................ 26 26 26520 ......................... Laclede County, Missouri ......................................................................... ........................... 26 26 26530 ......................... Lafayette County, Missouri ....................................................................... ........................... 3760 28140 26540 ......................... Lawrence County, Missouri ........................................................................ ......................... 26 26 26541 ......................... Lewis County, Missouri ........................................................................... ............................ 26 26 26560 ......................... Lincoln County, Missouri ......................................................................... ............................ 26 41180 26570 ......................... Linn County, Missouri ............................................................................ .............................. 26 26 26580 ......................... Livingston County, Missouri ...................................................................... .......................... 26 26 26590 ......................... Mc Donald County, Missouri ....................................................................... ........................ 26 22220 26600 ......................... Macon County, Missouri ........................................................................... ........................... 26 26 26601 ......................... Madison County, Missouri ......................................................................... .......................... 26 26 26620 ......................... Maries County, Missouri .......................................................................... ............................ 26 26 26630 ......................... Marion County, Missouri .......................................................................... ........................... 26 26 26631 ......................... Mercer County, Missouri .......................................................................... ........................... 26 26 26650 ......................... Miller County, Missouri .......................................................................... .............................. 26 26 26660 ......................... Mississippi County, Missouri ..................................................................... .......................... 26 26 26670 ......................... Moniteau County, Missouri ........................................................................ .......................... 26 27620 26680 ......................... Monroe County, Missouri .......................................................................... .......................... 26 26 26690 ......................... Montgomery County, Missouri ...................................................................... ...................... 26 26 26700 ......................... Morgan County, Missouri .......................................................................... .......................... 26 26 26710 ......................... New Madrid County, Missouri ...................................................................... ....................... 26 26 26720 ......................... Newton County, Missouri .......................................................................... .......................... 3710 27900 26730 ......................... Nodaway County, Missouri ......................................................................... ........................ 26 26 26740 ......................... Oregon County, Missouri .......................................................................... .......................... 26 26 26750 ......................... Osage County, Missouri ........................................................................... ........................... 26 27620 26751 ......................... Ozark County, Missouri ........................................................................... ............................ 26 26 26770 ......................... Pemiscot County, Missouri ........................................................................ .......................... 26 26 26780 ......................... Perry County, Missouri ........................................................................... ............................. 26 26 26790 ......................... Pettis County, Missouri .......................................................................... ............................. 26 26 26800 ......................... Phelps County, Missouri .......................................................................... ........................... 26 26 26810 ......................... Pike County, Missouri ............................................................................ ............................. 26 26 26820 ......................... Platte County, Missouri .......................................................................... ............................. 3760 28140 26821 ......................... Polk County, Missouri ............................................................................ ............................. 26 44180 26840 ......................... Pulaski County, Missouri ......................................................................... ............................ 26 26 26850 ......................... Putnam County, Missouri .......................................................................... .......................... 26 26 26860 ......................... Ralls County, Missouri ........................................................................... ............................. 26 26 26870 ......................... Randolph County, Missouri ........................................................................ ......................... 26 26 26880 ......................... Ray County, Missouri ............................................................................. ............................. 3760 28140 26881 ......................... Reynolds County, Missouri ........................................................................ ......................... 26 26 26900 ......................... Ripley County, Missouri .......................................................................... ............................ 26 26 26910 ......................... St Charles County, Missouri ...................................................................... ......................... 7040 41180 26911 ......................... St Clair County, Missouri ........................................................................ ............................ 26 26 26930 ......................... St Francois County, Missouri ..................................................................... ......................... 26 26 26940 ......................... St Louis County, Missouri ........................................................................ ........................... 7040 41180 26950 ......................... St Louis City County, Missouri ................................................................... ......................... 7040 41180 26960 ......................... Ste Genevieve County, Missouri ................................................................... ...................... 26 26 26970 ......................... Saline County, Missouri .......................................................................... ............................ 26 26 26980 ......................... Schuyler County, Missouri ........................................................................ .......................... 26 26 26981 ......................... Scotland County, Missouri ........................................................................ .......................... 26 26 26982 ......................... Scott County, Missouri ........................................................................... ............................. 26 26 26983 ......................... Shannon County, Missouri ......................................................................... ......................... 26 26 26984 ......................... Shelby County, Missouri .......................................................................... ........................... 26 26 26985 ......................... Stoddard County, Missouri ........................................................................ .......................... 26 26 26986 ......................... Stone County, Missouri ........................................................................... ............................ 26 26 26987 ......................... Sullivan County, Missouri ........................................................................ ............................ 26 26 26988 ......................... Taney County, Missouri ........................................................................... ........................... 26 26 26989 ......................... Texas County, Missouri ........................................................................... ............................ 26 26 26990 ......................... Vernon County, Missouri .......................................................................... ........................... 26 26 26991 ......................... Warren County, Missouri .......................................................................... ........................... 26 41180 26992 ......................... Washington County, Missouri ...................................................................... ....................... 26 41180 26993 ......................... Wayne County, Missouri ........................................................................... .......................... 26 26 26994 ......................... Webster County, Missouri ......................................................................... .......................... 26 44180 26995 ......................... Worth County, Missouri ........................................................................... ............................ 26 26 26996 ......................... Wright County, Missouri .......................................................................... ............................ 26 26 27000 ......................... Beaverhead County, Montana ....................................................................... ..................... 27 27 27010 ......................... Big Horn County, Montana ......................................................................... ......................... 27 27 27020 ......................... Blaine County, Montana ........................................................................... ........................... 27 27 27030 ......................... Broadwater County, Montana ....................................................................... ...................... 27 27


## 46033 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

27040 ......................... Carbon County, Montana ........................................................................... ......................... 27 13740 27050 ......................... Carter County, Montana ........................................................................... ........................... 27 27 27060 ......................... Cascade County, Montana .......................................................................... ........................ 3040 24500 27070 ......................... Chouteau County, Montana ......................................................................... ....................... 27 27 27080 ......................... Custer County, Montana ........................................................................... .......................... 27 27 27090 ......................... Daniels County, Montana .......................................................................... .......................... 27 27 27100 ......................... Dawson County, Montana ........................................................................... ........................ 27 27 27110 ......................... Deer Lodge County, Montana ....................................................................... ...................... 27 27 27113 ......................... Yellowstone National Park, Montana ............................................................... ................... 0880 27 27120 ......................... Fallon County, Montana ........................................................................... ........................... 27 27 27130 ......................... Fergus County, Montana ........................................................................... .......................... 27 27 27140 ......................... Flathead County, Montana ......................................................................... ......................... 27 27 27150 ......................... Gallatin County, Montana ......................................................................... ........................... 27 27 27160 ......................... Garfield County, Montana ......................................................................... .......................... 27 27 27170 ......................... Glacier County, Montana .......................................................................... .......................... 27 27 27180 ......................... Golden Valley County, Montana .................................................................... ..................... 27 27 27190 ......................... Granite County, Montana .......................................................................... .......................... 27 27 27200 ......................... Hill County, Montana ............................................................................. .............................. 27 27 27210 ......................... Jefferson County, Montana ........................................................................ ......................... 27 27 27220 ......................... Judith Basin County, Montana ..................................................................... ....................... 27 27 27230 ......................... Lake County, Montana ............................................................................. ........................... 27 27 27240 ......................... Lewis And Clark County, Montana .................................................................. ................... 27 27 27250 ......................... Liberty County, Montana .......................................................................... ........................... 27 27 27260 ......................... Lincoln County, Montana .......................................................................... .......................... 27 27 27270 ......................... Mc Cone County, Montana .......................................................................... ....................... 27 27 27280 ......................... Madison County, Montana .......................................................................... ........................ 27 27 27290 ......................... Meagher County, Montana .......................................................................... ........................ 27 27 27300 ......................... Mineral County, Montana .......................................................................... .......................... 27 27 27310 ......................... Missoula County, Montana ......................................................................... ......................... 27 33540 27320 ......................... Musselshell County, Montana ...................................................................... ....................... 27 27 27330 ......................... Park County, Montana ............................................................................. ........................... 27 27 27340 ......................... Petroleum County, Montana ........................................................................ ....................... 27 27 27350 ......................... Phillips County, Montana ......................................................................... ........................... 27 27 27360 ......................... Pondera County, Montana .......................................................................... ........................ 27 27 27370 ......................... Powder River County, Montana ..................................................................... ..................... 27 27 27380 ......................... Powell County, Montana ........................................................................... .......................... 27 27 27390 ......................... Prairie County, Montana .......................................................................... ........................... 27 27 27400 ......................... Ravalli County, Montana .......................................................................... ........................... 27 27 27410 ......................... Richland County, Montana ......................................................................... ......................... 27 27 27420 ......................... Roosevelt County, Montana ........................................................................ ........................ 27 27 27430 ......................... Rosebud County, Montana .......................................................................... ....................... 27 27 27440 ......................... Sanders County, Montana .......................................................................... ........................ 27 27 27450 ......................... Sheridan County, Montana ......................................................................... ........................ 27 27 27460 ......................... Silver Bow County, Montana ....................................................................... ........................ 27 27 27470 ......................... Stillwater County, Montana ....................................................................... .......................... 27 27 27480 ......................... Sweet Grass County, Montana ...................................................................... ..................... 27 27 27490 ......................... Teton County, Montana ............................................................................ ........................... 27 27 27500 ......................... Toole County, Montana ............................................................................ ........................... 27 27 27510 ......................... Treasure County, Montana ......................................................................... ........................ 27 27 27520 ......................... Valley County, Montana ........................................................................... ........................... 27 27 27530 ......................... Wheatland County, Montana ........................................................................ ....................... 27 27 27540 ......................... Wibaux County, Montana ........................................................................... ......................... 27 27 27550 ......................... Yellowstone County, Montana ...................................................................... ...................... 0880 13740 28000 ......................... Adams County, Nebraska ........................................................................... ........................ 28 28 28010 ......................... Antelope County, Nebraska ........................................................................ ........................ 28 28 28020 ......................... Arthur County, Nebraska .......................................................................... ........................... 28 28 28030 ......................... Banner County, Nebraska .......................................................................... ......................... 28 28 28040 ......................... Blaine County, Nebraska .......................................................................... .......................... 28 28 28050 ......................... Boone County, Nebraska ........................................................................... ......................... 28 28 28060 ......................... Box Butte County, Nebraska ....................................................................... ........................ 28 28 28070 ......................... Boyd County, Nebraska ............................................................................ .......................... 28 28 28080 ......................... Brown County, Nebraska ........................................................................... ......................... 28 28 28090 ......................... Buffalo County, Nebraska ......................................................................... .......................... 28 28 28100 ......................... Burt County, Nebraska ............................................................................ ............................ 28 28 28110 ......................... Butler County, Nebraska .......................................................................... ........................... 28 28 28120 ......................... Cass County, Nebraska ............................................................................ .......................... 28 36540 28130 ......................... Cedar County, Nebraska ........................................................................... .......................... 28 28 28140 ......................... Chase County, Nebraska ........................................................................... ......................... 28 28 28150 ......................... Cherry County, Nebraska .......................................................................... .......................... 28 28 28160 ......................... Cheyenne County, Nebraska ........................................................................ ...................... 28 28


## 46034 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

28170 ......................... Clay County, Nebraska ............................................................................ ........................... 28 28 28180 ......................... Colfax County, Nebraska .......................................................................... .......................... 28 28 28190 ......................... Cuming County, Nebraska .......................................................................... ........................ 28 28 28200 ......................... Custer County, Nebraska .......................................................................... .......................... 28 28 28210 ......................... Dakota County, Nebraska .......................................................................... ......................... 7720 43580 28220 ......................... Dawes County, Nebraska ........................................................................... ........................ 28 28 28230 ......................... Dawson County, Nebraska .......................................................................... ....................... 28 28 28240 ......................... Deuel County, Nebraska ........................................................................... .......................... 28 28 28250 ......................... Dixon County, Nebraska ........................................................................... .......................... 28 43580 28260 ......................... Dodge County, Nebraska ........................................................................... ......................... 28 28 28270 ......................... Douglas County, Nebraska ......................................................................... ........................ 5920 36540 28280 ......................... Dundy County, Nebraska ........................................................................... ......................... 28 28 28290 ......................... Fillmore County, Nebraska ........................................................................ .......................... 28 28 28300 ......................... Franklin County, Nebraska ........................................................................ .......................... 28 28 28310 ......................... Frontier County, Nebraska ........................................................................ .......................... 28 28 28320 ......................... Furnas County, Nebraska .......................................................................... ......................... 28 28 28330 ......................... Gage County, Nebraska ............................................................................ .......................... 28 28 28340 ......................... Garden County, Nebraska .......................................................................... ........................ 28 28 28350 ......................... Garfield County, Nebraska ........................................................................ .......................... 28 28 28360 ......................... Gosper County, Nebraska .......................................................................... ......................... 28 28 28370 ......................... Grant County, Nebraska ........................................................................... .......................... 28 28 28380 ......................... Greeley County, Nebraska ......................................................................... ......................... 28 28 28390 ......................... Hall County, Nebraska ............................................................................ ............................ 28 28 28400 ......................... Hamilton County, Nebraska ........................................................................ ........................ 28 28 28410 ......................... Harlan County, Nebraska .......................................................................... .......................... 28 28 28420 ......................... Hayes County, Nebraska ........................................................................... ......................... 28 28 28430 ......................... Hitchcock County, Nebraska ....................................................................... ........................ 28 28 28440 ......................... Holt County, Nebraska ............................................................................ ............................ 28 28 28450 ......................... Hooker County, Nebraska .......................................................................... ......................... 28 28 28460 ......................... Howard County, Nebraska .......................................................................... ........................ 28 28 28470 ......................... Jefferson County, Nebraska ....................................................................... ......................... 28 28 28480 ......................... Johnson County, Nebraska ......................................................................... ........................ 28 28 28490 ......................... Kearney County, Nebraska ......................................................................... ........................ 28 28 28500 ......................... Keith County, Nebraska ........................................................................... ........................... 28 28 28510 ......................... Keya Paha County, Nebraska ....................................................................... ...................... 28 28 28520 ......................... Kimball County, Nebraska ......................................................................... .......................... 28 28 28530 ......................... Knox County, Nebraska ............................................................................ .......................... 28 28 28540 ......................... Lancaster County, Nebraska ....................................................................... ........................ 4360 30700 28550 ......................... Lincoln County, Nebraska ......................................................................... .......................... 28 28 28560 ......................... Logan County, Nebraska ........................................................................... ......................... 28 28 28570 ......................... Loup County, Nebraska ............................................................................ .......................... 28 28 28580 ......................... Mc Pherson County, Nebraska ...................................................................... ..................... 28 28 28590 ......................... Madison County, Nebraska ......................................................................... ........................ 28 28 28600 ......................... Merrick County, Nebraska ......................................................................... .......................... 28 28 28610 ......................... Morrill County, Nebraska ......................................................................... ............................ 28 28 28620 ......................... Nance County, Nebraska ........................................................................... ......................... 28 28 28630 ......................... Nemaha County, Nebraska .......................................................................... ....................... 28 28 28640 ......................... Nuckolls County, Nebraska ........................................................................ ......................... 28 28 28650 ......................... Otoe County, Nebraska ............................................................................ ........................... 28 28 28660 ......................... Pawnee County, Nebraska .......................................................................... ....................... 28 28 28670 ......................... Perkins County, Nebraska ......................................................................... ......................... 28 28 28680 ......................... Phelps County, Nebraska .......................................................................... ......................... 28 28 28690 ......................... Pierce County, Nebraska .......................................................................... .......................... 28 28 28700 ......................... Platte County, Nebraska .......................................................................... ........................... 28 28 28710 ......................... Polk County, Nebraska ............................................................................ ........................... 28 28 28720 ......................... Redwillow County, Nebraska ....................................................................... ....................... 28 28 28730 ......................... Richardson County, Nebraska ...................................................................... ...................... 28 28 28740 ......................... Rock County, Nebraska ............................................................................ .......................... 28 28 28750 ......................... Saline County, Nebraska .......................................................................... .......................... 28 28 28760 ......................... Sarpy County, Nebraska ........................................................................... .......................... 5920 36540 28770 ......................... Saunders County, Nebraska ........................................................................ ....................... 28 36540 28780 ......................... Scotts Bluff County, Nebraska .................................................................... ........................ 28 28 28790 ......................... Seward County, Nebraska .......................................................................... ........................ 28 30700 28800 ......................... Sheridan County, Nebraska ........................................................................ ........................ 28 28 28810 ......................... Sherman County, Nebraska ......................................................................... ....................... 28 28 28820 ......................... Sioux County, Nebraska ........................................................................... .......................... 28 28 28830 ......................... Stanton County, Nebraska ......................................................................... ......................... 28 28 28840 ......................... Thayer County, Nebraska .......................................................................... ......................... 28 28 28850 ......................... Thomas County, Nebraska .......................................................................... ....................... 28 28 28860 ......................... Thurston County, Nebraska ........................................................................ ........................ 28 28


## 46035 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

28870 ......................... Valley County, Nebraska .......................................................................... ........................... 28 28 28880 ......................... Washington County, Nebraska ...................................................................... ..................... 5920 36540 28890 ......................... Wayne County, Nebraska ........................................................................... ........................ 28 28 28900 ......................... Webster County, Nebraska ......................................................................... ........................ 28 28 28910 ......................... Wheeler County, Nebraska ......................................................................... ........................ 28 28 28920 ......................... York County, Nebraska ............................................................................ ........................... 28 28 29000 ......................... Churchill County, Nevada ......................................................................... .......................... 29 29 29010 ......................... Clark County, Nevada ............................................................................. ............................ 4120 29820 29020 ......................... Douglas County, Nevada ........................................................................... ......................... 29 29 29030 ......................... Elko County, Nevada .............................................................................. ............................ 29 29 29040 ......................... Esmeralda County, Nevada ......................................................................... ....................... 29 29 29050 ......................... Eureka County, Nevada ............................................................................ .......................... 29 29 29060 ......................... Humboldt County, Nevada .......................................................................... ........................ 29 29 29070 ......................... Lander County, Nevada ............................................................................ .......................... 29 29 29080 ......................... Lincoln County, Nevada ........................................................................... ........................... 29 29 29090 ......................... Lyon County, Nevada .............................................................................. ............................ 29 29 29100 ......................... Mineral County, Nevada ........................................................................... ........................... 29 29 29110 ......................... Nye County, Nevada ............................................................................... ............................ 29 29 29120 ......................... Carson City County, Nevada ....................................................................... ....................... 29 16180 29130 ......................... Pershing County, Nevada .......................................................................... ......................... 29 29 29140 ......................... Storey County, Nevada ............................................................................ ........................... 29 39900 29150 ......................... Washoe County, Nevada ............................................................................ ........................ 6720 39900 29160 ......................... White Pine County, Nevada ........................................................................ ........................ 29 29 30000 ......................... Belknap County, New Hampshire .................................................................... ................... 30 30 30010 ......................... Carroll County, New Hampshire .................................................................... ..................... 30 30 30020 ......................... Cheshire County, New Hampshire ................................................................... ................... 30 30 30030 ......................... Coos County, New Hampshire ....................................................................... ..................... 30 30 30040 ......................... Grafton County, New Hampshire .................................................................... .................... 30 30 30050 ......................... Hillsboro County, New Hampshire .................................................................. .................... 4763 31700 30060 ......................... Merrimack County, New Hampshire .................................................................. ................. 4763 31700 30070 ......................... Rockingham County, New Hampshire ................................................................. ............... 6453 40484 30080 ......................... Strafford County, New Hampshire .................................................................. .................... 6453 40484 30090 ......................... Sullivan County, New Hampshire ................................................................... .................... 30 30 31000 ......................... Atlantic County, New Jersey ...................................................................... ......................... 0560 12100 31100 ......................... Bergen County, New Jersey ........................................................................ ....................... 0875 35644 31150 ......................... Burlington County, New Jersey .................................................................... ....................... 6160 15804 31160 ......................... Camden County, New Jersey ........................................................................ ..................... 6160 15804 31180 ......................... Cape May County, New Jersey ...................................................................... .................... 0560 36140 31190 ......................... Cumberland County, New Jersey .................................................................... ................... 8760 47220 31200 ......................... Essex County, New Jersey ......................................................................... ........................ 5640 35084 31220 ......................... Gloucester County, New Jersey .................................................................... ..................... 6160 15804 31230 ......................... Hudson County, New Jersey ........................................................................ ...................... 3640 35644 31250 ......................... Hunterdon County, New Jersey ..................................................................... ..................... 5015 35084 31260 ......................... Mercer County, New Jersey ........................................................................ ........................ 8480 45940 31270 ......................... Middlesex County, New Jersey ..................................................................... ...................... 5015 20764 31290 ......................... Monmouth County, New Jersey ...................................................................... .................... 5190 20764 31300 ......................... Morris County, New Jersey ........................................................................ ......................... 5640 35084 31310 ......................... Ocean County, New Jersey ......................................................................... ....................... 5190 20764 31320 ......................... Passaic County, New Jersey ....................................................................... ....................... 0875 35644 31340 ......................... Salem County, New Jersey ......................................................................... ........................ 9160 48864 31350 ......................... Somerset County, New Jersey ...................................................................... ..................... 5015 20764 31360 ......................... Sussex County, New Jersey ........................................................................ ....................... 5640 35084 31370 ......................... Union County, New Jersey ......................................................................... ........................ 5640 35084 31390 ......................... Warren County, New Jersey ........................................................................ ....................... 0240 10900 32000 ......................... Bernalillo County, New Mexico .................................................................... ....................... 0200 10740 32010 ......................... Catron County, New Mexico ........................................................................ ....................... 32 32 32020 ......................... Chaves County, New Mexico ........................................................................ ...................... 32 32 32025 ......................... Cibola County, New Mexico ........................................................................ ........................ 32 32 32030 ......................... Colfax County, New Mexico ........................................................................ ........................ 32 32 32040 ......................... Curry County, New Mexico ......................................................................... ........................ 32 32 32050 ......................... De Baca County, New Mexico ....................................................................... ..................... 32 32 32060 ......................... Dona Ana County, New Mexico ...................................................................... .................... 4100 29740 32070 ......................... Eddy County, New Mexico .......................................................................... ........................ 32 32 32080 ......................... Grant County, New Mexico ......................................................................... ........................ 32 32 32090 ......................... Guadalupe County, New Mexico ..................................................................... ................... 32 32 32100 ......................... Harding County, New Mexico ....................................................................... ...................... 32 32 32110 ......................... Hidalgo County, New Mexico ....................................................................... ....................... 32 32 32120 ......................... Lea County, New Mexico ........................................................................... ......................... 32 32 32130 ......................... Lincoln County, New Mexico ....................................................................... ........................ 32 32 32131 ......................... Los Alamos County, New Mexico .................................................................... ................... 7490 32


