48982 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

42 CFR Parts 405, 410, 411, 414, 415, 

and 424 

[CMS–1321–P] 

RIN 0938–AO24 

Medicare Program; Revisions to 

Payment Policies Under the Physician 

Fee Schedule for Calendar Year 2007 

and Other Changes to Payment Under 

Part B 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Proposed rule. 

SUMMARY: This proposed rule would 

address certain provisions of the Deficit 

Reduction Act of 2005, as well as make 

other proposed changes to Medicare 

Part B payment policy. 

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 practice cost 

indices (GPCI) changes; requests for 

additions to the list of telehealth 

services; payment for covered outpatient 

drugs and biologicals; payment for renal 

dialysis services; policies related to 

private contracts and opt-out; policies 

related to bone mass measurement 

services, independent diagnostic testing 

facilities, the physician self-referral 

prohibition; laboratory billing for the 

technical component (TC) of physician 

pathology services; the clinical 

laboratory fee schedule; certification of 

advanced practice nurses; health 

information technology, and the health 

care information transparency initiative. 

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 October 10, 2006. 

ADDRESSES: In commenting, please refer 

to file code CMS–1321–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/eRulemaking. Click 

on the link ‘‘Submit electronic 

comments on CMS regulations with an 

open comment period.’’ (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–1321–P, P.O. 

Box 8015, Baltimore, MD 21244–8015. 

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–1321–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). 

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). 

Roberta Epps, (410) 786–4503 (for 

issues related to diagnostic imaging 

services). 

Bill Larson, (410) 786–4639 (for issues 

related to coverage of bone mass 

measurement and addition of 

ultrasound screening for abdominal 

aortic aneurysm to the ‘‘Welcome to 

Medicare’’ benefit). 

Dorothy Shannon, (410) 786–3396 (for 

issues related to the outpatient therapy 

cap). 

Catherine Jansto, (410) 786–7762 (for 

issues related to payment for covered 

outpatient drugs and biologicals). 

Henry Richter, (410) 786–4562 (for 

issues related to payments for end-stage 

renal disease facilities). 

Fred Grabau, (410) 786–0206 (for 

issues related to private contracts and 

opt-out provision). 

Lisa Ohrin, (410) 786–4565 (for issues 

related to physician self-referral 

prohibitions). 

David Walczak (410) 786–4475 (for 

issues related to reassignment 

provisions). 

August Nemec (410) 786–0612 (for 

issues related to independent diagnostic 

testing facilities). 

Anita Greenberg, (410) 786–4601 (for 

issues related to the clinical laboratory 

fee schedule). 

James Menas (410) 786–4507 (for 

issues related to payment for physician 

pathology services). 

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–1321–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. We post all comments 

received before the close of the 

comment period on the following Web 

site as soon as possible after they have 

been received: http://www.cms.hhs.gov/ 

eRulemaking. Click on the link 

‘‘Electronic Comments on CMS 

Regulations’’ on that Web site to view 

public comments. 

Comments received timely will also 

be available for public inspection as 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 48983 

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 

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. 

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 following Web site: http:// 

www.cms.hhs.gov/PhysicianFeeSched/. 

2. Select ‘‘PFS Federal Regulation 

Notices.’’

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. Development of the Relative Value 

System 

1. Work RVUs 

2. Practice Expense Relative Value Units 

(PE RVUs) 

3. Resource-Based Malpractice RVUs 

4. Refinements to the RVUs 

5. Adjustments to RVUs Are Budget 

Neutral 

B. Components of the Fee Schedule 

Payment Amounts 

C. Most Recent Changes to the Fee 

Schedule 

II. Provisions of the Proposed Rule 

A. Resource-Based PE RVUs and Practice 

Expense Proposals for Calendar Year 

2007 

B. Geographic Practice Cost Indices 

C. Medicare Telehealth Services 

D. Miscellaneous Coding Issues 

1. Global Period for Remote Afterloading 

High Intensity Brachytherapy Procedures 

2. Assignment of RVUS to CPT Codes for 

Proton Beam Treatment Delivery 

Services 

E. Deficit Reduction Act (DRA) Related 

Proposals 

1. Section 5102 of the DRA—Proposed 

Adjustments for Payments to Imaging 

Services 

2. Section 5107 of the DRA—Revisions to 

Payments for Therapy Services 

3. Section 5112 of the DRA—Proposed 

Addition of Ultrasound Screening for 

Abdominal Aortic Aneurysm (AAA) 

4. Section 5113 of the DRA—Proposed 

Non-Application of the Part B Deductible 

for Colorectal Cancer Screening Tests 

5. Section 5114—Proposed Addition of 

Diabetes Outpatient Self-Management 

Training Services (DSMT) and Medical 

Nutrition Therapy (MNT) for the FQHC 

Program 

F. Proposed Payment for Covered 

Outpatient Drugs and Biologicals (ASP 

Issues) 

G. Proposed Provisions Related to Payment 

for Renal Dialysis Services Furnished by 

End Stage Renal Disease (ESRD) 

Facilities 

H. Private Contracts and Opt-Out 

Provision—Practitioner Definition 

I. Proposed Changes to Reassignment and 

Physician Self-Referral Rules Relating to 

Diagnostic Tests 

J. Supplier Access to Claims Billed on 

Reassignment 

K. Coverage of Bone Mass Measurement 

Tests 

L. Independent Diagnostic Testing Facility 

(IDTF) Issues 

1. Proposed IDTF Changes in the Physician 

Fee Schedule Proposed Rule 

2. Proposed Performance Standards for 

IDTFs 

3. Supervision 

4. Place of Service 

M. Independent Laboratory Billing for the 

Technical Component (TC) of Physician 

Pathology Services to Hospital Patients 

N. Public Consultation for Medicare 

Payment for New Outpatient Clinical 

Diagnostic Laboratory Tests 

O. Proposal To Establish Criteria for 

National Certifying Bodies That Certify 

Advanced Practice Nurses 

P. Chiropractic Services Demonstration 

Q. Promoting Effective Use of Health 

Information Technology 

R. Health Care Information Transparency 

Initiative 

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—2007 Relative Value Units 

and Related Information Used in 

Determining Medicare Payments for 

2007 

Addendum C—Codes for Which We 

Received Practice Expense Review 

Committee (PERC) Recommendations on 

Practice Expense Direct Cost Inputs 

Addendum D—2007 Geographic Practice 

Cost Indices (GPCIs) by Medicare Carrier 

and Locality 

Addendum E—2007 Geographic Adjustment 

Factors (GAF) 

Addendum F—Proposed CPT/HCPCS 

Imaging Codes Defined by Section 

5102(b) of the DRA 

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 

AAP Average acquisition price 

ACC American College of Cardiology 

ACG American College of Gastroenterology 

ACHPN Advanced Certified Hospice and 

Palliative Nurse 

ACOG American College of Obstetrics and 

Gynecology 

ACR American College of Radiology 

ADA American Dietetic Association 

AFROC Association of Freestanding 

Radiation Oncology Centers 

AGA American Gastroenterological 

Association 

AHRQ Agency for Healthcare Research and 

Quality 

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 Medicare, Medicaid, and SCHIP 

Benefits Improvement Protection Act of 

2000 

BLS Bureau of Labor Statistics 

BMD Bone mineral density 

BMI Body mass index 

BMM Bone mass measurement 

BNF Budget neutrality factor 

BP Best price 

BSA Body surface area 

CAH Critical access hospital 

CAP College of American Pathologists 

CBSA Core-Based Statistical Area 

CCI Correct Coding Initiative 

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 

DRA Deficit Reduction Act 

DSMT Diabetes outpatient self-management 

training services 

DXA Dual energy x-ray absorptiometry 

E&M Evaluation and management 

EPO Erythopoeitin 

ESRD End stage renal disease 

FAX Facsimile 

FI Fiscal intermediary 

FR Federal Register 

GAF Geographic adjustment factor 

GAO General Accounting Office 

GDP Gross domestic product 

GPO Group purchasing organization 

mstockstill on PROD1PC63 with PROPOSAL_2

48984 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

GPCI Geographic practice cost index 

HCPAC Health Care Professional Advisory 

Committee 

HCPCS Healthcare Common Procedure 

Coding System 

HCRIS Healthcare Cost Report Information 

System 

HSA Health Savings Account 

HHA Home health agency 

HHS (Department of) Health and Human 

Services 

HIT Health information technology 

HOCM High osmolar contrast media 

HPSA Health Professional Shortage Area 

HRSA Health Resources Services 

Administration (HHS) 

HUD (Department of) Housing and Urban 

Development 

IDTF Independent diagnostic testing facility 

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 

LOINC Logical Observation Identifiers 

Names and Codes 

MA Medicare Advantage 

MCAC Medicare Coverage Advisory 

Committee 

MCG Medical College of Georgia 

MedPAC Medicare Payment Advisory 

Commission 

MEI Medicare Economic Index 

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 

NPWP Nonphysician Work Pool 

OBRA Omnibus Budget Reconciliation Act 

OIG Office of Inspector General 

OMB Office of Management and Budget 

OPD Outpatient Department 

OPPS Outpatient prospective payment 

system 

OSCAR Online Survey and Certification 

and Reporting 

PA Physician assistant 

PBM Pharmacy benefit managers 

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 

QCT Quantitative computerized 

tomography 

RFA Regulatory Flexibility Act 

RIA Regulatory impact analysis 

RN Registered nurse 

RUC (AMA’s Specialty Society) Relative 

(Value) Update Committee 

RVU Relative value unit 

SXA Single energy x-ray absorptiometry 

SPA Single photon absorptiometry 

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 

UAF Update adjustment factor 

UPIN Unique Physician Identification 

Number 

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.] 

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. 

Before the establishment of the 

resource-based relative value system, 

Medicare payment for physicians’

services was based on reasonable 

charges. 

A. 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 Human 

Services (HHS). In constructing the 

code-specific vignettes for the original 

physician work RVUs, Harvard worked 

with panels of experts, both inside and 

outside the Federal 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 the 

requirement to transition to a resourcebased system for PE over a 4-year 

period, resource-based PE RVUs did not 

become fully effective until 2002. 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 48985 

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 SMS 

data 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 of 

Health and Human Services (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 

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 5 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. 

B. 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, PEs, 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 × GPCI work) + 

(RVU PE × GPCI PE) + (RVU 

malpractice × GPCI malpractice)] × 

CF. 

(Note: As discussed in the June 29, 

2006 proposed notice for the Five-Year 

Review of Work Relative Value Units 

Under the Physician Fee Schedule and 

Proposed Changes to the Practice 

Expense Methodology (71 FR 37170), 

we have proposed to establish a separate 

budget neutrality adjustor that would be 

applied in the calculation of the work 

RVUs. Application of this budget 

neutrality adjustor would enable us to 

meet the budget neutrality provisions of 

section 1848(c)(2)(B)(ii) of the Act.) 

C. Most Recent Changes to the Fee 

Schedule 

The final rule with comment period 

that appeared in the Federal Register on 

November 21, 2005 (70 FR 70116) 

addressed Medicare Part B payment 

policy, including the physician fee 

schedule, that is applicable for calendar 

year (CY) 2006; and finalized certain 

provisions of the interim final rule to 

implement the Competitive Acquisition 

Program (CAP) for Part B Drugs. 

It also revised Medicare Part B 

payment and related policies regarding: 

Physician work, practice expense and 

malpractice RVUs; Medicare telehealth 

services; multiple diagnostic imaging 

procedures; covered outpatient drugs 

and biologicals; supplemental payments 

to Federally Qualified Health Centers 

(FQHCs); renal dialysis services; 

coverage for glaucoma screening 

services; National Coverage 

Determination (NCD) timeframes; and 

physician referrals for nuclear medicine 

services and supplies to health care 

entities with which physicians have 

financial relationships. 

In addition, the rule finalized the 

interim RVUs for CY 2005 and issued 

interim RVUs for new and revised 

procedure codes for CY 2006. The rule 

also updated the codes subject to the 

physician self-referral prohibition and 

discussed payment policies relating to 

teaching anesthesia services, therapy 

caps, private contracts and opt-out, and 

chiropractic and oncology 

demonstrations. 

In accordance with section 

1848(d)(1)(E)(i) of the Act, we also 

announced that the PFS update for CY 

2006 would be ¥4.4 percent; the initial 

estimate for the sustainable growth rate 

for CY 2006 would be 1.7; and the CF 

for CY 2006 would be $36.1770. 

However, subsequent to publication of 

the CY 2005 PFS final rule with 

comment period, section 5104 of the 

Deficit Reduction Act (DRA) of 2005 

(Pub. L. 109–171, February 8, 2006), was 

enacted which amended section 1848(d) 

mstockstill on PROD1PC63 with PROPOSAL_2

48986 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

of the statute to provide for a 0 percent 

update effective January 1, 2006. 

We also note that the Five-Year 

Review of Work Relative Value Units 

Under the Physician Fee Schedule and 

Proposed Changes to the Practice 

Expense Methodology proposed notice 

appeared in the Federal Register on 

June 29, 2006 (71 FR 37170). In that 

notice, we proposed revisions to work 

RVUs affecting payment for physicians’

services. The revisions reflect changes 

in medical practice, coding changes, 

and new data on relative value 

components that affect the relative 

amount of physician work required to 

perform each service, as required by the 

statute. We also proposed revisions to 

our methodology for calculating PE 

RVUs, including changes based on 

supplemental survey data for PE. This 

revised methodology would be used to 

establish payment for services beginning 

January 1, 2007. 

As indicated in the June 29, 2006 

proposed notice, we will respond to the 

comments received on that notice as 

part of the final Medicare PFS rule for 

CY 2007 scheduled for publication this 

fall. If adopted, the RVU revisions 

would be fully implemented for services 

furnished to Medicare beneficiaries on 

or after January 1, 2007. The PE 

revisions would be phased-in over a 

four-year period; although, as we gain 

experience with the new methodology, 

we will reexamine this policy beginning 

next year and propose necessary 

revisions through future rulemaking. 

II. Provisions of the Proposed Rule 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘PROVISIONS’’ at the 

beginning of your comments.] 

A. Resource-Based Practice Expense 

(PE) RVU Proposals for CY 2007 

Major changes to the PE methodology 

for 2007, as well as a detailed 

discussion of the current PE 

methodology, are discussed in the June 

29, 2006 proposed notice (71 FR 37170 

through 37430). 

This proposed rule contains proposals 

for direct PE including clinical labor, 

medical supplies and medical 

equipment. 

1. RUC Recommendations for Direct PE 

Inputs and Other PE Input Issues 

The following discussions are 

proposals concerning direct PE inputs. 

(a) RUC Recommendations 

The AMA’s Relative Value Update 

Committee (RUC) established a new 

committee, the Practice Expense Review 

Committee (PERC), to assist the RUC in 

recommending direct PE inputs (clinical 

staff, supplies, and equipment) for new 

and existing CPT codes. 

The PERC reviewed the PE inputs for 

over 2000 existing codes, some of which 

were unresolved PE issues from the CY 

2006 PFS final rule with comment 

period, at their meetings held in 

September 2005, February 2006 and 

April 2006. (A list of these reviewed 

codes can be found in Addendum C of 

this proposed rule.) 

We have reviewed the PERCsubmitted recommendations and 

propose to adopt all of them. We have 

worked with the AMA staff to make 

corrections for any typographical errors 

and to ensure that previously PEACaccepted standards are incorporated in 

the recommendations. 

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.) 

(b) Standard Supplies and Equipment 

for 90-Day Global Codes 

We are proposing to revise the CPEP 

supply and equipment inputs for those 

90-day global procedures for which the 

RUC has only refined the clinical labor 

inputs. We are proposing to apply the 

standard supply and equipment inputs 

for the facility setting for 90-day global 

services to these remaining unrefined 

90-day global procedure codes. As 

recommended by the RUC, for supplies, 

we propose to include one minimum 

supply visit package for each postoperative visit assigned to each code 

and a post-surgical incision care kit 

(suture, staples, or both) where 

appropriate, along with additional items 

recommended by the RUC for certain 

procedures. For equipment, we are 

proposing to include an exam table and 

light. However, there are several issues 

on which we need input before we 

finalize the recommended standards. 

For example, for many of the 90-day 

codes in question, the current supply 

input data contain supplies in far larger 

quantities than are contained in either 

the visit package or incision care kit. For 

other codes, the current data includes 

items that are not contained in the 

package or kit. In other cases, the 

recommendations from the RUC contain 

additional items in quantities that 

appear excessive. We plan to work with 

all the concerned specialties to ensure 

that the finalized inputs do represent 

the typical supplies needed to perform 

each procedure. 

Because the application of the 90-day 

global standard supplies and equipment 

would result in the deletion of some 

original CPEP inputs, we are requesting 

that all the medical specialties examine 

the direct PE inputs on our Web site and 

let us know whether there are additional 

items from the original CPEP data that 

are a necessary part of the postoperative care and if the PE inputs listed 

are correct. (See the SUPPLEMENTARY

INFORMATION section of this proposed 

rule for directions on accessing our Web 

site.) 

2. Payment for Splint and Cast Supplies 

In the PFS final rules published 

November 1999 (64 FR 59380) and 

November 2000 (65 FR 65376), we 

removed splint and cast supplies from 

the PE database for the CPT codes for 

fracture management and cast/strapping 

application procedures. Because splint 

and cast supplies could be separately 

billed using Healthcare Common 

Procedure Coding System (HCPCS) 

codes (Q4001–Q4051) 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. 

In the CY 2006 PFS proposed rule (70 

FR 70116), we proposed to reinstate 

payment for all splints and cast supplies 

through the PE component of the PFS 

because we believed we may have 

unintentionally prohibited 

remuneration for these supplies when 

they are not used for reduction of a 

fracture or dislocation (covered under 

section 1861(s)(5) of the Act), but rather 

are provided (and covered) as ‘‘incident 

to’’ a physician service under section 

1861(s)(2)(A) of the Act. This proposal 

was not finalized; however, in our final 

rule we asked the medical specialties 

and the PERC to determine the typical 

supplies for splints and casts necessary 

for each of the fracture management 

codes and the cast/strapping application 

codes because we wanted to make 

certain that the supply inputs were 

correct before we proceeded with 

rulemaking for the CY 2007 PFS. At its 

February 2006 meeting, the PERC 

reviewed and approved the supply 

inputs submitted by the AAOS for each 

CPT code for fracture management and 

cast/strapping application and these 

were forwarded to us as PERC 

recommendations. During this interim 

period we also reassessed the options 

for payment of materials for splints and 

casts. 

We believe that the majority of the 

splint and cast supplies that are 

currently paid through the Q-codes are 

furnished in relationship to cast/ 

strapping procedures for the 

management of fractures and 

dislocations. However, we did not 

intend for the medically necessary 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 48987 

splint and cast supplies used for other 

reasons (for example, serial casting, 

wound care, or protection) not to be 

paid. Because it may be difficult for the 

contractors to identify the purpose for 

the cast/strapping application procedure 

on a claim form, we believe that 

contractors may have been paying for 

the splint and cast supply Q-codes 

when the service is performed for other 

purposes than treatment of fractures and 

dislocations. 

Since these splint and cast supplies 

can be covered under both sections 

1861(s)(5) and 1861(s)(2)(A) of the Act, 

we are proposing to include payment for 

both statutory benefits using the 

separate HCPCS Q-codes. This would 

allow for payment for these medically 

necessary supplies whether based on 

sections 1861(s)(5) or 1861(s)(2)(A) of 

the Act, while ensuring that no 

duplicate payments are made. 

Physicians would continue to bill the 

HCPCS Q-codes, in addition to the cast/ 

strapping application procedure codes, 

to be paid for these materials. 

The following supplies would 

continue to be paid separately using the 

HCPCS Q-codes and would not be 

included in the PE database upon 

adoption of this proposal: 

• Fiberglass roll. 

• Cast padding. 

• Cast shoe. 

• Stockingnet/stockinette. 

• Plaster bandage. 

• Denver splint. 

• Dome paste bandage. 

• Cast sole. 

• Elastoplast roll. 

• Fiberglass splint. 

• Ace wrap. 

• Kerlix. 

• Webril. 

• Malleable arch bars and elastics. 

The splint and cast supplies would 

not be included in the PEs for the 

following CPT codes: 

• 24500 through 24685 

• 25500 through 25695 

• 26600 through 26785 

• 27500 through 27566 

• 27750 through 27848 

• 28400 through 28675 

• 29000 through 29750. 

We are requesting input, specifically 

from medical specialties and contractors 

on this proposal. 

3. Medical Nutrition Therapy Services 

In 2000, the Health Care Professional 

Advisory Committee (HCPAC) 

recommended that we assign work 

RVUs to three new medical nutrition 

therapy (MNT) CPT codes—97802 

Medical nutrition therapy; initial 

assessment and intervention, 

individual, face-to-face with the patient, 

each 15 minutes at 0.45 RVUs, 97803 

Medical nutrition therapy; reassessment and intervention, 

individual, face-to-face with the patient, 

each 15 minutes at 0.37 RVUs, and 

97804 Medical nutrition therapy; group 

(two or more individuals), each 30 

minutes at 0.25 RVUs. However, during 

rulemaking for the CY 2001 PFS final 

rule, we indicated that MNT was not 

covered because there was yet no 

statutory benefit category that would 

allow medical nutritionists to bill these 

services. We also did not accept the 

HCPAC recommendations for work 

RVUs for these MNT services because 

the codes were designed for use only by 

nonphysicians. The following year, 

section 105(c) of the Medicare, 

Medicaid, and SCHIP Benefits 

Improvement Protection Act of 2000 

(BIPA) provided for the coverage of 

MNT services when furnished by 

registered dietitians or nutritional 

professionals at 85 percent of the 

amount that a physician would be paid 

for the same services. As a result, we 

established values for these MNT 

services for the 2002 PFS. In keeping 

with our earlier decision, we did not 

assign the HCPAC-recommended work 

values. However, the associated work 

value for each code was utilized in the 

conversion of work to clinical labor time 

for MNTs as part of the PE component. 

At that time we received several 

comments, including one from the 

American Dietetic Association (ADA), 

urging us to adopt the work values 

recommended by the HCPAC. 

More recently, the ADA has requested 

us to reconsider our decision not to 

accept the HCPAC recommended work 

RVUs. The ADA contends that the 

payment rate established by section 

105(c) of BIPA, 85 percent of the PFS 

amount that would be paid for the same 

service if furnished by a physician, is 

based on the premise that work values 

are inherent to these MNT services. The 

ADA believes that without work RVUs, 

the payment for these services does not 

reflect 85 percent of what a physician 

would be paid for performing the same 

service. Because these MNT codes were 

created specifically for MNT 

professionals, the ADA compared the 

work associated with their services to 

physician E/M services of CPT 99203 

and 99213, which have respective work 

RVUs of 1.34 and 0.67. 

After reviewing the issues and 

relevant arguments raised by the ADA, 

we are persuaded that it would be 

appropriate to include work RVUs for 

the MNT services. Consequently, we are 

proposing to establish work RVUs for 

each code at the level previously 

recommended by the HCPAC, as 

follows: 

• CPT 97802 = 0.45 RVUs. 

• CPT 97803 = 0.37 RVUs. 

• CPT 97804 = 0.25. 

Because we propose to add the work 

RVUs to these services, the MNT 

clinical labor time in the direct input 

database would be removed with the 

adoption of this proposal. Additionally, 

two HCPCS codes, G0270 MNT subs tx 

for change dx and G0271 Group MNT 2 

or more 30 mins were created to track 

MNT services following the second 

referral in the same year. These HCPCS 

codes correspond to CPT codes 97803 

and 97804, respectively. Therefore, we 

would also propose to add the same 

work RVUs to these HCPCS codes and 

to delete the clinical labor inputs from 

the PE database upon adoption of this 

policy. We encourage specialty societies 

and other professional groups to 

comment on this proposal. 

4. Surgical Pathology Codes 

We heard from the College of 

American Pathologists (CAP) regarding 

the equipment times assigned to CPT 

codes 88304 and 88305 in the basic 

surgical pathology family of codes. 

While all six codes in this family have 

been refined by the PEAC, this 

refinement occurred at 4 separate PEAC 

meetings. CPT codes 88304 and 88305 

were refined at the first PEAC meeting 

in April 1999 before time standards 

were established for the equipment at 

subsequent PEAC meetings when the 

other four CPT codes 88300, 88302, 

88307, and 88309 were reviewed. Using 

our proposed bottom-up PE 

methodology to value these codes, the 

lack of the equipment time standards for 

CPT codes 88304 and 88305 create a 

rank-order anomaly in this family. 

Consequently, CAP, after reviewing and 

applying current standards for the 

equipment times, submitted suggested 

revised equipment times to us. We are 

proposing to accept these times and the 

proposed times will be reflected in the 

PE database on our Web site (See the 

SUPPLEMENTARY INFORMATION section of 

this proposed notice for directions on 

accessing our Web site.) 

5. Other PE Issues 

In the CY 2006 PFS final rule with 

comment period (70 FR 70116), we 

explained that we were not 

implementing the PERC or other 

proposed PE changes for CY 2006 due 

to issues with the PE methodology. In 

this proposed rule, we are proposing 

that the PERC and other PE changes 

originally proposed for CY 2006 would 

be implemented and effective with the 

CY 2007 PFS. The following 

mstockstill on PROD1PC63 with PROPOSAL_2

48988 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

subsections, (a) through (j), summarize 

the PE proposals from the CY 2006 PFS 

final rule with comment period that we 

are including in this proposed rule. 

Additionally, we are including several 

other items which concern inputs for PE 

that are discussed below in subsections 

(k) through (n). 

(a) PE Recommendations on CPEP 

Inputs for CY 2006 

We are proposing to use a clinical 

labor time of 167 minutes for the service 

period for CPT code 36522, 

Extracorporeal Photopheresis; maintain 

the nonfacility setting PE RVUs for CPT 

code 78350, single photon bone 

densitometry; and remove the PE inputs 

for the nonfacility setting for CPT codes 

76975, GI endoscopic ultrasound, and 

15852, Dressing change not for burn. (70 

FR 70136 through 70137) 

(b) Supply Items for CPT Code 95015 

(Which Is Used for Intradermal Allergy 

Tests With Drugs, Biologicals, or 

Venoms) 

We are proposing to implement the 

allergy and immunology specialty’s 

recommendation 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). 

(See 70 FR 70138.) 

(c) Flow Cytometry Services 

Based on information from the society 

representing independent laboratories, 

we are proposing to implement the 

following direct PE inputs: 

• Clinical Labor—We are proposing 

to 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—We are proposing to 

change the antibody cost for both CPT 

codes 88184 and 88185 to $8.50 (from 

$3.544). 

• Equipment—We are proposing to 

add the following equipment to CPT 

code 88184: 

+ Computer. 

+ Printer. 

+ Slide strainer. 

+ Biohazard hood. 

+ Wash assistant. 

+ FAC loader. 

+ We are proposing to add a 

computer and printer to the equipment 

for CPT code 88185 (70 FR 70138). 

(d) Low Osmolar Contrast Media 

(LOCM) and High Osmolar Contrast 

Media (HOCM) 

Because separate payment is available 

for both types of contrast media, we are 

proposing to delete LOCM and HOCM 

from the PE database with the CY 2007 

PFS rule. (See 70 FR 70138). 

(e) Imaging Rooms 

We are proposing to implement the 

updates for the contents and prices of 5 

‘‘rooms’’ used in imaging procedures 

including—

• Basic radiology room; 

• Radiographic-fluoroscopic room; 

• Mammography room; 

• Computed tomography (CT) room; 

and 

• Magnetic resonance imaging (MRI) 

room (See 70 FR 70139). 

(f) Equipment Pricing for Select Services 

and Procedures 

We are proposing to accept the 

following equipment pricing 

information provided by various 

specialty societies for select services 

and procedures as discussed in the CY 

2006 PFS final rule with comment 

period. (See 70 FR 70139): 

• Equipment pricing for certain 

radiology services received from the 

ACR as presented in Table 15 of the CY 

2006 PFS proposed rule. 

• Equipment pricing on the 

ultrasound color doppler transducers 

and vaginal probe received from the 

American College of Obstetrics and 

Gynecology (ACOG). 

• For CPT 36522, extracorporeal 

photopheresis, equipment pricing 

information specific to this procedure. 

• Pricing of EMG botox machine used 

in CPT code 92265 as presented by the 

American Academy of Ophthalmology. 

(g) Supply Item for In Situ 

Hybridization Codes (CPT Codes 88365, 

88367, and 88368) 

We are proposing to implement the 

Society for Clinical Pathologists’ request 

to change the probe quantity for CPT 

code 88367 In situ hybridization, auto to 

1.5, equal to that of the other two codes 

in the family. 

(h) Supply Item for Percutaneous 

Vertebroplasty Procedures (CPT codes 

22520 and 22525) 

Based on documentation provided by 

the Society for Interventional Radiology, 

we are proposing to implement a new 

price of $696.00 for the vertebroplasty 

kit, to replace a temporary price of 

$660.50 that was a placeholder price 

from the CY 2006 PFS final rule with 

comment period. (See 70 FR 70139.) 

(i) Clinical Labor for G-Codes Related to 

Home Health and Hospice Physician 

Supervision, Certification and 

Recertification 

We are proposing to apply the 

refinements made to the PE inputs to 

CPT codes 99375 and 99378 for home 

health and hospice supervision to 4 Gcodes that are related to home health 

and hospice physician supervision, 

certification and recertification, G0179, 

GO180, GO181, and GO182. These Gcodes are incorrectly valued for clinical 

labor. These G-codes are cross-walked 

from CPT codes 99375 and 99378, 

which underwent PEAC refinement in 

January 2003 for the CY 2004 PFS. 

However, at that time we inadvertently 

did not apply the new refinements to 

these specific G-codes. (See 70 FR 70139 

through 70140.) 

(j) Programmers for Implantable 

Neurostimulators and Intrathecal Drug 

Infusion Pumps 

Although we had initially proposed, 

in the CY 2006 PFS proposed rule, to 

remove two programmers from the PE 

database (EQ208 for medication pump 

from two codes (CPT 62367 and 62368) 

and EQ209 for the neurostimulator from 

8 codes (CPT 95970–97979)), based on 

comments received as discussed in the 

CY 2006 PFS final rule with comment 

period (see 70 FR 70140), we 

determined that we will retain these 

programmers in the database. In 

addition, we added ‘‘with printer’’ to 

the description of EQ208 based on 

comments received. We are proposing to 

implement these decisions for CY 2007. 

(k) Cardiac Monitoring Services 

We are requesting more specific PE 

information related to remote cardiac 

monitoring services because these 

services do not fit the direct PE model 

used for typical physician services. 

These services are overwhelmingly 

performed by specialized independent 

diagnostic testing facilities (IDTFs) that 

are paid under the PFS, but due to the 

characteristics of cardiac monitoring 

services, frequently maintain more 

extensive operating hours than the 

typical physician office. Specifically, we 

are looking for data to indicate the 

typical number and type of 

transmissions or other encounters per 

day between the beneficiary and the 

IDTF for each of the remote monitoring 

services. We would also like to know 

the number and type of clinical staff, as 

well as the corresponding time, that are 

necessary to ensure appropriate services 

are available for each patient. 

Additionally, we are interested in 

identifying any other direct PE inputs 

for typical supplies and equipment 

relating to these services, and any data 

that would reflect indirect PEs, such as 

overhead and non-clinical payroll 

expenses. We believe that the following 

codes represent atypical PE scenarios 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 48989 

and would like to receive PE 

information regarding these services: 

• Cardiac event monitoring (CPT 

codes 93271, 93012 and 93270). 

• Pacemaker monitoring (CPT codes 

93733 and 93736). 

• Holter monitoring (CPT codes 

93232, 93226, 93231 and 93225). 

• INR monitoring (HCPCS codes 

G0248 and G0249). 

(l) Clarification With Respect to NonFacility PE RVUs 

In the CY 2006 PFS final rule with 

comment (70 FR 70335) we provided a 

clarification in Addendum A 

concerning use of ‘‘NA’’ in the PE RVU 

columns for Addendum B. Commenters 

requested that further clarification be 

made concerning the payment amount 

for procedures performed in the nonfacility setting if there is an ‘‘NA’’ in the 

non-facility PE RVU column. Our policy 

is that if the Medicare carrier pays for 

the service in the non-facility setting, 

the service will be paid at the facility PE 

RVU rate. In this proposed rule, we are 

proposing revisions to Addendum A to 

include this clarification. 

(m) Supply for CPT Code 50384, 

Removal (via Snare/Capture) of 

Internally Dwelling Ureteral Stent Via 

Percutaneous Approach, Including 

Radiological Supervision and 

Interpretation 

Upon review of the RUCrecommended direct PE inputs for CPT 

50384, a new procedure for CPT 2006, 

we identified the inappropriate 

inclusion of a ureteral stent that we are 

proposing to delete for CY 2007. We 

believe that the addition of the ureteral 

stent, valued by the specialty at $162, to 

CPT code 50384, which is the procedure 

for the removal of a stent, was an 

inadvertent error by the specialty during 

the April 2005 RUC meeting. 

(n) 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 1: Supply Items Needing 

Specialty Input for Pricing and Table 2: 

Equipment Items Needing Specialty 

Input for Pricing). During the CY 2006 

rulemaking process, 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 Web sites, 

invoices, and manufacturer quotes. We 

have accepted the documented prices 

for many of these items and these prices 

are reflected in the PE RVUs in 

Addendum B of this proposed rule. The 

items listed below in Tables 1 and 2 

represent the outstanding items from CY 

2006 and new items added from the 

current RUC recommendations. We are 

requesting that commenters provide 

pricing information on items in these 

tables along with acceptable 

documentation, as noted in the footnote 

to each table, to support recommended 

prices. For supplies or equipment that 

have previously appeared on this list, 

and for which we received no or 

inadequate documentation, we are 

proposing to delete these items unless 

we receive adequate information to 

support current pricing by the 

conclusion of the comment period for 

this proposed rule. 

BILLING CODE 4120–01–P 

mstockstill on PROD1PC63 with PROPOSAL_2

48990 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.000</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 48991 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.001</GPH>
48992 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

BILLING CODE 4120–01–C 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.002</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 48993 

B. Geographic Practice Cost Indices 

(GPCI) 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘GPCI’’ 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 PE and malpractice GPCIs 

reflect the full relative cost differences, 

section 1848(e)(1)(A)(iii) of the Act 

requires that the physician work GPCIs 

reflect only one-quarter of the relative 

cost differences compared to the 

national average. 

Section 1848(e)(1)(C) of the Act 

requires us, in consultation with 

appropriate physician representatives, 

to review the GPCIs at least every 3 

years and allows us to make 

adjustments based on our review. This 

section of the Act also requires us to 

phase-in the adjustment over 2 years, 

implementing only one-half of any 

adjustment in the first year if more than 

1 year has elapsed since the last GPCI 

revision. The GPCIs were first 

implemented in 1992. The first review 

and revision was implemented in 1995 

and the last GPCI revision was 

implemented in 2005. The next update 

is scheduled to be implemented in 

January 2008. 

We do not anticipate proposing 

significant changes to the GPCIs in 

response to changes in the source data. 

There have been no new Census data to 

affect the work GPCI, the PE GPCI will 

reflect any changes in the Department of 

Housing and Urban Development (HUD) 

rental data, and the malpractice GPCI 

(based on malpractice RVUs) will reflect 

the national claims-based premium data 

for 2004 and 2005. Details of the 

methodology, data sources, and 

adjustments to the GPCIs will be made 

available for public comment in the CY 

2008 PFS proposed rule. 

In addition, section 412 of the MMA 

amended section 1848(e)(1) of the Act to 

establish a floor of 1.0 for the work GPCI 

for any locality where the GPCI would 

otherwise fall below 1.0 for purposes of 

payment for services furnished on or 

after January 1, 2004 and before January 

1, 2007. Beginning on January 1, 2007, 

the 1.00 floor will be removed and the 

work GPCI will revert to the fully 

implemented value. The values for the 

work GPCI and subsequent changes to 

the Geographic Adjustment Factor 

(GAF) published in this proposed rule 

reflect the removal of the 1.0 floor. For 

many payment localities this change 

had no impact on the GAF; however, the 

GAFs for a number of payment localities 

were reduced due to this change. The 

impact of this change on the GAFs for 

those payment localities is shown below 

in Table 3. 

The proposed GPCIs for 2007 are 

shown in Addendum D and the 

proposed GAFs for 2007 are shown in 

Addendum E. The GPCIs shown in 

Addendum D are fully implemented 

and reflect 2007 budget neutrality 

scaling coefficients provided by the 

Office of the Actuary. 

TABLE 3.—PAYMENT LOCALITIES WITH NEGATIVE PERCENT CHANGE IN GAF 1 BETWEEN 2006 AND 2007 DUE TO

REMOVAL OF THE 1.000 WORK FLOOR

Locality name 2006 

GAF 

2007 

GAF 

Percent 

change 

Fort Worth, TX ..................................................................................................................................................... 0.998 0.996 ¥0.17 

Rest of Michigan .................................................................................................................................................. 0.986 0.984 ¥0.20 

Rest of New York ................................................................................................................................................ 0.952 0.950 ¥0.21 

Rest of Maryland ................................................................................................................................................. 0.982 0.978 ¥0.36 

Metropolitan St. Louis, MO .................................................................................................................................. 0.978 0.974 ¥0.41 

Rest of Pennsylvania ........................................................................................................................................... 0.950 0.946 ¥0.44 

Ohio ..................................................................................................................................................................... 0.970 0.966 ¥0.44 

Austin, TX ............................................................................................................................................................ 1.020 1.015 ¥0.47 

New Hampshire ................................................................................................................................................... 1.010 1.005 ¥0.50 

Minnesota ............................................................................................................................................................ 0.980 0.975 ¥0.53 

Galveston, TX ...................................................................................................................................................... 0.991 0.986 ¥0.54 

Metropolitan Kansas City, MO ............................................................................................................................. 0.987 0.981 ¥0.56 

Fort Lauderdale, FL ............................................................................................................................................. 1.022 1.016 ¥0.59 

Arizona ................................................................................................................................................................. 0.999 0.993 ¥0.65 

Wisconsin ............................................................................................................................................................. 0.956 0.950 ¥0.65 

Colorado .............................................................................................................................................................. 0.998 0.991 ¥0.67 

East St. Louis, IL ................................................................................................................................................. 1.003 0.996 ¥0.68 

New Orleans, LA ................................................................................................................................................. 0.984 0.977 ¥0.73 

Rest of Washington ............................................................................................................................................. 0.984 0.976 ¥0.77 

Indiana ................................................................................................................................................................. 0.937 0.930 ¥0.79 

Beaumont, TX ...................................................................................................................................................... 0.951 0.942 ¥0.96 

Alabama ............................................................................................................................................................... 0.923 0.914 ¥0.99 

Virginia ................................................................................................................................................................. 0.958 0.948 ¥1.06 

Southern Maine ................................................................................................................................................... 0.992 0.981 ¥1.09 

Rest of Georgia ................................................................................................................................................... 0.943 0.932 ¥1.14 

Tennessee ........................................................................................................................................................... 0.933 0.921 ¥1.27 

Utah ..................................................................................................................................................................... 0.960 0.948 ¥1.30 

South Carolina ..................................................................................................................................................... 0.930 0.917 ¥1.41 

Rest of Illinois ...................................................................................................................................................... 0.952 0.938 ¥1.43 

Rest of Florida ..................................................................................................................................................... 0.982 0.968 ¥1.45 

West Virginia ........................................................................................................................................................ 0.942 0.928 ¥1.47 

North Carolina ...................................................................................................................................................... 0.951 0.936 ¥1.55 

New Mexico ......................................................................................................................................................... 0.947 0.932 ¥1.57 

Kansas* ................................................................................................................................................................ 0.934 0.919 ¥1.60 

Rest of Louisiana ................................................................................................................................................. 0.936 0.919 ¥1.78 

Kentucky .............................................................................................................................................................. 0.932 0.915 ¥1.80 

Kansas* ................................................................................................................................................................ 0.936 0.919 ¥1.81 

Rest of Oregon .................................................................................................................................................... 0.946 0.929 ¥1.81 

mstockstill on PROD1PC63 with PROPOSAL_2

48994 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

TABLE 3.—PAYMENT LOCALITIES WITH NEGATIVE PERCENT CHANGE IN GAF 1 BETWEEN 2006 AND 2007 DUE TO

REMOVAL OF THE 1.000 WORK FLOOR—Continued 

Locality name 2006 

GAF 

2007 

GAF 

Percent 

change 

Vermont ............................................................................................................................................................... 0.968 0.950 ¥1.82 

Virgin Islands ....................................................................................................................................................... 1.007 0.989 ¥1.83 

Rest of Texas ...................................................................................................................................................... 0.947 0.929 ¥1.87 

Idaho .................................................................................................................................................................... 0.922 0.904 ¥1.91 

Iowa ..................................................................................................................................................................... 0.927 0.909 ¥1.97 

Rest of Maine ...................................................................................................................................................... 0.936 0.916 ¥2.14 

Oklahoma ............................................................................................................................................................. 0.913 0.893 ¥2.14 

Mississippi ............................................................................................................................................................ 0.919 0.898 ¥2.31 

Arkansas .............................................................................................................................................................. 0.905 0.884 ¥2.34 

Puerto Rico .......................................................................................................................................................... 0.905 0.883 ¥2.44 

Nebraska .............................................................................................................................................................. 0.925 0.902 ¥2.44 

Wyoming .............................................................................................................................................................. 0.934 0.910 ¥2.55 

Montana ............................................................................................................................................................... 0.928 0.902 ¥2.83 

Rest of Missouri * ................................................................................................................................................. 0.910 0.883 ¥2.97 

North Dakota ........................................................................................................................................................ 0.924 0.895 ¥3.16 

South Dakota ....................................................................................................................................................... 0.922 0.891 ¥3.35 

1 Calculation for the GAF: (.52466*work gpci) + (.03865*mp gpci) + (.52466*pe gpci). 

In the CY 2005 PFS proposed rule, 

published August 15, 2004, 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 the counties in the 

locality, removing high cost 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. 

We would be interested in receiving 

suggestions on alternative ways that we 

could administratively reconfigure 

payment localities that could be 

developed and proposed in future 

rulemaking. In addition, MEDPAC and 

the GAO have both expressed interest in 

studying the physician payment 

localities. CMS intends to work with 

both groups to study our current 

methodology and develop alternative 

options. 

C. 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)(4)(F) of the Act 

defines telehealth services as 

professional consultations, office 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) and any additional service 

specified by the Secretary. 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 services to or 

deleting services from 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 

faceπtoπface ‘‘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 faceπtoπface delivery of 

the requested service. 

Since establishing the process, we 

have added the following to the list of 

Medicare telehealth services: 

psychiatric diagnostic interview 

examination; ESRD services with two to 

three visits per month and four or more 

visits per month (although we require at 

least one visit a month by a physician, 

CNS, NP, or PA to examine the vascular 

access site); and individual medical 

nutritional therapy. 

Requests to add services to the list of 

Medicare telehealth services must be 

submitted and received no later than 

December 31 of each CY to be 

considered for the next proposed rule. 

For example, requests submitted before 

the end of CY 2005 are considered for 

the CY 2007 proposed rule. For more 

information on submitting a request for 

an addition to the list of Medicare 

telehealth services, visit our Web site at 

www.cms.hhs.gov/telehealth. 

2. Submitted Requests for Addition to 

the List of Telehealth Services 

We received the following requests for 

additional approved services in CY 

2005: (1) Nursing facility care; (2) 

speech language pathology; (3) 

audiology; and (4) physical therapy 

services. The following is a discussion 

of the requests submitted in CY 2005. 

Nursing Facility Care 

The American Telemedicine 

Association (ATA) and an individual 

practitioner submitted a request to add 

the following services: Initial nursing 

facility care (as represented by HCPCS 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 48995 

codes 99304 through 99306); subsequent 

nursing facility care (HCPCS codes 

99307 through 99310); nursing facility 

discharge services (HCPCS codes 99315 

and 99316); and other nursing facility 

services as described by HCPCS code 

99318. The requestors explained that 

the primary purpose of using telehealth 

in the Skilled Nursing Facility (SNF) 

setting is to provide urgent consultation 

when the patient has a sudden change 

in his or her condition, and to provide 

increased availability to primary and 

specialty care on days when the 

physician is not present in the SNF or 

when traveling is a hardship. The 

requestors believe that the current list of 

Medicare telehealth services is not 

appropriate because the list does not 

include codes that are specifically 

intended for nursing facility residents. 

CMS Review 

Nursing Facility Care 

Section 1834(m)(C)(ii) of the Act 

defines a telehealth originating site as a 

physician’s or practitioner’s office; or a 

hospital, critical access hospital (CAH), 

rural health clinic, or FQHC. SNFs are 

not defined in the statute as originating 

sites. 

However, section 418 of the MMA 

required the Health Resources Services 

Administration (HRSA), a component of 

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 the Secretary to submit a report 

to the Congress that includes 

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 visits furnished by a 

physician, or for in-person visits 

furnished by a physician assistant (PA), 

nurse practitioner (NP), or clinical nurse 

specialist (CNS), as is otherwise 

required by the Secretary’’ and provides 

the authority to include SNFs as a 

Medicare telehealth originating site, 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 

serve as a substitute for the required inperson physician or practitioner SNF 

visits. This report is currently under 

review in DHHS. 

Given that SNFs are not defined in the 

statute as a telehealth originating site 

and the report to the Congress, as 

discussed above, is currently being 

reviewed within DHHS, we cannot 

consider approving nursing facility care 

for telehealth at this time. We will 

review and consider the 

recommendations of the report to the 

Congress once it is issued. If it is 

determined that SNFs should be added 

as an originating site, this change will 

be considered in future rulemaking. 

Speech Language Pathology, Audiology 

and Physical Therapy 

The ATA and an individual 

practitioner submitted a request to add 

various speech therapy, audiology and 

physical therapy services to the list of 

Medicare telehealth services. The 

requestors also asked us to add physical 

therapists, speech language pathologists 

and audiologists to the list of approved 

telehealth practitioners. 

CMS Review 

Physical therapists, speech language 

pathologists and audiologists are not 

permitted under current law to provide 

and receive payment for Medicare 

telehealth services at the distant site. 

The statute permits only a physician, as 

defined by section 1861(r) of the Act or 

a practitioner as described in section 

1842(b)(18)(C) of the Act (CNS, NP, PA, 

nurse midwife, clinical psychologist, 

clinical social worker, registered 

dietitian or other nutrition professional), 

to furnish Medicare telehealth services. 

Since speech language pathologists, 

audiologists and physical therapists are 

not permitted under current law to 

provide and receive payment for 

Medicare telehealth services at the 

distant site, we cannot fully consider 

the request to add speech therapy, 

audiology services and physical therapy 

to the list of Medicare telehealth 

services. We are exploring this issue as 

part of a report to the Congress (required 

by section 223(d) of BIPA) on additional 

sites and settings, geographic areas, and 

types of non-physician practitioners that 

could be reimbursed for the provision of 

telehealth services. 

D. Miscellaneous Coding Issues 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘Miscellaneous Coding Issues’’

at the beginning of your comments.] 

The following sections address 

specific coding issues related to 

payment for services under the PFS. 

1. Global Period for Remote 

Afterloading High Intensity 

Brachytherapy Procedures 

CPT Code 77783, Remote afterloading 

high intensity brachytherapy; 9–12 

source positions or catheters, resides in 

a family of codes with varying numbers 

of source positions. All of the codes in 

the family, CPT codes 77781–77784 are 

currently designated as 90-day global 

services. CPT codes 77781–77784 are 

used to treat many clinical conditions, 

but primarily patients with prostate 

cancer, breast cancer and sarcoma. 

Patients with any of these conditions 

usually receive several treatments (2–

10) over a two to ten day period of time. 

Due to the increasing variability in 

treatment regimens, it is difficult to 

assign RVUs for a ‘‘typical’’ patient 

based on a global period of 90 days. 

Therefore, we are proposing that this 

family of codes (CPT codes 77781, 

77782, 77783 and 77784) be assigned a 

global period of ‘‘XXX’’, which will 

permit separate payment each time the 

services are provided and allow 

payment to be based on the actual 

service(s) provided. We will request that 

the RUC revalue the work RVUs and the 

PE inputs for these services if a change 

in the global period is finalized. 

However we are proposing, on an 

interim basis, to revise the work RVUs 

and PE inputs to reflect the removal of 

the postoperative visit, CPT code 99212, 

that is currently assigned to these 

services. The proposed interim work 

RVUs for these services would be as 

follows: 

• 77781 = 1.21 

• 77782 = 2.04 

• 77783 = 3.27 

• 77784 = 5.15 

We are also proposing to delete the 

registered nurse (RN) time in the postservice period as well as the patient 

gowns for the post-service visit. We 

would also note that, to the extent that 

these services are performed as staged 

procedures, providers may make use of 

applicable modifiers. 

2. Assignment of RVUs to CPT Codes for 

Proton Beam Treatment Delivery 

Services 

We have received a request to assign 

PE inputs for the non-facility setting to 

Proton Beam treatment delivery services 

represented by CPT codes 77520 

through 77525. 

These services are currently carrierpriced; therefore, payment in the facility 

or non-facility setting is established by 

each carrier. To the extent that 

physicians and suppliers wish to have 

national RVUs assigned for these 

services, there is an established process 

utilizing the AMA–RUC to recommend 

work RVUs, as well as the direct PE 

inputs used to compute the PE RVUs, to 

CMS. We would strongly encourage the 

physicians and suppliers to use this 

established process, and would also be 

mstockstill on PROD1PC63 with PROPOSAL_2

48996 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

interested in receiving comments on 

this issue. 

E. Deficit Reduction Act (DRA) Related 

Proposals 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘DRA PROPOSALS’’ at the 

beginning of your comments.] 

The DRA of 2005 (Pub. L. 109–171), 

was enacted February 8, 2006 and 

included provisions that affect the 

Medicare program. The following 

section addresses the specific DRA 

provisions that are being addressed in 

this proposed rule. 

1. Section 5102—Proposed Adjustments 

for Payments to Imaging Services 

Section 5102 of the DRA includes two 

provisions that affect payment of 

imaging services under the Medicare 

physician fee schedule. The first 

provision addresses payment for certain 

multiple imaging procedures for CY 

2007 and application of budget 

neutrality while the second provision 

addresses limiting the payment amount 

under PFS to the outpatient department 

(OPD) payment amount for the technical 

component (TC) of certain imaging 

services. 

(a) Payment for Multiple Imaging 

Procedures for 2007 

In general, Medicare prices diagnostic 

imaging procedures in the following 

three ways: 

• The professional component (PC) 

represents the physician’s interpretation 

(PC-only services are billed with the 26 

modifier). 

• The TC represents PE and includes 

clinical staff, supplies, and equipment 

(TC-only services are billed with the TC 

modifier). 

• The global service represents both 

PC and TC. 

As discussed in the CY 2006 PFS final 

rule with comment period (70 FR 

70261), in the CY 2006 PFS proposed 

rule (70 FR 45764 through 46064), we 

had proposed to reduce payment for the 

TC of selected diagnostic imaging 

procedures belonging to one of eleven 

imaging families when the procedures 

are performed on contiguous body areas 

by 50 percent for CY 2006. However, in 

the final rule with comment period, we 

stated that we would phase-in the 50 

percent reduction over two years, 

beginning with a 25 percent reduction 

in 2006. We also sought additional data 

and comments on the appropriateness of 

50 percent as the final level of 

reduction. The reduction applies to the 

TC and the technical portion of the 

global service, but does not apply to the 

PC of the service. Currently, we make 

full payment for the highest priced 

procedure and reduce payment for each 

additional procedure by 25 percent, 

when more than one procedure from the 

same imaging family is performed 

during the same session on the same 

day. 

As described in the CY 2006 PFS final 

rule with comment period, at the time, 

the statute required us to make changes 

such as this in a budget neutral manner, 

meaning that the estimated savings 

generated by the application of the 

multiple imaging procedure payment 

reduction were used to increase 

payment for other physician fee 

schedule services. We increased the CY 

2006 PE RVUs by 0.3 percent to offset 

the estimated savings generated by the 

multiple imaging payment reduction 

policy. 

Subsequent to the publication of the 

CY 2006 PFS final rule with comment 

period, section 5102(a) of the DRA 

(Multiple Procedure Payment Reduction 

for Imaging Exempted From Budget 

Neutrality), required that ‘‘effective for 

fee schedules established beginning 

with 2007, reduced expenditures 

attributable to the multiple procedure 

payment reduction for imaging under 

the final rule published by the Secretary 

in the Federal Register on November 21, 

2005 (42 CFR 405, et al.) insofar as it 

relates to the physician fee schedules for 

2006 and 2007’’ are exempted from the 

budget neutrality provision. As a result, 

we are proposing to remove the 0.3 

percent increase to the CY 2006 PE 

RVUs from the CY 2007 PE RVUs in 

accordance with the statute. 

In addition, in response to our request 

for data on the appropriateness of the 50 

percent reduction in the CY 2006 PFS 

final rule with comment period (70 FR 

70261), the ACR provided information 

for 25 code combinations supporting a 

reduction of between 21 and 44 percent. 

Given the expected interaction between 

the multiple procedure imaging policy 

and the further imaging payment 

reductions mandated by section 5102(b) 

of the DRA described below, along with 

the new information we have received 

from the ACR on the multiple imaging 

procedure policy as it applies to 

common combinations of imaging 

services, we believe it would be prudent 

to maintain the multiple imaging 

payment reduction at its current 25 

percent level while we continue to 

examine the appropriate payment 

levels. Therefore, we are proposing to 

continue the multiple imaging payment 

reduction for 2007 at the 25 percent 

level. We would proceed through future 

rulemaking in the event we determine 

that revisions to the policy are 

warranted. 

(b) Reduction in TC for Imaging Services 

Under the PFS to OPD Payment Amount 

Section 5102(b)(1) of the DRA 

amended section 1848 of the Act and 

requires that, with respect to imaging 

services, if—

‘‘(i) The technical component 

(including the technical component 

portion of a global fee) of the service 

established for a year under the fee 

schedule * * *, without application of 

the geographic adjustment factor * * *, 

exceeds, 

(ii) The Medicare OPD fee schedule 

amount established under the 

prospective payment system for hospital 

outpatient department services * * * 

for such service for such year, 

determined without regard to 

geographic adjustment * * *, the 

Secretary shall substitute the amount 

described in clause (ii), adjusted by the 

geographic adjustment factor [under the 

PFS] * * *, for the fee schedule amount 

for such technical component for such 

year.’’

As required by the statute, for imaging 

services (described below) furnished on 

or after January 1, 2007, we will cap the 

PFS payment amount for the year (prior 

to geographic adjustment) by the CY 

2007 outpatient prospective payment 

system (OPPS) payment amount (prior 

to geographic adjustment). We will then 

apply the PFS geographic adjustment to 

the capped payment amount. 

Section 5102(b)(2) of the DRA 

exempts the estimated savings from this 

provision from the PFS budget 

neutrality requirement. Section 

5102(b)(1) of the DRA defines imaging 

services as ‘‘* * * imaging and 

computer-assisted imaging services, 

including X-ray, ultrasound (including 

echocardiography), nuclear medicine 

(including positron emission 

tomography), magnetic resonance 

imaging, computed tomography, and 

fluoroscopy, but excluding diagnostic 

and screening mammography.’’

In order to apply section 5102(b) of 

the DRA, we needed to determine the 

CPT and alpha-numeric HCPCS codes 

that fall within the scope of ‘‘imaging 

services’’ defined by the DRA provision. 

In general, we believe that imaging 

services provide visual information 

regarding areas of the body that are not 

normally visible, thereby assisting in the 

diagnosis or treatment of illness or 

injury. We began by considering the 

CPT 7XXXX series codes for radiology 

services and then adding in other CPT 

codes and alpha-numeric HCPCS codes 

that describe imaging services. We then 

excluded nuclear medicine services that 

were either non-imaging diagnostic or 

treatment services. We also excluded all 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 48997 

codes for unlisted procedures, since we 

would not know in advance of any 

specific clinical scenario whether or not 

the unlisted procedure was an imaging 

service. We excluded all mammography 

services, consistent with the statute. We 

excluded radiation oncology services 

that were not imaging or computerassisted imaging services. We also 

excluded all HCPCS codes for imaging 

services that are not separately paid 

under the OPPS since there would be no 

corresponding OPPS payment to serve 

as a TC cap. We excluded any service 

where the CPT code describes a 

procedure for which fluoroscopy, 

ultrasound, or another imaging modality 

is either included in the code whether 

or not it is used or is employed 

peripherally in the performance of the 

main procedure, for example, 31622 for 

bronchoscopy with or without 

fluoroscopic guidance and 43242 for 

upper gastrointestinal endoscopy with 

transendoscopic ultrasound-guided 

intramural or transmural fine needle 

aspiration/biopsy(s). In these cases, we 

are unable to clearly distinguish 

imaging from non-imaging services 

because, for example, a specific 

procedure may or may not utilize an 

imaging modality, or the use of an 

imaging technology cannot be 

segregated from the performance of the 

main procedure. Note that we included 

carrier priced services since these 

services are within the statutory 

definition of imaging services and are 

also within the statutory definition of 

PFS services (that is, carrier-priced TCs 

of PET scans). 

Our proposed list of codes that 

identify imaging services defined by the 

DRA OPPS cap provision can be found 

in Addendum F to this proposed rule. 

Note that this is the list of imaging 

services for which we propose to make 

the comparison between the PFS TC 

payment amount and the OPPS payment 

amount used to establish OPD payment. 

Payment for an individual service on 

this list would only be capped if the 

PFS TC payment amount exceeds the 

OPPS payment amount. 

To the extent changes are made to 

codes for services already on the list, we 

propose to update the list through 

program instructions to our contractors. 

To the extent that the same imaging 

service is coded differently under the 

PFS and the OPPS, we propose to 

crosswalk the code under the PFS to the 

appropriate code under the OPPS that 

could be reported for the same service 

provided in the hospital outpatient 

setting. Our proposed list of crosswalks 

is below: 

MFS code Descriptor OPPS 

code Desc 

74185 ...... Mri angio, abdom w or w/o dye ........................................... C8900 .... MRA w/cont, abd. 

76093 ...... Magnetic image, breast ....................................................... C8905 .... MRI w/o fol w/cont, brst, un. 

76094 ...... Magnetic image, both breasts ............................................. C8908 .... MRI w/o fol w/cont, breast. 

71555 ...... Mri angio chest w or w/o dye .............................................. C8909 .... MRA w/cont, chest. 

73725 ...... Mr ang lwr ext w or w/o dye ................................................ C8912 .... MRA w/cont, lwr ext. 

72198 ...... Mr angio pelvis w/o & w/dye ............................................... C8918 .... MRA w/cont, pelvis. 

(c) Interaction of the Multiple Imaging 

Payment Reduction and the OPPS Cap 

For CY 2007 imaging services 

potentially subject to both the multiple 

imaging reduction and the OPPS cap, 

we propose to first apply the multiple 

imaging payment reduction and then 

apply the OPPS cap to the reduced 

amount as illustrated in the following 

example. 

HCPCS 

Pre-OPPS 

cap MPFS 

rate 

25% Multiple imaging reduction 

OPPS cap 

rate 

Final MPFS 

payment 

7XXX1 .............................................................................................................................. $341.89 $256.42 $316.55 $256.42 

7XXX2 .............................................................................................................................. 552.86 414.65 391.83 391.83 

We considered first applying the 

OPPS cap and then applying the 

multiple procedure reduction. However, 

as indicated in the CY 2006 OPPS final 

rule, we received public comments 

suggesting that the OPPS payment rates 

may implicitly include at least some 

multiple imaging discount. While we 

continue to examine this issue, we 

believe the most appropriate policy is to 

apply the multiple imaging payment 

reduction prior to the application of the 

OPPS cap. 

2. Section 5107—Revisions to Payments 

for Therapy Services 

Section 1833(g) of the Act applies an 

annual per beneficiary combined cap 

beginning January 1, 1999, on outpatient 

physical therapy and speech-language 

pathology services and a similar 

separate cap on outpatient occupational 

therapy services. These caps apply to 

expenses incurred for the respective 

therapy services under Medicare Part B, 

with the exception of outpatient 

hospital services. The caps were in 

effect from January 1, through December 

31, 1999, from September 1, 2003 

through December 7, 2003, and 

beginning January 1, 2006. In 2000 

through 2002, and from December 8, 

2003 through December 31, 2005, the 

Congress placed moratoria on 

implementation of the caps. Section 

1833(g)(2) of the Act provides that, for 

1999 through 2001, the caps were 

$1500, and for years after 2001, the caps 

are equal to the preceding year’s cap 

increased by the percentage increase in 

the Medicare Economic Index (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 implemented the separate 

statutory limits of $1740 for outpatient 

physical therapy and speech-language 

pathology services and $1740 for 

occupational therapy on January 1, 

2006. The DRA of 2005 was enacted on 

February 8, 2006. Section 5107(a) of the 

DRA required the Secretary to develop 

an exceptions process for the therapy 

caps effective January 1, 2006. The 

exceptions process applies only to 

expenses incurred in 2006. Details of 

the exceptions process were published 

in a manual change on February 13, 

2006 (CR4364). The change request 

mstockstill on PROD1PC63 with PROPOSAL_2

48998 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

consists of three transmittals with 

current numbers of—

• Transmittal 855, CR 4364, Pub. L. 

100–04; 

• Transmittal 47, CR 4365, Pub. L. 

100–02; and 

• Transmittal 140, CR 4364, Pub. L. 

100–08. 

The transmittals are available on our 

Web site at http://www.cms.hhs.gov/ 

Transmittals/. 

In accordance with the statute, the 

therapy caps will remain in effect, but 

without the exceptions process, with 

respect to expenses incurred beginning 

on January 1, 2007. The dollar amount 

of the therapy caps in 2007 will be the 

2006 rate ($1740) increased by the 

percentage increase in the MEI. As 

noted above, under current law, the 

exceptions process will not apply to 

therapy services incurred after 

December 31, 2006, but the therapy caps 

will remain inapplicable to therapy 

services provided in the outpatient 

hospital setting as provided in section 

1833(g) of the Act. 

Section 5107(b) of the DRA requires 

the Secretary to implement, by July 1, 

2006, edits for clinically illogical 

combinations of procedure codes and 

other edits in order to limit 

inappropriate payment for therapy 

services. In January 2006, we 

implemented Correct Coding Initiative 

(CCI) edits for the therapy providers that 

bill to the fiscal intermediaries, thus, 

addressing the section 5107 of the DRA 

requirement with respect to edits for 

clinically illogical combinations of 

procedure codes. Adoption of these 

code edits ensures that these providers 

of outpatient Part B therapy services, 

including SNFs, comprehensive 

outpatient rehabilitation facilities, 

certain outpatient physical therapy and 

speech-language therapy providers 

(rehabilitation agencies) and home 

health agencies (HHAs) (where 

beneficiary is not under a Part A plan 

of care) meet the same CCI edit 

requirements as those that have been in 

place for physicians, private practice 

therapists, and OPPS hospitals. We are 

considering the implementation of other 

edits in the future to further address 

concerns about inappropriate payment 

for therapy services. 

3. Section 5112-Proposed Addition of 

Ultrasound Screening for Abdominal 

Aortic Aneurysm (AAA) 

Section 5112 of the DRA of 2005 

amended section 1861 of the Act to 

provide for coverage under Part B of 

ultrasound screening for AAAs, 

effective for services furnished on or 

after January 1, 2007, subject to certain 

eligibility and other limitations. This 

screening test will be available even if 

the qualifying patient does not present 

signs or symptoms of disease or illness. 

To conform the regulations to the 

statutory requirements of section 5112 

of the DRA, we are proposing to include 

an exception in § 411.15(a)(1) to permit 

coverage for ultrasound screening for 

AAAs that meet the conditions for 

coverage that we are proposing to 

specify under new § 410.19(b) 

(Conditions for coverage of an 

ultrasound screening for abdominal 

aortic aneurysms). We are also adding a 

new § 411.15(k)(12). 

As provided in the DRA, this new 

coverage allows payment for a one-time 

only screening examination. We are 

proposing to add new § 410.19(b) to 

provide for the coverage of the screening 

examinations for AAAs as specified in 

section 5112 of the DRA. We are also 

proposing to add new § 410.19(c) 

(Limitation on coverage of ultrasound 

screening for abdominal aortic 

aneurysms.) to provide the limitation on 

coverage for an individual who is not an 

eligible beneficiary as defined in 

proposed new § 410.19(a). 

We are proposing definitions set forth 

in new § 410.19(a) of this proposed rule 

that would be included to implement 

the statutory provisions and to help the 

reader in understanding the provisions 

of this regulation. The proposed 

definitions include the following terms: 

• Eligible beneficiary. 

• Ultrasound screening for abdominal 

aortic aneurysms. 

Specifically, section 5112(a)(1) of the 

DRA amended section 1861 of the Act 

to provide that coverage of ultrasound 

screening for AAAs will be available for 

an individual—(i) who receives a 

referral for such an ultrasound screening 

as a result of an initial preventive 

physical examination (as defined in 

section 1861(ww)(1) of the Act); (ii) who 

has not been previously furnished such 

an ultrasound screening under this title; 

and (iii) who has a family history of 

AAA or manifests risk factors included 

in a beneficiary category recommended 

for screening by the United States 

Preventive Services Task Force 

regarding AAAs. 

Section 5112(a)(2) of the DRA also 

adds a definition of the term 

‘‘ultrasound screening for an Abdominal 

Aortic Aneurysm’’ to mean, ‘‘(1) a 

procedure using sound waves (or other 

procedures using alternative 

technologies, of commensurate accuracy 

and cost, that the Secretary may specify) 

provided for the early detection of 

abdominal aortic aneurysm; and (2) 

includes a physician’s interpretation of 

the results of the procedure.’’

In developing the proposed rule based 

on this provision, we reviewed the 2005 

United States Preventive Services Task 

Force (USPSTF) recommendations and 

related material on ultrasound screening 

for AAAs. This includes—

• A recommendation for a one-time 

ultrasound screening for men aged 65 to 

75 who have smoked at least 100 

cigarettes in their lifetime; 

• No recommendation for or against 

ultrasound screening for AAAs for men 

who have not smoked at least 100 

cigarettes in their lifetime; and 

• A recommendation against routine 

screening for AAAs in women. 

Based on the statutory language and 

the USPSTF recommendations outlined 

above, we are proposing to define the 

term ‘‘eligible beneficiary’’ for coverage 

of ultrasound screening examinations 

for AAA to mean an individual who—

• Has received a referral for an 

ultrasound screening as a result of an 

initial preventive physical examination 

(as defined in section 1861(ww)(1) of 

the Act); 

• Has not been previously furnished 

such a covered ultrasound screening 

examination under the Medicare 

program; and 

• Is included in at least one of the 

following risk categories: 

+ Has a family history of an AAA; or 

+ Is a man age 65 to 75 years who 

smoked at least 100 cigarettes in his 

lifetime; or 

+ Is an individual who manifests 

other risk factors that are described in 

a benefit category recommended by the 

USPSTF regarding an AAA that has 

been determined by the Secretary 

through the NCD process. 

To facilitate our consideration of 

possible expansions of coverage in the 

future for identifying (1) other risk 

factors in a benefit category 

recommended for screening for the early 

detection of AAAs by the USPSTF, and 

(2) alternative screening technologies to 

ultrasound screening for AAAs of 

commensurate accuracy and cost, we 

are proposing to add language to our 

regulations that would allow us to make 

determinations through the NCD 

process. The NCD process would allow 

the Secretary to expand coverage more 

quickly following an assessment of 

those subjects than is possible under the 

standard rulemaking process. We intend 

to use the NCD process, which includes 

an opportunity for public comments, for 

evaluating the medical and scientific 

issues relating to the coverage of 

alternative screening technologies and 

the identification of other risk factors for 

AAAs recommended by the USPSTF 

that may be brought to our attention in 

the future. Use of an NCD to establish 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 48999 

a change in the scope of benefits is 

authorized by section 1871(a)(2) of the 

Act. An aggrieved party can challenge 

an NCD under the procedures 

established by section 1869(f) of the Act. 

These proposed coverage provisions 

would be set forth in proposed new 

§ 410.19 (a)(1)(i) and 

§ 410.19(a)(2)(iii)(C). 

Section 5112(b) of DRA also amended 

section 1861(ww)(2) of the Act (the 

initial preventive physical examination 

benefit) by adding the new ultrasound 

screening benefit to the list of 

preventive services for which 

physicians and other qualified 

nonphysician practitioners must 

provide ‘‘education, counseling and 

referral’’ to new beneficiaries who take 

advantage of the initial preventive 

physical examination benefit within the 

first 6 months after the effective date of 

their first Part B coverage period. 

Therefore, we are also proposing to 

amend § 410.16(a)(7) of the regulations 

so that it reflects the additional 

responsibilities that physicians and 

qualified nonphysician practitioners 

will have under the initial preventive 

physical examination benefit with 

respect to the new ultrasound screening 

benefit. 

Beginning January 1, 2007, we are 

proposing to pay for ultrasound 

screening for AAAs through the use of 

a new HCPCS code GXXX1, Ultrasound, 

B-scan and/or real time with image 

documentation; for abdominal aortic 

aneurysm (AAA) screening. We are 

proposing that payment for this service 

be made at the same level as CPT code 

76775 Ultrasound, retroperitoneal (e.g., 

renal, aorta, nodes), B-scan and/or real 

time with image documentation; 

limited. CPT code 76775 is used to bill 

for the service when it is provided as a 

diagnostic test, and we believe the 

service associated with the proposed 

HCPCS code reflects equivalent 

resources and work intensity to those 

contained in CPT code 76775. 

In addition, since the DRA provides 

that the Medicare Part B deductible will 

not apply with respect to ultrasound 

screening for abdominal aortic 

aneurysm (as defined in section 

1861(bbb) of the Act), we are proposing 

to revise § 410.160 to include an 

exception from the Medicare Part B 

deductible for the ultrasound screening 

for abdominal aortic aneurysm as 

described in proposed § 410.19. 