## 46036 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

32140 ......................... Luna County, New Mexico .......................................................................... ........................ 32 32 32150 ......................... Mc Kinley County, New Mexico ..................................................................... ..................... 32 32 32160 ......................... Mora County, New Mexico .......................................................................... ........................ 32 32 32170 ......................... Otero County, New Mexico ......................................................................... ........................ 32 32 32180 ......................... Quay County, New Mexico .......................................................................... ....................... 32 32 32190 ......................... Rio Arriba County, New Mexico .................................................................... ...................... 32 32 32200 ......................... Roosevelt County, New Mexico ..................................................................... ..................... 32 32 32210 ......................... Sandoval County, New Mexico ...................................................................... ..................... 32 10740 32220 ......................... San Juan County, New Mexico ...................................................................... ..................... 32 22140 32230 ......................... San Miguel County, New Mexico .................................................................... .................... 32 32 32240 ......................... Santa Fe County, New Mexico ...................................................................... ..................... 7490 42140 32250 ......................... Sierra County, New Mexico ........................................................................ ........................ 32 32 32260 ......................... Socorro County, New Mexico ....................................................................... ...................... 32 32 32270 ......................... Taos County, New Mexico .......................................................................... ........................ 32 32 32280 ......................... Torrance County, New Mexico ...................................................................... ...................... 32 10740 32290 ......................... Union County, New Mexico ......................................................................... ........................ 32 32 32300 ......................... Valencia County, New Mexico ...................................................................... ...................... 32 10740 33000 ......................... Albany County, New York .......................................................................... ......................... 0160 10580 33010 ......................... Allegany County, New York ........................................................................ ........................ 33 33 33020 ......................... Bronx County, New York ........................................................................... .......................... 5600 35644 33030 ......................... Broome County, New York .......................................................................... ....................... 0960 13780 33040 ......................... Cattaraugus County, New York ..................................................................... ..................... 33 33 33050 ......................... Cayuga County, New York .......................................................................... ........................ 33 33 33060 ......................... Chautauqua County, New York ...................................................................... .................... 33 33 33070 ......................... Chemung County, New York ......................................................................... ..................... 2335 21300 33080 ......................... Chenango County, New York ........................................................................ ..................... 33 33 33090 ......................... Clinton County, New York ......................................................................... .......................... 33 33 33200 ......................... Columbia County, New York ........................................................................ ....................... 33 33 33210 ......................... Cortland County, New York ........................................................................ ........................ 33 33 33220 ......................... Delaware County, New York ........................................................................ ....................... 33 33 33230 ......................... Dutchess County, New York ........................................................................ ....................... 6460 39100 33240 ......................... Erie County, New York ............................................................................ ............................ 1280 15380 33260 ......................... Essex County, New York ........................................................................... ......................... 33 33 33270 ......................... Franklin County, New York ........................................................................ ......................... 33 33 33280 ......................... Fulton County, New York .......................................................................... .......................... 33 33 33290 ......................... Genesee County, New York ......................................................................... ...................... 33 33 33300 ......................... Greene County, New York .......................................................................... ........................ 0160 33 33310 ......................... Hamilton County, New York ........................................................................ ........................ 33 33 33320 ......................... Herkimer County, New York ........................................................................ ....................... 8680 46540 33330 ......................... Jefferson County, New York ....................................................................... ........................ 33 33 33331 ......................... Kings County, New York ........................................................................... .......................... 5600 35644 33340 ......................... Lewis County, New York ........................................................................... .......................... 33 33 33350 ......................... Livingston County, New York ...................................................................... ........................ 6840 40380 33360 ......................... Madison County, New York ......................................................................... ....................... 8160 45060 33370 ......................... Monroe County, New York .......................................................................... ........................ 6840 40380 33380 ......................... Montgomery County, New York ...................................................................... .................... 0160 33 33400 ......................... Nassau County, New York .......................................................................... ........................ 5380 35004 33420 ......................... New York County, New York ........................................................................ ...................... 5600 35644 33500 ......................... Niagara County, New York ......................................................................... ........................ 5700 15380 33510 ......................... Oneida County, New York .......................................................................... ........................ 8680 46540 33520 ......................... Onondaga County, New York ........................................................................ ..................... 8160 45060 33530 ......................... Ontario County, New York ......................................................................... ......................... 6840 40380 33540 ......................... Orange County, New York .......................................................................... ........................ 5950 39100 33550 ......................... Orleans County, New York ......................................................................... ........................ 6840 40380 33560 ......................... Oswego County, New York .......................................................................... ....................... 8160 45060 33570 ......................... Otsego County, New York .......................................................................... ........................ 33 33 33580 ......................... Putnam County, New York .......................................................................... ........................ 5600 35644 33590 ......................... Queens County, New York .......................................................................... ....................... 5600 35644 33600 ......................... Rensselaer County, New York ...................................................................... ...................... 0160 10580 33610 ......................... Richmond County, New York ........................................................................ ...................... 5600 35644 33620 ......................... Rockland County, New York ........................................................................ ....................... 5600 35644 33630 ......................... St Lawrence County, New York ..................................................................... ..................... 33 33 33640 ......................... Saratoga County, New York ........................................................................ ....................... 0160 10580 33650 ......................... Schenectady County, New York ..................................................................... .................... 0160 10580 33660 ......................... Schoharie County, New York ....................................................................... ....................... 33 10580 33670 ......................... Schuyler County, New York ........................................................................ ........................ 33 33 33680 ......................... Seneca County, New York .......................................................................... ........................ 33 33 33690 ......................... Steuben County, New York ......................................................................... ........................ 33 33 33700 ......................... Suffolk County, New York ......................................................................... .......................... 5380 35004 33710 ......................... Sullivan County, New York ........................................................................ ......................... 33 33


## 46037 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

33720 ......................... Tioga County, New York ........................................................................... .......................... 0960 13780 33730 ......................... Tompkins County, New York ........................................................................ ...................... 33 27060 33740 ......................... Ulster County, New York .......................................................................... ........................... 33 28740 33750 ......................... Warren County, New York .......................................................................... ........................ 2975 24020 33760 ......................... Washington County, New York ...................................................................... ..................... 2975 24020 33770 ......................... Wayne County, New York ........................................................................... ........................ 6840 40380 33800 ......................... Westchester County, New York ..................................................................... ..................... 5600 35644 33900 ......................... Wyoming County, New York ......................................................................... ...................... 33 33 33910 ......................... Yates County, New York ........................................................................... .......................... 33 33 34000 ......................... Alamance County, N Carolina ...................................................................... ....................... 1300 15500 34010 ......................... Alexander County, N Carolina ..................................................................... ....................... 3290 25860 34020 ......................... Alleghany County, N Carolina ..................................................................... ........................ 34 34 34030 ......................... Anson County, N Carolina ......................................................................... ......................... 34 16740 34040 ......................... Ashe County, N Carolina .......................................................................... .......................... 34 34 34050 ......................... Avery County, N Carolina ......................................................................... .......................... 34 34 34060 ......................... Beaufort County, N Carolina ...................................................................... ......................... 34 34 34070 ......................... Bertie County, N Carolina ........................................................................ ........................... 34 34 34080 ......................... Bladen County, N Carolina ........................................................................ ......................... 34 34 34090 ......................... Brunswick County, N Carolina ..................................................................... ....................... 34 48900 34100 ......................... Buncombe County, N Carolina ...................................................................... ..................... 0480 11700 34110 ......................... Burke County, N Carolina ......................................................................... .......................... 3290 25860 34120 ......................... Cabarrus County, N Carolina ...................................................................... ........................ 1520 16740 34130 ......................... Caldwell County, N Carolina ...................................................................... ......................... 34 25860 34140 ......................... Camden County, N Carolina ........................................................................ ....................... 34 34 34150 ......................... Carteret County, N Carolina ...................................................................... .......................... 34 34 34160 ......................... Caswell County, N Carolina ....................................................................... ......................... 34 34 34170 ......................... Catawba County, N Carolina ....................................................................... ....................... 3290 25860 34180 ......................... Chatham County, N Carolina ....................................................................... ....................... 34 20500 34190 ......................... Cherokee County, N Carolina ...................................................................... ....................... 34 34 34200 ......................... Chowan County, N Carolina ........................................................................ ....................... 34 34 34210 ......................... Clay County, N Carolina .......................................................................... ........................... 34 34 34220 ......................... Cleveland County, N Carolina ..................................................................... ........................ 34 34 34230 ......................... Columbus County, N Carolina ...................................................................... ...................... 34 34 34240 ......................... Craven County, N Carolina ........................................................................ ......................... 34 34 34250 ......................... Cumberland County, N Carolina .................................................................... ..................... 2560 22180 34251 ......................... Currituck County, N Carolina ..................................................................... ......................... 34 47260 34270 ......................... Dare County, N Carolina .......................................................................... ........................... 34 34 34280 ......................... Davidson County, N Carolina ...................................................................... ........................ 3120 34 34290 ......................... Davie County, N Carolina ......................................................................... .......................... 3120 49180 34300 ......................... Duplin County, N Carolina ........................................................................ .......................... 34 34 34310 ......................... Durham County, N Carolina ........................................................................ ........................ 6640 20500 34320 ......................... Edgecombe County, N Carolina ..................................................................... .................... 34 40580 34330 ......................... Forsyth County, N Carolina ....................................................................... .......................... 3120 49180 34340 ......................... Franklin County, N Carolina ...................................................................... .......................... 6640 39580 34350 ......................... Gaston County, N Carolina ........................................................................ ......................... 1520 16740 34360 ......................... Gates County, N Carolina ......................................................................... .......................... 34 34 34370 ......................... Graham County, N Carolina ........................................................................ ........................ 34 34 34380 ......................... Granville County, N Carolina ..................................................................... ......................... 34 34 34390 ......................... Greene County, N Carolina ........................................................................ ......................... 34 24780 34400 ......................... Guilford County, N Carolina ...................................................................... .......................... 3120 24660 34410 ......................... Halifax County, N Carolina ....................................................................... ........................... 34 34 34420 ......................... Harnett County, N Carolina ....................................................................... .......................... 34 34 34430 ......................... Haywood County, N Carolina ....................................................................... ....................... 34 11700 34440 ......................... Henderson County, N Carolina ..................................................................... ...................... 34 11700 34450 ......................... Hertford County, N Carolina ...................................................................... .......................... 34 34 34460 ......................... Hoke County, N Carolina .......................................................................... .......................... 34 22180 34470 ......................... Hyde County, N Carolina .......................................................................... .......................... 34 34 34480 ......................... Iredell County, N Carolina ....................................................................... ............................ 34 34 34490 ......................... Jackson County, N Carolina ....................................................................... ........................ 34 34 34500 ......................... Johnston County, N Carolina ...................................................................... ........................ 34 39580 34510 ......................... Jones County, N Carolina ......................................................................... .......................... 34 34 34520 ......................... Lee County, N Carolina ........................................................................... ............................ 34 34 34530 ......................... Lenoir County, N Carolina ........................................................................ ........................... 34 34 34540 ......................... Lincoln County, N Carolina ....................................................................... .......................... 1520 34 34550 ......................... Mc Dowell County, N Carolina ..................................................................... ....................... 34 34 34560 ......................... Macon County, N Carolina ......................................................................... ......................... 34 34 34570 ......................... Madison County, N Carolina ....................................................................... ........................ 34 11700 34580 ......................... Martin County, N Carolina ........................................................................ ........................... 34 34 34590 ......................... Mecklenburg County, N Carolina ................................................................... ..................... 1520 16740 34600 ......................... Mitchell County, N Carolina ...................................................................... .......................... 34 34


## 46038 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

34610 ......................... Montgomery County, N Carolina .................................................................... ..................... 34 34 34620 ......................... Moore County, N Carolina ......................................................................... ......................... 34 34 34630 ......................... Nash County, N Carolina .......................................................................... .......................... 34 40580 34640 ......................... New Hanover County, N Carolina ................................................................... .................... 9200 48900 34650 ......................... Northampton County, N Carolina ................................................................... ..................... 34 34 34660 ......................... Onslow County, N Carolina ........................................................................ ......................... 3605 27340 34670 ......................... Orange County, N Carolina ........................................................................ ......................... 6640 20500 34680 ......................... Pamlico County, N Carolina ....................................................................... ......................... 34 34 34690 ......................... Pasquotank County, N Carolina .................................................................... ...................... 34 34 34700 ......................... Pender County, N Carolina ........................................................................ ......................... 34 48900 34710 ......................... Perquimans County, N Carolina .................................................................... ..................... 34 34 34720 ......................... Person County, N Carolina ........................................................................ ......................... 34 20500 34730 ......................... Pitt County, N Carolina .......................................................................... ............................. 34 24780 34740 ......................... Polk County, N Carolina .......................................................................... ............................ 34 34 34750 ......................... Randolph County, N Carolina ...................................................................... ....................... 3120 24660 34760 ......................... Richmond County, N Carolina ...................................................................... ...................... 34 34 34770 ......................... Robeson County, N Carolina ....................................................................... ....................... 34 34 34780 ......................... Rockingham County, N Carolina .................................................................... ..................... 34 24660 34790 ......................... Rowan County, N Carolina ......................................................................... ........................ 1520 34 34800 ......................... Rutherford County, N Carolina .................................................................... ........................ 34 34 34810 ......................... Sampson County, N Carolina ....................................................................... ...................... 34 34 34820 ......................... Scotland County, N Carolina ...................................................................... ......................... 34 34 34830 ......................... Stanly County, N Carolina ........................................................................ ........................... 34 16740 34840 ......................... Stokes County, N Carolina ........................................................................ .......................... 3120 49180 34850 ......................... Surry County, N Carolina ......................................................................... ........................... 34 34 34860 ......................... Swain County, N Carolina ......................................................................... .......................... 34 34 34870 ......................... Transylvania County, N Carolina .................................................................. ...................... 34 34 34880 ......................... Tyrrell County, N Carolina ....................................................................... ............................ 34 34 34890 ......................... Union County, N Carolina ......................................................................... .......................... 1520 16740 34900 ......................... Vance County, N Carolina ......................................................................... ......................... 34 34 34910 ......................... Wake County, N Carolina .......................................................................... ......................... 6640 39580 34920 ......................... Warren County, N Carolina ........................................................................ ......................... 34 34 34930 ......................... Washington County, N Carolina .................................................................... ...................... 34 34 34940 ......................... Watauga County, N Carolina ....................................................................... ....................... 34 34 34950 ......................... Wayne County, N Carolina ......................................................................... ........................ 34 24140 34960 ......................... Wilkes County, N Carolina ........................................................................ .......................... 34 34 34970 ......................... Wilson County, N Carolina ........................................................................ .......................... 34 34 34980 ......................... Yadkin County, N Carolina ........................................................................ .......................... 3120 49180 34981 ......................... Yancey County, N Carolina ........................................................................ ......................... 34 34 35000 ......................... Adams County, N Dakota ........................................................................... ........................ 35 35 35010 ......................... Barnes County, N Dakota .......................................................................... ......................... 35 35 35020 ......................... Benson County, N Dakota .......................................................................... ........................ 35 35 35030 ......................... Billings County, N Dakota ........................................................................ ........................... 35 35 35040 ......................... Bottineau County, N Dakota ....................................................................... ........................ 35 35 35050 ......................... Bowman County, N Dakota .......................................................................... ....................... 35 35 35060 ......................... Burke County, N Dakota ........................................................................... .......................... 35 35 35070 ......................... Burleigh County, N Dakota ........................................................................ ......................... 1010 13900 35080 ......................... Cass County, N Dakota ............................................................................ .......................... 2520 22020 35090 ......................... Cavalier County, N Dakota ........................................................................ ......................... 35 35 35100 ......................... Dickey County, N Dakota .......................................................................... .......................... 35 35 35110 ......................... Divide County, N Dakota .......................................................................... ........................... 35 35 35120 ......................... Dunn County, N Dakota ............................................................................ .......................... 35 35 35130 ......................... Eddy County, N Dakota ............................................................................ .......................... 35 35 35140 ......................... Emmons County, N Dakota .......................................................................... ...................... 35 35 35150 ......................... Foster County, N Dakota .......................................................................... .......................... 35 35 35160 ......................... Golden Valley County, N Dakota ................................................................... ..................... 35 35 35170 ......................... Grand Forks County, N Dakota ..................................................................... ..................... 2985 24220 35180 ......................... Grant County, N Dakota ........................................................................... ........................... 35 35 35190 ......................... Griggs County, N Dakota .......................................................................... .......................... 35 35 35200 ......................... Hettinger County, N Dakota ....................................................................... ......................... 35 35 35210 ......................... Kidder County, N Dakota .......................................................................... .......................... 35 35 35220 ......................... La Moure County, N Dakota ........................................................................ ....................... 35 35 35230 ......................... Logan County, N Dakota ........................................................................... .......................... 35 35 35240 ......................... Mc Henry County, N Dakota ........................................................................ ....................... 35 35 35250 ......................... Mc Intosh County, N Dakota ....................................................................... ........................ 35 35 35260 ......................... Mc Kenzie County, N Dakota ....................................................................... ....................... 35 35 35270 ......................... Mc Lean County, N Dakota ......................................................................... ........................ 35 35 35280 ......................... Mercer County, N Dakota .......................................................................... ......................... 35 35 35290 ......................... Morton County, N Dakota .......................................................................... ......................... 1010 13900 35300 ......................... Mountrail County, N Dakota ....................................................................... ......................... 35 35


## 46039 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

35310 ......................... Nelson County, N Dakota .......................................................................... ......................... 35 35 35320 ......................... Oliver County, N Dakota .......................................................................... ........................... 35 35 35330 ......................... Pembina County, N Dakota ......................................................................... ....................... 35 35 35340 ......................... Pierce County, N Dakota .......................................................................... .......................... 35 35 35350 ......................... Ramsey County, N Dakota .......................................................................... ....................... 35 35 35360 ......................... Ransom County, N Dakota .......................................................................... ....................... 35 35 35370 ......................... Renville County, N Dakota ........................................................................ .......................... 35 35 35380 ......................... Richland County, N Dakota ........................................................................ ......................... 35 35 35390 ......................... Rolette County, N Dakota ......................................................................... .......................... 35 35 35400 ......................... Sargent County, N Dakota ......................................................................... ......................... 35 35 35410 ......................... Sheridan County, N Dakota ........................................................................ ........................ 35 35 35420 ......................... Sioux County, N Dakota ........................................................................... ........................... 35 35 35430 ......................... Slope County, N Dakota ........................................................................... .......................... 35 35 35440 ......................... Stark County, N Dakota ........................................................................... ........................... 35 35 35450 ......................... Steele County, N Dakota .......................................................................... .......................... 35 35 35460 ......................... Stutsman County, N Dakota ........................................................................ ....................... 35 35 35470 ......................... Towner County, N Dakota .......................................................................... ......................... 35 35 35480 ......................... Traill County, N Dakota .......................................................................... ............................. 35 35 35490 ......................... Walsh County, N Dakota ........................................................................... .......................... 35 35 35500 ......................... Ward County, N Dakota ............................................................................ .......................... 35 35 35510 ......................... Wells County, N Dakota ........................................................................... ........................... 35 35 35520 ......................... Williams County, N Dakota ........................................................................ ......................... 35 35 36000 ......................... Adams County, Ohio ............................................................................... ............................ 36 36 36010 ......................... Allen County, Ohio ............................................................................... ............................... 4320 30620 36020 ......................... Ashland County, Ohio ............................................................................. ............................ 36 36 36030 ......................... Ashtabula County, Ohio ........................................................................... ........................... 36 36 36040 ......................... Athens County, Ohio .............................................................................. ............................. 36 36 36050 ......................... Auglaize County, Ohio ............................................................................ ............................ 4320 36 36060 ......................... Belmont County, Ohio ............................................................................. ............................ 9000 48540 36070 ......................... Brown County, Ohio ............................................................................... ............................. 36 17140 36080 ......................... Butler County, Ohio .............................................................................. ............................... 3200 17140 36090 ......................... Carroll County, Ohio ............................................................................. ............................... 1320 15940 36100 ......................... Champaign County, Ohio ........................................................................... ......................... 36 36 36110 ......................... Clark County, Ohio ............................................................................... ............................... 2000 44220 36120 ......................... Clermont County, Ohio ............................................................................ ............................ 1640 17140 36130 ......................... Clinton County, Ohio ............................................................................. .............................. 36 36 36140 ......................... Columbiana County, Ohio .......................................................................... ......................... 36 36 36150 ......................... Coshocton County, Ohio ........................................................................... .......................... 36 36 36160 ......................... Crawford County, Ohio ............................................................................ ............................ 36 36 36170 ......................... Cuyahoga County, Ohio ............................................................................ .......................... 1680 17460 36190 ......................... Darke County, Ohio ............................................................................... .............................. 36 36 36200 ......................... Defiance County, Ohio ............................................................................ ............................ 36 36 36210 ......................... Delaware County, Ohio ............................................................................ ........................... 1840 18140 36220 ......................... Erie County, Ohio ................................................................................ ................................ 36 41780 36230 ......................... Fairfield County, Ohio ........................................................................... .............................. 1840 18140 36240 ......................... Fayette County, Ohio ............................................................................. ............................. 36 36 36250 ......................... Franklin County, Ohio ............................................................................ ............................. 1840 18140 36260 ......................... Fulton County, Ohio .............................................................................. .............................. 8400 45780 36270 ......................... Gallia County, Ohio .............................................................................. ............................... 36 36 36280 ......................... Geauga County, Ohio .............................................................................. ........................... 1680 17460 36290 ......................... Greene County, Ohio .............................................................................. ............................ 2000 19380 36300 ......................... Guernsey County, Ohio ............................................................................ ........................... 36 36 36310 ......................... Hamilton County, Ohio ............................................................................ ............................ 1640 17140 36330 ......................... Hancock County, Ohio ............................................................................. ........................... 36 36 36340 ......................... Hardin County, Ohio .............................................................................. .............................. 36 36 36350 ......................... Harrison County, Ohio ............................................................................ ............................. 36 36 36360 ......................... Henry County, Ohio ............................................................................... .............................. 36 36 36370 ......................... Highland County, Ohio ............................................................................ ............................ 36 36 36380 ......................... Hocking County, Ohio ............................................................................. ............................ 36 36 36390 ......................... Holmes County, Ohio .............................................................................. ............................ 36 36 36400 ......................... Huron County, Ohio ............................................................................... ............................. 36 36 36410 ......................... Jackson County, Ohio ............................................................................. ............................ 36 36 36420 ......................... Jefferson County, Ohio ........................................................................... ............................ 8080 48260 36430 ......................... Knox County, Ohio ................................................................................ .............................. 36 36 36440 ......................... Lake County, Ohio ................................................................................ .............................. 1680 17460 36450 ......................... Lawrence County, Ohio ............................................................................ ........................... 3400 26580 36460 ......................... Licking County, Ohio ............................................................................. .............................. 1840 18140 36470 ......................... Logan County, Ohio ............................................................................... ............................. 36 36 36480 ......................... Lorain County, Ohio .............................................................................. .............................. 4440 17460 36490 ......................... Lucas County, Ohio ............................................................................... .............................. 8400 45780


## 46040 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

36500 ......................... Madison County, Ohio ............................................................................. ............................ 1840 18140 36510 ......................... Mahoning County, Ohio ............................................................................ .......................... 9320 49660 36520 ......................... Marion County, Ohio .............................................................................. ............................. 36 36 36530 ......................... Medina County, Ohio .............................................................................. ............................ 1680 17460 36540 ......................... Meigs County, Ohio ............................................................................... .............................. 36 36 36550 ......................... Mercer County, Ohio .............................................................................. ............................. 36 36 36560 ......................... Miami County, Ohio ............................................................................... .............................. 2000 19380 36570 ......................... Monroe County, Ohio .............................................................................. ............................ 36 36 36580 ......................... Montgomery County, Ohio .......................................................................... ........................ 2000 19380 36590 ......................... Morgan County, Ohio .............................................................................. ............................ 36 36 36600 ......................... Morrow County, Ohio .............................................................................. ............................ 36 18140 36610 ......................... Muskingum County, Ohio ........................................................................... ......................... 36 36 36620 ......................... Noble County, Ohio ............................................................................... .............................. 36 36 36630 ......................... Ottawa County, Ohio .............................................................................. ............................. 36 45780 36640 ......................... Paulding County, Ohio ............................................................................ ............................ 36 36 36650 ......................... Perry County, Ohio ............................................................................... ............................... 36 36 36660 ......................... Pickaway County, Ohio ............................................................................ ........................... 1840 18140 36670 ......................... Pike County, Ohio ................................................................................ ............................... 36 36 36680 ......................... Portage County, Ohio ............................................................................. ............................. 0080 10420 36690 ......................... Preble County, Ohio .............................................................................. .............................. 36 19380 36700 ......................... Putnam County, Ohio .............................................................................. ............................ 36 36 36710 ......................... Richland County, Ohio ............................................................................ ............................ 4800 31900 36720 ......................... Ross County, Ohio ................................................................................ .............................. 36 36 36730 ......................... Sandusky County, Ohio ............................................................................ .......................... 36 36 36740 ......................... Scioto County, Ohio .............................................................................. .............................. 36 36 36750 ......................... Seneca County, Ohio .............................................................................. ............................ 36 36 36760 ......................... Shelby County, Ohio .............................................................................. ............................. 36 36 36770 ......................... Stark County, Ohio ............................................................................... ............................... 1320 15940 36780 ......................... Summit County, Ohio .............................................................................. ............................ 0080 10420 36790 ......................... Trumbull County, Ohio ............................................................................ ............................ 9320 49660 36800 ......................... Tuscarawas County, Ohio .......................................................................... ......................... 36 36 36810 ......................... Union County, Ohio ............................................................................... .............................. 1840 18140 36820 ......................... Van Wert County, Ohio ............................................................................ ........................... 36 36 36830 ......................... Vinton County, Ohio .............................................................................. .............................. 36 36 36840 ......................... Warren County, Ohio .............................................................................. ............................ 1640 17140 36850 ......................... Washington County, Ohio .......................................................................... ......................... 6020 37620 36860 ......................... Wayne County, Ohio ............................................................................... ............................ 36 36 36870 ......................... Williams County, Ohio ............................................................................ ............................. 36 36 36880 ......................... Wood County, Ohio ................................................................................ ............................. 8400 45780 36890 ......................... Wyandot County, Ohio ............................................................................. ........................... 36 36 37000 ......................... Adair County, Oklahoma ........................................................................... .......................... 37 37 37010 ......................... Alfalfa County, Oklahoma ......................................................................... .......................... 37 37 37020 ......................... Atoka County, Oklahoma ........................................................................... ......................... 37 37 37030 ......................... Beaver County, Oklahoma .......................................................................... ........................ 37 37 37040 ......................... Beckham County, Oklahoma ......................................................................... ..................... 37 37 37050 ......................... Blaine County, Oklahoma .......................................................................... ......................... 37 37 37060 ......................... Bryan County, Oklahoma ........................................................................... ......................... 37 37 37070 ......................... Caddo County, Oklahoma ........................................................................... ........................ 37 37 37080 ......................... Canadian County, Oklahoma ........................................................................ ...................... 5880 36420 37090 ......................... Carter County, Oklahoma .......................................................................... ......................... 37 37 37100 ......................... Cherokee County, Oklahoma ........................................................................ ...................... 37 37 37110 ......................... Choctaw County, Oklahoma ......................................................................... ...................... 37 37 37120 ......................... Cimarron County, Oklahoma ........................................................................ ....................... 37 37 37130 ......................... Cleveland County, Oklahoma ....................................................................... ...................... 5880 36420 37140 ......................... Coal County, Oklahoma ............................................................................ .......................... 37 37 37150 ......................... Comanche County, Oklahoma ........................................................................ .................... 4200 30020 37160 ......................... Cotton County, Oklahoma .......................................................................... ......................... 37 37 37170 ......................... Craig County, Oklahoma ........................................................................... .......................... 37 37 37180 ......................... Creek County, Oklahoma ........................................................................... ......................... 8560 46140 37190 ......................... Custer County, Oklahoma .......................................................................... ......................... 37 37 37200 ......................... Delaware County, Oklahoma ........................................................................ ...................... 37 37 37210 ......................... Dewey County, Oklahoma ........................................................................... ....................... 37 37 37220 ......................... Ellis County, Oklahoma ........................................................................... ............................ 37 37 37230 ......................... Garfield County, Oklahoma ........................................................................ ......................... 2340 37 37240 ......................... Garvin County, Oklahoma .......................................................................... ......................... 37 37 37250 ......................... Grady County, Oklahoma ........................................................................... ......................... 37 36420 37260 ......................... Grant County, Oklahoma ........................................................................... ......................... 37 37 37270 ......................... Greer County, Oklahoma ........................................................................... ......................... 37 37 37280 ......................... Harmon County, Oklahoma .......................................................................... ....................... 37 37 37290 ......................... Harper County, Oklahoma .......................................................................... ........................ 37 37


## 46041 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

37300 ......................... Haskell County, Oklahoma ......................................................................... ......................... 37 37 37310 ......................... Hughes County, Oklahoma .......................................................................... ....................... 37 37 37320 ......................... Jackson County, Oklahoma ......................................................................... ....................... 37 37 37330 ......................... Jefferson County, Oklahoma ....................................................................... ........................ 37 37 37340 ......................... Johnston County, Oklahoma ........................................................................ ....................... 37 37 37350 ......................... Kay County, Oklahoma ............................................................................. .......................... 37 37 37360 ......................... Kingfisher County, Oklahoma ...................................................................... ....................... 37 37 37370 ......................... Kiowa County, Oklahoma ........................................................................... ......................... 37 37 37380 ......................... Latimer County, Oklahoma ......................................................................... ........................ 37 37 37390 ......................... Le Flore County, Oklahoma ........................................................................ ........................ 37 22900 37400 ......................... Lincoln County, Oklahoma ......................................................................... ......................... 37 36420 37410 ......................... Logan County, Oklahoma ........................................................................... ........................ 5880 36420 37420 ......................... Love County, Oklahoma ............................................................................ .......................... 37 37 37430 ......................... Mc Clain County, Oklahoma ........................................................................ ....................... 5880 36420 37440 ......................... Mc Curtain County, Oklahoma ...................................................................... ...................... 37 37 37450 ......................... Mc Intosh County, Oklahoma ....................................................................... ....................... 37 37 37460 ......................... Major County, Oklahoma ........................................................................... ......................... 37 37 37470 ......................... Marshall County, Oklahoma ........................................................................ ........................ 37 37 37480 ......................... Mayes County, Oklahoma ........................................................................... ........................ 37 37 37490 ......................... Murray County, Oklahoma .......................................................................... ........................ 37 37 37500 ......................... Muskogee County, Oklahoma ........................................................................ ..................... 37 37 37510 ......................... Noble County, Oklahoma ........................................................................... ......................... 37 37 37520 ......................... Nowata County, Oklahoma .......................................................................... ....................... 37 37 37530 ......................... Okfuskee County, Oklahoma ........................................................................ ...................... 37 37 37540 ......................... Oklahoma County, Oklahoma ........................................................................ ..................... 5880 36420 37550 ......................... Okmulgee County, Oklahoma ........................................................................ ..................... 37 46140 37560 ......................... Osage County, Oklahoma ........................................................................... ........................ 8560 46140 37570 ......................... Ottawa County, Oklahoma .......................................................................... ........................ 37 37 37580 ......................... Pawnee County, Oklahoma .......................................................................... ...................... 37 46140 37590 ......................... Payne County, Oklahoma ........................................................................... ........................ 37 37 37600 ......................... Pittsburg County, Oklahoma ....................................................................... ........................ 37 37 37610 ......................... Pontotoc County, Oklahoma ........................................................................ ....................... 37 37 37620 ......................... Pottawatomie County, Oklahoma .................................................................... .................... 5880 37 37630 ......................... Pushmataha County, Oklahoma ...................................................................... ................... 37 37 37640 ......................... Roger Mills County, Oklahoma ..................................................................... ...................... 37 37 37650 ......................... Rogers County, Oklahoma .......................................................................... ........................ 8560 46140 37660 ......................... Seminole County, Oklahoma ........................................................................ ...................... 37 37 37670 ......................... Sequoyah County, Oklahoma ........................................................................ ..................... 2720 22900 37680 ......................... Stephens County, Oklahoma ........................................................................ ...................... 37 37 37690 ......................... Texas County, Oklahoma ........................................................................... ......................... 37 37 37700 ......................... Tillman County, Oklahoma ......................................................................... ......................... 37 37 37710 ......................... Tulsa County, Oklahoma ........................................................................... .......................... 8560 46140 37720 ......................... Wagoner County, Oklahoma ......................................................................... ...................... 8560 46140 37730 ......................... Washington County, Oklahoma ...................................................................... .................... 37 37 37740 ......................... Washita County, Oklahoma ......................................................................... ....................... 37 37 37750 ......................... Woods County, Oklahoma ........................................................................... ....................... 37 37 37760 ......................... Woodward County, Oklahoma ........................................................................ .................... 37 37 38000 ......................... Baker County, Oregon ............................................................................. ........................... 38 38 38010 ......................... Benton County, Oregon ............................................................................ .......................... 38 18700 38020 ......................... Clackamas County, Oregon ......................................................................... ....................... 6440 38900 38030 ......................... Clatsop County, Oregon ........................................................................... ........................... 38 38 38040 ......................... Columbia County, Oregon .......................................................................... ......................... 38 38900 38050 ......................... Coos County, Oregon .............................................................................. ........................... 38 38 38060 ......................... Crook County, Oregon ............................................................................. ........................... 38 38 38070 ......................... Curry County, Oregon ............................................................................. ............................ 38 38 38080 ......................... Deschutes County, Oregon ......................................................................... ........................ 38 13460 38090 ......................... Douglas County, Oregon ........................................................................... .......................... 38 38 38100 ......................... Gilliam County, Oregon ........................................................................... ............................ 38 38 38110 ......................... Grant County, Oregon ............................................................................. ............................ 38 38 38120 ......................... Harney County, Oregon ............................................................................ .......................... 38 38 38130 ......................... Hood River County, Oregon ........................................................................ ........................ 38 38 38140 ......................... Jackson County, Oregon ........................................................................... .......................... 4890 32780 38150 ......................... Jefferson County, Oregon ......................................................................... .......................... 38 38 38160 ......................... Josephine County, Oregon ......................................................................... ........................ 38 38 38170 ......................... Klamath County, Oregon ........................................................................... .......................... 38 38 38180 ......................... Lake County, Oregon .............................................................................. ............................ 38 38 38190 ......................... Lane County, Oregon .............................................................................. ............................ 2400 21660 38200 ......................... Lincoln County, Oregon ........................................................................... ........................... 38 38 38210 ......................... Linn County, Oregon .............................................................................. ............................. 38 38 38220 ......................... Malheur County, Oregon ........................................................................... .......................... 38 38


## 46042 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

38230 ......................... Marion County, Oregon ............................................................................ ........................... 7080 41420 38240 ......................... Morrow County, Oregon ............................................................................ .......................... 38 38 38250 ......................... Multnomah County, Oregon ......................................................................... ....................... 6440 38900 38260 ......................... Polk County, Oregon .............................................................................. ............................. 7080 41420 38270 ......................... Sherman County, Oregon ........................................................................... ........................ 38 38 38280 ......................... Tillamook County, Oregon ......................................................................... ......................... 38 38 38290 ......................... Umatilla County, Oregon .......................................................................... ........................... 38 38 38300 ......................... Union County, Oregon ............................................................................. ........................... 38 38 38310 ......................... Wallowa County, Oregon ........................................................................... ......................... 38 38 38320 ......................... Wasco County, Oregon ............................................................................. .......................... 38 38 38330 ......................... Washington County, Oregon ........................................................................ ....................... 6440 38900 38340 ......................... Wheeler County, Oregon ........................................................................... ......................... 38 38 38350 ......................... Yamhill County, Oregon ........................................................................... ........................... 6440 38900 39000 ......................... Adams County, Pennsylvania ....................................................................... ...................... 9280 39 39010 ......................... Allegheny County, Pennsylvania ................................................................... ...................... 6280 38300 39070 ......................... Armstrong County, Pennsylvania ................................................................... ..................... 39 38300 39080 ......................... Beaver County, Pennsylvania ...................................................................... ....................... 0845 38300 39100 ......................... Bedford County, Pennsylvania ..................................................................... ....................... 39 39 39110 ......................... Berks County, Pennsylvania ....................................................................... ........................ 6680 39740 39120 ......................... Blair County, Pennsylvania ....................................................................... .......................... 0280 11020 39130 ......................... Bradford County, Pennsylvania .................................................................... ....................... 39 39 39140 ......................... Bucks County, Pennsylvania ....................................................................... ........................ 6160 37964 39150 ......................... Butler County, Pennsylvania ...................................................................... ......................... 39 38300 39160 ......................... Cambria County, Pennsylvania ..................................................................... ...................... 3680 27780 39180 ......................... Cameron County, Pennsylvania ..................................................................... ..................... 39 39 39190 ......................... Carbon County, Pennsylvania ...................................................................... ....................... 0240 10900 39200 ......................... Centre County, Pennsylvania ...................................................................... ........................ 8050 44300 39210 ......................... Chester County, Pennsylvania ..................................................................... ....................... 6160 37964 39220 ......................... Clarion County, Pennsylvania ..................................................................... ........................ 39 39 39230 ......................... Clearfield County, Pennsylvania .................................................................. ....................... 39 39 39240 ......................... Clinton County, Pennsylvania ..................................................................... ........................ 39 39 39250 ......................... Columbia County, Pennsylvania .................................................................... ..................... 7560 39 39260 ......................... Crawford County, Pennsylvania .................................................................... ...................... 39 39 39270 ......................... Cumberland County, Pennsylvania .................................................................. ................... 3240 25420 39280 ......................... Dauphin County, Pennsylvania ..................................................................... ...................... 3240 25420 39290 ......................... Delaware County, Pennsylvania .................................................................... ..................... 6160 37964 39310 ......................... Elk County, Pennsylvania ......................................................................... .......................... 39 39 39320 ......................... Erie County, Pennsylvania ........................................................................ .......................... 2360 21500 39330 ......................... Fayette County, Pennsylvania ..................................................................... ....................... 6280 38300 39340 ......................... Forest County, Pennsylvania ...................................................................... ........................ 39 39 39350 ......................... Franklin County, Pennsylvania .................................................................... ........................ 39 39 39360 ......................... Fulton County, Pennsylvania ...................................................................... ........................ 39 39 39370 ......................... Greene County, Pennsylvania ...................................................................... ...................... 39 39 39380 ......................... Huntingdon County, Pennsylvania .................................................................. .................... 39 39 39390 ......................... Indiana County, Pennsylvania ..................................................................... ........................ 39 39 39400 ......................... Jefferson County, Pennsylvania ................................................................... ....................... 39 39 39410 ......................... Juniata County, Pennsylvania ..................................................................... ........................ 39 39 39420 ......................... Lackawanna County, Pennsylvania .................................................................. .................. 7560 42540 39440 ......................... Lancaster County, Pennsylvania ................................................................... ...................... 4000 29540 39450 ......................... Lawrence County, Pennsylvania .................................................................... ..................... 39 39 39460 ......................... Lebanon County, Pennsylvania ..................................................................... ..................... 3240 30140 39470 ......................... Lehigh County, Pennsylvania ...................................................................... ........................ 0240 10900 39480 ......................... Luzerne County, Pennsylvania ..................................................................... ...................... 7560 42540 39510 ......................... Lycoming County, Pennsylvania .................................................................... ..................... 9140 48700 39520 ......................... Mc Kean County, Pennsylvania ..................................................................... ..................... 39 39 39530 ......................... Mercer County, Pennsylvania ...................................................................... ....................... 7610 49660 39540 ......................... Mifflin County, Pennsylvania ..................................................................... .......................... 39 39 39550 ......................... Monroe County, Pennsylvania ...................................................................... ...................... 7560 39 39560 ......................... Montgomery County, Pennsylvania .................................................................. .................. 6160 37964 39580 ......................... Montour County, Pennsylvania ..................................................................... ...................... 39 39 39590 ......................... Northampton County, Pennsylvania ................................................................. ................... 0240 10900 39600 ......................... Northumberland County, Pennsylvania .............................................................. ................. 39 39 39610 ......................... Perry County, Pennsylvania ....................................................................... ......................... 3240 25420 39620 ......................... Philadelphia County, Pennsylvania ................................................................ ..................... 6160 37964 39630 ......................... Pike County, Pennsylvania ........................................................................ ......................... 5660 35084 39640 ......................... Potter County, Pennsylvania ...................................................................... ......................... 39 39 39650 ......................... Schuylkill County, Pennsylvania .................................................................. ....................... 39 39 39670 ......................... Snyder County, Pennsylvania ...................................................................... ....................... 39 39 39680 ......................... Somerset County, Pennsylvania .................................................................... ..................... 3680 39 39690 ......................... Sullivan County, Pennsylvania .................................................................... ........................ 39 39


## 46043 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

39700 ......................... Susquehanna County, Pennsylvania ................................................................. ................. 39 39 39710 ......................... Tioga County, Pennsylvania ....................................................................... ........................ 39 39 39720 ......................... Union County, Pennsylvania ....................................................................... ........................ 39 39 39730 ......................... Venango County, Pennsylvania ..................................................................... ..................... 39 39 39740 ......................... Warren County, Pennsylvania ...................................................................... ....................... 39 39 39750 ......................... Washington County, Pennsylvania .................................................................. ................... 6280 38300 39760 ......................... Wayne County, Pennsylvania ....................................................................... ...................... 39 39 39770 ......................... Westmoreland County, Pennsylvania ................................................................ ................. 6280 38300 39790 ......................... Wyoming County, Pennsylvania ..................................................................... .................... 7560 42540 39800 ......................... York County, Pennsylvania ........................................................................ ......................... 9280 49620 40010 ......................... Adjuntas County, Puerto Rico ..................................................................... ........................ 40 40 40020 ......................... Aguada County, Puerto Rico ....................................................................... ....................... 0060 10380 40030 ......................... Aguadilla County, Puerto Rico .................................................................... ........................ 0060 10380 40040 ......................... Aguas Buenas County, Puerto Rico ................................................................. .................. 7440 41980 40050 ......................... Aibonito County, Puerto Rico ..................................................................... ......................... 40 41980 40060 ......................... Anasco County, Puerto Rico ....................................................................... ........................ 4840 10380 40070 ......................... Arecibo County, Puerto Rico ...................................................................... ......................... 0470 41980 40080 ......................... Arroyo County, Puerto Rico ....................................................................... ......................... 40 25020 40090 ......................... Barceloneta County, Puerto Rico .................................................................. ...................... 7440 41980 40100 ......................... Barranquitas County, Puerto Rico ................................................................. ..................... 40 41980 40110 ......................... Bayamon County, Puerto Rico ...................................................................... ...................... 7440 41980 40120 ......................... Cabo Rojo County, Puerto Rico .................................................................... ...................... 4840 41900 40130 ......................... Caguas County, Puerto Rico ....................................................................... ....................... 1310 41980 40140 ......................... Camuy County, Puerto Rico ........................................................................ ....................... 0470 41980 40145 ......................... Canovanas County, Puerto Rico .................................................................... ..................... 7440 41980 40150 ......................... Carolina County, Puerto Rico ..................................................................... ........................ 7440 41980 40160 ......................... Catano County, Puerto Rico ....................................................................... ........................ 7440 41980 40170 ......................... Cayey County, Puerto Rico ........................................................................ ......................... 1310 41980 40180 ......................... Ceiba County, Puerto Rico ........................................................................ ......................... 40 21940 40190 ......................... Ciales County, Puerto Rico ....................................................................... .......................... 40 41980 40200 ......................... Cidra County, Puerto Rico ........................................................................ .......................... 1310 41980 40210 ......................... Coamo County, Puerto Rico ........................................................................ ....................... 40 40 40220 ......................... Comerio County, Puerto Rico ...................................................................... ....................... 40 41980 40230 ......................... Corozal County, Puerto Rico ...................................................................... ........................ 40 41980 40240 ......................... Culebra County, Puerto Rico ...................................................................... ........................ 40 40 40250 ......................... Dorado County, Puerto Rico ....................................................................... ........................ 40 41980 40260 ......................... Fajardo County, Puerto Rico ...................................................................... ......................... 40 21940 40265 ......................... Florida County, Puerto Rico ...................................................................... .......................... 40 41980 40270 ......................... Guanica County, Puerto Rico ...................................................................... ....................... 40 49500 40280 ......................... Guayama County, Puerto Rico ...................................................................... ..................... 40 25020 40290 ......................... Guayanilla County, Puerto Rico ................................................................... ....................... 6360 49500 40300 ......................... Guaynabo County, Puerto Rico ..................................................................... ..................... 40 41980 40310 ......................... Gurabo County, Puerto Rico ....................................................................... ........................ 1310 41980 40320 ......................... Hatillo County, Puerto Rico ...................................................................... ........................... 0470 41980 40330 ......................... Hormigueros County, Puerto Rico .................................................................. .................... 4840 32420 40340 ......................... Humacao County, Puerto Rico ...................................................................... ..................... 40 41980 40350 ......................... Isabela County, Puerto Rico ...................................................................... ......................... 40 10380 40360 ......................... Jayuya County, Puerto Rico ....................................................................... ........................ 40 40 40370 ......................... Juana Diaz County, Puerto Rico ................................................................... ...................... 6360 38660 40380 ......................... Juncos County, Puerto Rico ....................................................................... ........................ 40 41980 40390 ......................... Lajas County, Puerto Rico ........................................................................ .......................... 40 41900 40400 ......................... Lares County, Puerto Rico ........................................................................ .......................... 40 10380 40410 ......................... Las Marias County, Puerto Rico ................................................................... ...................... 40 40 40420 ......................... Las Piedras County, Puerto Rico .................................................................. ...................... 40 41980 40430 ......................... Loiza County, Puerto Rico ........................................................................ .......................... 7440 41980 40440 ......................... Luquillo County, Puerto Rico ..................................................................... ......................... 40 21940 40450 ......................... Manati County, Puerto Rico ....................................................................... ......................... 40 41980 40460 ......................... Maricao County, Puerto Rico ...................................................................... ........................ 40 40 40470 ......................... Maunabo County, Puerto Rico ...................................................................... ...................... 40 41980 40480 ......................... Mayaguez County, Puerto Rico ..................................................................... ..................... 4840 32420 40490 ......................... Moca County, Puerto Rico ......................................................................... ......................... 0060 10380 40500 ......................... Morovis County, Puerto Rico ...................................................................... ........................ 40 41980 40510 ......................... Naguabo County, Puerto Rico ...................................................................... ...................... 40 41980 40520 ......................... Naranjito County, Puerto Rico .................................................................... ........................ 40 41980 40530 ......................... Orocovis County, Puerto Rico ..................................................................... ........................ 40 41980 40540 ......................... Patillas County, Puerto Rico ..................................................................... .......................... 40 25020 40550 ......................... Penuelas County, Puerto Rico ..................................................................... ....................... 6360 49500 40560 ......................... Ponce County, Puerto Rico ........................................................................ ......................... 6360 38660 40570 ......................... Quebradillas County, Puerto Rico ................................................................. ...................... 40 41980 40580 ......................... Rincon County, Puerto Rico ....................................................................... ......................... 40 10380