(Conditions for coverage of an 

ultrasound screening for abdominal 

aortic aneurysms.) 

4. Section 5113—Proposed NonApplication of the Part B Deductible for 

Colorectal Cancer Screening Tests 

Current Medicare policy requires that, 

with limited exceptions, incurred 

expenses for covered part B services are 

subject to, and count toward meeting 

the Part B annual deductible. Section 

5113 of the DRA amended section 

1833(b) of the Act to provide for an 

exception to the application of the Part 

B deductible with respect to colorectal 

cancer screening tests. Beginning 

January 1, 2007, colorectal cancer 

screening services, as described in 

section 1861(pp)(1) of the Act, are no 

longer subject to the Part B deductible. 

The conditions for and limitations on 

coverage for colorectal cancer screening 

tests under Medicare part B are 

described in § 410.37. 

To conform our regulations to this 

statutory change, we are proposing to 

revise § 410.160 to include an exception 

from the Part B annual deductible for 

the colorectal cancer screening services 

described in § 410.37. 

5. Section 5114—Proposed Addition of 

Diabetes Outpatient Self-Management 

Training Services (DSMT) and Medical 

Nutrition Therapy (MNT) for the FQHC 

Program 

Section 5114 of the DRA amended 

section 1861(aa)(3) of the Act to add 

DSMT and MNT services to the list of 

Medicare covered and reimbursed 

services under the Medicare FQHC 

benefit, effective for services provided 

on or after January 1, 2006. Although 

this statutory change has already been 

implemented in administrative 

instructions, we are proposing to 

conform the regulations to the new 

statutory requirement. 

FQHCs certified as DSMT and MNT 

providers have been allowed to bundle 

the cost of those services into their 

FQHC payment rates. But before the 

enactment of the DRA, the provision of 

these services would not generate a 

separate FQHC visit payment. Effective 

for services furnished on or after 

January 1, 2006, FQHCs that are 

certified providers of DSMT and MNT 

services can receive per visit payments 

for covered services furnished by 

registered dietitians or nutrition 

professionals. In other words, if all 

relevant program requirements are met, 

these services are included under the 

Medicare FQHC benefit as billable 

visits. 

In order to conform the regulations, 

we are proposing to amend 

§ 405.2446(b) to expand the scope of 

FQHC services to include certified 

providers of DSMT and MNT services 

by adding a new paragraph (10). We are 

also proposing to revise § 405.2463 by—

• Revising paragraph (a) to expand 

the definition of an FQHC visit to 

include certified providers of DSMT and 

MNT services under new sub-paragraph 

(a)(1)(ii)(B). We would also revise the 

definition of an RHC visit in new 

subparagraph (a)(1)(i) to include a faceto-face encounter between a patient and 

a clinical psychologist or clinical social 

worker to conform to statutory language 

at section 1861(aa)(1)(B) of the Act. We 

are also proposing to redesignate and 

revise paragraphs (b) and (c) as new 

paragraphs (a)(2) and (a)(3), 

respectively. 

• We are proposing to incorporate 

paragraph (a)(2) into (a)(1), and to 

redesignate and revise current 

paragraph (a)(3) as new paragraph (b). 

We would also clarify that it is generally 

permissible for both FQHCs and Rural 

Health Clinics to furnish, when 

necessary, most types of medical and 

other health visits on the same day to 

the same patient. We are also proposing 

to amend this paragraph to permit a 

separate additional FQHC visit for 

DSMT and MNT services (which may 

occur on the same date of service when 

the beneficiary receives care from their 

FQHC physician or non-physician 

practitioner) when reasonable and 

necessary, consistent with the 

Congressional mandate under section 

5114 of the DRA to provide coverage 

and adequate access to these services in 

the FQHC setting. 

• We are proposing to redesignate 

and revise current paragraph (a)(4) as 

new paragraph (c). 

F. Proposed Payment for Covered 

Outpatient Drugs and Biologicals (ASP 

Issues) 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘ASP Issues’’ 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 

payment basis generally fall into the 

following three categories: 

• Drugs furnished incident to a 

physician’s service. 

• DME drugs. 

• Drugs specifically covered by 

statute (certain 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 

mstockstill on PROD1PC63 with PROPOSAL_2

49000 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

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 furnishing fee for blood 

clotting factors, a dispensing fee for 

inhalation drugs, and a supplying fee to 

pharmacies for certain Part B drugs. 

In January 2006, the drug coverage 

available to Medicare beneficiaries 

expanded with the implementation of 

Medicare Part D. The Medicare Part D 

program does not change Medicare Part 

B drug coverage. 

This section of the preamble discusses 

proposed changes and issues related to 

the determination of the payment 

amounts for covered Part B drugs and 

furnishing blood clotting factor. This 

section also discusses proposed changes 

to how manufacturers calculate and 

report ASP data to us. 

1. ASP Issues 

Section 303(c) of the MMA amended 

Title XVIII of the Act by adding new 

section 1847A. This new section revised 

the payment methodology for the vast 

majority of 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 for each 11-digit National Drug 

Code (NDC) 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. We update the Part B drug 

payment amounts quarterly based on 

the data we receive. 

In this section of the preamble, we 

discuss our intent to issue a final rule 

to implement the provisions in the 

MMA related to the calculation and 

submission of manufacturers’ ASP data, 

and seek further comments on specific 

issues related to price concessions and 

certain fees. 

On April 6, 2004, we published the 

Manufacturer’s Submission of Average 

Sales Price Data for Medicare Part B 

Drugs and Biologicals (ASP) interim 

final rule with comment period (IFC) 

(69 FR 17935) to implement the ASP 

calculation and reporting requirements. 

Manufacturers were required to submit 

their initial quarterly ASP data to us 

shortly thereafter, beginning April 30, 

2004. We received comments from drug 

manufacturers, pharmacies, physicians, 

national associations of the 

pharmaceutical industry, national 

associations of physicians, and 

consultants. These comments addressed 

a variety of aspects of calculating and 

reporting ASPs. On September 16, 2004, 

we published the Manufacturer’s 

Submission of Average Sales Price Data 

for Medicare Part B Drugs and 

Biologicals (ASP) final rule (69 FR 

55763) addressing only the comments 

pertaining to the methodology for 

estimating lagged price concessions. We 

have also addressed ASP calculation 

and reporting requirements in other 

proposed and final rules and 

information collection notices, 

including rulemaking to implement the 

Competitive Acquisition Program for 

Part B Drugs and Biologicals (CAP). (See 

70 FR 39069, 70 FR 45842, 70 FR 70215, 

and 70 FR 70477.) In addition, we 

posted official agency guidance, 

including responses to frequently asked 

questions, on our Web site to implement 

the ASP provisions in accordance with 

section 1847A(c)(5)(C) of the Act. 

We intend to publish a final rule 

addressing comments on the April 6, 

2004 IFC in the near future. We may 

publish the final rule as part of this 

rulemaking, or we may publish a 

separate final rule, in either case after 

the close of the comment period for this 

proposed rule. Because the comments 

received during the comment period in 

response to the April 6, 2004 IFC were 

made during the initial months of 

manufacturers’ experience with 

calculating and reporting ASPs and 

prior to publication of payment amounts 

based on the ASP methodology, we 

believe there is good reason to provide 

the public with the opportunity for 

additional comments based on what is 

now more than a year and a half of 

experience with the ASP reporting 

requirements. Therefore, we seek 

comments on the ASP reporting 

provisions in the April 6, 2004 IFC. In 

particular, we seek comments on the 

issues discussed in the sections below. 

We note that we received many 

comments in response to the April 6, 

2004 interim final rule on the use and 

potential impacts of the ASP payment 

methodology. As noted above, we are 

reopening the comment period on the 

issue of ASP reporting. Thus, comments 

about the use or appropriateness of the 

ASP payment methodology are outside 

the scope of this rulemaking and the 

ASP reporting rule (CMS–1380–IFC). 

Therefore, comments about the 

appropriateness and use of 106 percent 

of ASP as the basis for the Medicare Part 

B drug payment rates will be outside the 

scope of the comments considered for 

the final ASP reporting rule we are 

preparing to publish. 

a. Fees Not Considered 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; and 

• 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 using the 

required ratio methodology as specified 

in 42 CFR part 414, subpart J, 

§ 414.804(a)(3). 

Among the comments from drug 

manufacturers and national associations 

representing wholesalers and 

distributors, we received requests for 

clarification and detailed guidance on 

the treatment of administrative fees, 

service fees and fees paid to pharmacy 

benefit managers (PBMs) in the ASP 

calculation. We posted guidance on our 

Web site (http://questions.cms.hhs.gov/ 

cgi-bin/cmshhs.cfg/php/enduser/

std_adp.php?p_faqid=3323&p_

created=1095344721&

p_sid=Ghuscgci&p_accessibility=0&

p_lva=&p_sp=cF9zcmNoPTEmcF9zb3J

0X2J5PSZwX2dyaWRzb3J0

PSZwX3Jvd19jbnQ9M

zEmcF9wcm9kcz04LD

U2LDYwNCZwX2NhdHM9JnBfc

HY9My42MDQmcF9jdj0mcF9zZWFyY

2hfdHlwZT1hbnN3ZXJzLnNl

YXJjaF9ubCZwX3BhZ2U9MQ**&p_li=&

p_topview=1) to clarify that in the 

absence of specific guidance in the 

Social Security Act or Federal 

regulations, the manufacturer may make 

reasonable assumptions in its 

calculations of ASP, consistent with the 

general requirements and intent of the 

Social Security Act, Federal regulations, 

and its customary business practices. 

These assumptions should be submitted 

along with the ASP data. In December 

2004, we posted further guidance on our 

website addressing service fees and 

administrative fees paid to buyers 

(http://questions.cms.hhs.gov/cgi-bin/ 

cmshhs.cfg/php/enduser/

std_adp.php?p_faqid=3318&p_

created=1095343992&p_sid=a2qUcgci

&p_accessibility=0&p_lva=&p

_sp=cF9zcmNoPTEmcF9zb3J0X2J5PSZ

wX2dyaWRzb3J0PSZwX3Jvd19jbnQ9Mz

EmcF9wcm9kcz04LDU2LDY

wNCZwX2NhdHM9

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49001 

JnBfcHY9My42MDQmcF9jdj0

mcF9zZWFyY2hfdH

lwZT1hbnN3ZXJzLnNlYXJ

jaF9ubCZwX3BhZ2U9MQ**&p_li=&p

_topview=1 and http:// 

questions.cms.hhs.gov/cgi-bin/ 

cmshhs.cfg/php/enduser/std_adp.

php?p_faqid=4136&p

_created=1109786814&p_sid=bxw-cgci

&p_accessibility=0&p_lva=&

p_sp=cF9zcmNoPTE

mcF9zb3J0X2J5PSZwX2

dyaWRzb3J0PSZwX3Jvd19jbn

Q9MzEmcF9wcm9kcz04LDU2LDY

wNCZwX2NhdHM9JnBfcHY9

My42MDQmcF9jdj0mcF9zZWFyY2hfd

HlwZT1hbnN3ZXJzLnNlYXJjaF9

ubCZwX3BhZ2U9MQ**&p

_li=&p_topview=1). 

On July 6, 2005, we restated our 

guidance on service fees in the preamble 

of the Competitive Acquisition of 

Outpatient Drugs and Biologicals Under 

Part B (CAP) interim final rule with 

comment (70 FR 39069). Subsequently, 

we have received requests for 

clarification on how fees paid to entities 

such as group purchasing organizations 

(GPOs) or PBMs must be treated for 

purposes of the ASP calculation. 

We propose to further clarify in the 

final ASP reporting rule that, beginning 

with the ASP reporting for sales during 

the first calendar quarter of 2007, bona 

fide service fees that are paid by a 

manufacturer to an entity, whether or 

not the entity takes title to the drug, are 

not considered price concessions under 

§ 414.804(a)(2) insofar as, and to the 

extent that, they satisfy the definition of 

a bona fide service fee that we are 

proposing at § 414.802. In § 414.802, we 

propose to define bona fide service fees 

as fees paid by a manufacturer to an 

entity that represent fair market value 

for a bona fide, itemized service actually 

performed on behalf of the manufacturer 

that the manufacturer would otherwise 

perform (or contract for) in the absence 

of the service arrangement, and that are 

not passed on, in whole or in part, to a 

client or customer of an entity, whether 

or not the entity takes title to the drug. 

Our current guidance, which provides 

that bona fide service fees means 

expenses that would have generally 

been paid for by the manufacturer at the 

same rate had these services been 

performed by other entities, would 

continue unless we provide an 

alternative approach as discussed 

below. Further, we propose to clarify in 

the final ASP reporting rule that fees, 

including service fees, administrative 

fees and other fees, paid to GPOs or 

PBMs are not considered price 

concessions under § 414.804(a)(2) 

insofar as, and to the extent that, they 

satisfy the definition of a bona fide 

service fee that we have proposed at 

§ 414.802. 

In comments on the April 6, 2004 IFC, 

groups representing wholesalers, 

distributors and specialty pharmacies 

provided some insight into the types of 

activities that are performed in the 

distribution of drugs. These commenters 

suggested that costs for handling, 

storage, inventory reporting, shipping, 

receiving, patient education, disease 

management and data should be borne 

by manufacturers and be excluded from 

the ASP calculation as bona fide 

services. However, these commenters 

did not provide detailed information 

about whether and how one would 

determine the extent to which these 

activities are bona fide services actually 

performed on behalf of the manufacturer 

or otherwise. 

Because the scope of appropriate 

services may vary across categories of 

drugs, we are considering providing 

guidance on the types of services that 

may qualify as bona fide services for 

purposes of the ASP calculation. We are 

also considering providing further 

guidance on or revising the approach or 

methodology manufacturers must use to 

determine the fair market value of bona 

fide services performed on their behalf 

and whether the service fee paid was 

passed on in whole or in part. In either 

case, we may implement our policy 

through rulemaking or through program 

instruction or other guidance (consistent 

with our authority under section 

1847A(c)(5)(C) of the Act). 

We seek comments on the specific 

types of services entities perform on 

behalf of manufacturers that a 

manufacturer would otherwise perform 

(or contract for) and the necessity of 

those services in the efficient 

distribution of drugs. We also seek 

comments on activities that should not 

be considered bona fide services 

performed on behalf of manufacturers. 

To better understand which services 

may be considered bona fide services 

performed on behalf of the manufacturer 

that the manufacturer would otherwise 

perform (or contract for), we seek to 

understand the bona fide services that 

may be appropriate for all or specific 

types of products, as well as the specific 

services that may be applicable to 

unique products or circumstances. We 

also seek to understand the costs and 

relative costs of services performed on 

behalf of manufacturers. 

To exclude a bona fide service fee 

from the ASP calculation, a 

manufacturer must determine whether 

the fee paid to an entity represents fair 

market value for a bona fide service 

actually performed on behalf of the 

manufacturer that the manufacturer 

would otherwise perform (or contract 

for), and that the fee is not passed on, 

in whole or in part, to a client or 

customer of the entity. Our current 

guidance provides that bona fide service 

fees means expenses that would have 

generally been paid for by the 

manufacturer at the same rate had these 

services been performed by other 

entities. We seek comments on 

appropriate additional guidance or 

alternative methods for determining fair 

market value for purposes of identifying 

bona fide service fees that are excluded 

from the calculation of ASP, as well as 

comments on whether, and the extent to 

which, fees tied to performance of a 

service, fixed fee, revenue generated by 

product sales, or other basis may 

represent fair market prices for purposes 

of identifying bona fide service fees that 

are excluded from the calculation of 

ASP. In addition, we seek comments on 

the appropriate methods for 

determining whether a fee is passed on 

in whole or in part. We also seek 

comments on how Medicare’s guidance 

on the treatment of service fees for ASP 

calculation purposes may differ with the 

treatment of service fees for financial 

accounting or other purposes, and any 

implications that this may have for 

manufacturers. 

b. Estimation Methodology for Lagged 

Exempted Sales 

Section 1847A(c)(2) of the Act 

requires manufacturers to exclude from 

the calculation of ASP those sales that 

are exempt from the Medicaid best price 

(BP) calculation (for example, Federal 

sales, sales to State pharmacy assistance 

programs, sales to a prescription drug 

plan for use under Medicare Part D). In 

the comments on the April 6, 2004 IFC, 

commenters requested more guidance 

on the method manufacturers should 

use to exclude exempted sales that are 

known on a lagged basis. Manufacturers 

identify exempted sales based on direct 

sales and through chargeback and rebate 

data that may not be sufficiently 

available at the time the ASP is 

calculated. In the absence of specific 

guidance on how to account for lagged 

exempted sales (that is, exempted sales 

identified through chargeback or rebate 

processes), manufacturers have relied 

upon assumptions in accordance with 

their customary business practices to 

develop their approach for excluding 

these sales from the ASP calculation. In 

our work with manufacturers that 

submit ASP data, we understand that 

some manufacturers have used a ratio 

methodology for estimating exempted 

sales known on a lagged basis which is 

similar to the ratio methodology 

manufacturers must use to estimate 

mstockstill on PROD1PC63 with PROPOSAL_2

49002 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

price concessions known on a lagged 

basis. 

To establish a uniform approach, in 

§ 414.804(a)(4), we propose to require, 

in the final ASP reporting rule, that all 

manufacturers use a 12-month (or less, 

if applicable) rolling average ratio 

methodology to estimate exempted sales 

known on a lagged basis (through 

chargebacks or rebates) in order to more 

accurately exclude these sales from the 

ASP calculation. Specifically, for 

exempted sales known on a lagged 

basis, the manufacturer sums the lagged 

exempted sales for the most recent 12- 

month period available (or the number 

of months the NDC has been sold for 

NDCs with less than 12 months of sales, 

except for redesignated NDCs as 

described in section d below). The 

manufacturer then calculates a 

percentage using this summed amount 

as the numerator and the sales (the 

number of units after non-lagged 

exempted sales have been subtracted 

from total sales) for the same period (12 

months or less, if applicable) as the 

denominator. The result is a rolling 

average percentage estimate for lagged 

exempted sales that is applied to the 

sales (the number of units after nonlagged exempted sales have been 

subtracted from total sales) for the 

quarter being reported. The product that 

results from multiplying the rolling 

average percentage estimate of lagged 

exempted sales and sales (the number of 

units after non-lagged exempted sales 

have been subtracted from total sales) 

determines the number of lagged 

exempted sales (in units) to be excluded 

from the denominator of the ASP 

calculation. Manufacturers must make a 

corresponding adjustment to the 

numerator of the ASP calculation to 

ensure that the total in dollars for the 

reporting quarter does not include 

revenue related to lagged exempted 

sales excluded from the denominator 

using the proposed estimation 

methodology. Further, manufacturers 

must remove the dollar value of lagged 

exempted sales from their estimates of 

lagged price concessions by subtracting 

the dollar value of estimated lagged 

exempted sales from the denominator as 

specified in § 414.804(a)(3)(i). 

Our proposed methodology for 

excluding lagged exempted sales is 

similar to the methodology 

manufacturers are required to use to 

estimate price concessions known on a 

lagged basis, and was recommended by 

manufacturers. We believe requiring 

similar methods to estimate both lagged 

exempted sales and lagged price 

concessions is reasonable and reduces 

potential errors in the manufacturers’

ASP calculations, while ensuring that 

exempted sales are appropriately 

removed from the ASP calculation. In 

addition, using an estimation 

methodology to remove lagged 

exempted sales reduces the likelihood 

of quarter to quarter variations in the 

ASP. 

We seek comments on the proposed 

methodology for excluding exempted 

sales known on a lagged basis from the 

ASP calculation and estimate of lagged 

price concessions. We also solicit 

suggestions on appropriate alternative 

methodologies that may be less 

complex. 

c. Nominal Sales 

Section 1847A(c)(2)(B) of the Act 

requires manufacturers to exclude from 

the ASP calculation sales that are 

merely nominal in amount, as applied 

for purposes of section 

1927(c)(1)(C)(ii)(III) of the Act, except as 

the Secretary may otherwise provide. 

Effective January 1, 2007, the DRA (Pub. 

L. 109–171) modifies section 

1927(c)(1)(C)(ii)(III) of the Act. 

Limitations on nominal sales have been 

added in new section 1927(c)(1)(D) of 

the Act. The DRA also modified the 

average manufacturer price (AMP) 

calculation and frequency of AMP 

reporting. Therefore, we are proposing 

to clarify the method manufacturers 

must follow, beginning in 2007, to 

identify nominal sales for ASP reporting 

purposes and to exclude nominal sales 

from the calculation of the ASP. We also 

are seeking comments on whether we 

should establish an alternative 

definition of nominal sales for ASP 

purposes. 

In the preamble to the ASP reporting 

interim final rule, we stated sales to an 

entity that are nominal in amount are 

defined in the Medicaid drug rebate 

agreement (see sample agreement at 

http://www.cms.hhs.gov/ 

MedicaidDrugRebateProgram/ 

downloads/rebateagreement.pdf). That 

is, for ASP purposes, a nominal sale is 

a sale at a price less than 10 percent of 

the AMP in the same quarter for which 

the AMP is computed. Effective January 

1, 2007, the DRA revises the AMP 

calculation (to omit customary prompt 

pay discounts extended to wholesalers), 

added a monthly AMP reporting 

requirement, and established limitations 

on nominal sales (only sales to certain 

entities may qualify as nominal sales). 

Section 1927(c)(1)(D) of the Act limits 

the nominal sales exclusion to nominal 

sales made to the following entities: 

• 340B covered entities as described 

in section 340B(a)(4) of the Public 

Health Services Act (PHS Act). 

• Intermediate care facilities for the 

mentally retarded (ICFs/MR). 

• State-owned or operated nursing 

facilities. 

• Any other facility or entity that the 

Secretary determines is a safety net 

provider to which sales of such drugs at 

a nominal price would be appropriate 

based on the factors described in section 

1927(c)(1)(D)(ii) of the Act. 

Because section 1847A(c)(2)(B) of the 

Act requires manufacturers to exclude 

from the ASP calculation sales that are 

merely nominal in amount, as applied 

for purposes of section 

1927(c)(1)(C)(ii)(III) of the Act, except as 

the Secretary may otherwise provide, 

the DRA changes will have implications 

for ASP reporting beginning January 1, 

2007 (unless we provide an alternative 

policy for determining nominal sales as 

permitted under section 1847A(c)(2)(B) 

of the Act). One implication is that the 

limitations set forth in section 

1927(c)(1)(D) of the Act will continue 

the exclusion of nominal sales to certain 

entities while requiring that sales to 

entities not identified under section 

1927(c)(1)(D) of the Act are included in 

the ASP calculation, even if such sales 

are at very low prices. Another 

implication is the AMP calculation will 

exclude customary prompt pay 

discounts extended to wholesalers, yet 

prompt pay discounts will continue to 

be a type of price concession that 

manufacturers must include in their 

ASP calculations. The change in 

treatment of customary prompt pay 

discounts extended to wholesalers in 

the AMP calculation may result in a 

higher number of sales that are at less 

than 10 percent of the AMP than in past 

ASP reporting periods (notwithstanding 

the new limitation on what is 

considered a nominal sale under section 

1927(c)(1)(D) of the Act). Still another 

implication is that the frequency of 

AMP reporting will include monthly 

reporting; thus, for ASP purposes, there 

is further need to clarify how nominal 

sales are to be identified in 2007. 

Separate Medicaid rulemaking will 

address the DRA provisions related to 

AMP reporting. 

We believe the DRA modifications to 

section 1927 of the Act noted above will 

have minimal effect on reported ASPs. 

We would expect that the exclusion of 

customary prompt pay discounts 

extended to wholesalers from AMP 

would lead to a modest increase in 

AMP, and as a result a modest increase 

in the number of sales that would 

qualify as nominal under the current 

ASP reporting regulations. At the same 

time, we anticipate that the limitation 

on nominal sales in section 

1927(c)(1)(D) of the Act will result in a 

modest reduction in the number of sales 

that qualify as nominal sales for 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49003 

purposes of ASP reporting because we 

believe that the entities outlined in 

section 1927(c)(1)(D) of the Act 

generally represent the types of entities 

to which manufacturers may offer sales 

at a nominal amount. Consequently, we 

would expect these two countervailing 

changes would have a minimal overall 

impact on nominal sales that would be 

excluded from the ASP calculation. For 

2007 and beyond, we propose to revise 

§ 414.804(a)(4) to clarify that 

manufacturers must continue to use the 

Medicaid threshold (less than 10 

percent of AMP) to determine nominal 

sales that are excluded (subject to the 

limitations in section 1927(c)(1)(D) of 

the Act) from the ASP calculation. 

Further, we propose that, in identifying 

nominal sales, manufacturers must use 

the AMP for the calendar quarter that is 

the same calendar quarter for the ASP 

reporting period. For these reasons, we 

are proposing to continue the current 

methodology for identifying and 

excluding nominal sales (that is, sales 

that are exempt from the Medicaid best 

price calculation under section 

1927(c)(1)(C)(ii)(III) of the Act) from the 

manufacturer’s calculation of the ASP. 

We believe this approach helps 

maintain continuity in the ASP 

calculation and minimizes 

manufacturers’ reporting burden, as 

Medicare continues to follow the 

Medicaid approach for identifying 

nominal sales and manufacturers can 

use a single method for identifying 

nominal sales for both ASP and AMP 

purposes. 

We seek comments on our proposal to 

continue use of the AMP as the basis for 

identifying nominal sales excluded from 

the ASP calculation and on whether an 

alternative threshold for identifying 

nominal sales for ASP calculation 

purposes is necessary or desirable to 

ensure the accuracy of the ASP payment 

methodology. Specifically, we seek 

comments on whether sales at less than 

10 percent of the ASP (instead of the 

AMP) should be used to identify 

nominal sales for ASP purposes (with 

the new requirement in section 

1927(c)(1)(D) of the Act allowing only 

sales to certain entities to be considered 

nominal sales still being applicable). We 

also seek comments on our belief that 

the new limitations on nominal sales 

and change to the AMP calculation will 

have minimal impact on reported ASPs. 

Subsequent to the April 6, 2004 IFC, 

we received requests for clarification on 

a technical aspect related to the 

identification of nominal sales. 

Specifically, some manufacturers have 

asked whether nominal sales are 

identified by performing a series of 

calculations once or whether the 

manufacturer repeats the series of 

calculations until no remaining ASP 

eligible sales are below the nominal 

threshold. Consistent with current 

Medicaid reporting, for 2005 and 2006, 

manufacturers must identify nominal 

sales by performing the following steps 

once: 

• The manufacturer calculates the 

AMP for the reporting quarter to 

identify the dollar amount that 

represents 10 percent of the AMP for 

that reporting period. 

• The manufacturer then identifies 

sales below this amount and excludes 

these sales from the ASP calculation. 

• Beginning in 2007, the limitations 

in section 1927(c)(1)(D) of the Act must 

also be met to exclude the sale. 

d. Other Price Concession Issues 

In our ongoing work with 

manufacturers that submit ASP data, 

some manufacturers have posed 

questions or raised concerns about how 

the estimate of lagged price concessions 

is done prior to having 12 months of 

data for a NDC and, when a product is 

redesignated with a new NDC, whether 

price concessions from the prior NDC 

must be included in calculating the ASP 

for the new NDC. Manufacturers and 

other stakeholders have also asked us 

about how Medicare’s ASP guidance 

concerning price concessions is to be 

applied when drugs are sold under 

bundling arrangements. 

In response, we are proposing 

clarifications and seeking comment on 

these issues. 

(1) Price Concessions for NDCs With 

Less Than 12 Months of Sales 

To address situations when a NDC 

with price concessions known on a 

lagged basis has not been sold for a full 

12 months, we propose to revise 

§ 414.804(a)(3) to specify that the period 

used to estimate lagged price 

concessions is the total number of 

months the NDC has been sold. We 

propose to require that manufacturers 

use less than 12 months of data in the 

estimation methodology for lagged price 

concessions for NDCs with less than 12 

months of sales (except when the 

manufacturer has redesignated the 

product’s NDC, as discussed below). 

Manufacturers may include the current 

ASP reporting quarter in the most recent 

12 month period (or less for NDCs with 

less than 12 months of sales) so long as 

the manufacturer follows this approach 

in calculating the ASP for all of its 

reported NDCs. Using less than 12 

months in the estimation methodology 

for lagged price concessions is 

consistent with our proposal for 

estimating lagged excluded sales 

described in section b. above. 

(2) Redesignated NDCs 

From time to time, a manufacturer 

may change the NDC assigned to a 

specific product and package size while 

continuing or offering price concessions 

that span across sales of the product 

under its prior and redesignated NDCs. 

For example, an NDC may be changed 

to reflect a change in the labeler code 

while lagged price concessions in place 

under the prior NDC remain in effect 

and carry over to the redesignated NDC. 

Another example would be a 

manufacturer that modifies its package 

design or other non-drug feature of the 

NDC and assigns a new NDC to reflect 

the revised packaging. 

We propose to clarify in the final ASP 

reporting rule that, when an NDC is 

changed (except when a product is 

repackaged or relabeled by a different 

manufacturer or relabeler or is privately 

labeled) and lagged price concessions 

offered for the prior NDC remain in 

effect, the manufacturer must use 12 

months (or the total number of months 

of sales of the prior and redesignated 

NDCs if the total number of months of 

sales is less than 12 months) of sales 

and price concession data from the prior 

and redesignated NDCs to estimate 

lagged price concessions applicable to 

the redesignated NDC. In establishing 

this methodology, we are relying on our 

authority under section 1847A(c)(5)(A) 

of the Act. 

We seek comments on our proposed 

refinements to the estimation of lagged 

price concessions for NDCs with less 

than 12 months of sales and when a 

manufacturer redesignates the NDC 

assigned to a product. We also solicit 

suggestions for potentially clarifying 

these policies further. 

(3) Bundled Price Concessions 

We have heard a few concerns about 

how Medicare’s ASP guidance 

concerning price concessions is to be 

applied when drugs are sold under 

bundling arrangements (for example, 

when a purchaser’s price for one or 

more drugs is contingent upon the 

purchase of other drugs or items). We 

would like to better understand how 

bundling affects sales of Part B drugs 

and the ASP calculation, and any 

concerns stakeholders may have on this 

issue. Therefore, we are soliciting 

comments on a number of these issues. 

We note that we expect manufacturers 

of drugs reimbursed by Medicare Part B 

to comply with all applicable laws, 

regulations, and legal decisions 

including, but not limited to the Stark 

law, other relevant anti-kickback laws, 

mstockstill on PROD1PC63 with PROPOSAL_2

49004 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

antitrust laws, and laws governing fair 

trade practices. Our discussion of this 

issue in this proposed rule should not 

be construed as an endorsement or 

authorization of any pricing practices 

that contravene any laws, legal 

decisions, or regulations. 

Thus far, we have not provided 

specific guidance in the ASP context on 

the issue of apportioning price 

concessions across drugs that are sold 

under bundling arrangements. In the 

absence of specific guidance, the 

manufacturer may make reasonable 

assumptions in its calculations of ASP, 

consistent with the general 

requirements and the intent of the 

Social Security Act, Federal regulations, 

and its customary business practices. 

Manufacturers must include 

assumptions in their ASP submissions. 

We are now considering providing 

guidance, through rulemaking or 

through program instruction or other 

guidance (consistent with our authority 

under section 1847A(c)(5)(C) of the Act) 

on the methodology manufacturers must 

use for apportioning price concessions 

across Part B drugs sold under bundling 

arrangements for purposes of the 

calculation of ASP. As we consider this 

issue, our goal is to ensure that the ASP 

is an accurate reflection of market prices 

for Part B drugs and that the treatment 

of bundled price concessions in the ASP 

calculation does not create 

inappropriate financial incentives. 

We are soliciting comments on a 

number of issues, including how 

frequently Part B drugs are sold under 

bundling arrangements, the different 

structures of bundling arrangements that 

may exist (for example, the number of 

products included in a bundling 

arrangement; whether the price 

concessions are contingent on the 

purchase of only one product, the 

purchase of multiple products, or the 

inclusion of one or more products on a 

formulary; and the timing of the price 

concessions), and the extent to which 

sales of Part B drugs are bundled with 

sales of non-Part B drugs or non-drug 

products. We also seek comment on 

what effect bundling arrangements may 

have on the ASP calculation, on 

beneficiary access to high quality, 

appropriate care (including access to 

drugs that may not have clinical 

alternatives), and on costs to the 

Medicare program and beneficiaries. In 

addition, we seek comments on whether 

additional guidance on apportioning 

bundled price concessions for purposes 

of the calculation of ASP is needed and 

potential methodologies that Medicare 

could consider requiring. Furthermore, 

we seek comment on how variation in 

the structure of bundling arrangements 

may affect the impact of potential 

apportionment methodologies on the 

ASP calculation. 

2. Clotting Factor Furnishing Fee 

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 

centers and homecare companies for the 

items and services associated with the 

furnishing of blood clotting factor. 

Section 1842(o)(5)(C) of the Act 

specifies that the furnishing fee for 

clotting factor for years after CY 2006 

and subsequent years 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. In the 

CY 2006 PFS final rule, we announced 

that, based on the percentage increase in 

the CPI of 4.2 percent for the 12-month 

period ending June 2005, the furnishing 

fee is $0.146 per unit clotting factor for 

CY 2006. 

The CPI data for the 12-month period 

ending in June 2006 is not yet available. 

In the FY 2007 PFS final rule, we will 

include the actual figure for the percent 

change in the CPI for medical care for 

the 12-month period ending June 2006, 

and the updated furnishing fee for CY 

2007 calculated based on that figure. 

3. Widely Available Market Prices 

(WAMP) and AMP Threshold 

Section 1847A(d)(1) of the Act states 

that ‘‘the Inspector General of HHS shall 

conduct studies, which may include 

surveys to determine the widely 

available market prices (WAMP) 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 

(WAMP) for these drugs and biologicals 

(if any); and 

• The average manufacturer price 

(AMP) (as determined under section 

1927(k)(1) of the Act 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 WAMP or 

the AMP 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 WAMP or the AMP, or both.’’ In 

CY 2006, we specified an applicable 

threshold percentage of 5 percent for 

both the WAMP and AMP. We based 

this decision on the limited data 

available to support a change in the 

current threshold percentage. 

For CY 2007, we propose to specify an 

applicable threshold percentage of 5 

percent for the WAMP and the AMP. At 

present, the OIG is continuing its 

comparison of both the WAMP and the 

AMP. Since, at this time we do not have 

data that suggest another level is more 

appropriate, we believe that continuing 

the 5 percent applicable threshold 

percentage for both the WAMP and 

AMP is appropriate. 

There are a number of operational 

issues associated with Medicare’s 

authority to substitute a lower payment 

amount for a drug if the OIG finds and 

informs the Secretary, at such times as 

the Secretary may specify, that the ASP 

exceeds the WAMP or AMP by more 

than the established threshold 

(currently 5 percent). We would 

welcome public comment on 

operational issues such as the timing 

and frequency of the ASP, AMP, and 

WAMP comparisons and effective date 

and duration of the rate substitution. 

4. Payment for Drugs Furnished During 

CY 2006 and Subsequent Years in 

Connection With the Furnishing of 

Renal Dialysis Services if Separately 

Billed by Renal Dialysis Facilities 

In the November 21, 2005 PFS final 

rule (70 FR 70116), we stated that 

payment for a drug furnished during CY 

2006 in connection with renal dialysis 

services and separately billed by 

freestanding renal dialysis facilities and 

hospital-based facilities would be based 

on section 1847A of the Act. We 

intended this to mean CY 2006 and 

subsequent years. Therefore, in this 

proposed rule, we are not proposing a 

policy change, but rather, we are 

clarifying that this policy will apply to 

CY 2006 and subsequent years until 

otherwise specified. 

G. Proposed Provisions Related To 

Payment for Renal Dialysis Services 

Furnished by End-Stage Renal Disease 

(ESRD) Facilities 

[If you choose to comment on issues 

in this section, please include the 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49005 

caption ‘‘ESRD PROVISIONS’’ at the 

beginning of your comments.] 

Since August 1, 1983, payment for 

dialysis services furnished by ESRD 

facilities has been based on a composite 

rate payment system that provides a 

fixed, prospectively determined amount 

per dialysis treatment, adjusted for 

geographic differences in area wage 

levels. In accordance with section 

1881(b)(7) of the Act, separate 

composite rates have been established 

for hospital-based and independent 

ESRD facilities. The composite rate is 

designed to cover a package of goods 

and services needed to furnish dialysis 

treatments that include certain routinely 

provided drugs, laboratory tests, 

supplies, and equipment. Unless 

specifically included in the composite 

rate, other injectable drugs and 

laboratory tests medically necessary for 

the care of the dialysis patient are 

separately billable. The base composite 

rates per treatment, effective on August 

1, 1983, were $123 for independent 

ESRD facilities and $127 for hospitalbased ESRD facilities. The Congress has 

enacted a number of adjustments to the 

composite rate since that time. The 

current 2006 base composite rates are 

$130.40 for independent ESRD facilities 

and $134.53 for hospital-based ESRD 

facilities. 

Section 623 of the MMA amended 

section 1881 of the Act to require 

changes to the composite rate payment 

methodology, as well as to the pricing 

methodology for separately billable 

drugs and biologicals furnished by 

ESRD facilities. 

Section 1881(b)(12) of the Act, as 

added by MMA, required the 

establishment of a basic case-mix 

adjusted prospective payment system 

(PPS) that would include the services 

comprising the composite rate and an 

add-on to the composite rate component 

for the difference between current 

payments for separately billed drugs 

and the revised drug pricing specified in 

the statute. In addition, section 

1881(b)(12) of the Act required that the 

composite rate be adjusted for a limited 

number of patient characteristics (casemix) and section 1881(b)(12)(D) of the 

Act gave the Secretary discretion to 

revise the wage indices and the urban 

and rural definitions used to develop 

them. Finally, section 1881(b)(12)(E) of 

the Act imposed a budget neutrality 

requirement, so that aggregate payments 

under the basic case-mix adjusted 

composite payment system for 2005 

would equal the aggregate payments 

that would have been made for the same 

period if section 1881(b)(12) of the Act 

did not apply. 

Before January 1, 2005, payment to 

both independent and hospital-based 

facilities for the anti-anemia drug, 

Erythropoietin (EPO) was established 

pursuant to section 1881(b)(11) of the 

Act at $10.00 per 1,000 units. For 

independent ESRD facilities, payment 

for all other separately billable drugs 

and biologicals was based on the lower 

of actual charges or 95 percent of the 

average wholesale price (AWP). 

Hospital-based ESRD facilities were 

paid based on the reasonable cost 

methodology for separately billed drugs 

and biologicals (other than EPO) 

furnished to dialysis patients. Changes 

to the payment methodology for 

separately billed ESRD drugs and 

biologicals that were established by the 

MMA and were effective January 1, 

2005 are described in sections G.1. and 

G.2. below. These changes affected 

payments in both CYs 2005 and 2006. 

1. CY 2005 Revisions 

On November 15, 2004, we published 

the CY 2005 PFS final rule with 

comment period (69 FR 66319 through 

66334), that revised payments to ESRD 

facilities based on changes enacted by 

the MMA. The November 15, 2004 final 

rule with comment period implemented 

section 1881(b) of the Act, as amended 

by section 623 of the MMA. Changes 

effective January 1, 2005, included 

implementation of a case-mix adjusted 

payment system that incorporates 

services that comprise the composite 

rate; an update of 1.6 percent to the 

composite rate component of the 

payment system; and a drug add-on of 

8.7 percent to the composite rate for the 

difference between current payments for 

separately billable drugs and payments 

based on the revised drug pricing for 

2005 which used acquisition costs. The 

final rule also implemented case-mix 

adjustments to the composite rate for a 

limited number of patient 

characteristics (age, low body mass 

index (BMI), and body surface area 

(BSA)), effective April 1, 2005. 

In addition, to implement section 

1881(b)(13) of the Act, we revised 

payments for drugs billed separately by 

independent ESRD facilities, paying for 

the top 10 ESRD drugs based on 

acquisition costs (as determined by the 

OIG) and for other separately billed 

drugs at the average sales price +6 

percent (hereafter referred to as ASP+6 

percent). Hospital-based ESRD facilities 

continued to receive cost-based 

payments for all separately billable 

drugs and biologicals except for EPO 

which was paid based on average 

acquisition costs. 

2. CY 2006 Revisions 

In the November 21, 2005 Federal 

Register (70 FR 70161), we published 

the CY 2006 PFS final rule with 

comment period (70 FR 70161) 

implementing additional revisions to 

payments to ESRD facilities under 

section 623 of the MMA. For CY 2006, 

we further revised the drug payment 

methodology applicable to drugs 

furnished by ESRD facilities. All 

separately billed drugs and biologicals 

furnished by both hospital-based and 

independent ESRD facilities are now 

paid based on ASP+6 percent. 

We recalculated the 2005 drug add-on 

adjustment to reflect the difference in 

payments between the pre-MMA AWP 

pricing and the revised pricing based on 

ASP+6 percent. The recalculation did 

not affect the actual add-on adjustment 

applied to payments in 2005, but 

provided an estimate of what the 

adjustment would have been had the 

2006 payment methodology been in 

effect in 2005. The drug add-on 

adjustment was then updated to reflect 

the expected growth in expenditures for 

separately billable drugs in CY 2006. 

As of January 1, 2006, we also 

implemented a revised geographic 

adjustment authorized by section 

1881(b)(12) of the Act. As part of that 

change, we—

• Revised the labor market areas to 

incorporate the new CBSA designations 

established by the Office of Management 

and Budget (OMB); 

• Eliminated the wage index ceiling 

and reduced the floor to .8500; and 

• Revised the labor portion of the 

composite rate to which the geographic 

adjustment is applied. 

We also provided a 4-year transition 

from the previous wage-adjusted 

composite rates to the current wageadjusted rates. For CY 2006, only 25 

percent of the payment is based on the 

revised geographic adjustments, and the 

remaining 75 percent of payment is 

based on the old Metropolitan Statistical 

Area-based (MSA-based) payments. 

In addition, section 5106 of the DRA 

(Pub. L. 109–171), provided for a 1.6 

percent update to the composite rate 

component of the basic case-mix 

adjusted payment system, effective 

January 1, 2006. As a result, the current 

base composite rate is $130.40 for 

independent ESRD facilities and 

$134.53 for hospital-based facilities. The 

drug add-on adjustment (including the 

growth update) for 2006 is 14.5 percent. 

3. Provisions of the Proposed Rule 

For CY 2007, we are proposing the 

following provisions which are 

described in more detail below: 

mstockstill on PROD1PC63 with PROPOSAL_2

49006 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

• A method to annually calculate the 

growth update to the drug add-on 

adjustment required by section 

1881(b)(12) of the Act, as well as an 

estimated growth update adjustment to 

the add-on amount of 0.6 percent for CY 

2007. 

• An update to the wage index 

adjustments to reflect the latest hospital 

wage data, including a budget neutrality 

adjustment of 1.053069 to the wage 

index for CY 2007. 

4. Proposed Growth Update to the Drug 

Add-On Adjustment to the Composite 

Rates 

Section 623(d) of the MMA added 

section 1881(b)(12)(B)(ii) of the Act 

which required the establishment of an 

add-on to the composite rate to account 

for changes in the drug payment 

methodology stemming from enactment 

of the MMA. Section 1881(b)(12)(C) of 

the Act provides that the drug add-on 

must reflect the difference in aggregate 

payments between the revised drug 

payment methodology for separately 

billable ESRD drugs (acquisition costs in 

CY 2005; ASP+6 percent in CY 2006) 

and the AWP payment methodology in 

effect in CY 2004. 

In addition, section 1881(b)(12)(F) of 

the Act requires that, beginning in CY 

2006, we establish an annual update to 

the drug add-on to reflect estimated 

growth in expenditures for separately 

billable drugs and biologicals furnished 

by ESRD facilities. This growth update 

applies only to the drug add-on portion 

of the case-mix adjusted payment 

system. 

The CY 2006 drug add-on adjustment 

to the composite rate is 14.5 percent. 

The drug add-on adjustment for CY 

2006 incorporates an inflation 

adjustment of 1.4 percent. This 

computation is explained in detail in 

the CY 2006 PFS final rule with 

comment period (70 FR 70162). We note 

that the drug add-on adjustment of 14.7 

percent that was published in November 

21, 2005 PFS final rule with comment 

period did not account for the 1.6 

percent update to the composite rate 

portion of the basic case-mix adjustment 

payment system that was subsequently 

enacted by the DRA, effective January 1, 

2006. Since we compute the drug addon adjustment as a percentage of the 

weighted average base composite rate, 

the drug add-on percentage was 

decreased to account for the higher 

composite payment rate resulting in a 

14.5 percent add-on adjustment for CY 

2006. This adjustment was necessary to 

ensure that the total drug add-on dollars 

remained constant. 

a. Estimating Growth in Expenditures 

for Drugs and Biologicals for CY 2007 

In developing the growth update to 

the drug add-on for CY 2006 we 

conducted a trend analysis of prior 

years’ ESRD drug expenditure data 

(2001 through 2004). All 4 years of data 

used for the trend analysis reflected 

expenditures associated with payment 

for separately billed drugs and 

biologicals under the AWP 

methodology. We could, therefore, 

develop growth estimates for CY 2006 

using comparable historical expenditure 

data. To extend the trend analysis for 

CY 2007, we would need to include 

drug expenditure data from CY 2005. 

However, in CY 2005, section 

1881(b)(13)(A)(ii) of the Act required 

that we use a different drug payment 

methodology, based on average 

acquisition costs, rather than the AWP 

methodology used in prior years. 

Therefore, ESRD drug expenditure data 

for CY 2005 are not comparable to 

expenditure data for CY 2001 through 

CY 2004 for trend analysis purposes. 

This data issue will extend to 

subsequent years’ data as well, as we are 

now paying for separately billable drugs 

using ASP+6 percent. Because we do 

not have comparable data on which to 

base continuing trend analysis, we 

believe it is necessary to re-evaluate our 

methodology for updating the drug addon adjustment. 

In order to address the issue of data 

comparability described above, we 

considered using available drug proxy 

measures to predict growth in ESRD 

drug expenditures for CY 2007. We note 

that section 1881(b)(12)(F) of the Act 

specifies that the drug update must 

reflect ‘‘the estimated growth in 

expenditures for drugs and biologicals 

that are separately billable * * *.’’ By 

referring to ‘‘expenditures’’, we believe 

the statute contemplates that the update 

would account for both increases in 

drug prices as well as increases in 

utilization of those drugs. 

One available proxy measure that 

reflects both price and utilization is the 

national health expenditure projection 

for prescription drugs that is developed 

by CMS. However, because of 

uncertainties regarding the impact of the 

Medicare Part D prescription drug 

program on expenditures, we are 

concerned that the current estimates for 

CY 2007 will likely change, as actual 

Part D expenditure data become 

available. Therefore, we do not believe 

this measure would be an appropriate 

proxy measure for this purpose. 

Another widely recognized proxy 

measure is the producer price index 

(PPI) for prescription drugs. The PPI is 

a good measure of drug pricing growth, 

but does not capture the growth in per 

patient drug utilization that must also 

be part of an accurate estimate of growth 

in ESRD drug expenditures. However, if 

the PPI is used in conjunction with an 

estimate of per patient growth in drug 

utilization, we believe this measure 

would provide a simple and accurate 

approach to updating the drug add-on 

that could be readily used in subsequent 

years. Moreover, using the PPI would 

significantly reduce any data bias that is 

inherent in using historical drug 

expenditure data that do not reflect 

current drug payment methodologies. 

As discussed in detail below, we are 

proposing to estimate growth in per 

patient utilization of drugs by using 

historical data from 2004 and 2005. 

Another approach to estimating the 

growth in ESRD drug expenditures is to 

continue using historical trend analysis 

by making adjustments to the available 

data to permit year to year comparisons. 

This would be accomplished by making 

an adjustment to the CY 2005 data based 

on average acquisition price (AAP) 

using the weighted average difference 

between AWP prices and AAP prices. 

We would use trend analysis to project 

the growth in drug expenditures for CY 

2007. 

While we believe this approach is 

reasonably accurate for developing the 

CY 2007 growth estimates, since only 

one year of data would require 

adjustment, we are concerned about 

applying this methodology to future 

updates. Future year updates would 

require multiple year to year 

adjustments in prices. Moreover, 

historical AWP data does not provide an 

accurate measure of price changes for 

EPO under the revised drug payment 

methodology, since EPO pricing was 

held constant during that historical 

period. 

In addition, our estimate of the 

weighted average difference between 

AAP prices and AWP prices (and ASP 

versus AWP prices in CY 2006) was 

based on a projection of price levels. It 

is likely that the weighted average 

difference would change based on 

actual pricing data for each of those 

years. To be consistent with the statute, 

we expect to update the established 

adjustment to reflect estimated growth 

in drug expenditures, but we do not 

anticipate re-computing the drug add-on 

adjustment annually. Adjusting our 

assumptions to estimate projected 

growth without changing the underlying 

assumptions in the add-on adjustment 

would create inconsistencies between 

the two elements. Therefore, we are 

proposing to discontinue use of older 

historical drug spending data to 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49007 

estimate the growth update to the drug 

add-on adjustment. We will reconsider 

our methodology when we have 

sufficient historical data reflecting the 

revised drug payment methodology 

using ASP pricing. 

For the reasons discussed above, we 

are proposing to develop an estimate of 

the growth in expenditures for ESRD 

drugs and biologicals using the PPI for 

prescription drugs as a measure of price 

increases in conjunction with two years 

of historical data from 2004 and 2005 as 

a basis for estimating utilization growth 

at the per patient level. We believe that 

this approach will best reflect the 

estimated growth in expenditures for 

ESRD drugs and biologicals. 

b. Estimating Growth in Per Patient 

Drug Utilization 

To isolate and project the growth in 

per patient utilization of ESRD drugs for 

CY 2007, we need to remove the 

enrollment and price growth 

components from historical drug 

expenditure data and consider the 

residual utilization growth. We propose 

to use total drug expenditure data from 

CYs 2004 and 2005 to estimate per 

patient utilization growth for CY 2007. 

We first needed to estimate total drug 

expenditures. For this proposed rule, we 

used the final CY 2004 ESRD claims 

data and the latest available CY 2005 

ESRD facility claims, updated through 

December 31, 2005, that is, claims with 

dates of service from January 1 through 

December 31, 2005, that were received, 

processed, paid, and passed to the 

National Claims History File as of 

December 31, 2005. For the final rule, 

we will use more updated CY 2005 

claims with dates of service for the same 

time period. This updated CY 2005 data 

file will include claims that are 

received, processed, paid, and passed to 

the National Claims History File as of 

June 30, 2006. 

While the December 2005 update of 

CY 2005 claims used in this proposed 

rule is the most recently available 

claims data, we recognize that it is not 

a fully complete year as claims with 

dates of service towards the end of the 

year have not all been processed. To 

more accurately estimate the update to 

the drug add-on, we need aggregate drug 

expenditures. Based on an analysis of 

the 2004 claims data, we inflated the CY 

2005 drug expenditures to estimate the 

June 30, 2006 update of the 2005 claims 

file. We used the relationship between 

the December 2004 and the June 2005 

versions of 2004 claims to estimate the 

more complete 2005 claims that will be 

available in June 2006. We applied that 

ratio to the 2005 claims data from the 

December 2005 claims file. We did this 

for drug expenditures in aggregate, for 

each of top ten separately billable drugs, 

and within each for independent and 

hospital-based ESRD facilities. All 

components were then combined to 

estimate aggregate CY 2005 ESRD drug 

expenditures. The net adjustment to the 

CY 2005 claims data was an increase of 

13 percent to the 2005 expenditure data. 

This adjustment allows us to more 

accurately compare the 2004 and 2005 

data, to estimate utilization growth. 

The next step is to remove the 

enrollment and price growth 

components from that total. As 

discussed earlier in this section, in 

developing the per patient utilization 

growth for this proposed rule, we 

limited our analysis to the latest 2 years 

of available ESRD drug data, that is, 

2004 and 2005. We believe that per 

patient utilization growth between these 

years would be a better proxy for future 

growth, as it best represents current 

utilization trends. Furthermore, because 

of the implementation of the new EPO 

utilization monitoring policy that took 

effect on April 1, 2006 (Medicare Claims 

Processing Manual, Chapter 8, section 

60–4ff, p. 51–53), we believe that per 

patient utilization of ESRD drugs will 

remain relatively stable or decline 

slightly in future years. We note that 

EPO accounts for nearly 70 percent of 

ESRD drug expenditures. 

To calculate the per patient utilization 

growth, we removed the enrollment 

component by using the growth in 

enrollment data between 2004 and 2005. 

This was approximately 3 percent. To 

remove the price effect we used a twostep process. First we calculated a 

weighted average between EPO and 

non-EPO price growth factors to account 

for the growth in pre-MMA pricing 

between 2004 and 2005. Since EPO was 

priced at $10 per thousand units prior 

to the enactment of the MMA, there is 

no growth for EPO. For the non-EPO 

drugs, we used the PPI as a proxy for the 

growth between the 2 years to maintain 

consistency with the established 

methodology for calculating the drug 

add-on adjustment which used the PPI 

to estimate the price growth in 

separately billable drugs (November 15, 

2004, CY 2005 PFS final rule with 

comment period, 69 FR 66321). Next, 

we incorporated the estimated negative 

13 percent weighted price difference 

between 2005 AWP and 2005 AAP 

pricing as was published in the CY 2005 

PFS final rule with comment period (69 

FR 66319 through 66334). This two-step 

process to account for the price effect 

from 2004 to 2005 led to an overall 12 

percent reduction in price between 2004 

and 2005. 

After removing the enrollment and 

price effects from the expenditure data, 

we believe the residual growth would 

reflect the per patient utilization 

growth. To do this, we divided the 

product of the enrollment growth of 3 

percent (1.03) and the price reduction of 

12 percent (1.00 ¥ .12 = .88) into the 

total drug expenditure decrease between 

2004 and 2005 of 9 percent (1.00¥.09 

= .91). The result is a utilization factor 

equal to 1.00 (.91/(1.03 * .88) = 1.00). 

As we observed no growth in per 

patient utilization of drugs between 

2004 and 2005, we are, therefore, 

projecting no growth in per patient 

utilization for CY 2007. 

1. Applying the Proposed Growth 

Update to the Drug Add-on Adjustment 

In CY 2006, we estimated the growth 

update by trending drug expenditures 

forward based on four years of AWP 

payment data (CY 2001 through CY 

2004). We then applied the estimated 

growth update percentage to the total 

amount of drug add-on dollars 

established for CY 2005 to come up with 

a dollar amount for the CY 2006 growth 

update. In addition, we projected the 

growth in dialysis treatments for CY 

2006 based on the projected growth in 

ESRD enrollment. We divided the 

projected total dialysis treatments for 

CY 2006 into the projected dollar 

amount of the CY 2006 growth to 

develop the per treatment growth 

update amount. This growth update 

amount, combined with the CY 2005 per 

treatment drug add-on amount, resulted 

in an average drug add-on amount per 

treatment of $18.88 (or a 14.5 percent 

adjustment to the composite rate) for CY 

2006. 

Beginning in CY 2007, we are 

proposing to annually update the per 

treatment drug add-on amount of $18.88 

established in CY 2006 and convert the 

update to an adjustment factor as 

stipulated in section 1881(b)(12)(F) of 

the Act. As explained above, we believe 

this approach is more accurate than 

recalculating the per treatment add-on 

adjustment each year using an estimate 

of growth in treatments. We note that 

we had received comments that our 

projections of treatment growth used to 

calculate the CY 2006 adjustment may 

have been overstated, however, we 

believe that the use of enrollment data 

was and remains the best measure 

available to predict treatment growth. 

By proposing to apply the update to the 

CY 2006 per treatment add-on amount, 

this estimation component is eliminated 

for CY 2007 and future years. 

mstockstill on PROD1PC63 with PROPOSAL_2

49008 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

2. Proposed Update to the Drug Add-On 

Adjustment 

As discussed above, we estimate no 

growth in per patient utilization of 

ESRD drugs for CY 2007. Using the 

projected CY 2007 PPI for prescription 

drugs of 4.9 percent, we are projecting 

that the combined growth in per patient 

utilization and pricing for CY 2007 

would result in an update equal to the 

PPI or 4.9 percent (1.0*1.049 = 1.049). 

This update factor would be applied to 

the CY 2006 average per treatment drug 

add-on amount of $18.88 (reflecting a 

14.5 percent adjustment in CY 2006), 

resulting in a proposed weighted 

average increase to the composite rate of 

$.93 for CY 2007 or a 0.6 percent 

increase in the CY 2006 drug add-on 

percentage. Thus, the total proposed 

drug add-on adjustment to the 

composite rate for CY 2007, including 

the growth update, would be 15.2 

percent (1.145*1.006 = 1.152). 

In addition, we are proposing to 

continue to use this method to estimate 

the growth update to the drug add-on 

component of the case-mix adjusted 

payment system until we have at least 

three years worth of ASP-based 

historical drug expenditure data that 

could be used to conduct a trend 

analysis to estimate the growth in drug 

expenditures. Given the time lag in the 

availability of ASP drug expenditure 

data, we expect that the earliest we 

could consider using trend analysis to 

update the drug add-on adjustment 

would be 2010. We propose to 

reevaluate our methodology for 

estimating the growth update at that 

time. 

c. OIG Report on New Drug Codes 

Section 623(c)(1) of the MMA 

mandated that the OIG conduct two 

studies to determine the difference 

between the Medicare payment amount 

for separately billable ESRD drugs and 

the facilities’’ acquisition costs for these 

drugs, as well as estimating the growth 

rate of expenditures for these drugs. The 

initial study, ‘‘Medicare Reimbursement 

for Existing End Stage Renal Disease 

Drugs’’ (OEI–03–04–00120) was 

completed in May 2004, and reported 

on existing ESRD drugs. This report was 

used to set the CY 2005 reimbursement 

rates for ESRD drugs billed by 

independent dialysis facilities (69 FR 

66322). The second study (‘‘Medicare 

Reimbursement for New ESRD Drugs’’

(OEI–03–06–00200)) focused on new 

drugs. New drugs for the purpose of this 

study were defined as an ESRD drug 

that did not have a BILLING CODE prior 

to January 1, 2004. 

One drug, darbepoetin alfa (Aranesp) 

accounted for the majority of all 

payments for new drugs. Therefore, this 

was the only new ESRD drug studied. 

The OIG report found that use of this 

drug was limited to a small number of 

facilities (only 157 facilities reported 

using this drug with concentrated use in 

approximately 55 of these facilities). 

Because of the recent changes we made 

to the drug payment methodology and 

the lack of comparable historical data, 

the OIG report made no estimate of an 

expenditure growth rate for this drug. 

Darbepoetin alfa (Aranesp) is 

currently paid as a separately billable 

drug at ASP+6 percent. Because of the 

recent (CY 2006) implementation of the 

ASP+6 percent drug reimbursement 

methodology, the small number of 

facilities using this drug for ESRD 

patients, and the lack of historical data 

for trending purposes, we have no data 

to indicate that any difference in 

payment methods for Aranesp (between 

2004 and 2006) would affect our 

calculation of the drug add-on or of the 

growth update. Moreover, since Aranesp 

was approved in 2001 for use in ESRD 

patients, we believe that expenditures 

for Aranesp were reflected in the 

historical data used to establish the 

2005 drug add-on under a generic drug 

code. Therefore, we are proposing to 

make no additional changes to the drug 

add-on adjustment for CY 2007. 

5. Proposed Update to the Geographic 

Adjustments to the Composite Rates 

Section 1881(b)(12)(D) of the Act, as 

amended by section 623(d) of the MMA, 

gave the Secretary the authority to 

revise the wage indexes previously 

applied to the ESRD composite rates. 

The wage indexes are calculated for 

each urban and rural area. The purpose 

of the wage index is to adjust the 

composite rates for differing wage levels 

covering the areas in which ESRD 

facilities are located. 

a. Updates to CBSA Definitions 

In the CY 2006 PFS final rule with 

comment period (70 FR 70167), we 

announced our adoption of the OMB’s 

CBSA-based geographic area 

designations to develop revised urban/ 

rural definitions and corresponding 

wage index values for purposes of 

calculating ESRD composite rates. 

OMB’s CBSA-based geographic area 

designations were described in Bulletin 

03–04 originally issued June 6, 2003. On 

February 22, 2005 and December 5, 

2005, OMB released Bulletins 05–02 

and 06–01, respectively. Those bulletins 

contained updates to the metropolitan 

and micropolitan statistical area 

designations initially announced in 

Bulletin 03–04. OMB’s revisions had no 

effect on the classification of counties 

which comprise the urban and rural 

areas used to develop the ESRD wage 

index values. However, Bulletins 05–02 

and 06–01 changed the titles of several 

of the MSAs and Metropolitan Divisions 

used in connection with the ESRD 

urban wage index. Table 5 below, which 

contains the proposed wage index 

values for the ESRD urban areas, 

includes all of the changes announced 

by OMB in the February 22, 2005 and 

December 5, 2005 bulletins. 

b. Updated Wage Index Values 

In the CY 2006 PFS final rule with 

comment period, we stated that we 

intended to update the wage index 

values annually (70 FR 70167). Current 

ESRD wage index values for CY 2006 

were developed from FY 2002 wage and 

employment data obtained from the 

Medicare hospital cost reports. The 

values are calculated without regard to 

geographic reclassifications authorized 

under sections 1886(d)(8) and (d)(10) of 

the Act and utilize pre-floor hospital 

data that is unadjusted for occupational 

mix. 

The methodology for calculating the 

CY 2006 wage index values was 

described in the CY 2006 PFS final rule 

with comment period (70 FR 70168). We 

propose to use the same methodology 

for CY 2007, with the exception that FY 

2003 hospital data will be used to 

develop the CY 2007 ESRD wage index 

values. For a detailed description of the 

development of the proposed CY 2007 

ESRD wage index values based on FY 

2003 hospital data, see the FY 2007 

IPPS proposed rule entitled, ‘‘Proposed 

Changes to the Hospital Inpatient 

Prospective Payment Systems and Fiscal 

Year 2007 Rates,’’ (April 25, 2006, 71 FR 

24080). Section III F. (Computation of 

the Proposed FY 2007 Unadjusted Wage 

Index) of the preamble to that proposed 

rule describes the cost report schedules, 

line items, data elements, adjustments, 

and wage index computations. The 

wage index data affecting ESRD 

composite rates for each urban and rural 

locale may also be accessed on the CMS 

website at: http://www.cms.hhs.gov/ 

AcuteInpatientPPS/WIFN/list.asp. 

The wage data are located in the 

section entitled, ‘‘FY 2007 Proposed 

Rule Occupational Mix Adjusted and 

Unadjusted Average Hourly Wage and 

Pre-reclassified Wage Index by CBSA’’. 

(1) Wage Index Values for Areas With 

No Hospital Data 

In CY 2006, while adopting the CBSA 

designations, we identified a small 

number of ESRD facilities in both urban 

and rural geographic areas where there 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49009 

is no hospital wage data on which to 

base the calculations of the CY 2006 

ESRD wage index values. Our CY 2005 

policy and CY 2006 proposal for each 

area are discussed separately below. 

The first situation was rural 

Massachusetts. Because there were no 

reasonable proxies for rural data within 

Massachusetts, we used the prior year’s 

acute care hospital wage index value for 

rural Massachusetts. For CY 2007, we 

propose to continue to use this value 

and request public input on an 

alternative methodology. 

Since there may be additional rural 

areas in the future similarly impacted by 

a lack of hospital wage data on which 

to derive a hospital wage index, we are 

considering alternative methodologies 

for imputing a rural wage index for 

areas in States where no hospital wage 

data are available. We believe that an 

evaluation of alternative methodologies 

for imputing a rural wage index in these 

areas should adhere to four basic policy 

criteria. First, an alternative 

methodology should retain our current 

longstanding policy to use pre-floor, 

pre-reclassified hospital wage data to 

compute wage index values for post 

acute care facilities, including ESRD 

facilities. Second, any methodology to 

impute a rural wage index should use 

rural wage data to derive the rural wage 

index value. Third, any methodology to 

impute a rural wage index should be 

easy to evaluate. Fourth, any 

methodology to impute a rural wage 

index would be able to update wage 

data from year-to-year. 

We arrived at one alternative that 

meets all of the above policy criteria. 

Under this alternative, we would 

impute a rural wage index value by 

using a simple average CBSA-based 

rural wage index value at the Census 

Division level. Census Divisions are 

defined by the U.S. Census Bureau and 

may be found at (www.census.gov/geo/ 

www/us_regdiv.pdf). As stated above, 

for CY 2007, hospital wage data are not 

available to compute a rural wage index 

for ESRD facilities in rural 

Massachusetts, and this alternative 

methodology could be applied in this 

case. Massachusetts is located in Census 

Division I (New England). The States in 

this Census Division, and their 

respective rural wage index values 

(using hospital cost report wage data for 

FY 2003) include—

• Connecticut (1.1753); 

• Maine (0.8410); 

• New Hampshire (1.0800); 

• Vermont (0.9944) 

• Rhode Island (all five counties 

classified as urban); and 

• Massachusetts. 

Under this alternative methodology, 

the States in Census Division I for 

which rural wage index values are 

available, as shown above, would be 

used; this would result in a simple 

average rural wage index value of 

1.0227 (1.0770 after applying budget 

neutrality factor (BNF)). Although this 

methodology would result in a rural 

Massachusetts wage index that is 

currently greater than the value under 

the current proposed policy (1.0216, 

1.0758 after applying BNF), we believe 

this methodology may be able to 

accurately reflect future increases or 

decreases of wage data for the States 

within the applicable Census Division. 

Rural Puerto Rico is similar to rural 

Massachusetts in that there are ESRD 

facilities where there are no acute care 

hospitals and, therefore, no hospital 

data. However, the situation for 

facilities in rural Puerto Rico is different 

in that the floor would be applied to 

rural Puerto Rico ESRD facilities. All 

areas in Puerto Rico that have an index 

are eligible for the floor because they 

have wage-index values that are below 

.8000. For CY 2007, we propose to apply 

the floor to rural Puerto Rico. 

The third situation involves an urban 

area in Hinesville, GA (CBSA 25980). 

For CY 2006, we used a wage index 

value based on wage index values in all 

of the other urban areas within the same 

State to serve as a reasonable proxy for 

the urban areas without hospital wage 

index data. Specifically, we used the 

average wage index value for all urban 

areas within the State of Georgia as the 

urban wage index for purposes of 

calculating the value for Hinesville for 

CY 2006. For CY 2007, we are proposing 

to continue using this method for 

Hinesville, GA (CBSA 25980). 

We solicit comments on maintaining 

our current policy for establishing wage 

index values for rural and urban areas 

without hospitals, the alternative 

approach outlined above in developing 

wage index values for rural areas 

without hospitals for CY 2007 and 

subsequent years, and other methods 

that meet the policy criteria for 

imputing wage index values. We will 

also continue to evaluate existing 

hospital wage data and, possibly, wage 

data from other sources, such as the 

Bureau of Labor Statistics, to determine 

if other methodologies of imputing a 

wage index value where hospital wage 

data are not available may be feasible. 

(2) Second Year of the Transition 

In the CY 2006 PFS final rule with 

comment period, we indicated that we 

would apply a 4-year transition period 

to mitigate the impact on composite 

rates resulting from our adoption of 

CBSA-based geographic designations 

(70 FR 70169). Beginning January 1, 

2006, during each year of the transition, 

an ESRD facility’s wage-adjusted 

composite rate (that is, without regard to 

any case-mix adjustments) will be a 

blend of its old MSA-based wageadjusted payment rate and its new 

CBSA-based wage adjusted payment 

rate for the transition year involved. For 

each transition year, the share of the 

blended wage-adjusted base payment 

rate that is derived from the MSA-based 

and CBSA-based wage index values is 

shown in Table 4 below. In CY 2006, the 

first year of the transition, we 

implemented a 75/25 blend. CY 2007 is 

the second year of the 4-year transition 

period. Consistent with the transition 

blends announced in the November 21, 

2005 PFS final rule with comment 

period (70 FR 70170), we are proposing 

a 50/50 blend between an ESRD 

facility’s MSA-based composite rate, 

and its CY 2007 CBSA-based rate 

reflecting its revised wage index values. 

In CY 2006, we also eliminated the 

wage index cap of 1.30, and stated that 

we would implement a gradual 

reduction in the wage index floor of .90. 

Prior to January 1, 2006, the wage 

indexes were restricted to values no less 

than .90 and no greater than 1.30, 

meaning that payments to facilities in 

areas where labor costs fell below 90 

percent of the national average, or 

exceeded 130 percent of that average, 

were not adjusted beyond the 90 percent 

or 130 percent level. Although we stated 

that the ESRD wage index values should 

not be constrained by the application of 

floors and ceilings, we also expressed 

concern that the immediate elimination 

of the floor could adversely affect ESRD 

beneficiary access to care. Therefore, we 

reduced the floor to .85 in CY 2006. 

For CY 2007, we are proposing to 

reduce the wage index floor to .80. As 

we stated in the CY 2006 PFS final rule 

with comment period, we intend to 

reassess the continuing need for a wage 

index floor in CY 2008 and CY 2009 (CY 

2006 PFS final rule with comment 

period, November 21, 2005, 70 FR 

70169 through 70170). The proposed 

wage index floors, caps, and blended 

shares of the composite rates applicable 

to all ESRD facilities during CYs 2007 

through 2009 are shown in Table 4 

below. They are identical to the values 

shown in Table 20 of the CY 2006 PFS 

final rule with comment period (70 FR 

70170) for the applicable years. 

mstockstill on PROD1PC63 with PROPOSAL_2

49010 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

TABLE 4.—WAGE INDEX TRANSITION BLEND

CY payment Floor Ceiling Old MSA 

(percent) 

New CBSA 

(percent) 

2007 ............................................................................. .80 * .................................. None ................................ 50 50 

2008 ............................................................................. Reassess ......................... None ................................ 25 75 

2009 ............................................................................. Reassess ......................... None ................................ 0 100 

* Each wage index floor is multiplied by a budget neutrality adjustment factor. For CY 2007 the budget neutrality adjustment is 1.053069 resulting in an actual wage index floor of 0.8425. 