## 46044 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

40590 ......................... Rio Grande County, Puerto Rico ................................................................... ..................... 40 41980 40610 ......................... Sabana Grande County, Puerto Rico ................................................................ ................. 4840 41900 40620 ......................... Salinas County, Puerto Rico ...................................................................... ......................... 40 40 40630 ......................... San German County, Puerto Rico ................................................................... ................... 4840 41900 40640 ......................... San Juan County, Puerto Rico ..................................................................... ...................... 40 41980 40650 ......................... San Lorenzo County, Puerto Rico .................................................................. .................... 1310 41980 40660 ......................... San Sebastian County, Puerto Rico ................................................................ ................... 40 10380 40670 ......................... Santa Isabel County, Puerto Rico ................................................................. ...................... 40 40 40680 ......................... Toa Alta County, Puerto Rico ..................................................................... ........................ 40 41980 40690 ......................... Toa Baja County, Puerto Rico ..................................................................... ....................... 40 41980 40700 ......................... Trujillo Alto County, Puerto Rico ................................................................ ......................... 40 41980 40710 ......................... Utuado County, Puerto Rico ....................................................................... ........................ 40 40 40720 ......................... Vega Alta County, Puerto Rico .................................................................... ....................... 40 41980 40730 ......................... Vega Baja County, Puerto Rico .................................................................... ...................... 40 41980 40740 ......................... Vieques County, Puerto Rico ...................................................................... ........................ 40 40 40750 ......................... Villalba County, Puerto Rico ..................................................................... .......................... 6360 38660 40760 ......................... Yabucoa County, Puerto Rico ...................................................................... ....................... 40 41980 40770 ......................... Yauco County, Puerto Rico ........................................................................ ......................... 6360 49500 41000 ......................... Bristol County, Rhode Island ..................................................................... ......................... 6483 39300 41010 ......................... Kent County, Rhode Island ........................................................................ ......................... 6483 39300 41020 ......................... Newport County, Rhode Island ..................................................................... ...................... 6483 39300 41030 ......................... Providence County, Rhode Island .................................................................. .................... 6483 39300 41050 ......................... Washington County, Rhode Island .................................................................. ................... 6483 39300 42000 ......................... Abbeville County, S Carolina ..................................................................... ......................... 42 42 42010 ......................... Aiken County, S Carolina ......................................................................... ........................... 0600 12260 42020 ......................... Allendale County, S Carolina ..................................................................... ......................... 42 42 42030 ......................... Anderson County, S Carolina ...................................................................... ....................... 3160 11340 42040 ......................... Bamberg County, S Carolina ....................................................................... ....................... 42 42 42050 ......................... Barnwell County, S Carolina ...................................................................... ......................... 42 42 42060 ......................... Beaufort County, S Carolina ...................................................................... ......................... 42 42 42070 ......................... Berkeley County, S Carolina ...................................................................... ......................... 1440 16700 42080 ......................... Calhoun County, S Carolina ....................................................................... ........................ 42 17900 42090 ......................... Charleston County, S Carolina .................................................................... ....................... 1440 16700 42100 ......................... Cherokee County, S Carolina ...................................................................... ....................... 42 42 42110 ......................... Chester County, S Carolina ....................................................................... ......................... 42 42 42120 ......................... Chesterfield County, S Carolina .................................................................. ........................ 42 42 42130 ......................... Clarendon County, S Carolina ..................................................................... ....................... 42 42 42140 ......................... Colleton County, S Carolina ...................................................................... .......................... 42 42 42150 ......................... Darlington County, S Carolina .................................................................... ........................ 42 22500 42160 ......................... Dillon County, S Carolina ........................................................................ ............................ 42 42 42170 ......................... Dorchester County, S Carolina .................................................................... ....................... 1440 16700 42180 ......................... Edgefield County, S Carolina ..................................................................... ......................... 42 12260 42190 ......................... Fairfield County, S Carolina ..................................................................... ........................... 42 17900 42200 ......................... Florence County, S Carolina ...................................................................... ......................... 2655 22500 42210 ......................... Georgetown County, S Carolina .................................................................... ..................... 42 42 42220 ......................... Greenville County, S Carolina .................................................................... ......................... 3160 24860 42230 ......................... Greenwood County, S Carolina ..................................................................... ..................... 42 42 42240 ......................... Hampton County, S Carolina ....................................................................... ....................... 42 42 42250 ......................... Horry County, S Carolina ......................................................................... ........................... 42 34820 42260 ......................... Jasper County, S Carolina ........................................................................ .......................... 42 42 42270 ......................... Kershaw County, S Carolina ....................................................................... ........................ 42 17900 42280 ......................... Lancaster County, S Carolina ..................................................................... ........................ 42 42 42290 ......................... Laurens County, S Carolina ....................................................................... ......................... 42 24860 42300 ......................... Lee County, S Carolina ........................................................................... ............................ 42 42 42310 ......................... Lexington County, S Carolina ..................................................................... ........................ 1760 17900 42320 ......................... Mc Cormick County, S Carolina .................................................................... ...................... 42 42 42330 ......................... Marion County, S Carolina ........................................................................ .......................... 42 42 42340 ......................... Marlboro County, S Carolina ...................................................................... ......................... 42 42 42350 ......................... Newberry County, S Carolina ...................................................................... ....................... 42 42 42360 ......................... Oconee County, S Carolina ........................................................................ ........................ 42 42 42370 ......................... Orangeburg County, S Carolina .................................................................... ...................... 42 42 42380 ......................... Pickens County, S Carolina ....................................................................... ......................... 3160 24860 42390 ......................... Richland County, S Carolina ...................................................................... ......................... 1760 17900 42400 ......................... Saluda County, S Carolina ........................................................................ .......................... 42 17900 42410 ......................... Spartanburg County, S Carolina ................................................................... ...................... 3160 43900 42420 ......................... Sumter County, S Carolina ........................................................................ ......................... 42 44940 42430 ......................... Union County, S Carolina ......................................................................... .......................... 42 42 42440 ......................... Williamsburg County, S Carolina .................................................................. ...................... 42 42 42450 ......................... York County, S Carolina .......................................................................... ........................... 1520 16740 43010 ......................... Aurora County, S Dakota .......................................................................... .......................... 43 43


## 46045 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

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— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

43020 ......................... Beadle County, S Dakota .......................................................................... .......................... 43 43 43030 ......................... Bennett County, S Dakota ......................................................................... ......................... 43 43 43040 ......................... Bon Homme County, S Dakota ....................................................................... .................... 43 43 43050 ......................... Brookings County, S Dakota ....................................................................... ........................ 43 43 43060 ......................... Brown County, S Dakota ........................................................................... .......................... 43 43 43070 ......................... Brule County, S Dakota ........................................................................... ........................... 43 43 43080 ......................... Buffalo County, S Dakota ......................................................................... ........................... 43 43 43090 ......................... Butte County, S Dakota ........................................................................... ........................... 43 43 43100 ......................... Campbell County, S Dakota ........................................................................ ........................ 43 43 43110 ......................... Charles Mix County, S Dakota ..................................................................... ....................... 43 43 43120 ......................... Clark County, S Dakota ........................................................................... ........................... 43 43 43130 ......................... Clay County, S Dakota ............................................................................ ............................ 43 43 43140 ......................... Codington County, S Dakota ....................................................................... ....................... 43 43 43150 ......................... Corson County, S Dakota .......................................................................... ......................... 43 43 43160 ......................... Custer County, S Dakota .......................................................................... .......................... 43 43 43170 ......................... Davison County, S Dakota ......................................................................... ......................... 43 43 43180 ......................... Day County, S Dakota ............................................................................. ........................... 43 43 43190 ......................... Deuel County, S Dakota ........................................................................... .......................... 43 43 43200 ......................... Dewey County, S Dakota ........................................................................... ......................... 43 43 43210 ......................... Douglas County, S Dakota ......................................................................... ......................... 43 43 43220 ......................... Edmunds County, S Dakota ......................................................................... ....................... 43 43 43230 ......................... Fall River County, S Dakota ...................................................................... ......................... 43 43 43240 ......................... Faulk County, S Dakota ........................................................................... ........................... 43 43 43250 ......................... Grant County, S Dakota ........................................................................... ........................... 43 43 43260 ......................... Gregory County, S Dakota ......................................................................... ......................... 43 43 43270 ......................... Haakon County, S Dakota .......................................................................... ........................ 43 43 43280 ......................... Hamlin County, S Dakota .......................................................................... .......................... 43 43 43290 ......................... Hand County, S Dakota ............................................................................ .......................... 43 43 43300 ......................... Hanson County, S Dakota .......................................................................... ........................ 43 43 43310 ......................... Harding County, S Dakota ......................................................................... ......................... 43 43 43320 ......................... Hughes County, S Dakota .......................................................................... ........................ 43 43 43330 ......................... Hutchinson County, S Dakota ...................................................................... ....................... 43 43 43340 ......................... Hyde County, S Dakota ............................................................................ .......................... 43 43 43350 ......................... Jackson County, S Dakota ......................................................................... ......................... 43 43 43360 ......................... Jerauld County, S Dakota ......................................................................... .......................... 43 43 43370 ......................... Jones County, S Dakota ........................................................................... .......................... 43 43 43380 ......................... Kingsbury County, S Dakota ....................................................................... ........................ 43 43 43390 ......................... Lake County, S Dakota ............................................................................ ........................... 43 43 43400 ......................... Lawrence County, S Dakota ........................................................................ ....................... 43 43 43410 ......................... Lincoln County, S Dakota ......................................................................... .......................... 43 43620 43420 ......................... Lyman County, S Dakota ........................................................................... ......................... 43 43 43430 ......................... Mc Cook County, S Dakota ......................................................................... ....................... 43 43620 43440 ......................... Mc Pherson County, S Dakota ...................................................................... ..................... 43 43 43450 ......................... Marshall County, S Dakota ........................................................................ ......................... 43 43 43460 ......................... Meade County, S Dakota ........................................................................... ......................... 43 39660 43470 ......................... Mellette County, S Dakota ........................................................................ .......................... 43 43 43480 ......................... Miner County, S Dakota ........................................................................... ........................... 43 43 43490 ......................... Minnehaha County, S Dakota ....................................................................... ...................... 7760 43620 43500 ......................... Moody County, S Dakota ........................................................................... ......................... 43 43 43510 ......................... Pennington County, S Dakota ...................................................................... ....................... 6660 39660 43520 ......................... Perkins County, S Dakota ......................................................................... .......................... 43 43 43530 ......................... Potter County, S Dakota .......................................................................... ........................... 43 43 43540 ......................... Roberts County, S Dakota ......................................................................... ......................... 43 43 43550 ......................... Sanborn County, S Dakota ......................................................................... ........................ 43 43 43560 ......................... Shannon County, S Dakota ......................................................................... ....................... 43 43 43570 ......................... Spink County, S Dakota ........................................................................... ........................... 43 43 43580 ......................... Stanley County, S Dakota ......................................................................... .......................... 43 43 43590 ......................... Sully County, S Dakota ........................................................................... ............................ 43 43 43600 ......................... Todd County, S Dakota ............................................................................ ........................... 43 43 43610 ......................... Tripp County, S Dakota ........................................................................... ............................ 43 43 43620 ......................... Turner County, S Dakota .......................................................................... .......................... 43 43620 43630 ......................... Union County, S Dakota ........................................................................... .......................... 43 43580 43640 ......................... Walworth County, S Dakota ........................................................................ ........................ 43 43 43650 ......................... Washabaugh County, S Dakota ...................................................................... .................... 43 43 43670 ......................... Yankton County, S Dakota ......................................................................... ......................... 43 43 43680 ......................... Ziebach County, S Dakota ......................................................................... ......................... 43 43 44000 ......................... Anderson County, Tennessee ....................................................................... ...................... 3840 28940 44010 ......................... Bedford County, Tennessee ........................................................................ ....................... 44 44 44020 ......................... Benton County, Tennessee ......................................................................... ........................ 44 44 44030 ......................... Bledsoe County, Tennessee ........................................................................ ....................... 44 44


## 46046 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

44040 ......................... Blount County, Tennessee ......................................................................... ......................... 3840 28940 44050 ......................... Bradley County, Tennessee ........................................................................ ........................ 44 17420 44060 ......................... Campbell County, Tennessee ....................................................................... ...................... 44 44 44070 ......................... Cannon County, Tennessee ......................................................................... ...................... 44 34980 44080 ......................... Carroll County, Tennessee ........................................................................ ......................... 44 44 44090 ......................... Carter County, Tennessee ......................................................................... ......................... 3660 27740 44100 ......................... Cheatham County, Tennessee ....................................................................... .................... 5360 34980 44110 ......................... Chester County, Tennessee ........................................................................ ....................... 44 27180 44120 ......................... Claiborne County, Tennessee ...................................................................... ....................... 44 44 44130 ......................... Clay County, Tennessee ........................................................................... .......................... 44 44 44140 ......................... Cocke County, Tennessee .......................................................................... ........................ 44 44 44150 ......................... Coffee County, Tennessee ......................................................................... ........................ 44 44 44160 ......................... Crockett County, Tennessee ....................................................................... ........................ 44 44 44170 ......................... Cumberland County, Tennessee ..................................................................... ................... 44 44 44180 ......................... Davidson County, Tennessee ....................................................................... ...................... 5360 34980 44190 ......................... Decatur County, Tennessee ........................................................................ ....................... 44 44 44200 ......................... De Kalb County, Tennessee ........................................................................ ....................... 44 44 44210 ......................... Dickson County, Tennessee ........................................................................ ....................... 5360 34980 44220 ......................... Dyer County, Tennessee ........................................................................... ......................... 44 44 44230 ......................... Fayette County, Tennessee ........................................................................ ........................ 44 32820 44240 ......................... Fentress County, Tennessee ....................................................................... ....................... 44 44 44250 ......................... Franklin County, Tennessee ....................................................................... ........................ 44 44 44260 ......................... Gibson County, Tennessee ......................................................................... ........................ 44 44 44270 ......................... Giles County, Tennessee .......................................................................... .......................... 44 44 44280 ......................... Grainger County, Tennessee ....................................................................... ....................... 3840 34100 44290 ......................... Greene County, Tennessee ......................................................................... ....................... 44 44 44300 ......................... Grundy County, Tennessee ......................................................................... ....................... 44 44 44310 ......................... Hamblen County, Tennessee ........................................................................ ...................... 44 34100 44320 ......................... Hamilton County, Tennessee ....................................................................... ....................... 1560 16860 44330 ......................... Hancock County, Tennessee ........................................................................ ...................... 44 44 44340 ......................... Hardeman County, Tennessee ....................................................................... .................... 44 44 44350 ......................... Hardin County, Tennessee ......................................................................... ........................ 44 44 44360 ......................... Hawkins County, Tennessee ........................................................................ ...................... 3660 28700 44370 ......................... Haywood County, Tennessee ........................................................................ ..................... 44 44 44380 ......................... Henderson County, Tennessee ...................................................................... .................... 44 44 44390 ......................... Henry County, Tennessee .......................................................................... ........................ 44 44 44400 ......................... Hickman County, Tennessee ........................................................................ ...................... 44 34980 44410 ......................... Houston County, Tennessee ........................................................................ ....................... 44 44 44420 ......................... Humphreys County, Tennessee ...................................................................... .................... 44 44 44430 ......................... Jackson County, Tennessee ........................................................................ ....................... 44 44 44440 ......................... Jefferson County, Tennessee ...................................................................... ....................... 3840 34100 44450 ......................... Johnson County, Tennessee ........................................................................ ...................... 44 44 44460 ......................... Knox County, Tennessee ........................................................................... ......................... 3840 28940 44470 ......................... Lake County, Tennessee ........................................................................... ......................... 44 44 44480 ......................... Lauderdale County, Tennessee ..................................................................... ..................... 44 44 44490 ......................... Lawrence County, Tennessee ....................................................................... ..................... 44 44 44500 ......................... Lewis County, Tennessee .......................................................................... ......................... 44 44 44510 ......................... Lincoln County, Tennessee ........................................................................ ......................... 44 44 44520 ......................... Loudon County, Tennessee ......................................................................... ....................... 44 28940 44530 ......................... Mc Minn County, Tennessee ........................................................................ ...................... 44 44 44540 ......................... Mc Nairy County, Tennessee ....................................................................... ....................... 44 44 44550 ......................... Macon County, Tennessee .......................................................................... ....................... 44 34980 44560 ......................... Madison County, Tennessee ........................................................................ ...................... 3580 27180 44570 ......................... Marion County, Tennessee ......................................................................... ........................ 1560 16860 44580 ......................... Marshall County, Tennessee ....................................................................... ....................... 44 44 44590 ......................... Maury County, Tennessee .......................................................................... ........................ 44 44 44600 ......................... Meigs County, Tennessee .......................................................................... ........................ 44 44 44610 ......................... Monroe County, Tennessee ......................................................................... ....................... 44 44 44620 ......................... Montgomery County, Tennessee ..................................................................... ................... 1660 17300 44630 ......................... Moore County, Tennessee .......................................................................... ........................ 44 44 44640 ......................... Morgan County, Tennessee ......................................................................... ....................... 44 44 44650 ......................... Obion County, Tennessee .......................................................................... ........................ 44 44 44660 ......................... Overton County, Tennessee ........................................................................ ....................... 44 44 44670 ......................... Perry County, Tennessee .......................................................................... ......................... 44 44 44680 ......................... Pickett County, Tennessee ........................................................................ ......................... 44 44 44690 ......................... Polk County, Tennessee ........................................................................... .......................... 44 17420 44700 ......................... Putnam County, Tennessee ......................................................................... ....................... 44 44 44710 ......................... Rhea County, Tennessee ........................................................................... ........................ 44 44 44720 ......................... Roane County, Tennessee .......................................................................... ....................... 44 44 44730 ......................... Robertson County, Tennessee ...................................................................... ..................... 5360 34980


## 46047 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

44740 ......................... Rutherford County, Tennessee ..................................................................... ...................... 5360 34980 44750 ......................... Scott County, Tennessee .......................................................................... .......................... 44 44 44760 ......................... Sequatchie County, Tennessee ..................................................................... ..................... 1560 16860 44770 ......................... Sevier County, Tennessee ......................................................................... ......................... 3840 44 44780 ......................... Shelby County, Tennessee ......................................................................... ........................ 4920 32820 44790 ......................... Smith County, Tennessee .......................................................................... ......................... 44 34980 44800 ......................... Stewart County, Tennessee ........................................................................ ........................ 44 17300 44810 ......................... Sullivan County, Tennessee ....................................................................... ........................ 3660 28700 44820 ......................... Sumner County, Tennessee ......................................................................... ...................... 5360 34980 44830 ......................... Tipton County, Tennessee ......................................................................... ......................... 4920 32820 44840 ......................... Trousdale County, Tennessee ...................................................................... ...................... 44 34980 44850 ......................... Unicoi County, Tennessee ......................................................................... ......................... 3660 27740 44860 ......................... Union County, Tennessee .......................................................................... ......................... 3840 28940 44870 ......................... Van Buren County, Tennessee ...................................................................... ..................... 44 44 44880 ......................... Warren County, Tennessee ......................................................................... ....................... 44 44 44890 ......................... Washington County, Tennessee ..................................................................... .................... 3660 27740 44900 ......................... Wayne County, Tennessee .......................................................................... ....................... 44 44 44910 ......................... Weakley County, Tennessee ........................................................................ ...................... 44 44 44920 ......................... White County, Tennessee .......................................................................... ......................... 44 44 44930 ......................... Williamson County, Tennessee ..................................................................... ...................... 5360 34980 44940 ......................... Wilson County, Tennessee ......................................................................... ........................ 5360 34980 45000 ......................... Anderson County, Texas ........................................................................... .......................... 45 45 45010 ......................... Andrews County, Texas ............................................................................ .......................... 45 45 45020 ......................... Angelina County, Texas ........................................................................... ........................... 45 45 45030 ......................... Aransas County, Texas ............................................................................ ........................... 45 18580 45040 ......................... Archer County, Texas ............................................................................. ............................ 9080 48660 45050 ......................... Armstrong County, Texas .......................................................................... ......................... 45 11100 45060 ......................... Atascosa County, Texas ........................................................................... .......................... 45 41700 45070 ......................... Austin County, Texas ............................................................................. ............................. 45 26420 45080 ......................... Bailey County, Texas ............................................................................. ............................. 45 45 45090 ......................... Bandera County, Texas ............................................................................ .......................... 45 41700 45100 ......................... Bastrop County, Texas ............................................................................ ............................ 0640 12420 45110 ......................... Baylor County, Texas ............................................................................. ............................. 45 45 45113 ......................... Bee County, Texas ................................................................................ .............................. 45 45 45120 ......................... Bell County, Texas ............................................................................... ............................... 3810 28660 45130 ......................... Bexar County, Texas .............................................................................. ............................. 7240 41700 45140 ......................... Blanco County, Texas ............................................................................. ............................ 45 45 45150 ......................... Borden County, Texas ............................................................................. ........................... 45 45 45160 ......................... Bosque County, Texas ............................................................................. ........................... 45 45 45170 ......................... Bowie County, Texas .............................................................................. ............................ 8360 45500 45180 ......................... Brazoria County, Texas ........................................................................... ............................ 1145 26420 45190 ......................... Brazos County, Texas ............................................................................. ............................ 1260 17780 45200 ......................... Brewster County, Texas ........................................................................... ........................... 45 45 45201 ......................... Briscoe County, Texas ............................................................................ ............................ 45 45 45210 ......................... Brooks County, Texas ............................................................................. ............................ 45 45 45220 ......................... Brown County, Texas .............................................................................. ............................ 45 45 45221 ......................... Burleson County, Texas ........................................................................... ........................... 45 17780 45222 ......................... Burnet County, Texas ............................................................................. ............................ 45 45 45223 ......................... Caldwell County, Texas ........................................................................... ........................... 45 12420 45224 ......................... Calhoun County, Texas ............................................................................ ........................... 45 47020 45230 ......................... Callahan County, Texas ........................................................................... ........................... 45 10180 45240 ......................... Cameron County, Texas ............................................................................ ......................... 1240 15180 45250 ......................... Camp County, Texas ............................................................................... ........................... 45 45 45251 ......................... Carson County, Texas ............................................................................. ........................... 45 11100 45260 ......................... Cass County, Texas ............................................................................... ............................. 45 45 45270 ......................... Castro County, Texas ............................................................................. ............................ 45 45 45280 ......................... Chambers County, Texas ........................................................................... ........................ 45 26420 45281 ......................... Cherokee County, Texas ........................................................................... ......................... 45 45 45290 ......................... Childress County, Texas .......................................................................... ........................... 45 45 45291 ......................... Clay County, Texas ............................................................................... .............................. 45 48660 45292 ......................... Cochran County, Texas ............................................................................ .......................... 45 45 45300 ......................... Coke County, Texas ............................................................................... ............................. 45 45 45301 ......................... Coleman County, Texas ............................................................................ .......................... 45 45 45310 ......................... Collin County, Texas ............................................................................. .............................. 1920 19124 45311 ......................... Collingsworth County, Texas ...................................................................... ........................ 45 45 45312 ......................... Colorado County, Texas ........................................................................... .......................... 45 45 45320 ......................... Comal County, Texas .............................................................................. ............................ 7240 41700 45321 ......................... Comanche County, Texas ........................................................................... ........................ 45 45 45330 ......................... Concho County, Texas ............................................................................. ........................... 45 45 45340 ......................... Cooke County, Texas .............................................................................. ............................ 45 45


## 46048 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

45341 ......................... Coryell County, Texas ............................................................................ ............................. 3810 28660 45350 ......................... Cottle County, Texas ............................................................................. .............................. 45 45 45360 ......................... Crane County, Texas .............................................................................. ............................ 45 45 45361 ......................... Crockett County, Texas ........................................................................... ............................ 45 45 45362 ......................... Crosby County, Texas ............................................................................. ............................ 45 31180 45370 ......................... Culberson County, Texas .......................................................................... .......................... 45 45 45380 ......................... Dallam County, Texas ............................................................................. ............................ 45 45 45390 ......................... Dallas County, Texas ............................................................................. ............................. 1920 19124 45391 ......................... Dawson County, Texas ............................................................................. .......................... 45 45 45392 ......................... Deaf Smith County, Texas ......................................................................... ......................... 45 45 45400 ......................... Delta County, Texas .............................................................................. .............................. 45 19124 45410 ......................... Denton County, Texas ............................................................................. ........................... 1920 19124 45420 ......................... De Witt County, Texas ............................................................................ ............................ 45 45 45421 ......................... Dickens County, Texas ............................................................................ ........................... 45 45 45430 ......................... Dimmit County, Texas ............................................................................. ............................ 45 45 45431 ......................... Donley County, Texas ............................................................................. ............................ 45 45 45440 ......................... Duval County, Texas .............................................................................. ............................. 45 45 45450 ......................... Eastland County, Texas ........................................................................... ........................... 45 45 45451 ......................... Ector County, Texas .............................................................................. .............................. 5800 36220 45460 ......................... Edwards County, Texas ............................................................................ .......................... 45 45 45470 ......................... Ellis County, Texas .............................................................................. ............................... 1920 19124 45480 ......................... El Paso County, Texas ............................................................................ ........................... 2320 21340 45490 ......................... Erath County, Texas .............................................................................. ............................. 45 45 45500 ......................... Falls County, Texas .............................................................................. .............................. 45 45 45510 ......................... Fannin County, Texas ............................................................................. ............................ 45 45 45511 ......................... Fayette County, Texas ............................................................................ ............................ 45 45 45520 ......................... Fisher County, Texas ............................................................................. ............................. 45 45 45521 ......................... Floyd County, Texas .............................................................................. ............................. 45 45 45522 ......................... Foard County, Texas .............................................................................. ............................. 45 45 45530 ......................... Fort Bend County, Texas .......................................................................... .......................... 3360 26420 45531 ......................... Franklin County, Texas ........................................................................... ............................ 45 45 45540 ......................... Freestone County, Texas .......................................................................... .......................... 45 45 45541 ......................... Frio County, Texas ............................................................................... ............................... 45 45 45542 ......................... Gaines County, Texas ............................................................................. ............................ 45 45 45550 ......................... Galveston County, Texas .......................................................................... .......................... 2920 26420 45551 ......................... Garza County, Texas .............................................................................. ............................ 45 45 45552 ......................... Gillespie County, Texas .......................................................................... ............................ 45 45 45560 ......................... Glasscock County, Texas .......................................................................... ......................... 45 45 45561 ......................... Goliad County, Texas ............................................................................. ............................. 45 47020 45562 ......................... Gonzales County, Texas ........................................................................... .......................... 45 45 45563 ......................... Gray County, Texas ............................................................................... ............................. 45 45 45564 ......................... Grayson County, Texas ............................................................................ .......................... 7640 43300 45570 ......................... Gregg County, Texas .............................................................................. ............................ 4420 30980 45580 ......................... Grimes County, Texas ............................................................................. ........................... 45 45 45581 ......................... Guadaloupe County, Texas ......................................................................... ....................... 7240 41700 45582 ......................... Hale County, Texas ............................................................................... .............................. 45 45 45583 ......................... Hall County, Texas ............................................................................... ............................... 45 45 45590 ......................... Hamilton County, Texas ........................................................................... ........................... 45 45 45591 ......................... Hansford County, Texas ........................................................................... .......................... 45 45 45592 ......................... Hardeman County, Texas ........................................................................... ........................ 45 45 45600 ......................... Hardin County, Texas ............................................................................. ............................ 0840 13140 45610 ......................... Harris County, Texas ............................................................................. ............................. 3360 26420 45620 ......................... Harrison County, Texas ........................................................................... ........................... 4420 45 45621 ......................... Hartley County, Texas ............................................................................ ............................. 45 45 45630 ......................... Haskell County, Texas ............................................................................ ............................ 45 45 45631 ......................... Hays County, Texas ............................................................................... ............................. 0640 12420 45632 ......................... Hemphill County, Texas ........................................................................... ........................... 45 45 45640 ......................... Henderson County, Texas .......................................................................... ........................ 45 45 45650 ......................... Hidalgo County, Texas ............................................................................ ............................ 4880 32580 45651 ......................... Hill County, Texas ............................................................................... ................................ 45 45 45652 ......................... Hockley County, Texas ............................................................................ ........................... 45 45 45653 ......................... Hood County, Texas ............................................................................... ............................ 45 45 45654 ......................... Hopkins County, Texas ............................................................................ ........................... 45 45 45660 ......................... Houston County, Texas ............................................................................ ........................... 45 45 45661 ......................... Howard County, Texas ............................................................................. ........................... 45 45 45662 ......................... Hudspeth County, Texas ........................................................................... .......................... 45 45 45670 ......................... Hunt County, Texas ............................................................................... ............................. 45 19124 45671 ......................... Hutchinson County, Texas ......................................................................... ......................... 45 45 45672 ......................... Irion County, Texas .............................................................................. ............................... 45 41660 45680 ......................... Jack County, Texas ............................................................................... .............................. 45 45


## 46049 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

45681 ......................... Jackson County, Texas ............................................................................ ........................... 45 45 45690 ......................... Jasper County, Texas ............................................................................. ............................ 45 45 45691 ......................... Jeff Davis County, Texas ......................................................................... ........................... 45 45 45700 ......................... Jefferson County, Texas .......................................................................... ........................... 0840 13140 45710 ......................... Jim Hogg County, Texas ........................................................................... .......................... 45 45 45711 ......................... Jim Wells County, Texas .......................................................................... .......................... 45 45 45720 ......................... Johnson County, Texas ............................................................................ .......................... 2800 23104 45721 ......................... Jones County, Texas .............................................................................. ............................ 45 10180 45722 ......................... Karnes County, Texas ............................................................................. ............................ 45 45 45730 ......................... Kaufman County, Texas ............................................................................ .......................... 1920 19124 45731 ......................... Kendall County, Texas ............................................................................ ............................ 45 41700 45732 ......................... Kenedy County, Texas ............................................................................. ........................... 45 45 45733 ......................... Kent County, Texas ............................................................................... .............................. 45 45 45734 ......................... Kerr County, Texas ............................................................................... .............................. 45 45 45740 ......................... Kimble County, Texas ............................................................................. ............................ 45 45 45741 ......................... King County, Texas ............................................................................... .............................. 45 45 45742 ......................... Kinney County, Texas ............................................................................. ............................ 45 45 45743 ......................... Kleberg County, Texas ............................................................................ ............................ 45 45 45744 ......................... Knox County, Texas ............................................................................... ............................. 45 45 45750 ......................... Lamar County, Texas .............................................................................. ............................ 45 45 45751 ......................... Lamb County, Texas ............................................................................... ............................ 45 45 45752 ......................... Lampasas County, Texas ........................................................................... ........................ 45 28660 45753 ......................... La Salle County, Texas ........................................................................... ............................ 45 45 45754 ......................... Lavaca County, Texas ............................................................................. ........................... 45 45 45755 ......................... Lee County, Texas ................................................................................ .............................. 45 45 45756 ......................... Leon County, Texas ............................................................................... ............................. 45 45 45757 ......................... Liberty County, Texas ............................................................................ ............................. 3360 26420 45758 ......................... Limestone County, Texas .......................................................................... ......................... 45 45 45759 ......................... Lipscomb County, Texas ........................................................................... .......................... 45 45 45760 ......................... Live Oak County, Texas ........................................................................... ........................... 45 45 45761 ......................... Llano County, Texas .............................................................................. ............................. 45 45 45762 ......................... Loving County, Texas ............................................................................. ............................ 45 45 45770 ......................... Lubbock County, Texas ............................................................................ .......................... 4600 31180 45771 ......................... Lynn County, Texas ............................................................................... ............................. 45 45 45772 ......................... Mc Culloch County, Texas ......................................................................... ......................... 45 45 45780 ......................... Mc Lennan County, Texas .......................................................................... ........................ 8800 47380 45781 ......................... Mc Mullen County, Texas .......................................................................... ......................... 45 45 45782 ......................... Madison County, Texas ............................................................................ .......................... 45 45 45783 ......................... Marion County, Texas ............................................................................. ............................ 45 45 45784 ......................... Martin County, Texas ............................................................................. ............................. 45 45 45785 ......................... Mason County, Texas .............................................................................. ........................... 45 45 45790 ......................... Matagorda County, Texas .......................................................................... ......................... 45 45 45791 ......................... Maverick County, Texas ........................................................................... ........................... 45 45 45792 ......................... Medina County, Texas ............................................................................. ........................... 45 41700 45793 ......................... Menard County, Texas ............................................................................. ........................... 45 45 45794 ......................... Midland County, Texas ............................................................................ ........................... 5040 33260 45795 ......................... Milam County, Texas .............................................................................. ............................ 45 45 45796 ......................... Mills County, Texas .............................................................................. ............................... 45 45 45797 ......................... Mitchell County, Texas ........................................................................... ............................. 45 45 45800 ......................... Montague County, Texas ........................................................................... ......................... 45 45 45801 ......................... Montgomery County, Texas ......................................................................... ....................... 3360 26420 45802 ......................... Moore County, Texas .............................................................................. ............................ 45 45 45803 ......................... Morris County, Texas ............................................................................. ............................. 45 45 45804 ......................... Motley County, Texas ............................................................................. ............................ 45 45 45810 ......................... Nacogdoches County, Texas ........................................................................ ...................... 45 45 45820 ......................... Navarro County, Texas ............................................................................ ........................... 45 45 45821 ......................... Newton County, Texas ............................................................................. ........................... 45 45 45822 ......................... Nolan County, Texas .............................................................................. ............................. 45 45 45830 ......................... Nueces County, Texas ............................................................................. ........................... 1880 18580 45831 ......................... Ochiltree County, Texas .......................................................................... ............................ 45 45 45832 ......................... Oldham County, Texas ............................................................................. .......................... 45 45 45840 ......................... Orange County, Texas ............................................................................. ........................... 0840 13140 45841 ......................... Palo Pinto County, Texas ......................................................................... .......................... 45 45 45842 ......................... Panola County, Texas ............................................................................. ............................ 45 45 45843 ......................... Parker County, Texas ............................................................................. ............................ 2800 23104 45844 ......................... Parmer County, Texas ............................................................................. ........................... 45 45 45845 ......................... Pecos County, Texas .............................................................................. ............................ 45 45 45850 ......................... Polk County, Texas ............................................................................... .............................. 45 45 45860 ......................... Potter County, Texas ............................................................................. ............................. 0320 11100 45861 ......................... Presidio County, Texas ........................................................................... ............................ 45 45


## 46050 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

45870 ......................... Rains County, Texas .............................................................................. ............................. 45 45 45871 ......................... Randall County, Texas ............................................................................ ............................ 0320 11100 45872 ......................... Reagan County, Texas ............................................................................. .......................... 45 45 45873 ......................... Real County, Texas ............................................................................... .............................. 45 45 45874 ......................... Red River County, Texas .......................................................................... .......................... 45 45 45875 ......................... Reeves County, Texas ............................................................................. ........................... 45 45 45876 ......................... Refugio County, Texas ............................................................................ ............................ 45 45 45877 ......................... Roberts County, Texas ............................................................................ ........................... 45 45 45878 ......................... Robertson County, Texas .......................................................................... ......................... 45 17780 45879 ......................... Rockwall County, Texas ........................................................................... ........................... 1920 19124 45880 ......................... Runnels County, Texas ............................................................................ ........................... 45 45 45881 ......................... Rusk County, Texas ............................................................................... ............................. 45 30980 45882 ......................... Sabine County, Texas ............................................................................. ............................ 45 45 45883 ......................... San Augustine County, Texas ...................................................................... ...................... 45 45 45884 ......................... San Jacinto County, Texas ........................................................................ ......................... 45 26420 45885 ......................... San Patricio County, Texas ....................................................................... ......................... 1880 18580 45886 ......................... San Saba County, Texas ........................................................................... ......................... 45 45 45887 ......................... Schleicher County, Texas ......................................................................... .......................... 45 45 45888 ......................... Scurry County, Texas ............................................................................. ............................. 45 45 45889 ......................... Shackelford County, Texas ........................................................................ ......................... 45 45 45890 ......................... Shelby County, Texas ............................................................................. ............................ 45 45 45891 ......................... Sherman County, Texas ............................................................................ ......................... 45 45 45892 ......................... Smith County, Texas .............................................................................. ............................. 8640 46340 45893 ......................... Somervell County, Texas .......................................................................... .......................... 45 45 45900 ......................... Starr County, Texas .............................................................................. .............................. 45 45 45901 ......................... Stephens County, Texas ........................................................................... .......................... 45 45 45902 ......................... Sterling County, Texas ........................................................................... ............................. 45 45 45903 ......................... Stonewall County, Texas .......................................................................... .......................... 45 45 45904 ......................... Sutton County, Texas ............................................................................. ............................. 45 45 45905 ......................... Swisher County, Texas ............................................................................ ........................... 45 45 45910 ......................... Tarrant County, Texas ............................................................................ ............................ 2800 23104 45911 ......................... Taylor County, Texas ............................................................................. ............................. 0040 10180 45912 ......................... Terrell County, Texas ............................................................................ .............................. 45 45 45913 ......................... Terry County, Texas .............................................................................. .............................. 45 45 45920 ......................... Throckmorton County, Texas ....................................................................... ....................... 45 45 45921 ......................... Titus County, Texas .............................................................................. .............................. 45 45 45930 ......................... Tom Green County, Texas .......................................................................... ........................ 7200 41660 45940 ......................... Travis County, Texas ............................................................................. ............................. 0640 12420 45941 ......................... Trinity County, Texas ............................................................................ .............................. 45 45 45942 ......................... Tyler County, Texas .............................................................................. .............................. 45 45 45943 ......................... Upshur County, Texas ............................................................................. ........................... 45 30980 45944 ......................... Upton County, Texas .............................................................................. ............................ 45 45 45945 ......................... Uvalde County, Texas ............................................................................. ............................ 45 45 45946 ......................... Val Verde County, Texas .......................................................................... .......................... 45 45 45947 ......................... Van Zandt County, Texas .......................................................................... ......................... 45 45 45948 ......................... Victoria County, Texas ........................................................................... ............................. 8750 47020 45949 ......................... Walker County, Texas ............................................................................. ............................ 45 45 45950 ......................... Waller County, Texas ............................................................................. ............................. 3360 26420 45951 ......................... Ward County, Texas ............................................................................... ............................ 45 45 45952 ......................... Washington County, Texas ......................................................................... ........................ 45 45 45953 ......................... Webb County, Texas ............................................................................... ............................ 4080 29700 45954 ......................... Wharton County, Texas ............................................................................ .......................... 45 45 45955 ......................... Wheeler County, Texas ............................................................................ ........................... 45 45 45960 ......................... Wichita County, Texas ............................................................................ ............................ 9080 48660 45961 ......................... Wilbarger County, Texas .......................................................................... ........................... 45 45 45962 ......................... Willacy County, Texas ............................................................................ ............................. 45 45 45970 ......................... Williamson County, Texas ......................................................................... .......................... 0640 12420 45971 ......................... Wilson County, Texas ............................................................................. ............................ 45 41700 45972 ......................... Winkler County, Texas ............................................................................ ............................ 45 45 45973 ......................... Wise County, Texas ............................................................................... ............................. 45 23104 45974 ......................... Wood County, Texas ............................................................................... ............................ 45 45 45980 ......................... Yoakum County, Texas ............................................................................. .......................... 45 45 45981 ......................... Young County, Texas .............................................................................. ............................ 45 45 45982 ......................... Zapata County, Texas ............................................................................. ............................ 45 45 45983 ......................... Zavala County, Texas ............................................................................. ............................ 45 45 46000 ......................... Beaver County, Utah .............................................................................. ............................. 46 46 46010 ......................... Box Elder County, Utah ........................................................................... ........................... 46 46 46020 ......................... Cache County, Utah ............................................................................... ............................. 46 30860 46030 ......................... Carbon County, Utah .............................................................................. ............................ 46 46 46040 ......................... Daggett County, Utah ............................................................................. ............................. 46 46


## 46051 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

46050 ......................... Davis County, Utah ............................................................................... .............................. 7160 36260 46060 ......................... Duchesne County, Utah ............................................................................ .......................... 46 46 46070 ......................... Emery County, Utah ............................................................................... ............................. 46 46 46080 ......................... Garfield County, Utah ............................................................................ .............................. 46 46 46090 ......................... Grand County, Utah ............................................................................... ............................. 46 46 46100 ......................... Iron County, Utah ................................................................................ ................................ 46 46 46110 ......................... Juab County, Utah ................................................................................ .............................. 46 39340 46120 ......................... Kane County, Utah ................................................................................ .............................. 45 46 46130 ......................... Millard County, Utah ............................................................................. ............................... 46 46 46140 ......................... Morgan County, Utah .............................................................................. ............................ 46 36260 46150 ......................... Piute County, Utah ............................................................................... ............................... 46 46 46160 ......................... Rich County, Utah ................................................................................ ............................... 46 46 46170 ......................... Salt Lake County, Utah ........................................................................... ............................ 7160 41620 46180 ......................... San Juan County, Utah ............................................................................ ........................... 46 46 46190 ......................... Sanpete County, Utah ............................................................................. ............................ 46 46 46200 ......................... Sevier County, Utah .............................................................................. .............................. 46 46 46210 ......................... Summit County, Utah .............................................................................. ............................ 46 41620 46220 ......................... Tooele County, Utah .............................................................................. ............................. 46 41620 46230 ......................... Uintah County, Utah .............................................................................. .............................. 46 46 46240 ......................... Utah County, Utah ................................................................................ ............................... 6520 39340 46250 ......................... Wasatch County, Utah ............................................................................. ........................... 46 46 46260 ......................... Washington County, Utah .......................................................................... ......................... 46 41100 46270 ......................... Wayne County, Utah ............................................................................... ............................ 46 46 46280 ......................... Weber County, Utah ............................................................................... ............................. 7160 36260 47000 ......................... Addison County, Vermont .......................................................................... ......................... 47 47 47010 ......................... Bennington County, Vermont ....................................................................... ....................... 47 47 47020 ......................... Caledonia County, Vermont ........................................................................ ........................ 47 47 47030 ......................... Chittenden County, Vermont ....................................................................... ........................ 1303 15540 47040 ......................... Essex County, Vermont ............................................................................ .......................... 47 47 47050 ......................... Franklin County, Vermont ......................................................................... .......................... 47 15540 47060 ......................... Grand Isle County, Vermont ....................................................................... ........................ 1303 15540 47070 ......................... Lamoille County, Vermont ......................................................................... .......................... 47 47 47080 ......................... Orange County, Vermont ........................................................................... ......................... 47 47 47090 ......................... Orleans County, Vermont .......................................................................... .......................... 47 47 47100 ......................... Rutland County, Vermont .......................................................................... .......................... 47 47 47110 ......................... Washington County, Vermont ....................................................................... ...................... 47 47 47120 ......................... Windham County, Vermont .......................................................................... ....................... 47 47 47130 ......................... Windsor County, Vermont .......................................................................... ......................... 47 47 49000 ......................... Accomack County, Virginia ........................................................................ ......................... 49 49 49010 ......................... Albemarle County, Virginia ....................................................................... ........................... 1540 16820 49011 ......................... Alexandria City County, Virginia ................................................................. ........................ 8840 47894 49020 ......................... Alleghany County, Virginia ....................................................................... ........................... 49 49 49030 ......................... Amelia County, Virginia .......................................................................... ............................. 49 40060 49040 ......................... Amherst County, Virginia ......................................................................... ........................... 4640 31340 49050 ......................... Appomattox County, Virginia ...................................................................... ......................... 49 31340 49060 ......................... Arlington County, Virginia ....................................................................... ............................. 8840 47894 49070 ......................... Augusta County, Virginia ......................................................................... ............................ 49 49 49080 ......................... Bath County, Virginia ............................................................................ .............................. 49 49 49088 ......................... Bedford City County, Virginia .................................................................... .......................... 49 31340 49090 ......................... Bedford County, Virginia ......................................................................... ............................ 49 31340 49100 ......................... Bland County, Virginia ........................................................................... .............................. 49 49 49110 ......................... Botetourt County, Virginia ....................................................................... ............................ 6800 40220 49111 ......................... Bristol City County, Virginia .................................................................... ............................ 3660 28700 49120 ......................... Brunswick County, Virginia ....................................................................... .......................... 49 49 49130 ......................... Buchanan County, Virginia ........................................................................ .......................... 49 49 49140 ......................... Buckingham County, Virginia ...................................................................... ........................ 49 49 49141 ......................... Buena Vista City County, Virginia ................................................................ ....................... 49 49 49150 ......................... Campbell County, Virginia ........................................................................ ........................... 4640 31340 49160 ......................... Caroline County, Virginia ........................................................................ ............................ 49 40060 49170 ......................... Carroll County, Virginia ......................................................................... .............................. 49 49 49180 ......................... Charles City County, Virginia .................................................................... .......................... 6760 40060 49190 ......................... Charlotte County, Virginia ....................................................................... ............................ 49 49 49191 ......................... Charlottesville City County, Virginia ............................................................ ........................ 1540 16820 49194 ......................... Chesapeake County, Virginia ...................................................................... ........................ 5720 47260 49200 ......................... Chesterfield County, Virginia .................................................................... ........................... 6760 40060 49210 ......................... Clarke County, Virginia .......................................................................... ............................. 49 47894 49211 ......................... Clifton Forge City County, Virginia .............................................................. ........................ 49 49 49212 ......................... Colonial Heights County, Virginia ................................................................ ....................... 6760 40060 49213 ......................... Covington City County, Virginia .................................................................. ........................ 49 49 49220 ......................... Craig County, Virginia ........................................................................... .............................. 49 40220


## 46052 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

49230 ......................... Culpeper County, Virginia ........................................................................ ........................... 49 49 49240 ......................... Cumberland County, Virginia ...................................................................... ........................ 49 40060 49241 ......................... Danville City County, Virginia ................................................................... ........................... 1950 19260 49250 ......................... Dickenson County, Virginia ....................................................................... .......................... 49 49 49260 ......................... Dinniddie County, Virginia ....................................................................... ............................ 6760 40060 49270 ......................... Emporia County, Virginia ......................................................................... ........................... 49 49 49280 ......................... Essex County, Virginia ........................................................................... ............................. 49 49 49288 ......................... Fairfax City County, Virginia .................................................................... ........................... 8840 47894 49290 ......................... Fairfax County, Virginia ......................................................................... .............................. 8840 47894 49291 ......................... Falls Church City County, Virginia ............................................................... ....................... 8840 47894 49300 ......................... Fauquier County, Virginia ........................................................................ ............................ 49 47894 49310 ......................... Floyd County, Virginia ........................................................................... .............................. 49 49 49320 ......................... Fluvanna County, Virginia ........................................................................ ........................... 1540 16820 49328 ......................... Franklin City County, Virginia ................................................................... ........................... 49 49 49330 ......................... Franklin County, Virginia ........................................................................ ............................. 49 40220 49340 ......................... Frederick County, Virginia ....................................................................... ............................ 49 49020 49342 ......................... Fredericksburg City County, Virginia ............................................................. ..................... 49 47894 49343 ......................... Galax City County, Virginia ...................................................................... ........................... 49 49 49350 ......................... Giles County, Virginia ........................................................................... ............................... 49 13980 49360 ......................... Gloucester County, Virginia ...................................................................... .......................... 5720 47260 49370 ......................... Goochland County, Virginia ....................................................................... ......................... 6760 40060 49380 ......................... Grayson County, Virginia ......................................................................... ........................... 49 49 49390 ......................... Greene County, Virginia .......................................................................... ............................ 1540 16820 49400 ......................... Greensville County, Virginia ..................................................................... ........................... 49 49 49410 ......................... Halifax County, Virginia ......................................................................... .............................. 49 49 49411 ......................... Hampton City County, Virginia .................................................................... ........................ 5720 47260 49420 ......................... Hanover County, Virginia ......................................................................... ........................... 6760 40060 49421 ......................... Harrisonburg City County, Virginia ............................................................... ....................... 49 25500 49430 ......................... Henrico County, Virginia ......................................................................... ............................ 6760 40060 49440 ......................... Henry County, Virginia ........................................................................... ............................. 49 49 49450 ......................... Highland County, Virginia ........................................................................ ............................ 49 49 49451 ......................... Hopewell City County, Virginia ................................................................... ......................... 6760 40060 49460 ......................... Isle Of Wight County, Virginia ................................................................... .......................... 49 47260 49470 ......................... James City Co County, Virginia ................................................................... ....................... 5720 47260 49480 ......................... King And Queen County, Virginia .................................................................. ..................... 49 40060 49490 ......................... King George County, Virginia ..................................................................... ........................ 49 49 49500 ......................... King William County, Virginia .................................................................... .......................... 49 40060 49510 ......................... Lancaster County, Virginia ....................................................................... ........................... 49 49 49520 ......................... Lee County, Virginia ............................................................................. ............................... 49 49 49522 ......................... Lexington County, Virginia ....................................................................... ........................... 49 49 49530 ......................... Loudoun County, Virginia ......................................................................... ........................... 8840 47894 49540 ......................... Louisa County, Virginia .......................................................................... ............................. 49 40060 49550 ......................... Lunenburg County, Virginia ....................................................................... .......................... 49 49 49551 ......................... Lynchburg City County, Virginia .................................................................. ........................ 4640 31340 49560 ......................... Madison County, Virginia ......................................................................... ........................... 49 49 49561 ......................... Martinsville City County, Virginia ............................................................... ......................... 49 49 49563 ......................... Manassas City County, Virginia ................................................................... ....................... 8840 47894 49565 ......................... Manassas Park City County, Virginia .............................................................. ................... 8840 47894 49570 ......................... Mathews County, Virginia ......................................................................... .......................... 49 47260 49580 ......................... Mecklenburg County, Virginia ..................................................................... ........................ 49 49 49590 ......................... Middlesex County, Virginia ....................................................................... ........................... 49 49 49600 ......................... Montgomery County, Virginia ...................................................................... ........................ 49 13980 49610 ......................... Nansemond County, Virginia ....................................................................... ....................... 49 49 49620 ......................... Nelson County, Virginia .......................................................................... ............................. 49 16820 49621 ......................... New Kent County, Virginia ........................................................................ .......................... 6760 40060 49622 ......................... Newport News City County, Virginia ............................................................... .................... 5720 47260 49641 ......................... Norfolk City County, Virginia .................................................................... ........................... 5720 47260 49650 ......................... Northampton County, Virginia ..................................................................... ........................ 49 49 49660 ......................... Northumberland County, Virginia .................................................................. ...................... 49 49 49661 ......................... Norton City County, Virginia ..................................................................... ........................... 49 49 49670 ......................... Nottoway County, Virginia ........................................................................ ........................... 49 49 49680 ......................... Orange County, Virginia .......................................................................... ............................ 49 49 49690 ......................... Page County, Virginia ............................................................................ ............................. 49 49 49700 ......................... Patrick County, Virginia ......................................................................... .............................. 49 49 49701 ......................... Petersburg City County, Virginia ................................................................. ........................ 6760 40060 49710 ......................... Pittsylvania County, Virginia .................................................................... ............................ 1950 19260 49711 ......................... Portsmouth City County, Virginia ................................................................. ....................... 5720 47260 49712 ......................... Poquoson City County, Virginia ................................................................... ....................... 5720 47260 49720 ......................... Powhatan County, Virginia ........................................................................ .......................... 6760 40060 49730 ......................... Prince Edward County, Virginia ................................................................... ....................... 49 49