An example of how the wage-adjusted 

composite rates would be blended 

during CY 2007 and the two subsequent 

transition years follows. 

Example: An ESRD facility has a wageadjusted composite rate (without regard to 

any case-mix adjustments) of $135.00 per 

treatment in CY 2006. Using CBSA-based 

geographic area designations, the facility’s 

CY 2007 wage-adjusted composite rate, 

reflecting its wage index value as shown in 

Table 5 below, would be $145.00. During the 

remaining 3 years of the four-year transition 

period to the new CBSA-based wage index 

values, this facility’s blended rate through 

2009 would be calculated as follows: 

CY 2007 .50 × $135.00 + .50 × $145.00 

= $140.00 

CY 2008 .25 × $135.00 + .75 × $145.00 

= $142.50 

CY 2009 0 × $135.00 + 1.0 × $145.00 

= $145.00 

We note that this hypothetical 

example assumes that the calculated 

wage-adjusted composite rate of $145.00 

for CY 2007 does not change in CYs 

2008 and 2009. In actuality, the wageadjusted composite rate would change 

because of annual revisions to the wage 

index. However, the example serves 

only to demonstrate the effect on the 

composite rate of the CBSA-based wage 

index values which will be phased-in 

during the remaining 3 years of the 

transition period. 

c. Budget Neutrality Adjustment 

Section 1881(b)(12)(E)(i) of the Act, as 

added by section 623(d) of the MMA, 

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 2007 should be the same 

as aggregate payments that would have 

been made if we had not made any 

changes to the geographic adjusters. We 

note that this budget neutrality 

adjustment only addresses the impact of 

changes in the geographic adjustments. 

A separate budget neutrality adjustment 

was developed for the case-mix 

adjustments, currently in effect. Since 

we are not proposing any changes to the 

case-mix measures for CY 2007, the 

current case-mix budget neutrality will 

remain in effect for CY 2007. For CY 

2007, we again propose to apply a BNF 

directly to the ESRD wage index values, 

as we did in CY 2006. As we explained 

in the CY 2006 PFS final rule with 

comment period (70 FR 70170 through 

70171), we believe this is the simplest 

approach because it allows us to 

maintain our base composite rates 

during the transition from the current 

wage adjustments to the revised wage 

adjustments described earlier in this 

section. Because the ESRD wage index 

is only applied to the labor-related 

portion of the composite rate, we 

computed the BNF adjustment based on 

that proportion (53.711 percent). 

In order to compute the proposed CY 

2007 wage index BNF, we used the 

wage index values in Tables 5 and 6 

below, 2005 outpatient claims (paid and 

processed as of December 31, 2005), and 

geographic location information for each 

facility which may be found through 

Dialysis Facility Compare. Dialysis 

Facility Compare can be found by going 

to the following Web site: http:// 

www.cms.hhs.gov/ 

DialysisFacilityCompare/. 

Using treatment counts from the 2005 

claims and facility-specific CY 2006 

composite rates, we computed the 

estimated total dollar amount each 

ESRD provider would have received in 

CY 2006 (the first year of the 4-year 

transition). The total of these payments 

became the target amount of 

expenditures for all ESRD facilities for 

CY 2007. Next, we computed the 

estimated dollar amount that would 

have been paid to the same ESRD 

facilities using the proposed ESRD wage 

index for CY 2007 (the second year of 

the 4-year transition). The total of these 

payments became the second year new 

amount of wage-adjusted composite rate 

expenditures for all ESRD facilities. 

After comparing these two dollar 

amounts (target amount divided by 

second year new amount), we calculated 

an adjustment factor that, when 

multiplied by the applicable CY 2007 

ESRD wage index shown in Tables 5 

and 6 below, will result in payments to 

each facility that will remain within the 

target amount of composite rate 

expenditures when totaled for all ESRD 

facilities. The proposed budget 

neutrality adjustment factor for the CY 

2007 wage index is 1.053069. 

To ensure budget neutrality we also 

must apply the BNF to the wage index 

floor of 0.8000 which results in a 

proposed adjusted wage index floor of 

0.8425 for CY 2007. 

d. ESRD Wage Index Tables 

The following two tables show the 

proposed CY 2007 ESRD wage index, 

including the BNF adjustment, for urban 

areas (Table 5) and rural areas (Table 6). 

BILLING CODE 4120–01–P 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49011 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.003</GPH>
49012 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.004</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49013 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.005</GPH>
49014 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.006</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49015 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.007</GPH>
49016 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.008</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49017 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.009</GPH>
49018 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.010</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49019 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.011</GPH>
49020 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.012</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49021 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.013</GPH>
49022 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.014</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49023 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.015</GPH>
49024 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.016</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49025 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.017</GPH>
49026 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.018</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49027 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.019</GPH>
49028 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.020</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49029 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.021</GPH>
49030 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.022</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49031 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.023</GPH>
49032 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.024</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49033 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.025</GPH>
49034 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.026</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49035 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.027</GPH>
49036 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.028</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49037 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.029</GPH>
49038 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.030</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49039 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.031</GPH>
49040 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.032</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49041 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.033</GPH>
49042 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.034</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49043 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.035</GPH>
49044 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.036</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49045 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.037</GPH>
49046 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.038</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49047 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.039</GPH>
49048 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.040</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49049 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.041</GPH>
49050 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.042</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49051 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.043</GPH>
49052 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

BILLING CODE 4120–01–C 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.044</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49053 

TABLE 6.—PROPOSED CY 2007 ESRD WAGE INDEX FOR RURAL AREAS BASED ON CBSA LABOR MARKET AREAS

CBSA code Nonurban area Wage index 

1 .................................................................................................. Alabama ..................................................................................... 0.8425 

2 .................................................................................................. Alaska ........................................................................................ 1.1247 

3 .................................................................................................. Arizona ....................................................................................... 0.9398 

4 .................................................................................................. Arkansas .................................................................................... 0.8425 

5 .................................................................................................. California .................................................................................... 1.1902 

6 .................................................................................................. Colorado ..................................................................................... 0.9838 

7 .................................................................................................. Connecticut ................................................................................ 1.2377 

8 .................................................................................................. Delaware .................................................................................... 1.0239 

10 ................................................................................................ Florida ........................................................................................ 0.9051 

11 ................................................................................................ Georgia ...................................................................................... 0.8425 

12 ................................................................................................ Hawaii ........................................................................................ 1.1022 

13 ................................................................................................ Idaho .......................................................................................... 0.8566 

14 ................................................................................................ Illinois ......................................................................................... 0.8769 

15 ................................................................................................ Indiana ....................................................................................... 0.8927 

16 ................................................................................................ Iowa ............................................................................................ 0.9159 

17 ................................................................................................ Kansas ....................................................................................... 0.8425 

18 ................................................................................................ Kentucky .................................................................................... 0.8425 

19 ................................................................................................ Louisiana .................................................................................... 0.8425 

20 ................................................................................................ Maine ......................................................................................... 0.8856 

21 ................................................................................................ Maryland .................................................................................... 0.9417 

22 ................................................................................................ Massachusetts ........................................................................... 1.0758 

23 ................................................................................................ Michigan ..................................................................................... 0.9532 

24 ................................................................................................ Minnesota ................................................................................... 0.9653 

25 ................................................................................................ Mississippi .................................................................................. 0.8425 

26 ................................................................................................ Missouri ...................................................................................... 0.8425 

27 ................................................................................................ Montana ..................................................................................... 0.9062 

28 ................................................................................................ Nebraska .................................................................................... 0.9154 

29 ................................................................................................ Nevada ....................................................................................... 0.9435 

30 ................................................................................................ New Hampshire ......................................................................... 1.1373 

31 ................................................................................................ 1 New Jersey ..............................................................................

32 ................................................................................................ New Mexico ............................................................................... 0.8790 

33 ................................................................................................ New York ................................................................................... 0.8688 

34 ................................................................................................ North Carolina ............................................................................ 0.9055 

35 ................................................................................................ North Dakota .............................................................................. 0.8425 

36 ................................................................................................ Ohio ............................................................................................ 0.9134 

37 ................................................................................................ Oklahoma ................................................................................... 0.8425 

38 ................................................................................................ Oregon ....................................................................................... 1.0288 

39 ................................................................................................ Pennsylvania .............................................................................. 0.8774 

41 ................................................................................................ 1 Rhode Island ............................................................................

42 ................................................................................................ South Carolina ........................................................................... 0.8425 

43 ................................................................................................ South Dakota ............................................................................. 0.9038 

44 ................................................................................................ Tennessee ................................................................................. 0.8425 

45 ................................................................................................ Texas ......................................................................................... 0.8425 

46 ................................................................................................ Utah ............................................................................................ 0.8587 

47 ................................................................................................ Vermont ...................................................................................... 1.0472 

48 ................................................................................................ Virgin Islands ............................................................................. 0.8425 

49 ................................................................................................ Virginia ....................................................................................... 0.8425 

50 ................................................................................................ Washington ................................................................................ 1.0827 

51 ................................................................................................ West Virginia .............................................................................. 0.8425 

52 ................................................................................................ Wisconsin ................................................................................... 0.9970 

53 ................................................................................................ Wyoming .................................................................................... 0.9805 

1All counties in the States of New Jersey and Rhode Island are urban. 

H. Private Contracts and Opt-Out 

Provision—Practitioner Definition 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘PRIVATE CONTRACTS AND 

OPT-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. Before enactment 

of BIPA (Pub.L. 106–554), section 

1802(b)(5)(C) of the Act, which refers to 

the definition of ‘‘practitioner’’ at 

section 1842(b)(18)(C) of the Act, did 

not include registered dietitians or 

nutrition professionals among the 

practitioners who may choose to opt-out 

of Medicare. Section 105(d) of BIPA 

amended the definition of practitioner 

located at section 1842(b)(18)(c) of the 

Act to include registered dietitians or 

nutrition professionals. Because section 

1802(b)(5)(C) of the Act references 

section 1842(b)(18)(c) of the Act in order 

to define the term practitioner for 

purposes of opting out of Medicare, 

current law permits registered dietitians 

or nutrition professionals to opt-out of 

Medicare. Because the definition of 

practitioner located in the current 

regulations at § 405.400 does not 

include registered dietitians or nutrition 

professionals, we are proposing to 

amend that section so that it is 

consistent with section 1802(b)(5)(C) of 

the Act. 

mstockstill on PROD1PC63 with PROPOSAL_2

49054 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

I. Proposed Changes to Reassignment 

and Physician Self-Referral Rules 

Relating to Diagnostic Tests 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘REASSIGNMENT AND 

PHYSICIAN SELF-REFERRAL’’ at the 

beginning of your comments.] 

Historically, Medicare rules have 

prohibited the markup of the TC of 

certain diagnostic tests that are 

performed by outside suppliers and 

billed to Medicare by a different 

individual or entity. In addition, 

Medicare rules restrict who may bill 

Medicare for the PC (hereafter, also 

referred to as the ‘‘interpretation’’) of 

diagnostic tests. Recent changes to our 

rules on reassignment of the right to 

receive Medicare payment may have led 

to some confusion as to whether the 

anti-markup and purchased 

interpretation requirements apply to 

certain situations where a reassignment 

has occurred pursuant to a contractual 

arrangement. 

Likewise, we are concerned about the 

existence of certain arrangements that 

are not within the intended purpose of 

our physician self-referral rules, which 

allow physician group practices to bill 

for services furnished by a contractor 

physician in a ‘‘centralized building.’’

We are concerned that allowing 

physician group practices or other 

suppliers to purchase or otherwise 

contract for the provision of diagnostic 

tests and then to realize a profit when 

billing Medicare may lead to patient and 

program abuse in the form of 

overutilization of services and result in 

higher costs to the Medicare program. 

Therefore, we are proposing to amend 

our reassignment regulations to clarify 

how the purchased test and purchased 

test interpretation rules apply in the 

case of a reassignment made under the 

contractual arrangement exception set 

forth at § 424.80(d)(2). Specifically, in 

our reassignment regulations, we 

propose to incorporate provisions 

similar to those that currently appear in 

§ 414.50 of our regulations on purchased 

tests, and we are considering 

incorporating provisions on purchased 

test interpretations that currently appear 

in our manual instructions. In addition, 

we are proposing to change the 

definition of ‘‘centralized building’’ at 

§ 411.351 of the physician self-referral 

regulations to place certain restrictions 

on what types of space ownership or 

leasing arrangements will qualify for 

purposes of the physician self-referral 

in-office ancillary services exception 

and physician services exception. 

Our proposals regarding the 

reassignment regulations are based on 

existing requirements for purchased 

tests and purchased test interpretations. 

Section 1842(n) of the Act contains 

certain limitations on billing for the TC 

of diagnostic tests described in section 

1861(s)(3) of the Act (other than clinical 

diagnostic laboratory tests paid under 

section 1833(a)(2)(D) of the Act, which 

are subject to the special rules set forth 

in section 1833(h)(5)(A) of the Act). 

Section 1842(n)(1)(A) of the Act 

provides that if the test was not 

performed by the billing physician and 

also was not performed or supervised by 

a physician with whom the billing 

physician shares a practice, Medicare 

payment is the lower of the costs (net of 

any discount) charged by the performing 

supplier to the billing physician, or the 

performing supplier’s reasonable charge 

(or other applicable limit). This is 

commonly known as the anti-markup 

provision. Section 1842(n)(2) of the Act 

further provides that a physician may 

not bill a beneficiary any amount other 

than the amount specified in section 

1842(n)(1)(A) of the Act and any 

applicable deductible and coinsurance. 

Under section 1842(n)(3) of the Act, if 

a physician knowingly, willfully, and 

repeatedly bills a Medicare beneficiary 

for more than the amount allowed under 

section 1842(n)(2) of the Act, he or she 

is subject to civil monetary penalties 

and assessments, and exclusion from 

Medicare and Medicaid for up to 5 

years. Our regulations implementing 

section 1842(n) of the Act appear at 

§ 414.50 and § 402.1(c)(15). 

In addition, our Claims Processing 

Manual (Pub. 100–4) outlines certain 

conditions regarding who can submit a 

claim for purchased diagnostic test 

intepretations. As set forth in Chapter 1, 

Section 30.2.9.1 of the Claims 

Processing Manual, the following 

requirements must be satisfied in order 

to submit a claim for a purchased 

diagnostic test interpretation: 

• The test must be ordered by a 

physician or medical group that is 

independent of the person or entity 

performing the TC of the test, and also 

must be independent of the physician or 

medical group performing the 

interpretations. 

• The physician or medical group 

performing the interpretations does not 

see the patient. 

• The purchaser (or employee, 

partner, or owner of the purchaser) 

performs the TC of the test, and the 

interpreting physician must be enrolled 

in the Medicare program. 

Section 1842(b)(6) of the Act generally 

prohibits Medicare payment to anyone 

other than the Medicare beneficiary or 

the physician or other person who 

performed the service for the 

beneficiary. However, section 1842(b)(6) 

of the Act, also provides exceptions, 

known as the reassignment exceptions, 

to this general rule. These exceptions 

allow us to make payment to an 

individual or an entity other than the 

beneficiary or the physician or other 

person who performed the service for 

the beneficiary. For example, the 

reassignment exceptions allow us to 

make payment to an employer of a 

physician, such as a group practice or a 

hospital, to which the physician 

employee has reassigned his or her right 

to payment. 

Prior to the MMA, a physician or 

other individual supplier could reassign 

his or her right to bill and receive 

payment under a contractual 

arrangement, rather than an employeeemployer relationship, only if the 

services being paid for were performed 

on the premises of the contracting 

hospital, critical access hospital, clinic, 

or other facility. Section 952 of the 

MMA, however, amended section 

1842(b)(6)(A)(ii) of the Act to extend the 

reassignment exception to contractual 

arrangements regardless of whether the 

services are performed on the premises 

of the billing entity. Section 952 of the 

MMA permits us to recognize this type 

of reassignment to the extent that the 

contractual arrangement between the 

physician or other individual supplier 

and the billing entity (excluding a 

billing agent, which cannot receive 

reassigned benefits) meets program 

integrity and other safeguards as the 

Secretary may determine to be 

appropriate. A motivating factor behind 

the passage of section 952 of the MMA 

appears to have been the desire by the 

Congress to permit us to allow hospital 

emergency department staffing 

companies that employ physicians on a 

contract basis to bill Medicare (if the 

staffing companies enroll in Medicare). 

Our proposed implementation of 

section 952 of the MMA appeared in the 

Revisions to Payment Policies Under the 

Physician Fee Schedule for Calendar 

Year 2005 proposed rule, 69 FR 47488, 

47524 through 47525 (August 5, 2004). 

We proposed program safeguards, 

whereby the parties to the contractual 

arrangement would have joint and 

several liability for any Medicare 

overpayments, and the physician or 

other individual supplier would have 

unrestricted access to billings submitted 

on his or her behalf by the entity 

receiving reassigned payments. In that 

proposed rule, we stated our awareness 

that the changes to the reassignment 

rules authorized by section 952 of the 

MMA may create new fraud and abuse 

vulnerabilities, which may not become 

apparent until the program has 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49055 

experience with new contractual 

arrangements. We solicited comments 

on these potential program 

vulnerabilities and on possible 

additional safeguards to protect against 

such vulnerabilities. 

Comments submitted in response to 

the CY 2005 PFS proposed rule 

expressed concern over the recent 

growth of ‘‘pod’’ or ‘‘condo’’ laboratories 

(hereinafter ‘‘pod labs’’). In a typical 

pod lab arrangement involving 

pathology services, an entity leases 

space in a medical building and then 

subdivides the space into separate areas 

or cubicles, which are equipped with 

microscopes and a minimal amount of 

other laboratory equipment. The entity 

subleases each space to a physician 

group practice, even though the space 

may be located many miles away from 

any medical office of the group practice 

and is often located in a different state. 

The entity hires a histologist who 

performs the TC of the pathology 

service, by preparing a microscopic 

slide of each specimen for review by a 

pathologist. The entity also makes 

arrangements with a pathologist, who 

performs the PC of the pathology service 

and who also supervises the pod lab. 

In one type of arrangement, the 

pathologist and histologist perform their 

services for the different group practices 

by moving from cubicle to cubicle. Each 

group practice pays the pathologist a fee 

for every slide reviewed and pays the 

entity a management fee, which covers 

the rental of the pod lab and the 

histologist’s salary. The group practice 

then bills Medicare for the entire 

pathology service, typically at a markup 

from what the group practice paid the 

pathologist for the professional service 

and the entity for its services. In another 

common arrangement, the histologist 

performs the TC of the pathology service 

for the entity and the entity bills 

Medicare for that service, while the 

group practice bills for the 

interpretation that was performed by its 

independent contractor pathologist, 

who has reassigned to the group 

practice his or her right to receive 

Medicare payment. 

The commenters stated that pod lab 

arrangements are subject to fraud, waste 

and abuse, including, but not limited to 

the following: 

• Generation of medically 

unnecessary biopsies. 

• Kickbacks. 

• Fee-splitting. 

• Referrals that would otherwise be 

prohibited under the physician selfreferral statute. 

The commenters provided several 

suggestions. One commenter suggested 

that we prohibit a physician from 

reassigning benefits to another 

physician if the physicians do not 

practice in substantially the same 

medical specialty. Some commenters 

also stated that our regulations need to 

state more clearly that all requirements 

of the purchased diagnostic test rules 

and purchased test interpretation rules 

need to be met. 

In the CY 2005 PFS final rule, we 

responded that we shared the 

commenters concerns, although we 

declined to incorporate the suggested 

revisions at that time. We said that we 

would be paying close attention to this 

issue, and that we might initiate future 

rulemaking to address arrangements that 

are fraudulent or abusive. (See 69 FR 

66316, November 15, 2004.) In that final 

rule, we amended our reassignment 

regulation at § 424.80(a) to state that 

nothing in § 424.80 alters an 

individual’s or entity’s obligations 

under other Medicare statutes or rules, 

including, but not limited to, the 

physician self-referral law (section 1877 

of the Act), the anti-kickback statute 

(section 1128B(b)(1) of the Act), the 

regulations regarding purchased 

diagnostic tests, and the regulations 

regarding services and supplies 

provided incident to a physician’s 

service. 

At about the same time as we 

published our proposed rule for 

implementing section 952 of the MMA, 

we published an IFC concerning 

exceptions to the physician self-referral 

law in section 1877 of the Act (69 FR 

16054). Section 1877 of the Act 

prohibits a physician from making 

referrals for DHS, as defined in section 

1877(h)(6) of the Act, payable by 

Medicare to an entity with which he or 

she (or an immediate family member) 

has a financial relationship (ownership 

or compensation), and it prohibits the 

entity from billing Medicare, another 

payor, or the beneficiary for those 

referred services, unless an exception 

applies. The statute establishes a 

number of specific exceptions to these 

prohibitions and grants the Secretary 

the authority to create regulatory 

exceptions for financial relationships 

that pose no risk of fraud or abuse. 

One significant exception is at 

§ 411.355(a) for the provision of 

‘‘physician services’’ as defined in 

§ 410.20(a). Under this exception, 

professional physician services that are 

DHS must be furnished personally by 

another physician who is a member of 

the referring physician’s group practice, 

or by a physician in the same group 

practice as the referring physician, or by 

someone under the supervision of one 

of these physicians. A ‘‘member’’ of a 

group practice is a physician owner, a 

physician employee, a locum tenens 

physician, or an on-call physician while 

the physician is providing on-call 

services for members of the group 

practice. ‘‘Physician in the group 

practice’’ means a member of the group 

practice, as well as an independent 

contractor physician during the time the 

independent contractor is furnishing 

patient care services for the group 

practice to the group practice’s patients 

in the group practice’s facilities. (See 

§ 411.351.) 

Another significant exception, at 

§ 411.355(b), is for the provision of inoffice ancillary services. This exception 

allows group practice physicians to refer 

patients for DHS to other members of 

their group or to nonphysician staff, 

provided that certain supervision, 

location, and billing requirements are 

satisfied. Specifically, the DHS must be 

furnished personally by the referring 

physician, a member of the group 

practice, or an individual who is 

supervised by the referring physician or 

by a physician in the group practice. In 

addition, the DHS must be furnished 

in—(1) the ‘‘same building’’ where 

group physicians perform a certain 

amount of physician services (as set 

forth in § 411.355(b)(2)), including 

physician services unrelated to the 

provision of DHS; or (2) in a 

‘‘centralized building.’’ We define 

‘‘centralized building,’’ in pertinent 

part, as all or part of building that is 

owned or leased on a full-time basis 24 

hours per day, 7 days per week. In the 

‘‘Phase II’’ physician self-referral IFC, 

we reaffirmed our earlier position, set 

forth in the ‘‘Phase I’’ final rule with 

comment period that, a group practice 

may have more than one centralized 

building (69 FR at 16075). 

In response to the Phase II IFC, 

several commenters strongly criticized 

the centralized building prong of the inoffice ancillary services exception. They 

requested that the rule be changed to 

require full-time use of the facility and 

the addition of a commercially 

reasonable test. According to the 

commenters, the Phase II IFC 

encourages numerous abusive 

arrangements that are designed solely to 

permit medical groups to bill in 

circumvention of the prohibition in 

section 1877 of the Act. Commenters 

objected to medical groups establishing 

satellite DHS facilities, sometimes in 

different States, specifically to capture 

ancillary income. Several commenters 

identified pod labs that rent space to 

urology groups as among the types of 

abusive arrangements that are 

proliferating. Several other commenters 

requested clarification that the in-office 

ancillary services exception did not 

mstockstill on PROD1PC63 with PROPOSAL_2

49056 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

override our policies on reassignment 

and purchased diagnostic tests. 

According to the comments, some of the 

arrangements do not satisfy the rules 

regarding purchased diagnostic tests. On 

the other hand, a professional 

association complained that the 

requirement that the centralized 

building be occupied exclusively by the 

medical group is too restrictive. 

As noted above, we stated, in 

response to the comments on the 

proposed rule implementing section 952 

of the MMA, that we might address 

suspect arrangements in a future 

rulemaking. After additional 

consideration, including consideration 

of the comments we received in 

response to the Phase II IFC, we are now 

proposing to amend our regulations on 

reassignment and physician self-referral 

in this proposed rule. 

We are proposing to amend § 424.80 

of our regulations to clarify that any 

reassignment pursuant to the 

contractual arrangement exception is 

subject to program integrity safeguards 

that relate to the right to payment for 

diagnostic tests. First, we would amend 

§ 424.80 of our regulations to provide 

that if the TC of a diagnostic test (other 

than clinical diagnostic laboratory tests 

paid under section 1833(a)(2)(D) of the 

Act, which are subject to the special 

rules set forth in section 1833(h)(5)(A) 

of the Act) is billed by a physician or 

medical group (the ‘‘billing entity’’) 

under a reassignment involving a 

contractual arrangement with a 

physician or other supplier who 

performs the service, the amount billed 

to Medicare by the billing entity, less 

the applicable deductibles and 

coinsurance, may not exceed the lowest 

of the following amounts: 

• The physician or other supplier’s 

net charge to the billing physician or 

medical group. 

• The billing physician’s or medical 

group’s actual charge. 

• The fee schedule amount for the 

service that would be allowed if the 

physician or other supplier billed 

directly. 

Second, we would also require that, 

in order to bill for the TC, the billing 

entity would be required to perform the 

interpretation. Third, we are 

considering further amendments to 

§ 424.80(d) that would impose certain 

conditions on when a physician or 

medical group can bill for a reassigned 

PC of a diagnostic test. We are 

considering the following conditions: 

• The test must be ordered by a 

physician that is financially 

independent of the person or entity 

performing the test and also of the 

physician or medical group performing 

the interpretation. 

• The physician or medical group 

performing the interpretation does not 

see the patient. 

• The physician or medical group 

billing for the interpretation must have 

performed the TC of the test. 

We believe that we are comfortably 

within our authority to place the 

proposed restrictions on reassignments 

made before a contractual arrangement, 

in order to guard against patient and 

program abuse, and we also believe that 

we would be within our authority to 

adopt the conditions on billing for a 

reassigned PC before a contractual 

arrangement that we continue to 

consider. 

We note that there is no right to effect 

a reassignment under section 1842(b)(6) 

of the Act (rather, this section allows, 

but does not require us to make 

payment to someone other than the 

beneficiary or the physician or other 

person who performed the service), and 

that section 952 of the MMA permits us 

to recognize reassignments under the 

contractual arrangement exception only 

to the extent that the arrangement meets 

program integrity and other safeguards 

as the Secretary may determine to be 

appropriate. Moreover, we believe that 

our current rules on purchased 

diagnostic tests generally should be 

applicable to both situations in which 

the billing entity is purchasing the test 

without a formal reassignment as well 

as situations in which the physician 

performing the test has reassigned his or 

her right to Medicare payment to the 

billing physician or medical group. 

Although we welcome comments on 

all aspects of our proposals, we are 

particularly interested in soliciting 

comments on the amendments we have 

proposed, as well as those we are still 

considering involving reassigned 

interpretations, to § 424.80(d). In 

particular, we are soliciting comments 

as to whether diagnostic tests in the 

DHS category of radiology and certain 

other imaging services should be 

excepted from any those provisions; 

whether the proposal in whole or in part 

should apply only to pathology services; 

whether any of these provisions should 

apply to services performed on the 

premises of the billing entity and if so, 

how to define the premises 

appropriately. We are also soliciting 

suggested regulatory text for the 

proposal under consideration involving 

purchased test interpretations, as well 

as any other comments regarding the 

appropriate scope of the provisions 

under consideration. 

In addition, we are soliciting 

comments on whether an anti-markup 

provision should apply to the 

reassignment of the PC of diagnostic 

tests performed under a contractual 

arrangement, and if so, how to 

determine the correct amount that 

should be billed to the Medicare 

program. 

In addition to our proposed changes 

to the reassignment rules, we are 

proposing to change the definition of 

‘‘centralized building’’ in § 411.351 for 

purposes of our physician self-referral 

regulations. We are persuaded by the 

commenters who responded to the 

Phase II IFC that our present definition 

may encourage the unnecessary 

ordering of ancillary services. Section 

1877(b)(1) of the Act, in conjunction 

with section 1877(h)(4)(vi) of the Act, 

states that the Secretary may define by 

regulation what constitutes a ‘‘group 

practice’’ for purposes of the physician 

services exception. Similarly, section 

1877(b)(2) of the Act authorizes the 

Secretary to determine additional terms 

and conditions relating to the 

supervision and location requirements 

of the in-office ancillary services 

exception as may be necessary to 

prevent a risk of program or patient 

abuse. Accordingly, we propose to 

modify the definition of ‘‘centralized 

building’’ to include a minimum square 

footage requirement of 350 square feet. 

Our modified definition would be 

relevant to both the physician services 

exception and the in-office ancillary 

services exception. That is because, 

under § 411.351, a ‘‘physician in the 

group practice’’ includes an 

independent contractor physician 

during the time he or she is providing 

services to the group’s patients in the 

group’s facilities. Thus, to the extent 

that an independent contractor 

physician would qualify as a ‘‘physician 

in the group’’ on the basis of furnishing 

services to a group’s patients in a 

centralized building, the space owned 

or leased by the group would need to 

comply with the proposed modification 

to the definition of ‘‘centralized 

building’’ in order for the group to rely 

on the physician services exception or 

the in-office ancillary services exception 

when billing Medicare for services 

furnished by the independent contractor 

physician. 

Although we believe that the 

arrangements we seek to address 

through our proposed change to the 

definition of ‘‘centralized building’’

primarily involves independent 

contractor physicians, the proposed 

definition would also apply to services 

performed by physicians who are 

employees of a group practice. 

The proposed minimum square 

footage requirement would not apply to 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49057 

space owned or rented in a building in 

which no more than three group 

practices own or lease space in the 

‘‘same building,’’ as defined in 

§ 411.351 (that is, in a building with the 

same street address) and share the same 

‘‘physician in the group practice’’ (as 

defined in § 411.351). The purpose of 

the square foot minimum and the 

exception is to prevent abusive 

arrangements such as pod labs, while 

not disqualifying legitimate, stand-alone 

physician offices that are unusually 

small. The following examples are 

intended to illustrate how the proposed 

exception might apply: 

+ Example 1—A space of 200 square 

feet located in a building in which only 

two other group practices lease space 

could qualify as a centralized building, 

irrespective of whether all three group 

practices contract with the same 

individual as a ‘‘physician in the group 

practice.’’

+ Example 2—A space of 200 square 

feet is located in a building in which 

seven other group practices lease space. 

Dr. Jones has a contractual relationship 

with three group practices as a 

‘‘physician in the group practice.’’ Dr. 

Smith also has a contractual 

relationship with three group practices. 

No physician has a contractual 

relationship as a ‘‘physician in the 

group practice’’ with four or more group 

practices that are located in that 

building. The space could qualify as a 

‘‘centralized building.’’

We would also require the space to 

contain, on a permanent basis, the 

necessary equipment to perform 

substantially all of the DHS that are 

performed in this space, in order to 

meet the definition of a ‘‘centralized 

building.’’ That is, we wish to prevent 

the situation in which an entity would 

routinely move equipment as needed 

from one group’s space to another 

group’s space (for example, from cubicle 

to cubicle). We believe these situations 

are abusive and contrary to the purpose 

of concept of the ‘‘centralized building’’

concept, but we recognize that there 

may be an occasional need to bring 

specialized equipment into the space on 

a temporary basis. 

We believe that the proposed 

clarification to our reassignment rules, 

in tandem with our proposed changes to 

the definition of ‘‘centralized building’’

for purposes of our physician selfreferral rules would prevent abusive 

arrangements while preserving 

legitimate small physician offices. In 

particular, we anticipate that 

restrictions on marking up the TC of 

diagnostic tests as well as the limits we 

are considering for who can bill for the 

PC of diagnostic tests, combined with 

square footage limits and requirements 

of having necessary equipment on site 

would make it not financially feasible 

for pod labs to exist. 

With respect to our proposed change 

to the definition of ‘‘centralized 

building,’’ we seek comments on 

whether there should be a minimum 

square foot requirement, and if so, 

whether the minimum should be 350 

square feet or an amount more or less 

than that. In addition, we seek 

comments regarding whether there 

should be an exception to any minimum 

square foot requirement, and if so, the 

circumstances under which an 

exception should apply. 

With respect to our proposal that the 

‘‘centralized building’’ permanently 

contain the necessary equipment to 

perform substantially all of the DHS that 

is furnished in the ‘‘centralized 

building,’’ we seek comments on 

whether this test should be imposed, 

and whether at least 90 percent or some 

other minimum percentage or 

measurement is appropriate. We are also 

considering whether to require that, for 

space to qualify as a ‘‘centralized 

building,’’ the group practice must 

employ, in that space, a nonphysician 

employee or independent contractor 

who will perform services exclusively 

for the group for at least 35 hours per 

week. We seek comments on whether 

we should have this requirement or 

similar requirement, or whether this 

requirement would be unduly 

burdensome on a small group practice, 

and whether this requirement would be 

likely to reduce the number of existing 

pod labs and to discourage the 

development of new pod labs. Finally, 

we seek comments on whether a group 

practice should be allowed to maintain 

a ‘‘centralized building’’ in a State 

different from the State(s) in which it 

has an office that meets the criteria of 

§ 411.355(b)(2)(i), and if so, whether 

space that is located in a different State 

must be within a certain number of 

miles from an office of the group 

practice that meets the criteria of 

§ 411.355(b)(2)(i), in order to qualify as 

a ‘‘centralized building.’’

J. Supplier Access to Claims Billed on 

Reassignment 

Section 1833(e) of the Act provides 

that, ‘‘no payment shall be made to any 

provider of services or other person 

under this part unless there has been 

furnished such information as may be 

necessary in order to determine the 

amounts due such provider or other 

person under this part for the period 

with respect to which the amounts are 

being paid or for any prior period.’’

Section 1842(b)(6) of the Act generally 

provides that payment may not be made 

to anyone other than the beneficiary or 

the physician or other person who 

provided the service. There are certain 

exceptions to this prohibition whereby 

payment may be made to others. These 

are commonly referred to as the 

reassignment exceptions and are found 

at section 1842(b)(6)(A) of the Act. 

Taking these two statutory provisions 

together, we are permitted, but not 

required, to make payment to someone 

other than the beneficiary, or the 

physician or other person who 

furnished the service, but only if we 

have determined that Medicare has 

received all necessary information to 

determine the amounts due the 

provider. Where Medicare makes 

payment to an entity rather than to the 

physician or other person who 

furnished the service, there is a 

heightened concern that payment may 

not be correct. By allowing physicians 

and other individual suppliers who 

reassign benefits to an entity such as a 

group practice to have access to the 

billing information concerning the 

services they allegedly furnish, we 

believe we will reduce the risk of 

inappropriate billing. 

Moreover, as noted in section I.2. of 

this proposed rule, section 952 of the 

MMA amended section 1842(b)(6)(A)(ii) 

of the Act to allow a physician or other 

person who was in a contractual 

arrangement rather than in an 

employee-employer relationship to 

reassign his or her right to bill and 

receive payment, irrespective of 

whether the services were performed on 

the premises of the entity. Section 952 

of the MMA permits reassignment to the 

extent that the contractual arrangement 

between the physician or other 

individual supplier and the billing 

entity meets program integrity and other 

safeguards that the Secretary may 

determine to be appropriate. 

In the FY 2005 Physician Fee 

Schedule proposed rule, published 

August 5, 2005 (69 FR 47488, 47524 

through 47525), we stated our 

awareness that changes in the 

reassignment rules based on section 952 

of the MMA may create new fraud and 

abuse vulnerabilities, which may not 

become apparent until the program has 

experience with new contractual 

arrangements. We proposed program 

safeguards, whereby the parties to the 

contractual arrangement would have 

joint and several liability for any 

Medicare overpayments, and the 

physician or other individual supplier 

would have unrestricted access to 

billings submitted on their behalf by the 

entity receiving reassigned payments. In 

response to the August 5, 2005 proposed 

mstockstill on PROD1PC63 with PROPOSAL_2

49058 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

rule, we received a comment that 

questioned the need for the two program 

integrity safeguards (joint and several 

liability and unrestricted access to 

billing records) as a requirement for a 

reassignment of claims involving a 

contractual arrangement. The 

commenter believed that it was 

premature for CMS to implement these 

program safeguards, that CMS already 

imposes joint and several liability 

through Medicare participation 

agreements and the signing of the 

enrollment form for billing reassigned 

claims (the CMS–855–R form), and 

questioned why the program safeguards 

applied only to independent contractors 

and not to employees. (69 FR 66316 

through 66317 (November 15, 2004).) 

In response to the commenter, we 

stated that those program integrity 

safeguards were necessary to monitor 

the billings of entities with which we 

have had billing problems (for example, 

billing for services never furnished and 

upcoding resulting in Medicare 

overpayments) in the past, and that the 

reason the safeguards applied to 

independent contractors and not to 

employees, was that the billing 

problems identified thus far involved 

certain entities (which, for the most 

part, contracted with, rather than 

employed, emergency room (ER) 

physicians). We also stated that we 

would study whether the same program 

integrity safeguards applicable to 

independent contractors should also 

apply to employees. 

Prior to January 1, 2005, the effective 

date of the program integrity safeguards 

for the contractual arrangement 

reassignment exception, we received 

public inquiries asking why employees 

do not have unrestricted access to 

billing records. Since the January 1, 

2005 effective date of the program 

integrity safeguards, we have received 

an inquiry from an ER physician 

employee of a medium-sized ER 

physician staffing company, who was 

denied access to billing records for 

services that he claims to have 

furnished, and who had his 

employment terminated. We also note 

that the MMA Conference Report, in its 

discussion of section 952 of the MMA, 

states that the Conference Committee 

supports appropriate program integrity 

efforts for any entities billing the 

Medicare program, including entities 

with independent contractors as well as 

employees. Having reconsidered the 

issue, we find no valid reason why an 

employee should not have access to 

records on billings for services 

furnished by that employee. Therefore, 

we are proposing to change the title of 

§ 424.80(d) and amend § 424.80(d)(2) of 

our regulations to state that the supplier 

who reassigns his or her right to bill and 

receive Medicare payment to an entity 

has unrestricted access to claims 

information submitted by that entity for 

services supposedly furnished by the 

individual supplier, irrespective of 

whether the supplier is an employee or 

independent contractor of the entity. If 

adopted, our proposal would also mean 

that if an entity receiving the reassigned 

benefits were to refuse to provide the 

billing information to the employee 

supplier requesting the information, the 

entity’s right to receive reassigned 

benefits may be revoked under 42 CFR 

424.82(c)(3) (which is currently the case 

with respect to an entity’s refusal to 

provide billing information to an 

independent contractor supplier). 

K. Coverage of Bone Mass Measurement 

(BMM) Tests 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘BONE MASS MEASUREMENT 

TESTS’’ at the beginning of your 

comments.] 

In an IFC entitled ‘‘Medicare Coverage 

of and Payment for Bone Mass 

Measurements’’ published in the 

Federal Register on June 24, 1998 (63 

FR 34320), we implemented section 

4106 of the BBA by establishing a new 

regulatory section, 42 CFR 410.31 (Bone 

Mass Measurement: Conditions for 

Coverage and Frequency Standards). 

Section 4106 of the BBA statutorily 

defined BMM and individuals that are 

qualified to receive a BMM. The June 

24, 1998 IFC, under the ‘‘reasonable and 

necessary’’ provisions of 1862(a)(1)(A) 

of the Act, also established conditions 

for coverage of the tests that must be 

ordered by physicians or nonphysician 

practitioners. Lastly, as directed by 

section 4106 of the BBA, we established 

frequency standards governing the time 

period when qualified individuals 

would be eligible to receive covered 

BMMs. 

1. Provisions of the June 24, 1998 IFC 

As stated earlier in this section, the 

June 24, 1998 IFC implemented section 

4106 of the BBA by establishing 

conditions for coverage and frequency 

standards for BMMs to ensure that they 

are paid for uniformly throughout the 

Medicare program and that they are 

reasonable and necessary for Medicare 

beneficiaries who are eligible to receive 

these measurements. This section 

summarizes the provisions discussed in 

the June 24, 1998 IFC. 

a. Coverage Conditions and Frequency 

Standards 

We established conditions for 

coverage and frequency standards for 

medically necessary BMMs for five 

categories of Medicare beneficiaries in 

§ 410.31. 

In § 410.31(a), we defined ‘‘bone mass 

measurement’’ based on the statutory 

definition in section 4106 of the BBA. 

In accordance with the ‘‘reasonable and 

necessary’’ provisions of section 

1862(a)(1)(A) of the Act, we established 

the conditions for coverage of BMMs in 

§ 410.31(b) of the regulations. Consistent 

with § 410.32 (Diagnostic x-ray tests, 

diagnostic laboratory tests, and 

diagnostic tests: Conditions), we 

provided that coverage be available for 

the BMM only if it is ordered by the 

physician or a qualified nonphysician 

practitioner (as defined in § 410.32(a)) 

treating the beneficiary following an 

evaluation of the beneficiary’s need for 

the test, including a determination as to 

the medically appropriate procedure to 

be used for the beneficiary. We believed 

that BMMs were not demonstrably 

reasonable and necessary unless (among 

other things) they are ordered by the 

physician treating the beneficiary 

following a careful evaluation of the 

beneficiary’s medical need, and they are 

employed to manage the beneficiary’s 

care. 

To ensure that the BMM is performed 

as accurately and consistently in 

accordance with appropriate quality 

assurance guidelines as possible, we 

required that it be performed under the 

appropriate supervision of a physician 

as defined in § 410.32(b)(3). To ensure 

that the BMM is medically appropriate 

for the five categories specified in the 

law, we provided that it be reasonable 

and necessary for diagnosing, treating, 

or monitoring the condition of the 

beneficiary who meets the coverage 

requirements specified in § 410.31(d). 

Furthermore, in § 410.31(c), we set 

forth limitations on the frequency for 

covering a BMM. Generally, we cover a 

BMM for a beneficiary if at least 23 

months have passed since the month the 

last BMM was performed. However, we 

allow for coverage of follow-up BMMs 

performed more frequently than once 

every 23 months when medically 

necessary. We listed the following 

examples of situations where more 

frequent BMMs procedures may be 

medically necessary to include: 

• Monitoring beneficiaries on longterm glucocorticoid (steroid) therapy of 

more than 3 months. 

• Allowing for a confirmatory 

baseline bone mass measurement (either 

central or peripheral) to permit 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49059 

monitoring of beneficiaries in the future 

if the initial test was performed with a 

technique that is different from the 

proposed monitoring method. 

b. Beneficiaries Who May Be Covered 

In § 410.31(d), we amended our 

regulations to conform to the statutory 

requirement that the following 

categories of beneficiaries may receive 

Medicare coverage for a medically 

necessary BMM: 

• A woman who has been determined 

by the physician or a qualified 

nonphysician practitioner treating her to 

be estrogen-deficient and at clinical risk 

for osteoporosis, based on her medical 

history and other findings. 

• An individual with vertebral 

abnormalities as demonstrated by an xray to be indicative of osteoporosis, 

osteopenia, or vertebral fracture. 

• An individual receiving (or 

expecting to receive) glucocorticoid 

(steroid) therapy equivalent to 7.5 mg of 

prednisone, or greater, per day, for more 

than 3 months. 

• An individual with primary 

hyperparathyroidism. 

• An individual being monitored to 

assess the response to or efficacy of an 

FDA-approved osteoporosis drug 

therapy. 

c. Waiver of Liability 

Section 410.31(e) provides that 

Medicare payment would be denied for 

a BMM in accordance with section 

1862(a)(1)(A) of the Act if the regulatory 

standards are not satisfied. Existing 

regulations concerning limitation on 

liability are set forth in §§ 411.400 

through 411.406 and are applicable to 

denial of BMMs under § 410.31. 

d. Payments for BMMs 

Medicare payments for covered 

BMMs are paid for under the PFS (42 

CFR part 414) as required by statute. In 

the June 24, 1998 IFC, we revised the 

definition of ‘‘physician services’’ in 

§ 414.2 to include bone mass 

measurements. When BMM procedures 

are furnished to hospital inpatients and 

outpatients, the TCs of these procedures 

are payable under existing payment 

methods for hospital services. These 

methods include payments under the 

prospective payment system, on a 

reasonable cost basis, or under a special 

provision for determining payment rates 

for hospital outpatient radiology 

services. 

In the June 24, 1998 IFC, we revised 

§ 414.50(a), regarding physician billing 

for purchased diagnostic tests, to clarify 

that the section does not apply to 

payment for BMMs. 

e. Conforming Changes 

In the June 24, 1998 IFC, to allow for 

appropriate placement in the CFR of the 

BMM coverage requirements, we 

redesignated § 410.31 (Prescription 

drugs used in immunosuppressive 

therapy) as § 410.30. 

2. Additional Scientific Evidence 

In 2004, the Surgeon General issued a 

report, Bone Health and Osteoporosis 

(U.S. Department of Health and Human 

Services, Bone Health and Osteoporosis: 

A Report of the Surgeon General. 

Rockville, MD: U.S. Department of 

Health and Human Services, Office of 

the Surgeon General, 2004). This report 

provides scientific evidence related to 

the prevention, assessment, diagnosis, 

and treatment of bone disease. The 

report states that identification of those 

at risk of bone disease and fracture is 

important so that appropriate 

interventions can be implemented. 

However, as the report states, 

‘‘Assessing the risk of bone disease and 

fracture remains a challenge. Not all of 

the risk factors have been identified, 

and the relative importance of those that 

are known remains unclear.’’

As bone strength is not measured 

directly, bone mineral density (BMD) 

remains the single best predictor of 

fracture risk, with the most widely 

accepted method for measuring BMD 

being the dual energy x-ray 

absorptiometry (DXA) for a bone density 

study at the axial skeleton (for example, 

hips and spine). As there are many 

sources of variability in the 

measurement of BMD, a quality control 

system related to both the methodology 

and reporting of test results is important 

to ensure the validity of DXA analysis. 

In addition to DXA of the axial 

skeleton, bone mass can also be 

measured using other techniques. These 

other techniques include DXA bone 

density study for the appendicular 

skeleton (for example, radius, wrist, 

heel); quantitative computerized 

tomography (QCT), bone mineral 

density study for the axial skeleton or 

appendicular skeleton; radiographic 

absorptiometry (photodensitometry, 

radiogrammetry); single-photon 

absorptiometry (SPA); single energy xray absorptiometry (SXA) for the 

appendicular skeleton; and ultrasound 

bone mineral density study for the 

appendicular skeleton. With regard to 

these techniques (except for SPA which 

was not discussed), the 2004 Surgeon 

General report states, ‘‘While these 

methods do assess bone density and 

may provide an indication of fracture 

risk, it is important to note that the 

WHO [World Health Organization] 

recommendations and other guidelines 

for using BMD and interpreting BMD 

results for diagnosis are based on DXA 

measurements of the hip or spine.’’ The 

report further states, ‘‘Incorporating 

these techniques for bone assessment 

into future clinical trials and 

observational studies will help in better 

understanding their appropriate use as a 

means of predicting the risk of bone 

disease and fracture.’’

3. Proposed Changes to the June 24, 

1998 IFC 

We received 18 public comments on 

the June 24, 1998 IFC. The majority of 

the comments had specific 

recommendations for changes to the 

IFC. In addition to responding to 

comments that we may receive on our 

proposed revisions to § 410.31, it is our 

intent to address all these previous 

comments in the CY 2007 PFS final 

rule. 

Based on the comments received on 

the IFC, the Surgeon General’s report, 

and other evidence, we are proposing 

changes to § 410.31. We encourage 

comments on these proposals. 

a. Proposed ‘‘BMM’’ Definition 

(§ 410.31(a)) 

We are proposing to revise the 

definition of ‘‘bone mass measurement’’

at § 410.31(a)(2) to remove coverage for 

the use of SPA, which uses isotope 

sources to measure BMD. Many medical 

experts indicate that SPA has largely 

been replaced by the newer techniques 

of DXA, which are believed to be 

superior in accuracy and precision. 

Medicare claims data in recent years 

continue to show a steady decline in the 

use of the SPA procedure by the 

beneficiary population. Further, there is 

a lack of evidence to support continued 

use of SPA, an older procedure where 

the metrics have not been correlated 

with fracture rate. 

We are proposing to revise the 

definition of a ‘‘bone mass 

measurement’’ to read, ‘‘Is performed 

with either a bone densitometer (other 

than a single-photon or dual-photon 

absorptiometry) or with a bone 

sonometer system that has been cleared 

for marketing for this use by the FDA 

under 21 CFR part 807, or approved for 

marketing by the FDA for this use under 

21 CFR part 814.’’

We are specifically requesting 

comments on this proposal regarding 

the evidence of benefit for SPA, 

particularly in comparison with other 

alternatives. 

b. Conditions for Coverage (§ 410.31(b)) 

We are proposing to revise the 

conditions for coverage for BMMs in 

mstockstill on PROD1PC63 with PROPOSAL_2

49060 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

§ 410.31(b) by requiring that for a 

medically necessary BMM to be covered 

for an individual being monitored to 

assess the response to or efficacy of an 

FDA-approved osteoporosis drug 

therapy (§ 410.31(d)(5)) the individual 

would be required to meet the present 

conditions for coverage under 

§ 410.31(b), and the monitoring would 

have to be performed by the use of an 

dual energy x-ray absorptiometry system 

(axial system). 

We recognize that in the June 24, 1998 

IFC, we allowed the physician or 

qualified nonphysician practitioner 

treating the beneficiary more flexibility 

in ordering those diagnostic 

measurements, but we are proposing to 

limit that flexibility with respect to the 

type of BMM that is used for monitoring 

individuals receiving osteoporosis drug 

therapy and other purposes (as 

discussed later in this section) because 

of new evidence and other information 

received since publication of the June 

24, 1998 IFC that supports the need for 

requiring the use of the DXA 

measurement (axial skeleton) in those 

circumstances. In addition to the 2004 

Surgeon General’s Report that 

recognized the superiority of the DXA 

(axial skeleton) for measuring bone mass 

over time, the International Society for 

Clinical Densitometry currently 

recommends that if an individual has a 

low bone mass using a peripheral 

measurement (appendicular skeleton) 

he or she should have a DXA (axial 

skeleton) performed for monitoring or 

confirmatory diagnostic purposes. 

Therefore, we are also proposing to 

revise § 410.31(b) by adding a 

requirement that in the case of any 

individual who qualifies for a bone 

mass measurement as provided for in 

§ 410.31(d) and who receives a 

confirmatory baseline BMM to permit 

monitoring in the future, Medicare may 

cover a medically necessary BMM for 

that individual, if the present conditions 

for coverage under § 410.31(b) are met, 

and the BMM is performed by a dual 

energy x-ray absorptiometry system 

(axial skeleton) (if the initial 

measurement was not performed by this 

system). 

As indicated previously, the most 

widely accepted method for measuring 

bone mineral density (BMD) is the use 

of DXA (Surgeons General’s Report 

2004) at axial skeletal sites. DXA (axial 

skeleton) measures BMD at the hip and 

spine (sites likely to fracture in patients 

who have osteoporosis). DXA is precise, 

safe, and low in radiation exposure, and 

permits more accurate and reliable 

monitoring of individuals over time. 

DXA of the femoral neck is the best 

validated test to predict hip fracture and 

is comparable to forearm measurements 

for predicting fractures at other sites 

(Evidence Report/Technology 

Assessment No 28, Agency for 

Healthcare Research and Quality 

(AHRQ), January 2001). 

c. Bone Mass Measurement: Standards 

on Frequency of Coverage (§ 410.31(c)) 

To conform the examples of a BMM 

exception to the standards on frequency 

of coverage in § 410.31(c)(2) to the 

regulation change we are proposing in 

§ 410.31(b)(3), we are proposing to 

revise the confirmatory baseline test 

example in § 410.31(c)(2)(ii) to read, 

‘‘Allowing for a confirmatory baseline 

measurement to permit monitoring of 

beneficiaries in the future if the 

requirements of paragraph (b)(3) of this 

section are met.’’

d. Bone Mass Measurement: 

Beneficiaries Who May Be Covered 

(§ 410.31(d)) 

The Congress has recognized that 

individuals receiving long-term 

glucocorticoid steroid therapy are 

qualified individuals for purposes of 

section 1861(rr)(1) of the Act. Therapy 

to prevent bone loss in most patients 

beginning long-term therapy has been 

recommended at a prednisone 

equivalent of ≥ 5 mg/day for at least 3 

months (McIlwain, 2003). Based on our 

review of the current evidence, we are 

proposing to reduce the dosage 

equivalent in § 410.31(d)(3) from an 

average of 7.5 mg/day of prednisone for 

at least 3 months to an average of 5.0 

mg/day of prednisone for the same 

period. 

e. Use of the NCD Process (§ 410.31(f)) 

To facilitate future consideration of 

coverage of additional BMM systems for 

purposes of proposed paragraphs 

§ 410.31(b)(2) and (b)(3), which would 

limit coverage of BMMs for monitoring 

individuals receiving osteoporosis drug 

therapy and for performing confirmatory 

baseline measurements, we are 

proposing to allow CMS, through the 

NCD process, to identify additional 

BMM systems for those purposes. By 

using the NCD process, we could 

conduct a timely assessment of FDAapproved BMMs. Use of an NCD to add 

coverage of effective BMM systems for 

these purposes is authorized by the 

reasonable and necessary provision of 

sections 1862(a)(1)(A) and 1871(a)(2) of 

the Act. 

In summary, in view of the 18 

comments and our review of the post1998 medical literature, we have 

decided to propose several revisions to 

§ 410.31 relative to the definition of the 

term ‘‘Bone Mass Measurement’’

(§ 410.31(a)(2)), the conditions for 

coverage (§ 410.31(b)), the examples of 

exceptions to the standards on 

frequency of coverage (§ 410.31(c)(2)), 

the category of individuals receiving (or 

expecting to receive) glucocorticoid 

(steroid) therapy (§ 410.31(d)(3)), and 

the addition of a new subparagraph 

(§ 410.31(f)) on use of the NCD process. 

L. Independent Diagnostic Testing 

Facility (IDTF) Issues 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘IDTF ISSUES’’ at the beginning 

of your comments.] 

1. Proposed IDTF Changes in the 

Physician Fee Schedule Proposed Rule 

During the course of a national review 

in 2003–2004, the Office of Inspector 

General (OIG) found a potential $71 

million in improper payments made to 

IDTFs (Review of Claims Billed by 

Independent Diagnostic Testing 

Facilities for Services Provided to 

Medicare Beneficiaries During Calendar 

Year 2001 (A–03–03–00002)). The OIG 

found that erroneous payments were 

made as the result of poor or missing 

documentation or the lack of medical 

necessity. Moreover, in recent years, 

CMS and its contractors have 

determined that a number of IDTFs in 

California and other States are 

perpetrating schemes to defraud the 

Medicare program. 

Since 2000, the number of IDTFs in 

California has increased by 40 percent, 

which is a far greater percentage 

increase than the Medicare population 

in that State. The number of IDTFs 

billing Medicare in California alone 

increased more than 400 percent from 

2000 to 2005. The increased use of IDTF 

services has not lowered the use of 

diagnostic testing within other settings. 

The increased rates of utilization within 

IDTFs is likely to be unrealistic due to 

an increase in the need of diagnostic 

testing within California’s Medicare 

population. Also, these IDTFs are 

growing at a rate faster than CMS can 

survey these facilities. The actual 

growth of IDTFs is not a problem, 

however, the results of the OIG audit 

make it clear that we need to closely 

monitor IDTFs and establish standards 

to ensure quality care for Medicare 

beneficiaries. To address the erroneous 

payments identified by the OIG above, 

we are proposing to establish IDTF 

supplier standards similar to those we 

adopted for Durable Medical 

Equipment, Prosthetics, Orthotics, and 

Supplies (DMEPOS) Suppliers on 

October 11, 2000 (see 42 CFR 424.57). 

We are proposing that each IDTF be 

required to be in compliance with the 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49061 

proposed fourteen suppler standards 

discussed in section L.2. below in order 

to obtain or retain enrollment in the 

Medicare program. Accordingly, at 

proposed § 410.33(h), we are proposing 

that if an IDTF fails to meet one or more 

of the proposed standards at the time of 

enrollment or at the time of reenrollment, then its enrollment 

application would be denied. Also, if at 

any time we determine that an enrolled 

IDTF no longer meets the proposed 

supplier standards, its billing privileges 

would be revoked. 

We believe that these supplier 

standards are needed to ensure that 

minimum quality standards are met to 

protect beneficiaries as well as the 

Medicare Trust Fund. These standards 

are merely good business practices 

which will help to ensure that suppliers 

are providing a quality care to Medicare 

beneficiaries. Examples of the kind of 

standards are a primary business phone 

number and address. Another example 

is a posting of standards for review by 

patients and the public. 

We are proposing to adopt, for IDTFs, 

a number of standards we adopted for 

DMEPOS suppliers, including supplier 

standard number 6 which requires a 

supplier to maintain a comprehensive 

liability insurance policy of $300,000 or 

20 percent of its average annual 

Medicare billings, whichever amount is 

greater, that covers both the place of 

business and all customers and 

employees of the IDTF. 

Furthermore, we are proposing in the 

new performance standard number 7 

that an IDTF agrees not to directly 

solicit patients. This provision does not 

preclude the IDTF from public 

advertisement or marketing its services 

to physicians and other suppliers, 

however it does prohibit recruitment of 

beneficiaries through direct solicitation. 

Additionally, the IDTF would be 

required to grant CMS, or its designated 

fee-for-service contractors, including 

our agents, to have access to the IDTF 

physical location, all equipment, and 

beneficiary medical records during 

normal business hours. For portable 

equipment, an IDTF would be required 

to maintain a catalog of portable 

equipment and be able to produce the 

cataloged equipment within two 

business days. If the IDTF denies this 

access, the IDTF’s Medicare enrollment 

would be immediately revoked. 

To ensure that equipment used by an 

IDTF is maintained and operates 

properly, we are seeking public 

comment regarding IDTF supplier 

standard number 11, which would 

require that an IDTF must have its 

testing equipment calibrated per 

equipment instructions or in 

compliance with applicable industry 

standards. Specifically, we are seeking 

public comment regarding the 

organizations or entities that may 

currently establish testing specifications 

for diagnostics equipment. Further, if 

these organizations or entities do not 

exist, we invite public comment 

regarding establishment of a supplier 

standard that relies on the 

manufacturer’s maintenance and 

calibration standards. 

While we understand that these 

proposed additional standards could 

lead certain IDTFs to withdraw from the 

Medicare program rather than comply 

with the new standards, we believe that 

legitimate businesses would not oppose 

these changes. Moreover, we emphasize 

that services provided by an IDTF are 

also readily available to beneficiaries 

through other avenues such as 

physicians’ offices, outpatient 

laboratories, outpatient radiology 

facilities, and outpatient clinics. We 

believe that the implementation of these 

proposed standards would improve the 

quality of services provided to Medicare 

beneficiaries by IDTFs without any 

associated access concerns. 

2. Proposed Performance Standards for 

IDTFs 

The IDTF would be required to meet 

the following standards as of January 1, 

2007 and any newly or reenrolling IDTF 

would be required to certify in its 

enrollment application that it meets and 

would continue to meet the standards. 

At § 410.33, we are proposing to revise 

the regulation to specify that the IDTF 

would be required to—

• Operate its business in compliance 

with all applicable Federal, State, and 

local licensure and regulatory 

requirements with regard to the health 

and safety of patients; 

• Provide complete and accurate 

information on its enrollment 

application as stated in the 

‘‘Requirements for Providers and 

Suppliers to Establish and Maintain 

Enrollment final rule’’ (April 21, 2006 

(42 FR 20754)). Any change in 

enrollment information would be 

required to be reported to the designated 

fee-for-service contractor on the 

Medicare enrollment application within 

30 calendar days; 

• Maintain a physical facility on an 

appropriate site. For the purposes of this 

proposed standard, a post office box or 

commercial mailbox would not be 

considered a physical facility. The 

physical facility would be required to 

contain space for equipment appropriate 

to the services designated on the 

enrollment application, facilities for 

hand washing, adequate patient privacy 

accommodations, and the storage of 

both business records and current 

medical records; 

• Have all applicable testing 

equipment available at the physical site, 

excluding portable equipment. A catalog 

of portable equipment, including 

equipment serial numbers, would be 

maintained at the physical site. In 

addition, portable equipment would be 

made available for inspection within 

two business days of our inspection 

request. The IDTF would be required to 

maintain a current inventory of the 

equipment (including serial/registration 

numbers), provide this information to 

the designated fee-for-service contractor 

and notify the contractor of any changes 

in equipment; 

• Maintain a primary business phone 

under the name of the business. The 

business phone would be located at the 

designated site of the business. The 

telephone number or toll free numbers 

would be available in a local directory 

and through directory assistance; 

• Have a comprehensive liability 

insurance policy of at least $300,000 or 

20 percent of its average annual 

Medicare billings, whichever amount is 

greater, that covers both the place of 

business and all customers and 

employees of the IDTF. The insurance 

policy would be carried by a nonrelative owned company. The policy 

would be required to list the serial 

numbers of any and all equipment used 

by the IDTF; 

• Agree not to directly solicit 

patients, which includes, but is not 

limited to, a prohibition on telephone, 

computer, or in-person contracts. The 

IDTF would accept only those patients 

referred for diagnostic testing by an 

attending physician, who is furnishing a 

consultation or treating a beneficiary for 

a specific medical problem and who 

uses the results in the management of 

the beneficiary’s specific medical 

problem. Nonphysician practictioners 

may order tests as set forth in 

§ 410.32(a)(3); 

• Answer beneficiaries’ questions and 

respond to their complaints. 

Documentation of those contacts would 

be maintained at the physical site; 

• Openly post these standards for 

review by patients and the public; 

• Disclose to the government, any 

person having ownership, financial or 

control interest, or any other legal 

interest in the supplier at the time of 

enrollment or within 30 days of a 

change; 

• Have its testing equipment 

calibrated per equipment instructions 

and in compliance with applicable 

national standards; 

mstockstill on PROD1PC63 with PROPOSAL_2

49062 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

• Have technical staff on duty with 

the appropriate credentials to perform 

tests. The IDTF would be required to 

produce the applicable Federal or State 

licenses and/or certifications of the 

individuals performing these services; • Have proper medical record storage 

and be able to retrieve medical records 

upon request from CMS or its 

designated fee-for-service contractor 

within 2 business days; and • Permit CMS, including its agents or 

its designated fee-for-service 

contractors, to conduct unannounced, 

on-site inspections to confirm the 

IDTF’s compliance with these proposed 

standards. The IDTF would be required 

to provide access, during regular 

business hours, to CMS and 

beneficiaries, as well as maintain a 

visible sign posting the normal business 

hours of the IDTF. 

3. Supervision 

To ensure quality care is provided to 

Medicare beneficiaries, we are 

proposing to revise § 410.33(b)(1) to 

read that physicians will be limited to 

providing supervision to ‘‘no more than 

three (3) IDTF sites.’’

4. Place of Service 

In addition to proposing the 

establishment of specific supplier 

standards for IDTFs, at proposed 

§ 410.33(i), we are proposing to define 

the ‘‘point of the actual delivery of 

service’’ as the correct ‘‘Place of 

Service’’ for the claim form in the case 

of diagnostic testing performed outside 

the IDTF’s physical location. For 

example, when an IDTF performs a 

diagnostic test at a beneficiary’s 

residence, we believe that it is 

reasonable to establish the beneficiary’s 

residence as the ‘‘Place of Service.’’

Previously, there has been no set 

procedure, so therefore, we believe that 

the information is gathered at the 

collection point from the beneficiary, 

and this is the point service. While most 

diagnostic tests are performed in an 

office setting, we are seeking public 

comment regarding the types of services 

that can be safely and appropriately 

used in a residential setting. 

M. Independent Laboratory Billing for 

the TC of Physician Pathology Services 

to Hospital Patients 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘INDEPENDENT LAB 

BILLING’’ at the beginning of your 

comments.] 

The TC of physician pathology 

services refers to the preparation of the 

slide involving tissue or cells that a 

pathologist will interpret. (In contrast, 

the pathologist’s interpretation of the 

slide is the PC service. If this service is 

furnished by the hospital pathologist for 

a hospital patient, it is separately 

billable. If the independent laboratory’s 

pathologist furnishes the PC service, it 

is usually billed with the TC service as 

a combined service.) 

In the ‘‘Revisions to Payment Policies 

Under the Physician Fee Schedule for 

Calendar Year 2000’’ final rule 

published in the Federal Register on 

November 2, 1999 (64 FR 59380 and 

59408 through 59409), we stated that we 

would implement a policy to pay only 

the hospital for the TC of physician 

pathology services furnished to hospital 

patients. Before that proposal, any 

independent laboratory could bill the 

carrier under the PFS for the TC of 

physician pathology services for 

hospital patients. As pointed out in the 

November 2, 1999 final rule, this policy 

has contributed to the Medicare 

program paying twice for the TC service, 

first through the inpatient prospective 

payment rate to the hospital where the 

patient is an inpatient and again to the 

independent laboratory that bills the 

carrier, instead of the hospital, for the 

TC service. 

Therefore, in that final rule at 

§ 415.130, we provided that, for services 

furnished on or after January 11, 2001, 

the carriers would no longer pay claims 

to the independent laboratory under the 

physician fee schedule for the TC of 

physician pathology services for 

hospital patients. 

Ordinarily, the provisions in the final 

PFS are implemented in the following 

year. However, in this case, the change 

to § 415.130 was delayed one year (until 

January 1, 2001), at the request of the 

industry, to allow independent 

laboratories and hospitals sufficient 

time to negotiate arrangements. 

Moreover, our full implementation of 

§ 415.130 was further delayed through 

CY 2006. 

We continue to believe, however, that 

hospital prospective payment amounts 

already compensate hospitals for the TC 

of physician pathology tests and that 

additional payment under the PFS is 

inappropriate. Therefore, we are 

proposing to amend § 415.130 to 

provide that, for services furnished after 

December 31, 2006, an independent 

laboratory may not bill the carrier for 

physician pathology services furnished 

to a hospital inpatient or outpatient. 

Under proposed § 415.130(d), we would 

pay under the PFS for the TC of a 

physician pathology service furnished 

by an independent laboratory for 

services provided to an inpatient or 

outpatient of a ‘‘covered hospital’’ on or 

before December 31, 2006. A ‘‘covered 

hospital’’ is defined in § 415.130(a)(1). 

N. Public Consultation for Medicare 

Payment for New Outpatient Clinical 

Diagnostic Laboratory Tests 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘CLINICAL DIAGNOSTIC LAB 

TESTS’’ at the beginning of your 

comments.] 

Section 1833(h) of the Act requires 

the Secretary to establish fee schedules 

for clinical laboratory tests under 

Medicare Part B. In this section of the 

preamble, we are proposing to 

implement section 942(b) of the MMA 

which specifies annual procedures for 

consulting the public on how to 

establish payment for new clinical 

laboratory test codes to be included in 

the annual update of the clinical 

laboratory fee schedule. 

1. BIPA (Pub. L. 106–554) 

Section 531(b) of BIPA mandated that 

we establish, no later than 1 year after 

the date of enactment, procedures that 

permit public consultation for payment 

determinations for new clinical 

diagnostic laboratory tests under 

Medicare Part B in a manner consistent 

with the procedures established for 

implementing ICD–9–CM coding 

modifications. In the November 23, 

2001 Federal Register (66 FR 58743), we 

specified the procedures to implement 

section 531(b) of BIPA. 

These procedures were most recently 

used to determine the payments for new 

2006 clinical laboratory fee schedule 

codes. First, we convened a public 

meeting to solicit expert input on the 

nature of the new tests before rate 

determinations were made. We have 

held these meetings each year since 

2002 to receive this expert input on the 

next year’s codes. Our most recent 

meeting was announced in the Federal 

Register on May 27, 2005 (70 FR 30734) 

and occurred on July 18, 2005. In that 

meeting, we requested that presenters 

address the new test codes, each test’s 

purpose, method, cost, and a 

recommendation for one of two methods 

(crosswalking or gapfilling) for 

determining payment for the new 

clinical laboratory codes. Crosswalking 

and gapfilling are discussed below in 

section N.2.d. 

Following the public meeting, we 

posted, on our Website, a summary of 

the new codes and the payment 

recommendations that were presented 

during the public meeting. The 

summary also displayed our tentative 

payment determinations and indicated a 

comment period for interested parties to 

submit written comments. After 

reviewing the comments received, we 

issued Medicare Transmittal 750, 2006 

Annual Update for Clinical Laboratory 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49063 

Fee Schedule, which provided all 

instructions and final rate 

determinations for the 2006 clinical 

laboratory fee schedule including the 

new codes and fees, on November 18, 

2005. 

2. Medicare Prescription Drug, 

Improvement, and Modernization Act of 

2003 (MMA) (Pub. L. 108–173) 

Further legislation affecting public 

consultation for new clinical laboratory 

tests was enacted at section 942(b) of the 

MMA (Pub. L. 108–173), which added 

section 1833(h)(8) to the Act. Section 

1833(h)(8)(A) of the Act requires the 

Secretary to establish by regulation 

procedures for determining the basis for 

and amount of payment for a clinical 

diagnostic laboratory test that is 

assigned a new or substantially revised 

Healthcare Common Procedure Coding 

System (HCPCS) code on or after 

January 1, 2005. We refer to these tests 

as ‘‘new tests.’’

Section 1833(h)(8)(B) of the Act 

provides that determinations of 

payment amounts for new tests shall be 

made only after the Secretary—

• Makes available to the public 

(through an Internet Web site and other 

appropriate mechanisms) a list that 

includes codes for which establishment 

of a payment amount is being 

considered for the next calendar year; 

• On the same day the list of codes 

is made available, publishes a Federal 

Register notice of a meeting to receive 

public comments and recommendations 

(and data on which recommendations 

are based) on the appropriate basis for 

establishing payment amounts for the 

list of codes made available to the 

public; 

• Not less than 30 days after 

publication of the notice in the Federal 

Register, convenes a meeting that 

includes representatives of CMS 

officials involved in determining 

payment amounts, to receive public 

comments and recommendations (and 

data on which the recommendations are 

based); and 

• Taking into account the comments 

and recommendations (and 

accompanying data) received at the 

public meeting, develops and makes 

available to the public (through an 

Internet Web site and other appropriate 

mechanisms)—

+ A list of proposed determinations 

with respect to the appropriate basis for 

establishing a payment amount for each 

code, together with an explanation of 

the reasons for each determination, the 

data on which the determinations are 

based, and a request for public written 

comments on the proposed 

determination; and 

+ A list of final determinations of the 

payment amounts for tests, together 

with the rationale for each 

determination, the data on which the 

determinations are based, and responses 

to comments and suggestions from the 

public. 

We believe that our current process 

for providing for public consultation on 

the establishment of payment amounts 

for new clinical laboratory tests is 

consistent with the requirements of 

section 1833(h)(8)(B) of the Act. We 

currently make available to the public 

through a posting on the CMS Web site 

a list of new laboratory test codes for the 

next calendar year. We publish a 

Federal Register notice of a meeting to 

receive public comments and 

recommendations and convene the 

meeting with appropriate CMS officials 

in attendance. We take into account the 

input received at the public meeting and 

we make available to the public on the 

CMS Web site a list of the proposed 

determinations and seek comment. We 

then make available to the public our 

final determinations in the instructions 

that we provide to our claims processing 

contractors to implement the Medicare 

Part B clinical laboratory fee schedule 

each year. 

The most significant change required 

by section 1886(h)(8)(A) of the Act with 

respect to our procedures for public 

consultation is that we codify this 

process in regulations. Therefore, in this 

proposed rule, we are proposing to 

codify our current process for public 

consultation for new clinical diagnostic 

laboratory tests paid under the Medicare 

Part B clinical laboratory fee schedule at 

proposed new Subpart F—Payment for 

New Clinical Diagnostic Laboratory 

Tests (§ 414.402 through § 414.406). 

a. Proposed Basis and Scope (§ 414.400) 

This proposed new subpart would 

implement provisions of section 

1833(h)(8) of the Act—procedures for 

determining the basis for, and amount 

of, payment for a new clinical 

diagnostic laboratory test with respect to 

which a new or substantially revised 

Healthcare Common Procedure Coding 

System code is assigned on or after 

January 1, 2005. 

b. Proposed Definition (§ 414.402) 

As specified in section 942(b) of the 

MMA, we propose to define the term 

‘‘Substantially Revised Healthcare 

Common Procedure Coding System 

Code’’ to mean a code for which there 

has been a substantive change to the 

definition of the test or procedure to 

which the code applies (such as a new 

analyte or a new methodology for 

measuring an existing analyte specific 

test). 

c. Proposed Procedures for Public 

Consultation for Payment for a New 

Clinical Diagnostic Laboratory Test 

(§ 414.406) 

For a clinical laboratory test that is 

assigned a new or substantially revised 

code on or after January 1, 2005, we 

would establish a local fee schedule 

amount only after the following: 

• We make available to the public 

(through an Internet Web site and other 

appropriate mechanisms) a list that 

includes codes for which establishment 

of a payment amount is being 

considered for the next calendar year. 

• We publish a Federal Register 

notice of a meeting to receive public 

comments and recommendations (and 

data on which recommendations are 

based) on the appropriate basis, as 

specified in proposed new § 414.408, for 

establishing payment amounts for the 

list of codes made available to the 

public. 

• Not less than 30 days after 

publication of the notice in the Federal 

Register, we convene a meeting, that 

includes representatives of CMS 

officials involved in determining 

payment amounts, to receive public 

comments and recommendations (and 

data on which the recommendations are 

based). 

• Taking into account the comments 

and recommendations (and 

accompanying data) received at the 

public meeting, we develop and make 

available to the public (through an 

Internet Web site and other appropriate 

mechanisms)—

+ A list of proposed determinations 

with respect to the appropriate basis for 

establishing a payment amount for each 

code, together with an explanation of 

the reasons for each determination, the 

data on which the determinations are 

based, and a request for public written 

comments on the proposed 

determination within a specified time 

period; and 

+ A list of final determinations of the 

payment amounts for tests, together 

with the rationale for each 

determination, the data on which the 

determinations are based, and responses 

to comments and suggestions from the 

public. 

d. Proposed Payment for a New Clinical 

Diagnostic Laboratory Test—

Crosswalking and Gapfilling (§ 414.408) 

We are proposing to add a new 

§ 414.408 to indicate when, in 

establishing the payment amount for a 

new clinical laboratory test, one of two 

payment methods can be utilized. The 

mstockstill on PROD1PC63 with PROPOSAL_2

49064 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

first payment method, called 

‘‘crosswalking,’’ is used if a new test is 

determined to be comparable to an 

existing test, multiple existing test 

codes, or a portion of an existing test 

code. We propose that a new test code 

would be assigned the related existing 

local fee schedule amounts and national 

limitation amount. 

In new § 414.408, we propose to use 

the second method, called ‘‘gapfilling,’’

when no comparable, existing test is 

available. Currently when using this 

method, manual instructions are 

provided to each Medicare carrier to 

determine a payment amount for its 

geographic area(s) for use in the first 

year, and the carrier-specific amounts 

are used to establish a national 

limitation amount for following years. 

Consistent with our current process, the 

sources of information carriers examine 

in determining gapfill amounts, if 

available, include—

• Charges for the test and routine 

discounts to charges; 

• Resources required to perform the 

test; 

• Payment amounts determined by 

other payers; and 

• Charges, payment amounts, and 

resources required for other tests that 

may be comparable or otherwise 

relevant. 

Currently, our manual instructions 

allow carriers to consider other sources 

of information as appropriate, including 

clinical studies and information 

provided by clinicians practicing in the 

area, manufacturers, or other interested 

parties. Carriers are also instructed to 

establish carrier specific amounts on or 

before March 31 of the year and to 

revise their carrier specific amount, if 

necessary, on or before September 1 of 

the year. In this manner, a carrier may 

revise its carrier specific amount based 

on additional information, but there is 

also a specific time frame to perform 

this revision so that we have adequate 

time to receive and use the carrier 

specific amounts for the calculation of 

the next year’s clinical laboratory fee 

schedule. 

Currently for new gapfilled laboratory 

tests, the payment amount beginning in 

the second year is based on the lower of 

the carrier specific amount determined 

in the first year or the national 

limitation amount. In accordance with 

section 1833(h) of the Act, the national 

limitation amount is set at the median 

of the carrier-specific amounts. 

In light of new MMA provisions, 

however, we are proposing, in new 

§ 414.408, to prospectively eliminate 

payment of new gapfilled tests at a 

carrier specific amount after the first 

year. Section 1833(h)(8)(A) of the Act 

gives the Secretary authority to establish 

procedures for determining the payment 

amount for laboratory tests for which 

new or substantially revised HCPCS 

codes were established on or after 

January 1, 2005. Under this authority, 

we propose, in new § 414.408(b), to pay 

for a new gapfilled laboratory test under 

our existing methodology for the first 

year (the carrier would establish a 

gapfill amount.) Beginning in the 

second year, the test would be paid at 

the national limitation amount. This 

would result in consistent payment in 

geographic areas for a new test using the 

median of the carrier gapfill amounts. 

3. Other Laboratory Issues 

This section discusses other 

laboratory issues related to quality and 

glucose monitoring in SNFs. 

a. Quality 

In addition to providing payments, 

Medicare’s clinical laboratory fee 

schedule for both new and existing tests 

should foster the provision of quality 

care and the prevention of avoidable 

health care costs. We are exploring the 

development of measures related to the 

quality and efficiency of care, including 

those involving clinical laboratory fee 

schedule services. Physicians’ decisions 

are central to the health care their 

patients receive and are informed by 

appropriate clinical laboratory testing. 

We want to work with physicians, 

providers and the clinical laboratory 

community to identify ways to promote 

utilization decisions that clearly 

increase the quality of care while 

avoiding unnecessary costs for 

beneficiaries and the Medicare program. 

As part of its strategies to improve 

quality of care, CMS could require those 

who perform laboratory tests to submit 

laboratory values using common 

vocabulary standards, such as those 

found in the Logical Observation 

Identifiers Names and Codes (LOINC) 

database. 

The LOINC database currently 

contains about 41,000 observational 

terms, of which nearly 31,000 are 

observational terms related to laboratory 

testing. The laboratory subset of the 

LOINC database provides universal 

names and codes for identifying the 

results of clinical laboratory tests and it 

facilitates the exchange and pooling of 

clinical laboratory results for clinical 

care, outcomes management and 

research. Note that LOINC describes 

the test result, but does not provide it. 

It is, therefore, only one possible 

component of a comprehensive system 

of collecting clinical laboratory fee test 

results. Each LOINC record 

corresponds to a single test result or 

panel. The following are some examples 

of LOINC records: 

LOINC code LOINC name (component: 

property: timing: specimen: scale) 

2951–2 SODIUM:SCNC:PT:SER/ 

PLAS:QN 

2955–2 SODIUM:SCNC:PT:UR:QN 

2956–1 SODIUM:SRAT:24H:UR:QN 

2164–2 CREATININE RENAL 

CLEARANCE:VRAT:24H:UR:QN 

1514–9 GLUCOSE∧2H POST 100 G 

GLUCOSE 

PO:MCNC:PT:SER/PLAS:QN 

3665–7 GENTAMICIN∧

TROUGH:MCNC:PT:SER/PLAS:QN 

17863–2 CALCIUM.IONIZED:

MCNC:PT:SER/PLAS:QN 

2863–9 ALBUMIN:MCNC:PT:SNV:

QN:ELECTROPHORESIS 

The parts of the LOINC name refer 

to different aspects of the test result. 

The component is the analyte (for 

example, sodium). The property is the 

characteristic of the analyte that is 

measured, evaluated or observed (for 

example SCNC = substance 

concentration). Timing indicates 

whether the measurement is an 

observation at a moment of time, or an 

observation integrated over an extended 

duration of time (for example, PT = 

point in time). The specimen is the type 

of sample (for example, SER/PLAS = 

serum or plasma). The scale is the type 

of scale (for example QN = quantitative). 

For further detail, please see the 

LOINC Web site at http:// 

www.loinc.org. 

On September 23, 2005 (70 FR 55900–

56025), we published the proposed rule 

‘‘HIPAA Administrative Simplification: 

Standards for Electronic Health Care 

Claims Attachments.’’ This rule 

proposed standards for electronically 

requesting and supplying particular 

types of additional health care 

information in the form of an electronic 

attachment to support submitted health 

care claims data. The proposed rule 

specified a standard attachment form for 

reporting laboratory results (among 

other standards) and proposed adoption 

of LOINC as the standard code set for 

reporting such results. 

While the laboratory claims 

attachment standard and use of LOINC

could provide a means for reporting test 

result data, we recognize that there are 

significant operational and other 

challenges that would need to be 

addressed before Medicare could begin 

to collect laboratory values in a 

comprehensive fashion using common 

vocabulary standards and that these 

challenges need to be met in partnership 

with the clinical laboratory community. 

We look forward to working 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49065 

collaboratively with the clinical 

laboratory community on these issues. 

b. Blood Glucose Monitoring in SNFs 

In response to inquiries regarding our 

policy on blood glucose monitoring in 

SNFs, we are taking this opportunity to 

restate our long-standing policy on 

coverage of blood glucose monitoring 

services and to propose to codify 

physician certification requirements for 

blood glucose monitoring in SNFs. 

Generally, section 1862(a)(1)(A) of the 

Act requires that a service be reasonable 

and necessary for diagnosis and 

treatment in order to be eligible for 

coverage by Medicare. Our regulations 

at § 410.32(a) already require that, for 

any diagnostic test, including a clinical 

diagnostic laboratory test, to be 

considered reasonable and necessary, it 

must be both ordered by the physician 

and the ordering physician must use the 

result in the management of the 

beneficiary’s specific medical problem. 

Tests not ordered by the physician who 

is treating the beneficiary are not 

reasonable and necessary. 

In the context of blood glucose 

monitoring, we most recently stated this 

policy in Transmittal AB–00–108, 

‘‘Glucose Monitoring’’, which is 

available on our Web site at http:// 

www.cms.hhs.gov/transmittals/ 

downloads/ab00108.pdf. This 

interpretation of § 410.32 is also the 

basis for our policy in Chapter 7 of the 

Medicare Claims Processing Manual 

(‘‘Skilled Nursing Facility Part B 

Billing’’ available on our Web site at 

http://www.cms.hhs.gov/manuals/ 

downloads/clm104c07.pdf.) 

In addition, section 1835(a)(2)(B) of 

the Act provides that, in the case of 

certain ‘‘medical and other health 

services’’ (including clinical diagnostic 

laboratory services), payment may be 

made for Part B services that are 

furnished by a provider of services only 

if a physician certifies—and recertifies 

where those services are furnished over 

a period of time, with such frequency, 

and accompanied by such supporting 

material, as may be provided by 

regulation—that those services were 

medically necessary. The regulations 

currently implementing this provision 

at § 424.24 do not specifically address 

the issue of blood glucose monitoring in 

SNFs. Therefore, we are proposing to 

amend § 424.24 to provide that, for each 

blood glucose test furnished to a 

resident of a SNF, the physician must 

certify that the test is medically 

necessary. We are also proposing to 

amend § 424.24 to clarify that a 

physician’s standing order is not 

sufficient to order routine blood glucose 

monitoring. 

c. Other Lab Issues—Proposed Clinical 

Diagnostic Laboratory Date of Service 

(DOS) for Stored Specimens 

We are proposing to add a new 

§ 414.410 to address concerns that have 

been raised regarding the date of service 

of a clinical diagnostic laboratory test 

that use a stored (or ‘‘archived’’) 

specimen. In the final rule of coverage 

and administrative policies for clinical 

diagnostic laboratory services that we 

published on November 23, 2001 (66 FR 

58792), we adopted a policy under 

which the date of service for clinical 

diagnostic laboratory services generally 

is the date the specimen is collected. 

For laboratory tests that use an archived 

specimen, however, the date of service 

is the date the specimen was obtained 

from the storage. In 2002, we issued 

Program Memorandum AB–02–134 

which permitted contractors discretion 

in making determinations regarding the 

length of time a specimen must be 

stored to be considered archived. In 

response to comments requesting that 

we issue a national standard to clarify 

when a stored specimen can be 

considered ‘‘archived,’’ in the 

Procedures for Maintaining Code Lists 

in the Negotiated National Coverage 

Determinations for Clinical Diagnostic 

Laboratory Services final notice, 

published in the Federal Register on 

February 25, 2005 (70 FR 9355), we 

defined an ‘‘archived’’ specimen as a 

specimen that is stored for more than 30 

calendar days before testing. The date of 

service for these archived specimens is 

the date the specimen was obtained 

from storage. Specimens stored 30 days 

or less have a date of service of the date 

the specimen was collected. The 

February 25, 2005 final notice also 

clarified that the date of service for tests 

when the collection spanned more than 

two calendar days is the date the 

collection ended. Instructions that 

implemented these policies were added 

to Chapter 16, section 40.8 of the 

Medicare Claims Processing Manual 

(Pub. 100–04) with the issuance of 

Transmittal 800 (CR 4156), on December 

30, 2005. 

Recently, we have received 

correspondence that expressed concern 

that our policies have created some 

unintended consequences, especially in 

situations in which a specimen is taken 

in a hospital setting, but then later used 

for a test after the patient has left the 

hospital. Under the current manual 

instructions, if the specimen used for a 

test ordered subsequent to the 

beneficiary’s discharge is obtained less 

than 31 calendar days following the date 

the specimen was collected, the date of 

service of the test is the date of 

collection. The date of service of a test 

may affect payment because, if the date 

of service falls during an inpatient stay 

or on a day on which the beneficiary 

had an outpatient procedure, payment 

for the laboratory test usually is bundled 

with the hospital service. To address 

these concerns, we are proposing to 

change our current policy so that the 

date of service would be the date the 

specimen is obtained from storage, even 

if the specimen is obtained less than 31 

days from the date it was collected, 

without violating the unbundling rules 

as long as the following conditions are 

met: 

• The test is ordered by the patient’s 

physician at least 14 days following the 

date of the patient’s discharge from the 

hospital. 

• The test could not reasonably have 

been ordered while the patient was 

hospitalized. 

• The procedure performed while the 

beneficiary is a patient of the hospital is 

for purposes other than collection of the 

specimen needed for the test. 

• The test is reasonable and 

medically necessary. 

These conditions are consistent with 

the guidance in Chapter 16, sec 40.3 of 

the Claims Processing Manual, which 

states that ‘‘When the hospital obtains 

laboratory tests for outpatients under 

arrangements with clinical laboratories 

or other hospital laboratories, only the 

hospital can bill for the arranged 

services.’’

In addition, Chapter 3 of the Program 

Integrity Manual contains instructions 

for additional documentation if further 

development of laboratory claims for 

pre-or postpay are required. Although 

we believe these changes will help to 

maintain beneficiary access to care, we 

are concerned about the potential for 

these policy changes creating 

inappropriate incentives in the 

development of technology and the 

implications for the unbundling of 

services. We solicit comment on the 

proposed changes and these concerns. 

O. Proposal to Establish Criteria for 

National Certifying Bodies That Certify 

Advanced Practice Nurses 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘Criteria for National Certifying 

Bodies-Advanced Practice Nurses’’ at 

the beginning of your comments.] 

Federal regulatory qualifications for 

nurse practitioners (NPs) at 42 CFR 

410.75 require that an individual be 

certified as an NP by a recognized 

national certifying body that has 

established standards for NPs. Similarly, 

Federal regulatory qualifications for 

clinical nurse specialists (CNSs) at 42 

mstockstill on PROD1PC63 with PROPOSAL_2

49066 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

CFR 410.76 require that an individual 

be certified as a CNS by a national 

certifying body that has established 

standards for CNSs and that is approved 

by the Secretary. 

Currently, there is not a list of 

recognized or approved national 

certifying bodies for NPs and CNSs in 

regulations. However, Chapter 15, 

section 200 of the Benefit Policy 

Manual, Pub. 100–02 contains a list of 

national certifying bodies that are 

recognized by Medicare as being 

appropriate for certification of NPs. 

Although the manual provision 

regarding CNS services at Chapter 15, 

section 210 of the Benefit Policy Manual 

lists only the American Nurses 

Credentialing Center as an approved 

national certifying body for CNSs, we 

indicated that the list of recognized 

certifying bodies in the manual 

provision for NP services would also 

apply for CNSs in the ‘‘Revisions to 

Payment Policies Under the CY 2003 

Physician Fee Schedule and Inclusion 

of Registered Nurses in the Personnel 

Provision of the Critical Access Hospital 

Emergency Services Requirement for 

Frontier Areas and Remote Locations; 

Payment Policies final rule (December 

31, 2002, 67 FR 79987). The national 

certifying bodies that are listed under 

the manual instruction at section 200, 

and that currently apply for both NPs 

and CNSs (collectively, advanced 

practice nurses) are as follows: 

• American Academy of Nurse 

Practitioners; 

• American Nurses Credentialing 

Center; 

• National Certification Corporation 

for Obstetric, Gynecologic and Neonatal 

Nursing Specialties; 

• National Certification Board of 

Pediatric Nurse Practitioners and 

Nurses; 

• Oncology Nurses Certification 

Corporation; 

• Critical Care Certification 

Corporation. 

In the December 31, 2002 final rule, 

in response to a public comment, we 

stated, ‘‘it is not the agency’s intention 

to be overly restrictive in our program 

requirements and consequently prevent 

qualified CNSs who specialize in areas 

of medicine other than those certified by 

the American Nurses Credentialing 

Center (ANCC) from participating under 

the CNS benefit and from rendering care 

to patients in need of specialized 

services. Furthermore, the intent of the 

revision to the certification requirement 

for CNSs is to recognize all appropriate 

national certifying bodies for CNSs as 

the program does for NPs.’’ Accordingly, 

in an effort to recognize all appropriate 

national certifying bodies for CNSs and 

NPs, we added, at that time, the 

Oncology Nurses Certification 

Corporation (ONCC) and the Critical 

Care Certification Corporation (CCCC) to 

the list of recognized national certifying 

bodies for advanced practice nurses. 

The National Board on Certification of 

Hospice and Palliative Care Nurses 

(NBCHPN) has requested that we now 

follow the same course of action as we 

did for the ONCC and the CCCC by 

adding its name to the list of recognized 

national certifying bodies. That is, 

NBCHPN believes that it is an 

appropriate national certifying body 

based on its certification experience, 

principles, services, and the 

certification exam that it administers to 

advanced practice nurses who 

specialize in palliative care for hospice 

patients. 

The NBCHPN stated in information it 

sent to the agency that its organization 

is a well-established certification body 

with more than 12-years history of 

certification and that it has been 

certifying advanced practice hospice 

and palliative nurses since 2003 in 

partnership with the ANCC. Starting in 

2005, the NBCHPN became sole 

proprietor of the Advanced Certified 

Hospice and Palliative Nurse (ACHPN) 

examination. Master’s level nurse 

practitioners and clinical nurse 

specialists sit for this ACHPN 

examination that is based on a role 

delineation study for the advanced 

practice level of hospice and palliative 

nursing. Additionally, the NBCHPN 

stated that it has met the requirements 

of the American Board of Nursing 

Specialties and is an active member of 

the Board of Specialties, as is the ANCC. 

The Executive Director of the NBCHPN 

stated that she believes that the absence 

of the NBCHPN from the current list of 

recognized national certifying bodies 

presents a barrier for advanced practice 

nurses in the hospice palliative care 

specialty because they are denied 

enrollment on the basis that they do not 

meet the certification qualification 

requirement. The Web site for the 

NBCHPN can be found at 

www.nbchpn.com. 

We are soliciting public comments on 

whether it would be appropriate to 

include the NBCHPN under the list of 

recognized and approved national 

certifying bodies for NPs and CNSs 

under manual instructions for both NPs 

and CNSs. We are also soliciting public 

comments on criteria or standards that 

we could use to determine whether an 

organization is an appropriate national 

certifying body for advanced practice 

nurses. CMS realizes that the agency 

may receive other requests in the future 

from organizations that wish to be to be 

added to the list of recognized or 

approved national certifying bodies. In 

anticipation of those requests, the 

agency is interested in developing 

certification standards that would 

facilitate the process for making these 

decisions. 

P. Chiropractic Services Demonstration 

[If you choose to comment on issues 

in this section, please include the 

caption ‘‘Chiropractic Services 

Demonstration’’ at the beginning of your 

comments.] 

In the FY 2006 PFS final rule 

(November 21, 2005), we included a 

discussion of the 2-year demonstration 

authorized by section 651 of the MMA 

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 

cover diagnostic and other services that 

a chiropractor is legally authorized to 

perform by the State or jurisdiction in 

which the treatment is provided. The 

demonstration is being conducted in 

four sites, two rural and two urban. The 

demonstration must be budget neutral 

as the statute requires the Secretary to 

ensure that the aggregate payment made 

under the Medicare program does not 

exceed the amount which would be 

paid in the absence of the 

demonstration. 

Ensuring budget neutrality requires 

that the Secretary develop a strategy for 

recouping funds should the 

demonstration result in costs higher 

than those that would occur in the 

absence of the demonstration. As we 

stated in the FY 2006 PFS, 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 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. 

Any needed reduction would be made 

in the 2010 and 2011 physician fee 

schedules as 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 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49067 

1RAND News Release: Rand Study Says 

Computerizing Medical Records Could Save $81 

Billion Annually and Improve the Quality of 

Medical Care, September 14, 2005, available at 

http://rand.org/news/press.05/09.14.html. 

2Transforming Health Care: The President’s 

Health Information Technology Plan, available at: 

http://www.whitehouse.gov/infocus/technology/ 

economic_policy200404/chap3.html. 

currently covered CPT codes 98940, 

98941, and 98942), we would 

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 

would implement the adjustment over a 

1-year period. We will include the 

detailed analysis of budget neutrality 

and the proposed offset during the 2009 

rulemaking process. PT services 

performed by chiropractors under the 

demonstration are subject to the PT 

therapy cap. These services are included 

under the cap because chiropractors are 

subject to the same rules as medical 

doctors for therapy services under the 

demonstration. 

Q. Promoting Effective Use of Health 

Information Technology (HIT) 

(If you choose to comment on issues 

in this section, please include the 

caption ‘‘Promoting Effective Use of 

HIT’’ at the beginning of your 

comment.) 

We recognize the potential for health 

information technology (HIT) to 

facilitate improvements in the quality 

and efficiency of health care services. 

One recent RAND study found that 

broad adoption of electronic health 

records could save more than $81 

billion annually and, at the same time, 

improve quality of care.1 The largest 

potential savings that the study 

identified was in the hospital setting 

because of shorter hospital stays 

promoted by better coordinated care; 

less nursing time spent on 

administrative tasks; better use of 

medications in hospitals; and better 

utilization of drugs, laboratory services, 

and radiology services in hospital 

outpatient settings. The study also 

identified potential quality gains 

through enhanced patient safety, 

decision support tools for evidencebased medicine, and reminder 

mechanisms for screening and 

preventive care. Despite these large 

potential benefits, the study found that 

only about 20 to 25 percent of hospitals 

have adopted HIT systems. 

It is important to note the caveats to 

the RAND study. The projected savings 

are across the health care sector, and 

any Federal savings would be a reduced 

percentage. In addition, there are 

significant assumptions made in the 

RAND study. National savings are 

projected in some cases based on one or 

two small studies. Also, the study 

assumes patient compliance, in the form 

of participation in disease management 

programs and following medical advice. 

For these reasons, extreme caution 

should be used in interpreting these 

results. 

In summary, there are mixed signals 

about the potential of HIT to reduce 

costs. Some studies have indicated that 

HIT adoption does not necessarily lead 

to lower costs and improved quality. In 

addition, some industry experts have 

stated that factors such as an aging 

population, medical advances, and 

increasing provider expenses would 

make any projected savings impossible. 

In his 2004 State of the Union 

Address, the President announced a 

plan to ensure that most Americans 

have electronic health records within 10 

years.2 One part of this plan involves 

developing voluntary standards and 

promoting the adoption of interoperable 

HIT systems that use these standards. 

The 2007 Budget states that ‘‘The 

Administration supports the adoption of 

health information technology (IT) as a 

normal cost of doing business to ensure 

patients receive high quality care.’’

Over the past several years, we have 

undertaken several activities to promote 

the adoption and effective use of HIT in 

coordination with other Federal 

agencies and with the Office of the 

National Coordinator for Health 

Information Technology. One of those 

activities is promotion of data standards 

for clinical information, as well as for 

claims and administrative data. 

As noted above, the Administration 

supports the adoption of HIT as a 

normal cost of doing business. The 

adoption and use of HIT may contribute 

to improved processes and outcomes of 

care, including shortened illnesses and 

the avoidance of adverse drug reactions. 

R. Health Care Information 

Transparency Initiative 

(If you choose to comment on issues 

in this section, please include the 

caption ‘‘Health Care Information 

Transparency Initiative’’ at the 

beginning of your comment.) 

The United States (U.S.) faces a 

dilemma in health care. Although the 

rate of increase in health care spending 

slowed last year, costs are still growing 

at an unsustainable rate. The U.S. 

spends $1.9 trillion on health care, or 16 

percent of the gross domestic product 

(GDP). By 2015, projections are that 

health care will consume 20 percent of 

GDP. As indicated in the 2006 Annual 

Report of the Boards of Trustees, the 

Medicare program alone consumes 3.2 

percent of the GDP and by 2040, it will 

consume 8.0 percent of the GDP. 

Part of the reason health care costs are 

rising so quickly is that most consumers 

of health care—the patients—are 

frequently not aware of the actual cost 

of their care. Health insurance shields 

them from the full cost of services, and 

they have only limited information 

about the quality and costs of their care. 

Consequently, consumers do not have 

the incentive or means to carefully shop 

for providers offering the best value. 

Thus, providers of care are not subject 

to the competitive pressures that exist in 

other markets for offering quality 

services at the best possible price. 

Reducing the rate of increase in health 

care prices and avoiding health services 

of little value could help to stem the 

growth in health care spending, and 

potentially reduce the number of 

individuals who are unable to afford 

health insurance. Part of the President’s 

health care agenda is to expand Health 

Savings Accounts (HSAs), which would 

provide consumers with greater 

financial incentives to compare 

providers in terms of price and quality, 

and choose those that offer the best 

value. 

In order to exercise those choices, 

consumers must have accessible and 

useful information on the price and 

quality of health care items and 

services. Typically, health care 

providers do not publicly quote or 

publish their prices. Moreover, list 

prices, or charges, generally differ from 

the actual prices negotiated and paid by 

different health plans. Thus, even if 

consumers were financially motivated 

to shop for the best price, it would be 

very difficult at the current time for 

them to access usable information. 

For these reasons, DHHS is launching 

a major health care information 

transparency initiative in 2006. This 

effort builds on steps taken by CMS to 

make quality and price information 

available. For example, Medicare has 

provided unprecedented information 

about drug prices in the Medicare drug 

benefit, and is now adding to these 

efforts in other areas. Medicare payment 

information for common elective 

procedures and other common 

admissions for all hospitals by county 

has been posted on our Web site at: 

http://www.cms.hhs.gov/ 

HealthCareConInit/01 

Overview.asp#TopOfP. 

We will post geographically-based 

Medicare payment information for 

common elective procedures for 

ambulatory surgery centers this summer 

and for common hospital outpatient and 

physician services this fall. 

mstockstill on PROD1PC63 with PROPOSAL_2

49068 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

In addition, a number of tools 

providing usable healthcare information 

are already available to Medicare 

beneficiaries. Supported by the publicprivate quality alliances, consumers can 

access ‘‘Compare’’ Web sites through 

www.medicare.gov where they can 

evaluate important aspects of their 

health care options for care at a hospital, 

nursing home, home health agency, and 

dialysis facility, as well as compare 

their costs and coverage when choosing 

a prescription drug plan. 

We are developing a project with the 

goals of providing more comprehensive 

information on quality and costs, 

including more complete measures of 

health outcomes, satisfaction, and 

volume of services that matter to 

consumers, and more comprehensive 

measures of costs for entire episodes of 

care, not just payments for particular 

services and admissions. We intend for 

the project to combine public and 

private health care data to measure cost 

and quality of care information at the 

physician and hospital levels. Quality, 

cost, pricing, and patient information 

will be reported to consumers and 

purchasers of health care in a 

meaningful and transparent way. 

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 410.33 Independent Diagnostic 

Testing Facility 

Section 410.33(e)(1) imposes a 

recordkeeping requirement on multistate entities. Specifically, an 

independent diagnostic testing facility 

(IDTF) that operates across State 

boundaries must maintain 

documentation that its supervising 

physicians and technicians are licensed 

and certified in each of the States in 

which it operates. The burden 

associated with this requirement is the 

time and effort it takes the IDTF to 

collect and maintain the aforementioned 

information. 

While subject to the PRA, we believe 

this information collection requirement 

is exempt as defined in 5 CFR 

1320.3(b)(2), because the time, effort, 

and financial resources necessary to 

comply with the requirement would be 

incurred by persons in the normal 

course of their activities (for example, in 

compiling and maintaining business 

records) and is considered to be usual 

and customary. 

Section 410.33(g) discusses the 

application certification standards that 

an IDTF must meet. An IDTF must 

complete an enrollment application and 

certify the information contained in the 

application. The certification is part of 

an application that is subject to the 

PRA. The burden associated with this 

requirement is the time and effort 

necessary to complete the application. 

This requirement is currently approved 

in OMB No. 0938–0685, with a current 

expiration date of April 30, 2009. 

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: William N. Parham, III, [CMS–

1321–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: Carolyn Lovett, CMS 

Desk Officer, [CMS–1321–P], 

carolyn_lovett@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 19, 

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 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49069 

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 the 

222 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 

980,000 physicians, other practitioners 

and medical suppliers that receive 

Medicare payment under the PFS. 

For purposes of the RFA, 

approximately 80 percent of clinical 

diagnostic laboratories are considered 

small businesses according to the Small 

Business Administration’s size 

standards. 

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 

927 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 0.9 percent 

increase in overall payments relative to 

current overall payments. 

IDTFs are suppliers under the 

Medicare program. For purposes of the 

RFA, suppliers with annual sales of $6 

million or less are considered to be 

small entities. (Individuals and States 

are not included in the definition of a 

small entity.) We believe that our 

proposed standards for IDTFs will help 

bar fraudulent suppliers from 

participating in the Medicare program 

and provide an added level of 

protection to Medicare beneficiaries. 

Therefore, we expect to have an impact 

on an unknown number of persons and 

entities who will effectively be 

prevented from practicing their aberrant 

billing activities. The vast majority of 

suppliers would not be significantly 

affected by this proposed rule. The 

reduction in program overpayments and 

the added level of protection to 

beneficiaries that we expect to achieve 

as a result of this proposed rule justifies 

the relatively small burden this 

proposed rule would impose on all 

small entities. 

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 $120 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. The analysis explains the 

rationale for and purposes of this 

proposed 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 PE 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 RVU Proposals 

for CY 2007 and Section 5102 of the 

DRA-Proposed Adjustments for 

Payments for Imaging Services 

As required by section 5102(a) of the 

DRA and described earlier in section 

II.E.1. of this proposed rule, we are 

removing, from the PE RVUs under the 

PFS the 0.3 percent increase made to the 

PE RVUs in the CY 2006 PFS final rule 

with comment period to ensure the 

budget neutrality of the impact of the 

multiple imaging policy adopted for CY 

2006. Section 5102(a) of the DRA 

exempts the CY 2006 and 2007 impact 

of the multiple imaging policy from 

budget neutrality. Because we are 

proposing to maintain the current 25 

percent payment reduction for multiple 

imaging procedures in CY 2007, there is 

no additional impact resulting from our 

proposals for CY 2007. Section 5102 of 

the DRA also exempts the estimated 

savings from the application of the 

OPPS-based payment limitation on PFS 

imaging services from the PFS budget 

neutrality requirement. We estimate that 

the combined impact of the budget 

neutrality exemptions in section 5102 of 

the DRA would reduce PFS 

expenditures by approximately 1.3 

percent in CY 2007. 

Table 7 below shows the specialtylevel impact of section 5102 of the DRA 

and our most recent estimate (¥5.1 

percent) of the CY 2007 Medicare PFS 

update. For reference purposes, we have 

also included the specialty-level 

impacts using the methodology from the 

separate June 29, 2006 proposed notice 

(71 FR 37170), which solicited 

comments on proposed changes to the 

PE methodology as well as changes to 

work RVUs for certain services based on 

the agency’s completion of a five-year 

review of work RVUs. The CY 2007 

impact of the PE input changes 

described in section II.A. of this 

proposed rule that were not included in 

the June 29, 2006 proposed notice are 

minimal at the specialty level. 

Additionally, the impacts in this 

proposed rule reflect the use of updated 

physician time data from the AMA–

RUC. 

Our estimates of changes in Medicare 

revenues for PFS services compare 

payment rates for CY 2006 with 

proposed payment rates for CY 2007 

using CY 2005 Medicare utilization for 

all years. We are using CY 2005 

Medicare claims processed and paid 

through March 30, 2005, that we 

estimate are 98 percent complete. To the 

extent that there are year-to-year 

changes in the volume and mix of 

services provided by physicians, the 

actual impact on total Medicare 

revenues will be different than those 

shown here. The payment impacts 

reflect averages for each specialty based 

on Medicare utilization. The payment 

impact for an individual physician 

would be different from the average, 

based on the mix of services the 

physician provides. The average change 

in total revenues would be less than the 

impact displayed here because 

physicians furnish services to both 

Medicare and non-Medicare patients 

mstockstill on PROD1PC63 with PROPOSAL_2

49070 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

and specialties may receive substantial 

Medicare revenues for services that are 

not paid under the PFS. For instance, 

independent laboratories receive 

approximately 80 percent of their 

Medicare revenues from clinical 

laboratory services that are not paid 

under the PFS. 

Table 7 shows only the payment 

impact on PFS services. The following 

is an explanation of the information 

represented in Table 7: 

• Specialty—The physician specialty 

or type of practitioner/supplier. 

• Allowed Charges—Allowed charges 

are the Medicare Fee Schedule amounts 

for covered services and include 

copayments and deductibles (which are 

the financial responsibility of the 

beneficiary.) These amounts have been 

summed across all services provided by 

physicians, practitioners, or suppliers 

with a specialty to arrive at the total 

allowed charges for the specialty. 

• Impact of Work and PE RVU 

Changes using the June 29, 2006 

proposed notice methodology—For 

references purposes, the combined CY 

2007 percentage increase or decrease in 

allowed charges attributed to changes in 

the work and PE RVUs described in and 

republished from the June 29, 2006 

proposed notice methodology. 

• Impact of section 5102 of the 

DRA—The CY 2007 percentage decrease 

in allowed charges attributed to section 

5102 of the DRA. 

• Combined impact of the June 29, 

2006 proposed notice methodology and 

section 5102 of the DRA. 

• CY 2007 Update—The percentage 

decrease in allowed charges attributed 

to the most recent estimate of the CY 

2007 PFS conversion factor update 

(¥5.1 percent). 

• Combined impact with CY 2007 

update—The CY 2007 percentage 

decrease in allowed charges attributed 

to the June 29, 2006 proposed notice 

methodology, section 5102 of the DRA, 

and the CY 2007 update. 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.045</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49071 

Table 8 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 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.046</GPH>
49072 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

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 PE refer to 

Addendum A of this proposed rule. If 

we change any of the proposed 

provisions following the consideration 

of public comments, these figures may 

change. 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.047</GPH>
Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49073 

B. Geographic Practice Cost Indices 

(GPCI)—Payment Localities 

As discussed in section II.B. of the 

preamble to this proposed rule, we are 

proposing new GPCIs for 2007. In the 

November 15, 2004 PFS final rule, we 

published 2005 and 2006 GPCI and GAF 

values reflecting the 2 year phase-in of 

updated GPCI data. In 2007, the 

proposed GPCI and GAF values will 

reflect new budget neutrality scalers 

(developed by the Office of the Actuary) 

and the removal of the 1.000 MMA floor 

from the physician work GPCI. The 

negative impact of these changes on a 

number of payment localities is shown 

in 4 of section II.B. in this proposed 

rule. 

C. Global Period for Remote 

Afterloading High Intensity 

Brachytherapy Procedures 

As discussed in section II.D.1. of this 

proposed rule, we are proposing 

changes to the global period for these 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.048</GPH>
49074 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

services. We do not anticipate this 

proposed change will have a significant 

impact on Medicare expenditures. 

D. DRA 5112—Proposed Addition of the 

Ultrasound Screening for Abdominal 

Aortic Aneurysm to Welcome to 

Medicare Benefit 

As discussed earlier in section II.E.3. 

of this preamble, section 5112 of the 

DRA authorizes coverage of an 

ultrasound screening for abdominal 

aortic aneurysms effective January 1, 

2007, subject to certain eligibility and 

other limitations. We estimate that this 

new benefit would result in an increase 

in Medicare expenditures to physicians 

and other practitioners and suppliers of 

ultrasound services and related followup tests and treatment that may be 

required as a result of the coverage of 

these screening examinations. However, 

this is not expected to have a significant 

cost impact on the Medicare program. 

E. DRA 5113—Proposed Colorectal 

Screening Exemption From Part B 

Deductible 

As discussed earlier in section II.E.4. 

of this preamble, beginning January 1, 

2007, colorectal cancer screening 

services as described in section 

1861(pp)(1) of the Act are no longer 

subject to the Part B deductible. While 

waiver of this deductible will be 

beneficial to Medicare beneficiaries, we 

do not anticipate that this change will 

have a significant cost impact on the 

Medicare program. 

F. Section 5114—Proposed Addition of 

Diabetes Outpatient Self-Management 

Training Services (DSMT) and Medical 

Nutrition Therapy (MNT) for the FQHC 

Program 

As discussed earlier in section E.4. of 

this preamble, section 5114 of the DRA 

amended section 1861(aa)(3) the Act to 

add DSMT and MNT to the list of 

Medicare covered and reimbursed 

services under the Medicare FQHC 

benefit, effective for services provided 

on or after January 1, 2006. Although 

this statutory change has already been 

implemented in administrative 

instructions, we are proposing to 

conform the regulations to meet the new 

statutory requirement. FQHCs certified 

as DSMT and MNT providers have been 

allowed to bundle the cost of those 

services into their FQHC payment rates. 

But before the enactment of the DRA, 

the provision of these services would 

not generate a separate FQHC visit 

payment. Effective for services 

furnished on or after January 1, 2006, 

FQHCs that are certified providers of 

DSMT and MNT services can receive 

per visit payments for covered services 

furnished by registered dietitians or 

nutrition professionals. In light of the 

fact there are a limited number of 

qualified centers for DSMT and MNT 

services, the increase in Medicare 

expenditures should be negligible. 

G. Proposed Payment for Covered 

Outpatient Drugs and Biologicals (ASP 

Issues) 

The proposed changes discussed in 

section II.F. of this proposed rule, with 

respect to payment for covered 

outpatient drugs and biologicals, are 

estimated to have no impact on 

Medicare expenditures. However, we 

believe the changes will assist in 

clarifying existing policy with respect to 

ASP payment. 

H. Proposed Provisions Related to 

Payment for Renal Dialysis Services 

Furnished by End State Renal Disease 

(ESRD) Facilities 

The ESRD related provisions in this 

proposed rule are discussed in section 

II.G. of this preamble. 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 year 

(current 2006 payments) to estimated 

payments under the proposed revisions 

to the composite rate payment system as 

discussed in II.G. of this proposed rule 

(proposed 2007 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 

that we are able to calculate both 

current 2006 payments and proposed 

2007 payments. 

Due to data limitations, we are unable 

to estimate current and proposed 

payments for 226 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 2005 update of CY 

2005 National Claims History file as a 

basis for Medicare dialysis treatments 

and separately billable drugs and 

biologicals. While the December 2005 

update of the 2005 claims file is not 

complete, we wanted to use the most 

recent data available, and plan to use an 

updated version of the 2005 claims file 

for the final rule. 

BILLING CODE 4120–01–P 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49075 

Table 9 above shows the impact of 

this year’s proposed changes to CY 2007 

payments to hospital-based and 

independent ESRD facilities. The first 

column of Table 9 identifies the type of 

ESRD provider, the second column 


mstockstill on PROD1PC63 with PROPOSAL_2EP22AU06.049</GPH>
49076 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

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 

CY 2007 proposed changes to the ESRD 

wage index as it affects the composite 

rate payments to ESRD facilities. The 

fourth column compares aggregate ESRD 

wage adjusted composite rate payments 

in the second year of the transition (CY 

2007) to aggregate ESRD wage adjusted 

composite rate payments in first year of 

the transition (CY 2006). In the second 

year of the transition (CY 2007), ESRD 

facilities receive 50 percent of the CBSA 

wage adjusted composite rate and 50 

percent of the MSA adjusted composite 

rate. In the first year of the transition, 

ESRD facilities receive 25 percent of the 

CBSA wage adjusted composite rate and 

75 percent of the MSA adjusted 

composite rate. The overall effect to all 

ESRD providers in aggregate is zero 

because the proposed CY 2007 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 decreases shown 

among census regions is primarily due 

to reducing the wage index floor, as 

there were areas in these areas with 

wage index values below the proposed 

floor. 

The fifth column shows the overall 

effect of the proposed changes in 

composite rate payments to ESRD 

providers. The overall effect is 

measured as the difference between CY 

2007 proposed payment with all 

changes as proposed in this rule and CY 

2006 current payment. This amount is 

computed by multiplying the wage 

adjusted composite rate with the drug 

add-on for each provider times dialysis 

treatments from 2005 claims. The CY 

2007 proposed payment is transition 

year two wage adjusted composite rate 

for each provider (with the proposed 

15.2 percent drug add-on) times dialysis 

treatments from 2005 claims. The CY 

2006 current payment is transition year 

one wage adjusted composite rate for 

each provider (with the current 14.5 

percent drug add on) times dialysis 

treatments from 2005 claims. 

The overall impact to ESRD providers 

in aggregate is 0.6 percent. This increase 

corresponds to the proposed 0.6 percent 

increase to the drug add-on. The 

variation seen in column 5 is due to 

variation in change in the wage index 

(column 4). All provider types receive 

the same 0.6 percent increase to the 

drug add on. 

I. Private Contracts and Opt-Out 

Provision 

The changes discussed in this 

proposed rule, with respect to private 

contracts and the opt-out provision, are 

currently estimated to have no 

significant impact on Medicare 

expenditures. 

J. Proposals Related to Physician Self 

Referral Prohibitions 

As discussed in section II.I of this 

proposed rule, we would clarify in 

regulations at § 424.80(d) under the 

contractual arrangement reassignment 

exception that, if a physician or other 

individual supplier reassigns his or her 

right to bill for the TC of a diagnostic 

test, the entity to which the 

reassignment is made may not be paid 

more than the physician or other 

individual supplier would have been 

paid for the TC. In addition, in order to 

bill for the TC of the diagnostic test, the 

entity to which the reassignment is 

made must perform the PC. We also 

propose that, in order to bill for the PC 

of a diagnostic test following a 

reassignment, the billing entity must 

meet current requirements in our 

manual instructions. 

In addition, as discussed in section 

II.I., we also propose to revise 

§§ 424.80(b) and (d) to provide that a 

physician or other individual supplier 

who reassigns his or her right to benefits 

has a right to review the bills for his or 

her services, irrespective of whether the 

individual is an employee or an 

independent contractor of the entity to 

which the reassignment is made. 

We also propose the following 

changes to the physician self-referral 

provisions: 

• A ‘‘centralized building’’ for 

purposes of the physician services 

exception and the in-office ancillary 

services exception at §§ 411.355(a) and 

(b), respectively, would have to measure 

at least 350 square feet and include 

permanent placement of the equipment 

used in the provision of substantially all 

of the designated health services. We 

believe that these changes would have 

little effect on Medicare expenditures. 

K. Supplier Access to Claims Billed on 

Reassignment 

The reassignment provisions 

discussed in section II.J.2. of this 

preamble are currently estimated to 

have no significant impact on Medicare 

expenditures. 

L. Proposed Coverage of Bone Mass 

Measurement 

As discussed in section II.K. of this 

preamble, we have decided to propose 

several revisions to § 410.31 relative to 

the definition of the term ‘‘Bone Mass 

Measurement’’ (§ 410.31(a)(2)), the 

conditions for coverage (§ 410.31(b)), the 

examples of exceptions to the standards 

on frequency of coverage 

(§ 410.31(c)(2)), and the category of 

individuals receiving glucocorticoid 

(steroid) therapy (§ 410.31(d)(3)). We are 

also proposing the addition of a new 

paragraph (f) that would allow CMS, 

through the NCD process, to identify 

additional BMM systems for monitoring 

individuals receiving osteoporosis drug 

therapy and for performing confirmatory 

baseline measurements. We do not 

expect that this addition would have a 

significant cost impact on the Medicare 

program in the next several years. 

Based on the projected impact of the 

first three changes that would place 

greater reliance on the use of the more 

expensive DXA (axial skeleton) devices, 

we estimate that this revised benefit 

would result in an increase in Medicare 

payments for providers who use the 

DXA (axial skeleton) devices and a 

somewhat smaller decrease in payments 

to providers who use QCT (axial 

skeleton) and peripheral devices. 

However, we do not expect that these 

changes would have a significant cost 

impact on the Medicare program due to 

the fact that at present a very small 

percentage of our total Medicare 

payments for bone mass measurements 

are being made to providers who use 

QCT or peripheral devices. In addition, 

we estimate that lowering the eligibility 

standard for coverage of individuals on 

steroid therapy from 7.5 mg/day to 5.0 

mg/day of prednisone (the fourth 

change) would result in an increase in 

Medicare payment for testing of 

additional patients, but this modest 

lowering of the steroid standard is not 

expected to have a significant cost 

impact on the program. 

M. Proposed IDTF Changes 

The costs associated with these 

proposed changes would be as follows: 

1. Liability Insurance Requirement 

(§ 424.57(c)(10)) 

We estimate that only 10 percent of 

IDTFs do not already have liability 

insurance that meets this requirement. 

Based on Medicare data as of June 2005, 

10 percent of the total number of IDTFs 

is approximately 559 suppliers. Using 

the previously highest estimate received 

($1,800 annually), results in an 

approximate additional liability 

insurance cost of $1 million annually 

(559 times $1,800) to the IDTF industry 

due to this proposed rule. 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49077 

2. Primary Business Telephone Listed 

Under the Name of the Business Locally 

or Toll-free for Beneficiaries Proposed 

Requirement (§ 424.57(c)(9)) 

We estimate that only 1 percent of 

IDTFs do not already meet this 

requirement. Based on Medicare data as 

of June 2005, we determined that 1 

percent of IDTFs is approximately 56 

suppliers. Therefore, 56 times the 

approximate $600 annual cost of 

telephone service results in an 

additional cost of $33,600 annually. 

Total Cost = $1 Million + $33,600 = 

approximately $1.04 million annually. 

N. Independent Lab Billing for TC 

Component of Physician Pathology 

Services for Hospital Patients 

The most current information on the 

number of affected hospitals and the 

impact on laboratories and hospitals 

comes from a report issued by the 

General Accounting Office (GAO) in 

September 2003. 

The GAO estimated that 

approximately 95 percent of the total of 

all Medicare hospitals on the 

prospective payment system, as well as 

CAHs sent the TC of physician 

pathology services to independent 

laboratories and the independent 

laboratories billed the carrier under the 

PFS. 

The GAO estimated that the median 

number of services sent by each hospital 

to outside independent laboratories was 

small, approximately 81 services. The 

GAO was unable to identify the number 

of laboratories billing for the TC service 

because a single laboratory may submit 

claims under multiple provider 

numbers. In general, the impact on the 

individual hospital is small; however, 

we do not know the impact on the 

individual independent laboratory 

If the independent laboratories had 

not received payments from the carriers 

for these TC services for hospital 

patients, the GAO estimates that 

Medicare spending would have been 

$42 million less in 2001 and beneficiary 

cost sharing obligations for inpatient 

and outpatient services would have 

been reduced by $2 million. 

Based on what they learned from the 

hospital industry, the GAO thought that 

Medicare beneficiaries’ access to 

pathology services would not likely be 

affected if independent laboratories 

could not longer bill the carrier for these 

services. Hospital representatives 

indicated that they would likely 

continue to use independent 

laboratories to provide TC pathology 

services. 

In is unclear if the hospitals 

contracting with independent 

laboratories would pay the laboratories 

at the same rates that the laboratories 

received by billing the Medicare carriers 

under the physician fee schedule. 

O. Public Consultation for Medicare 

Payment for New Outpatient Clinical 

Diagnostic Laboratory Tests 

This codification of our process for 

public consultation for new clinical 

diagnostic laboratory tests paid under 

the Medicare Part B clinical laboratory 

fee schedule, if adopted, would not 

increase or decrease payment amounts 

for existing clinical diagnostic 

laboratory tests because it would not 

alter our current methodology for 

calculating payment amounts for 

existing clinical diagnostic laboratory 

tests. For new tests, this proposal would 

primarily codify an existing process for 

the determination of payment amounts. 

Because any new laboratory tests to be 

gapfilled are unknown to us at the 

current time, we do not have any data 

to estimate the impact of our proposal 

to pay for new gapfilled lab tests at the 

median of the local carrier amounts for 

all carriers rather than the lower of that 

amount and the local carrier amount. 

P. 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. 

Q. 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 proposed changes, 

particularly the DRA provisions that 

provide for an exception to the 

application of the Part B deductible 

with respect to colorectal cancer 

screening tests and coverage of an 

ultrasound screening for the early 

detection of AAAs, as part of the Initial 

Preventive Physical Examination benefit 

(referred to as the Welcome to Medicare 

benefit) would improve beneficiary 

access to services that are currently 

covered or 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 would 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 8, the 2006 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. 

Based on the June 29, 2006 proposed 

notice (71 FR 37170) and this proposed 

rule, the 2007 national payment amount 

in the nonfacility setting for CPT code 

99203, as shown in Table 8, is $91.71 

which means that, in 2007, the 

beneficiary coinsurance for this service 

would be $18.34. 

Very few of the changes we are 

proposing impact overall payments and, 

therefore, would affect Medicare 

beneficiaries’ coinsurance liability. 

Proposals discussed above that do affect 

overall spending, such as DRA 5102 

imaging provisions, would similarly 

impact beneficiaries’ coinsurance. 

R. Accounting Statement 

As required by OMB Circular A–4 

(available at http:// 

www.whitehouse.gov/omb/circulars/ 

a004/a–4.pdf), in Table 10 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. 

Expenditures are classified as 

transfers to Medicare providers/or 

suppliers (that is, ESRD facilities and 

physicians, other practitioners, clinical 

laboratories and medical suppliers that 

receive payment under the physician fee 

schedule or Medicare Part B). Based on 

the proposals contained in this 

proposed rule, there would be an 

estimated decrease in expenditures from 

CY 2006 to 2007. This is a result of the 

CY 2007 increased payment to ESRD 

facilities the reduction to the payments 

for imaging services under the PFS 

required by section 5102 of the DRA and 

the ¥5.1 percent Medicare PFS 

conversion factor update required by the 

statutory update formula. 

TABLE 10.—ACCOUNTING STATEMENT: 

CLASSIFICATION OF ESTIMATED EXPENDITURES, FROM CY 2006 TO

THE CY 2007 (IN MILLIONS) 

Category Transfers 

Annualized Monetized 

Transfers.

Estimated decrease 

in expenditures of 

$3,600 

mstockstill on PROD1PC63 with PROPOSAL_2

49078 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

TABLE 10.—ACCOUNTING STATEMENT: 

CLASSIFICATION OF ESTIMATED EXPENDITURES, FROM CY 2006 TO

THE CY 2007 (IN MILLIONS)—Continued 

Category Transfers 

From Whom To 

Whom? 

Federal Government 

To ESRD Medicare 

Providers; physicians, other practitioners 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 414 

Administrative practice and 

procedure, Health facilities, Health 

professions, Kidney diseases, Medicare, 

Reporting and recordkeeping. 

42 CFR Part 415 

Health facilities, Health professions, 

Medicare, Reporting and recordkeeping 

requirements. 

42 CFR Part 424 

Emergency medical services, Health 

facilities, Health professions, 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 405.400 is amended by 

revising the definition of ‘‘Practitioner’’

to read as follows: 

§ 405.400 Definitions. 

* * * * * 

Practitioner means a physician 

assistant, nurse practitioner, clinical 

nurse specialist, certified registered 

nurse anesthetist, certified nurse 

midwife, clinical psychologist, clinical 

social worker, registered dietitian or 

nutrition professional, who is currently 

legally authorized to practice in that 

capacity by each State in which he or 

she furnishes services to patients or 

clients. 

* * * * * 

Subpart X—Rural Health Clinic and 

Federally Qualified Health Center 

Services Payment for Rural Health 

Clinic and Federally Qualified Health 

Center Services 

3. Section 405.2446 is amended by 

adding paragraph (b)(10) to read as 

follows: 

§ 405.2446 Scope of services. 

* * * * * 

(b) * * * 

(10) Medical nutrition therapy 

services as specified in part 410, subpart 

G of this chapter, and diabetes 

outpatient self-management training 

services as specified in part 410, subpart 

H of this chapter. 

* * * * * 

4. Section 405.2463 is revised to read 

as follows: 

§ 405.2463 What constitutes a visit. 

(a) Visit—(1) General. (i) For RHCs, a 

visit is a face-to-face encounter between 

a clinic or center patient and a 

physician, physician assistant, nurse 

practitioner, nurse midwife, visiting 

nurse, clinical psychologist, or clinical 

social worker. 

(ii) For FQHCs, a visit means—

(A) A face-to-face encounter, as 

described in paragraph (a)(1)(i) of this 

section; or 

(B) A face-to-face encounter between 

a patient and a qualified provider of 

medical nutrition therapy services as 

defined in part 410, subpart G of this 

chapter; or a qualified provider of 

outpatient diabetes self-management 

training services as defined in part 410, 

subpart H of this chapter. 

(2) Medical visit. For purposes of this 

section, a medical visit is a face-to-face 

encounter between a clinic or center 

patient and a physician, physician 

assistant, nurse practitioner, nurse 

midwife, or a visiting nurse; and for 

FQHCs only, a medical visit also 

includes a separately billable medical 

nutrition therapy visit or a diabetes 

outpatient self-management training 

visit. 

(3) Other health visit. For purposes of 

this section, a other health visit is a 

face-to-face encounter between a clinic 

or center patient and a clinical 

psychologist, clinical social worker, or 

other health professional for mental 

health services. 

(b) Encounters. Encounters with more 

than one health professional and 

multiple encounters with the same 

health professional that take place on 

the same day and at a single location 

constitute a single visit, except when 

one of the following conditions exist: 

(1) After the first encounter, the 

patient suffers illness or injury requiring 

additional diagnosis or treatment. 

(2) The patient has a medical visit and 

other health visit(s), as defined in 

paragraph (a) of this section. 

(c) Payment. Medicare pays for more 

than one visit per day when the 

conditions in paragraph (b) of this 

section are met or a separate visit under 

paragraph (a)(1)(ii)(B) of this section is 

made. 

PART 410—SUPPLEMENTARY 

MEDICAL INSURANCE (SMI) 

BENEFITS 

5. The authority citation for part 410 

continues to read as follows: 

Authority: Secs. 1102, 1834, and 1871 of 

the Social Security Act (42 U.S.C. 1302, 

1395m, and 1395hh). 

Subpart B—Medical and Other Health 

Services 

6. Section 410.16 is amended in 

paragraph (a) by revising paragraph (7) 

of the definition of ‘‘Initial preventive 

physical examination’’ to read as 

follows: 

§ 410.16 Initial preventive physical 

examination: Conditions for and limitations 

on coverage. 

(a) * * * 

* * * * * 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49079 

Initial preventive physical 

examination * * * 

* * * * * 

(7) Education, counseling, and 

referral, including a written plan such 

as a checklist provided to the 

beneficiary for obtaining the appropriate 

screening and other preventive services 

that are covered as separate Medicare 

Part B benefits as described in section 

1861(s)(10), section 1861(jj), section 

1861(nn), section 1861(oo), section 

1861(pp), section 1861(qq)(1), section 

1861(rr), section 1861(uu), section 

1861(vv), section 1861(xx)(1), section 

1861(yy), and section 1861(bbb) of the 

Act. 

* * * * * 

7. A new § 410.19 is added to read as 

follows: 

§ 410.19 Ultrasound screening for 

abdominal aortic aneurysms: Condition for 

and limitation on coverage. 

(a) Definitions: As used in this 

section, the following definitions apply: 

Eligible beneficiary means an 

individual who—

(1) Has received a referral for an 

ultrasound screening for an abdominal 

aortic aneurysm as a result of an initial 

preventive physical examination (as 

defined in section 1861(ww)(1) of the 

Act); 

(2) Has not been previously furnished 

an ultrasound screening for an 

abdominal aortic aneurysm under the 

Medicare program; and 

(3) Is included in at least one of the 

following risk categories: 

(i) Has a family history of an 

abdominal aortic aneurysm. 

(ii) Is a man age 65 to 75 who has 

smoked at least 100 cigarettes in his 

lifetime. 

(iii) Is an individual who manifests 

other risk factors in a beneficiary 

category recommended for screening by 

the United States Preventive Services 

Task Force regarding abdominal aortic 

aneurysms, as specified by the Secretary 

through a national coverage 

determination process. 

Ultrasound screening for abdominal 

aortic aneurysms means the following 

services furnished to an asymptomatic 

individual for the early detection of an 

abdominal aortic aneurysm: 

(1) A procedure using soundwaves (or 

other procedures using alternative 

technologies of commensurate accuracy 

and cost, as specified by the Secretary 

through a national coverage 

determination process) provided for the 

early detection of abdominal aortic 

aneurysms. 

(2) Includes a physician’s 

interpretation of the results of the 

procedure. 

(b) Conditions for coverage of an 

ultrasound screening for abdominal 

aortic aneurysms. Medicare Part B pays 

for one ultrasound screening for an 

abdominal aortic aneurysm provided to 

eligible beneficiaries, as described in 

this section, after a referral from a 

physician or a qualified nonphysician 

practitioner as defined in § 410.16(a). 

(c) Limitation on coverage of 

ultrasound screening for abdominal 

aortic aneurysms. Payment may not be 

made for an ultrasound screening for an 

abdominal aortic aneurysm that is 

performed for an individual who is not 

an eligible beneficiary, as described in 

the definition of ‘‘Eligible beneficiary’’

in this section. 

8. Section 410.31 is revised to read as 

follows: 

§ 410.31 Bone mass measurement: 

Conditions for coverage and frequency 

standards. 

(a) Definition. As used in this section 

unless specified otherwise, the 

following definition applies: 

Bone mass measurement means a 

radiologic, radioisotopic, or other 

procedure that meets the following 

conditions: 

(1) Is performed for the purpose of 

identifying bone mass, detecting bone 

loss, or determining bone quality. 

(2) Is performed with either a bone 

densitometer (other than single-photon 

or dual-photon absorptiometry) or with 

a bone sonometer system that has been 

cleared for marketing for this use by the 

FDA under 21 CFR part 807, or 

approved for marketing by the FDA for 

this use under 21 CFR part 814. 

(3) Includes a physician’s 

interpretation of the results of the 

procedure. 

(b) Conditions for coverage. (1) 

Medicare covers a medically necessary 

bone mass measurement if the following 

conditions are met: 

(i) Following an evaluation of the 

beneficiary’s need for the measurement, 

including a determination as to the 

medically appropriate procedure to be 

used for the beneficiary, it is ordered by 

the physician or a qualified 

nonphysician practitioner (as these 

terms are defined in § 410.32(a)) treating 

the beneficiary. 

(ii) It is performed under the 

appropriate level of supervision of a 

physician (as set forth in § 410.32(b)). 

(iii) It is reasonable and necessary for 

diagnosing and treating the condition of 

a beneficiary who meets the conditions 

described in paragraph (d) of this 

section. 

(2) Medicare covers a medically 

necessary bone mass measurement for 

an individual defined under paragraph 

(d)(5) of this section if the conditions 

under paragraph (b)(1) of this section 

are met and the monitoring is performed 

by the use of a dual energy x-ray 

absorptiometry system (axial skeleton). 

(3) Medicare covers a medically 

necessary confirmatory baseline bone 

mass measurement for an individual 

defined under paragraph (d) of this 

section, if the conditions under 

paragraph (b)(1) of this section are met 

and the confirmatory baseline bone 

mass measurement is performed by a 

dual energy x-ray absorptiometry system 

(axial skeleton) and the initial 

measurement was not performed by a 

dual energy x-ray absorptiometry system 

(axial skeleton). 

(c) Standards on frequency of 

coverage —(1) General rule. Except as 

allowed under paragraph (c)(2) of this 

section, Medicare may cover a bone 

mass measurement for a beneficiary if at 

least 23 months have passed since the 

month the last bone mass measurement 

was performed. 

(2) Exception. If medically necessary, 

Medicare may cover a bone mass 

measurement for a beneficiary more 

frequently than allowed under 

paragraph (c)(1) of this section. 

Examples of situations where more 

frequent bone mass measurement 

procedures may be medically necessary 

include, but are not limited to the 

following medical circumstances. 

(i) Monitoring beneficiaries on longterm glucocorticoid (steroid) therapy of 

more than 3 months. 

(ii) Allowing for a confirmatory 

baseline measurement to permit 

monitoring of beneficiaries in the future 

if the requirements of paragraph (b)(3) of 

this section are met. 

(d) Beneficiaries who may be covered. 

The following categories of beneficiaries 

may receive Medicare coverage for a 

medically necessary bone mass 

measurement: 

(1) A woman who has been 

determined by the physician (or a 

qualified nonphysician practitioner) 

treating her to be estrogen-deficient and 

at clinical risk for osteoporosis, based 

on her medical history and other 

findings. 

(2) An individual with vertebral 

abnormalities as demonstrated by an xray to be indicative of osteoporosis, 

osteopenia, or vertebral fracture. 

(3) An individual receiving (or 

expecting to receive) glucocorticoid 

(steroid) therapy equivalent to an 

average of 5.0 mg of prednisone, or 

greater, per day for more than 3 months. 

(4) An individual with primary 

hyperparathyroidism. 

(5) An individual being monitored to 

assess the response to or efficacy of an 

mstockstill on PROD1PC63 with PROPOSAL_2

49080 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

FDA-approved osteoporosis drug 

therapy. 

(e) Denial as not reasonable and 

necessary. If CMS determines that a 

bone mass measurement does not meet 

the conditions for coverage in 

paragraphs (b) or (d) of this section, or 

the standards on frequency of coverage 

in paragraph (c) of this section, it is 

excluded from Medicare coverage as not 

‘‘reasonable’’ and ‘‘necessary’’ under 

section 1862(a)(1)(A) of the Act and 

§ 411.15(k) of this chapter. 

(f) Use of the National Coverage 

Determination Process. For the purposes 

of paragraphs (b)(2) and (b)(3) of this 

section, CMS may determine through 

the National Coverage Determination 

process that additional bone mass 

measurement systems are reasonable 

and necessary under section 1862(a)(1) 

of the Act for monitoring and 

confirming baseline bone mass 

measurements. 

* * * * * 

9. Section 410.33 is amended by—

A. Revising paragraph (b)(1). 

B. Revising paragraph (e). 

C. Adding paragraphs (g), (h), and (i). 

The revision and additions read as 

follows: 

§ 410.33 Independent diagnostic testing 

facility. 

* * * * * * 

(b) Supervising physician. (1) Each 

supervising physician must be limited 

to providing supervision to no more 

than three (3) IDTF sites. The IDTF 

supervising physician is responsible for 

the overall operation and administration 

of the IDTFs, including the employment 

of personnel who are competent to 

perform test procedures, record and 

report test results promptly, accurately 

and proficiently, and for assuring 

compliance with the applicable 

regulations. 

* * * * * 

(e) Multi-State entities. (1) An IDTF 

that operates across State boundaries 

must—

(i) Maintain documentation that its 

supervising physicians and technicians 

are licensed and certified in each of the 

States in which it operates; and 

(ii) Operate in compliance with all 

applicable Federal, State, and local 

licensure and regulatory requirements 

with regard to the health and safety of 

patients. 

(2) The point of the actual delivery of 

services is the Place of Service on the 

claim form. When an IDTF performs a 

diagnostic test at the beneficiary’s 

residence, the beneficiary’s residence is 

the Place of Service. 

* * * * * 

(g) Application certification 

standards. The IDTF must certify in its 

enrollment application that it meets the 

following standards: 

(1) Operate its business in compliance 

with all applicable Federal and State 

licensure and regulatory requirements. 

(2) Provide complete and accurate 

information on their enrollment 

application. Any change in enrollment 

information must be reported to the 

designated fee-for-service contractor on 

the Medicare enrollment application 

within 30 calendar days of the change. 

(3) Maintain a physical facility on an 

appropriate site. For the purposes of this 

standard, a post office box or 

commercial mail box is not considered 

a physical facility. The physical facility 

must contain space for equipment 

appropriate to the services designated 

on the enrollment application, facilities 

for hand washing, adequate patient 

privacy accommodations, and the 

storage of both business records and 

current medical records. 

(4) Have all applicable testing 

equipment available at the physical site 

excluding portable equipment. A catalog 

of portable equipment, including 

equipment serial numbers, must be 

maintained at the physical site. In 

addition, portable equipment must be 

available for inspection within two 

business days of a CMS inspection 

request. The IDTF must maintain a 

current inventory of the equipment, 

including serial and registration 

numbers, provide this information to 

the designated fee-for-service contractor 

upon request, and notify the contractor 

of any changes in equipment within 90 

days. 

(5) Maintain a primary business 

phone under the name of the designated 

business. The business phone must be 

located at the designated site of the 

business. The telephone number or toll 

free numbers must be available in a 

local directory and through directory 

assistance. 

(6) Have a comprehensive liability 

insurance policy of at least $300,000 or 

20 percent of its average annual 

Medicare billings, whichever amount is 

greater, that covers both the place of 

business and all customers and 

employees of the IDTF. The policy must 

be carried by a non-relative owned 

company and list the serial numbers of 

any and all equipment used by the 

IDTF. 

(7) Agree not to directly solicit 

patients through any means including, 

but not limited to, a prohibition on 

telephone, computer, or in-person 

contacts. The IDTF must accept only 

those patients referred for diagnostic 

testing by an attending physician, who 

is furnishing a consultation or treating 

a beneficiary for a specific medical 

problem and who uses the results in the 

management of the beneficiary’s specific 

medical problem. Nonphysician 

practictioners may order tests as set 

forth in § 410.32(a)(3). 

(8) Answer beneficiaries’ questions 

and respond to their complaints. 

Documentation of those contacts must 

be maintained at the physical site. 

(9) Openly post these standards for 

review by patients and the public. 

(10) Disclose to the government any 

person having ownership, financial, or 

control interest or any other legal 

interest in the supplier. 

(11) Have its testing equipment 

calibrated per equipment instructions 

and in compliance with applicable 

national standards. 

(12) Have technical staff on duty with 

the appropriate credentials to perform 

tests. The IDTF must be able to produce 

the applicable Federal or State licenses 

or certifications of the individuals 

performing these services. 

(13) Have proper medical record 

storage and be able to retrieve medical 

records upon request from CMS or its 

fee-for-service contractor within 2 

business days. 

(14) Permit CMS, including its agents, 

or its designated fee-for-service 

contractors, to conduct unannounced, 

on-site inspections to confirm the 

IDTF’s compliance with these 

standards. The IDTF must be accessible 

during regular business hours to CMS 

and beneficiaries and must maintain a 

visible sign posting the normal business 

hours of the IDTF. 

(h) Failure to meet standards. If an 

IDTF fails to meet one or more of the 

standards in paragraph (g) of this 

section at the time of enrollment, its 

enrollment will be denied. CMS will 

revoke a supplier’s billing privileges if 

and IDTF is found not to meet the 

standards in paragraph (g) or (b)(1) of 

this section. 