## 46053 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

49740 ......................... Prince George County, Virginia ................................................................... ....................... 6760 40060 49750 ......................... Prince William County, Virginia .................................................................. ......................... 8840 47894 49770 ......................... Pulaski County, Virginia ......................................................................... ............................. 49 13980 49771 ......................... Radford City County, Virginia .................................................................... .......................... 49 13980 49780 ......................... Rappahannock County, Virginia .................................................................... ...................... 49 49 49790 ......................... Richmond County, Virginia ........................................................................ .......................... 49 49 49791 ......................... Richmond City County, Virginia ................................................................... ....................... 6760 40060 49800 ......................... Roanoke County, Virginia ......................................................................... .......................... 6800 40220 49801 ......................... Roanoke City County, Virginia .................................................................... ........................ 6800 40220 49810 ......................... Rockbridge County, Virginia ...................................................................... .......................... 49 49 49820 ......................... Rockingham County, Virginia ...................................................................... ........................ 49 25500 49830 ......................... Russell County, Virginia ......................................................................... ............................. 49 49 49838 ......................... Salem County, Virginia ........................................................................... ............................. 6800 40220 49840 ......................... Scott County, Virginia ........................................................................... ............................... 3660 28700 49850 ......................... Shenandoah County, Virginia ...................................................................... ....................... 49 49 49860 ......................... Smyth County, Virginia ........................................................................... ............................. 49 49 49867 ......................... South Boston City County, Virginia ............................................................... ...................... 49 49 49870 ......................... Southampton County, Virginia ..................................................................... ....................... 49 49 49880 ......................... Spotsylvania County, Virginia .................................................................... ......................... 49 47894 49890 ......................... Stafford County, Virginia ........................................................................ ............................. 8840 47894 49891 ......................... Staunton City County, Virginia ................................................................... ......................... 49 49 49892 ......................... Suffolk City County, Virginia .................................................................... ........................... 5720 47260 49900 ......................... Surry County, Virginia ........................................................................... .............................. 49 47260 49910 ......................... Sussex County, Virginia .......................................................................... ............................ 49 40060 49920 ......................... Tazewell County, Virginia ........................................................................ ............................ 49 49 49921 ......................... Virginia Beach City County, Virginia ............................................................. ...................... 5720 47260 49930 ......................... Warren County, Virginia .......................................................................... ............................ 49 47894 49950 ......................... Washington County, Virginia ...................................................................... ......................... 3660 28700 49951 ......................... Waynesboro City County, Virginia ................................................................. ..................... 49 49 49960 ......................... Westmoreland County, Virginia .................................................................... ....................... 49 49 49961 ......................... Williamsburg City County, Virginia ............................................................... ....................... 5720 47260 49962 ......................... Winchester City County, Virginia ................................................................. ....................... 49 49020 49970 ......................... Wise County, Virginia ............................................................................ .............................. 49 49 49980 ......................... Wythe County, Virginia ........................................................................... ............................. 49 49 49981 ......................... York County, Virginia ............................................................................ .............................. 5720 47260 50000 ......................... Adams County, Washington ......................................................................... ....................... 50 50 50010 ......................... Asotin County, Washington ........................................................................ ......................... 50 30300 50020 ......................... Benton County, Washington ........................................................................ ....................... 6740 28420 50030 ......................... Chelan County, Washington ........................................................................ ....................... 50 48300 50040 ......................... Clallam County, Washington ....................................................................... ........................ 50 50 50050 ......................... Clark County, Washington ......................................................................... ......................... 8725 38900 50060 ......................... Columbia County, Washington ...................................................................... ...................... 50 50 50070 ......................... Cowlitz County, Washington ....................................................................... ........................ 50 31020 50080 ......................... Douglas County, Washington ....................................................................... ....................... 50 48300 50090 ......................... Ferry County, Washington ......................................................................... ......................... 50 50 50100 ......................... Franklin County, Washington ...................................................................... ........................ 6740 28420 50110 ......................... Garfield County, Washington ...................................................................... ........................ 50 50 50120 ......................... Grant County, Washington ......................................................................... ......................... 50 50 50130 ......................... Grays Harbor County, Washington .................................................................. ................... 50 50 50140 ......................... Island County, Washington ........................................................................ ......................... 50 50 50150 ......................... Jefferson County, Washington ..................................................................... ....................... 50 50 50160 ......................... King County, Washington .......................................................................... .......................... 7600 42644 50170 ......................... Kitsap County, Washington ........................................................................ ......................... 1150 14740 50180 ......................... Kittitas County, Washington ...................................................................... .......................... 50 50 50190 ......................... Klickitat County, Washington ..................................................................... ......................... 50 50 50200 ......................... Lewis County, Washington ......................................................................... ......................... 50 50 50210 ......................... Lincoln County, Washington ....................................................................... ........................ 50 50 50220 ......................... Mason County, Washington ......................................................................... ....................... 50 50 50230 ......................... Okanogan County, Washington ...................................................................... .................... 50 50 50240 ......................... Pacific County, Washington ....................................................................... ......................... 50 50 50250 ......................... Pend Oreille County, Washington .................................................................. ..................... 50 50 50260 ......................... Pierce County, Washington ........................................................................ ......................... 8200 45104 50270 ......................... San Juan County, Washington ...................................................................... ..................... 50 50 50280 ......................... Skagit County, Washington ........................................................................ ......................... 50 34580 50290 ......................... Skamania County, Washington ...................................................................... ..................... 50 38900 50300 ......................... Snohomish County, Washington ..................................................................... .................... 7600 42644 50310 ......................... Spokane County, Washington ....................................................................... ...................... 7840 44060 50320 ......................... Stevens County, Washington ....................................................................... ....................... 50 50 50330 ......................... Thurston County, Washington ...................................................................... ....................... 5910 36500 50340 ......................... Wahkiakum County, Washington ..................................................................... ................... 50 50


## 46054 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

50350 ......................... Walla Walla County, Washington ................................................................... ..................... 50 50 50360 ......................... Whatcom County, Washington ....................................................................... ..................... 0860 13380 50370 ......................... Whitman County, Washington ....................................................................... ...................... 50 50 50380 ......................... Yakima County, Washington ........................................................................ ....................... 9260 49420 51000 ......................... Barbour County, W Virginia ....................................................................... ......................... 51 51 51010 ......................... Berkeley County, W Virginia ...................................................................... ......................... 51 25180 51020 ......................... Boone County, W Virginia ......................................................................... .......................... 51 16620 51030 ......................... Braxton County, W Virginia ....................................................................... .......................... 51 51 51040 ......................... Brooke County, W Virginia ........................................................................ .......................... 8080 48260 51050 ......................... Cabell County, W Virginia ........................................................................ ........................... 3400 26580 51060 ......................... Calhoun County, W Virginia ....................................................................... ......................... 51 51 51070 ......................... Clay County, W Virginia .......................................................................... ............................ 51 16620 51080 ......................... Doddridge County, W Virginia ..................................................................... ........................ 51 51 51090 ......................... Fayette County, W Virginia ....................................................................... .......................... 51 51 51100 ......................... Gilmer County, W Virginia ........................................................................ ........................... 51 51 51110 ......................... Grant County, W Virginia ......................................................................... ........................... 51 51 51120 ......................... Greenbrier County, W Virginia .................................................................... ........................ 51 51 51130 ......................... Hampshire County, W Virginia ..................................................................... ....................... 51 49020 51140 ......................... Hancock County, W Virginia ....................................................................... ........................ 8080 48260 51150 ......................... Hardy County, W Virginia ......................................................................... ........................... 51 51 51160 ......................... Harrison County, W Virginia ...................................................................... .......................... 51 51 51170 ......................... Jackson County, W Virginia ....................................................................... ......................... 51 51 51180 ......................... Jefferson County, W Virginia ..................................................................... ......................... 51 47894 51190 ......................... Kanawha County, W Virginia ....................................................................... ....................... 1480 16620 51200 ......................... Lewis County, W Virginia ......................................................................... ........................... 51 51 51210 ......................... Lincoln County, W Virginia ....................................................................... ........................... 51 16620 51220 ......................... Logan County, W Virginia ......................................................................... .......................... 51 51 51230 ......................... Mc Dowell County, W Virginia ..................................................................... ....................... 51 51 51240 ......................... Marion County, W Virginia ........................................................................ .......................... 51 51 51250 ......................... Marshall County, W Virginia ...................................................................... .......................... 9000 48540 51260 ......................... Mason County, W Virginia ......................................................................... ......................... 51 51 51270 ......................... Mercer County, W Virginia ........................................................................ .......................... 51 51 51280 ......................... Mineral County, W Virginia ....................................................................... .......................... 1900 19060 51290 ......................... Mingo County, W Virginia ......................................................................... .......................... 51 51 51300 ......................... Monongalia County, W Virginia .................................................................... ....................... 51 34060 51310 ......................... Monroe County, W Virginia ........................................................................ ......................... 51 51 51320 ......................... Morgan County, W Virginia ........................................................................ ......................... 51 25180 51330 ......................... Nicholas County, W Virginia ...................................................................... ......................... 51 51 51340 ......................... Ohio County, W Virginia .......................................................................... ............................ 9000 48540 51350 ......................... Pendleton County, W Virginia ..................................................................... ........................ 51 51 51360 ......................... Pleasants County, W Virginia ..................................................................... ........................ 51 37620 51370 ......................... Pocahontas County, W Virginia .................................................................... ...................... 51 51 51380 ......................... Preston County, W Virginia ....................................................................... .......................... 51 34060 51390 ......................... Putnam County, W Virginia ........................................................................ ......................... 1480 16620 51400 ......................... Raleigh County, W Virginia ....................................................................... .......................... 51 51 51410 ......................... Randolph County, W Virginia ...................................................................... ........................ 51 51 51420 ......................... Ritchie County, W Virginia ....................................................................... ........................... 51 51 51430 ......................... Roane County, W Virginia ......................................................................... .......................... 51 51 51440 ......................... Summers County, W Virginia ....................................................................... ....................... 51 51 51450 ......................... Taylor County, W Virginia ........................................................................ ........................... 51 51 51460 ......................... Tucker County, W Virginia ........................................................................ .......................... 51 51 51470 ......................... Tyler County, W Virginia ......................................................................... ............................ 51 51 51480 ......................... Upshur County, W Virginia ........................................................................ .......................... 51 51 51490 ......................... Wayne County, W Virginia ......................................................................... ......................... 3400 26580 51500 ......................... Webster County, W Virginia ....................................................................... ......................... 51 51 51510 ......................... Wetzel County, W Virginia ........................................................................ .......................... 51 51 51520 ......................... Wirt County, W Virginia .......................................................................... ............................. 51 37620 51530 ......................... Wood County, W Virginia .......................................................................... .......................... 6020 37620 51540 ......................... Wyoming County, W Virginia ....................................................................... ....................... 51 51 52000 ......................... Adams County, Wisconsin .......................................................................... ........................ 52 52 52010 ......................... Ashland County, Wisconsin ........................................................................ ........................ 52 52 52020 ......................... Barron County, Wisconsin ......................................................................... .......................... 52 52 52030 ......................... Bayfield County, Wisconsin ....................................................................... .......................... 52 52 52040 ......................... Brown County, Wisconsin .......................................................................... ......................... 3080 24580 52050 ......................... Buffalo County, Wisconsin ........................................................................ .......................... 52 52 52060 ......................... Burnett County, Wisconsin ........................................................................ .......................... 52 52 52070 ......................... Calumet County, Wisconsin ........................................................................ ........................ 0460 11540 52080 ......................... Chippewa County, Wisconsin ....................................................................... ...................... 2290 20740 52090 ......................... Clark County, Wisconsin .......................................................................... ........................... 52 52 52100 ......................... Columbia County, Wisconsin ....................................................................... ....................... 52 31540


## 46055 Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

52110 ......................... Crawford County, Wisconsin ....................................................................... ........................ 52 52 52120 ......................... Dane County, Wisconsin ........................................................................... .......................... 4720 31540 52130 ......................... Dodge County, Wisconsin .......................................................................... ......................... 52 52 52140 ......................... Door County, Wisconsin ........................................................................... ........................... 52 52 52150 ......................... Douglas County, Wisconsin ........................................................................ ........................ 2240 20260 52160 ......................... Dunn County, Wisconsin ........................................................................... .......................... 52 52 52170 ......................... Eau Claire County, Wisconsin ..................................................................... ....................... 2290 20740 52180 ......................... Florence County, Wisconsin ....................................................................... ........................ 52 52 52190 ......................... Fond Du Lac County, Wisconsin .................................................................... .................... 52 22540 52200 ......................... Forest County, Wisconsin ......................................................................... .......................... 52 52 52210 ......................... Grant County, Wisconsin .......................................................................... .......................... 52 52 52220 ......................... Green County, Wisconsin .......................................................................... ......................... 52 52 52230 ......................... Green Lake County, Wisconsin ..................................................................... ..................... 52 52 52240 ......................... Iowa County, Wisconsin ........................................................................... ........................... 52 31540 52250 ......................... Iron County, Wisconsin ........................................................................... ............................ 52 52 52260 ......................... Jackson County, Wisconsin ........................................................................ ........................ 52 52 52270 ......................... Jefferson County, Wisconsin ...................................................................... ......................... 52 52 52280 ......................... Juneau County, Wisconsin ......................................................................... ......................... 52 52 52290 ......................... Kenosha County, Wisconsin ........................................................................ ....................... 3800 29404 52300 ......................... Kewaunee County, Wisconsin ....................................................................... ..................... 52 24580 52310 ......................... La Crosse County, Wisconsin ...................................................................... ....................... 3870 29100 52320 ......................... Lafayette County, Wisconsin ...................................................................... ......................... 3880 52 52330 ......................... Langlade County, Wisconsin ....................................................................... ........................ 52 52 52340 ......................... Lincoln County, Wisconsin ........................................................................ .......................... 52 52 52350 ......................... Manitowoc County, Wisconsin ...................................................................... ...................... 52 52 52360 ......................... Marathon County, Wisconsin ....................................................................... ....................... 8940 48140 52370 ......................... Marinette County, Wisconsin ...................................................................... ........................ 52 52 52380 ......................... Marquette County, Wisconsin ...................................................................... ....................... 52 52 52381 ......................... Menominee County, Wisconsin ...................................................................... ..................... 52 52 52390 ......................... Milwaukee County, Wisconsin ...................................................................... ...................... 5080 33340 52400 ......................... Monroe County, Wisconsin ......................................................................... ........................ 52 52 52410 ......................... Oconto County, Wisconsin ......................................................................... ......................... 52 24580 52420 ......................... Oneida County, Wisconsin ......................................................................... ......................... 52 52 52430 ......................... Outagamie County, Wisconsin ...................................................................... ...................... 0460 11540 52440 ......................... Ozaukee County, Wisconsin ........................................................................ ....................... 5080 33340 52450 ......................... Pepin County, Wisconsin .......................................................................... .......................... 52 52 52460 ......................... Pierce County, Wisconsin ......................................................................... .......................... 52 33460 52470 ......................... Polk County, Wisconsin ........................................................................... ........................... 52 52 52480 ......................... Portage County, Wisconsin ........................................................................ ......................... 52 52 52490 ......................... Price County, Wisconsin .......................................................................... ........................... 52 52 52500 ......................... Racine County, Wisconsin ......................................................................... ......................... 6600 39540 52510 ......................... Richland County, Wisconsin ....................................................................... ........................ 52 52 52520 ......................... Rock County, Wisconsin ........................................................................... .......................... 3620 27500 52530 ......................... Rusk County, Wisconsin ........................................................................... .......................... 52 52 52540 ......................... St Croix County, Wisconsin ....................................................................... ......................... 5120 33460 52550 ......................... Sauk County, Wisconsin ........................................................................... .......................... 52 52 52560 ......................... Sawyer County, Wisconsin ......................................................................... ........................ 52 52 52570 ......................... Shawano County, Wisconsin ........................................................................ ...................... 52 52 52580 ......................... Sheboygan County, Wisconsin ...................................................................... ..................... 7620 43100 52590 ......................... Taylor County, Wisconsin ......................................................................... .......................... 52 52 52600 ......................... Trempealeau County, Wisconsin .................................................................... .................... 52 52 52610 ......................... Vernon County, Wisconsin ......................................................................... ......................... 52 52 52620 ......................... Vilas County, Wisconsin .......................................................................... ............................ 52 52 52630 ......................... Walworth County, Wisconsin ....................................................................... ....................... 52 52 52640 ......................... Washburn County, Wisconsin ....................................................................... ...................... 52 52 52650 ......................... Washington County, Wisconsin ..................................................................... ..................... 5080 33340 52660 ......................... Waukesha County, Wisconsin ....................................................................... ..................... 5080 33340 52670 ......................... Waupaca County, Wisconsin ........................................................................ ...................... 52 52 52680 ......................... Waushara County, Wisconsin ....................................................................... ...................... 52 52 52690 ......................... Winnebago County, Wisconsin ...................................................................... ..................... 0460 36780 52700 ......................... Wood County, Wisconsin ........................................................................... ......................... 52 52 53000 ......................... Albany County, Wyoming ........................................................................... ......................... 53 53 53010 ......................... Big Horn County, Wyoming ......................................................................... ........................ 53 53 53020 ......................... Campbell County, Wyoming ......................................................................... ....................... 53 53 53030 ......................... Carbon County, Wyoming ........................................................................... ........................ 53 53 53040 ......................... Converse County, Wyoming ......................................................................... ...................... 53 53 53050 ......................... Crook County, Wyoming ............................................................................ ......................... 53 53 53060 ......................... Fremont County, Wyoming .......................................................................... ....................... 53 53 53070 ......................... Goshen County, Wyoming ........................................................................... ....................... 53 53 53080 ......................... Hot Springs County, Wyoming ...................................................................... ...................... 53 53


## 46056

A DDENDUM 

### F.

— ESRD FACILITIES



### — M ETROPOLITAN 

### S TATISTICAL 

### A REAS 

### (MSA)/C ORE 

### -B ASED 

### S TATISTICAL 

### A REAS 

### (CBSA) C ROSSWALK



### —Continued

SSA state/county code County and state name ESRD MSA No. CBSA No.

53090 ......................... Johnson County, Wyoming .......................................................................... ....................... 53 53 53100 ......................... Laramie County, Wyoming .......................................................................... ........................ 1580 16940 53110 ......................... Lincoln County, Wyoming .......................................................................... ......................... 53 53 53120 ......................... Natrona County, Wyoming .......................................................................... ........................ 1350 16220 53130 ......................... Niobrara County, Wyoming ......................................................................... ........................ 53 53 53140 ......................... Park County, Wyoming ............................................................................. .......................... 53 53 53150 ......................... Platte County, Wyoming ........................................................................... ........................... 53 53 53160 ......................... Sheridan County, Wyoming ......................................................................... ....................... 53 53 53170 ......................... Sublette County, Wyoming ......................................................................... ......................... 53 53 53180 ......................... Sweetwater County, Wyoming ....................................................................... ..................... 53 53 53190 ......................... Teton County, Wyoming ............................................................................ .......................... 53 53 53200 ......................... Uinta County, Wyoming ............................................................................ .......................... 53 53 53210 ......................... Washakie County, Wyoming ......................................................................... ...................... 53 53 53220 ......................... Weston County, Wyoming ........................................................................... ........................ 53 53

—————————— CPT codes and descriptions only are copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS App ly. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### G.