(i) Definition. For purposes of this 

section, the following definition applies: 

Point of actual delivery of service. The 

point of the actual delivery of service 

means the Place of Service on the claim 

form. When an IDTF performs a 

diagnostic test at the beneficiary’s 

residence, the beneficiary’s residence is 

the Place of Service. 

Subpart I—Payment of SMI Benefits 

10. Section 410.160 is amended by 

adding paragraphs (b)(7) and (b)(8) to 

read as follows: 

§ 410.160 Part B annual deductible. 

* * * * * 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49081 

(b) * * * 

(7) Beginning January 1, 2007, 

colorectal cancer screening tests as 

described in § 410.37. 

(8) Beginning January 1, 2007, 

ultrasound screening for abdominal 

aortic aneurysms described in § 410.19. 

* * * * * 

PART 411—EXCLUSIONS FROM 

MEDICARE AND LIMITATIONS ON 

MEDICARE PAYMENT 

11. The authority citation for part 411 

is amended to read as follows: 

Authority: Secs. 1102, 1860D–1 through 

1860D–42, 1871, and 1877 of the Social 

Security Act (42 U.S.C. 1302, 1395w–101 

through 1395w–152, 1395hh, and 1395nn). 

Subpart A—General Exclusions and 

Exclusion of Particular Services 

12. Section 411.15 is amended by—

A. Revising paragraph (a)(1). 

B. Adding a new paragraph (k)(12). 

C. Revising paragraph (o). 

The revisions and addition read as 

follows: 

§ 411.15 Particular services excluded from 

coverage. 

* * * * * 

(a) * * * 

(1) Examinations performed for a 

purpose other than treatment or 

diagnosis of a specific illness, 

symptoms, complaint, or injury, except 

for screening mammography, colorectal 

cancer screening tests, screening pelvic 

exams, prostate cancer screening tests, 

glaucoma screening exams, initial 

preventive physical examinations, or 

ultrasound screening for abdominal 

aortic aneurysms that meet the criteria 

specified in paragraphs (k)(6) through 

(k)(12) of this section. 

* * * * * 

(k) * * * 

(12) In the case of ultrasound 

screening for abdominal aortic 

aneurysms, with the goal of early 

detection of abdominal aortic 

aneurysms, subject to the conditions 

and limitation specified in § 410.19 of 

this chapter. 

* * * * * 

(o) Experimental or investigational 

devices, except for certain devices—

(1) Categorized by the FDA as a 

Category A or B device defined in 

§ 405.201(b) of this chapter; and 

(2) Furnished in accordance with the 

CMS clinical research policy. 

Subpart J—Financial Relationships 

Between Physicians and Entities 

Furnishing Designated Health Services 

13. Section 411.351 is amended by—

A. Revising the definition 

‘‘Centralized building’’. 

B. Revising the definition ‘‘Physician 

in the group practice’’. 

The revisions read as follows: 

§ 411.351 Definitions. 

* * * * * 

Centralized building means all or part 

of a building, including, for purposes of 

this subpart only, a mobile vehicle, van, 

or trailer that is owned or leased on a 

full-time basis (that is, 24 hours per day, 

7 days per week, for a term of not less 

than 6 months) by a group practice and 

that is used exclusively by the group 

practice. Space in a building or a mobile 

vehicle, van, or trailer that is shared by 

more than one group practice, by a 

group practice and one or more solo 

practitioners, or by a group practice and 

another provider or supplier (for 

example, a diagnostic imaging facility) 

is not a centralized building for 

purposes of this subpart. This definition 

does not preclude a group practice from 

providing services to other providers or 

suppliers (for example, purchased 

diagnostic tests) in the group practice’s 

centralized building. A group practice 

may have more than one centralized 

building. A centralized building does 

not include space that is owned or 

leased by a group practice if that space 

is less than 350 square feet. This 

limitation does not apply to space 

owned or rented in a building where no 

more than three group practices own or 

lease space in the ‘‘same building’’ (as 

defined in this section) and share the 

same ‘‘physician in the group practice’’

(as defined in this section). A 

centralized building does not include 

space owned or leased by a group 

practice if equipment needed to perform 

substantially all (at least 90 percent) of 

the designated health services furnished 

in that space in any given calendar year 

is not permanently located in that space. 

That is, equipment needed to perform 

more than 10 percent of the designated 

health services furnished in that space 

in a calendar year cannot be temporarily 

moved into that space from another 

space in the ‘‘same building’’ or from 

outside the ‘‘same building’’ (as defined 

in this section). 

* * * * * 

Physician in the group practice means 

a member of the group practice, as well 

as an independent contractor physician 

during the time the independent 

contractor is furnishing patient care 

services (as defined in this section) for 

the group practice under a contractual 

arrangement with the group practice to 

provide services to the group practice’s 

patients in the group practice’s 

facilities. The contract must contain the 

same restrictions on compensation that 

apply to members of the group practice 

under § 411.352(g) (or the contract must 

fit in the personal services exception in 

§ 411.357(d)), and the independent 

contractor’s arrangement with the group 

practice and must comply with the 

reassignment rules at § 424.80(d)(3) of 

this chapter or section 30.2.9.1 of the 

CMS Internet-only manual, publication 

100–04, Claims Processing Manual, 

chapter 1 on general billing 

requirements (as amended or replaced 

from time to time). Referrals from an 

independent contractor who is a 

physician in the group practice are 

subject to the prohibition on referrals in 

§ 411.353(a), and the group practice is 

subject to the limitation on billing for 

those referrals in § 411.353(b). 

* * * * * 

PART 414—PAYMENT FOR PART B 

MEDICAL AND OTHER HEALTH 

SERVICES 

14. 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). 

15. A new subpart F is added as 

follows: 

Subpart F—Payment for New Clinical 

Diagnostic Laboratory Tests 

Sec. 

414.400 Basis and scope. 

414.402 Definitions. 

414.404 [Reserved] 

414.406 Procedures for public consultation 

for payment for a new clinical diagnostic 

laboratory test. 

414.408 Payment for a new clinical 

diagnostic laboratory test. 

414.410 Clinical Diagnostic Laboratory Date 

of Service for Specimens 

Subpart F—Payment for New Clinical 

Diagnostic Laboratory Tests 

§ 414.400 Basis and scope. 

This subpart implements provisions 

of 1833(h)(8) of the Act procedures for 

determining the basis for, and amount 

of, payment for a new clinical 

diagnostic laboratory test with respect to 

which a new or substantially revised 

Healthcare Common Procedure Coding 

System code is assigned on or after 

January 1, 2005. 

§ 414.402 Definitions. 

For purposes of this subpart—

Substantially Revised Healthcare 

Common Procedure Coding System 

Code means a code for which there has 

been a substantive change to the 

definition of the test or procedure to 

which the code applies (such as a new 

mstockstill on PROD1PC63 with PROPOSAL_2

49082 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

analyte or a new methodology for 

measuring an existing analyte specific 

test). 

§ 414.404 [Reserved] 

§ 414.406 Procedures for public 

consultation for payment for a new clinical 

diagnostic laboratory test. 

For a new clinical diagnostic 

laboratory test that is assigned a new or 

substantially revised code on or after 

January 1, 2005, CMS determines the 

payment after the performance of the 

following: 

(a) CMS makes available to the public 

(through an Internet Web site and other 

appropriate mechanisms) a list that 

includes codes for which establishment 

of a payment amount is being 

considered for the next calendar year. 

(b) CMS publishes a Federal Register 

notice of a meeting to receive public 

comments and recommendations (and 

data on which recommendations are 

based) on the appropriate basis, as 

specified in § 414.408, for establishing 

payment amounts for the list of codes 

made available to the public. 

(c) Not fewer than 30 days after 

publication of the notice in the Federal 

Register, CMS convenes a meeting that 

includes representatives of CMS 

officials involved in determining 

payment amounts, to receive public 

comments and recommendations (and 

data on which the recommendations are 

based). 

(d) Taking into account the comments 

and recommendations (and 

accompanying data) received at the 

public meeting, CMS develops and 

makes available to the public (through 

an Internet Web site and other 

appropriate mechanisms)—

(1) A list of proposed determinations 

with respect to the appropriate basis for 

establishing a payment amount for each 

code, with an explanation of the reasons 

for each determination, the data on 

which the determinations are based, and 

a request for public written comments 

within a specified time period on the 

proposed determination; and 

(2) A list of final determinations of the 

payment amounts for tests, with the 

rationale for each determination, the 

data on which the determinations are 

based, and responses to comments and 

suggestions from the public. 

§ 414.408 Payment for a new clinical 

diagnostic laboratory test. 

For a new clinical diagnostic 

laboratory test that is assigned a new or 

substantially revised code on or after 

January 1, 2005, CMS determines the 

payment amount based on either of the 

following: 

(a) Crosswalking. Crosswalking is 

used if it is determined that a new test 

is comparable to an existing test, 

multiple existing test codes, or a portion 

of an existing test code. 

(1) CMS assigns to the new test code, 

the local fee schedule amounts and 

national limitation amount of the 

existing test. 

(2) Payment for the new test code is 

made at the lesser of the local fee 

schedule amount or the national 

limitation amount. 

(b) Gapfilling. Gapfilling is used when 

no comparable existing test is available. 

(1) Carrier-specific amounts are 

established for the new test code for the 

first year using the following sources of 

information to determine gapfill 

amounts, if available: 

(i) Charges for the test and routine 

discounts to charges; 

(ii) Resources required to perform the 

test; 

(iii) Payment amounts determined by 

other payers; and 

(iv) Charges, payment amounts, and 

resources required for other tests that 

may be comparable or otherwise 

relevant. 

(2) In the second year, the test code 

is paid at the national limitation 

amount, which is the median of the 

carrier-specific amounts. 

§ 414.410 Clinical Diagnostic Laboratory 

Date of Service for Specimens. 

The date of service for a laboratory 

test is as follows: 

(a) Except as provided under 

paragraph (b) of this section, the date of 

service of the test shall be the date the 

specimen was collected. 

(b)(1) If a specimen is collected over 

a period that spans two calendar days, 

then the date of service shall be the date 

the collection ended. 

(2) If a specimen was stored for more 

than 30 calendar days before testing 

(otherwise known as ‘‘an archived 

specimen’’), the date of service of the 

test shall be the date the specimen was 

obtained from storage. 

(3) If a specimen was stored for less 

than or equal to 30 calendar days from 

the date it was collected, the date of 

service of the test must be the date the 

specimen was obtained from storage if—

(i) The test is ordered by the patient’s 

physician at least 14 days following the 

date of the patient’s discharge from the 

hospital. 

(ii) The test could not reasonably have 

been ordered while the patient was 

hospitalized. 

(iii) The procedure performed while 

the beneficiary is a patient of the 

hospital is for purposes other than 

collection of the specimen needed for 

the test. 

(iv) The test is reasonable and 

medically necessary. 

Subpart J—Submission of 

Manufacturer’s Average Sales Price 

Data 

16. Section 414.802 is amended by 

adding the definition of ‘‘Bona fide 

service fees’’ in alphabetical order to 

read as follows: 

§ 414.802 Definitions. 

* * * * * 

Bona fide service fees means fees paid 

by a manufacturer to an entity, that 

represent fair market value for a bona 

fide, itemized service actually 

performed on behalf of the manufacturer 

that the manufacturer would otherwise 

perform (or contract for) in the absence 

of the service arrangement, and that are 

not passed on in whole or in part to a 

client or customer of an entity, whether 

or not the entity takes title to the drug. 

* * * * * 

17. Section 414.804 is amended by 

revising paragraphs (a)(1), (a)(2), (a)(3), 

and (a)(4). 

The revisions read as follows: 

§ 414.804 Basis of Payment. 

(a) * * * 

(1) The manufacturer’s average sales 

price for a quarter for a drug represented 

by a particular 11-digit National Drug 

Code must be calculated as the 

manufacturer’s sales to all purchasers in 

the United States for that particular 11- 

digit National Drug Code (after 

excluding sales as specified in 

paragraph (a)(4) of this section and then 

deducting price concessions as specified 

in paragraphs (a)(2) and (a)(3) of this 

section) divided by the total number of 

units sold by the manufacturer in that 

quarter (after excluding units associated 

with sales as specified in paragraph 

(a)(4) of this section). 

(2) Price concessions. (i) In calculating 

the manufacturer’s average sales price, a 

manufacturer must deduct price 

concessions. Price concessions include 

the following types of transactions and 

items: 

(A) Volume discounts. 

(B) Prompt pay discounts. 

(C) Cash discounts. 

(D) Free goods that are contingent on 

any purchase requirement. 

(E) Chargebacks and rebates (other 

than rebates under the Medicaid 

program). 

(ii) For the purposes of paragraph 

(a)(2)(i), bona fide services fees are not 

considered price concessions. 

(3) To the extent that data on price 

concessions, as described in paragraph 

(a)(2) of this section, are available on a 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49083 

lagged basis, the manufacturer must 

estimate this amount in accordance with 

the methodology described in this 

paragraph. 

(i)(A) For each National Drug Code 

with at least 12 months of sales 

(including products for which the 

manufacturer has redesignated the 

National Drug Code for the specific 

product and package size and has 12 

months of sales across the prior and 

current National Drug Codes), after 

adjusting for exempted sales, 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. 

(B) For each National Drug Code with 

less than 12 months of sales, the 

calculation described in paragraph (i)(A) 

of this section is performed for the time 

period equaling the total number of 

months of sales. 

(ii) The manufacturer multiplies the 

applicable percentage described in 

paragraph (a)(3)(i)(A) or (a)(3)(i)(B) of 

this section by the total in dollars for the 

sales subject to the average sales price 

reporting requirement (after adjusting 

for exempted sales) 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 (after adjusting for 

exempted sales) for the quarter being 

submitted. 

(iii) The manufacturer uses the result 

of the calculation described in 

paragraph (a)(3)(ii) of this section as the 

numerator and the number of units sold 

in the quarter (after adjusting for 

exempted sales) as the denominator to 

calculate the manufacturer’s average 

sales price for the National Drug Code 

for the quarter being submitted. 

(iv) Example. After adjusting for 

exempted sales, the total lagged price 

concessions (discounts, rebates, etc.) 

over the most recent 12-month period 

available associated with sales for 

National Drug Code 12345–6789–01 

subject to the ASP reporting 

requirement equal $200,000, and the 

total in dollars for the 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 sales subject to the 

average sales price reporting 

requirement for the quarter being 

reported, after accounting for nonlagged price concessions, equals 

$50,000 for 10,000 units sold. The 

manufacturer’s average sales price 

calculation for this National Drug Code 

for this quarter is: $50,000 ¥ (0.33333 

× 50,000) = $33,334 (net total sales 

amount); $33,334/10,000 = $3.33 

(average sales price). 

(4) Exempted sales. (i) In calculating 

the manufacturer’s average sales price, a 

manufacturer must exclude sales that 

are exempt from the Medicaid best price 

calculation under sections 

1927(c)(1)(C)(i) and 1927(c)(1)(C)(ii)(III) 

of the Act as limited by section 

1927(c)(1)(D) of the Act. 

(ii) In determining nominal sales 

exempted under section 

1927(c)(1)(C)(ii)(III) of the Act, the 

manufacturer calculates the average 

manufacturer price as defined in section 

1927(k) of the Act and then identifies 

sales that are eligible to be considered 

a nominal sale under section 

1927(c)(1)(D) of the Act and are at less 

than 10 percent of the average 

manufacturer price. To identify nominal 

sales, the manufacturer must use the 

average manufacturer price for the 

calendar quarter that is the same 

calendar quarter as the average sales 

price reporting period. 

(iii) For exempted sales under section 

1927(c)(1)(C)(i) of the Act known on a 

lagged basis because of chargebacks or 

rebates, manufacturers must estimate 

such lagged exempted sales using the 

ratio methodology specified in this 

paragraph to exclude lagged exempted 

sales before accounting for price 

concessions as specified in paragraphs 

(a)(2) and (a)(3) of this section. 

(A) For each National Drug Code with 

at least 12 months of sales (including 

products for which the manufacturer 

has redesignated the Nation Drug Code 

and has 12 months of sales across the 

prior and current National Drug Codes), 

the manufacturer calculates a 

percentage using the sum of lagged 

exempted sales (in units) for the most 

recent 12 month period available as the 

numerator and the sales (the number of 

units after non-lagged exempted sales 

have been subtracted from total sales) 

for the same 12 month period as the 

denominator. The result is a rolling 

average percentage estimate of lagged 

exempted sales that is applied to the 

sales (the number of units after nonlagged exempted sales have been 

subtracted from total sales) for the 

quarter being submitted. The product 

that results from the multiplication of 

the rolling average percentage estimate 

of lagged exempted sales and the sales 

for the quarter determines the estimated 

lagged exempted sales in units to 

subtract from the denominator of the 

average sales price calculation. 

Manufacturers must make a 

corresponding adjustment to the 

numerator of the average sales price 

calculation to ensure that the total in 

dollars for the reporting quarter does not 

include revenue related to lagged 

exempted sales removed from the 

denominator using the estimation 

methodology. 

(B) For National Drug Codes with less 

than 12 months of sales, the calculation 

described in paragraph (4)(iii)(A) of this 

section is calculated based on the sales 

and exempted sales (lagged and nonlagged) for the period equaling the total 

number of months of sales. 

(C) Manufacturers must exclude 

lagged exempted sales (as calculated 

using the ratio methodology in 

paragraph (a)(4)(iii)(A) of this section) 

from their estimates of lagged price 

concessions described in paragraph 

(a)(3) of this section. 

* * * * * 

Subpart K—Payment for Drugs and 

Biologicals Under Part B 

18. Section 414.904 is amended by 

revising paragraphs (d)(2)(iii) and (d)(3) 

to read as follows: 

§ 414.904 Average sales price as the basis 

for payment. 

* * * * * 

(d) * * * 

(2) * * * 

(iii) Effective for drugs and biologicals 

furnished in CY 2006 and subsequent 

calendar years, the payment for such 

drugs and biologicals furnished in 

connection with renal dialysis services 

and separately billed by freestanding 

and hospital-based renal dialysis 

facilities not paid on a cost basis is 106 

percent of the average sales price. 

(3) Widely available market price and 

average manufacturer price. If the 

Inspector General finds that the average 

sales price exceeds the widely available 

market price or the average 

manufacturer price by 5 percent or more 

in CY 2007, the payment limit in the 

quarter following the transmittal of this 

information to the Secretary is the lesser 

of the widely available market price or 

103 percent of the average manufacturer 

price. 

* * * * * 

mstockstill on PROD1PC63 with PROPOSAL_2

49084 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

PART 415—SERVICES FURNISHED BY 

PHYSICIANS IN PROVIDERS, 

SUPERVISING PHYSICIANS IN 

TEACHING SETTINGS, AND 

RESIDENTS IN CERTAIN SETTINGS 

19. The authority citation for part 415 

continues to read as follows: 

Authority: Secs. 1102 and 1871 of the 

Social Security Act (42 U.S.C. 1302 and 

1395hh). 

Subpart C—Part B Carrier Payments 

for Physician Services to Beneficiaries 

in Providers 

20. Section 415.130 is amended by 

revising paragraph (d) to read as 

follows: 

§ 415.130 Conditions for payment: 

Physician pathology services. 

* * * * * 

(d) Physician pathology services 

furnished by an independent laboratory. 

The technical component of physician 

pathology services furnished by an 

independent laboratory to a hospital 

inpatient or outpatient on or before 

December 31, 2006 may be paid to the 

laboratory by the carrier under the 

physician fee schedule if the Medicare 

beneficiary is a patient of a covered 

hospital as defined in paragraph (a)(1) of 

this section. For services furnished after 

December 31, 2006, an independent 

laboratory may not bill the carrier for 

physician pathology services furnished 

to a hospital inpatient or outpatient. 

* * * * * 

PART 424—CONDITIONS FOR 

MEDICARE PAYMENT 

21. The authority citation for part 424 

continues to read as follows: 

Authority: Secs. 1102 and 1871 of the 

Social Security Act (42 U.S.C. 1302 and 

1395hh). 

Subpart B—Certification and Plan of 

Treatment Requirements 

22. Section 424.24 is amended by—

A. Redesignating paragraph (f) as 

paragraph (g). 

B. Adding a new paragraph (f). 

The addition reads as follows: 

§ 424.24 Requirements for medical and 

other health services furnished by 

providers under Medicare Part B. 

* * * * * 

(f) Blood glucose monitoring in skilled 

nursing facilities. For each blood 

glucose test furnished to a resident of a 

skilled nursing facility, the physician 

must certify that the test is medically 

necessary. A physician’s standing order 

is not sufficient to order a series of 

blood glucose tests. 

* * * * * 

Subpart F—Limitations on Assignment 

and Reassignment of Claims 

23. Section 424.80 is amended by—

A. Revising the heading of paragraph 

(d). 

B. Revising paragraph (d)(2) 

C. Adding a new paragraph (d)(3). 

The revisions and addition read as 

follows: 

§ 424.80 Prohibition of reassignment of 

claims by suppliers. 

* * * * * 

(d) Reassignment to an entity under 

an employer-employee relationship or 

under a contractual arrangement: 

Conditions and limitations. (1) * * * 

(2) Access to records. The supplier 

who furnishes the service has 

unrestricted access to claims submitted 

by an entity for services provided by 

that supplier. This paragraph applies 

irrespective of whether the supplier is 

an employee or whether the service is 

provided under a contractual 

arrangement. If an entity refuses to 

provide, upon request, the billing 

information to the supplier performing 

the service, the entity’s right to receive 

reassigned benefits may be revoked 

under § 424.82(c)(3). 

(3) Contractual arrangements for 

provision of diagnostic test services. If a 

physician or medical group bills for the 

technical component of a diagnostic test 

covered under section 1861(s)(3) of the 

Act and paid for under part 414 of this 

chapter (other than clinical diagnostic 

laboratory tests paid under section 

1833(a)(2)(D) of the Act, which are 

subject to the special rules set forth in 

section 1833(h)(5)(A) of the Act), 

following a reassignment involving a 

contractual arrangement with the 

physician or other supplier who 

performed the technical component, 

each of the following conditions must 

be met: 

(i) The payment to the billing 

physician, or medical group, less the 

applicable deductibles and coinsurance, 

may not exceed the lowest of the 

following amounts: 

(A) The physician or other supplier’s 

net charge to the billing physician or 

medical group. 

(B) The billing physician’s or medical 

group’s actual charge. 

(C) The fee schedule amount for the 

service that would be allowed if the 

physician or other supplier billed 

directly. 

(ii) The physician or medical group 

billing for the test must identify the 

physician or other supplier that 

performed the test and indicate the 

supplier’s net charge for the test. If the 

physician or medical group billing for 

the test fails to provide this information, 

CMS will not make any payment to the 

physician or medical group billing for 

the test and the billing physician or 

medical group can not bill the 

beneficiary. 

(iii) In order to bill for the technical 

component of the service, the physician 

or medical group must directly perform 

the professional component of the 

service. 

(Catalog of Federal Domestic Assistance 

Program No. 93.774, Medicare—

Supplementary Medical Insurance Program) 

Dated: June 29, 2006. 

Mark B. McClellan, 

Administrator, Centers for Medicare & 

Medicaid Services. 

Approved: August 3, 2006. 

Michael O. Leavitt, 

Secretary. 

Note: These addenda will not appear in the 

Code of Federal Regulations. 

Addendum A: Explanation and Use of 

Addenda B 

The addenda on the following pages 

provide various data pertaining to the 

Medicare fee schedule for physicians’

services furnished in 2007. Addendum 

B contains the RVUs for work, nonfacility PE, facility PE, and malpractice 

expense, and other information for all 

services included in the PFS. 

In previous years, we have listed 

many services in Addendum B that are 

not paid under the PFS. To avoid 

publishing as many pages of codes for 

these services, we are not including 

clinical laboratory codes or the 

alphanumeric codes (Healthcare 

Common Procedure Coding System 

(HCPCS) codes not included in CPT) not 

paid under the PFS in Addendum B. 

Addendum B—2007 Relative Value 

Units and Related Information Used in 

Determining Medicare Payments for 

2007 

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 stcodes for 

nonphysicians’ services or items), or L 

(orthotics); and codes for 

anesthesiology. Please also note the 

following: 

• An ‘‘NA’’ in the ‘‘Non-facility PE 

RVUs’’ column of Addendum B means 

that CMS has not developed a PE RVU 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49085 

in the non-facility setting for the service 

because it is typically performed in the 

hospital (for example, an open heart 

surgery is generally performed in the 

hospital setting and not a physician’s 

office). If there is an ‘‘NA’’ in the nonfacility PE RVU column, and the 

contractor determines that this service 

can be performed in the non-facility 

setting, the service will be paid at the 

facility PE RVU rate. 

• Services that have an ‘‘NA’’ in the 

‘‘Facility PE RVUs’’ column of 

Addendum B are typically not paid 

using the PFS when provided in a 

facility setting. These services (which 

include ‘‘incident to’’ services and the 

technical portion of diagnostic tests) are 

generally paid under either the 

outpatient hospital prospective payment 

system or bundled into the hospital 

inpatient prospective payment system 

payment. 

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. A code for: the global values 

(both professional and technical); 

modifier –26 (PC); and, 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, for example, a 

colonoscopy that is not completed. 

There will be RVUs for a code with this 

modifier. 

3. Status indicator. This indicator 

shows whether the CPT/HCPCS code is 

in the PFS and whether it is separately 

payable if the service is covered. 

A = Active code. These codes are 

separately payable under the PFS 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 service. 

Carriers remain responsible for coverage 

decisions in the absence of a national 

Medicare policy. 

B = Bundled code. Payments for 

covered services are 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 = Carriers price the code. Carriers 

will establish RVUs and payment 

amounts for these services, generally on 

an individual case basis following 

review of documentation, such as an 

operative report. 

D* = Deleted/discontinued code. 

E = Excluded from the PFS by 

regulation. These codes are for items 

and services that CMS chose to exclude 

from the fee schedule payment by 

regulation. No RVUs are shown, and no 

payment may be made under the PFS 

for these codes. Payment for them, when 

covered, continues under reasonable 

charge 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 

beginning with the 2005 fee schedule as 

of January 1, 2005. 

G = Code not valid for Medicare 

purposes. Medicare uses another code 

for reporting of, and payment for, these 

services. (Codes subject to a 90-day 

grace period.) This indicator is no 

longer effective with the 2005 PFS as of 

January 1, 2005. 

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 database 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. (Codes not subject to a 90-day 

grace period.) 

L = Local codes. Carriers will apply 

this status to all local codes in effect on 

January 1, 1998 or subsequently 

approved by central office for use. 

Carriers will complete the RVUs and 

payment amounts for these codes. 

M = Measurement codes, used for 

reporting purposes only. There are no 

RVUs and no payment amounts for 

these codes. Medicare uses them to aid 

with performance measurement. No 

separate payment is made. These codes 

should be billed with a zero (($0.00) 

charge and are denied) on the MPFSDB. 

N = Non-covered 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. 

R = Restricted coverage. Special 

coverage instructions apply. If the 

service is covered and no RVUs are 

shown, it is carrier-priced. 

T = There are RVUs for these services, 

but they are only paid if there are no 

other services payable under the PFS 

billed on the same date by the same 

provider. If any other services payable 

under the PFS are billed on the same 

date by the same provider, these 

services are bundled into the service(s) 

for which payment is made. 

X = Statutory exclusion. These codes 

represent an item or service that is not 

within the statutory definition of 

‘‘physicians’ services’’ for PFS payment 

purposes. No RVUs are shown for these 

codes, and no payment may be made 

under the PFS. (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 2007. As stated in the June 29, 

2006 proposed notice, the RVUs for 

codes with a 10- or 90-day global period 

reflect the application of the RUCrecommended values for the E/M 

services that are included as part of the 

global period for the service. 

Note: The separate budget neutrality 

adjustor is not reflected in these 

physician work RVUs. 

6. Fully implemented non-facility 

practice expense RVUs. These are the 

fully implemented resource-based PE 

RVUs for non-facility settings. 

7. Transitional Non-facility practice 

expense RVUs. These are the 2007 

resource-based PE RVUs for non-facility 

settings. 

8. Fully implemented facility practice 

expense RVUs. These are the fully 

implemented resource-based PE RVUs 

for facility settings. 

9. Transitional facility practice 

expense RVUs. These are the 2007 

resource-based PE RVUs for facility 

settings. 

10. Malpractice expense RVUs. These 

are the RVUs for the malpractice 

expense for the service for 2006. 

11. Non-facility total. This is the sum 

of the work, fully implemented nonfacility PE, and malpractice expense 

RVUs. 

12. Transitional non-facility total. 

This is the sum of the work, 2007 

transitional non-facility PE, and 

malpractice expense RVUs. 

13. Facility total. This is the sum of 

the work, fully implemented facility PE, 

and malpractice expense RVUs. 

14. Transitional facility total. This is 

the sum of the work, 2007 transitional 

facility PE, and malpractice expense 

RVUs. 

15. Global period. This indicator 

shows the number of days in the global 

period for the code (0, 10, or 90 days). 

mstockstill on PROD1PC63 with PROPOSAL_2

49086 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

An explanation of the alpha codes 

follows: 

MMM = 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 PE are associated 

with intra service time and in some 

instances in the post service time. 

*Codes with these indicators had a 

90-day grace period before January 1, 

2005. 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49087 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

0003T ......... ............ C Cervicography ............................................... 0.00 0.00 0.00 0.00 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 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 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 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 0.00 0.00 0.00 0.00 XXX 0019T ......... ............ C Extracorp shock wv tx,ms nos ...................... 0.00 0.00 0.00 0.00 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 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 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 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 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 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 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 0.00 0.00 0.00 0.00 XXX 0031T ......... ............ C Speculoscopy ................................................ 0.00 0.00 0.00 0.00 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 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 0.00 0.00 0.00 0.00 XXX 0073T ......... ............ A Delivery, comp imrt ....................................... 0.00 13.02 16.77 NA NA 0.13 13.15 16.90 NA NA XXX 0075T ......... ............ C Perq stent/chest vert art ................................ 0.00 0.00 0.00 0.00 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 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 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 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 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 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 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 0.00 0.00 0.00 0.00 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49088 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

0079T ......... ............ C Endovasc visc extnsn repr ............................ 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 XXX 0082T ......... ............ C Stereotactic rad delivery ................................ 0.00 0.00 0.00 0.00 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 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 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 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 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 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 0.00 0.00 0.00 0.00 XXX 0089T ......... ............ C Actigraphy testing, 3-day ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0090T ......... ............ C Cervical artific disc ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0091T ......... ............ C Lumbar artific disc ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0092T ......... ............ C Artific disc addl .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0093T ......... ............ C Cervical artific diskectomy ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0094T ......... ............ C Lumbar artific diskectomy ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0095T ......... ............ C Artific diskectomy addl .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0096T ......... ............ C Rev cervical artific disc ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0097T ......... ............ C Rev lumbar artific disc ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0098T ......... ............ C Rev artific disc addl ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0099T ......... ............ C Implant corneal ring ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0100T ......... ............ C Prosth retina receive&gen ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0101T ......... ............ C Extracorp shockwv tx,hi enrg ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0102T ......... ............ C Extracorp shockwv tx,anesth ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0103T ......... ............ C Holotranscobalamin ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0104T ......... ............ C At rest cardio gas rebreathe ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0105T ......... ............ C Exerc cardio gas rebreathe ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0106T ......... ............ C Touch quant sensory test .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0107T ......... ............ C Vibrate quant sensory test ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0108T ......... ............ C Cool quant sensory test ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0109T ......... ............ C Heat quant sensory test ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0110T ......... ............ C Nos quant sensory test ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0111T ......... ............ C Rbc membranes fatty acids .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0115T ......... ............ C Med tx mngmt 15 min ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0116T ......... ............ C Med tx mngmt subsqt .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0117T ......... ............ C Med tx mngmt addl 15 min ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0120T ......... ............ C Fibroadenoma cryoablate, ea ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0123T ......... ............ C Scleral fistulization ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0124T ......... ............ C Conjunctival drug placement ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0126T ......... ............ C Chd risk imt study ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0130T ......... ............ C Chron care drug investigatn .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0133T ......... ............ C Esophageal implant injexn ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0135T ......... ............ C Perq cryoablate renal tumor .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0137T ......... ............ C Prostate saturation sampling ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0140T ......... ............ C Exhaled breath condensate ph ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0144T ......... ............ C CT heart wo dye; qual calc ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0144T ......... 26 ....... C CT heart wo dye; qual calc ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0144T ......... TC ...... C CT heart wo dye; qual calc ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0145T ......... ............ C CT heart w/wo dye funct ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0145T ......... 26 ....... C CT heart w/wo dye funct ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0145T ......... TC ...... C CT heart w/wo dye funct ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0146T ......... ............ C CCTA w/wo dye ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0146T ......... 26 ....... C CCTA w/wo dye ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0146T ......... TC ...... C CCTA w/wo dye ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0147T ......... ............ C CCTA w/wo, quan calcium ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0147T ......... 26 ....... C CCTA w/wo, quan calcium ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49089 

0147T ......... TC ...... C CCTA w/wo, quan calcium ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0148T ......... ............ C CCTA w/wo, strxr .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0148T ......... 26 ....... C CCTA w/wo, strxr .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0148T ......... TC ...... C CCTA w/wo, strxr .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0149T ......... ............ C CCTA w/wo, strxr quan calc ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0149T ......... 26 ....... C CCTA w/wo, strxr quan calc ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0149T ......... TC ...... C CCTA w/wo, strxr quan calc ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0150T ......... ............ C CCTA w/wo, disease strxr ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0150T ......... 26 ....... C CCTA w/wo, disease strxr ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0150T ......... TC ...... C CCTA w/wo, disease strxr ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0151T ......... ............ C CT heart funct add-on ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0151T ......... 26 ....... C CT heart funct add-on ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0151T ......... TC ...... C CT heart funct add-on ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0152T ......... ............ C Computer chest add-on ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0153T ......... ............ C Implant aneur sensor add-on ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0154T ......... ............ C Implant aneur sensor study ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0155T ......... ............ C Lap ins gastr eltrd for mo .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0156T ......... ............ C Lap redo gastr eltrd for mo ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0157T ......... ............ C Opn ins gastr eltrd for mo ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0158T ......... ............ C Opn redo gastr eltrd for mo .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0159T ......... ............ C Computer breast MRI add-on ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 0159T ......... 26 ....... C Computer breast MRI add-on ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ0159T ......... TC ...... C Computer breast MRI add-on ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 0160T ......... ............ C Transcran mag stim planning ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 0161T ......... ............ C Transcran mag stim delivery ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 10021 ......... ............ A Fna w/o image ............................................... 1.27 2.13 2.15 0.36 0.50 0.10 3.50 3.52 1.73 1.87 XXX 10022 ......... ............ A Fna w/image .................................................. 1.27 2.13 2.44 0.38 0.41 0.08 3.48 3.79 1.73 1.76 XXX 10040 ......... ............ A Acne surgery ................................................. 1.18 1.26 1.07 0.93 0.83 0.05 2.49 2.30 2.16 2.06 010 10060 ......... ............ A Drainage of skin abscess .............................. 1.17 1.50 1.28 1.08 0.97 0.12 2.79 2.57 2.37 2.26 010 10061 ......... ............ A Drainage of skin abscess .............................. 2.40 2.07 1.88 1.51 1.50 0.26 4.73 4.54 4.17 4.16 010 10080 ......... ............ A Drainage of pilonidal cyst .............................. 1.17 2.65 2.99 1.09 1.11 0.11 3.93 4.27 2.37 2.39 010 10081 ......... ............ A Drainage of pilonidal cyst .............................. 2.45 3.49 3.93 1.44 1.49 0.24 6.18 6.62 4.13 4.18 010 10120 ......... ............ A Remove foreign body .................................... 1.22 2.10 2.15 0.94 0.96 0.12 3.44 3.49 2.28 2.30 010 10121 ......... ............ A Remove foreign body .................................... 2.69 3.52 3.51 1.65 1.75 0.33 6.54 6.53 4.67 4.77 010 10140 ......... ............ A Drainage of hematoma/fluid .......................... 1.53 2.27 1.90 1.29 1.29 0.19 3.99 3.62 3.01 3.01 010 10160 ......... ............ A Puncture drainage of lesion .......................... 1.20 1.85 1.66 1.07 1.08 0.14 3.19 3.00 2.41 2.42 010 10180 ......... ............ A Complex drainage, wound ............................ 2.25 3.30 3.06 1.83 1.94 0.35 5.90 5.66 4.43 4.54 010 11000 ......... ............ A Debride infected skin ..................................... 0.60 0.73 0.62 0.16 0.21 0.07 1.40 1.29 0.83 0.88 000 11001 ......... ............ A Debride infected skin add-on ........................ 0.30 0.23 0.23 0.08 0.10 0.04 0.57 0.57 0.42 0.44 ZZZ 11004 ......... ............ A Debride genitalia & perineum ........................ 10.31 NA NA 3.04 3.69 0.67 NA NA 14.02 14.67 000 11005 ......... ............ A Debride abdom wall ...................................... 13.75 NA NA 4.06 5.19 0.96 NA NA 18.77 19.90 000 11006 ......... ............ A Debride genit/per/abdom wall ....................... 12.61 NA NA 3.61 4.54 1.28 NA NA 17.50 18.43 00011008 ......... ............ A Remove mesh from abd wall ........................ 5.00 NA NA 1.36 1.86 0.61 NA NA 6.97 7.47 ZZZ 11010 ......... ............ A Debride skin, fx ............................................. 4.19 6.77 6.85 2.33 2.55 0.66 11.62 11.70 7.18 7.40 010 11011 ......... ............ A Debride skin/muscle, fx ................................. 4.94 7.09 7.89 2.04 2.27 0.74 12.77 13.57 7.72 7.95 000 11012 ......... ............ A Debride skin/muscle/bone, fx ........................ 6.87 9.03 11.33 3.12 3.66 1.16 17.06 19.36 11.15 11.69 000 11040 ......... ............ A Debride skin, partial ...................................... 0.48 0.68 0.56 0.16 0.20 0.06 1.22 1.10 0.70 0.74 000 11041 ......... ............ A Debride skin, full ............................................ 0.60 0.73 0.68 0.19 0.30 0.10 1.43 1.38 0.89 1.00 000 11042 ......... ............ A Debride skin/tissue ........................................ 0.80 0.96 0.97 0.25 0.39 0.13 1.89 1.90 1.18 1.32 000 11043 ......... ............ A Debride tissue/muscle ................................... 3.00 3.64 3.45 2.71 2.62 0.32 6.96 6.77 6.03 5.94 010 11044 ......... ............ A Debride tissue/muscle/bone .......................... 4.05 4.96 4.58 3.67 3.73 0.43 9.44 9.06 8.15 8.21 010 11055 ......... ............ R Trim skin lesion ............................................. 0.43 0.82 0.63 0.11 0.16 0.05 1.30 1.11 0.59 0.64 000 11056 ......... ............ R Trim skin lesions, 2 to 4 ................................ 0.61 0.89 0.70 0.16 0.21 0.07 1.57 1.38 0.84 0.89 000 11057 ......... ............ R Trim skin lesions, over 4 ............................... 0.79 1.00 0.81 0.21 0.28 0.10 1.89 1.70 1.10 1.17 000 11100 ......... ............ A Biopsy, skin lesion ......................................... 0.81 1.83 1.40 0.37 0.37 0.03 2.67 2.24 1.21 1.21 000 11101 ......... ............ A Biopsy, skin add-on ....................................... 0.41 0.40 0.35 0.19 0.19 0.02 0.83 0.78 0.62 0.62 ZZZ 11200 ......... ............ A Removal of skin tags ..................................... 0.77 1.20 1.08 0.88 0.79 0.04 2.01 1.89 1.69 1.60 010 11201 ......... ............ A Remove skin tags add-on ............................. 0.29 0.16 0.16 0.11 0.12 0.02 0.47 0.47 0.42 0.43 ZZZ 11300 ......... ............ A Shave skin lesion .......................................... 0.51 1.17 1.04 0.20 0.21 0.03 1.71 1.58 0.74 0.75 000 11301 ......... ............ A Shave skin lesion .......................................... 0.85 1.47 1.20 0.37 0.38 0.04 2.36 2.09 1.26 1.27 000 11302 ......... ............ A Shave skin lesion .......................................... 1.05 1.73 1.41 0.47 0.46 0.05 2.83 2.51 1.57 1.56 000 11303 ......... ............ A Shave skin lesion .......................................... 1.24 1.97 1.68 0.53 0.52 0.07 3.28 2.99 1.84 1.83 000 11305 ......... ............ A Shave skin lesion .......................................... 0.67 1.06 0.90 0.20 0.25 0.07 1.80 1.64 0.94 0.99 000 11306 ......... ............ A Shave skin lesion .......................................... 0.99 1.39 1.17 0.37 0.41 0.07 2.45 2.23 1.43 1.47 000 11307 ......... ............ A Shave skin lesion .......................................... 1.14 1.66 1.38 0.46 0.48 0.07 2.87 2.59 1.67 1.69 000 11308 ......... ............ A Shave skin lesion .......................................... 1.41 1.71 1.52 0.50 0.57 0.13 3.25 3.06 2.04 2.11 000 

mstockstill on PROD1PC63 with PROPOSAL_2

49090 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

11310 ......... ............ A Shave skin lesion .......................................... 0.73 1.35 1.17 0.30 0.32 0.04 2.12 1.94 1.07 1.09 000 11311 ......... ............ A Shave skin lesion .......................................... 1.05 1.60 1.32 0.46 0.48 0.05 2.70 2.42 1.56 1.58 000 11312 ......... ............ A Shave skin lesion .......................................... 1.20 1.87 1.53 0.54 0.55 0.06 3.13 2.79 1.80 1.81 000 11313 ......... ............ A Shave skin lesion .......................................... 1.62 2.13 1.88 0.71 0.72 0.10 3.85 3.60 2.43 2.44 000 11400 ......... ............ A Exc tr-ext b9+marg 0.5 < cm ........................ 0.85 1.86 1.96 0.92 0.89 0.06 2.77 2.87 1.83 1.80 010 11401 ......... ............ A Exc tr-ext b9+marg 0.6–1 cm ....................... 1.23 2.14 2.07 1.12 1.05 0.10 3.47 3.40 2.45 2.38 010 11402 ......... ............ A Exc tr-ext b9+marg 1.1–2 cm ....................... 1.40 2.35 2.25 1.18 1.11 0.13 3.88 3.78 2.71 2.64 010 11403 ......... ............ A Exc tr-ext b9+marg 2.1–3 cm ....................... 1.79 2.52 2.42 1.54 1.38 0.17 4.48 4.38 3.50 3.34 010 11404 ......... ............ A Exc tr-ext b9+marg 3.1–4 cm ....................... 2.06 2.84 2.74 1.61 1.45 0.21 5.11 5.01 3.88 3.72 010 11406 ......... ............ A Exc tr-ext b9+marg > 4.0 cm ........................ 3.45 3.50 3.17 2.07 1.76 0.32 7.27 6.94 5.84 5.53 010 11420 ......... ............ A Exc h-f-nk-sp b9+marg 0.5 < ........................ 0.98 1.82 1.78 0.92 0.93 0.09 2.89 2.85 1.99 2.00 010 11421 ......... ............ A Exc h-f-nk-sp b9+marg 0.6–1 ....................... 1.42 2.18 2.09 1.14 1.12 0.13 3.73 3.64 2.69 2.67 010 11422 ......... ............ A Exc h-f-nk-sp b9+marg 1.1–2 ....................... 1.63 2.39 2.29 1.50 1.37 0.16 4.18 4.08 3.29 3.16 010 11423 ......... ............ A Exc h-f-nk-sp b9+marg 2.1–3 ....................... 2.01 2.62 2.59 1.62 1.49 0.20 4.83 4.80 3.83 3.70 010 11424 ......... ............ A Exc h-f-nk-sp b9+marg 3.1–4 ....................... 2.43 2.94 2.84 1.75 1.64 0.25 5.62 5.52 4.43 4.32 010 11426 ......... ............ A Exc h-f-nk-sp b9+marg > 4 cm ..................... 4.02 3.58 3.51 2.29 2.15 0.44 8.04 7.97 6.75 6.61 010 11440 ......... ............ A Exc face-mm b9+marg 0.5 < cm .................. 1.00 1.99 2.15 1.30 1.31 0.08 3.07 3.23 2.38 2.39 01011441 ......... ............ A Exc face-mm b9+marg 0.6–1 cm .................. 1.48 2.34 2.33 1.52 1.50 0.13 3.95 3.94 3.13 3.11 010 11442 ......... ............ A Exc face-mm b9+marg 1.1–2 cm .................. 1.72 2.59 2.55 1.62 1.58 0.16 4.47 4.43 3.50 3.46 010 11443 ......... ............ A Exc face-mm b9+marg 2.1–3 cm .................. 2.29 2.82 2.89 1.79 1.81 0.22 5.33 5.40 4.30 4.32 010 11444 ......... ............ A Exc face-mm b9+marg 3.1–4 cm .................. 3.14 3.23 3.41 2.04 2.15 0.30 6.67 6.85 5.48 5.59 010 11446 ......... ............ A Exc face-mm b9+marg > 4 cm ..................... 4.73 4.01 4.03 2.62 2.73 0.43 9.17 9.19 7.78 7.89 010 11450 ......... ............ A Removal, sweat gland lesion ........................ 3.11 5.19 5.07 2.44 2.13 0.34 8.64 8.52 5.89 5.58 090 11451 ......... ............ A Removal, sweat gland lesion ........................ 4.32 6.17 6.49 2.79 2.60 0.53 11.02 11.34 7.64 7.45 090 11462 ......... ............ A Removal, sweat gland lesion ........................ 2.89 5.33 5.17 2.47 2.13 0.32 8.54 8.38 5.68 5.34 090 11463 ......... ............ A Removal, sweat gland lesion ........................ 4.32 6.64 6.78 2.98 2.76 0.54 11.50 11.64 7.84 7.62 090 11470 ......... ............ A Removal, sweat gland lesion ........................ 3.63 5.61 5.20 2.70 2.37 0.40 9.64 9.23 6.73 6.40 090 11471 ......... ............ A Removal, sweat gland lesion ........................ 4.78 6.48 6.65 2.99 2.82 0.58 11.84 12.01 8.35 8.18 090 11600 ......... ............ A Exc tr-ext mlg+marg 0.5 < cm ...................... 1.56 2.71 2.65 1.12 1.01 0.10 4.37 4.31 2.78 2.67 010 11601 ......... ............ A Exc tr-ext mlg+marg 0.6–1 cm ...................... 2.00 3.37 2.87 1.47 1.28 0.12 5.49 4.99 3.59 3.40 010 11602 ......... ............ A Exc tr-ext mlg+marg 1.1–2 cm ...................... 2.20 3.74 3.05 1.63 1.35 0.12 6.06 5.37 3.95 3.67 010 11603 ......... ............ A Exc tr-ext mlg+marg 2.1–3 cm ...................... 2.75 3.95 3.29 1.81 1.45 0.16 6.86 6.20 4.72 4.36 010 11604 ......... ............ A Exc tr-ext mlg+marg 3.1–4 cm ...................... 3.10 4.26 3.59 1.88 1.51 0.20 7.56 6.89 5.18 4.81 010 11606 ......... ............ A Exc tr-ext mlg+marg > 4 cm ......................... 4.95 5.41 4.40 2.41 1.90 0.36 10.72 9.71 7.72 7.21 010 11620 ......... ............ A Exc h-f-nk-sp mlg+marg 0.5 < ...................... 1.57 2.81 2.65 1.17 1.01 0.09 4.47 4.31 2.83 2.67 010 11621 ......... ............ A Exc h-f-nk-sp mlg+marg 0.6–1 ...................... 2.01 3.42 2.88 1.49 1.30 0.12 5.55 5.01 3.62 3.43 010 11622 ......... ............ A Exc h-f-nk-sp mlg+marg 1.1–2 ...................... 2.34 3.80 3.17 1.69 1.47 0.14 6.28 5.65 4.17 3.95 010 11623 ......... ............ A Exc h-f-nk-sp mlg+marg 2.1–3 ...................... 3.04 4.03 3.51 1.90 1.66 0.20 7.27 6.75 5.14 4.90 010 11624 ......... ............ A Exc h-f-nk-sp mlg+marg 3.1–4 ...................... 3.55 4.35 3.89 2.03 1.84 0.27 8.17 7.71 5.85 5.66 010 11626 ......... ............ A Exc h-f-nk-sp mlg+mar > 4 cm ..................... 4.54 4.90 4.70 2.28 2.36 0.45 9.89 9.69 7.27 7.35 010 11640 ......... ............ A Exc face-mm malig+marg 0.5 < .................... 1.60 3.00 2.74 1.26 1.15 0.11 4.71 4.45 2.97 2.86 010 11641 ......... ............ A Exc face-mm malig+marg 0.6–1 ................... 2.10 3.55 3.15 1.56 1.54 0.16 5.81 5.41 3.82 3.80 010 11642 ......... ............ A Exc face-mm malig+marg 1.1–2 ................... 2.55 3.93 3.53 1.78 1.73 0.19 6.67 6.27 4.52 4.47 010 11643 ......... ............ A Exc face-mm malig+marg 2.1–3 ................... 3.35 4.18 3.90 2.04 1.98 0.26 7.79 7.51 5.65 5.59 010 11644 ......... ............ A Exc face-mm malig+marg 3.1–4 ................... 4.27 4.95 4.75 2.38 2.43 0.37 9.59 9.39 7.02 7.07 010 11646 ......... ............ A Exc face-mm mlg+marg > 4 cm .................... 6.19 5.76 5.75 3.03 3.36 0.61 12.56 12.55 9.83 10.16 010 11719 ......... ............ R Trim nail(s) .................................................... 0.17 0.38 0.28 0.04 0.06 0.02 0.57 0.47 0.23 0.25 000 11720 ......... ............ A Debride nail, 1–5 ........................................... 0.32 0.47 0.37 0.08 0.11 0.04 0.83 0.73 0.44 0.47 000 11721 ......... ............ A Debride nail, 6 or more ................................. 0.54 0.55 0.47 0.14 0.19 0.07 1.16 1.08 0.75 0.80 000 11730 ......... ............ A Removal of nail plate .................................... 1.10 1.35 1.11 0.29 0.40 0.14 2.59 2.35 1.53 1.64 000 11732 ......... ............ A Remove nail plate, add-on ............................ 0.57 0.55 0.47 0.15 0.20 0.07 1.19 1.11 0.79 0.84 ZZZ 11740 ......... ............ A Drain blood from under nail .......................... 0.37 0.80 0.61 0.44 0.37 0.04 1.21 1.02 0.85 0.78 000 11750 ......... ............ A Removal of nail bed ...................................... 2.36 2.98 2.37 1.89 1.79 0.22 5.56 4.95 4.47 4.37 010 11752 ......... ............ A Remove nail bed/finger tip ............................ 3.42 4.12 3.27 2.82 2.95 0.35 7.89 7.04 6.59 6.72 010 11755 ......... ............ A Biopsy, nail unit ............................................. 1.31 2.02 1.68 0.76 0.77 0.14 3.47 3.13 2.21 2.22 000 11760 ......... ............ A Repair of nail bed .......................................... 1.58 3.45 2.83 1.44 1.70 0.21 5.24 4.62 3.23 3.49 010 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49091 

11762 ......... ............ A Reconstruction of nail bed ............................ 2.89 3.72 3.09 1.69 2.18 0.36 6.97 6.34 4.94 5.43 010 11765 ......... ............ A Excision of nail fold, toe ................................ 0.69 2.69 2.01 1.01 0.82 0.08 3.46 2.78 1.78 1.59 010 11770 ......... ............ A Removal of pilonidal lesion ........................... 2.61 3.49 3.48 1.53 1.51 0.33 6.43 6.42 4.47 4.45 010 11771 ......... ............ A Removal of pilonidal lesion ........................... 5.91 6.72 5.91 3.74 3.42 0.74 13.37 12.56 10.39 10.07 090 11772 ......... ............ A Removal of pilonidal lesion ........................... 7.15 8.06 7.64 5.56 5.19 0.89 16.10 15.68 13.60 13.23 090 11900 ......... ............ A Injection into skin lesions .............................. 0.52 0.89 0.71 0.24 0.22 0.02 1.43 1.25 0.78 0.76 000 11901 ......... ............ A Added skin lesions injection .......................... 0.80 0.98 0.74 0.38 0.36 0.03 1.81 1.57 1.21 1.19 000 11920 ......... ............ R Correct skin color defects ............................. 1.61 2.40 3.38 1.12 1.10 0.24 4.25 5.23 2.97 2.95 000 11921 ......... ............ R Correct skin color defects ............................. 1.93 2.67 3.64 1.26 1.27 0.29 4.89 5.86 3.48 3.49 000 11922 ......... ............ R Correct skin color defects ............................. 0.49 0.93 1.09 0.22 0.24 0.07 1.49 1.65 0.78 0.80 ZZZ 11950 ......... ............ R Therapy for contour defects .......................... 0.84 0.86 1.07 0.35 0.38 0.06 1.76 1.97 1.25 1.28 000 11951 ......... ............ R Therapy for contour defects .......................... 1.19 1.18 1.41 0.53 0.52 0.11 2.48 2.71 1.83 1.82 000 11952 ......... ............ R Therapy for contour defects .......................... 1.69 1.71 1.82 0.81 0.71 0.16 3.56 3.67 2.66 2.56 000 11954 ......... ............ R Therapy for contour defects .......................... 1.85 1.76 2.27 0.76 0.87 0.25 3.86 4.37 2.86 2.97 000 11960 ......... ............ A Insert tissue expander(s) ............................... 10.85 NA NA 10.58 10.44 1.31 NA NA 22.74 22.60 090 11970 ......... ............ A Replace tissue expander ............................... 7.80 NA NA 6.20 6.15 1.05 NA NA 15.05 15.00 090 11971 ......... ............ A Remove tissue expander(s) .......................... 3.13 7.42 8.69 4.01 3.85 0.32 10.87 12.14 7.46 7.30 090 11975 ......... ............ N Insert contraceptive cap ................................ 1.48 1.55 1.45 0.34 0.51 0.17 3.20 3.10 1.99 2.16 XXX 11976 ......... ............ R Removal of contraceptive cap ....................... 1.78 1.71 1.72 0.47 0.63 0.21 3.70 3.71 2.46 2.62 000 11977 ......... ............ N Removal/reinsert contra cap ......................... 3.30 2.00 2.20 0.77 1.14 0.37 5.67 5.87 4.44 4.81 XXX 11980 ......... ............ A Implant hormone pellet(s) ............................. 1.48 1.17 1.10 0.55 0.54 0.13 2.78 2.71 2.16 2.15 000 11981 ......... ............ A Insert drug implant device ............................. 1.48 1.92 1.76 0.59 0.66 0.12 3.52 3.36 2.19 2.26 XXX 11982 ......... ............ A Remove drug implant device ........................ 1.78 2.05 1.97 0.71 0.80 0.17 4.00 3.92 2.66 2.75 XXX 11983 ......... ............ A Remove/insert drug implant .......................... 3.30 2.67 2.38 1.34 1.44 0.23 6.20 5.91 4.87 4.97 XXX 12001 ......... ............ A Repair superficial wound(s) ........................... 1.70 1.73 1.92 0.72 0.76 0.15 3.58 3.77 2.57 2.61 010 12002 ......... ............ A Repair superficial wound(s) ........................... 1.86 1.79 1.98 0.83 0.88 0.17 3.82 4.01 2.86 2.91 010 12004 ......... ............ A Repair superficial wound(s) ........................... 2.24 2.07 2.26 0.92 0.99 0.21 4.52 4.71 3.37 3.44 010 12005 ......... ............ A Repair superficial wound(s) ........................... 2.86 2.52 2.75 1.06 1.17 0.27 5.65 5.88 4.19 4.30 010 12006 ......... ............ A Repair superficial wound(s) ........................... 3.66 3.03 3.30 1.30 1.46 0.35 7.04 7.31 5.31 5.47 010 12007 ......... ............ A Repair superficial wound(s) ........................... 4.11 3.40 3.72 1.49 1.73 0.45 7.96 8.28 6.05 6.29 010 12011 ......... ............ A Repair superficial wound(s) ........................... 1.76 1.89 2.07 0.75 0.77 0.16 3.81 3.99 2.67 2.69 010 12013 ......... ............ A Repair superficial wound(s) ........................... 1.99 2.05 2.22 0.88 0.92 0.18 4.22 4.39 3.05 3.09 010 12014 ......... ............ A Repair superficial wound(s) ........................... 2.46 2.28 2.50 0.97 1.04 0.23 4.97 5.19 3.66 3.73 010 12015 ......... ............ A Repair superficial wound(s) ........................... 3.19 2.76 3.04 1.11 1.22 0.29 6.24 6.52 4.59 4.70 010 12016 ......... ............ A Repair superficial wound(s) ........................... 3.92 3.16 3.45 1.29 1.46 0.37 7.45 7.74 5.58 5.75 010 12017 ......... ............ A Repair superficial wound(s) ........................... 4.70 NA NA 1.48 1.79 0.47 NA NA 6.65 6.96 01012018 ......... ............ A Repair superficial wound(s) ........................... 5.52 NA NA 1.96 2.18 0.64 NA NA 8.12 8.34 01012020 ......... ............ A Closure of split wound ................................... 2.62 3.75 3.80 1.77 1.88 0.30 6.67 6.72 4.69 4.80 010 12021 ......... ............ A Closure of split wound ................................... 1.84 1.86 1.83 1.33 1.39 0.24 3.94 3.91 3.41 3.47 010 12031 ......... ............ A Layer closure of wound(s) ............................. 2.15 3.82 2.67 1.73 1.15 0.17 6.14 4.99 4.05 3.47 010 12032 ......... ............ A Layer closure of wound(s) ............................. 2.47 5.08 4.15 2.21 1.90 0.16 7.71 6.78 4.84 4.53 010 12034 ......... ............ A Layer closure of wound(s) ............................. 2.92 4.50 3.52 1.93 1.57 0.25 7.67 6.69 5.10 4.74 010 12035 ......... ............ A Layer closure of wound(s) ............................. 3.42 5.25 5.21 2.08 2.13 0.39 9.06 9.02 5.89 5.94 010 12036 ......... ............ A Layer closure of wound(s) ............................. 4.04 5.38 5.51 2.22 2.46 0.55 9.97 10.10 6.81 7.05 010 12037 ......... ............ A Layer closure of wound(s) ............................. 4.66 5.94 6.05 2.59 2.87 0.66 11.26 11.37 7.91 8.19 010 12041 ......... ............ A Layer closure of wound(s) ............................. 2.37 3.77 2.85 1.72 1.28 0.19 6.33 5.41 4.28 3.84 010 12042 ......... ............ A Layer closure of wound(s) ............................. 2.74 4.36 3.54 2.04 1.61 0.17 7.27 6.45 4.95 4.52 010 12044 ......... ............ A Layer closure of wound(s) ............................. 3.14 5.27 3.73 1.89 1.67 0.27 8.68 7.14 5.30 5.08 010 12045 ......... ............ A Layer closure of wound(s) ............................. 3.63 5.07 5.21 2.06 2.23 0.41 9.11 9.25 6.10 6.27 010 12046 ......... ............ A Layer closure of wound(s) ............................. 4.24 5.64 6.29 2.27 2.63 0.54 10.42 11.07 7.05 7.41 010 12047 ......... ............ A Layer closure of wound(s) ............................. 4.64 6.16 6.30 2.51 2.94 0.58 11.38 11.52 7.73 8.16 010 12051 ......... ............ A Layer closure of wound(s) ............................. 2.47 4.01 3.46 1.86 1.55 0.20 6.68 6.13 4.53 4.22 010 12052 ......... ............ A Layer closure of wound(s) ............................. 2.77 4.69 3.59 2.44 1.68 0.17 7.63 6.53 5.38 4.62 010 12053 ......... ............ A Layer closure of wound(s) ............................. 3.12 5.23 3.74 2.05 1.66 0.23 8.58 7.09 5.40 5.01 010 12054 ......... ............ A Layer closure of wound(s) ............................. 3.45 5.30 4.00 2.01 1.73 0.30 9.05 7.75 5.76 5.48 010 12055 ......... ............ A Layer closure of wound(s) ............................. 4.42 6.00 4.86 2.10 2.12 0.45 10.87 9.73 6.97 6.99 010 12056 ......... ............ A Layer closure of wound(s) ............................. 5.23 6.21 6.62 2.38 2.88 0.59 12.03 12.44 8.20 8.70 010 12057 ......... ............ A Layer closure of wound(s) ............................. 5.95 7.45 6.46 2.79 3.51 0.56 13.96 12.97 9.30 10.02 010 13100 ......... ............ A Repair of wound or lesion ............................. 3.12 4.32 4.12 2.39 2.32 0.26 7.70 7.50 5.77 5.70 010 13101 ......... ............ A Repair of wound or lesion ............................. 3.91 5.79 4.94 2.88 2.73 0.26 9.96 9.11 7.05 6.90 010 13102 ......... ............ A Repair wound/lesion add-on ......................... 1.24 1.34 1.21 0.52 0.56 0.13 2.71 2.58 1.89 1.93 ZZZ 13120 ......... ............ A Repair of wound or lesion ............................. 3.30 4.46 4.22 2.50 2.38 0.26 8.02 7.78 6.06 5.94 010 13121 ......... ............ A Repair of wound or lesion ............................. 4.32 6.47 5.26 3.46 2.96 0.25 11.04 9.83 8.03 7.53 010 13122 ......... ............ A Repair wound/lesion add-on ......................... 1.44 1.37 1.48 0.58 0.62 0.15 2.96 3.07 2.17 2.21 ZZZ 13131 ......... ............ A Repair of wound or lesion ............................. 3.78 4.86 4.49 2.78 2.71 0.26 8.90 8.53 6.82 6.75 010 13132 ......... ............ A Repair of wound or lesion ............................. 6.44 7.64 6.34 4.77 4.31 0.32 14.40 13.10 11.53 11.07 010 

mstockstill on PROD1PC63 with PROPOSAL_2

49092 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

13133 ......... ............ A Repair wound/lesion add-on ......................... 2.19 1.82 1.70 0.94 1.01 0.18 4.19 4.07 3.31 3.38 ZZZ 13150 ......... ............ A Repair of wound or lesion ............................. 3.80 4.59 4.80 2.64 2.73 0.34 8.73 8.94 6.78 6.87 010 13151 ......... ............ A Repair of wound or lesion ............................. 4.44 5.35 4.94 3.11 3.13 0.31 10.10 9.69 7.86 7.88 010 13152 ......... ............ A Repair of wound or lesion ............................. 6.32 7.31 6.35 3.77 3.97 0.40 14.03 13.07 10.49 10.69 010 13153 ......... ............ A Repair wound/lesion add-on ......................... 2.38 1.98 1.94 0.98 1.10 0.24 4.60 4.56 3.60 3.72 ZZZ 13160 ......... ............ A Late closure of wound ................................... 11.76 NA NA 7.07 7.14 1.54 NA NA 20.37 20.44 090 14000 ......... ............ A Skin tissue rearrangement ............................ 6.76 8.78 8.08 5.92 5.58 0.59 16.13 15.43 13.27 12.93 090 14001 ......... ............ A Skin tissue rearrangement ............................ 9.52 10.90 9.78 7.40 7.15 0.82 21.24 20.12 17.74 17.49 090 14020 ......... ............ A Skin tissue rearrangement ............................ 7.58 9.79 8.91 6.70 6.57 0.64 18.01 17.13 14.92 14.79 090 14021 ......... ............ A Skin tissue rearrangement ............................ 11.10 12.13 10.52 8.40 8.31 0.81 24.04 22.43 20.31 20.22 090 14040 ......... ............ A Skin tissue rearrangement ............................ 8.36 9.92 9.08 6.77 7.09 0.62 18.90 18.06 15.75 16.07 090 14041 ......... ............ A Skin tissue rearrangement ............................ 12.59 13.17 11.24 9.03 8.76 0.73 26.49 24.56 22.35 22.08 090 14060 ......... ............ A Skin tissue rearrangement ............................ 8.99 9.40 8.94 6.94 7.31 0.68 19.07 18.61 16.61 16.98 090 14061 ......... ............ A Skin tissue rearrangement ............................ 13.58 14.41 12.30 9.84 9.59 0.76 28.75 26.64 24.18 23.93 090 14300 ......... ............ A Skin tissue rearrangement ............................ 13.17 13.26 11.66 9.24 9.19 1.16 27.59 25.99 23.57 23.52 090 14350 ......... ............ A Skin tissue rearrangement ............................ 10.73 NA NA 6.92 7.09 1.34 NA NA 18.99 19.16 090 15000 ......... ............ A Wound prep, 1st 100 sq cm .......................... 3.99 4.24 3.90 1.73 2.07 0.54 8.77 8.43 6.26 6.60 000 15001 ......... ............ A Wound prep, addl 100 sq cm ........................ 1.00 0.56 1.15 0.35 0.40 0.14 1.70 2.29 1.49 1.54 ZZZ 15040 ......... ............ A Harvest cultured skin graft ............................ 2.00 3.86 4.39 1.03 1.11 0.24 6.10 6.63 3.27 3.35 000 15050 ......... ............ A Skin pinch graft ............................................. 5.29 7.65 7.10 5.02 5.09 0.57 13.51 12.96 10.88 10.95 090 15100 ......... ............ A Skin splt grft, trnk/arm/leg ............................. 9.66 9.84 11.90 6.73 7.55 1.28 20.78 22.84 17.67 18.49 090 15101 ......... ............ A Skin splt grft t/a/l, add-on .............................. 1.72 2.51 3.43 0.87 1.10 0.24 4.47 5.39 2.83 3.06 ZZZ 15110 ......... ............ A Epidrm autogrft trnk/arm/leg .......................... 10.82 8.92 10.23 6.50 6.88 1.31 21.05 22.36 18.63 19.01 090 15111 ......... ............ A Epidrm autogrft t/a/l add-on .......................... 1.85 0.89 1.19 0.64 0.75 0.26 3.00 3.30 2.75 2.86 ZZZ 15115 ......... ............ A Epidrm a-grft face/nck/hf/g ............................ 11.13 9.16 9.21 6.68 7.18 1.15 21.44 21.49 18.96 19.46 090 15116 ......... ............ A Epidrm a-grft f/n/hf/g addl ............................. 2.50 1.22 1.49 0.89 1.06 0.33 4.05 4.32 3.72 3.89 ZZZ 15120 ......... ............ A Skn splt a-grft fac/nck/hf/g ............................ 10.88 11.18 10.84 7.32 7.67 1.16 23.22 22.88 19.36 19.71 090 15121 ......... ............ A Skn splt a-grft f/n/hf/g add ............................. 2.67 3.47 4.24 1.33 1.71 0.36 6.50 7.27 4.36 4.74 ZZZ 15130 ......... ............ A Derm autograft, trnk/arm/leg ......................... 7.33 8.03 9.40 5.64 6.17 0.97 16.33 17.70 13.94 14.47 090 15131 ......... ............ A Derm autograft t/a/l add-on ........................... 1.50 0.70 0.98 0.52 0.61 0.21 2.41 2.69 2.23 2.32 ZZZ 15135 ......... ............ A Derm autograft face/nck/hf/g ......................... 10.83 9.41 9.76 6.98 7.84 1.23 21.47 21.82 19.04 19.90 090 15136 ......... ............ A Derm autograft, f/n/hf/g add .......................... 1.50 0.68 0.84 0.53 0.64 0.20 2.38 2.54 2.23 2.34 ZZZ 15150 ......... ............ A Cult epiderm grft t/arm/leg ............................ 9.24 7.22 8.15 5.92 6.31 1.14 17.60 18.53 16.30 16.69 090 15151 ......... ............ A Cult epiderm grft t/a/l addl ............................. 2.00 0.90 1.21 0.70 0.81 0.28 3.18 3.49 2.98 3.09 ZZZ 15152 ......... ............ A Cult epiderm graft t/a/l +% ............................ 2.50 1.08 1.44 0.87 1.01 0.35 3.93 4.29 3.72 3.86 ZZZ 15155 ......... ............ A Cult epiderm graft, f/n/hf/g ............................ 9.99 7.60 7.77 6.25 6.78 1.05 18.64 18.81 17.29 17.82 090 15156 ......... ............ A Cult epidrm grft f/n/hfg add ........................... 2.75 1.18 1.47 0.98 1.18 0.36 4.29 4.58 4.09 4.29 ZZZ 15157 ......... ............ A Cult epiderm grft f/n/hfg +% .......................... 3.00 1.37 1.67 1.07 1.28 0.39 4.76 5.06 4.46 4.67 ZZZ 15170 ......... ............ A Acell graft trunk/arms/legs ............................. 5.99 3.65 3.79 2.36 2.36 0.55 10.19 10.33 8.90 8.90 090 15171 ......... ............ A Acell graft t/arm/leg add-on ........................... 1.55 0.65 0.67 0.51 0.59 0.19 2.39 2.41 2.25 2.33 ZZZ 15175 ......... ............ A Acellular graft, f/n/hf/g ................................... 7.99 5.24 5.38 3.75 3.94 0.82 14.05 14.19 12.56 12.75 090 15176 ......... ............ A Acell graft, f/n/hf/g add-on ............................. 2.45 1.07 1.10 0.81 0.95 0.29 3.81 3.84 3.55 3.69 ZZZ 15200 ......... ............ A Skin full graft, trunk ....................................... 8.90 9.85 9.51 6.29 6.22 0.98 19.73 19.39 16.17 16.10 090 15201 ......... ............ A Skin full graft trunk add-on ............................ 1.32 2.11 2.45 0.56 0.61 0.19 3.62 3.96 2.07 2.12 ZZZ 15220 ......... ............ A Skin full graft sclp/arm/leg ............................. 7.86 10.21 9.44 6.51 6.64 0.84 18.91 18.14 15.21 15.34 090 15221 ......... ............ A Skin full graft add-on ..................................... 1.19 2.01 2.24 0.50 0.55 0.16 3.36 3.59 1.85 1.90 ZZZ 15240 ......... ............ A Skin full grft face/genit/hf ............................... 10.03 11.73 10.58 8.64 8.12 0.92 22.68 21.53 19.59 19.07 090 15241 ......... ............ A Skin full graft add-on ..................................... 1.86 2.51 2.46 0.79 0.88 0.23 4.60 4.55 2.88 2.97 ZZZ 15260 ......... ............ A Skin full graft een & lips ................................ 11.29 12.63 10.82 9.02 8.69 0.69 24.61 22.80 21.00 20.67 090 15261 ......... ............ A Skin full graft add-on ..................................... 2.23 2.91 2.75 1.12 1.33 0.21 5.35 5.19 3.56 3.77 ZZZ 15300 ......... ............ A Apply skinallogrft, t/arm/lg ............................. 4.65 3.36 3.24 2.10 2.20 0.49 8.50 8.38 7.24 7.34 090 15301 ......... ............ A Apply sknallogrft t/a/l addl ............................. 1.00 0.47 0.47 0.34 0.39 0.14 1.61 1.61 1.48 1.53 ZZZ 15320 ......... ............ A Apply skin allogrft f/n/hf/g .............................. 5.36 3.75 3.65 2.32 2.48 0.58 9.69 9.59 8.26 8.42 090 15321 ......... ............ A Aply sknallogrft f/n/hfg add ............................ 1.50 0.68 0.69 0.50 0.57 0.21 2.39 2.40 2.21 2.28 ZZZ 15330 ......... ............ A Aply acell alogrft t/arm/leg ............................. 3.99 3.14 3.18 1.90 2.14 0.49 7.62 7.66 6.38 6.62 090 15331 ......... ............ A Aply acell grft t/a/l add-on ............................. 1.00 0.46 0.46 0.34 0.39 0.14 1.60 1.60 1.48 1.53 ZZZ 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49093 

15335 ......... ............ A Apply acell graft, f/n/hf/g ............................... 4.50 3.40 3.45 2.06 2.35 0.55 8.45 8.50 7.11 7.40 090 15336 ......... ............ A Aply acell grft f/n/hf/g add ............................. 1.43 0.72 0.70 0.48 0.55 0.20 2.35 2.33 2.11 2.18 ZZZ 15340 ......... ............ A Apply cult skin substitute ............................... 3.72 3.79 3.95 2.72 2.74 0.41 7.92 8.08 6.85 6.87 010 15341 ......... ............ A Apply cult skin sub add-on ............................ 0.50 0.72 0.64 0.17 0.19 0.06 1.28 1.20 0.73 0.75 ZZZ 15360 ......... ............ A Apply cult derm sub, t/a/l .............................. 3.87 4.31 4.43 3.11 3.09 0.43 8.61 8.73 7.41 7.39 090 15361 ......... ............ A Aply cult derm sub t/a/l add .......................... 1.15 0.57 0.58 0.38 0.44 0.14 1.86 1.87 1.67 1.73 ZZZ 15365 ......... ............ A Apply cult derm sub f/n/hf/g .......................... 4.15 4.35 4.50 3.19 3.19 0.46 8.96 9.11 7.80 7.80 090 15366 ......... ............ A Apply cult derm f/hf/g add ............................. 1.45 0.69 0.70 0.48 0.56 0.17 2.31 2.32 2.10 2.18 ZZZ 15400 ......... ............ A Apply skin xenograft, t/a/l .............................. 4.32 4.91 4.24 3.69 3.93 0.47 9.70 9.03 8.48 8.72 090 15401 ......... ............ A Apply skn xenogrft t/a/l add .......................... 1.00 1.02 1.67 0.35 0.42 0.14 2.16 2.81 1.49 1.56 ZZZ 15420 ......... ............ A Apply skin xgraft, f/n/hf/g ............................... 4.83 5.04 4.85 3.86 3.81 0.52 10.39 10.20 9.21 9.16 090 15421 ......... ............ A Apply skn xgrft f/n/hf/g add ........................... 1.50 1.20 1.29 0.52 0.60 0.21 2.91 3.00 2.23 2.31 ZZZ 15430 ......... ............ A Apply acellular xenograft ............................... 5.75 7.01 6.93 6.44 6.57 0.66 13.42 13.34 12.85 12.98 090 15431 ......... ............ C Apply acellular xgraft add .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 15570 ......... ............ A Form skin pedicle flap ................................... 9.94 10.36 11.07 6.46 6.69 1.34 21.64 22.35 17.74 17.97 090 15572 ......... ............ A Form skin pedicle flap ................................... 9.88 9.74 9.55 6.62 6.49 1.20 20.82 20.63 17.70 17.57 090 15574 ......... ............ A Form skin pedicle flap ................................... 10.48 10.36 10.60 6.89 7.57 1.20 22.04 22.28 18.57 19.25 090 15576 ......... ............ A Form skin pedicle flap ................................... 9.18 9.50 9.69 6.39 6.76 0.87 19.55 19.74 16.44 16.81 090 15600 ......... ............ A Skin graft ....................................................... 1.91 5.28 7.02 2.71 2.97 0.27 7.46 9.20 4.89 5.15 090 15610 ......... ............ A Skin graft ....................................................... 2.42 5.55 4.91 3.03 3.32 0.35 8.32 7.68 5.80 6.09 090 15620 ......... ............ A Skin graft ....................................................... 3.57 6.33 7.42 3.80 3.86 0.35 10.25 11.34 7.72 7.78 090 15630 ......... ............ A Skin graft ....................................................... 3.90 6.89 7.00 4.18 4.16 0.34 11.13 11.24 8.42 8.40 090 15650 ......... ............ A Transfer skin pedicle flap .............................. 4.59 7.02 7.11 4.20 4.21 0.42 12.03 12.12 9.21 9.22 090 15732 ......... ............ A Muscle-skin graft, head/neck ........................ 19.62 14.71 17.21 11.13 11.94 1.99 36.32 38.82 32.74 33.55 090 15734 ......... ............ A Muscle-skin graft, trunk ................................. 19.52 15.75 17.52 11.89 12.25 2.61 37.88 39.65 34.02 34.38 090 15736 ......... ............ A Muscle-skin graft, arm ................................... 16.86 13.77 17.12 9.95 10.90 2.45 33.08 36.43 29.26 30.21 090 15738 ......... ............ A Muscle-skin graft, leg .................................... 18.86 14.03 16.99 10.41 11.39 2.65 35.54 38.50 31.92 32.90 090 15740 ......... ............ A Island pedicle flap graft ................................. 11.48 13.10 10.87 9.05 8.46 0.63 25.21 22.98 21.16 20.57 090 15750 ......... ............ A Neurovascular pedicle graft .......................... 12.64 NA NA 8.80 8.98 1.42 NA NA 22.86 23.04 090 15756 ......... ............ A Free myo/skin flap microvasc ....................... 36.64 NA NA 18.38 20.02 4.61 NA NA 59.63 61.27 090 15757 ......... ............ A Free skin flap, microvasc .............................. 36.85 NA NA 16.63 20.35 3.89 NA NA 57.37 61.09 090 15758 ......... ............ A Free fascial flap, microvasc .......................... 36.60 NA NA 16.47 20.30 4.23 NA NA 57.30 61.13 090 15760 ......... ............ A Composite skin graft ..................................... 9.61 10.14 10.05 6.84 7.16 0.85 20.60 20.51 17.30 17.62 090 15770 ......... ............ A Derma-fat-fascia graft .................................... 8.64 NA NA 6.56 6.65 1.05 NA NA 16.25 16.34 090 15775 ......... ............ R Hair transplant punch grafts .......................... 3.95 3.50 4.05 1.70 1.40 0.52 7.97 8.52 6.17 5.87 000 15776 ......... ............ R Hair transplant punch grafts .......................... 5.53 3.98 5.01 1.61 2.50 0.72 10.23 11.26 7.86 8.75 000 15780 ......... ............ A Abrasion treatment of skin ............................ 8.41 11.65 11.55 6.74 7.87 0.67 20.73 20.63 15.82 16.95 090 15781 ......... ............ A Abrasion treatment of skin ............................ 4.84 8.43 7.29 5.47 5.39 0.34 13.61 12.47 10.65 10.57 090 15782 ......... ............ A Abrasion treatment of skin ............................ 4.31 9.44 9.75 5.43 6.27 0.34 14.09 14.40 10.08 10.92 090 15783 ......... ............ A Abrasion treatment of skin ............................ 4.28 7.83 7.11 4.89 4.36 0.28 12.39 11.67 9.45 8.92 090 15786 ......... ............ A Abrasion, lesion, single ................................. 2.03 3.76 3.45 1.22 1.30 0.11 5.90 5.59 3.36 3.44 010 15787 ......... ............ A Abrasion, lesions, add-on .............................. 0.33 0.83 1.03 0.10 0.15 0.04 1.20 1.40 0.47 0.52 ZZZ 15788 ......... ............ R Chemical peel, face, epiderm ....................... 2.09 8.43 7.14 3.66 3.23 0.11 10.63 9.34 5.86 5.43 090 15789 ......... ............ R Chemical peel, face, dermal ......................... 4.91 9.00 8.32 5.56 4.99 0.20 14.11 13.43 10.67 10.10 090 15792 ......... ............ R Chemical peel, nonfacial ............................... 1.86 6.85 7.03 3.46 4.20 0.13 8.84 9.02 5.45 6.19 090 15793 ......... ............ A Chemical peel, nonfacial ............................... 3.73 5.54 6.10 3.27 4.10 0.19 9.46 10.02 7.19 8.02 090 15819 ......... ............ A Plastic surgery, neck ..................................... 10.37 NA NA 6.67 7.05 0.97 NA NA 18.01 18.39 090 15820 ......... ............ A Revision of lower eyelid ................................ 6.02 6.47 6.85 5.25 5.48 0.40 12.89 13.27 11.67 11.90 090 15821 ......... ............ A Revision of lower eyelid ................................ 6.59 6.73 7.20 5.41 5.64 0.45 13.77 14.24 12.45 12.68 090 15822 ......... ............ A Revision of upper eyelid ................................ 4.44 5.34 5.71 4.18 4.41 0.37 10.15 10.52 8.99 9.22 090 15823 ......... ............ A Revision of upper eyelid ................................ 8.04 7.59 7.79 6.29 6.40 0.50 16.13 16.33 14.83 14.94 090 15831 ......... ............ A Excise excessive skin tissue ......................... 13.57 NA NA 8.73 8.30 1.75 NA NA 24.05 23.62 090 15832 ......... ............ A Excise excessive skin tissue ......................... 12.57 NA NA 8.30 8.33 1.66 NA NA 22.53 22.56 090 15833 ......... ............ A Excise excessive skin tissue ......................... 11.62 NA NA 7.09 7.93 1.49 NA NA 20.20 21.04 090 15834 ......... ............ A Excise excessive skin tissue ......................... 11.89 NA NA 7.73 7.70 1.61 NA NA 21.23 21.20 090 15835 ......... ............ A Excise excessive skin tissue ......................... 12.71 NA NA 7.81 7.61 1.60 NA NA 22.12 21.92 090 15836 ......... ............ A Excise excessive skin tissue ......................... 10.33 NA NA 7.02 6.84 1.34 NA NA 18.69 18.51 090 15837 ......... ............ A Excise excessive skin tissue ......................... 9.30 8.79 8.61 5.78 6.97 1.18 19.27 19.09 16.26 17.45 090 15838 ......... ............ A Excise excessive skin tissue ......................... 8.00 NA NA 4.88 5.77 0.58 NA NA 13.46 14.35 090 15839 ......... ............ A Excise excessive skin tissue ......................... 10.25 9.40 8.97 6.19 6.34 1.22 20.87 20.44 17.66 17.81 090 15840 ......... ............ A Graft for face nerve palsy ............................. 14.67 NA NA 8.55 9.62 1.32 NA NA 24.54 25.61 090 15841 ......... ............ A Graft for face nerve palsy ............................. 25.57 NA NA 13.05 14.51 2.54 NA NA 41.16 42.62 090 15842 ......... ............ A Flap for face nerve palsy .............................. 40.55 NA NA 21.01 22.44 4.93 NA NA 66.49 67.92 090 15845 ......... ............ A Skin and muscle repair, face ........................ 13.93 NA NA 8.77 9.17 0.81 NA NA 23.51 23.91 090 15850 ......... ............ B Removal of sutures ....................................... 0.78 1.21 1.47 0.18 0.27 0.05 2.04 2.30 1.01 1.10 XXX 15851 ......... ............ A Removal of sutures ....................................... 0.86 1.33 1.59 0.24 0.29 0.06 2.25 2.51 1.16 1.21 000 

mstockstill on PROD1PC63 with PROPOSAL_2

49094 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

15852 ......... ............ A Dressing change not for burn ....................... 0.86 1.62 1.79 0.25 0.31 0.09 2.57 2.74 1.20 1.26 000 15860 ......... ............ A Test for blood flow in graft ............................ 1.95 NA NA 0.70 0.76 0.27 NA NA 2.92 2.98 000 15920 ......... ............ A Removal of tail bone ulcer ............................ 8.06 NA NA 5.83 5.62 1.04 NA NA 14.93 14.72 090 15922 ......... ............ A Removal of tail bone ulcer ............................ 10.13 NA NA 7.01 7.16 1.42 NA NA 18.56 18.71 090 15931 ......... ............ A Remove sacrum pressure sore ..................... 9.89 NA NA 5.55 5.65 1.25 NA NA 16.69 16.79 090 15933 ......... ............ A Remove sacrum pressure sore ..................... 11.49 NA NA 7.34 7.72 1.52 NA NA 20.35 20.73 090 15934 ......... ............ A Remove sacrum pressure sore ..................... 13.45 NA NA 7.61 7.93 1.78 NA NA 22.84 23.16 090 15935 ......... ............ A Remove sacrum pressure sore ..................... 15.45 NA NA 10.14 10.28 2.09 NA NA 27.68 27.82 090 15936 ......... ............ A Remove sacrum pressure sore ..................... 12.96 NA NA 7.49 8.04 1.76 NA NA 22.21 22.76 090 15937 ......... ............ A Remove sacrum pressure sore ..................... 14.91 NA NA 8.96 9.61 2.06 NA NA 25.93 26.58 090 15940 ......... ............ A Remove hip pressure sore ............................ 10.05 NA NA 5.84 6.09 1.31 NA NA 17.20 17.45 090 15941 ......... ............ A Remove hip pressure sore ............................ 12.13 NA NA 8.51 9.22 1.66 NA NA 22.30 23.01 090 15944 ......... ............ A Remove hip pressure sore ............................ 12.16 NA NA 8.24 8.51 1.65 NA NA 22.05 22.32 090 15945 ......... ............ A Remove hip pressure sore ............................ 13.45 NA NA 9.15 9.52 1.84 NA NA 24.44 24.81 090 15946 ......... ............ A Remove hip pressure sore ............................ 23.72 NA NA 13.95 14.27 3.16 NA NA 40.83 41.15 090 15950 ......... ............ A Remove thigh pressure sore ......................... 7.83 NA NA 5.40 5.41 1.04 NA NA 14.27 14.28 090 15951 ......... ............ A Remove thigh pressure sore ......................... 11.30 NA NA 8.00 7.90 1.49 NA NA 20.79 20.69 09015952 ......... ............ A Remove thigh pressure sore ......................... 12.03 NA NA 7.77 7.76 1.60 NA NA 21.40 21.39 09015953 ......... ............ A Remove thigh pressure sore ......................... 13.27 NA NA 9.10 9.02 1.79 NA NA 24.16 24.08 09015956 ......... ............ A Remove thigh pressure sore ......................... 16.46 NA NA 9.66 10.49 2.21 NA NA 28.33 29.16 090 15958 ......... ............ A Remove thigh pressure sore ......................... 16.42 NA NA 10.28 10.85 2.25 NA NA 28.95 29.52 090 15999 ......... ............ C Removal of pressure sore ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 16000 ......... ............ A Initial treatment of burn(s) ............................. 0.89 0.73 0.83 0.24 0.26 0.08 1.70 1.80 1.21 1.23 000 16020 ......... ............ A Dress/debrid p-thick burn, s .......................... 0.80 1.11 1.25 0.56 0.58 0.08 1.99 2.13 1.44 1.46 000 16025 ......... ............ A Dress/debrid p-thick burn, m ......................... 1.85 1.61 1.72 0.88 0.94 0.19 3.65 3.76 2.92 2.98 000 16030 ......... ............ A Dress/debrid p-thick burn, l ........................... 2.08 1.98 2.12 0.96 1.08 0.24 4.30 4.44 3.28 3.40 000 16035 ......... ............ A Incision of burn scab, initi ............................. 3.74 NA NA 1.27 1.50 0.46 NA NA 5.47 5.70 090 16036 ......... ............ A Escharotomy; addIl incision .......................... 1.50 NA NA 0.49 0.57 0.20 NA NA 2.19 2.27 ZZZ 17000 ......... ............ A Destroy benign/premlg lesion ........................ 0.60 1.36 1.07 0.71 0.58 0.03 1.99 1.70 1.34 1.21 010 17003 ......... ............ A Destroy lesions, 2–14 .................................... 0.07 0.10 0.11 0.03 0.06 0.01 0.18 0.19 0.11 0.14 ZZZ 17004 ......... ............ A Destroy lesions, 15 or more .......................... 1.58 2.23 2.28 1.20 1.49 0.11 3.92 3.97 2.89 3.18 010 17106 ......... ............ A Destruction of skin lesions ............................ 4.58 4.56 4.59 3.18 3.29 0.35 9.49 9.52 8.11 8.22 090 17107 ......... ............ A Destruction of skin lesions ............................ 9.15 7.08 7.17 5.01 5.34 0.63 16.86 16.95 14.79 15.12 090 17108 ......... ............ A Destruction of skin lesions ............................ 13.18 9.19 9.24 6.64 7.41 0.54 22.91 22.96 20.36 21.13 090 17110 ......... ............ A Destruct lesion, 1–14 .................................... 0.65 1.74 1.65 0.85 0.74 0.05 2.44 2.35 1.55 1.44 010 17111 ......... ............ A Destruct lesion, 15 or more ........................... 0.92 2.23 1.81 1.09 0.88 0.05 3.20 2.78 2.06 1.85 010 17250 ......... ............ A Chemical cautery, tissue ............................... 0.50 1.32 1.25 0.38 0.35 0.06 1.88 1.81 0.94 0.91 000 17260 ......... ............ A Destruction of skin lesions ............................ 0.91 1.37 1.30 0.68 0.67 0.04 2.32 2.25 1.63 1.62 010 17261 ......... ............ A Destruction of skin lesions ............................ 1.17 2.42 1.81 1.02 0.88 0.05 3.64 3.03 2.24 2.10 010 17262 ......... ............ A Destruction of skin lesions ............................ 1.58 2.74 2.10 1.22 1.07 0.06 4.38 3.74 2.86 2.71 010 17263 ......... ............ A Destruction of skin lesions ............................ 1.79 2.97 2.28 1.31 1.15 0.07 4.83 4.14 3.17 3.01 010 17264 ......... ............ A Destruction of skin lesions ............................ 1.94 3.17 2.46 1.38 1.19 0.08 5.19 4.48 3.40 3.21 010 17266 ......... ............ A Destruction of skin lesions ............................ 2.34 3.42 2.73 1.54 1.30 0.09 5.85 5.16 3.97 3.73 010 17270 ......... ............ A Destruction of skin lesions ............................ 1.32 2.36 1.87 1.05 0.92 0.05 3.73 3.24 2.42 2.29 010 17271 ......... ............ A Destruction of skin lesions ............................ 1.49 2.58 1.97 1.17 1.03 0.06 4.13 3.52 2.72 2.58 010 17272 ......... ............ A Destruction of skin lesions ............................ 1.77 2.88 2.21 1.31 1.16 0.07 4.72 4.05 3.15 3.00 010 17273 ......... ............ A Destruction of skin lesions ............................ 2.05 3.12 2.43 1.43 1.27 0.08 5.25 4.56 3.56 3.40 010 17274 ......... ............ A Destruction of skin lesions ............................ 2.59 3.50 2.80 1.68 1.50 0.10 6.19 5.49 4.37 4.19 010 17276 ......... ............ A Destruction of skin lesions ............................ 3.20 3.78 3.15 1.91 1.74 0.16 7.14 6.51 5.27 5.10 010 17280 ......... ............ A Destruction of skin lesions ............................ 1.17 2.29 1.78 0.99 0.86 0.05 3.51 3.00 2.21 2.08 010 17281 ......... ............ A Destruction of skin lesions ............................ 1.72 2.65 2.09 1.28 1.14 0.07 4.44 3.88 3.07 2.93 010 17282 ......... ............ A Destruction of skin lesions ............................ 2.04 3.04 2.37 1.43 1.29 0.08 5.16 4.49 3.55 3.41 010 17283 ......... ............ A Destruction of skin lesions ............................ 2.64 3.45 2.77 1.70 1.54 0.11 6.20 5.52 4.45 4.29 010 17284 ......... ............ A Destruction of skin lesions ............................ 3.21 3.86 3.16 1.95 1.80 0.13 7.20 6.50 5.29 5.14 010 17286 ......... ............ A Destruction of skin lesions ............................ 4.43 4.28 3.82 2.38 2.43 0.23 8.94 8.48 7.04 7.09 010 17304 ......... ............ A 1 stage mohs, up to 5 spec .......................... 7.59 11.63 9.09 3.58 3.57 0.30 19.52 16.98 11.47 11.46 000 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49095 

17305 ......... ............ A 2 stage mohs, up to 5 spec .......................... 2.85 6.74 4.60 1.34 1.34 0.11 9.70 7.56 4.30 4.30 000 17306 ......... ............ A 3 stage mohs, up to 5 spec .......................... 2.85 6.99 4.68 1.33 1.35 0.11 9.95 7.64 4.29 4.31 000 17307 ......... ............ A Mohs addl stage up to 5 spec ...................... 2.85 6.74 4.36 1.34 1.36 0.11 9.70 7.32 4.30 4.32 000 17310 ......... ............ A Mohs any stage > 5 spec each .................... 0.95 1.94 1.70 0.45 0.46 0.03 2.92 2.68 1.43 1.44 ZZZ 17340 ......... ............ A Cryotherapy of skin ....................................... 0.76 0.33 0.36 0.36 0.36 0.05 1.14 1.17 1.17 1.17 010 17360 ......... ............ A Skin peel therapy .......................................... 1.43 1.38 1.43 0.95 0.89 0.06 2.87 2.92 2.44 2.38 010 17999 ......... ............ C Skin tissue procedure .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 19000 ......... ............ A Drainage of breast lesion .............................. 0.84 1.90 1.96 0.24 0.29 0.08 2.82 2.88 1.16 1.21 000 19001 ......... ............ A Drain breast lesion add-on ............................ 0.42 0.24 0.25 0.12 0.14 0.04 0.70 0.71 0.58 0.60 ZZZ 19020 ......... ............ A Incision of breast lesion ................................ 3.68 6.67 6.42 3.05 2.77 0.45 10.80 10.55 7.18 6.90 090 19030 ......... ............ A Injection for breast x-ray ............................... 1.53 2.62 2.80 0.48 0.50 0.09 4.24 4.42 2.10 2.12 000 19100 ......... ............ A Bx breast percut w/o image .......................... 1.27 2.09 2.08 0.33 0.40 0.16 3.52 3.51 1.76 1.83 000 19101 ......... ............ A Biopsy of breast, open .................................. 3.18 4.35 4.46 1.77 1.88 0.39 7.92 8.03 5.34 5.45 010 19102 ......... ............ A Bx breast percut w/image ............................. 2.00 3.41 3.73 0.61 0.65 0.14 5.55 5.87 2.75 2.79 000 19103 ......... ............ A Bx breast percut w/device ............................. 3.69 10.05 11.13 1.09 1.20 0.30 14.04 15.12 5.08 5.19 000 19110 ......... ............ A Nipple exploration .......................................... 4.29 6.45 5.96 3.28 2.97 0.57 11.31 10.82 8.14 7.83 090 19112 ......... ............ A Excise breast duct fistula .............................. 3.66 6.31 6.12 3.17 2.80 0.48 10.45 10.26 7.31 6.94 090 19120 ......... ............ A Removal of breast lesion .............................. 5.80 5.12 4.69 3.39 3.14 0.73 11.65 11.22 9.92 9.67 090 19125 ......... ............ A Excision, breast lesion .................................. 6.55 5.60 4.99 3.68 3.38 0.80 12.95 12.34 11.03 10.73 090 19126 ......... ............ A Excision, addl breast lesion .......................... 2.93 NA NA 0.76 0.94 0.38 NA NA 4.07 4.25 ZZZ19140 ......... ............ A Removal of breast tissue .............................. 5.13 8.06 7.37 3.85 3.51 0.69 13.88 13.19 9.67 9.33 090 19160 ......... ............ A Partial mastectomy ........................................ 5.98 NA NA 3.64 3.48 0.79 NA NA 10.41 10.25 090 19162 ......... ............ A P-mastectomy w/ln removal .......................... 13.81 NA NA 6.16 6.29 1.79 NA NA 21.76 21.89 09019180 ......... ............ A Removal of breast ......................................... 15.61 NA NA 7.07 5.53 1.18 NA NA 23.86 22.32 090 19182 ......... ............ A Removal of breast ......................................... 7.72 NA NA 5.01 4.82 1.04 NA NA 13.77 13.58 090 19200 ......... ............ A Removal of breast ......................................... 17.14 NA NA 8.22 8.03 1.92 NA NA 27.28 27.09 090 19220 ......... ............ A Removal of breast ......................................... 17.74 NA NA 8.69 8.35 2.07 NA NA 28.50 28.16 090 19240 ......... ............ A Removal of breast ......................................... 17.84 NA NA 8.85 8.36 2.12 NA NA 28.81 28.32 090 19260 ......... ............ A Removal of chest wall lesion ........................ 17.53 NA NA 10.33 10.95 2.13 NA NA 29.99 30.61 090 19271 ......... ............ A Revision of chest wall ................................... 21.73 NA NA 16.03 17.47 2.62 NA NA 40.38 41.82 090 19272 ......... ............ A Extensive chest wall surgery ......................... 24.68 NA NA 17.13 18.48 2.99 NA NA 44.80 46.15 090 19290 ......... ............ A Place needle wire, breast .............................. 1.27 2.85 2.85 0.39 0.41 0.07 4.19 4.19 1.73 1.75 000 19291 ......... ............ A Place needle wire, breast .............................. 0.63 1.12 1.19 0.20 0.21 0.04 1.79 1.86 0.87 0.88 ZZZ 19295 ......... ............ A Place breast clip, percut ................................ 0.00 2.30 2.59 0.00 2.02 0.01 2.31 2.60 0.01 2.03 ZZZ 19296 ......... ............ A Place po breast cath for rad ......................... 3.63 85.32 115.4 1.21 1.45 0.36 89.31 119.4 5.20 5.44 000 19297 ......... ............ A Place breast cath for rad ............................... 1.72 NA NA 0.47 0.60 0.17 NA NA 2.36 2.49 ZZZ 19298 ......... ............ A Place breast rad tube/caths .......................... 6.00 22.79 37.32 1.92 2.29 0.43 29.22 43.75 8.35 8.72 000 19316 ......... ............ A Suspension of breast .................................... 10.92 NA NA 7.10 7.41 1.64 NA NA 19.66 19.97 090 19318 ......... ............ A Reduction of large breast .............................. 15.85 NA NA 9.99 10.88 2.92 NA NA 28.76 29.65 090 19324 ......... ............ A Enlarge breast ............................................... 6.59 NA NA 4.67 4.84 0.84 NA NA 12.10 12.27 090 19325 ......... ............ A Enlarge breast with implant ........................... 8.44 NA NA 6.46 6.51 1.33 NA NA 16.23 16.28 090 19328 ......... ............ A Removal of breast implant ............................ 6.30 NA NA 5.03 5.02 0.91 NA NA 12.24 12.23 090 19330 ......... ............ A Removal of implant material ......................... 8.33 NA NA 6.21 6.08 1.26 NA NA 15.80 15.67 09019340 ......... ............ A Immediate breast prosthesis ......................... 6.32 NA NA 2.86 3.05 1.06 NA NA 10.24 10.43 ZZZ19342 ......... ............ A Delayed breast prosthesis ............................. 12.31 NA NA 9.01 8.94 1.83 NA NA 23.15 23.08 090 19350 ......... ............ A Breast reconstruction .................................... 8.91 9.93 12.86 6.61 7.03 1.41 20.25 23.18 16.93 17.35 090 19355 ......... ............ A Correct inverted nipple(s) .............................. 8.31 7.78 9.63 4.93 4.76 0.92 17.01 18.86 14.16 13.99 090 19357 ......... ............ A Breast reconstruction .................................... 20.33 NA NA 15.50 15.58 2.93 NA NA 38.76 38.84 090 19361 ......... ............ A Breast reconstruction .................................... 20.63 NA NA 12.36 12.41 2.92 NA NA 35.91 35.96 090 19364 ......... ............ A Breast reconstruction .................................... 42.30 NA NA 22.88 23.38 6.22 NA NA 71.40 71.90 090 19366 ......... ............ A Breast reconstruction .................................... 21.62 NA NA 10.10 11.21 3.24 NA NA 34.96 36.07 090 19367 ......... ............ A Breast reconstruction .................................... 26.51 NA NA 15.33 16.35 4.03 NA NA 45.87 46.89 090 19368 ......... ............ A Breast reconstruction .................................... 33.51 NA NA 18.23 18.75 5.52 NA NA 57.26 57.78 090 19369 ......... ............ A Breast reconstruction .................................... 30.92 NA NA 15.98 17.80 4.50 NA NA 51.40 53.22 090 19370 ......... ............ A Surgery of breast capsule ............................. 8.92 NA NA 6.86 6.89 1.29 NA NA 17.07 17.10 090 19371 ......... ............ A Removal of breast capsule ........................... 10.34 NA NA 7.74 7.80 1.62 NA NA 19.70 19.76 090 19380 ......... ............ A Revise breast reconstruction ......................... 10.13 NA NA 7.67 7.69 1.44 NA NA 19.24 19.26 090 19396 ......... ............ A Design custom breast implant ....................... 2.17 4.52 1.94 1.24 1.05 0.30 6.99 4.41 3.71 3.52 000 19499 ......... ............ C Breast surgery procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 20000 ......... ............ A Incision of abscess ........................................ 2.12 2.79 2.72 1.53 1.68 0.25 5.16 5.09 3.90 4.05 010 20005 ......... ............ A Incision of deep abscess ............................... 3.53 3.72 3.55 2.04 2.20 0.46 7.71 7.54 6.03 6.19 010 20100 ......... ............ A Explore wound, neck ..................................... 10.31 NA NA 3.63 4.25 1.21 NA NA 15.15 15.77 010 20101 ......... ............ A Explore wound, chest .................................... 3.22 6.46 6.06 1.52 1.60 0.44 10.12 9.72 5.18 5.26 010 20102 ......... ............ A Explore wound, abdomen ............................. 3.93 6.99 7.34 1.85 1.89 0.49 11.41 11.76 6.27 6.31 010 20103 ......... ............ A Explore wound, extremity .............................. 5.29 7.72 8.37 2.73 3.23 0.75 13.76 14.41 8.77 9.27 010 20150 ......... ............ A Excise epiphyseal bar ................................... 14.54 NA NA 7.73 7.21 2.03 NA NA 24.30 23.78 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49096 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

20200 ......... ............ A Muscle biopsy ................................................ 1.46 3.17 3.07 0.70 0.74 0.23 4.86 4.76 2.39 2.43 000 20205 ......... ............ A Deep muscle biopsy ...................................... 2.35 3.86 3.88 1.11 1.17 0.33 6.54 6.56 3.79 3.85 000 20206 ......... ............ A Needle biopsy, muscle .................................. 0.99 5.25 6.19 0.54 0.61 0.07 6.31 7.25 1.60 1.67 000 20220 ......... ............ A Bone biopsy, trocar/needle ........................... 1.27 2.71 4.10 0.65 0.76 0.08 4.06 5.45 2.00 2.11 000 20225 ......... ............ A Bone biopsy, trocar/needle ........................... 1.87 13.16 21.63 1.03 1.11 0.22 15.25 23.72 3.12 3.20 000 20240 ......... ............ A Bone biopsy, excisional ................................. 3.23 NA NA 2.07 2.43 0.44 NA NA 5.74 6.10 010 20245 ......... ............ A Bone biopsy, excisional ................................. 8.71 NA NA 5.79 6.38 1.31 NA NA 15.81 16.40 010 20250 ......... ............ A Open bone biopsy ......................................... 5.14 NA NA 3.74 3.56 1.02 NA NA 9.90 9.72 010 20251 ......... ............ A Open bone biopsy ......................................... 5.67 NA NA 3.91 4.10 1.15 NA NA 10.73 10.92 010 20500 ......... ............ A Injection of sinus tract ................................... 1.23 1.30 2.02 0.85 1.36 0.12 2.65 3.37 2.20 2.71 010 20501 ......... ............ A Inject sinus tract for x-ray .............................. 0.76 2.35 2.77 0.24 0.25 0.04 3.15 3.57 1.04 1.05 000 20520 ......... ............ A Removal of foreign body ............................... 1.85 2.59 2.83 1.44 1.68 0.21 4.65 4.89 3.50 3.74 010 20525 ......... ............ A Removal of foreign body ............................... 3.49 7.09 8.63 2.20 2.52 0.51 11.09 12.63 6.20 6.52 010 20526 ......... ............ A Ther injection, carp tunnel ............................. 0.94 0.82 0.93 0.41 0.49 0.13 1.89 2.00 1.48 1.56 000 20550 ......... ............ A Inj tendon sheath/ligament ............................ 0.75 0.63 0.69 0.28 0.24 0.09 1.47 1.53 1.12 1.08 000 20551 ......... ............ A Inj tendon origin/insertion .............................. 0.75 0.64 0.67 0.29 0.32 0.08 1.47 1.50 1.12 1.15 000 20552 ......... ............ A Inj trigger point, 1/2 muscl ............................. 0.66 0.58 0.69 0.25 0.21 0.05 1.29 1.40 0.96 0.92 000 20553 ......... ............ A Inject trigger points, =/> 3 ............................. 0.75 0.65 0.78 0.27 0.23 0.04 1.44 1.57 1.06 1.02 000 20600 ......... ............ A Drain/inject, joint/bursa .................................. 0.66 0.67 0.66 0.31 0.34 0.08 1.41 1.40 1.05 1.08 000 20605 ......... ............ A Drain/inject, joint/bursa .................................. 0.68 0.74 0.76 0.33 0.35 0.08 1.50 1.52 1.09 1.11 000 20610 ......... ............ A Drain/inject, joint/bursa .................................. 0.79 1.07 0.98 0.40 0.42 0.11 1.97 1.88 1.30 1.32 000 20612 ......... ............ A Aspirate/inj ganglion cyst .............................. 0.70 0.70 0.71 0.32 0.35 0.10 1.50 1.51 1.12 1.15 000 20615 ......... ............ A Treatment of bone cyst ................................. 2.28 2.72 3.31 1.41 1.73 0.20 5.20 5.79 3.89 4.21 010 20650 ......... ............ A Insert and remove bone pin .......................... 2.23 2.51 2.40 1.48 1.53 0.31 5.05 4.94 4.02 4.07 010 20660 ......... ............ A Apply, rem fixation device ............................. 2.51 3.39 3.14 1.50 1.58 0.59 6.49 6.24 4.60 4.68 000 20661 ......... ............ A Application of head brace ............................. 5.06 NA NA 6.00 5.18 1.14 NA NA 12.20 11.38 090 20662 ......... ............ A Application of pelvis brace ............................ 6.18 NA NA 4.85 5.35 0.56 NA NA 11.59 12.09 090 20663 ......... ............ A Application of thigh brace .............................. 5.54 NA NA 5.14 4.91 0.94 NA NA 11.62 11.39 090 20664 ......... ............ A Halo brace application ................................... 9.78 NA NA 8.13 7.31 1.74 NA NA 19.65 18.83 090 20665 ......... ............ A Removal of fixation device ............................ 1.31 1.38 1.96 0.97 1.26 0.19 2.88 3.46 2.47 2.76 010 20670 ......... ............ A Removal of support implant .......................... 1.74 6.70 10.33 1.68 2.00 0.28 8.72 12.35 3.70 4.02 010 20680 ......... ............ A Removal of support implant .......................... 5.86 8.20 8.64 4.10 3.82 0.56 14.62 15.06 10.52 10.24 090 20690 ......... ............ A Apply bone fixation device ............................ 3.63 NA NA 2.27 2.45 0.59 NA NA 6.49 6.67 09020692 ......... ............ A Apply bone fixation device ............................ 6.40 NA NA 3.29 3.65 1.05 NA NA 10.74 11.10 090 20693 ......... ............ A Adjust bone fixation device ........................... 5.91 NA NA 4.54 5.22 0.98 NA NA 11.43 12.11 090 20694 ......... ............ A Remove bone fixation device ........................ 4.15 5.37 6.70 3.56 3.92 0.71 10.23 11.56 8.42 8.78 090 20802 ......... ............ A Replantation, arm, complete ......................... 42.16 NA NA 24.05 21.73 3.81 NA NA 70.02 67.70 090 20805 ......... ............ A Replant forearm, complete ............................ 51.00 NA NA 25.95 32.22 4.84 NA NA 81.79 88.06 090 20808 ......... ............ A Replantation hand, complete ........................ 62.63 NA NA 38.79 41.36 6.86 NA NA 108.28 110.85 090 20816 ......... ............ A Replantation digit, complete .......................... 31.64 NA NA 24.53 34.48 4.52 NA NA 60.69 70.64 090 20822 ......... ............ A Replantation digit, complete .......................... 26.30 NA NA 22.24 31.50 4.18 NA NA 52.72 61.98 090 20824 ......... ............ A Replantation thumb, complete ...................... 31.64 NA NA 25.77 33.85 4.61 NA NA 62.02 70.10 090 20827 ......... ............ A Replantation thumb, complete ...................... 27.12 NA NA 23.90 33.33 3.66 NA NA 54.68 64.11 090 20838 ......... ............ A Replantation foot, complete .......................... 42.42 NA NA 13.65 20.12 1.12 NA NA 57.19 63.66 090 20900 ......... ............ A Removal of bone for graft ............................. 5.69 9.33 8.66 4.95 5.49 0.94 15.96 15.29 11.58 12.12 090 20902 ......... ............ A Removal of bone for graft ............................. 7.90 NA NA 5.84 6.62 1.30 NA NA 15.04 15.82 090 20910 ......... ............ A Remove cartilage for graft ............................. 5.33 NA NA 4.62 5.04 0.71 NA NA 10.66 11.08 090 20912 ......... ............ A Remove cartilage for graft ............................. 6.34 NA NA 4.67 5.51 0.69 NA NA 11.70 12.54 090 20920 ......... ............ A Removal of fascia for graft ............................ 5.36 NA NA 4.36 4.26 0.66 NA NA 10.38 10.28 090 20922 ......... ............ A Removal of fascia for graft ............................ 6.78 7.52 7.54 4.96 4.89 0.70 15.00 15.02 12.44 12.37 090 20924 ......... ............ A Removal of tendon for graft .......................... 6.53 NA NA 5.00 5.66 1.04 NA NA 12.57 13.23 090 20926 ......... ............ A Removal of tissue for graft ............................ 5.64 NA NA 4.41 4.67 0.87 NA NA 10.92 11.18 090 20931 ......... ............ A Spinal bone allograft ..................................... 1.81 NA NA 0.69 0.87 0.43 NA NA 2.93 3.11 ZZZ 20937 ......... ............ A Spinal bone autograft .................................... 2.79 NA NA 1.09 1.36 0.54 NA NA 4.42 4.69 ZZZ 20938 ......... ............ A Spinal bone autograft .................................... 3.02 NA NA 1.16 1.46 0.64 NA NA 4.82 5.12 ZZZ 20950 ......... ............ A Fluid pressure, muscle .................................. 1.26 4.19 6.18 0.88 0.96 0.20 5.65 7.64 2.34 2.42 000 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49097 

20955 ......... ............ A Fibula bone graft, microvasc ......................... 39.90 NA NA 18.08 22.72 4.89 NA NA 62.87 67.51 090 20956 ......... ............ A Iliac bone graft, microvasc ............................ 40.79 NA NA 20.77 23.75 7.01 NA NA 68.57 71.55 090 20957 ......... ............ A Mt bone graft, microvasc ............................... 42.17 NA NA 19.43 19.06 7.05 NA NA 68.65 68.28 090 20962 ......... ............ A Other bone graft, microvasc .......................... 39.21 NA NA 21.28 25.21 6.55 NA NA 67.04 70.97 090 20969 ......... ............ A Bone/skin graft, microvasc ............................ 44.99 NA NA 20.27 25.04 4.79 NA NA 70.05 74.82 090 20970 ......... ............ A Bone/skin graft, iliac crest ............................. 44.14 NA NA 20.21 24.09 6.60 NA NA 70.95 74.83 090 20972 ......... ............ A Bone/skin graft, metatarsal ........................... 44.07 NA NA 17.61 19.84 5.30 NA NA 66.98 69.21 090 20973 ......... ............ A Bone/skin graft, great toe .............................. 46.83 NA NA 15.05 22.63 5.54 NA NA 67.42 75.00 090 20974 ......... ............ A Electrical bone stimulation ............................ 0.62 0.99 0.77 0.49 0.53 0.11 1.72 1.50 1.22 1.26 000 20975 ......... ............ A Electrical bone stimulation ............................ 2.60 NA NA 1.48 1.65 0.51 NA NA 4.59 4.76 000 20979 ......... ............ A Us bone stimulation ....................................... 0.62 0.58 0.75 0.19 0.30 0.09 1.29 1.46 0.90 1.01 000 20982 ......... ............ A Ablate, bone tumor(s) perq ........................... 7.27 83.20 103.0 2.62 2.88 0.69 91.16 110.9 10.58 10.84 000 20999 ......... ............ C Musculoskeletal surgery ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21010 ......... ............ A Incision of jaw joint ........................................ 10.82 NA NA 5.85 6.78 1.11 NA NA 17.78 18.71 090 21015 ......... ............ A Resection of facial tumor .............................. 5.53 NA NA 4.30 4.83 0.70 NA NA 10.53 11.06 090 21025 ......... ............ A Excision of bone, lower jaw .......................... 10.99 12.48 12.30 8.68 9.18 1.32 24.79 24.61 20.99 21.49 090 21026 ......... ............ A Excision of facial bone(s) .............................. 5.46 8.70 8.07 5.84 6.20 0.60 14.76 14.13 11.90 12.26 090 21029 ......... ............ A Contour of face bone lesion .......................... 8.20 9.26 9.34 6.27 6.83 0.94 18.40 18.48 15.41 15.97 090 21030 ......... ............ A Excise max/zygoma b9 tumor ....................... 4.74 7.18 6.54 4.67 4.94 0.54 12.46 11.82 9.95 10.22 090 21031 ......... ............ A Remove exostosis, mandible ........................ 3.24 5.99 5.38 3.51 3.59 0.48 9.71 9.10 7.23 7.31 090 21032 ......... ............ A Remove exostosis, maxilla ............................ 3.24 6.07 5.52 3.37 3.48 0.47 9.78 9.23 7.08 7.19 090 21034 ......... ............ A Excise max/zygoma mlg tumor ..................... 17.09 13.17 15.23 9.51 11.87 1.71 31.97 34.03 28.31 30.67 090 21040 ......... ............ A Excise mandible lesion .................................. 4.74 7.25 6.61 4.67 4.71 0.54 12.53 11.89 9.95 9.99 090 21044 ......... ............ A Removal of jaw bone lesion .......................... 12.53 NA NA 7.48 8.90 1.12 NA NA 21.13 22.55 090 21045 ......... ............ A Extensive jaw surgery ................................... 18.03 NA NA 10.01 11.77 1.52 NA NA 29.56 31.32 090 21046 ......... ............ A Remove mandible cyst complex ................... 13.85 NA NA 11.62 11.83 1.85 NA NA 27.32 27.53 090 21047 ......... ............ A Excise lwr jaw cyst w/repair .......................... 19.71 NA NA 9.74 12.52 2.12 NA NA 31.57 34.35 090 21048 ......... ............ A Remove maxilla cyst complex ....................... 14.35 NA NA 11.37 11.94 1.76 NA NA 27.48 28.05 090 21049 ......... ............ A Excis uppr jaw cyst w/repair ......................... 18.96 NA NA 9.09 12.04 1.59 NA NA 29.64 32.59 090 21050 ......... ............ A Removal of jaw joint ...................................... 11.44 NA NA 8.18 9.13 1.47 NA NA 21.09 22.04 090 21060 ......... ............ A Remove jaw joint cartilage ............................ 10.83 NA NA 7.52 8.34 1.38 NA NA 19.73 20.55 090 21070 ......... ............ A Remove coronoid process ............................ 8.44 NA NA 6.15 6.86 1.27 NA NA 15.86 16.57 090 21076 ......... ............ A Prepare face/oral prosthesis ......................... 13.40 7.85 11.23 4.80 8.70 1.99 23.24 26.62 20.19 24.09 010 21077 ......... ............ A Prepare face/oral prosthesis ......................... 33.70 18.26 28.06 12.31 22.58 4.55 56.51 66.31 50.56 60.83 090 21079 ......... ............ A Prepare face/oral prosthesis ......................... 22.31 13.35 19.46 8.28 14.93 3.15 38.81 44.92 33.74 40.39 090 21080 ......... ............ A Prepare face/oral prosthesis ......................... 25.06 15.43 22.23 9.22 16.83 3.74 44.23 51.03 38.02 45.63 090 21081 ......... ............ A Prepare face/oral prosthesis ......................... 22.85 14.17 20.27 8.48 15.24 3.20 40.22 46.32 34.53 41.29 090 21082 ......... ............ A Prepare face/oral prosthesis ......................... 20.84 14.12 18.04 8.42 13.90 3.11 38.07 41.99 32.37 37.85 090 21083 ......... ............ A Prepare face/oral prosthesis ......................... 19.27 14.06 17.61 7.91 12.80 2.88 36.21 39.76 30.06 34.95 090 21084 ......... ............ A Prepare face/oral prosthesis ......................... 22.48 15.56 20.71 8.82 15.48 2.18 40.22 45.37 33.48 40.14 090 21085 ......... ............ A Prepare face/oral prosthesis ......................... 8.99 6.54 7.85 3.57 5.98 1.27 16.80 18.11 13.83 16.24 010 21086 ......... ............ A Prepare face/oral prosthesis ......................... 24.88 12.62 20.96 8.63 16.73 3.71 41.21 49.55 37.22 45.32 090 21087 ......... ............ A Prepare face/oral prosthesis ......................... 24.88 12.85 20.67 8.82 16.60 3.44 41.17 48.99 37.14 44.92 090 21088 ......... ............ C Prepare face/oral prosthesis ......................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 090 21100 ......... ............ A Maxillofacial fixation ...................................... 4.46 13.75 12.09 5.05 4.82 0.34 18.55 16.89 9.85 9.62 090 21110 ......... ............ A Interdental fixation ......................................... 5.70 13.26 10.49 9.89 8.74 0.72 19.68 16.91 16.31 15.16 090 21116 ......... ............ A Injection, jaw joint x-ray ................................. 0.81 2.44 3.86 0.22 0.30 0.06 3.31 4.73 1.09 1.17 000 21120 ......... ............ A Reconstruction of chin ................................... 4.92 10.02 10.44 6.88 7.34 0.60 15.54 15.96 12.40 12.86 090 21121 ......... ............ A Reconstruction of chin ................................... 7.63 10.59 9.95 7.50 7.74 0.90 19.12 18.48 16.03 16.27 090 21122 ......... ............ A Reconstruction of chin ................................... 8.51 NA NA 7.64 8.38 1.07 NA NA 17.22 17.96 090 21123 ......... ............ A Reconstruction of chin ................................... 11.14 NA NA 10.06 10.62 1.40 NA NA 22.60 23.16 090 21125 ......... ............ A Augmentation, lower jaw bone ...................... 10.60 68.89 58.64 7.04 8.00 0.79 80.28 70.03 18.43 19.39 090 21127 ......... ............ A Augmentation, lower jaw bone ...................... 12.16 86.74 53.79 7.70 9.01 1.52 100.4 67.47 21.38 22.69 090 21137 ......... ............ A Reduction of forehead ................................... 10.06 NA NA 6.30 7.37 1.32 NA NA 17.68 18.75 090 21138 ......... ............ A Reduction of forehead ................................... 12.67 NA NA 8.50 9.27 1.74 NA NA 22.91 23.68 090 21139 ......... ............ A Reduction of forehead ................................... 14.84 NA NA 8.49 10.42 1.18 NA NA 24.51 26.44 090 21141 ......... ............ A Reconstruct midface, lefort ........................... 19.13 NA NA 11.47 13.11 2.35 NA NA 32.95 34.59 090 21142 ......... ............ A Reconstruct midface, lefort ........................... 19.84 NA NA 10.53 12.25 2.38 NA NA 32.75 34.47 090 21143 ......... ............ A Reconstruct midface, lefort ........................... 20.61 NA NA 8.90 12.96 1.66 NA NA 31.17 35.23 090 21145 ......... ............ A Reconstruct midface, lefort ........................... 23.52 NA NA 12.75 13.61 2.84 NA NA 39.11 39.97 090 21146 ......... ............ A Reconstruct midface, lefort ........................... 24.42 NA NA 9.45 13.86 3.09 NA NA 36.96 41.37 090 21147 ......... ............ A Reconstruct midface, lefort ........................... 26.01 NA NA 13.58 14.68 1.84 NA NA 41.43 42.53 090 21150 ......... ............ A Reconstruct midface, lefort ........................... 25.70 NA NA 13.25 15.88 2.55 NA NA 41.50 44.13 090 21151 ......... ............ A Reconstruct midface, lefort ........................... 28.76 NA NA 11.72 20.14 2.30 NA NA 42.78 51.20 090 21154 ......... ............ A Reconstruct midface, lefort ........................... 30.95 NA NA 21.25 22.65 2.48 NA NA 54.68 56.08 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49098 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

21155 ......... ............ A Reconstruct midface, lefort ........................... 34.88 NA NA 13.43 21.28 6.64 NA NA 54.95 62.80 090 21159 ......... ............ A Reconstruct midface, lefort ........................... 42.80 NA NA 15.27 25.63 8.18 NA NA 66.25 76.61 090 21160 ......... ............ A Reconstruct midface, lefort ........................... 46.85 NA NA 23.11 26.38 4.13 NA NA 74.09 77.36 090 21172 ......... ............ A Reconstruct orbit/forehead ............................ 28.01 NA NA 13.59 13.71 3.55 NA NA 45.15 45.27 090 21175 ......... ............ A Reconstruct orbit/forehead ............................ 33.37 NA NA 12.92 16.57 4.83 NA NA 51.12 54.77 090 21179 ......... ............ A Reconstruct entire forehead .......................... 22.47 NA NA 10.96 13.34 2.80 NA NA 36.23 38.61 090 21180 ......... ............ A Reconstruct entire forehead .......................... 25.40 NA NA 13.01 14.79 3.48 NA NA 41.89 43.67 090 21181 ......... ............ A Contour cranial bone lesion .......................... 10.14 NA NA 7.05 7.36 1.32 NA NA 18.51 18.82 090 21182 ......... ............ A Reconstruct cranial bone .............................. 32.39 NA NA 14.29 17.91 2.80 NA NA 49.48 53.10 090 21183 ......... ............ A Reconstruct cranial bone .............................. 35.51 NA NA 15.48 19.49 4.47 NA NA 55.46 59.47 090 21184 ......... ............ A Reconstruct cranial bone .............................. 38.43 NA NA 21.02 21.71 5.70 NA NA 65.15 65.84 090 21188 ......... ............ A Reconstruction of midface ............................. 22.91 NA NA 14.82 17.86 1.69 NA NA 39.42 42.46 090 21193 ......... ............ A Reconst lwr jaw w/o graft .............................. 18.55 NA NA 10.06 12.00 2.23 NA NA 30.84 32.78 090 21194 ......... ............ A Reconst lwr jaw w/graft ................................. 21.43 NA NA 11.45 13.18 2.02 NA NA 34.90 36.63 090 21195 ......... ............ A Reconst lwr jaw w/o fixation .......................... 18.77 NA NA 13.26 14.43 1.64 NA NA 33.67 34.84 090 21196 ......... ............ A Reconst lwr jaw w/fixation ............................. 20.44 NA NA 13.20 15.07 2.07 NA NA 35.71 37.58 090 21198 ......... ............ A Reconstr lwr jaw segment ............................. 15.39 NA NA 11.05 12.29 1.44 NA NA 27.88 29.12 090 21199 ......... ............ A Reconstr lwr jaw w/advance ......................... 16.56 NA NA 6.79 8.53 1.39 NA NA 24.74 26.48 09021206 ......... ............ A Reconstruct upper jaw bone ......................... 15.27 NA NA 11.15 12.26 1.33 NA NA 27.75 28.86 090 21208 ......... ............ A Augmentation of facial bones ........................ 11.03 32.43 24.86 7.71 9.11 1.09 44.55 36.98 19.83 21.23 090 21209 ......... ............ A Reduction of facial bones .............................. 7.46 12.33 11.18 7.42 7.91 0.90 20.69 19.54 15.78 16.27 090 21210 ......... ............ A Face bone graft ............................................. 11.28 43.84 29.61 7.70 8.94 1.30 56.42 42.19 20.28 21.52 090 21215 ......... ............ A Lower jaw bone graft ..................................... 11.82 86.57 53.05 7.99 9.02 1.53 99.92 66.40 21.34 22.37 090 21230 ......... ............ A Rib cartilage graft .......................................... 11.00 NA NA 6.94 7.77 1.29 NA NA 19.23 20.06 090 21235 ......... ............ A Ear cartilage graft .......................................... 7.21 9.70 9.81 5.89 6.28 0.61 17.52 17.63 13.71 14.10 090 21240 ......... ............ A Reconstruction of jaw joint ............................ 15.65 NA NA 11.31 11.87 2.24 NA NA 29.20 29.76 090 21242 ......... ............ A Reconstruction of jaw joint ............................ 14.20 NA NA 10.64 11.29 1.78 NA NA 26.62 27.27 090 21243 ......... ............ A Reconstruction of jaw joint ............................ 23.83 NA NA 15.77 17.02 3.25 NA NA 42.85 44.10 090 21244 ......... ............ A Reconstruction of lower jaw .......................... 13.23 NA NA 10.93 11.80 1.25 NA NA 25.41 26.28 090 21245 ......... ............ A Reconstruction of jaw .................................... 12.78 13.37 14.14 7.99 9.39 1.19 27.34 28.11 21.96 23.36 090 21246 ......... ............ A Reconstruction of jaw .................................... 12.70 NA NA 6.67 8.45 1.35 NA NA 20.72 22.50 090 21247 ......... ............ A Reconstruct lower jaw bone .......................... 23.91 NA NA 13.59 16.41 2.83 NA NA 40.33 43.15 090 21248 ......... ............ A Reconstruction of jaw .................................... 12.46 12.60 12.25 7.51 8.93 1.55 26.61 26.26 21.52 22.94 090 21249 ......... ............ A Reconstruction of jaw .................................... 18.49 16.13 16.57 9.94 12.00 2.48 37.10 37.54 30.91 32.97 090 21255 ......... ............ A Reconstruct lower jaw bone .......................... 18.00 NA NA 13.33 15.43 2.38 NA NA 33.71 35.81 090 21256 ......... ............ A Reconstruction of orbit .................................. 17.32 NA NA 9.98 11.36 1.50 NA NA 28.80 30.18 090 21260 ......... ............ A Revise eye sockets ....................................... 17.66 NA NA 9.51 11.95 0.97 NA NA 28.14 30.58 090 21261 ......... ............ A Revise eye sockets ....................................... 33.66 NA NA 14.88 21.89 3.42 NA NA 51.96 58.97 090 21263 ......... ............ A Revise eye sockets ....................................... 30.60 NA NA 14.17 17.85 2.62 NA NA 47.39 51.07 090 21267 ......... ............ A Revise eye sockets ....................................... 20.35 NA NA 16.14 18.86 1.70 NA NA 38.19 40.91 090 21268 ......... ............ A Revise eye sockets ....................................... 26.66 NA NA 15.74 19.09 3.65 NA NA 46.05 49.40 090 21270 ......... ............ A Augmentation, cheek bone ........................... 10.46 11.17 11.53 5.89 6.91 0.72 22.35 22.71 17.07 18.09 090 21275 ......... ............ A Revision, orbitofacial bones .......................... 11.59 NA NA 7.41 7.97 1.29 NA NA 20.29 20.85 090 21280 ......... ............ A Revision of eyelid .......................................... 6.84 NA NA 5.84 5.90 0.42 NA NA 13.10 13.16 090 21282 ......... ............ A Revision of eyelid .......................................... 4.05 NA NA 4.26 4.43 0.26 NA NA 8.57 8.74 090 21295 ......... ............ A Revision of jaw muscle/bone ........................ 1.78 NA NA 2.61 2.55 0.16 NA NA 4.55 4.49 090 21296 ......... ............ A Revision of jaw muscle/bone ........................ 4.61 NA NA 5.46 5.05 0.34 NA NA 10.41 10.00 090 21299 ......... ............ C Cranio/maxillofacial surgery .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21300 ......... ............ A Treatment of skull fracture ............................ 0.72 0.28 1.84 0.28 0.27 0.13 1.13 2.69 1.13 1.12 000 21310 ......... ............ A Treatment of nose fracture ............................ 0.58 1.97 2.20 0.11 0.14 0.05 2.60 2.83 0.74 0.77 000 21315 ......... ............ A Treatment of nose fracture ............................ 1.76 4.46 4.29 1.65 1.82 0.14 6.36 6.19 3.55 3.72 010 21320 ......... ............ A Treatment of nose fracture ............................ 1.85 4.05 3.95 1.25 1.53 0.18 6.08 5.98 3.28 3.56 010 21325 ......... ............ A Treatment of nose fracture ............................ 4.01 NA NA 6.72 8.15 0.31 NA NA 11.04 12.47 090 21330 ......... ............ A Treatment of nose fracture ............................ 5.62 NA NA 7.44 9.14 0.56 NA NA 13.62 15.32 090 21335 ......... ............ A Treatment of nose fracture ............................ 8.85 NA NA 7.74 9.15 0.74 NA NA 17.33 18.74 090 21336 ......... ............ A Treat nasal septal fracture ............................ 6.46 NA NA 8.16 9.25 0.55 NA NA 15.17 16.26 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49099 

21337 ......... ............ A Treat nasal septal fracture ............................ 3.20 5.87 6.06 3.36 3.52 0.28 9.35 9.54 6.84 7.00 090 21338 ......... ............ A Treat nasoethmoid fracture ........................... 6.70 NA NA 9.66 12.93 0.82 NA NA 17.18 20.45 090 21339 ......... ............ A Treat nasoethmoid fracture ........................... 8.33 NA NA 10.63 13.08 0.96 NA NA 19.92 22.37 090 21340 ......... ............ A Treatment of nose fracture ............................ 11.25 NA NA 7.36 8.14 1.15 NA NA 19.76 20.54 090 21343 ......... ............ A Treatment of sinus fracture ........................... 14.01 NA NA 12.51 14.73 1.47 NA NA 27.99 30.21 090 21344 ......... ............ A Treatment of sinus fracture ........................... 21.26 NA NA 13.04 15.64 2.43 NA NA 36.73 39.33 090 21345 ......... ............ A Treat nose/jaw fracture ................................. 8.77 9.69 9.80 5.98 6.87 0.92 19.38 19.49 15.67 16.56 090 21346 ......... ............ A Treat nose/jaw fracture ................................. 11.21 NA NA 10.76 11.84 1.21 NA NA 23.18 24.26 090 21347 ......... ............ A Treat nose/jaw fracture ................................. 13.29 NA NA 11.56 15.03 1.47 NA NA 26.32 29.79 090 21348 ......... ............ A Treat nose/jaw fracture ................................. 17.28 NA NA 6.42 9.94 2.48 NA NA 26.18 29.70 090 21355 ......... ............ A Treat cheek bone fracture ............................. 4.26 5.61 6.08 3.00 3.36 0.34 10.21 10.68 7.60 7.96 010 21356 ......... ............ A Treat cheek bone fracture ............................. 4.64 6.78 7.04 3.92 4.39 0.46 11.88 12.14 9.02 9.49 010 21360 ......... ............ A Treat cheek bone fracture ............................. 6.95 NA NA 5.25 5.76 0.74 NA NA 12.94 13.45 090 21365 ......... ............ A Treat cheek bone fracture ............................. 16.42 NA NA 8.90 10.35 1.69 NA NA 27.01 28.46 090 21366 ......... ............ A Treat cheek bone fracture ............................. 18.36 NA NA 10.35 11.09 2.49 NA NA 31.20 31.94 090 21385 ......... ............ A Treat eye socket fracture .............................. 9.40 NA NA 6.90 7.94 0.97 NA NA 17.27 18.31 090 21386 ......... ............ A Treat eye socket fracture .............................. 9.40 NA NA 5.69 6.73 0.97 NA NA 16.06 17.10 090 21387 ......... ............ A Treat eye socket fracture .............................. 9.94 NA NA 7.25 8.53 1.08 NA NA 18.27 19.55 090 21390 ......... ............ A Treat eye socket fracture .............................. 11.01 NA NA 7.05 7.61 0.90 NA NA 18.96 19.52 090 21395 ......... ............ A Treat eye socket fracture .............................. 14.58 NA NA 7.78 8.71 1.44 NA NA 23.80 24.73 090 21400 ......... ............ A Treat eye socket fracture .............................. 1.40 2.74 2.64 1.98 1.90 0.15 4.29 4.19 3.53 3.45 090 21401 ......... ............ A Treat eye socket fracture .............................. 3.51 7.21 7.80 3.10 3.39 0.38 11.10 11.69 6.99 7.28 090 21406 ......... ............ A Treat eye socket fracture .............................. 7.25 NA NA 5.08 5.83 0.73 NA NA 13.06 13.81 090 21407 ......... ............ A Treat eye socket fracture .............................. 8.85 NA NA 5.89 6.62 0.94 NA NA 15.68 16.41 090 21408 ......... ............ A Treat eye socket fracture .............................. 12.61 NA NA 7.91 8.64 1.44 NA NA 21.96 22.69 090 21421 ......... ............ A Treat mouth roof fracture .............................. 5.70 12.09 10.02 8.96 8.47 0.73 18.52 16.45 15.39 14.90 090 21422 ......... ............ A Treat mouth roof fracture .............................. 8.56 NA NA 6.79 7.76 0.99 NA NA 16.34 17.31 090 21423 ......... ............ A Treat mouth roof fracture .............................. 10.63 NA NA 7.28 8.81 1.27 NA NA 19.18 20.71 090 21431 ......... ............ A Treat craniofacial fracture ............................. 7.66 NA NA 9.34 9.48 0.70 NA NA 17.70 17.84 090 21432 ......... ............ A Treat craniofacial fracture ............................. 8.72 NA NA 7.18 7.84 0.81 NA NA 16.71 17.37 090 21433 ......... ............ A Treat craniofacial fracture ............................. 26.05 NA NA 12.51 15.43 2.78 NA NA 41.34 44.26 090 21435 ......... ............ A Treat craniofacial fracture ............................. 19.92 NA NA 10.77 12.22 1.98 NA NA 32.67 34.12 090 21436 ......... ............ A Treat craniofacial fracture ............................. 29.89 NA NA 14.38 17.26 3.09 NA NA 47.36 50.24 090 21440 ......... ............ A Treat dental ridge fracture ............................. 3.20 10.31 7.90 7.63 6.53 0.38 13.89 11.48 11.21 10.11 090 21445 ......... ............ A Treat dental ridge fracture ............................. 5.94 12.48 10.43 8.61 8.43 0.78 19.20 17.15 15.33 15.15 090 21450 ......... ............ A Treat lower jaw fracture ................................ 3.47 10.41 8.14 7.64 7.06 0.33 14.21 11.94 11.44 10.86 090 21451 ......... ............ A Treat lower jaw fracture ................................ 5.36 12.93 10.25 9.63 8.71 0.63 18.92 16.24 15.62 14.70 090 21452 ......... ............ A Treat lower jaw fracture ................................ 2.23 11.77 12.71 5.89 4.93 0.27 14.27 15.21 8.39 7.43 090 21453 ......... ............ A Treat lower jaw fracture ................................ 6.28 14.74 11.74 11.59 10.95 0.74 21.76 18.76 18.61 17.97 090 21454 ......... ............ A Treat lower jaw fracture ................................ 7.07 NA NA 5.64 6.11 0.82 NA NA 13.53 14.00 090 21461 ......... ............ A Treat lower jaw fracture ................................ 8.95 41.23 28.65 12.59 12.64 0.98 51.16 38.58 22.52 22.57 090 21462 ......... ............ A Treat lower jaw fracture ................................ 10.65 42.46 31.32 13.17 12.83 1.27 54.38 43.24 25.09 24.75 090 21465 ......... ............ A Treat lower jaw fracture ................................ 12.76 NA NA 8.26 9.42 1.50 NA NA 22.52 23.68 090 21470 ......... ............ A Treat lower jaw fracture ................................ 17.12 NA NA 10.05 11.53 1.96 NA NA 29.13 30.61 090 21480 ......... ............ A Reset dislocated jaw ..................................... 0.61 1.51 1.71 0.18 0.19 0.06 2.18 2.38 0.85 0.86 000 21485 ......... ............ A Reset dislocated jaw ..................................... 4.48 12.20 9.22 9.18 8.04 0.51 17.19 14.21 14.17 13.03 090 21490 ......... ............ A Repair dislocated jaw .................................... 12.59 NA NA 7.86 9.23 1.96 NA NA 22.41 23.78 090 21495 ......... ............ A Treat hyoid bone fracture .............................. 6.43 NA NA 9.57 8.71 0.46 NA NA 16.46 15.60 090 21497 ......... ............ A Interdental wiring ........................................... 4.35 11.96 9.33 9.14 8.02 0.50 16.81 14.18 13.99 12.87 090 21499 ......... ............ C Head surgery procedure ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21501 ......... ............ A Drain neck/chest lesion ................................. 3.80 6.42 6.42 3.43 3.72 0.43 10.65 10.65 7.66 7.95 090 21502 ......... ............ A Drain chest lesion .......................................... 7.35 NA NA 4.77 5.42 0.97 NA NA 13.09 13.74 090 21510 ......... ............ A Drainage of bone lesion ................................ 5.97 NA NA 4.71 5.42 0.80 NA NA 11.48 12.19 090 21550 ......... ............ A Biopsy of neck/chest ..................................... 2.06 4.28 3.76 1.73 1.72 0.16 6.50 5.98 3.95 3.94 010 21555 ......... ............ A Remove lesion, neck/chest ........................... 4.34 5.76 5.57 3.41 3.25 0.56 10.66 10.47 8.31 8.15 090 21556 ......... ............ A Remove lesion, neck/chest ........................... 5.56 NA NA 4.01 4.08 0.65 NA NA 10.22 10.29 09021557 ......... ............ A Remove tumor, neck/chest ........................... 8.87 NA NA 4.42 5.12 1.08 NA NA 14.37 15.07 090 21600 ......... ............ A Partial removal of rib ..................................... 7.06 NA NA 5.79 5.75 0.99 NA NA 13.84 13.80 090 21610 ......... ............ A Partial removal of rib ..................................... 15.70 NA NA 8.13 8.68 3.07 NA NA 26.90 27.45 090 21615 ......... ............ A Removal of rib ............................................... 10.22 NA NA 5.46 6.38 1.45 NA NA 17.13 18.05 090 21616 ......... ............ A Removal of rib and nerves ............................ 12.44 NA NA 7.15 7.80 1.86 NA NA 21.45 22.10 090 21620 ......... ............ A Partial removal of sternum ............................ 7.08 NA NA 4.88 5.70 0.98 NA NA 12.94 13.76 090 21627 ......... ............ A Sternal debridement ...................................... 7.10 NA NA 5.62 6.13 1.02 NA NA 13.74 14.25 090 21630 ......... ............ A Extensive sternum surgery ............................ 18.90 NA NA 10.55 11.52 2.58 NA NA 32.03 33.00 090 21632 ......... ............ A Extensive sternum surgery ............................ 19.40 NA NA 9.62 10.74 2.65 NA NA 31.67 32.79 090 21685 ......... ............ A Hyoid myotomy & suspension ....................... 14.77 NA NA 7.81 9.43 1.06 NA NA 23.64 25.26 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49100 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