— L IST OF 

### CPT/HCPCS C ODES 

### U SED TO 

### D ESCRIBE 

### N UCLEAR 

### M EDICINE 

### D ESIGNATED 

### H EALTH 

### S ERVICES 

### U NDER 

### S ECTION 

### 1877 OF THE 

### S OCIAL 

### S ECURITY 

### ACT
[Effective January 1, 2006]

CPT/HCPCS Codes MOD Description Status code

78000 ............................ .................. Thyroid, single uptake ...................................................... .............................................................. A 78000 ............................ TC ............ Thyroid, single uptake .......................................................... .......................................................... A 78000 ............................ 26 ............. Thyroid, single uptake ......................................................... ........................................................... A 78001 ............................ .................. Thyroid, multiple uptakes ................................................... ............................................................ A 78001 ............................ TC ............ Thyroid, multiple uptakes ....................................................... ........................................................ A 78001 ............................ 26 ............. Thyroid, multiple uptakes ...................................................... ......................................................... A 78003 ............................ .................. Thyroid suppress/stimul ..................................................... ............................................................ A 78003 ............................ TC ............ Thyroid suppress/stimul ......................................................... ........................................................ A 78003 ............................ 26 ............. Thyroid suppress/stimul ........................................................ ......................................................... A 78006 ............................ .................. Thyroid imaging with uptake ................................................. ......................................................... A 78006 ............................ TC ............ Thyroid imaging with uptake ..................................................... ..................................................... A 78006 ............................ 26 ............. Thyroid imaging with uptake .................................................... ...................................................... A 78007 ............................ .................. Thyroid image, mult uptakes ................................................. ......................................................... A 78007 ............................ TC ............ Thyroid image, mult uptakes ..................................................... ..................................................... A 78007 ............................ 26 ............. Thyroid image, mult uptakes .................................................... ...................................................... A 78010 ............................ .................. Thyroid imaging ............................................................. ................................................................. A 78010 ............................ TC ............ Thyroid imaging ................................................................. ............................................................. A 78010 ............................ 26 ............. Thyroid imaging ................................................................ .............................................................. A 78011 ............................ .................. Thyroid imaging with flow ................................................... ........................................................... A 78011 ............................ TC ............ Thyroid imaging with flow ....................................................... ....................................................... A 78011 ............................ 26 ............. Thyroid imaging with flow ...................................................... ........................................................ A 78015 ............................ .................. Thyroid met imaging ......................................................... ............................................................. A 78015 ............................ TC ............ Thyroid met imaging ............................................................. ......................................................... A 78015 ............................ 26 ............. Thyroid met imaging ............................................................ .......................................................... A 78016 ............................ .................. Thyroid met imaging/studies ................................................. ......................................................... A 78016 ............................ TC ............ Thyroid met imaging/studies ..................................................... ..................................................... A 78016 ............................ 26 ............. Thyroid met imaging/studies .................................................... ...................................................... A 78018 ............................ .................. Thyroid met imaging, body ................................................... ......................................................... A 78018 ............................ TC ............ Thyroid met imaging, body ....................................................... ..................................................... A 78018 ............................ 26 ............. Thyroid met imaging, body ...................................................... ...................................................... A 78020 ............................ .................. Thyroid met uptake .......................................................... .............................................................. A 78020 ............................ TC ............ Thyroid met uptake .............................................................. .......................................................... A 78020 ............................ 26 ............. Thyroid met uptake ............................................................. ........................................................... A 78070 ............................ .................. Parathyroid nuclear imaging ................................................. ......................................................... A 78070 ............................ TC ............ Parathyroid nuclear imaging ..................................................... ..................................................... A 78070 ............................ 26 ............. Parathyroid nuclear imaging .................................................... ...................................................... A 78075 ............................ .................. Adrenal nuclear imaging ..................................................... ........................................................... A 78075 ............................ TC ............ Adrenal nuclear imaging ......................................................... ....................................................... A 78075 ............................ 26 ............. Adrenal nuclear imaging ........................................................ ........................................................ A 78099 ............................ .................. Endocrine nuclear procedure ................................................. ........................................................ C 78099 ............................ TC ............ Endocrine nuclear procedure ..................................................... .................................................... C 78099 ............................ 26 ............. Endocrine nuclear procedure .................................................... ..................................................... C


## 46057

—————————— CPT codes and descriptions only are copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS App ly. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### G.

— L IST OF 

### CPT/HCPCS C ODES 

### U SED TO 

### D ESCRIBE 

### N UCLEAR 

### M EDICINE 

### D ESIGNATED 

### H EALTH 

### S ERVICES 

### U NDER 

### S ECTION 

### 1877 OF THE 

### S OCIAL 

### S ECURITY 

### ACT



### —Continued

[Effective January 1, 2006]

CPT/HCPCS Codes MOD Description Status code

78102 ............................ .................. Bone marrow imaging, ltd .................................................... .......................................................... A 78102 ............................ TC ............ Bone marrow imaging, ltd ........................................................ ...................................................... A 78102 ............................ 26 ............. Bone marrow imaging, ltd ....................................................... ....................................................... A 78103 ............................ .................. Bone marrow imaging, mult ................................................... ........................................................ A 78103 ............................ TC ............ Bone marrow imaging, mult ....................................................... .................................................... A 78103 ............................ 26 ............. Bone marrow imaging, mult ...................................................... ..................................................... A 78104 ............................ .................. Bone marrow imaging, body ................................................... ....................................................... A 78104 ............................ TC ............ Bone marrow imaging, body ....................................................... ................................................... A 78104 ............................ 26 ............. Bone marrow imaging, body ...................................................... .................................................... A 78110 ............................ .................. Plasma volume, single ....................................................... ............................................................ A 78110 ............................ TC ............ Plasma volume, single ........................................................... ........................................................ A 78110 ............................ 26 ............. Plasma volume, single .......................................................... ......................................................... A 78111 ............................ .................. Plasma volume, multiple ..................................................... ........................................................... A 78111 ............................ TC ............ Plasma volume, multiple ......................................................... ....................................................... A 78111 ............................ 26 ............. Plasma volume, multiple ........................................................ ........................................................ A 78120 ............................ .................. Red cell mass, single ....................................................... .............................................................. A 78120 ............................ TC ............ Red cell mass, single ........................................................... .......................................................... A 78120 ............................ 26 ............. Red cell mass, single .......................................................... ........................................................... A 78121 ............................ .................. Red cell mass, multiple ..................................................... ............................................................. A 78121 ............................ TC ............ Red cell mass, multiple ......................................................... ......................................................... A 78121 ............................ 26 ............. Red cell mass, multiple ........................................................ .......................................................... A 78122 ............................ .................. Blood volume ................................................................ ................................................................. A 78122 ............................ TC ............ Blood volume .................................................................... ............................................................. A 78122 ............................ 26 ............. Blood volume ................................................................... .............................................................. A 78130 ............................ .................. Red cell survival study ..................................................... .............................................................. A 78130 ............................ TC ............ Red cell survival study ......................................................... .......................................................... A 78130 ............................ 26 ............. Red cell survival study ........................................................ ........................................................... A 78135 ............................ .................. Red cell survival kinetics .................................................. .............................................................. A 78135 ............................ TC ............ Red cell survival kinetics ...................................................... .......................................................... A 78135 ............................ 26 ............. Red cell survival kinetics ..................................................... ........................................................... A 78140 ............................ .................. Red cell sequestration ...................................................... ............................................................. A 78140 ............................ TC ............ Red cell sequestration .......................................................... ......................................................... A 78140 ............................ 26 ............. Red cell sequestration ......................................................... .......................................................... A 78160 ............................ .................. Plasma iron turnover ........................................................ .............................................................. A 78160 ............................ TC ............ Plasma iron turnover ............................................................ .......................................................... A 78160 ............................ 26 ............. Plasma iron turnover ........................................................... ........................................................... A 78162 ............................ .................. Radioiron absorption exam ................................................... ......................................................... A 78162 ............................ TC ............ Radioiron absorption exam ....................................................... ..................................................... A 78162 ............................ 26 ............. Radioiron absorption exam ...................................................... ...................................................... A 78170 ............................ .................. Red cell iron utilization ................................................... ................................................................ A 78170 ............................ TC ............ Red cell iron utilization ....................................................... ............................................................ A 78170 ............................ 26 ............. Red cell iron utilization ...................................................... ............................................................. A 78172 ............................ .................. Total body iron estimation .................................................. ............................................................ C 78172 ............................ TC ............ Total body iron estimation ...................................................... ........................................................ C 78172 ............................ 26 ............. Total body iron estimation ..................................................... ......................................................... A 78185 ............................ .................. Spleen imaging .............................................................. ................................................................ A 78185 ............................ TC ............ Spleen imaging .................................................................. ............................................................ A 78185 ............................ 26 ............. Spleen imaging ................................................................. ............................................................. A 78190 ............................ .................. Platelet survival, kinetics ................................................. ............................................................... A 78190 ............................ TC ............ Platelet survival, kinetics ..................................................... ........................................................... A 78190 ............................ 26 ............. Platelet survival, kinetics .................................................... ............................................................ A 78191 ............................ .................. Platelet survival ........................................................... ................................................................... A 78191 ............................ TC ............ Platelet survival ............................................................... ............................................................... A 78191 ............................ 26 ............. Platelet survival .............................................................. ................................................................ A 78195 ............................ .................. Lymph system imaging ........................................................ .......................................................... A 78195 ............................ TC ............ Lymph system imaging ............................................................ ...................................................... A 78195 ............................ 26 ............. Lymph system imaging ........................................................... ....................................................... A 78199 ............................ .................. Blood/lymph nuclear exam .................................................... ......................................................... C 78199 ............................ TC ............ Blood/lymph nuclear exam ........................................................ ..................................................... C 78199 ............................ 26 ............. Blood/lymph nuclear exam ....................................................... ...................................................... C 78201 ............................ .................. Liver imaging ............................................................... ................................................................... A 78201 ............................ TC ............ Liver imaging ................................................................... ............................................................... A 78201 ............................ 26 ............. Liver imaging .................................................................. ................................................................ A 78202 ............................ .................. Liver imaging with flow ..................................................... .............................................................. A


## 46058

—————————— CPT codes and descriptions only are copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS App ly. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### G.

— L IST OF 

### CPT/HCPCS C ODES 

### U SED TO 

### D ESCRIBE 

### N UCLEAR 

### M EDICINE 

### D ESIGNATED 

### H EALTH 

### S ERVICES 

### U NDER 

### S ECTION 

### 1877 OF THE 

### S OCIAL 

### S ECURITY 

### ACT



### —Continued

[Effective January 1, 2006]

CPT/HCPCS Codes MOD Description Status code

78202 ............................ TC ............ Liver imaging with flow ......................................................... .......................................................... A 78202 ............................ 26 ............. Liver imaging with flow ........................................................ ........................................................... A 78205 ............................ .................. Liver imaging (3D) .......................................................... ................................................................ A 78205 ............................ TC ............ Liver imaging (3D) .............................................................. ............................................................ A 78205 ............................ 26 ............. Liver imaging (3D) ............................................................. ............................................................. A 78206 ............................ .................. Liver image (3d) with flow .................................................. ............................................................ A 78206 ............................ TC ............ Liver image (3d) with flow ...................................................... ........................................................ A 78206 ............................ 26 ............. Liver image (3d) with flow ..................................................... ......................................................... A 78215 ............................ .................. Liver and spleen imaging .................................................... ........................................................... A 78215 ............................ TC ............ Liver and spleen imaging ........................................................ ....................................................... A 78215 ............................ 26 ............. Liver and spleen imaging ....................................................... ........................................................ A 78216 ............................ .................. Liver & spleen image/flow ................................................... ........................................................... A 78216 ............................ TC ............ Liver & spleen image/flow ....................................................... ....................................................... A 78216 ............................ 26 ............. Liver & spleen image/flow ...................................................... ........................................................ A 78220 ............................ .................. Liver function study ........................................................ ................................................................ A 78220 ............................ TC ............ Liver function study ............................................................ ............................................................ A 78220 ............................ 26 ............. Liver function study ........................................................... ............................................................. A 78223 ............................ .................. Hepatobiliary imaging ....................................................... .............................................................. A 78223 ............................ TC ............ Hepatobiliary imaging ........................................................... .......................................................... A 78223 ............................ 26 ............. Hepatobiliary imaging .......................................................... ........................................................... A 78230 ............................ .................. Salivary gland imaging ...................................................... ............................................................. A 78230 ............................ TC ............ Salivary gland imaging .......................................................... ......................................................... A 78230 ............................ 26 ............. Salivary gland imaging ......................................................... .......................................................... A 78231 ............................ .................. Serial salivary imaging ..................................................... .............................................................. A 78231 ............................ TC ............ Serial salivary imaging ......................................................... .......................................................... A 78231 ............................ 26 ............. Serial salivary imaging ........................................................ ........................................................... A 78232 ............................ .................. Salivary gland function exam ................................................ ......................................................... A 78232 ............................ TC ............ Salivary gland function exam .................................................... ..................................................... A 78232 ............................ 26 ............. Salivary gland function exam ................................................... ...................................................... A 78258 ............................ .................. Esophageal motility study ................................................... ........................................................... A 78258 ............................ TC ............ Esophageal motility study ....................................................... ....................................................... A 78258 ............................ 26 ............. Esophageal motility study ...................................................... ........................................................ A 78261 ............................ .................. Gastric mucosa imaging ...................................................... .......................................................... A 78261 ............................ TC ............ Gastric mucosa imaging .......................................................... ...................................................... A 78261 ............................ 26 ............. Gastric mucosa imaging ......................................................... ....................................................... A 78262 ............................ .................. Gastroesophageal reflux exam ................................................ ...................................................... A 78262 ............................ TC ............ Gastroesophageal reflux exam .................................................... .................................................. A 78262 ............................ 26 ............. Gastroesophageal reflux exam ................................................... ................................................... A 78264 ............................ .................. Gastric emptying study ...................................................... ............................................................ A 78264 ............................ TC ............ Gastric emptying study .......................................................... ........................................................ A 78264 ............................ 26 ............. Gastric emptying study ......................................................... ......................................................... A 78270 ............................ .................. Vit B-12 absorption exam .................................................... .......................................................... A 78270 ............................ TC ............ Vit B-12 absorption exam ........................................................ ...................................................... A 78270 ............................ 26 ............. Vit B-12 absorption exam ....................................................... ....................................................... A 78271 ............................ .................. Vit b-12 absrp exam, int fac ................................................ ........................................................... A 78271 ............................ TC ............ Vit b-12 absrp exam, int fac .................................................... ....................................................... A 78271 ............................ 26 ............. Vit b-12 absrp exam, int fac ................................................... ........................................................ A 78272 ............................ .................. Vit B-12 absorp, combined ................................................... ......................................................... A 78272 ............................ TC ............ Vit B-12 absorp, combined ....................................................... ..................................................... A 78272 ............................ 26 ............. Vit B-12 absorp, combined ...................................................... ...................................................... A 78278 ............................ .................. Acute GI blood loss imaging ................................................. ......................................................... A 78278 ............................ TC ............ Acute GI blood loss imaging ..................................................... ..................................................... A 78278 ............................ 26 ............. Acute GI blood loss imaging .................................................... ...................................................... A 78282 ............................ .................. GI protein loss exam ........................................................ .............................................................. C 78282 ............................ TC ............ GI protein loss exam ............................................................ .......................................................... C 78282 ............................ 26 ............. GI protein loss exam ........................................................... ........................................................... A 78290 ............................ .................. Meckel ’ s divert exam .................................................................................................................. ... A 78290 ............................ TC ............ Meckel ’ s divert exam .................................................................................................................. ... A 78290 ............................ 26 ............. Meckel ’ s divert exam .................................................................................................................. ... A 78291 ............................ .................. Leveen/shunt patency exam ................................................... ....................................................... A 78291 ............................ TC ............ Leveen/shunt patency exam ....................................................... ................................................... A 78291 ............................ 26 ............. Leveen/shunt patency exam ...................................................... .................................................... A 78299 ............................ .................. GI nuclear procedure ........................................................ ............................................................. C 78299 ............................ TC ............ GI nuclear procedure ............................................................ ......................................................... C


## 46059

—————————— CPT codes and descriptions only are copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS App ly. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### G.

— L IST OF 

### CPT/HCPCS C ODES 

### U SED TO 

### D ESCRIBE 

### N UCLEAR 

### M EDICINE 

### D ESIGNATED 

### H EALTH 

### S ERVICES 

### U NDER 

### S ECTION 

### 1877 OF THE 

### S OCIAL 

### S ECURITY 

### ACT



### —Continued

[Effective January 1, 2006]

CPT/HCPCS Codes MOD Description Status code

78299 ............................ 26 ............. GI nuclear procedure ........................................................... .......................................................... C 78300 ............................ .................. Bone imaging, limited area .................................................. .......................................................... A 78300 ............................ TC ............ Bone imaging, limited area ...................................................... ...................................................... A 78300 ............................ 26 ............. Bone imaging, limited area ..................................................... ....................................................... A 78305 ............................ .................. Bone imaging, multiple areas ................................................ ........................................................ A 78305 ............................ TC ............ Bone imaging, multiple areas .................................................... .................................................... A 78305 ............................ 26 ............. Bone imaging, multiple areas ................................................... ..................................................... A 78306 ............................ .................. Bone imaging, whole body .................................................... ......................................................... A 78306 ............................ TC ............ Bone imaging, whole body ........................................................ ..................................................... A 78306 ............................ 26 ............. Bone imaging, whole body ....................................................... ...................................................... A 78315 ............................ .................. Bone imaging, 3 phase ....................................................... ........................................................... A 78315 ............................ TC ............ Bone imaging, 3 phase ........................................................... ....................................................... A 78315 ............................ 26 ............. Bone imaging, 3 phase .......................................................... ........................................................ A 78320 ............................ .................. Bone imaging (3D) ........................................................... .............................................................. A 78320 ............................ TC ............ Bone imaging (3D) ............................................................... .......................................................... A 78320 ............................ 26 ............. Bone imaging (3D) .............................................................. ........................................................... A 78350 ............................ .................. Bone mineral, single photon ................................................. ......................................................... A 78350 ............................ TC ............ Bone mineral, single photon ..................................................... ..................................................... A 78350 ............................ 26 ............. Bone mineral, single photon .................................................... ...................................................... A 78351 ............................ .................. Bone mineral, dual photon ................................................... .......................................................... N 78399 ............................ .................. Musculoskeletal nuclear exam ................................................ ....................................................... C 78399 ............................ TC ............ Musculoskeletal nuclear exam .................................................... ................................................... C 78399 ............................ 26 ............. Musculoskeletal nuclear exam ................................................... .................................................... C 78414 ............................ .................. Non-imaging heart function .................................................. .......................................................... C 78414 ............................ TC ............ Non-imaging heart function ...................................................... ...................................................... C 78414 ............................ 26 ............. Non-imaging heart function ..................................................... ....................................................... A 78428 ............................ .................. Cardiac shunt imaging ....................................................... ............................................................ A 78428 ............................ TC ............ Cardiac shunt imaging ........................................................... ........................................................ A 78428 ............................ 26 ............. Cardiac shunt imaging .......................................................... ......................................................... A 78445 ............................ .................. Vascular flow imaging ....................................................... ............................................................. A 78445 ............................ TC ............ Vascular flow imaging ........................................................... ......................................................... A 78445 ............................ 26 ............. Vascular flow imaging .......................................................... .......................................................... A 78455 ............................ .................. Venous thrombosis study ..................................................... .......................................................... A 78455 ............................ TC ............ Venous thrombosis study ......................................................... ...................................................... A 78455 ............................ 26 ............. Venous thrombosis study ........................................................ ....................................................... A 78456 ............................ .................. Acute venous thrombus image ................................................. ..................................................... A 78456 ............................ TC ............ Acute venous thrombus image ..................................................... ................................................. A 78456 ............................ 26 ............. Acute venous thrombus image .................................................... .................................................. A 78457 ............................ .................. Venous thrombosis imaging ................................................... ........................................................ A 78457 ............................ TC ............ Venous thrombosis imaging ....................................................... .................................................... A 78457 ............................ 26 ............. Venous thrombosis imaging ...................................................... ..................................................... A 78458 ............................ .................. Ven thrombosis images, bilat ................................................ ......................................................... A 78458 ............................ TC ............ Ven thrombosis images, bilat .................................................... ..................................................... A 78458 ............................ 26 ............. Ven thrombosis images, bilat ................................................... ...................................................... A 78459 ............................ .................. Heart muscle imaging (PET) .................................................. ........................................................ C 78459 ............................ TC ............ Heart muscle imaging (PET) ...................................................... .................................................... C 78459 ............................ 26 ............. Heart muscle imaging (PET) ..................................................... ..................................................... A 78460 ............................ .................. Heart muscle blood, single .................................................. .......................................................... A 78460 ............................ TC ............ Heart muscle blood, single ...................................................... ...................................................... A 78460 ............................ 26 ............. Heart muscle blood, single ..................................................... ....................................................... A 78461 ............................ .................. Heart muscle blood, multiple ................................................ ......................................................... A 78461 ............................ TC ............ Heart muscle blood, multiple .................................................... ..................................................... A 78461 ............................ 26 ............. Heart muscle blood, multiple ................................................... ...................................................... A 78464 ............................ .................. Heart image (3d), single .................................................... ............................................................ A 78464 ............................ TC ............ Heart image (3d), single ........................................................ ........................................................ A 78464 ............................ 26 ............. Heart image (3d), single ....................................................... ......................................................... A 78465 ............................ .................. Heart image (3d), multiple .................................................. ........................................................... A 78465 ............................ TC ............ Heart image (3d), multiple ...................................................... ....................................................... A 78465 ............................ 26 ............. Heart image (3d), multiple ..................................................... ........................................................ A 78466 ............................ .................. Heart infarct image ......................................................... ................................................................ A 78466 ............................ TC ............ Heart infarct image ............................................................. ............................................................ A 78466 ............................ 26 ............. Heart infarct image ............................................................ ............................................................. A 78468 ............................ .................. Heart infarct image (ef) .................................................... .............................................................. A 78468 ............................ TC ............ Heart infarct image (ef) ........................................................ .......................................................... A


## 46060

—————————— CPT codes and descriptions only are copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS App ly. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### G.

— L IST OF 

### CPT/HCPCS C ODES 

### U SED TO 

### D ESCRIBE 

### N UCLEAR 

### M EDICINE 

### D ESIGNATED 

### H EALTH 

### S ERVICES 

### U NDER 

### S ECTION 

### 1877 OF THE 

### S OCIAL 

### S ECURITY 

### ACT



### —Continued

[Effective January 1, 2006]

CPT/HCPCS Codes MOD Description Status code

78468 ............................ 26 ............. Heart infarct image (ef) ....................................................... ........................................................... A 78469 ............................ .................. Heart infarct image (3D) .................................................... ............................................................ A 78469 ............................ TC ............ Heart infarct image (3D) ........................................................ ........................................................ A 78469 ............................ 26 ............. Heart infarct image (3D) ....................................................... ......................................................... A 78472 ............................ .................. Gated heart, planar, single ................................................. ........................................................... A 78472 ............................ TC ............ Gated heart, planar, single ..................................................... ....................................................... A 78472 ............................ 26 ............. Gated heart, planar, single .................................................... ........................................................ A 78473 ............................ .................. Gated heart, multiple ....................................................... ............................................................... A 78473 ............................ TC ............ Gated heart, multiple ........................................................... ........................................................... A 78473 ............................ 26 ............. Gated heart, multiple .......................................................... ............................................................ A 78478 ............................ .................. Heart wall motion add-on .................................................... ........................................................... A 78478 ............................ TC ............ Heart wall motion add-on ........................................................ ....................................................... A 78478 ............................ 26 ............. Heart wall motion add-on ....................................................... ........................................................ A 78480 ............................ .................. Heart function add-on ....................................................... ............................................................. A 78480 ............................ TC ............ Heart function add-on ........................................................... ......................................................... A 78480 ............................ 26 ............. Heart function add-on .......................................................... .......................................................... A 78481 ............................ .................. Heart first pass, single .................................................... ............................................................... A 78481 ............................ TC ............ Heart first pass, single ........................................................ ........................................................... A 78481 ............................ 26 ............. Heart first pass, single ....................................................... ............................................................ A 78483 ............................ .................. Heart first pass, multiple .................................................. .............................................................. A 78483 ............................ TC ............ Heart first pass, multiple ...................................................... .......................................................... A 78483 ............................ 26 ............. Heart first pass, multiple ..................................................... ........................................................... A 78491 ............................ .................. Heart image (pet), single ................................................... ............................................................ C 78491 ............................ TC ............ Heart image (pet), single ....................................................... ........................................................ C 78491 ............................ 26 ............. Heart image (pet), single ...................................................... ......................................................... A 78492 ............................ .................. Heart image (pet), multiple ................................................. ........................................................... C 78492 ............................ TC ............ Heart image (pet), multiple ..................................................... ....................................................... C 78492 ............................ 26 ............. Heart image (pet), multiple .................................................... ........................................................ A 78494 ............................ .................. Heart image, spect .......................................................... ............................................................... A 78494 ............................ TC ............ Heart image, spect .............................................................. ........................................................... A 78494 ............................ 26 ............. Heart image, spect ............................................................. ............................................................ A 78496 ............................ .................. Heart first pass add-on ..................................................... ............................................................. A 78496 ............................ TC ............ Heart first pass add-on ......................................................... ......................................................... A 78496 ............................ 26 ............. Heart first pass add-on ........................................................ .......................................................... A 78499 ............................ .................. Cardiovascular nuclear exam ................................................. ....................................................... C 78499 ............................ TC ............ Cardiovascular nuclear exam ..................................................... ................................................... C 78499 ............................ 26 ............. Cardiovascular nuclear exam .................................................... .................................................... C 78580 ............................ .................. Lung perfusion imaging ...................................................... ............................................................ A 78580 ............................ TC ............ Lung perfusion imaging .......................................................... ........................................................ A 78580 ............................ 26 ............. Lung perfusion imaging ......................................................... ......................................................... A 78584 ............................ .................. Lung V/Q image single breath ................................................ ....................................................... A 78584 ............................ TC ............ Lung V/Q image single breath .................................................... ................................................... A 78584 ............................ 26 ............. Lung V/Q image single breath ................................................... .................................................... A 78585 ............................ .................. Lung V/Q imaging ............................................................ .............................................................. A 78585 ............................ TC ............ Lung V/Q imaging ................................................................ .......................................................... A 78585 ............................ 26 ............. Lung V/Q imaging ............................................................... ........................................................... A 78586 ............................ .................. Aerosol lung image, single .................................................. ........................................................... A 78586 ............................ TC ............ Aerosol lung image, single ...................................................... ....................................................... A 78586 ............................ 26 ............. Aerosol lung image, single ..................................................... ........................................................ A 78587 ............................ .................. Aerosol lung image, multiple ................................................ .......................................................... A 78587 ............................ TC ............ Aerosol lung image, multiple .................................................... ...................................................... A 78587 ............................ 26 ............. Aerosol lung image, multiple ................................................... ....................................................... A 78588 ............................ .................. Perfusion lung image ........................................................ ............................................................. A 78588 ............................ TC ............ Perfusion lung image ............................................................ ......................................................... A 78588 ............................ 26 ............. Perfusion lung image ........................................................... .......................................................... A 78591 ............................ .................. Vent image, 1 breath, 1 proj ................................................ .......................................................... A 78591 ............................ TC ............ Vent image, 1 breath, 1 proj .................................................... ...................................................... A 78591 ............................ 26 ............. Vent image, 1 breath, 1 proj ................................................... ....................................................... A 78593 ............................ .................. Vent image, 1 proj, gas ..................................................... ............................................................. A 78593 ............................ TC ............ Vent image, 1 proj, gas ......................................................... ......................................................... A 78593 ............................ 26 ............. Vent image, 1 proj, gas ........................................................ .......................................................... A 78594 ............................ .................. Vent image, mult proj, gas .................................................. ........................................................... A 78594 ............................ TC ............ Vent image, mult proj, gas ...................................................... ....................................................... A 78594 ............................ 26 ............. Vent image, mult proj, gas ..................................................... ........................................................ A


## 46061

—————————— CPT codes and descriptions only are copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS App ly. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### G.