21700 ......... ............ A Revision of neck muscle ............................... 6.18 NA NA 3.93 4.31 0.32 NA NA 10.43 10.81 090 21705 ......... ............ A Revision of neck muscle/rib .......................... 9.77 NA NA 4.71 5.36 1.43 NA NA 15.91 16.56 090 21720 ......... ............ A Revision of neck muscle ............................... 5.67 NA NA 4.32 2.93 0.91 NA NA 10.90 9.51 090 21725 ......... ............ A Revision of neck muscle ............................... 7.04 NA NA 4.60 5.23 1.21 NA NA 12.85 13.48 090 21740 ......... ............ A Reconstruction of sternum ............................ 17.43 NA NA 8.77 8.58 2.36 NA NA 28.56 28.37 090 21742 ......... ............ C Repair stern/nuss w/o scope ......................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 090 21750 ......... ............ A Repair of sternum separation ........................ 11.33 NA NA 5.45 5.95 1.63 NA NA 18.41 18.91 090 21800 ......... ............ A Treatment of rib fracture ............................... 0.96 1.35 1.34 1.42 1.36 0.09 2.40 2.39 2.47 2.41 090 21805 ......... ............ A Treatment of rib fracture ............................... 2.75 NA NA 3.56 3.29 0.38 NA NA 6.69 6.42 090 21810 ......... ............ A Treatment of rib fracture(s) ........................... 6.85 NA NA 5.27 5.05 0.94 NA NA 13.06 12.84 090 21820 ......... ............ A Treat sternum fracture ................................... 1.28 1.80 1.82 1.87 1.79 0.16 3.24 3.26 3.31 3.23 090 21825 ......... ............ A Treat sternum fracture ................................... 7.58 NA NA 5.46 6.16 1.11 NA NA 14.15 14.85 090 21899 ......... ............ C Neck/chest surgery procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 21920 ......... ............ A Biopsy soft tissue of back ............................. 2.06 4.32 3.54 1.82 1.56 0.14 6.52 5.74 4.02 3.76 010 21925 ......... ............ A Biopsy soft tissue of back ............................. 4.48 5.50 5.25 3.45 3.29 0.60 10.58 10.33 8.53 8.37 090 21930 ......... ............ A Remove lesion, back or flank ........................ 4.99 6.05 5.80 3.77 3.49 0.66 11.70 11.45 9.42 9.14 090 21935 ......... ............ A Remove tumor, back ..................................... 18.29 NA NA 8.56 9.36 2.47 NA NA 29.32 30.12 090 22010 ......... ............ A I&d, p-spine, c/t/cerv-thor .............................. 12.49 NA NA 8.06 8.68 1.73 NA NA 22.28 22.90 090 22015 ......... ............ A I&d, p-spine, l/s/ls .......................................... 12.38 NA NA 8.02 8.62 1.71 NA NA 22.11 22.71 090 22100 ......... ............ A Remove part of neck vertebra ...................... 10.72 NA NA 8.01 7.65 2.13 NA NA 20.86 20.50 090 22101 ......... ............ A Remove part, thorax vertebra ....................... 10.80 NA NA 7.94 7.80 1.90 NA NA 20.64 20.50 09022102 ......... ............ A Remove part, lumbar vertebra ...................... 10.80 NA NA 7.24 7.89 1.87 NA NA 19.91 20.56 090 22103 ......... ............ A Remove extra spine segment ....................... 2.34 NA NA 0.89 1.13 0.44 NA NA 3.67 3.91 ZZZ 22110 ......... ............ A Remove part of neck vertebra ...................... 13.72 NA NA 9.09 9.14 2.76 NA NA 25.57 25.62 090 22112 ......... ............ A Remove part, thorax vertebra ....................... 13.79 NA NA 8.97 9.20 2.52 NA NA 25.28 25.51 09022114 ......... ............ A Remove part, lumbar vertebra ...................... 13.79 NA NA 9.08 9.21 2.63 NA NA 25.50 25.63 090 22116 ......... ............ A Remove extra spine segment ....................... 2.32 NA NA 0.87 1.10 0.50 NA NA 3.69 3.92 ZZZ 22210 ......... ............ A Revision of neck spine .................................. 25.03 NA NA 14.74 15.24 5.44 NA NA 45.21 45.71 090 22212 ......... ............ A Revision of thorax spine ................................ 20.64 NA NA 12.49 13.08 3.90 NA NA 37.03 37.62 090 22214 ......... ............ A Revision of lumbar spine ............................... 20.67 NA NA 12.59 13.51 3.91 NA NA 37.17 38.09 090 22216 ......... ............ A Revise, extra spine segment ......................... 6.03 NA NA 2.37 2.94 1.29 NA NA 9.69 10.26 ZZZ 22220 ......... ............ A Revision of neck spine .................................. 22.59 NA NA 13.42 13.57 5.06 NA NA 41.07 41.22 090 22222 ......... ............ A Revision of thorax spine ................................ 22.74 NA NA 12.19 11.40 4.12 NA NA 39.05 38.26 090 22224 ......... ............ A Revision of lumbar spine ............................... 22.74 NA NA 13.17 13.96 4.18 NA NA 40.09 40.88 090 22226 ......... ............ A Revise, extra spine segment ......................... 6.03 NA NA 2.15 2.86 1.29 NA NA 9.47 10.18 ZZZ 22305 ......... ............ A Treat spine process fracture ......................... 2.05 2.16 2.27 1.81 1.89 0.39 4.60 4.71 4.25 4.33 090 22310 ......... ............ A Treat spine fracture ....................................... 3.61 2.99 2.85 2.50 2.39 0.50 7.10 6.96 6.61 6.50 090 22315 ......... ............ A Treat spine fracture ....................................... 9.83 9.81 9.71 7.39 7.35 1.85 21.49 21.39 19.07 19.03 090 22318 ......... ............ A Treat odontoid fx w/o graft ............................ 22.46 NA NA 13.25 13.35 5.28 NA NA 40.99 41.09 090 22319 ......... ............ A Treat odontoid fx w/graft ............................... 25.07 NA NA 14.00 14.53 6.03 NA NA 45.10 45.63 090 22325 ......... ............ A Treat spine fracture ....................................... 19.52 NA NA 12.03 12.06 3.87 NA NA 35.42 35.45 090 22326 ......... ............ A Treat neck spine fracture .............................. 20.56 NA NA 12.13 12.56 4.42 NA NA 37.11 37.54 090 22327 ......... ............ A Treat thorax spine fracture ............................ 20.42 NA NA 12.07 12.29 3.98 NA NA 36.47 36.69 090 22328 ......... ............ A Treat each add spine fx ................................ 4.60 NA NA 1.80 2.15 0.94 NA NA 7.34 7.69 ZZZ 22505 ......... ............ A Manipulation of spine .................................... 1.87 NA NA 1.06 0.97 0.36 NA NA 3.29 3.20 010 22520 ......... ............ A Percut vertebroplasty thor ............................. 9.15 44.71 57.42 4.39 4.92 1.71 55.57 68.28 15.25 15.78 010 22521 ......... ............ A Percut vertebroplasty lumb ........................... 8.58 45.98 53.47 4.20 4.76 1.60 56.16 63.65 14.38 14.94 010 22522 ......... ............ A Percut vertebroplasty addIl ........................... 4.30 NA NA 1.41 1.61 0.82 NA NA 6.53 6.73 ZZZ22523 ......... ............ A Percut kyphoplasty, thor ................................ 9.19 NA NA 4.75 5.61 1.71 NA NA 15.65 16.51 010 22524 ......... ............ A Percut kyphoplasty, lumbar ........................... 8.79 NA NA 4.60 5.42 1.60 NA NA 14.99 15.81 010 22525 ......... ............ A Percut kyphoplasty, add-on ........................... 4.47 NA NA 1.68 2.12 0.82 NA NA 6.97 7.41 ZZZ 22532 ......... ............ A Lat thorax spine fusion .................................. 25.73 NA NA 13.79 14.56 4.34 NA NA 43.86 44.63 090 22533 ......... ............ A Lat lumbar spine fusion ................................. 24.53 NA NA 13.43 13.55 3.15 NA NA 41.11 41.23 090 22534 ......... ............ A Lat thor/lumb, addIl seg ................................ 5.99 NA NA 2.31 2.85 1.25 NA NA 9.55 10.09 ZZZ 22548 ......... ............ A Neck spine fusion .......................................... 26.78 NA NA 15.08 15.62 5.59 NA NA 47.45 47.99 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49101 

22554 ......... ............ A Neck spine fusion .......................................... 17.48 NA NA 10.74 11.94 4.45 NA NA 32.67 33.87 090 22556 ......... ............ A Thorax spine fusion ....................................... 24.42 NA NA 13.07 14.32 4.34 NA NA 41.83 43.08 090 22558 ......... ............ A Lumbar spine fusion ...................................... 23.25 NA NA 11.53 12.85 3.15 NA NA 37.93 39.25 090 22585 ......... ............ A Additional spinal fusion ................................. 5.52 NA NA 2.09 2.62 1.25 NA NA 8.86 9.39 ZZZ 22590 ......... ............ A Spine & skull spinal fusion ............................ 21.48 NA NA 13.10 13.27 4.78 NA NA 39.36 39.53 090 22595 ......... ............ A Neck spinal fusion ......................................... 20.36 NA NA 12.61 12.78 4.40 NA NA 37.37 37.54 090 22600 ......... ............ A Neck spine fusion .......................................... 17.12 NA NA 11.28 11.21 3.72 NA NA 32.12 32.05 090 22610 ......... ............ A Thorax spine fusion ....................................... 17.00 NA NA 10.88 11.28 3.52 NA NA 31.40 31.80 090 22612 ......... ............ A Lumbar spine fusion ...................................... 22.50 NA NA 12.92 13.88 4.46 NA NA 39.88 40.84 090 22614 ......... ............ A Spine fusion, extra segment ......................... 6.43 NA NA 2.49 3.14 1.38 NA NA 10.30 10.95 ZZZ22630 ......... ............ A Lumbar spine fusion ...................................... 21.81 NA NA 12.64 13.36 4.72 NA NA 39.17 39.89 090 22632 ......... ............ A Spine fusion, extra segment ......................... 5.22 NA NA 2.01 2.50 1.16 NA NA 8.39 8.88 ZZZ 22800 ......... ............ A Fusion of spine .............................................. 19.22 NA NA 11.15 12.37 3.75 NA NA 34.12 35.34 090 22802 ......... ............ A Fusion of spine .............................................. 31.83 NA NA 16.17 18.74 6.15 NA NA 54.15 56.72 090 22804 ......... ............ A Fusion of spine .............................................. 37.22 NA NA 18.20 21.57 6.98 NA NA 62.40 65.77 090 22808 ......... ............ A Fusion of spine .............................................. 27.23 NA NA 13.85 15.69 4.92 NA NA 46.00 47.84 090 22810 ......... ............ A Fusion of spine .............................................. 31.22 NA NA 14.93 17.50 5.13 NA NA 51.28 53.85 090 22812 ......... ............ A Fusion of spine .............................................. 33.90 NA NA 16.75 19.23 5.28 NA NA 55.93 58.41 090 22818 ......... ............ A Kyphectomy, 1–2 segments .......................... 34.12 NA NA 16.65 18.32 6.45 NA NA 57.22 58.89 090 22819 ......... ............ A Kyphectomy, 3 or more ................................. 39.10 NA NA 19.45 19.90 7.65 NA NA 66.20 66.65 090 22830 ......... ............ A Exploration of spinal fusion ........................... 11.07 NA NA 7.11 7.75 2.29 NA NA 20.47 21.11 090 22840 ......... ............ A Insert spine fixation device ............................ 12.52 NA NA 4.84 6.08 2.78 NA NA 20.14 21.38 ZZZ 22842 ......... ............ A Insert spine fixation device ............................ 12.56 NA NA 4.86 6.09 2.74 NA NA 20.16 21.39 ZZZ 22843 ......... ............ A Insert spine fixation device ............................ 13.44 NA NA 5.26 6.27 2.85 NA NA 21.55 22.56 ZZZ 22844 ......... ............ A Insert spine fixation device ............................ 16.42 NA NA 6.47 8.18 3.18 NA NA 26.07 27.78 ZZZ 22845 ......... ............ A Insert spine fixation device ............................ 11.94 NA NA 4.55 5.69 2.85 NA NA 19.34 20.48 ZZZ 22846 ......... ............ A Insert spine fixation device ............................ 12.40 NA NA 4.72 5.93 2.95 NA NA 20.07 21.28 ZZZ 22847 ......... ............ A Insert spine fixation device ............................ 13.78 NA NA 5.34 6.60 2.99 NA NA 22.11 23.37 ZZZ 22848 ......... ............ A Insert pelv fixation device .............................. 5.99 NA NA 2.37 2.98 1.15 NA NA 9.51 10.12 ZZZ 22849 ......... ............ A Reinsert spinal fixation .................................. 19.02 NA NA 10.28 11.37 3.89 NA NA 33.19 34.28 090 22850 ......... ............ A Remove spine fixation device ....................... 9.69 NA NA 6.51 6.87 2.04 NA NA 18.24 18.60 090 22851 ......... ............ A Apply spine prosth device ............................. 6.70 NA NA 2.58 3.17 1.49 NA NA 10.77 11.36 ZZZ 22852 ......... ............ A Remove spine fixation device ....................... 9.24 NA NA 6.23 6.65 1.89 NA NA 17.36 17.78 090 22855 ......... ............ A Remove spine fixation device ....................... 15.71 NA NA 9.28 9.57 3.51 NA NA 28.50 28.79 09022899 ......... ............ C Spine surgery procedure ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 22900 ......... ............ A Remove abdominal wall lesion ..................... 6.09 NA NA 3.56 3.31 0.76 NA NA 10.41 10.16 090 22999 ......... ............ C Abdomen surgery procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 23000 ......... ............ A Removal of calcium deposits ........................ 4.35 7.83 8.36 3.68 4.24 0.68 12.86 13.39 8.71 9.27 090 23020 ......... ............ A Release shoulder joint ................................... 9.16 NA NA 6.51 7.30 1.54 NA NA 17.21 18.00 090 23030 ......... ............ A Drain shoulder lesion .................................... 3.42 6.32 7.12 2.41 2.78 0.57 10.31 11.11 6.40 6.77 010 23031 ......... ............ A Drain shoulder bursa ..................................... 2.74 6.53 7.53 2.23 2.60 0.46 9.73 10.73 5.43 5.80 010 23035 ......... ............ A Drain shoulder bone lesion ........................... 8.96 NA NA 7.02 7.96 1.47 NA NA 17.45 18.39 090 23040 ......... ............ A Exploratory shoulder surgery ........................ 9.55 NA NA 6.80 7.60 1.60 NA NA 17.95 18.75 09023044 ......... ............ A Exploratory shoulder surgery ........................ 7.41 NA NA 5.59 6.22 1.24 NA NA 14.24 14.87 09023065 ......... ............ A Biopsy shoulder tissues ................................ 2.27 2.91 2.59 1.70 1.64 0.20 5.38 5.06 4.17 4.11 010 23066 ......... ............ A Biopsy shoulder tissues ................................ 4.15 7.72 7.68 3.60 3.89 0.63 12.50 12.46 8.38 8.67 090 23075 ......... ............ A Removal of shoulder lesion ........................... 2.39 3.74 3.68 1.74 1.77 0.34 6.47 6.41 4.47 4.50 010 23076 ......... ............ A Removal of shoulder lesion ........................... 7.68 NA NA 5.33 5.50 1.13 NA NA 14.14 14.31 090 23077 ......... ............ A Remove tumor of shoulder ............................ 17.98 NA NA 9.81 10.11 2.33 NA NA 30.12 30.42 090 23100 ......... ............ A Biopsy of shoulder joint ................................. 6.02 NA NA 5.15 5.53 1.04 NA NA 12.21 12.59 090 23101 ......... ............ A Shoulder joint surgery ................................... 5.57 NA NA 4.58 5.14 0.96 NA NA 11.11 11.67 090 23105 ......... ............ A Remove shoulder joint lining ......................... 8.28 NA NA 6.12 6.87 1.42 NA NA 15.82 16.57 090 23106 ......... ............ A Incision of collarbone joint ............................. 5.95 NA NA 4.62 5.43 0.99 NA NA 11.56 12.37 090 23107 ......... ............ A Explore treat shoulder joint ........................... 8.67 NA NA 6.27 7.11 1.49 NA NA 16.43 17.27 090 23120 ......... ............ A Partial removal, collar bone .......................... 7.16 NA NA 5.50 6.22 1.23 NA NA 13.89 14.61 090 23125 ......... ............ A Removal of collar bone ................................. 9.44 NA NA 6.38 7.27 1.62 NA NA 17.44 18.33 090 23130 ......... ............ A Remove shoulder bone, part ......................... 7.54 NA NA 6.10 6.87 1.30 NA NA 14.94 15.71 090 23140 ......... ............ A Removal of bone lesion ................................ 6.94 NA NA 4.82 5.12 1.08 NA NA 12.84 13.14 090 23145 ......... ............ A Removal of bone lesion ................................ 9.20 NA NA 5.83 7.04 1.49 NA NA 16.52 17.73 090 23146 ......... ............ A Removal of bone lesion ................................ 7.88 NA NA 5.99 6.83 1.35 NA NA 15.22 16.06 090 23150 ......... ............ A Removal of humerus lesion .......................... 8.71 NA NA 6.06 6.71 1.32 NA NA 16.09 16.74 090 23155 ......... ............ A Removal of humerus lesion .......................... 10.63 NA NA 7.36 8.09 1.80 NA NA 19.79 20.52 09023156 ......... ............ A Removal of humerus lesion .......................... 8.91 NA NA 6.42 7.14 1.50 NA NA 16.83 17.55 090 23170 ......... ............ A Remove collar bone lesion ............................ 7.03 NA NA 5.08 5.79 1.12 NA NA 13.23 13.94 090 23172 ......... ............ A Remove shoulder blade lesion ...................... 7.13 NA NA 4.98 5.96 1.01 NA NA 13.12 14.10 090 23174 ......... ............ A Remove humerus lesion ............................... 9.80 NA NA 7.30 8.10 1.65 NA NA 18.75 19.55 090

mstockstill on PROD1PC63 with PROPOSAL_2

49102 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

23180 ......... ............ A Remove collar bone lesion ............................ 8.76 NA NA 7.08 8.51 1.47 NA NA 17.31 18.74 090 23182 ......... ............ A Remove shoulder blade lesion ...................... 8.38 NA NA 6.91 8.14 1.37 NA NA 16.66 17.89 090 23184 ......... ............ A Remove humerus lesion ............................... 9.67 NA NA 7.55 8.87 1.63 NA NA 18.85 20.17 09023190 ......... ............ A Partial removal of scapula ............................. 7.29 NA NA 5.43 5.99 1.17 NA NA 13.89 14.45 090 23195 ......... ............ A Removal of head of humerus ........................ 10.16 NA NA 6.80 7.50 1.70 NA NA 18.66 19.36 090 23200 ......... ............ A Removal of collar bone ................................. 12.60 NA NA 7.51 8.42 1.93 NA NA 22.04 22.95 090 23210 ......... ............ A Removal of shoulder blade ........................... 13.07 NA NA 8.24 8.80 2.02 NA NA 23.33 23.89 090 23220 ......... ............ A Partial removal of humerus ........................... 15.26 NA NA 9.09 10.39 2.48 NA NA 26.83 28.13 090 23221 ......... ............ A Partial removal of humerus ........................... 18.31 NA NA 6.67 10.46 3.05 NA NA 28.03 31.82 090 23222 ......... ............ A Partial removal of humerus ........................... 25.36 NA NA 13.58 15.23 3.94 NA NA 42.88 44.53 090 23330 ......... ............ A Remove shoulder foreign body ..................... 1.85 3.37 3.60 1.53 1.79 0.24 5.46 5.69 3.62 3.88 010 23331 ......... ............ A Remove shoulder foreign body ..................... 7.43 NA NA 5.89 6.57 1.27 NA NA 14.59 15.27 090 23332 ......... ............ A Remove shoulder foreign body ..................... 12.14 NA NA 8.03 9.00 2.02 NA NA 22.19 23.16 090 23350 ......... ............ A Injection for shoulder x-ray ............................ 1.00 2.72 3.28 0.32 0.33 0.06 3.78 4.34 1.38 1.39 000 23395 ......... ............ A Muscle transfer,shoulder/arm ........................ 18.19 NA NA 11.26 12.46 2.93 NA NA 32.38 33.58 090 23397 ......... ............ A Muscle transfers ............................................ 16.53 NA NA 9.70 10.95 2.73 NA NA 28.96 30.21 090 23400 ......... ............ A Fixation of shoulder blade ............................. 13.64 NA NA 8.57 9.70 2.29 NA NA 24.50 25.63 090 23405 ......... ............ A Incision of tendon & muscle .......................... 8.36 NA NA 5.97 6.68 1.45 NA NA 15.78 16.49 090 23406 ......... ............ A Incise tendon(s) & muscle(s) ........................ 10.83 NA NA 6.95 7.99 1.87 NA NA 19.65 20.69 090 23410 ......... ............ A Repair rotator cuff, acute .............................. 12.55 NA NA 7.84 9.01 2.16 NA NA 22.55 23.72 090 23412 ......... ............ A Repair rotator cuff, chronic ............................ 13.47 NA NA 8.23 9.48 2.31 NA NA 24.01 25.26 090 23415 ......... ............ A Release of shoulder ligament ....................... 10.02 NA NA 6.62 7.65 1.73 NA NA 18.37 19.40 09023420 ......... ............ A Repair of shoulder ......................................... 14.65 NA NA 9.78 10.58 2.31 NA NA 26.74 27.54 090 23430 ......... ............ A Repair biceps tendon .................................... 9.97 NA NA 6.81 7.78 1.73 NA NA 18.51 19.48 090 23440 ......... ............ A Remove/transplant tendon ............................ 10.46 NA NA 6.82 7.90 1.82 NA NA 19.10 20.18 090 23450 ......... ............ A Repair shoulder capsule ............................... 13.50 NA NA 8.21 9.43 2.32 NA NA 24.03 25.25 090 23455 ......... ............ A Repair shoulder capsule ............................... 14.47 NA NA 8.60 9.98 2.49 NA NA 25.56 26.94 090 23460 ......... ............ A Repair shoulder capsule ............................... 15.59 NA NA 9.36 10.87 2.66 NA NA 27.61 29.12 090 23462 ......... ............ A Repair shoulder capsule ............................... 15.52 NA NA 9.11 10.34 2.59 NA NA 27.22 28.45 090 23465 ......... ............ A Repair shoulder capsule ............................... 16.07 NA NA 9.61 10.79 2.76 NA NA 28.44 29.62 090 23466 ......... ............ A Repair shoulder capsule ............................... 15.45 NA NA 10.11 11.06 2.46 NA NA 28.02 28.97 090 23470 ......... ............ A Reconstruct shoulder joint ............................. 17.66 NA NA 10.20 11.74 2.98 NA NA 30.84 32.38 090 23472 ......... ............ A Reconstruct shoulder joint ............................. 22.39 NA NA 12.25 13.87 3.66 NA NA 38.30 39.92 090 23480 ......... ............ A Revision of collar bone .................................. 11.34 NA NA 7.37 8.42 1.94 NA NA 20.65 21.70 090 23485 ......... ............ A Revision of collar bone .................................. 13.71 NA NA 8.33 9.50 2.33 NA NA 24.37 25.54 090 23490 ......... ............ A Reinforce clavicle .......................................... 11.96 NA NA 6.69 8.19 1.47 NA NA 20.12 21.62 090 23491 ......... ............ A Reinforce shoulder bones ............................. 14.31 NA NA 8.89 10.26 2.46 NA NA 25.66 27.03 090 23500 ......... ............ A Treat clavicle fracture .................................... 2.08 2.64 2.81 2.71 2.57 0.30 5.02 5.19 5.09 4.95 090 23505 ......... ............ A Treat clavicle fracture .................................... 3.68 4.03 4.32 3.63 3.79 0.61 8.32 8.61 7.92 8.08 090 23515 ......... ............ A Treat clavicle fracture .................................... 7.40 NA NA 5.59 6.31 1.28 NA NA 14.27 14.99 090 23520 ......... ............ A Treat clavicle dislocation ............................... 2.16 2.65 2.80 2.72 2.74 0.34 5.15 5.30 5.22 5.24 090 23525 ......... ............ A Treat clavicle dislocation ............................... 3.59 4.51 4.53 3.92 3.94 0.46 8.56 8.58 7.97 7.99 090 23530 ......... ............ A Treat clavicle dislocation ............................... 7.30 NA NA 5.28 5.77 1.20 NA NA 13.78 14.27 090 23532 ......... ............ A Treat clavicle dislocation ............................... 8.00 NA NA 6.08 6.75 1.38 NA NA 15.46 16.13 090 23540 ......... ............ A Treat clavicle dislocation ............................... 2.23 2.62 2.80 2.70 2.45 0.29 5.14 5.32 5.22 4.97 090 23545 ......... ............ A Treat clavicle dislocation ............................... 3.25 3.75 4.08 3.27 3.34 0.35 7.35 7.68 6.87 6.94 090 23550 ......... ............ A Treat clavicle dislocation ............................... 7.41 NA NA 5.54 6.16 1.25 NA NA 14.20 14.82 090 23552 ......... ............ A Treat clavicle dislocation ............................... 8.62 NA NA 6.28 7.06 1.46 NA NA 16.36 17.14 090 23570 ......... ............ A Treat shoulder blade fx ................................. 2.23 2.80 2.96 2.94 2.90 0.36 5.39 5.55 5.53 5.49 090 23575 ......... ............ A Treat shoulder blade fx ................................. 4.05 4.36 4.75 3.86 4.20 0.59 9.00 9.39 8.50 8.84 090 23585 ......... ............ A Treat scapula fracture ................................... 9.07 NA NA 6.52 7.36 1.54 NA NA 17.13 17.97 090 23600 ......... ............ A Treat humerus fracture .................................. 2.93 4.08 4.43 3.66 3.58 0.48 7.49 7.84 7.07 6.99 090 23605 ......... ............ A Treat humerus fracture .................................. 4.86 5.42 5.97 4.63 4.99 0.84 11.12 11.67 10.33 10.69 090 23615 ......... ............ A Treat humerus fracture .................................. 10.83 NA NA 8.33 8.71 1.62 NA NA 20.78 21.16 090 23616 ......... ............ A Treat humerus fracture .................................. 21.60 NA NA 11.56 13.50 3.69 NA NA 36.85 38.79 090 23620 ......... ............ A Treat humerus fracture .................................. 2.40 3.42 3.56 3.16 3.03 0.40 6.22 6.36 5.96 5.83 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49103 

23625 ......... ............ A Treat humerus fracture .................................. 3.92 4.44 4.82 3.91 4.19 0.67 9.03 9.41 8.50 8.78 090 23630 ......... ............ A Treat humerus fracture .................................. 7.40 NA NA 5.69 6.40 1.27 NA NA 14.36 15.07 090 23650 ......... ............ A Treat shoulder dislocation ............................. 3.38 3.27 3.65 2.80 2.77 0.30 6.95 7.33 6.48 6.45 090 23655 ......... ............ A Treat shoulder dislocation ............................. 4.56 NA NA 4.17 4.17 0.69 NA NA 9.42 9.42 090 23660 ......... ............ A Treat shoulder dislocation ............................. 7.48 NA NA 5.63 6.19 1.29 NA NA 14.40 14.96 090 23665 ......... ............ A Treat dislocation/fracture ............................... 4.46 4.85 5.21 4.26 4.61 0.71 10.02 10.38 9.43 9.78 090 23670 ......... ............ A Treat dislocation/fracture ............................... 7.95 NA NA 5.89 6.60 1.36 NA NA 15.20 15.91 090 23675 ......... ............ A Treat dislocation/fracture ............................... 6.04 6.16 6.66 5.16 5.66 1.01 13.21 13.71 12.21 12.71 090 23680 ......... ............ A Treat dislocation/fracture ............................... 10.22 NA NA 7.02 7.84 1.75 NA NA 18.99 19.81 090 23700 ......... ............ A Fixation of shoulder ....................................... 2.52 NA NA 1.92 2.11 0.44 NA NA 4.88 5.07 010 23800 ......... ............ A Fusion of shoulder joint ................................. 14.50 NA NA 7.55 9.70 2.35 NA NA 24.40 26.55 090 23802 ......... ............ A Fusion of shoulder joint ................................. 18.07 NA NA 10.99 10.38 2.70 NA NA 31.76 31.15 090 23900 ......... ............ A Amputation of arm & girdle ........................... 20.47 NA NA 10.72 11.46 3.18 NA NA 34.37 35.11 090 23920 ......... ............ A Amputation at shoulder joint ......................... 15.95 NA NA 9.56 9.83 2.46 NA NA 27.97 28.24 090 23921 ......... ............ A Amputation follow-up surgery ........................ 5.54 NA NA 4.88 5.03 0.78 NA NA 11.20 11.35 09023929 ......... ............ C Shoulder surgery procedure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 23930 ......... ............ A Drainage of arm lesion .................................. 2.94 5.00 5.99 1.99 2.23 0.43 8.37 9.36 5.36 5.60 010 23931 ......... ............ A Drainage of arm bursa .................................. 1.79 4.34 5.52 1.75 2.07 0.28 6.41 7.59 3.82 4.14 010 23935 ......... ............ A Drain arm/elbow bone lesion ........................ 6.20 NA NA 5.14 5.72 1.05 NA NA 12.39 12.97 090 24000 ......... ............ A Exploratory elbow surgery ............................. 5.93 NA NA 4.78 5.25 0.97 NA NA 11.68 12.15 090 24006 ......... ............ A Release elbow joint ....................................... 9.54 NA NA 6.67 7.48 1.50 NA NA 17.71 18.52 090 24065 ......... ............ A Biopsy arm/elbow soft tissue ........................ 2.08 4.08 3.43 1.87 1.77 0.17 6.33 5.68 4.12 4.02 010 24066 ......... ............ A Biopsy arm/elbow soft tissue ........................ 5.20 8.33 8.78 3.94 4.08 0.80 14.33 14.78 9.94 10.08 090 24075 ......... ............ A Remove arm/elbow lesion ............................. 3.91 7.22 7.32 3.27 3.37 0.56 11.69 11.79 7.74 7.84 090 24076 ......... ............ A Remove arm/elbow lesion ............................. 6.29 NA NA 4.59 4.79 0.95 NA NA 11.83 12.03 09024077 ......... ............ A Remove tumor of arm/elbow ......................... 11.86 NA NA 6.96 7.55 1.72 NA NA 20.54 21.13 090 24100 ......... ............ A Biopsy elbow joint lining ................................ 4.92 NA NA 4.28 4.46 0.85 NA NA 10.05 10.23 090 24101 ......... ............ A Explore/treat elbow joint ................................ 6.12 NA NA 5.08 5.72 1.03 NA NA 12.23 12.87 090 24102 ......... ............ A Remove elbow joint lining ............................. 8.08 NA NA 5.82 6.60 1.33 NA NA 15.23 16.01 090 24105 ......... ............ A Removal of elbow bursa ............................... 3.60 NA NA 4.04 4.30 0.61 NA NA 8.25 8.51 090 24110 ......... ............ A Remove humerus lesion ............................... 7.38 NA NA 5.66 6.41 1.28 NA NA 14.32 15.07 09024115 ......... ............ A Remove/graft bone lesion ............................. 9.92 NA NA 6.83 7.12 1.67 NA NA 18.42 18.71 090 24116 ......... ............ A Remove/graft bone lesion ............................. 12.03 NA NA 7.67 8.72 2.05 NA NA 21.75 22.80 090 24120 ......... ............ A Remove elbow lesion .................................... 6.64 NA NA 5.22 5.75 1.10 NA NA 12.96 13.49 090 24125 ......... ............ A Remove/graft bone lesion ............................. 7.94 NA NA 6.03 6.13 1.06 NA NA 15.03 15.13 090 24126 ......... ............ A Remove/graft bone lesion ............................. 8.42 NA NA 6.22 6.82 1.16 NA NA 15.80 16.40 090 24130 ......... ............ A Removal of head of radius ............................ 6.24 NA NA 5.13 5.80 1.04 NA NA 12.41 13.08 090 24134 ......... ............ A Removal of arm bone lesion ......................... 10.02 NA NA 7.49 8.51 1.64 NA NA 19.15 20.17 09024136 ......... ............ A Remove radius bone lesion .......................... 8.22 NA NA 5.67 6.83 1.38 NA NA 15.27 16.43 090 24138 ......... ............ A Remove elbow bone lesion ........................... 8.22 NA NA 6.71 7.51 1.34 NA NA 16.27 17.07 090 24140 ......... ............ A Partial removal of arm bone .......................... 9.35 NA NA 7.20 8.63 1.51 NA NA 18.06 19.49 090 24145 ......... ............ A Partial removal of radius ............................... 7.63 NA NA 6.30 7.62 1.25 NA NA 15.18 16.50 090 24147 ......... ............ A Partial removal of elbow ................................ 7.59 NA NA 6.90 8.18 1.30 NA NA 15.79 17.07 090 24149 ......... ............ A Radical resection of elbow ............................ 15.80 NA NA 10.86 11.43 2.34 NA NA 29.00 29.57 090 24150 ......... ............ A Extensive humerus surgery ........................... 13.61 NA NA 8.54 9.63 2.32 NA NA 24.47 25.56 090 24151 ......... ............ A Extensive humerus surgery ........................... 15.98 NA NA 9.77 11.08 2.59 NA NA 28.34 29.65 090 24152 ......... ............ A Extensive radius surgery ............................... 10.16 NA NA 6.29 7.37 1.48 NA NA 17.93 19.01 090 24153 ......... ............ A Extensive radius surgery ............................... 11.64 NA NA 4.92 5.41 0.74 NA NA 17.30 17.79 090 24155 ......... ............ A Removal of elbow joint .................................. 11.89 NA NA 7.61 8.20 1.92 NA NA 21.42 22.01 090 24160 ......... ............ A Remove elbow joint implant .......................... 7.82 NA NA 5.82 6.62 1.30 NA NA 14.94 15.74 09024164 ......... ............ A Remove radius head implant ........................ 6.28 NA NA 4.92 5.56 1.03 NA NA 12.23 12.87 090 24200 ......... ............ A Removal of arm foreign body ........................ 1.76 2.78 3.25 1.38 1.57 0.20 4.74 5.21 3.34 3.53 010 24201 ......... ............ A Removal of arm foreign body ........................ 4.55 7.92 9.34 3.71 4.10 0.72 13.19 14.61 8.98 9.37 090 24220 ......... ............ A Injection for elbow x-ray ................................ 1.31 2.64 3.38 0.43 0.44 0.08 4.03 4.77 1.82 1.83 000 24300 ......... ............ A Manipulate elbow w/anesth ........................... 3.74 NA NA 5.18 5.58 0.65 NA NA 9.57 9.97 090 24301 ......... ............ A Muscle/tendon transfer .................................. 10.18 NA NA 6.85 7.85 1.66 NA NA 18.69 19.69 090 24305 ......... ............ A Arm tendon lengthening ................................ 7.44 NA NA 5.66 6.45 1.15 NA NA 14.25 15.04 090 24310 ......... ............ A Revision of arm tendon ................................. 5.97 NA NA 4.78 5.38 0.96 NA NA 11.71 12.31 090 24320 ......... ............ A Repair of arm tendon .................................... 10.66 NA NA 7.11 7.43 1.73 NA NA 19.50 19.82 090 24330 ......... ............ A Revision of arm muscles ............................... 9.59 NA NA 6.64 7.57 1.60 NA NA 17.83 18.76 090 24331 ......... ............ A Revision of arm muscles ............................... 10.75 NA NA 6.52 8.13 1.77 NA NA 19.04 20.65 090 24332 ......... ............ A Tenolysis, triceps ........................................... 7.69 NA NA 5.75 6.52 1.23 NA NA 14.67 15.44 090 24340 ......... ............ A Repair of biceps tendon ................................ 7.88 NA NA 6.00 6.74 1.36 NA NA 15.24 15.98 090 24341 ......... ............ A Repair arm tendon/muscle ............................ 9.14 NA NA 7.52 7.82 1.36 NA NA 18.02 18.32 09024342 ......... ............ A Repair of ruptured tendon ............................. 10.66 NA NA 7.11 8.17 1.85 NA NA 19.62 20.68 090 24343 ......... ............ A Repr elbow lat ligmnt w/tiss .......................... 8.89 NA NA 7.02 7.87 1.43 NA NA 17.34 18.19 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49104 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

24344 ......... ............ A Reconstruct elbow lat ligmnt ......................... 14.85 NA NA 10.06 11.16 2.36 NA NA 27.27 28.37 090 24345 ......... ............ A Repr elbw med ligmnt w/tissu ....................... 8.89 NA NA 6.98 7.76 1.44 NA NA 17.31 18.09 090 24346 ......... ............ A Reconstruct elbow med ligmnt ...................... 14.85 NA NA 10.06 11.02 2.33 NA NA 27.24 28.20 090 24350 ......... ............ A Repair of tennis elbow .................................. 5.24 NA NA 4.89 5.41 0.87 NA NA 11.00 11.52 090 24351 ......... ............ A Repair of tennis elbow .................................. 5.90 NA NA 5.01 5.69 1.02 NA NA 11.93 12.61 090 24352 ......... ............ A Repair of tennis elbow .................................. 6.42 NA NA 5.23 5.94 1.10 NA NA 12.75 13.46 090 24354 ......... ............ A Repair of tennis elbow .................................. 6.47 NA NA 5.25 5.93 1.07 NA NA 12.79 13.47 090 24356 ......... ............ A Revision of tennis elbow ............................... 6.67 NA NA 5.32 6.06 1.11 NA NA 13.10 13.84 090 24360 ......... ............ A Reconstruct elbow joint ................................. 12.44 NA NA 7.97 9.10 2.05 NA NA 22.46 23.59 090 24361 ......... ............ A Reconstruct elbow joint ................................. 14.18 NA NA 8.78 10.13 2.18 NA NA 25.14 26.49 090 24362 ......... ............ A Reconstruct elbow joint ................................. 15.09 NA NA 9.30 9.86 2.60 NA NA 26.99 27.55 090 24363 ......... ............ A Replace elbow joint ....................................... 22.39 NA NA 12.26 13.35 3.01 NA NA 37.66 38.75 090 24365 ......... ............ A Reconstruct head of radius ........................... 8.44 NA NA 5.94 6.89 1.41 NA NA 15.79 16.74 090 24366 ......... ............ A Reconstruct head of radius ........................... 9.18 NA NA 6.31 7.23 1.52 NA NA 17.01 17.93 090 24400 ......... ............ A Revision of humerus ..................................... 11.10 NA NA 7.62 8.54 1.92 NA NA 20.64 21.56 090 24410 ......... ............ A Revision of humerus ..................................... 14.86 NA NA 9.32 10.06 2.57 NA NA 26.75 27.49 090 24420 ......... ............ A Revision of humerus ..................................... 13.48 NA NA 8.88 10.13 2.17 NA NA 24.53 25.78 090 24430 ......... ............ A Repair of humerus ......................................... 14.99 NA NA 9.30 9.63 2.21 NA NA 26.50 26.83 090 24435 ......... ............ A Repair humerus with graft ............................. 14.64 NA NA 9.86 10.63 2.27 NA NA 26.77 27.54 090 24470 ......... ............ A Revision of elbow joint .................................. 8.73 NA NA 6.43 7.40 1.48 NA NA 16.64 17.61 090 24495 ......... ............ A Decompression of forearm ............................ 8.23 NA NA 6.68 8.23 1.18 NA NA 16.09 17.64 09024498 ......... ............ A Reinforce humerus ........................................ 12.08 NA NA 7.75 8.88 2.06 NA NA 21.89 23.02 090 24500 ......... ............ A Treat humerus fracture .................................. 3.21 4.45 4.75 3.80 3.71 0.50 8.16 8.46 7.51 7.42 090 24505 ......... ............ A Treat humerus fracture .................................. 5.16 5.87 6.42 4.90 5.27 0.89 11.92 12.47 10.95 11.32 090 24515 ......... ............ A Treat humerus fracture .................................. 11.87 NA NA 8.09 9.06 2.02 NA NA 21.98 22.95 090 24516 ......... ............ A Treat humerus fracture .................................. 11.99 NA NA 7.71 8.76 2.02 NA NA 21.72 22.77 090 24530 ......... ............ A Treat humerus fracture .................................. 3.49 4.74 5.09 4.00 4.03 0.57 8.80 9.15 8.06 8.09 090 24535 ......... ............ A Treat humerus fracture .................................. 6.86 6.82 7.59 5.86 6.43 1.18 14.86 15.63 13.90 14.47 090 24538 ......... ............ A Treat humerus fracture .................................. 9.54 NA NA 7.22 8.33 1.64 NA NA 18.40 19.51 090 24545 ......... ............ A Treat humerus fracture .................................. 10.80 NA NA 7.24 8.15 1.82 NA NA 19.86 20.77 090 24546 ......... ............ A Treat humerus fracture .................................. 15.91 NA NA 9.50 10.87 2.73 NA NA 28.14 29.51 090 24560 ......... ............ A Treat humerus fracture .................................. 2.80 4.05 4.37 3.38 3.24 0.44 7.29 7.61 6.62 6.48 090 24565 ......... ............ A Treat humerus fracture .................................. 5.55 5.86 6.42 4.97 5.38 0.93 12.34 12.90 11.45 11.86 090 24566 ......... ............ A Treat humerus fracture .................................. 8.78 NA NA 6.97 7.86 1.30 NA NA 17.05 17.94 090 24575 ......... ............ A Treat humerus fracture .................................. 10.94 NA NA 7.27 8.12 1.86 NA NA 20.07 20.92 090 24576 ......... ............ A Treat humerus fracture .................................. 2.86 4.45 4.68 3.74 3.72 0.46 7.77 8.00 7.06 7.04 090 24577 ......... ............ A Treat humerus fracture .................................. 5.78 6.01 6.70 5.08 5.65 0.95 12.74 13.43 11.81 12.38 090 24579 ......... ............ A Treat humerus fracture .................................. 11.88 NA NA 7.87 8.59 2.02 NA NA 21.77 22.49 090 24582 ......... ............ A Treat humerus fracture .................................. 9.79 NA NA 8.21 8.89 1.48 NA NA 19.48 20.16 090 24586 ......... ............ A Treat elbow fracture ...................................... 15.55 NA NA 9.36 10.76 2.64 NA NA 27.55 28.95 090 24587 ......... ............ A Treat elbow fracture ...................................... 15.56 NA NA 9.37 10.61 2.52 NA NA 27.45 28.69 090 24600 ......... ............ A Treat elbow dislocation ................................. 4.22 3.87 4.61 3.29 3.45 0.50 8.59 9.33 8.01 8.17 090 24605 ......... ............ A Treat elbow dislocation ................................. 5.41 NA NA 4.96 5.26 0.89 NA NA 11.26 11.56 090 24615 ......... ............ A Treat elbow dislocation ................................. 9.65 NA NA 6.59 7.51 1.60 NA NA 17.84 18.76 090 24620 ......... ............ A Treat elbow fracture ...................................... 6.97 NA NA 5.48 6.06 1.07 NA NA 13.52 14.10 090 24635 ......... ............ A Treat elbow fracture ...................................... 13.47 NA NA 10.23 13.10 2.28 NA NA 25.98 28.85 090 24640 ......... ............ A Treat elbow dislocation ................................. 1.20 1.48 1.75 0.80 0.80 0.12 2.80 3.07 2.12 2.12 010 24650 ......... ............ A Treat radius fracture ...................................... 2.16 3.44 3.70 3.00 2.81 0.35 5.95 6.21 5.51 5.32 090 24655 ......... ............ A Treat radius fracture ...................................... 4.39 5.20 5.76 4.41 4.70 0.70 10.29 10.85 9.50 9.79 090 24665 ......... ............ A Treat radius fracture ...................................... 8.13 NA NA 6.53 7.27 1.41 NA NA 16.07 16.81 090 24666 ......... ............ A Treat radius fracture ...................................... 9.66 NA NA 7.00 7.80 1.62 NA NA 18.28 19.08 090 24670 ......... ............ A Treat ulnar fracture ........................................ 2.54 3.74 4.02 3.16 3.09 0.41 6.69 6.97 6.11 6.04 090 24675 ......... ............ A Treat ulnar fracture ........................................ 4.71 5.30 5.83 4.50 4.85 0.81 10.82 11.35 10.02 10.37 090 24685 ......... ............ A Treat ulnar fracture ........................................ 8.85 NA NA 6.48 7.26 1.52 NA NA 16.85 17.63 090 24800 ......... ............ A Fusion of elbow joint ..................................... 11.18 NA NA 7.66 8.47 1.63 NA NA 20.47 21.28 090 24802 ......... ............ A Fusion/graft of elbow joint ............................. 14.09 NA NA 8.56 9.93 2.37 NA NA 25.02 26.39 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49105 

24900 ......... ............ A Amputation of upper arm .............................. 9.95 NA NA 6.47 6.91 1.53 NA NA 17.95 18.39 090 24920 ......... ............ A Amputation of upper arm .............................. 9.95 NA NA 6.45 6.82 1.61 NA NA 18.01 18.38 090 24925 ......... ............ A Amputation follow-up surgery ........................ 7.12 NA NA 4.95 5.80 1.14 NA NA 13.21 14.06 09024930 ......... ............ A Amputation follow-up surgery ........................ 10.65 NA NA 5.90 6.91 1.67 NA NA 18.22 19.23 090 24931 ......... ............ A Amputate upper arm & implant ..................... 13.24 NA NA 8.23 6.35 1.89 NA NA 23.36 21.48 090 24935 ......... ............ A Revision of amputation .................................. 16.20 NA NA 8.90 8.24 2.13 NA NA 27.23 26.57 090 24940 ......... ............ C Revision of upper arm ................................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 YYY 25000 ......... ............ A Incision of tendon sheath .............................. 3.37 NA NA 5.06 6.42 0.55 NA NA 8.98 10.34 090 25001 ......... ............ A Incise flexor carpi radialis .............................. 3.62 NA NA 3.85 4.14 0.55 NA NA 8.02 8.31 090 25020 ......... ............ A Decompress forearm 1 space ....................... 5.91 NA NA 6.90 8.90 0.93 NA NA 13.74 15.74 090 25023 ......... ............ A Decompress forearm 1 space ....................... 13.60 NA NA 11.48 14.08 2.03 NA NA 27.11 29.71 09025024 ......... ............ A Decompress forearm 2 spaces ..................... 10.52 NA NA 7.20 7.40 1.36 NA NA 19.08 19.28 090 25025 ......... ............ A Decompress forearm 2 spaces ..................... 17.67 NA NA 9.03 9.74 1.82 NA NA 28.52 29.23 090 25028 ......... ............ A Drainage of forearm lesion ............................ 5.24 NA NA 6.25 7.68 0.81 NA NA 12.30 13.73 090 25031 ......... ............ A Drainage of forearm bursa ............................ 4.13 NA NA 5.47 7.31 0.63 NA NA 10.23 12.07 090 25035 ......... ............ A Treat forearm bone lesion ............................. 7.47 NA NA 8.88 12.41 1.24 NA NA 17.59 21.12 090 25040 ......... ............ A Explore/treat wrist joint .................................. 7.35 NA NA 5.90 6.95 1.15 NA NA 14.40 15.45 090 25065 ......... ............ A Biopsy forearm soft tissues ........................... 1.99 4.19 3.46 1.90 1.90 0.15 6.33 5.60 4.04 4.04 010 25066 ......... ............ A Biopsy forearm soft tissues ........................... 4.12 NA NA 5.46 6.66 0.64 NA NA 10.22 11.42 090 25075 ......... ............ A Removal forearm lesion subcu ..................... 3.73 NA NA 4.90 5.64 0.55 NA NA 9.18 9.92 090 25076 ......... ............ A Removal forearm lesion deep ....................... 4.91 NA NA 6.92 8.89 0.74 NA NA 12.57 14.54 090 25077 ......... ............ A Remove tumor, forearm/wrist ........................ 9.81 NA NA 8.95 11.30 1.42 NA NA 20.18 22.53 09025085 ......... ............ A Incision of wrist capsule ................................ 5.49 NA NA 5.44 6.70 0.85 NA NA 11.78 13.04 090 25100 ......... ............ A Biopsy of wrist joint ....................................... 3.89 NA NA 4.28 5.02 0.59 NA NA 8.76 9.50 090 25101 ......... ............ A Explore/treat wrist joint .................................. 4.68 NA NA 4.83 5.63 0.75 NA NA 10.26 11.06 090 25105 ......... ............ A Remove wrist joint lining ............................... 5.84 NA NA 5.82 6.93 0.92 NA NA 12.58 13.69 090 25107 ......... ............ A Remove wrist joint cartilage .......................... 7.42 NA NA 7.16 8.05 0.99 NA NA 15.57 16.46 090 25110 ......... ............ A Remove wrist tendon lesion .......................... 3.91 NA NA 5.29 6.61 0.62 NA NA 9.82 11.14 090 25111 ......... ............ A Remove wrist tendon lesion .......................... 3.38 NA NA 4.10 4.55 0.53 NA NA 8.01 8.46 090 25112 ......... ............ A Reremove wrist tendon lesion ....................... 4.52 NA NA 4.54 5.07 0.70 NA NA 9.76 10.29 090 25115 ......... ............ A Remove wrist/forearm lesion ......................... 9.81 NA NA 10.21 13.08 1.31 NA NA 21.33 24.20 090 25116 ......... ............ A Remove wrist/forearm lesion ......................... 7.28 NA NA 9.08 12.13 1.11 NA NA 17.47 20.52 090 25118 ......... ............ A Excise wrist tendon sheath ........................... 4.36 NA NA 4.63 5.46 0.68 NA NA 9.67 10.50 09025119 ......... ............ A Partial removal of ulna .................................. 6.03 NA NA 5.86 7.17 0.96 NA NA 12.85 14.16 090 25120 ......... ............ A Removal of forearm lesion ............................ 6.09 NA NA 7.93 11.04 1.00 NA NA 15.02 18.13 090 25125 ......... ............ A Remove/graft forearm lesion ......................... 7.47 NA NA 8.75 11.82 1.06 NA NA 17.28 20.35 090 25126 ......... ............ A Remove/graft forearm lesion ......................... 7.54 NA NA 8.78 11.95 1.27 NA NA 17.59 20.76 090 25130 ......... ............ A Removal of wrist lesion ................................. 5.25 NA NA 5.21 6.12 0.80 NA NA 11.26 12.17 090 25135 ......... ............ A Remove & graft wrist lesion .......................... 6.88 NA NA 6.12 7.16 1.02 NA NA 14.02 15.06 090 25136 ......... ............ A Remove & graft wrist lesion .......................... 5.96 NA NA 5.53 6.33 1.03 NA NA 12.52 13.32 090 25145 ......... ............ A Remove forearm bone lesion ........................ 6.36 NA NA 8.12 11.08 1.01 NA NA 15.49 18.45 090 25150 ......... ............ A Partial removal of ulna .................................. 7.20 NA NA 6.38 7.75 1.14 NA NA 14.72 16.09 090 25151 ......... ............ A Partial removal of radius ............................... 7.50 NA NA 8.52 11.67 1.18 NA NA 17.20 20.35 090 25170 ......... ............ A Extensive forearm surgery ............................ 11.25 NA NA 10.52 13.99 1.77 NA NA 23.54 27.01 090 25210 ......... ............ A Removal of wrist bone .................................. 5.94 NA NA 5.53 6.48 0.88 NA NA 12.35 13.30 090 25215 ......... ............ A Removal of wrist bones ................................. 7.94 NA NA 6.83 8.27 1.19 NA NA 15.96 17.40 090 25230 ......... ............ A Partial removal of radius ............................... 5.22 NA NA 4.96 5.85 0.79 NA NA 10.97 11.86 090 25240 ......... ............ A Partial removal of ulna .................................. 5.16 NA NA 5.27 6.53 0.81 NA NA 11.24 12.50 090 25246 ......... ............ A Injection for wrist x-ray .................................. 1.45 2.70 3.26 0.48 0.48 0.09 4.24 4.80 2.02 2.02 000 25248 ......... ............ A Remove forearm foreign body ...................... 5.13 NA NA 6.57 8.03 0.72 NA NA 12.42 13.88 090 25250 ......... ............ A Removal of wrist prosthesis .......................... 6.59 NA NA 5.32 5.91 1.01 NA NA 12.92 13.51 090 25251 ......... ............ A Removal of wrist prosthesis .......................... 9.62 NA NA 6.71 7.62 1.26 NA NA 17.59 18.50 090 25259 ......... ............ A Manipulate wrist w/anesthes ......................... 3.74 NA NA 5.14 5.58 0.62 NA NA 9.50 9.94 090 25260 ......... ............ A Repair forearm tendon/muscle ...................... 7.79 NA NA 9.22 12.29 1.19 NA NA 18.20 21.27 090 25263 ......... ............ A Repair forearm tendon/muscle ...................... 7.81 NA NA 8.96 12.19 1.18 NA NA 17.95 21.18 090 25265 ......... ............ A Repair forearm tendon/muscle ...................... 9.87 NA NA 10.00 13.23 1.47 NA NA 21.34 24.57 09025270 ......... ............ A Repair forearm tendon/muscle ...................... 5.99 NA NA 7.90 11.00 0.95 NA NA 14.84 17.94 090 25272 ......... ............ A Repair forearm tendon/muscle ...................... 7.03 NA NA 8.37 11.69 1.11 NA NA 16.51 19.83 090 25274 ......... ............ A Repair forearm tendon/muscle ...................... 8.74 NA NA 9.20 12.52 1.36 NA NA 19.30 22.62 090 25275 ......... ............ A Repair forearm tendon sheath ...................... 8.74 NA NA 6.50 7.31 1.31 NA NA 16.55 17.36 090 25280 ......... ............ A Revise wrist/forearm tendon ......................... 7.21 NA NA 8.47 11.59 1.08 NA NA 16.76 19.88 090 25290 ......... ............ A Incise wrist/forearm tendon ........................... 5.28 NA NA 9.17 13.54 0.82 NA NA 15.27 19.64 090 25295 ......... ............ A Release wrist/forearm tendon ....................... 6.54 NA NA 8.14 11.15 1.00 NA NA 15.68 18.69 09025300 ......... ............ A Fusion of tendons at wrist ............................. 8.79 NA NA 7.19 8.14 1.26 NA NA 17.24 18.19 090 25301 ......... ............ A Fusion of tendons at wrist ............................. 8.39 NA NA 6.73 7.73 1.29 NA NA 16.41 17.41 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49106 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

25310 ......... ............ A Transplant forearm tendon ............................ 8.19 NA NA 8.82 11.98 1.21 NA NA 18.22 21.38 090 25312 ......... ............ A Transplant forearm tendon ............................ 9.62 NA NA 9.60 12.86 1.41 NA NA 20.63 23.89 090 25315 ......... ............ A Revise palsy hand tendon(s) ........................ 10.48 NA NA 10.00 13.30 1.58 NA NA 22.06 25.36 090 25316 ......... ............ A Revise palsy hand tendon(s) ........................ 12.67 NA NA 11.08 14.94 1.74 NA NA 25.49 29.35 090 25320 ......... ............ A Repair/revise wrist joint ................................. 12.28 NA NA 10.38 11.14 1.61 NA NA 24.27 25.03 090 25332 ......... ............ A Revise wrist joint ........................................... 11.51 NA NA 7.74 8.81 1.83 NA NA 21.08 22.15 090 25335 ......... ............ A Realignment of hand ..................................... 13.16 NA NA 7.01 10.45 1.92 NA NA 22.09 25.53 090 25337 ......... ............ A Reconstruct ulna/radioulnar .......................... 11.36 NA NA 9.39 10.66 1.61 NA NA 22.36 23.63 090 25350 ......... ............ A Revision of radius .......................................... 8.89 NA NA 9.27 12.80 1.46 NA NA 19.62 23.15 090 25355 ......... ............ A Revision of radius .......................................... 10.33 NA NA 10.03 13.47 1.73 NA NA 22.09 25.53 090 25360 ......... ............ A Revision of ulna ............................................. 8.54 NA NA 9.13 12.69 1.41 NA NA 19.08 22.64 090 25365 ......... ............ A Revise radius & ulna ..................................... 12.68 NA NA 11.06 14.50 2.15 NA NA 25.89 29.33 090 25370 ......... ............ A Revise radius or ulna .................................... 13.82 NA NA 11.97 15.05 2.28 NA NA 28.07 31.15 090 25375 ......... ............ A Revise radius & ulna ..................................... 13.32 NA NA 11.33 15.15 2.26 NA NA 26.91 30.73 090 25390 ......... ............ A Shorten radius or ulna ................................... 10.50 NA NA 9.94 13.42 1.65 NA NA 22.09 25.57 090 25391 ......... ............ A Lengthen radius or ulna ................................ 14.05 NA NA 11.65 15.33 2.21 NA NA 27.91 31.59 090 25392 ......... ............ A Shorten radius & ulna ................................... 14.35 NA NA 11.78 14.92 2.10 NA NA 28.23 31.37 090 25393 ......... ............ A Lengthen radius & ulna ................................. 16.33 NA NA 13.18 16.48 2.76 NA NA 32.27 35.57 090 25394 ......... ............ A Repair carpal bone, shorten .......................... 10.63 NA NA 6.80 7.75 1.59 NA NA 19.02 19.97 090 25400 ......... ............ A Repair radius or ulna ..................................... 11.08 NA NA 10.18 13.94 1.82 NA NA 23.08 26.84 090 25405 ......... ............ A Repair/graft radius or ulna ............................ 14.78 NA NA 11.92 15.93 2.32 NA NA 29.02 33.03 090 25415 ......... ............ A Repair radius & ulna ..................................... 13.57 NA NA 11.02 15.14 2.17 NA NA 26.76 30.88 090 25420 ......... ............ A Repair/graft radius & ulna ............................. 16.79 NA NA 12.79 16.90 2.61 NA NA 32.19 36.30 090 25425 ......... ............ A Repair/graft radius or ulna ............................ 13.49 NA NA 14.14 19.58 2.08 NA NA 29.71 35.15 090 25426 ......... ............ A Repair/graft radius & ulna ............................. 16.22 NA NA 12.50 15.54 2.54 NA NA 31.26 34.30 090 25430 ......... ............ A Vasc graft into carpal bone ........................... 9.49 NA NA 7.04 7.27 1.27 NA NA 17.80 18.03 090 25431 ......... ............ A Repair nonunion carpal bone ........................ 10.67 NA NA 7.26 8.12 1.90 NA NA 19.83 20.69 09025440 ......... ............ A Repair/graft wrist bone .................................. 10.48 NA NA 7.53 8.93 1.63 NA NA 19.64 21.04 090 25441 ......... ............ A Reconstruct wrist joint ................................... 13.06 NA NA 8.50 9.63 2.07 NA NA 23.63 24.76 090 25442 ......... ............ A Reconstruct wrist joint ................................... 10.89 NA NA 7.32 8.49 1.53 NA NA 19.74 20.91 090 25443 ......... ............ A Reconstruct wrist joint ................................... 10.43 NA NA 6.61 8.23 1.37 NA NA 18.41 20.03 090 25444 ......... ............ A Reconstruct wrist joint ................................... 11.19 NA NA 7.65 8.69 1.71 NA NA 20.55 21.59 090 25445 ......... ............ A Reconstruct wrist joint ................................... 9.68 NA NA 6.72 7.67 1.55 NA NA 17.95 18.90 090 25446 ......... ............ A Wrist replacement ......................................... 17.07 NA NA 9.88 11.41 2.47 NA NA 29.42 30.95 090 25447 ......... ............ A Repair wrist joint(s) ....................................... 10.85 NA NA 7.88 8.46 1.61 NA NA 20.34 20.92 090 25449 ......... ............ A Remove wrist joint implant ............................ 14.71 NA NA 9.05 10.27 2.21 NA NA 25.97 27.19 090 25450 ......... ............ A Revision of wrist joint .................................... 7.86 NA NA 7.34 9.48 1.36 NA NA 16.56 18.70 090 25455 ......... ............ A Revision of wrist joint .................................... 9.48 NA NA 6.50 9.77 0.96 NA NA 16.94 20.21 090 25490 ......... ............ A Reinforce radius ............................................ 9.53 NA NA 9.47 12.67 1.43 NA NA 20.43 23.63 090 25491 ......... ............ A Reinforce ulna ............................................... 9.95 NA NA 9.73 13.28 1.60 NA NA 21.28 24.83 090 25492 ......... ............ A Reinforce radius and ulna ............................. 12.43 NA NA 10.59 14.12 2.14 NA NA 25.16 28.69 090 25500 ......... ............ A Treat fracture of radius .................................. 2.45 3.33 3.51 2.89 2.76 0.35 6.13 6.31 5.69 5.56 090 25505 ......... ............ A Treat fracture of radius .................................. 5.20 5.87 6.37 5.01 5.32 0.90 11.97 12.47 11.11 11.42 090 25515 ......... ............ A Treat fracture of radius .................................. 9.29 NA NA 6.75 7.28 1.59 NA NA 17.63 18.16 090 25520 ......... ............ A Treat fracture of radius .................................. 6.25 6.02 6.65 5.43 5.90 1.08 13.35 13.98 12.76 13.23 090 25525 ......... ............ A Treat fracture of radius .................................. 12.59 NA NA 8.74 9.68 2.12 NA NA 23.45 24.39 090 25526 ......... ............ A Treat fracture of radius .................................. 13.33 NA NA 10.23 12.68 2.19 NA NA 25.75 28.20 090 25530 ......... ............ A Treat fracture of ulna ..................................... 2.09 3.48 3.69 2.97 2.89 0.34 5.91 6.12 5.40 5.32 090 25535 ......... ............ A Treat fracture of ulna ..................................... 5.13 5.68 5.93 4.93 5.20 0.89 11.70 11.95 10.95 11.22 090 25545 ......... ............ A Treat fracture of ulna ..................................... 9.01 NA NA 6.64 7.41 1.53 NA NA 17.18 17.95 090 25560 ......... ............ A Treat fracture radius & ulna .......................... 2.44 3.40 3.62 2.87 2.67 0.35 6.19 6.41 5.66 5.46 090 25565 ......... ............ A Treat fracture radius & ulna .......................... 5.62 5.97 6.52 4.99 5.31 0.93 12.52 13.07 11.54 11.86 090 25574 ......... ............ A Treat fracture radius & ulna .......................... 7.37 NA NA 6.64 7.06 1.21 NA NA 15.22 15.64 090 25575 ......... ............ A Treat fracture radius/ulna .............................. 11.92 NA NA 9.00 9.38 1.81 NA NA 22.73 23.11 090 25600 ......... ............ A Treat fracture radius/ulna .............................. 2.63 3.69 3.99 3.18 3.02 0.42 6.74 7.04 6.23 6.07 090 25605 ......... ............ A Treat fracture radius/ulna .............................. 6.93 6.91 7.15 6.18 6.21 1.00 14.84 15.08 14.11 14.14 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49107 