— L IST OF 

### CPT/HCPCS C ODES 

### U SED TO 

### D ESCRIBE 

### N UCLEAR 

### M EDICINE 

### D ESIGNATED 

### H EALTH 

### S ERVICES 

### U NDER 

### S ECTION 

### 1877 OF THE 

### S OCIAL 

### S ECURITY 

### ACT



### —Continued

[Effective January 1, 2006]

CPT/HCPCS Codes MOD Description Status code

78596 ............................ .................. Lung differential function .................................................. .............................................................. A 78596 ............................ TC ............ Lung differential function ...................................................... .......................................................... A 78596 ............................ 26 ............. Lung differential function ..................................................... ........................................................... A 78599 ............................ .................. Respiratory nuclear exam .................................................... .......................................................... C 78599 ............................ TC ............ Respiratory nuclear exam ........................................................ ...................................................... C 78599 ............................ 26 ............. Respiratory nuclear exam ....................................................... ....................................................... C 78600 ............................ .................. Brain imaging, ltd static ................................................... ............................................................... A 78600 ............................ TC ............ Brain imaging, ltd static ....................................................... ........................................................... A 78600 ............................ 26 ............. Brain imaging, ltd static ...................................................... ............................................................ A 78601 ............................ .................. Brain imaging, ltd w/flow ................................................... ............................................................. A 78601 ............................ TC ............ Brain imaging, ltd w/flow ....................................................... ......................................................... A 78601 ............................ 26 ............. Brain imaging, ltd w/flow ...................................................... .......................................................... A 78605 ............................ .................. Brain imaging, complete ..................................................... ........................................................... A 78605 ............................ TC ............ Brain imaging, complete ......................................................... ....................................................... A 78605 ............................ 26 ............. Brain imaging, complete ........................................................ ........................................................ A 78606 ............................ .................. Brain imaging, compl w/flow ................................................. ......................................................... A 78606 ............................ TC ............ Brain imaging, compl w/flow ..................................................... ..................................................... A 78606 ............................ 26 ............. Brain imaging, compl w/flow .................................................... ...................................................... A 78607 ............................ .................. Brain imaging (3D) .......................................................... ............................................................... A 78607 ............................ TC ............ Brain imaging (3D) .............................................................. ........................................................... A 78607 ............................ 26 ............. Brain imaging (3D) ............................................................. ............................................................ A 78608 ............................ .................. Brain imaging (PET) ......................................................... .............................................................. C 78608 ............................ TC ............ Brain imaging (PET) ............................................................. .......................................................... C 78608 ............................ 26 ............. Brain imaging (PET) ............................................................ ........................................................... A 78609 ............................ .................. Brain imaging (PET) ......................................................... .............................................................. C 78609 ............................ TC ............ Brain imaging (PET) ............................................................. .......................................................... C 78609 ............................ 26 ............. Brain imaging (PET) ............................................................ ........................................................... A 78610 ............................ .................. Brain flow imaging only ..................................................... ............................................................. A 78610 ............................ TC ............ Brain flow imaging only ......................................................... ......................................................... A 78610 ............................ 26 ............. Brain flow imaging only ........................................................ .......................................................... A 78615 ............................ .................. Cerebral vascular flow image ................................................ ........................................................ A 78615 ............................ TC ............ Cerebral vascular flow image .................................................... .................................................... A 78615 ............................ 26 ............. Cerebral vascular flow image ................................................... ..................................................... A 78630 ............................ .................. Cerebrospinal fluid scan .................................................... ............................................................ A 78630 ............................ TC ............ Cerebrospinal fluid scan ........................................................ ........................................................ A 78630 ............................ 26 ............. Cerebrospinal fluid scan ....................................................... ......................................................... A 78635 ............................ .................. CSF ventriculography ........................................................ ............................................................. A 78635 ............................ TC ............ CSF ventriculography ............................................................ ......................................................... A 78635 ............................ 26 ............. CSF ventriculography ........................................................... .......................................................... A 78645 ............................ .................. CSF shunt evaluation ........................................................ ............................................................. A 78645 ............................ TC ............ CSF shunt evaluation ............................................................ ......................................................... A 78645 ............................ 26 ............. CSF shunt evaluation ........................................................... .......................................................... A 78647 ............................ .................. Cerebrospinal fluid scan .................................................... ............................................................ A 78647 ............................ TC ............ Cerebrospinal fluid scan ........................................................ ........................................................ A 78647 ............................ 26 ............. Cerebrospinal fluid scan ....................................................... ......................................................... A 78650 ............................ .................. CSF leakage imaging ......................................................... ............................................................ A 78650 ............................ TC ............ CSF leakage imaging ............................................................. ........................................................ A 78650 ............................ 26 ............. CSF leakage imaging ............................................................ ......................................................... A 78660 ............................ .................. Nuclear exam of tear flow ................................................... ........................................................... A 78660 ............................ TC ............ Nuclear exam of tear flow ....................................................... ....................................................... A 78660 ............................ 26 ............. Nuclear exam of tear flow ...................................................... ........................................................ A 78699 ............................ .................. Nervous system nuclear exam ................................................. ..................................................... C 78699 ............................ TC ............ Nervous system nuclear exam ..................................................... ................................................. C 78699 ............................ 26 ............. Nervous system nuclear exam .................................................... .................................................. C 78700 ............................ .................. Kidney imaging, static ...................................................... .............................................................. A 78700 ............................ TC ............ Kidney imaging, static .......................................................... .......................................................... A 78700 ............................ 26 ............. Kidney imaging, static ......................................................... ........................................................... A 78701 ............................ .................. Kidney imaging with flow .................................................... ........................................................... A 78701 ............................ TC ............ Kidney imaging with flow ........................................................ ....................................................... A 78701 ............................ 26 ............. Kidney imaging with flow ....................................................... ........................................................ A 78704 ............................ .................. Imaging renogram ............................................................ .............................................................. A 78704 ............................ TC ............ Imaging renogram ................................................................ .......................................................... A 78704 ............................ 26 ............. Imaging renogram ............................................................... ........................................................... A 78707 ............................ .................. Kidney flow/function image .................................................. .......................................................... A


## 46062

—————————— CPT codes and descriptions only are copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS App ly. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### G.

— L IST OF 

### CPT/HCPCS C ODES 

### U SED TO 

### D ESCRIBE 

### N UCLEAR 

### M EDICINE 

### D ESIGNATED 

### H EALTH 

### S ERVICES 

### U NDER 

### S ECTION 

### 1877 OF THE 

### S OCIAL 

### S ECURITY 

### ACT



### —Continued

[Effective January 1, 2006]

CPT/HCPCS Codes MOD Description Status code

78707 ............................ TC ............ Kidney flow/function image ...................................................... ...................................................... A 78707 ............................ 26 ............. Kidney flow/function image ..................................................... ....................................................... A 78708 ............................ .................. Kidney flow/function image .................................................. .......................................................... A 78708 ............................ TC ............ Kidney flow/function image ...................................................... ...................................................... A 78708 ............................ 26 ............. Kidney flow/function image ..................................................... ....................................................... A 78709 ............................ .................. Kidney flow/function image .................................................. .......................................................... A 78709 ............................ TC ............ Kidney flow/function image ...................................................... ...................................................... A 78709 ............................ 26 ............. Kidney flow/function image ..................................................... ....................................................... A 78710 ............................ .................. Kidney imaging (3D) ......................................................... ............................................................. A 78710 ............................ TC ............ Kidney imaging (3D) ............................................................. ......................................................... A 78710 ............................ 26 ............. Kidney imaging (3D) ............................................................ .......................................................... A 78715 ............................ .................. Renal vascular flow exam .................................................... .......................................................... A 78715 ............................ TC ............ Renal vascular flow exam ........................................................ ...................................................... A 78715 ............................ 26 ............. Renal vascular flow exam ....................................................... ....................................................... A 78725 ............................ .................. Kidney function study ....................................................... .............................................................. A 78725 ............................ TC ............ Kidney function study ........................................................... .......................................................... A 78725 ............................ 26 ............. Kidney function study .......................................................... ........................................................... A 78730 ............................ .................. Urinary bladder retention ................................................... ............................................................ A 78730 ............................ TC ............ Urinary bladder retention ....................................................... ........................................................ A 78730 ............................ 26 ............. Urinary bladder retention ...................................................... ......................................................... A 78740 ............................ .................. Ureteral reflux study ....................................................... ................................................................ A 78740 ............................ TC ............ Ureteral reflux study ........................................................... ............................................................ A 78740 ............................ 26 ............. Ureteral reflux study .......................................................... ............................................................. A 78760 ............................ .................. Testicular imaging .......................................................... ................................................................ A 78760 ............................ TC ............ Testicular imaging .............................................................. ............................................................ A 78760 ............................ 26 ............. Testicular imaging ............................................................. ............................................................. A 78761 ............................ .................. Testicular imaging/flow ..................................................... .............................................................. A 78761 ............................ TC ............ Testicular imaging/flow ......................................................... .......................................................... A 78761 ............................ 26 ............. Testicular imaging/flow ........................................................ ........................................................... A 78799 ............................ .................. Genitourinary nuclear exam .................................................. ......................................................... C 78799 ............................ TC ............ Genitourinary nuclear exam ...................................................... ..................................................... C 78799 ............................ 26 ............. Genitourinary nuclear exam ..................................................... ...................................................... C 78800 ............................ .................. Tumor imaging, limited area ................................................. ......................................................... A 78800 ............................ TC ............ Tumor imaging, limited area ..................................................... ..................................................... A 78800 ............................ 26 ............. Tumor imaging, limited area .................................................... ...................................................... A 78801 ............................ .................. Tumor imaging, mult areas ................................................... ......................................................... A 78801 ............................ TC ............ Tumor imaging, mult areas ....................................................... ..................................................... A 78801 ............................ 26 ............. Tumor imaging, mult areas ...................................................... ...................................................... A 78802 ............................ .................. Tumor imaging, whole body ................................................... ........................................................ A 78802 ............................ TC ............ Tumor imaging, whole body ....................................................... .................................................... A 78802 ............................ 26 ............. Tumor imaging, whole body ...................................................... ..................................................... A 78803 ............................ .................. Tumor imaging (3D) .......................................................... ............................................................. A 78803 ............................ TC ............ Tumor imaging (3D) .............................................................. ......................................................... A 78803 ............................ 26 ............. Tumor imaging (3D) ............................................................. .......................................................... A 78804 ............................ .................. Tumor imaging, whole body ................................................... ........................................................ A 78804 ............................ TC ............ Tumor imaging, whole body ....................................................... .................................................... A 78804 ............................ 26 ............. Tumor imaging, whole body ...................................................... ..................................................... A 78805 ............................ .................. Abscess imaging, ltd area ................................................... ........................................................... A 78805 ............................ TC ............ Abscess imaging, ltd area ....................................................... ....................................................... A 78805 ............................ 26 ............. Abscess imaging, ltd area ...................................................... ........................................................ A 78806 ............................ .................. Abscess imaging, whole body ................................................. ...................................................... A 78806 ............................ TC ............ Abscess imaging, whole body ..................................................... .................................................. A 78806 ............................ 26 ............. Abscess imaging, whole body .................................................... ................................................... A 78807 ............................ .................. Nuclear localization/abscess ................................................ .......................................................... A 78807 ............................ TC ............ Nuclear localization/abscess .................................................... ...................................................... A 78807 ............................ 26 ............. Nuclear localization/abscess ................................................... ....................................................... A 78811 ............................ .................. Tumor imaging (pet), limited ................................................ .......................................................... C 78811 ............................ TC ............ Tumor imaging (pet), limited .................................................... ...................................................... C 78811 ............................ 26 ............. Tumor imaging (pet), limited ................................................... ....................................................... A 78812 ............................ .................. Tumor image (pet)/skul-thigh ................................................ ......................................................... C 78812 ............................ TC ............ Tumor image (pet)/skul-thigh .................................................... ..................................................... C 78812 ............................ 26 ............. Tumor image (pet)/skul-thigh ................................................... ...................................................... A 78813 ............................ .................. Tumor image (pet) full body ................................................. .......................................................... C 78813 ............................ TC ............ Tumor image (pet) full body ..................................................... ...................................................... C


## 46063

—————————— CPT codes and descriptions only are copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS App ly. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

A DDENDUM 

### G.

— L IST OF 

### CPT/HCPCS C ODES 

### U SED TO 

### D ESCRIBE 

### N UCLEAR 

### M EDICINE 

### D ESIGNATED 

### H EALTH 

### S ERVICES 

### U NDER 

### S ECTION 

### 1877 OF THE 

### S OCIAL 

### S ECURITY 

### ACT



### —Continued

[Effective January 1, 2006]

CPT/HCPCS Codes MOD Description Status code

78813 ............................ 26 ............. Tumor image (pet) full body .................................................... ....................................................... A 78814 ............................ .................. Tumor image pet/ct, limited ................................................. .......................................................... C 78814 ............................ TC ............ Tumor image pet/ct, limited ..................................................... ...................................................... C 78814 ............................ 26 ............. Tumor image pet/ct, limited .................................................... ....................................................... A 78815 ............................ .................. Tumorimage pet/ct skul-thigh ................................................ ......................................................... C 78815 ............................ TC ............ Tumorimage pet/ct skul-thigh .................................................... ..................................................... C 78815 ............................ 26 ............. Tumorimage pet/ct skul-thigh ................................................... ...................................................... A 78816 ............................ .................. Tumor image pet/ct full body ................................................ ......................................................... C 78816 ............................ TC ............ Tumor image pet/ct full body .................................................... ..................................................... C 78816 ............................ 26 ............. Tumor image pet/ct full body ................................................... ...................................................... A 78890 ............................ .................. Nuclear medicine data proc .................................................. ......................................................... B 78890 ............................ TC ............ Nuclear medicine data proc ...................................................... ..................................................... B 78890 ............................ 26 ............. Nuclear medicine data proc ..................................................... ...................................................... B 78891 ............................ .................. Nuclear med data proc ....................................................... ........................................................... B 78891 ............................ TC ............ Nuclear med data proc ........................................................... ....................................................... B 78891 ............................ 26 ............. Nuclear med data proc .......................................................... ........................................................ B 78999 ............................ .................. Nuclear diagnostic exam ..................................................... ........................................................... C 78999 ............................ TC ............ Nuclear diagnostic exam ......................................................... ....................................................... C 78999 ............................ 26 ............. Nuclear diagnostic exam ........................................................ ........................................................ C 79005 ............................ .................. Nuclear rx, oral admin ...................................................... .............................................................. A 79005 ............................ TC ............ Nuclear rx, oral admin .......................................................... .......................................................... A 79005 ............................ 26 ............. Nuclear rx, oral admin ......................................................... ........................................................... A 79101 ............................ .................. Nuclear rx, iv admin ........................................................ ............................................................... A 79101 ............................ TC ............ Nuclear rx, iv admin ............................................................ ........................................................... A 79101 ............................ 26 ............. Nuclear rx, iv admin ........................................................... ............................................................ A 79200 ............................ .................. Nuclear rx, intracav admin .................................................. ........................................................... A 79200 ............................ TC ............ Nuclear rx, intracav admin ...................................................... ....................................................... A 79200 ............................ 26 ............. Nuclear rx, intracav admin ..................................................... ........................................................ A 79300 ............................ .................. Nuclr rx, interstit colloid ................................................. ................................................................. C 79300 ............................ TC ............ Nuclr rx, interstit colloid ..................................................... ............................................................. C 79300 ............................ 26 ............. Nuclr rx, interstit colloid .................................................... .............................................................. A 79403 ............................ .................. Hematopoietic nuclear tx .................................................... ........................................................... A 79403 ............................ TC ............ Hematopoietic nuclear tx ........................................................ ....................................................... A 79403 ............................ 26 ............. Hematopoietic nuclear tx ....................................................... ........................................................ A 79440 ............................ .................. Nuclear rx, intra-articular ................................................. ............................................................... A 79440 ............................ TC ............ Nuclear rx, intra-articular ..................................................... ........................................................... A 79440 ............................ 26 ............. Nuclear rx, intra-articular .................................................... ............................................................ A 79445 ............................ .................. Nuclear rx, intra-arterial .................................................. ............................................................... A 79445 ............................ TC ............ Nuclear rx, intra-arterial ...................................................... ........................................................... A 79445 ............................ 26 ............. Nuclear rx, intra-arterial ..................................................... ............................................................ A 79999 ............................ .................. Nuclear medicine therapy .................................................... .......................................................... C 79999 ............................ TC ............ Nuclear medicine therapy ........................................................ ...................................................... C 79999 ............................ 26 ............. Nuclear medicine therapy ....................................................... ....................................................... C A4641 ........................... .................. Diagnostic imaging agent. A4642 ........................... .................. Satumomab pendetide per dose. A9500 ........................... .................. Technetium TC 99m sestamibi. A9502 ........................... .................. Technetium TC99M tetrofosmin. A9503 ........................... .................. Technetium TC 99m medronate. A9504 ........................... .................. Technetium tc 99m apcitide. A9505 ........................... .................. Thallous chloride TL 201/mci. A9507 ........................... .................. Indium/111 capromab pendetid. A9508 ........................... .................. Iobenguane sulfate I-131. A9510 ........................... .................. Technetium TC99m Disofenin. A9511 ........................... .................. Technetium TC 99m depreotide. A9512 ........................... .................. Technetiumtc99mpertechnetate. A9513 ........................... .................. Technetium tc-99m mebrofenin. A9514 ........................... .................. Technetiumtc99mpyrophosphate. A9515 ........................... .................. Technetium tc-99m pentetate. A9516 ........................... .................. I-123 sodium iodide capsule. A9517 ........................... .................. Th I131 so iodide cap millic. A9519 ........................... .................. Technetiumtc-99mmacroag albu. A9520 ........................... .................. Technetiumtc-99m sulfur clld.
A9521 ........................... .................. Technetiumtc-99m exametazine. A9522 ........................... .................. Indium111ibritumomabtiuxetan.


## 46064

A DDENDUM 

### G.

— L IST OF 

### CPT/HCPCS C ODES 

### U SED TO 

### D ESCRIBE 

### N UCLEAR 

### M EDICINE 

### D ESIGNATED 

### H EALTH 

### S ERVICES 

### U NDER 

### S ECTION 

### 1877 OF THE 

### S OCIAL 

### S ECURITY 

### ACT



### —Continued

[Effective January 1, 2006]

CPT/HCPCS Codes MOD Description Status code

A9523 ........................... .................. Yttrium90ibritumomabtiuxetan. A9524 ........................... .................. Iodinated I-131 serumalbumin. A9526 ........................... .................. Ammonia N-13, per dose. A9527 ........................... .................. I-131 tositumomab therapeut. A9528 ........................... .................. Dx I131 so iodide cap millic. A9529 ........................... .................. Dx I131 so iodide sol millic. A9530 ........................... .................. Th I131 so iodide sol millic. A9531 ........................... .................. Dx I131 so iodide microcurie. A9532 ........................... .................. I-125 serum albumin micro. A9533 ........................... .................. I-131 tositumomab diagnostic. A9534 ........................... .................. I-131 tositumomab therapeut. A9600 ........................... .................. Strontium-89 chloride. A9603 ........................... .................. I-131sodiumiodidecap per mci. A9605 ........................... .................. Samarium sm153 lexidronamm. A9699 ........................... .................. Noc therapeutic radiopharm. C1079 ........................... .................. CO 57/58 per 0.5 uCi. C1080 ........................... .................. I-131 tositumomab, dx. C1081 ........................... .................. I-131 tositumomab, tx. C1082 ........................... .................. In-111 ibritumomab tiuxetan. C1083 ........................... .................. Yttrium 90 ibritumomab tiuxe. C1091 ........................... .................. IN111 oxyquinoline,per0.5mCi. C1092 ........................... .................. IN 111 pentetate per 0.5 mCi. C1093 ........................... .................. TC99M fanolesomab. C1122 ........................... .................. Tc 99M ARCITUMOMAB PER VIAL. C1200 ........................... .................. TC 99M Sodium Glucoheptonat. C1201 ........................... .................. TC 99M SUCCIMER, PER Vial. C1775 ........................... .................. FDG, per dose (4-40 mCi/ml). C9102 ........................... .................. 51 Na Chromate, 50mCi. C9103 ........................... .................. Na Iothalamate I-125, 10 uCi. C9400 ........................... .................. Thallous chloride, brand. C9401 ........................... .................. Strontium-89 chloride,brand. C9402 ........................... .................. Th I131 so iodide cap, brand. C9403 ........................... .................. Dx I131 so iodide cap, brand. C9404 ........................... .................. Dx I131 so iodide sol, brand. C9405 ........................... .................. Th I131 so iodide sol, brand. Q3000 ........................... .................. Rubidium RB-82. Q3002 ........................... .................. Gallium ga 67. Q3003 ........................... .................. Technetium tc99m bicisate. Q3004 ........................... .................. Xenon xe 133. Q3005 ........................... .................. Technetium tc99m mertiatide. Q3006 ........................... .................. Technetium tc99m glucepatate. Q3007 ........................... .................. Sodium phosphate p32. Q3008 ........................... .................. Indium 111-in pentetreotide. Q3009 ........................... .................. Technetium tc99m oxidronate. Q3010 ........................... .................. Technetium tc99mlabeledrbcs. Q3011 ........................... .................. Chromic phosphate p32.

CPT codes and descriptions only are copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS app ly. 

### Federal Register / Vol. 70, No. 151 / Monday, August 8, 2005 / Proposed Rules

[FR Doc. 05

– 15370 Filed 8

– 1

–05; 4:16 pm]

**BILLING CODE 4120**

**– 01** 

**– P**