25611 ......... ............ A Treat fracture radius/ulna .............................. 9.14 NA NA 8.34 8.81 1.34 NA NA 18.82 19.29 090 25620 ......... ............ A Treat fracture radius/ulna .............................. 8.54 NA NA 6.27 7.01 1.42 NA NA 16.23 16.97 090 25622 ......... ............ A Treat wrist bone fracture ............................... 2.61 3.91 4.18 3.36 3.17 0.41 6.93 7.20 6.38 6.19 090 25624 ......... ............ A Treat wrist bone fracture ............................... 4.52 5.58 6.12 4.73 4.99 0.76 10.86 11.40 10.01 10.27 090 25628 ......... ............ A Treat wrist bone fracture ............................... 9.42 NA NA 7.34 7.70 1.37 NA NA 18.13 18.49 090 25630 ......... ............ A Treat wrist bone fracture ............................... 2.88 3.76 4.08 3.25 3.02 0.45 7.09 7.41 6.58 6.35 090 25635 ......... ............ A Treat wrist bone fracture ............................... 4.38 5.38 5.80 4.56 4.07 0.74 10.50 10.92 9.68 9.19 090 25645 ......... ............ A Treat wrist bone fracture ............................... 7.24 NA NA 5.80 6.42 1.20 NA NA 14.24 14.86 090 25650 ......... ............ A Treat wrist bone fracture ............................... 3.05 3.86 4.20 3.46 3.24 0.45 7.36 7.70 6.96 6.74 090 25651 ......... ............ A Pin ulnar styloid fracture ............................... 5.60 NA NA 5.13 5.39 0.86 NA NA 11.59 11.85 090 25652 ......... ............ A Treat fracture ulnar styloid ............................ 7.84 NA NA 6.21 6.80 1.21 NA NA 15.26 15.85 090 25660 ......... ............ A Treat wrist dislocation ................................... 4.75 NA NA 4.48 4.65 0.58 NA NA 9.81 9.98 090 25670 ......... ............ A Treat wrist dislocation ................................... 7.91 NA NA 5.99 6.74 1.28 NA NA 15.18 15.93 090 25671 ......... ............ A Pin radioulnar dislocation .............................. 6.24 NA NA 5.53 6.00 1.00 NA NA 12.77 13.24 090 25675 ......... ............ A Treat wrist dislocation ................................... 4.66 4.88 5.46 4.14 4.52 0.62 10.16 10.74 9.42 9.80 090 25676 ......... ............ A Treat wrist dislocation ................................... 8.09 NA NA 6.28 7.05 1.34 NA NA 15.71 16.48 090 25680 ......... ............ A Treat wrist fracture ........................................ 5.98 NA NA 4.37 4.65 0.78 NA NA 11.13 11.41 090 25685 ......... ............ A Treat wrist fracture ........................................ 9.89 NA NA 6.70 7.53 1.60 NA NA 18.19 19.02 090 25690 ......... ............ A Treat wrist dislocation ................................... 5.49 NA NA 4.82 5.33 0.88 NA NA 11.19 11.70 090 25695 ......... ............ A Treat wrist dislocation ................................... 8.33 NA NA 6.19 6.87 1.32 NA NA 15.84 16.52 090 25800 ......... ............ A Fusion of wrist joint ....................................... 9.87 NA NA 7.28 8.64 1.57 NA NA 18.72 20.08 090 25805 ......... ............ A Fusion/graft of wrist joint ............................... 11.50 NA NA 8.17 9.73 1.80 NA NA 21.47 23.03 090 25810 ......... ............ A Fusion/graft of wrist joint ............................... 11.67 NA NA 8.56 9.57 1.67 NA NA 21.90 22.91 090 25820 ......... ............ A Fusion of hand bones ................................... 7.44 NA NA 6.28 7.46 1.22 NA NA 14.94 16.12 090 25825 ......... ............ A Fuse hand bones with graft .......................... 9.44 NA NA 7.56 8.81 1.41 NA NA 18.41 19.66 09025830 ......... ............ A Fusion, radioulnar jnt/ulna ............................. 10.61 NA NA 10.46 13.42 1.55 NA NA 22.62 25.58 090 25900 ......... ............ A Amputation of forearm ................................... 9.36 NA NA 9.27 11.74 1.30 NA NA 19.93 22.40 090 25905 ......... ............ A Amputation of forearm ................................... 9.41 NA NA 8.44 11.33 1.40 NA NA 19.25 22.14 090 25907 ......... ............ A Amputation follow-up surgery ........................ 7.91 NA NA 7.81 10.77 1.10 NA NA 16.82 19.78 090 25909 ......... ............ A Amputation follow-up surgery ........................ 9.13 NA NA 9.04 11.46 1.44 NA NA 19.61 22.03 090 25915 ......... ............ A Amputation of forearm ................................... 17.30 NA NA 8.23 16.22 2.93 NA NA 28.46 36.45 090 25920 ......... ............ A Amputate hand at wrist ................................. 8.85 NA NA 6.72 7.57 1.35 NA NA 16.92 17.77 090 25922 ......... ............ A Amputate hand at wrist ................................. 7.47 NA NA 6.40 6.89 1.12 NA NA 14.99 15.48 090 25924 ......... ............ A Amputation follow-up surgery ........................ 8.63 NA NA 6.71 7.75 1.32 NA NA 16.66 17.70 09025927 ......... ............ A Amputation of hand ....................................... 8.91 NA NA 8.62 10.92 1.27 NA NA 18.80 21.10 090 25929 ......... ............ A Amputation follow-up surgery ........................ 7.64 NA NA 5.42 5.76 1.14 NA NA 14.20 14.54 09025931 ......... ............ A Amputation follow-up surgery ........................ 7.86 NA NA 8.53 10.73 1.15 NA NA 17.54 19.74 090 25999 ......... ............ C Forearm or wrist surgery ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 26010 ......... ............ A Drainage of finger abscess ........................... 1.54 4.02 5.18 1.51 1.60 0.18 5.74 6.90 3.23 3.32 010 26011 ......... ............ A Drainage of finger abscess ........................... 2.19 6.29 8.18 1.98 2.24 0.33 8.81 10.70 4.50 4.76 010 26020 ......... ............ A Drain hand tendon sheath ............................. 4.90 NA NA 4.75 5.20 0.73 NA NA 10.38 10.83 090 26025 ......... ............ A Drainage of palm bursa ................................. 4.93 NA NA 4.46 4.96 0.76 NA NA 10.15 10.65 090 26030 ......... ............ A Drainage of palm bursa(s) ............................ 6.10 NA NA 4.99 5.54 0.92 NA NA 12.01 12.56 090 26034 ......... ............ A Treat hand bone lesion ................................. 6.40 NA NA 5.55 6.15 1.01 NA NA 12.96 13.56 090 26035 ......... ............ A Decompress fingers/hand ............................. 11.05 NA NA 8.01 7.91 1.47 NA NA 20.53 20.43 090 26037 ......... ............ A Decompress fingers/hand ............................. 7.42 NA NA 5.51 6.12 1.13 NA NA 14.06 14.67 09026040 ......... ............ A Release palm contracture ............................. 3.33 NA NA 3.60 3.94 0.53 NA NA 7.46 7.80 090 26045 ......... ............ A Release palm contracture ............................. 5.55 NA NA 4.88 5.45 0.93 NA NA 11.36 11.93 090 26055 ......... ............ A Incise finger tendon sheath ........................... 2.94 9.07 13.03 3.83 3.91 0.43 12.44 16.40 7.20 7.28 090 26060 ......... ............ A Incision of finger tendon ................................ 2.81 NA NA 3.06 3.40 0.45 NA NA 6.32 6.66 090 26070 ......... ............ A Explore/treat hand joint ................................. 3.68 NA NA 3.04 3.28 0.48 NA NA 7.20 7.44 090 26075 ......... ............ A Explore/treat finger joint ................................ 3.78 NA NA 3.41 3.69 0.53 NA NA 7.72 8.00 090 26080 ......... ............ A Explore/treat finger joint ................................ 4.29 NA NA 4.34 4.72 0.66 NA NA 9.29 9.67 090 26100 ......... ............ A Biopsy hand joint lining ................................. 3.66 NA NA 3.56 3.99 0.54 NA NA 7.76 8.19 090 26105 ......... ............ A Biopsy finger joint lining ................................ 3.70 NA NA 3.74 4.11 0.59 NA NA 8.03 8.40 090 26110 ......... ............ A Biopsy finger joint lining ................................ 3.52 NA NA 3.60 3.93 0.53 NA NA 7.65 7.98 090 26115 ......... ............ A Removal hand lesion subcut ......................... 3.85 9.84 12.28 4.21 4.63 0.59 14.28 16.72 8.65 9.07 090 26116 ......... ............ A Removal hand lesion, deep .......................... 5.52 NA NA 5.29 5.82 0.84 NA NA 11.65 12.18 090 26117 ......... ............ A Remove tumor, hand/finger ........................... 8.54 NA NA 6.21 6.85 1.26 NA NA 16.01 16.65 09026121 ......... ............ A Release palm contracture ............................. 7.53 NA NA 5.94 6.71 1.17 NA NA 14.64 15.41 090 26123 ......... ............ A Release palm contracture ............................. 10.53 NA NA 8.23 8.70 1.43 NA NA 20.19 20.66 090 26125 ......... ............ A Release palm contracture ............................. 4.60 NA NA 1.89 2.30 0.70 NA NA 7.19 7.60 ZZZ 26130 ......... ............ A Remove wrist joint lining ............................... 5.41 NA NA 4.85 5.22 0.94 NA NA 11.20 11.57 090 26135 ......... ............ A Revise finger joint, each ................................ 6.95 NA NA 5.49 6.22 1.07 NA NA 13.51 14.24 090 26140 ......... ............ A Revise finger joint, each ................................ 6.16 NA NA 5.17 5.82 0.92 NA NA 12.25 12.90 090 26145 ......... ............ A Tendon excision, palm/finger ........................ 6.31 NA NA 5.19 5.84 0.97 NA NA 12.47 13.12 090

mstockstill on PROD1PC63 with PROPOSAL_2

49108 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

26160 ......... ............ A Remove tendon sheath lesion ...................... 3.40 9.02 11.53 3.92 4.07 0.49 12.91 15.42 7.81 7.96 090 26170 ......... ............ A Removal of palm tendon, each ..................... 4.76 NA NA 4.36 4.80 0.69 NA NA 9.81 10.25 090 26180 ......... ............ A Removal of finger tendon .............................. 5.17 NA NA 4.77 5.25 0.78 NA NA 10.72 11.20 090 26185 ......... ............ A Remove finger bone ...................................... 6.24 NA NA 5.81 5.98 0.81 NA NA 12.86 13.03 090 26200 ......... ............ A Remove hand bone lesion ............................ 5.50 NA NA 4.58 5.16 0.88 NA NA 10.96 11.54 090 26205 ......... ............ A Remove/graft bone lesion ............................. 7.75 NA NA 5.85 6.63 1.20 NA NA 14.80 15.58 090 26210 ......... ............ A Removal of finger lesion ............................... 5.14 NA NA 4.74 5.25 0.79 NA NA 10.67 11.18 090 26215 ......... ............ A Remove/graft finger lesion ............................ 7.09 NA NA 5.53 6.12 0.98 NA NA 13.60 14.19 090 26230 ......... ............ A Partial removal of hand bone ........................ 6.32 NA NA 5.01 5.69 1.01 NA NA 12.34 13.02 09026235 ......... ............ A Partial removal, finger bone .......................... 6.18 NA NA 4.96 5.60 0.95 NA NA 12.09 12.73 090 26236 ......... ............ A Partial removal, finger bone .......................... 5.31 NA NA 4.55 5.13 0.81 NA NA 10.67 11.25 090 26250 ......... ............ A Extensive hand surgery ................................. 7.54 NA NA 5.21 6.13 1.07 NA NA 13.82 14.74 090 26255 ......... ............ A Extensive hand surgery ................................. 12.71 NA NA 8.39 9.13 1.68 NA NA 22.78 23.52 090 26260 ......... ............ A Extensive finger surgery ................................ 7.02 NA NA 5.36 5.98 1.01 NA NA 13.39 14.01 090 26261 ......... ............ A Extensive finger surgery ................................ 9.20 NA NA 6.88 6.35 1.14 NA NA 17.22 16.69 090 26262 ......... ............ A Partial removal of finger ................................ 5.66 NA NA 4.66 5.16 0.88 NA NA 11.20 11.70 090 26320 ......... ............ A Removal of implant from hand ...................... 3.97 NA NA 3.78 4.18 0.59 NA NA 8.34 8.74 090 26340 ......... ............ A Manipulate finger w/anesth ........................... 2.50 NA NA 4.60 4.81 0.39 NA NA 7.49 7.70 090 26350 ......... ............ A Repair finger/hand tendon ............................. 5.98 NA NA 9.45 13.32 0.93 NA NA 16.36 20.23 090 26352 ......... ............ A Repair/graft hand tendon .............................. 7.67 NA NA 10.04 14.03 1.13 NA NA 18.84 22.83 090 26356 ......... ............ A Repair finger/hand tendon ............................. 10.06 NA NA 13.68 17.20 1.21 NA NA 24.95 28.47 090 26357 ......... ............ A Repair finger/hand tendon ............................. 8.57 NA NA 10.26 14.29 1.33 NA NA 20.16 24.19 090 26358 ......... ............ A Repair/graft hand tendon .............................. 9.13 NA NA 10.81 15.18 1.38 NA NA 21.32 25.69 090 26370 ......... ............ A Repair finger/hand tendon ............................. 7.10 NA NA 9.50 13.71 1.12 NA NA 17.72 21.93 090 26372 ......... ............ A Repair/graft hand tendon .............................. 8.81 NA NA 10.48 15.02 1.40 NA NA 20.69 25.23 090 26373 ......... ............ A Repair finger/hand tendon ............................. 8.21 NA NA 10.16 14.57 1.23 NA NA 19.60 24.01 090 26390 ......... ............ A Revise hand/finger tendon ............................ 9.24 NA NA 9.08 12.23 1.40 NA NA 19.72 22.87 090 26392 ......... ............ A Repair/graft hand tendon .............................. 10.30 NA NA 11.02 15.30 1.57 NA NA 22.89 27.17 090 26410 ......... ............ A Repair hand tendon ....................................... 4.62 NA NA 7.56 10.85 0.73 NA NA 12.91 16.20 090 26412 ......... ............ A Repair/graft hand tendon .............................. 6.30 NA NA 8.57 12.10 0.97 NA NA 15.84 19.37 090 26415 ......... ............ A Excision, hand/finger tendon ......................... 8.33 NA NA 6.71 10.51 0.98 NA NA 16.02 19.82 090 26416 ......... ............ A Graft hand or finger tendon ........................... 9.36 NA NA 8.70 13.12 0.79 NA NA 18.85 23.27 090 26418 ......... ............ A Repair finger tendon ...................................... 4.24 NA NA 8.07 11.26 0.67 NA NA 12.98 16.17 090 26420 ......... ............ A Repair/graft finger tendon ............................. 6.76 NA NA 8.75 12.41 1.07 NA NA 16.58 20.24 090 26426 ......... ............ A Repair finger/hand tendon ............................. 6.14 NA NA 8.52 12.00 0.95 NA NA 15.61 19.09 090 26428 ......... ............ A Repair/graft finger tendon ............................. 7.20 NA NA 9.19 12.69 1.09 NA NA 17.48 20.98 090 26432 ......... ............ A Repair finger tendon ...................................... 4.01 NA NA 6.71 9.37 0.64 NA NA 11.36 14.02 090 26433 ......... ............ A Repair finger tendon ...................................... 4.55 NA NA 6.93 9.83 0.72 NA NA 12.20 15.10 090 26434 ......... ............ A Repair/graft finger tendon ............................. 6.08 NA NA 7.87 10.62 0.93 NA NA 14.88 17.63 090 26437 ......... ............ A Realignment of tendons ................................ 5.81 NA NA 7.71 10.61 0.89 NA NA 14.41 17.31 090 26440 ......... ............ A Release palm/finger tendon .......................... 5.01 NA NA 8.43 12.18 0.75 NA NA 14.19 17.94 090 26442 ......... ............ A Release palm & finger tendon ...................... 9.40 NA NA 11.61 14.86 1.20 NA NA 22.21 25.46 09026445 ......... ............ A Release hand/finger tendon .......................... 4.30 NA NA 8.10 11.88 0.65 NA NA 13.05 16.83 090 26449 ......... ............ A Release forearm/hand tendon ....................... 8.24 NA NA 11.30 14.65 1.06 NA NA 20.60 23.95 09026450 ......... ............ A Incision of palm tendon ................................. 3.66 NA NA 5.11 6.78 0.59 NA NA 9.36 11.03 090 26455 ......... ............ A Incision of finger tendon ................................ 3.63 NA NA 5.07 6.73 0.58 NA NA 9.28 10.94 090 26460 ......... ............ A Incise hand/finger tendon .............................. 3.45 NA NA 5.01 6.61 0.55 NA NA 9.01 10.61 090 26471 ......... ............ A Fusion of finger tendons ............................... 5.72 NA NA 7.66 10.35 0.88 NA NA 14.26 16.95 090 26474 ......... ............ A Fusion of finger tendons ............................... 5.31 NA NA 7.48 10.41 0.76 NA NA 13.55 16.48 090 26476 ......... ............ A Tendon lengthening ...................................... 5.17 NA NA 7.39 10.05 0.79 NA NA 13.35 16.01 090 26477 ......... ............ A Tendon shortening ........................................ 5.14 NA NA 7.47 10.16 0.81 NA NA 13.42 16.11 090 26478 ......... ............ A Lengthening of hand tendon ......................... 5.79 NA NA 7.67 10.80 0.90 NA NA 14.36 17.49 09026479 ......... ............ A Shortening of hand tendon ............................ 5.73 NA NA 7.66 10.59 0.92 NA NA 14.31 17.24 090 26480 ......... ............ A Transplant hand tendon ................................ 6.68 NA NA 9.57 13.67 1.02 NA NA 17.27 21.37 090 26483 ......... ............ A Transplant/graft hand tendon ........................ 8.28 NA NA 10.22 14.18 1.26 NA NA 19.76 23.72 090 26485 ......... ............ A Transplant palm tendon ................................ 7.69 NA NA 9.94 14.01 1.15 NA NA 18.78 22.85 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49109 

26489 ......... ............ A Transplant/graft palm tendon ........................ 9.66 NA NA 10.29 11.62 1.26 NA NA 21.21 22.54 090 26490 ......... ............ A Revise thumb tendon .................................... 8.40 NA NA 8.89 11.84 1.21 NA NA 18.50 21.45 090 26492 ......... ............ A Tendon transfer with graft ............................. 9.61 NA NA 9.77 12.64 1.40 NA NA 20.78 23.65 090 26494 ......... ............ A Hand tendon/muscle transfer ........................ 8.46 NA NA 9.01 11.98 1.28 NA NA 18.75 21.72 09026496 ......... ............ A Revise thumb tendon .................................... 9.58 NA NA 9.46 12.29 1.45 NA NA 20.49 23.32 090 26497 ......... ............ A Finger tendon transfer ................................... 9.56 NA NA 9.42 12.53 1.41 NA NA 20.39 23.50 090 26498 ......... ............ A Finger tendon transfer ................................... 13.98 NA NA 11.48 14.99 2.10 NA NA 27.56 31.07 090 26499 ......... ............ A Revision of finger .......................................... 8.97 NA NA 8.72 11.96 1.35 NA NA 19.04 22.28 090 26500 ......... ............ A Hand tendon reconstruction .......................... 5.95 NA NA 7.75 10.52 0.90 NA NA 14.60 17.37 090 26502 ......... ............ A Hand tendon reconstruction .......................... 7.13 NA NA 8.34 11.10 1.13 NA NA 16.60 19.36 090 26504 ......... ............ A Hand tendon reconstruction .......................... 7.46 NA NA 8.59 11.58 1.24 NA NA 17.29 20.28 090 26508 ......... ............ A Release thumb contracture ........................... 6.00 NA NA 7.75 10.70 0.98 NA NA 14.73 17.68 090 26510 ......... ............ A Thumb tendon transfer .................................. 5.42 NA NA 7.56 10.40 0.79 NA NA 13.77 16.61 090 26516 ......... ............ A Fusion of knuckle joint .................................. 7.14 NA NA 8.22 11.23 1.10 NA NA 16.46 19.47 090 26517 ......... ............ A Fusion of knuckle joints ................................. 8.88 NA NA 9.21 12.43 1.41 NA NA 19.50 22.72 090 26518 ......... ............ A Fusion of knuckle joints ................................. 9.07 NA NA 9.24 12.35 1.35 NA NA 19.66 22.77 090 26520 ......... ............ A Release knuckle contracture ......................... 5.29 NA NA 8.81 12.62 0.80 NA NA 14.90 18.71 090 26525 ......... ............ A Release finger contracture ............................ 5.32 NA NA 8.82 12.68 0.81 NA NA 14.95 18.81 090 26530 ......... ............ A Revise knuckle joint ...................................... 6.68 NA NA 5.43 5.96 1.04 NA NA 13.15 13.68 090 26531 ......... ............ A Revise knuckle with implant .......................... 7.90 NA NA 6.15 6.88 1.17 NA NA 15.22 15.95 090 26535 ......... ............ A Revise finger joint .......................................... 5.23 NA NA 4.04 3.82 0.71 NA NA 9.98 9.76 090 26536 ......... ............ A Revise/implant finger joint ............................. 6.36 NA NA 9.14 9.52 0.96 NA NA 16.46 16.84 090 26540 ......... ............ A Repair hand joint ........................................... 6.42 NA NA 7.98 10.90 0.99 NA NA 15.39 18.31 090 26541 ......... ............ A Repair hand joint with graft ........................... 8.61 NA NA 9.04 12.30 1.28 NA NA 18.93 22.19 090 26542 ......... ............ A Repair hand joint with graft ........................... 6.77 NA NA 8.13 11.06 1.02 NA NA 15.92 18.85 090 26545 ......... ............ A Reconstruct finger joint ................................. 6.91 NA NA 8.32 11.18 1.05 NA NA 16.28 19.14 090 26546 ......... ............ A Repair nonunion hand ................................... 10.41 NA NA 11.42 14.13 1.44 NA NA 23.27 25.98 090 26548 ......... ............ A Reconstruct finger joint ................................. 8.02 NA NA 8.78 11.83 1.20 NA NA 18.00 21.05 090 26550 ......... ............ A Construct thumb replacement ....................... 21.46 NA NA 15.40 17.04 2.45 NA NA 39.31 40.95 090 26551 ......... ............ A Great toe-hand transfer ................................. 48.09 NA NA 21.71 29.76 7.96 NA NA 77.76 85.81 090 26553 ......... ............ A Single transfer, toe-hand ............................... 47.78 NA NA 20.29 22.08 2.41 NA NA 70.48 72.27 090 26554 ......... ............ A Double transfer, toe-hand ............................. 56.57 NA NA 19.56 33.04 9.41 NA NA 85.54 99.02 090 26555 ......... ............ A Positional change of finger ............................ 16.86 NA NA 13.88 17.11 2.48 NA NA 33.22 36.45 090 26556 ......... ............ A Toe joint transfer ........................................... 49.27 NA NA 17.86 29.46 2.57 NA NA 69.70 81.30 090 26560 ......... ............ A Repair of web finger ...................................... 5.37 NA NA 7.09 9.12 0.85 NA NA 13.31 15.34 090 26561 ......... ............ A Repair of web finger ...................................... 10.90 NA NA 9.41 11.61 1.45 NA NA 21.76 23.96 090 26562 ......... ............ A Repair of web finger ...................................... 16.30 NA NA 13.88 16.33 2.23 NA NA 32.41 34.86 090 26565 ......... ............ A Correct metacarpal flaw ................................ 6.73 NA NA 7.90 10.98 1.00 NA NA 15.63 18.71 090 26567 ......... ............ A Correct finger deformity ................................. 6.81 NA NA 8.15 11.00 1.04 NA NA 16.00 18.85 090 26568 ......... ............ A Lengthen metacarpal/finger ........................... 9.07 NA NA 10.13 14.11 1.49 NA NA 20.69 24.67 090 26580 ......... ............ A Repair hand deformity ................................... 19.40 NA NA 11.01 12.98 2.28 NA NA 32.69 34.66 090 26587 ......... ............ A Reconstruct extra finger ................................ 14.28 NA NA 8.43 9.02 1.53 NA NA 24.24 24.83 090 26590 ......... ............ A Repair finger deformity .................................. 18.43 NA NA 10.52 13.09 2.77 NA NA 31.72 34.29 090 26591 ......... ............ A Repair muscles of hand ................................ 3.25 NA NA 6.26 8.78 0.48 NA NA 9.99 12.51 090 26593 ......... ............ A Release muscles of hand .............................. 5.30 NA NA 7.73 10.28 0.78 NA NA 13.81 16.36 090 26596 ......... ............ A Excision constricting tissue ........................... 8.94 NA NA 7.48 8.49 1.43 NA NA 17.85 18.86 090 26600 ......... ............ A Treat metacarpal fracture .............................. 2.40 3.83 3.67 3.48 2.86 0.30 6.53 6.37 6.18 5.56 090 26605 ......... ............ A Treat metacarpal fracture .............................. 2.85 4.09 4.44 3.50 3.61 0.49 7.43 7.78 6.84 6.95 090 26607 ......... ............ A Treat metacarpal fracture .............................. 5.35 NA NA 4.88 5.92 0.87 NA NA 11.10 12.14 090 26608 ......... ............ A Treat metacarpal fracture .............................. 5.35 NA NA 5.25 6.00 0.88 NA NA 11.48 12.23 090 26615 ......... ............ A Treat metacarpal fracture .............................. 5.32 NA NA 4.75 5.16 0.86 NA NA 10.93 11.34 090 26641 ......... ............ A Treat thumb dislocation ................................. 3.93 4.17 4.47 3.52 3.53 0.39 8.49 8.79 7.84 7.85 090 26645 ......... ............ A Treat thumb fracture ...................................... 4.40 4.62 5.03 3.93 4.13 0.67 9.69 10.10 9.00 9.20 090 26650 ......... ............ A Treat thumb fracture ...................................... 5.71 NA NA 5.62 6.42 0.94 NA NA 12.27 13.07 090 26665 ......... ............ A Treat thumb fracture ...................................... 7.65 NA NA 5.87 6.43 0.90 NA NA 14.42 14.98 090 26670 ......... ............ A Treat hand dislocation ................................... 3.68 3.55 4.08 2.96 2.95 0.39 7.62 8.15 7.03 7.02 090 26675 ......... ............ A Treat hand dislocation ................................... 4.63 4.85 5.32 4.15 4.39 0.77 10.25 10.72 9.55 9.79 090 26676 ......... ............ A Pin hand dislocation ...................................... 5.51 NA NA 5.57 6.41 0.91 NA NA 11.99 12.83 090 26685 ......... ............ A Treat hand dislocation ................................... 7.03 NA NA 5.44 5.97 1.09 NA NA 13.56 14.09 090 26686 ......... ............ A Treat hand dislocation ................................... 7.99 NA NA 6.12 6.71 1.24 NA NA 15.35 15.94 090 26700 ......... ............ A Treat knuckle dislocation ............................... 3.68 3.32 3.65 2.95 2.88 0.35 7.35 7.68 6.98 6.91 090 26705 ......... ............ A Treat knuckle dislocation ............................... 4.18 4.82 5.20 4.10 4.25 0.66 9.66 10.04 8.94 9.09 090 26706 ......... ............ A Pin knuckle dislocation .................................. 5.11 NA NA 4.69 4.99 0.81 NA NA 10.61 10.91 090 26715 ......... ............ A Treat knuckle dislocation ............................... 5.73 NA NA 4.92 5.36 0.91 NA NA 11.56 12.00 090 26720 ......... ............ A Treat finger fracture, each ............................. 1.66 2.59 2.73 2.31 2.12 0.24 4.49 4.63 4.21 4.02 090 26725 ......... ............ A Treat finger fracture, each ............................. 3.33 4.10 4.60 3.42 3.48 0.53 7.96 8.46 7.28 7.34 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49110 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

26727 ......... ............ A Treat finger fracture, each ............................. 5.22 NA NA 5.21 5.98 0.84 NA NA 11.27 12.04 090 26735 ......... ............ A Treat finger fracture, each ............................. 5.97 NA NA 5.00 5.41 0.95 NA NA 11.92 12.33 090 26740 ......... ............ A Treat finger fracture, each ............................. 1.94 2.95 3.09 2.66 2.69 0.31 5.20 5.34 4.91 4.94 090 26742 ......... ............ A Treat finger fracture, each ............................. 3.84 4.33 4.83 3.62 3.82 0.58 8.75 9.25 8.04 8.24 090 26746 ......... ............ A Treat finger fracture, each ............................. 5.80 NA NA 4.96 5.41 0.91 NA NA 11.67 12.12 090 26750 ......... ............ A Treat finger fracture, each ............................. 1.70 2.25 2.42 2.26 2.07 0.22 4.17 4.34 4.18 3.99 090 26755 ......... ............ A Treat finger fracture, each ............................. 3.10 3.79 4.26 2.98 3.00 0.42 7.31 7.78 6.50 6.52 090 26756 ......... ............ A Pin finger fracture, each ................................ 4.38 NA NA 4.86 5.51 0.71 NA NA 9.95 10.60 090 26765 ......... ............ A Treat finger fracture, each ............................. 4.16 NA NA 4.02 4.30 0.66 NA NA 8.84 9.12 090 26770 ......... ............ A Treat finger dislocation .................................. 3.02 2.91 3.30 2.53 2.44 0.27 6.20 6.59 5.82 5.73 090 26775 ......... ............ A Treat finger dislocation .................................. 3.70 4.54 5.03 3.81 3.81 0.54 8.78 9.27 8.05 8.05 090 26776 ......... ............ A Pin finger dislocation ..................................... 4.79 NA NA 5.01 5.75 0.77 NA NA 10.57 11.31 090 26785 ......... ............ A Treat finger dislocation .................................. 4.20 NA NA 4.08 4.42 0.68 NA NA 8.96 9.30 090 26820 ......... ............ A Thumb fusion with graft ................................. 8.25 NA NA 8.71 12.12 1.30 NA NA 18.26 21.67 090 26841 ......... ............ A Fusion of thumb ............................................ 7.12 NA NA 8.69 12.10 1.18 NA NA 16.99 20.40 090 26842 ......... ............ A Thumb fusion with graft ................................. 8.29 NA NA 8.95 12.27 1.32 NA NA 18.56 21.88 090 26843 ......... ............ A Fusion of hand joint ....................................... 7.60 NA NA 8.17 11.31 1.15 NA NA 16.92 20.06 090 26844 ......... ............ A Fusion/graft of hand joint .............................. 8.78 NA NA 9.14 12.31 1.33 NA NA 19.25 22.42 090 26850 ......... ............ A Fusion of knuckle .......................................... 6.96 NA NA 8.29 11.22 1.06 NA NA 16.31 19.24 090 26852 ......... ............ A Fusion of knuckle with graft .......................... 8.51 NA NA 9.12 11.95 1.22 NA NA 18.85 21.68 090 26860 ......... ............ A Fusion of finger joint ...................................... 4.68 NA NA 7.54 10.28 0.73 NA NA 12.95 15.69 090 26861 ......... ............ A Fusion of finger jnt, add-on ........................... 1.74 NA NA 0.71 0.88 0.27 NA NA 2.72 2.89 ZZZ 26862 ......... ............ A Fusion/graft of finger joint ............................. 7.36 NA NA 8.68 11.43 1.10 NA NA 17.14 19.89 090 26863 ......... ............ A Fuse/graft added joint ................................... 3.89 NA NA 1.58 1.98 0.56 NA NA 6.03 6.43 ZZZ 26910 ......... ............ A Amputate metacarpal bone ........................... 7.59 NA NA 8.30 10.49 1.16 NA NA 17.05 19.24 09026951 ......... ............ A Amputation of finger/thumb ........................... 5.75 NA NA 8.39 9.71 0.71 NA NA 14.85 16.17 090 26952 ......... ............ A Amputation of finger/thumb ........................... 6.30 NA NA 7.94 10.73 0.95 NA NA 15.19 17.98 090 26989 ......... ............ C Hand/finger surgery ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 26990 ......... ............ A Drainage of pelvis lesion ............................... 7.77 NA NA 6.29 6.98 1.22 NA NA 15.28 15.97 090 26991 ......... ............ A Drainage of pelvis bursa ............................... 6.91 8.60 10.52 4.85 5.29 1.11 16.62 18.54 12.87 13.31 090 26992 ......... ............ A Drainage of bone lesion ................................ 13.30 NA NA 8.64 9.95 2.16 NA NA 24.10 25.41 090 27000 ......... ............ A Incision of hip tendon .................................... 5.61 NA NA 4.55 5.10 0.98 NA NA 11.14 11.69 090 27001 ......... ............ A Incision of hip tendon .................................... 6.99 NA NA 5.23 5.88 1.24 NA NA 13.46 14.11 090 27003 ......... ............ A Incision of hip tendon .................................... 7.63 NA NA 5.82 6.32 1.12 NA NA 14.57 15.07 090 27005 ......... ............ A Incision of hip tendon .................................... 9.89 NA NA 6.79 7.56 1.72 NA NA 18.40 19.17 090 27006 ......... ............ A Incision of hip tendons .................................. 9.91 NA NA 6.84 7.70 1.69 NA NA 18.44 19.30 090 27025 ......... ............ A Incision of hip/thigh fascia ............................. 12.57 NA NA 8.10 8.44 1.84 NA NA 22.51 22.85 090 27030 ......... ............ A Drainage of hip joint ...................................... 13.47 NA NA 8.10 9.26 2.26 NA NA 23.83 24.99 090 27033 ......... ............ A Exploration of hip joint ................................... 13.91 NA NA 8.45 9.55 2.32 NA NA 24.68 25.78 090 27035 ......... ............ A Denervation of hip joint ................................. 17.14 NA NA 9.53 10.81 2.15 NA NA 28.82 30.10 090 27036 ......... ............ A Excision of hip joint/muscle ........................... 14.10 NA NA 8.98 9.75 2.26 NA NA 25.34 26.11 090 27040 ......... ............ A Biopsy of soft tissues .................................... 2.87 5.14 5.21 1.81 1.96 0.27 8.28 8.35 4.95 5.10 010 27041 ......... ............ A Biopsy of soft tissues .................................... 10.00 NA NA 5.79 6.43 1.35 NA NA 17.14 17.78 090 27047 ......... ............ A Remove hip/pelvis lesion .............................. 7.44 7.12 7.11 4.57 4.72 1.03 15.59 15.58 13.04 13.19 090 27048 ......... ............ A Remove hip/pelvis lesion .............................. 6.36 NA NA 4.65 4.76 0.92 NA NA 11.93 12.04 090 27049 ......... ............ A Remove tumor, hip/pelvis .............................. 15.12 NA NA 8.24 8.36 2.06 NA NA 25.42 25.54 090 27050 ......... ............ A Biopsy of sacroiliac joint ................................ 4.59 NA NA 3.79 4.26 0.60 NA NA 8.98 9.45 090 27052 ......... ............ A Biopsy of hip joint .......................................... 7.21 NA NA 5.68 5.83 1.08 NA NA 13.97 14.12 090 27054 ......... ............ A Removal of hip joint lining ............................. 9.01 NA NA 6.49 7.13 1.47 NA NA 16.97 17.61 090 27060 ......... ............ A Removal of ischial bursa ............................... 5.72 NA NA 4.38 4.37 0.80 NA NA 10.90 10.89 090 27062 ......... ............ A Remove femur lesion/bursa .......................... 5.60 NA NA 4.63 5.05 0.93 NA NA 11.16 11.58 090 27065 ......... ............ A Removal of hip bone lesion .......................... 6.37 NA NA 5.12 5.36 1.01 NA NA 12.50 12.74 09027066 ......... ............ A Removal of hip bone lesion .......................... 10.97 NA NA 7.46 8.20 1.79 NA NA 20.22 20.96 090 27067 ......... ............ A Remove/graft hip bone lesion ....................... 14.47 NA NA 8.80 10.20 1.84 NA NA 25.11 26.51 090 27070 ......... ............ A Partial removal of hip bone ........................... 11.36 NA NA 7.94 8.83 1.74 NA NA 21.04 21.93 090 27071 ......... ............ A Partial removal of hip bone ........................... 12.16 NA NA 8.54 9.73 1.92 NA NA 22.62 23.81 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49111 

27075 ......... ............ A Extensive hip surgery .................................... 36.71 NA NA 16.62 18.56 5.64 NA NA 58.97 60.91 090 27076 ......... ............ A Extensive hip surgery .................................... 24.17 NA NA 12.75 14.07 3.70 NA NA 40.62 41.94 090 27077 ......... ............ A Extensive hip surgery .................................... 42.48 NA NA 19.99 21.99 6.12 NA NA 68.59 70.59 090 27078 ......... ............ A Extensive hip surgery .................................... 14.44 NA NA 8.79 9.65 2.22 NA NA 25.45 26.31 090 27079 ......... ............ A Extensive hip surgery .................................... 14.81 NA NA 7.52 9.04 1.94 NA NA 24.27 25.79 090 27080 ......... ............ A Removal of tail bone ..................................... 6.74 NA NA 4.72 4.80 0.93 NA NA 12.39 12.47 090 27086 ......... ............ A Remove hip foreign body .............................. 1.87 3.78 4.36 1.54 1.75 0.25 5.90 6.48 3.66 3.87 010 27087 ......... ............ A Remove hip foreign body .............................. 8.65 NA NA 5.66 6.41 1.35 NA NA 15.66 16.41 090 27090 ......... ............ A Removal of hip prosthesis ............................. 11.49 NA NA 7.44 8.45 1.94 NA NA 20.87 21.88 090 27091 ......... ............ A Removal of hip prosthesis ............................. 24.07 NA NA 13.05 13.76 3.84 NA NA 40.96 41.67 090 27093 ......... ............ A Injection for hip x-ray ..................................... 1.30 3.09 4.12 0.44 0.47 0.13 4.52 5.55 1.87 1.90 000 27095 ......... ............ A Injection for hip x-ray ..................................... 1.50 3.73 5.22 0.50 0.52 0.14 5.37 6.86 2.14 2.16 000 27096 ......... ............ A Inject sacroiliac joint ...................................... 1.40 2.54 3.90 0.33 0.33 0.08 4.02 5.38 1.81 1.81 000 27097 ......... ............ A Revision of hip tendon .................................. 9.09 NA NA 6.35 6.40 1.57 NA NA 17.01 17.06 090 27098 ......... ............ A Transfer tendon to pelvis .............................. 9.12 NA NA 4.96 6.51 0.95 NA NA 15.03 16.58 090 27100 ......... ............ A Transfer of abdominal muscle ....................... 11.12 NA NA 7.39 8.34 1.85 NA NA 20.36 21.31 09027105 ......... ............ A Transfer of spinal muscle .............................. 11.81 NA NA 7.93 8.85 1.72 NA NA 21.46 22.38 090 27110 ......... ............ A Transfer of iliopsoas muscle ......................... 13.54 NA NA 8.61 8.99 2.18 NA NA 24.33 24.71 090 27111 ......... ............ A Transfer of iliopsoas muscle ......................... 12.37 NA NA 8.13 8.88 1.94 NA NA 22.44 23.19 090 27120 ......... ............ A Reconstruction of hip socket ......................... 19.00 NA NA 10.79 11.58 3.08 NA NA 32.87 33.66 090 27122 ......... ............ A Reconstruction of hip socket ......................... 15.86 NA NA 9.49 10.65 2.61 NA NA 27.96 29.12 090 27125 ......... ............ A Partial hip replacement ................................. 16.39 NA NA 9.69 10.39 2.54 NA NA 28.62 29.32 090 27130 ......... ............ A Total hip arthroplasty ..................................... 17.40 NA NA 10.24 12.54 3.50 NA NA 31.14 33.44 090 27132 ......... ............ A Total hip arthroplasty ..................................... 25.41 NA NA 13.57 15.12 4.04 NA NA 43.02 44.57 090 27134 ......... ............ A Revise hip joint replacement ......................... 30.07 NA NA 14.86 17.06 4.94 NA NA 49.87 52.07 090 27137 ......... ............ A Revise hip joint replacement ......................... 22.49 NA NA 11.85 13.41 3.67 NA NA 38.01 39.57 090 27138 ......... ............ A Revise hip joint replacement ......................... 23.49 NA NA 12.24 13.85 3.84 NA NA 39.57 41.18 090 27140 ......... ............ A Transplant femur ridge .................................. 12.58 NA NA 7.81 9.01 2.11 NA NA 22.50 23.70 090 27146 ......... ............ A Incision of hip bone ....................................... 18.64 NA NA 10.74 11.78 2.96 NA NA 32.34 33.38 090 27147 ......... ............ A Revision of hip bone ..................................... 21.79 NA NA 11.94 12.92 3.57 NA NA 37.30 38.28 090 27151 ......... ............ A Incision of hip bones ..................................... 23.84 NA NA 12.44 9.07 3.91 NA NA 40.19 36.82 090 27156 ......... ............ A Revision of hip bones .................................... 25.95 NA NA 13.54 15.43 4.21 NA NA 43.70 45.59 090 27158 ......... ............ A Revision of pelvis .......................................... 20.79 NA NA 7.19 10.03 3.16 NA NA 31.14 33.98 090 27161 ......... ............ A Incision of neck of femur ............................... 17.64 NA NA 10.42 11.68 2.94 NA NA 31.00 32.26 090 27165 ......... ............ A Incision/fixation of femur ............................... 19.97 NA NA 11.73 12.62 3.10 NA NA 34.80 35.69 090 27170 ......... ............ A Repair/graft femur head/neck ........................ 17.40 NA NA 9.82 10.93 2.81 NA NA 30.03 31.14 090 27175 ......... ............ A Treat slipped epiphysis ................................. 9.23 NA NA 5.80 6.45 1.46 NA NA 16.49 17.14 090 27176 ......... ............ A Treat slipped epiphysis ................................. 12.69 NA NA 8.26 8.82 2.22 NA NA 23.17 23.73 090 27177 ......... ............ A Treat slipped epiphysis ................................. 15.84 NA NA 9.69 10.59 2.61 NA NA 28.14 29.04 090 27178 ......... ............ A Treat slipped epiphysis ................................. 12.69 NA NA 8.26 8.38 2.08 NA NA 23.03 23.15 090 27179 ......... ............ A Revise head/neck of femur ........................... 13.74 NA NA 8.56 9.63 2.25 NA NA 24.55 25.62 090 27181 ......... ............ A Treat slipped epiphysis ................................. 15.90 NA NA 9.83 10.11 1.57 NA NA 27.30 27.58 090 27185 ......... ............ A Revision of femur epiphysis .......................... 9.59 NA NA 6.69 7.31 2.39 NA NA 18.67 19.29 090 27187 ......... ............ A Reinforce hip bones ...................................... 14.00 NA NA 8.72 9.92 2.37 NA NA 25.09 26.29 090 27193 ......... ............ A Treat pelvic ring fracture ............................... 5.92 4.65 4.98 4.78 5.01 0.96 11.53 11.86 11.66 11.89 090 27194 ......... ............ A Treat pelvic ring fracture ............................... 10.00 NA NA 6.62 7.39 1.65 NA NA 18.27 19.04 090 27200 ......... ............ A Treat tail bone fracture .................................. 1.84 2.09 2.19 2.24 2.17 0.28 4.21 4.31 4.36 4.29 090 27202 ......... ............ A Treat tail bone fracture .................................. 7.21 NA NA 11.28 15.47 1.06 NA NA 19.55 23.74 090 27215 ......... ............ A Treat pelvic fracture(s) .................................. 10.39 NA NA 6.53 6.94 1.97 NA NA 18.89 19.30 090 27216 ......... ............ A Treat pelvic ring fracture ............................... 15.65 NA NA 9.25 9.51 2.63 NA NA 27.53 27.79 090 27217 ......... ............ A Treat pelvic ring fracture ............................... 14.57 NA NA 8.70 9.78 2.41 NA NA 25.68 26.76 090 27218 ......... ............ A Treat pelvic ring fracture ............................... 20.85 NA NA 11.41 11.40 3.48 NA NA 35.74 35.73 090 27220 ......... ............ A Treat hip socket fracture ............................... 6.65 5.28 5.61 5.18 5.52 1.07 13.00 13.33 12.90 13.24 090 27222 ......... ............ A Treat hip socket fracture ............................... 13.88 NA NA 8.50 9.60 2.19 NA NA 24.57 25.67 090 27226 ......... ............ A Treat hip wall fracture ................................... 15.37 NA NA 9.00 8.11 2.48 NA NA 26.85 25.96 090 27227 ......... ............ A Treat hip fracture(s) ....................................... 25.13 NA NA 13.44 14.91 4.05 NA NA 42.62 44.09 090 27228 ......... ............ A Treat hip fracture(s) ....................................... 29.05 NA NA 15.03 16.97 4.66 NA NA 48.74 50.68 090 27230 ......... ............ A Treat thigh fracture ........................................ 5.61 4.98 5.38 4.91 5.05 0.95 11.54 11.94 11.47 11.61 090 27232 ......... ............ A Treat thigh fracture ........................................ 11.62 NA NA 6.00 6.88 1.85 NA NA 19.47 20.35 090 27235 ......... ............ A Treat thigh fracture ........................................ 12.80 NA NA 8.05 9.10 2.11 NA NA 22.96 24.01 090 27236 ......... ............ A Treat thigh fracture ........................................ 14.54 NA NA 9.10 10.56 2.71 NA NA 26.35 27.81 090 27238 ......... ............ A Treat thigh fracture ........................................ 5.57 NA NA 4.69 5.03 0.89 NA NA 11.15 11.49 090 27240 ......... ............ A Treat thigh fracture ........................................ 13.56 NA NA 8.10 9.13 2.16 NA NA 23.82 24.85 090 27244 ......... ............ A Treat thigh fracture ........................................ 17.00 NA NA 9.71 10.90 2.77 NA NA 29.48 30.67 090 27245 ......... ............ A Treat thigh fracture ........................................ 21.01 NA NA 11.46 13.17 3.52 NA NA 35.99 37.70 090 27246 ......... ............ A Treat thigh fracture ........................................ 4.70 3.93 4.33 3.97 4.31 0.81 9.44 9.84 9.48 9.82 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49112 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

27248 ......... ............ A Treat thigh fracture ........................................ 10.73 NA NA 7.01 7.91 1.81 NA NA 19.55 20.45 090 27250 ......... ............ A Treat hip dislocation ...................................... 7.12 NA NA 4.27 4.53 0.62 NA NA 12.01 12.27 090 27252 ......... ............ A Treat hip dislocation ...................................... 10.85 NA NA 6.52 7.20 1.66 NA NA 19.03 19.71 090 27253 ......... ............ A Treat hip dislocation ...................................... 13.38 NA NA 8.26 9.40 2.24 NA NA 23.88 25.02 090 27254 ......... ............ A Treat hip dislocation ...................................... 18.71 NA NA 10.56 11.66 3.17 NA NA 32.44 33.54 090 27256 ......... ............ A Treat hip dislocation ...................................... 4.23 2.39 3.24 1.39 1.91 0.46 7.08 7.93 6.08 6.60 010 27257 ......... ............ A Treat hip dislocation ...................................... 5.33 NA NA 2.57 2.75 0.69 NA NA 8.59 8.77 010 27258 ......... ............ A Treat hip dislocation ...................................... 15.95 NA NA 9.45 10.52 2.64 NA NA 28.04 29.11 090 27259 ......... ............ A Treat hip dislocation ...................................... 22.95 NA NA 12.91 13.82 3.74 NA NA 39.60 40.51 090 27265 ......... ............ A Treat hip dislocation ...................................... 5.04 NA NA 3.98 4.59 0.63 NA NA 9.65 10.26 090 27266 ......... ............ A Treat hip dislocation ...................................... 7.60 NA NA 5.55 6.14 1.29 NA NA 14.44 15.03 090 27275 ......... ............ A Manipulation of hip joint ................................ 2.27 NA NA 1.89 2.05 0.39 NA NA 4.55 4.71 010 27280 ......... ............ A Fusion of sacroiliac joint ................................ 14.39 NA NA 9.05 9.96 2.53 NA NA 25.97 26.88 090 27282 ......... ............ A Fusion of pubic bones ................................... 11.62 NA NA 7.83 7.96 1.86 NA NA 21.31 21.44 090 27284 ......... ............ A Fusion of hip joint .......................................... 24.85 NA NA 12.86 14.29 3.92 NA NA 41.63 43.06 090 27286 ......... ............ A Fusion of hip joint .......................................... 24.89 NA NA 13.47 15.21 3.12 NA NA 41.48 43.22 090 27290 ......... ............ A Amputation of leg at hip ................................ 24.27 NA NA 12.53 13.68 3.43 NA NA 40.23 41.38 090 27295 ......... ............ A Amputation of leg at hip ................................ 19.46 NA NA 9.79 10.93 2.95 NA NA 32.20 33.34 090 27299 ......... ............ C Pelvis/hip joint surgery .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 27301 ......... ............ A Drain thigh/knee lesion .................................. 6.60 8.23 9.61 4.66 5.02 1.04 15.87 17.25 12.30 12.66 090 27303 ......... ............ A Drainage of bone lesion ................................ 8.45 NA NA 6.07 6.75 1.43 NA NA 15.95 16.63 090 27305 ......... ............ A Incise thigh tendon & fascia .......................... 6.03 NA NA 4.63 5.04 1.01 NA NA 11.67 12.08 090 27306 ......... ............ A Incision of thigh tendon ................................. 4.61 NA NA 4.07 4.56 0.85 NA NA 9.53 10.02 090 27307 ......... ............ A Incision of thigh tendons ............................... 5.91 NA NA 4.81 5.24 1.04 NA NA 11.76 12.19 090 27310 ......... ............ A Exploration of knee joint ................................ 9.80 NA NA 6.83 7.39 1.61 NA NA 18.24 18.80 090 27315 ......... ............ A Partial removal, thigh nerve .......................... 7.02 NA NA 5.44 5.07 1.09 NA NA 13.55 13.18 090 27320 ......... ............ A Partial removal, thigh nerve .......................... 6.29 NA NA 4.75 5.11 1.06 NA NA 12.10 12.46 090 27323 ......... ............ A Biopsy, thigh soft tissues .............................. 2.28 4.09 3.66 1.87 1.88 0.24 6.61 6.18 4.39 4.40 010 27324 ......... ............ A Biopsy, thigh soft tissues .............................. 4.89 NA NA 3.85 4.10 0.75 NA NA 9.49 9.74 090 27327 ......... ............ A Removal of thigh lesion ................................. 4.46 6.08 6.01 3.61 3.69 0.64 11.18 11.11 8.71 8.79 090 27328 ......... ............ A Removal of thigh lesion ................................. 5.56 NA NA 4.07 4.30 0.84 NA NA 10.47 10.70 090 27329 ......... ............ A Remove tumor, thigh/knee ............................ 15.60 NA NA 8.58 8.91 2.14 NA NA 26.32 26.65 090 27330 ......... ............ A Biopsy, knee joint lining ................................ 4.96 NA NA 4.12 4.46 0.86 NA NA 9.94 10.28 090 27331 ......... ............ A Explore/treat knee joint ................................. 5.87 NA NA 4.84 5.35 1.02 NA NA 11.73 12.24 090 27332 ......... ............ A Removal of knee cartilage ............................ 8.26 NA NA 6.15 6.88 1.43 NA NA 15.84 16.57 090 27333 ......... ............ A Removal of knee cartilage ............................ 7.35 NA NA 5.73 6.44 1.26 NA NA 14.34 15.05 090 27334 ......... ............ A Remove knee joint lining ............................... 8.99 NA NA 6.49 7.18 1.51 NA NA 16.99 17.68 090 27335 ......... ............ A Remove knee joint lining ............................... 10.35 NA NA 7.06 7.93 1.74 NA NA 19.15 20.02 090 27340 ......... ............ A Removal of kneecap bursa ........................... 4.17 NA NA 4.05 4.43 0.72 NA NA 8.94 9.32 090 27345 ......... ............ A Removal of knee cyst .................................... 5.91 NA NA 4.89 5.44 1.00 NA NA 11.80 12.35 090 27347 ......... ............ A Remove knee cyst ......................................... 6.52 NA NA 5.26 5.38 0.98 NA NA 12.76 12.88 090 27350 ......... ............ A Removal of kneecap ..................................... 8.46 NA NA 6.29 7.00 1.41 NA NA 16.16 16.87 090 27355 ......... ............ A Remove femur lesion .................................... 7.82 NA NA 5.87 6.55 1.32 NA NA 15.01 15.69 090 27356 ......... ............ A Remove femur lesion/graft ............................ 9.89 NA NA 6.86 7.60 1.65 NA NA 18.40 19.14 090 27357 ......... ............ A Remove femur lesion/graft ............................ 10.93 NA NA 7.54 8.41 1.95 NA NA 20.42 21.29 090 27358 ......... ............ A Remove femur lesion/fixation ........................ 4.73 NA NA 1.90 2.37 0.82 NA NA 7.45 7.92 ZZZ 27360 ......... ............ A Partial removal, leg bone(s) .......................... 11.26 NA NA 8.13 9.20 1.83 NA NA 21.22 22.29 090 27365 ......... ............ A Extensive leg surgery .................................... 17.85 NA NA 10.52 11.39 2.79 NA NA 31.16 32.03 090 27370 ......... ............ A Injection for knee x-ray .................................. 0.96 2.82 3.50 0.33 0.32 0.08 3.86 4.54 1.37 1.36 000 27372 ......... ............ A Removal of foreign body ............................... 5.06 8.34 9.62 4.05 4.53 0.84 14.24 15.52 9.95 10.43 090 27380 ......... ............ A Repair of kneecap tendon ............................. 7.27 NA NA 6.08 6.98 1.24 NA NA 14.59 15.49 090 27381 ......... ............ A Repair/graft kneecap tendon ......................... 10.56 NA NA 7.56 8.71 1.79 NA NA 19.91 21.06 090 27385 ......... ............ A Repair of thigh muscle .................................. 7.93 NA NA 6.36 7.31 1.36 NA NA 15.65 16.60 090 27386 ......... ............ A Repair/graft of thigh muscle .......................... 10.90 NA NA 7.98 9.13 1.85 NA NA 20.73 21.88 090 27390 ......... ............ A Incision of thigh tendon ................................. 5.38 NA NA 4.57 4.98 0.92 NA NA 10.87 11.28 090 27391 ......... ............ A Incision of thigh tendons ............................... 7.31 NA NA 5.52 6.30 1.23 NA NA 14.06 14.84 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49113 

27392 ......... ............ A Incision of thigh tendons ............................... 9.43 NA NA 6.72 7.37 1.57 NA NA 17.72 18.37 090 27393 ......... ............ A Lengthening of thigh tendon ......................... 6.44 NA NA 5.01 5.63 1.10 NA NA 12.55 13.17 09027394 ......... ............ A Lengthening of thigh tendons ........................ 8.61 NA NA 6.19 6.96 1.47 NA NA 16.27 17.04 09027395 ......... ............ A Lengthening of thigh tendons ........................ 12.01 NA NA 7.99 8.99 2.04 NA NA 22.04 23.04 090 27396 ......... ............ A Transplant of thigh tendon ............................ 7.97 NA NA 5.93 6.73 1.34 NA NA 15.24 16.04 090 27397 ......... ............ A Transplants of thigh tendons ......................... 12.38 NA NA 8.42 8.89 1.82 NA NA 22.62 23.09 090 27400 ......... ............ A Revise thigh muscles/tendons ...................... 9.13 NA NA 6.17 6.98 1.31 NA NA 16.61 17.42 090 27403 ......... ............ A Repair of knee cartilage ................................ 8.44 NA NA 6.09 6.91 1.44 NA NA 15.97 16.79 090 27405 ......... ............ A Repair of knee ligament ................................ 8.88 NA NA 6.44 7.23 1.51 NA NA 16.83 17.62 090 27407 ......... ............ A Repair of knee ligament ................................ 10.62 NA NA 6.67 7.91 1.78 NA NA 19.07 20.31 090 27409 ......... ............ A Repair of knee ligaments .............................. 13.48 NA NA 8.44 9.57 2.24 NA NA 24.16 25.29 090 27412 ......... ............ A Autochondrocyte implant knee ...................... 24.43 NA NA 13.66 14.52 4.35 NA NA 42.44 43.30 090 27415 ......... ............ A Osteochondral knee allograft ........................ 19.69 NA NA 11.86 12.38 4.35 NA NA 35.90 36.42 090 27418 ......... ............ A Repair degenerated kneecap ........................ 11.37 NA NA 7.61 8.58 1.88 NA NA 20.86 21.83 090 27420 ......... ............ A Revision of unstable kneecap ....................... 10.06 NA NA 6.96 7.82 1.71 NA NA 18.73 19.59 09027422 ......... ............ A Revision of unstable kneecap ....................... 10.01 NA NA 6.91 7.82 1.70 NA NA 18.62 19.53 09027424 ......... ............ A Revision/removal of kneecap ........................ 10.04 NA NA 6.92 7.80 1.70 NA NA 18.66 19.54 09027425 ......... ............ A Lat retinacular release open ......................... 5.21 NA NA 4.71 5.32 0.90 NA NA 10.82 11.43 090 27427 ......... ............ A Reconstruction, knee ..................................... 9.59 NA NA 6.70 7.53 1.63 NA NA 17.92 18.75 090 27428 ......... ............ A Reconstruction, knee ..................................... 15.23 NA NA 10.13 10.96 2.42 NA NA 27.78 28.61 090 27429 ......... ............ A Reconstruction, knee ..................................... 17.12 NA NA 11.33 12.14 2.70 NA NA 31.15 31.96 090 27430 ......... ............ A Revision of thigh muscles ............................. 9.96 NA NA 6.89 7.72 1.69 NA NA 18.54 19.37 090 27435 ......... ............ A Incision of knee joint ..................................... 10.60 NA NA 7.69 8.28 1.69 NA NA 19.98 20.57 090 27437 ......... ............ A Revise kneecap ............................................. 8.75 NA NA 6.24 6.99 1.49 NA NA 16.48 17.23 090 27438 ......... ............ A Revise kneecap with implant ........................ 11.69 NA NA 7.57 8.30 1.95 NA NA 21.21 21.94 09027440 ......... ............ A Revision of knee joint .................................... 10.89 NA NA 7.16 6.28 1.81 NA NA 19.86 18.98 090 27441 ......... ............ A Revision of knee joint .................................... 11.34 NA NA 7.50 6.91 1.88 NA NA 20.72 20.13 090 27442 ......... ............ A Revision of knee joint .................................... 12.17 NA NA 7.78 8.63 2.09 NA NA 22.04 22.89 090 27443 ......... ............ A Revision of knee joint .................................... 11.21 NA NA 7.40 8.39 1.90 NA NA 20.51 21.50 090 27445 ......... ............ A Revision of knee joint .................................... 18.43 NA NA 10.53 11.90 3.08 NA NA 32.04 33.41 090 27446 ......... ............ A Revision of knee joint .................................... 16.18 NA NA 9.37 10.80 2.80 NA NA 28.35 29.78 090 27447 ......... ............ A Total knee arthroplasty .................................. 20.81 NA NA 11.84 13.91 3.79 NA NA 36.44 38.51 090 27448 ......... ............ A Incision of thigh ............................................. 11.40 NA NA 7.43 8.31 1.94 NA NA 20.77 21.65 090 27450 ......... ............ A Incision of thigh ............................................. 14.38 NA NA 8.85 10.15 2.42 NA NA 25.65 26.95 090 27454 ......... ............ A Realignment of thigh bone ............................ 18.89 NA NA 10.74 12.06 3.12 NA NA 32.75 34.07 090 27455 ......... ............ A Realignment of knee ..................................... 13.16 NA NA 8.40 9.51 2.24 NA NA 23.80 24.91 090 27457 ......... ............ A Realignment of knee ..................................... 13.85 NA NA 8.26 9.51 2.34 NA NA 24.45 25.70 090 27465 ......... ............ A Shortening of thigh bone ............................... 18.36 NA NA 10.30 10.24 2.47 NA NA 31.13 31.07 090 27466 ......... ............ A Lengthening of thigh bone ............................ 17.03 NA NA 10.15 11.41 2.77 NA NA 29.95 31.21 090 27468 ......... ............ A Shorten/lengthen thighs ................................ 19.72 NA NA 11.28 12.08 3.30 NA NA 34.30 35.10 090 27470 ......... ............ A Repair of thigh ............................................... 16.87 NA NA 10.22 11.40 2.79 NA NA 29.88 31.06 090 27472 ......... ............ A Repair/graft of thigh ....................................... 18.47 NA NA 10.72 12.19 3.07 NA NA 32.26 33.73 090 27475 ......... ............ A Surgery to stop leg growth ............................ 8.75 NA NA 6.65 7.07 1.36 NA NA 16.76 17.18 090 27477 ......... ............ A Surgery to stop leg growth ............................ 9.96 NA NA 6.65 7.46 1.73 NA NA 18.34 19.15 090 27479 ......... ............ A Surgery to stop leg growth ............................ 12.96 NA NA 5.11 8.51 2.78 NA NA 20.85 24.25 090 27485 ......... ............ A Surgery to stop leg growth ............................ 8.95 NA NA 6.24 7.11 1.53 NA NA 16.72 17.59 090 27486 ......... ............ A Revise/replace knee joint .............................. 20.84 NA NA 11.74 13.05 3.36 NA NA 35.94 37.25 090 27487 ......... ............ A Revise/replace knee joint .............................. 26.83 NA NA 14.14 15.95 4.39 NA NA 45.36 47.17 090 27488 ......... ............ A Removal of knee prosthesis .......................... 17.32 NA NA 10.34 11.36 2.74 NA NA 30.40 31.42 090 27495 ......... ............ A Reinforce thigh .............................................. 16.31 NA NA 9.70 10.98 2.71 NA NA 28.72 30.00 090 27496 ......... ............ A Decompression of thigh/knee ........................ 6.58 NA NA 5.02 5.46 0.99 NA NA 12.59 13.03 090 27497 ......... ............ A Decompression of thigh/knee ........................ 7.64 NA NA 4.68 5.24 1.15 NA NA 13.47 14.03 090 27498 ......... ............ A Decompression of thigh/knee ........................ 8.46 NA NA 5.37 5.81 1.24 NA NA 15.07 15.51 090 27499 ......... ............ A Decompression of thigh/knee ........................ 9.23 NA NA 5.83 6.57 1.47 NA NA 16.53 17.27 090 27500 ......... ............ A Treatment of thigh fracture ............................ 6.15 5.44 5.95 4.65 4.91 1.02 12.61 13.12 11.82 12.08 090 27501 ......... ............ A Treatment of thigh fracture ............................ 6.28 5.04 5.60 4.95 5.27 1.03 12.35 12.91 12.26 12.58 090 27502 ......... ............ A Treatment of thigh fracture ............................ 11.16 NA NA 6.92 7.81 1.78 NA NA 19.86 20.75 090 27503 ......... ............ A Treatment of thigh fracture ............................ 11.05 NA NA 7.26 8.03 1.84 NA NA 20.15 20.92 090 27506 ......... ............ A Treatment of thigh fracture ............................ 19.33 NA NA 11.21 12.39 3.03 NA NA 33.57 34.75 090 27507 ......... ............ A Treatment of thigh fracture ............................ 14.33 NA NA 8.20 9.43 2.42 NA NA 24.95 26.18 090 27508 ......... ............ A Treatment of thigh fracture ............................ 6.00 5.71 6.27 5.07 5.38 0.97 12.68 13.24 12.04 12.35 090 27509 ......... ............ A Treatment of thigh fracture ............................ 7.94 NA NA 6.57 7.61 1.34 NA NA 15.85 16.89 090 27510 ......... ............ A Treatment of thigh fracture ............................ 9.60 NA NA 6.34 7.08 1.53 NA NA 17.47 18.21 090 27511 ......... ............ A Treatment of thigh fracture ............................ 13.86 NA NA 9.11 10.68 2.37 NA NA 25.34 26.91 090 27513 ......... ............ A Treatment of thigh fracture ............................ 19.37 NA NA 11.85 13.37 3.12 NA NA 34.34 35.86 090 27514 ......... ............ A Treatment of thigh fracture ............................ 19.00 NA NA 11.98 13.01 3.00 NA NA 33.98 35.01 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49114 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

27516 ......... ............ A Treat thigh fx growth plate ............................ 5.36 5.69 6.19 5.05 5.40 0.81 11.86 12.36 11.22 11.57 090 27517 ......... ............ A Treat thigh fx growth plate ............................ 8.89 NA NA 6.04 7.10 1.22 NA NA 16.15 17.21 090 27519 ......... ............ A Treat thigh fx growth plate ............................ 15.72 NA NA 9.88 11.16 2.55 NA NA 28.15 29.43 090 27520 ......... ............ A Treat kneecap fracture .................................. 2.86 4.11 4.43 3.53 3.46 0.47 7.44 7.76 6.86 6.79 090 27524 ......... ............ A Treat kneecap fracture .................................. 10.17 NA NA 6.98 7.92 1.74 NA NA 18.89 19.83 090 27530 ......... ............ A Treat knee fracture ........................................ 3.89 4.83 5.19 4.27 4.38 0.65 9.37 9.73 8.81 8.92 090 27532 ......... ............ A Treat knee fracture ........................................ 7.35 6.45 7.13 5.67 6.26 1.26 15.06 15.74 14.28 14.87 090 27535 ......... ............ A Treat knee fracture ........................................ 11.72 NA NA 8.26 9.65 2.00 NA NA 21.98 23.37 090 27536 ......... ............ A Treat knee fracture ........................................ 17.11 NA NA 10.29 11.28 2.73 NA NA 30.13 31.12 090 27538 ......... ............ A Treat knee fracture(s) .................................... 4.86 5.54 5.98 4.92 5.12 0.84 11.24 11.68 10.62 10.82 090 27540 ......... ............ A Treat knee fracture ........................................ 13.38 NA NA 8.02 9.14 2.27 NA NA 23.67 24.79 090 27550 ......... ............ A Treat knee dislocation ................................... 5.75 5.31 5.84 4.59 4.85 0.76 11.82 12.35 11.10 11.36 090 27552 ......... ............ A Treat knee dislocation ................................... 7.95 NA NA 6.12 6.74 1.36 NA NA 15.43 16.05 090 27556 ......... ............ A Treat knee dislocation ................................... 14.87 NA NA 9.31 11.07 2.50 NA NA 26.68 28.44 090 27557 ......... ............ A Treat knee dislocation ................................... 17.22 NA NA 10.58 12.49 2.97 NA NA 30.77 32.68 090 27558 ......... ............ A Treat knee dislocation ................................... 17.93 NA NA 10.62 12.44 3.08 NA NA 31.63 33.45 090 27560 ......... ............ A Treat kneecap dislocation ............................. 3.81 3.93 4.61 3.41 3.24 0.40 8.14 8.82 7.62 7.45 090 27562 ......... ............ A Treat kneecap dislocation ............................. 5.78 NA NA 4.45 4.69 0.94 NA NA 11.17 11.41 090 27566 ......... ............ A Treat kneecap dislocation ............................. 12.51 NA NA 7.85 8.95 2.12 NA NA 22.48 23.58 090 27570 ......... ............ A Fixation of knee joint ..................................... 1.74 NA NA 1.62 1.73 0.30 NA NA 3.66 3.77 010 27580 ......... ............ A Fusion of knee ............................................... 20.82 NA NA 12.34 14.19 3.37 NA NA 36.53 38.38 090 27590 ......... ............ A Amputate leg at thigh .................................... 13.27 NA NA 6.14 6.54 1.74 NA NA 21.15 21.55 090 27591 ......... ............ A Amputate leg at thigh .................................... 13.74 NA NA 7.43 8.34 2.02 NA NA 23.19 24.10 090 27592 ......... ............ A Amputate leg at thigh .................................... 10.78 NA NA 5.50 6.00 1.45 NA NA 17.73 18.23 090 27594 ......... ............ A Amputation follow-up surgery ........................ 7.09 NA NA 4.76 5.07 1.02 NA NA 12.87 13.18 09027596 ......... ............ A Amputation follow-up surgery ........................ 11.06 NA NA 6.06 6.62 1.57 NA NA 18.69 19.25 090 27598 ......... ............ A Amputate lower leg at knee .......................... 10.99 NA NA 6.34 6.85 1.65 NA NA 18.98 19.49 090 27599 ......... ............ C Leg surgery procedure .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 27600 ......... ............ A Decompression of lower leg .......................... 5.88 NA NA 3.85 4.36 0.86 NA NA 10.59 11.10 09027601 ......... ............ A Decompression of lower leg .......................... 5.87 NA NA 4.26 4.70 0.80 NA NA 10.93 11.37 09027602 ......... ............ A Decompression of lower leg .......................... 7.64 NA NA 4.39 4.95 1.10 NA NA 13.13 13.69 09027603 ......... ............ A Drain lower leg lesion .................................... 5.05 7.05 7.38 3.90 4.10 0.74 12.84 13.17 9.69 9.89 090 27604 ......... ............ A Drain lower leg bursa .................................... 4.46 6.47 6.18 3.42 3.83 0.69 11.62 11.33 8.57 8.98 090 27605 ......... ............ A Incision of achilles tendon ............................. 2.87 5.28 7.08 1.78 2.19 0.41 8.56 10.36 5.06 5.47 010 27606 ......... ............ A Incision of achilles tendon ............................. 4.13 NA NA 2.67 3.19 0.69 NA NA 7.49 8.01 010 27607 ......... ............ A Treat lower leg bone lesion ........................... 8.44 NA NA 5.76 6.07 1.31 NA NA 15.51 15.82 090 27610 ......... ............ A Explore/treat ankle joint ................................. 8.93 NA NA 6.17 6.79 1.40 NA NA 16.50 17.12 090 27612 ......... ............ A Exploration of ankle joint ............................... 7.92 NA NA 5.35 5.91 1.13 NA NA 14.40 14.96 090 27613 ......... ............ A Biopsy lower leg soft tissue .......................... 2.17 3.81 3.38 1.72 1.78 0.20 6.18 5.75 4.09 4.15 010 27614 ......... ............ A Biopsy lower leg soft tissue .......................... 5.65 7.88 7.32 4.00 4.33 0.78 14.31 13.75 10.43 10.76 090 27615 ......... ............ A Remove tumor, lower leg .............................. 12.84 NA NA 8.04 9.05 1.83 NA NA 22.71 23.72 090 27618 ......... ............ A Remove lower leg lesion ............................... 5.08 6.40 6.11 3.77 3.94 0.72 12.20 11.91 9.57 9.74 090 27619 ......... ............ A Remove lower leg lesion ............................... 8.39 10.08 9.65 5.29 5.79 1.25 19.72 19.29 14.93 15.43 090 27620 ......... ............ A Explore/treat ankle joint ................................. 5.97 NA NA 4.61 5.25 0.97 NA NA 11.55 12.19 090 27625 ......... ............ A Remove ankle joint lining .............................. 8.29 NA NA 5.59 6.24 1.28 NA NA 15.16 15.81 090 27626 ......... ............ A Remove ankle joint lining .............................. 8.90 NA NA 5.95 6.68 1.48 NA NA 16.33 17.06 090 27630 ......... ............ A Removal of tendon lesion ............................. 4.79 7.98 7.67 3.80 4.24 0.74 13.51 13.20 9.33 9.77 090 27635 ......... ............ A Remove lower leg bone lesion ...................... 7.83 NA NA 5.67 6.47 1.31 NA NA 14.81 15.61 090 27637 ......... ............ A Remove/graft leg bone lesion ....................... 10.08 NA NA 7.16 8.01 1.66 NA NA 18.90 19.75 09027638 ......... ............ A Remove/graft leg bone lesion ....................... 10.79 NA NA 6.98 7.96 1.84 NA NA 19.61 20.59 09027640 ......... ............ A Partial removal of tibia .................................. 12.01 NA NA 8.19 9.78 1.88 NA NA 22.08 23.67 090 27641 ......... ............ A Partial removal of fibula ................................ 9.65 NA NA 6.78 7.95 1.46 NA NA 17.89 19.06 090 27645 ......... ............ A Extensive lower leg surgery .......................... 14.69 NA NA 9.51 11.42 2.41 NA NA 26.61 28.52 090 27646 ......... ............ A Extensive lower leg surgery .......................... 13.12 NA NA 8.41 10.38 2.05 NA NA 23.58 25.55 090 27647 ......... ............ A Extensive ankle/heel surgery ........................ 12.76 NA NA 6.61 7.36 1.75 NA NA 21.12 21.87 090 27648 ......... ............ A Injection for ankle x-ray ................................. 0.96 2.71 3.32 0.31 0.33 0.08 3.75 4.36 1.35 1.37 000 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49115 

27650 ......... ............ A Repair achilles tendon ................................... 9.86 NA NA 6.30 7.21 1.59 NA NA 17.75 18.66 090 27652 ......... ............ A Repair/graft achilles tendon .......................... 10.55 NA NA 6.45 7.64 1.71 NA NA 18.71 19.90 090 27654 ......... ............ A Repair of achilles tendon .............................. 10.24 NA NA 5.96 6.85 1.58 NA NA 17.78 18.67 090 27656 ......... ............ A Repair leg fascia defect ................................ 4.56 8.06 8.41 3.65 3.74 0.69 13.31 13.66 8.90 8.99 090 27658 ......... ............ A Repair of leg tendon, each ............................ 4.97 NA NA 3.91 4.40 0.79 NA NA 9.67 10.16 090 27659 ......... ............ A Repair of leg tendon, each ............................ 6.92 NA NA 4.87 5.45 1.09 NA NA 12.88 13.46 090 27664 ......... ............ A Repair of leg tendon, each ............................ 4.58 NA NA 3.95 4.40 0.76 NA NA 9.29 9.74 09027665 ......... ............ A Repair of leg tendon, each ............................ 5.39 NA NA 4.50 4.85 0.89 NA NA 10.78 11.13 090 27675 ......... ............ A Repair lower leg tendons .............................. 7.17 NA NA 4.75 5.49 1.11 NA NA 13.03 13.77 090 27676 ......... ............ A Repair lower leg tendons .............................. 8.53 NA NA 5.79 6.51 1.37 NA NA 15.69 16.41 090 27680 ......... ............ A Release of lower leg tendon ......................... 5.73 NA NA 4.37 4.93 0.93 NA NA 11.03 11.59 09027681 ......... ............ A Release of lower leg tendons ....................... 6.87 NA NA 4.77 5.63 1.15 NA NA 12.79 13.65 090 27685 ......... ............ A Revision of lower leg tendon ......................... 6.49 8.82 7.67 4.59 5.24 0.97 16.28 15.13 12.05 12.70 090 27686 ......... ............ A Revise lower leg tendons .............................. 7.57 NA NA 5.38 6.21 1.24 NA NA 14.19 15.02 090 27687 ......... ............ A Revision of calf tendon .................................. 6.23 NA NA 4.54 5.12 1.00 NA NA 11.77 12.35 090 27690 ......... ............ A Revise lower leg tendon ................................ 8.88 NA NA 5.47 6.13 1.33 NA NA 15.68 16.34 090 27691 ......... ............ A Revise lower leg tendon ................................ 10.19 NA NA 6.72 7.50 1.64 NA NA 18.55 19.33 090 27692 ......... ............ A Revise additional leg tendon ......................... 1.87 NA NA 0.73 0.88 0.32 NA NA 2.92 3.07 ZZZ 27695 ......... ............ A Repair of ankle ligament ............................... 6.50 NA NA 5.00 5.65 1.05 NA NA 12.55 13.20 090 27696 ......... ............ A Repair of ankle ligaments ............................. 8.38 NA NA 5.39 6.17 1.28 NA NA 15.05 15.83 090 27698 ......... ............ A Repair of ankle ligament ............................... 9.41 NA NA 5.93 6.69 1.47 NA NA 16.81 17.57 090 27700 ......... ............ A Revision of ankle joint ................................... 9.46 NA NA 5.14 5.55 1.30 NA NA 15.90 16.31 090 27702 ......... ............ A Reconstruct ankle joint .................................. 14.19 NA NA 8.73 10.03 2.37 NA NA 25.29 26.59 090 27703 ......... ............ A Reconstruction, ankle joint ............................ 16.69 NA NA 9.89 10.90 2.76 NA NA 29.34 30.35 090 27704 ......... ............ A Removal of ankle implant .............................. 7.61 NA NA 5.70 5.62 1.27 NA NA 14.58 14.50 090 27705 ......... ............ A Incision of tibia .............................................. 10.66 NA NA 6.91 7.86 1.80 NA NA 19.37 20.32 090 27707 ......... ............ A Incision of fibula ............................................ 4.60 NA NA 4.50 4.83 0.76 NA NA 9.86 10.19 090 27709 ......... ............ A Incision of tibia & fibula ................................. 17.24 NA NA 9.94 8.58 1.73 NA NA 28.91 27.55 090 27712 ......... ............ A Realignment of lower leg .............................. 15.59 NA NA 9.18 10.35 2.47 NA NA 27.24 28.41 090 27715 ......... ............ A Revision of lower leg ..................................... 15.27 NA NA 9.07 10.35 2.49 NA NA 26.83 28.11 090 27720 ......... ............ A Repair of tibia ................................................ 12.13 NA NA 7.97 9.04 2.04 NA NA 22.14 23.21 090 27722 ......... ............ A Repair/graft of tibia ........................................ 12.22 NA NA 8.07 8.87 2.05 NA NA 22.34 23.14 090 27724 ......... ............ A Repair/graft of tibia ........................................ 19.12 NA NA 10.34 11.86 3.16 NA NA 32.62 34.14 090 27725 ......... ............ A Repair of lower leg ........................................ 17.07 NA NA 10.61 11.59 2.71 NA NA 30.39 31.37 090 27727 ......... ............ A Repair of lower leg ........................................ 14.59 NA NA 8.59 9.90 2.43 NA NA 25.61 26.92 090 27730 ......... ............ A Repair of tibia epiphysis ................................ 7.52 NA NA 5.30 6.14 1.72 NA NA 14.54 15.38 090 27732 ......... ............ A Repair of fibula epiphysis .............................. 5.31 NA NA 4.68 4.87 0.77 NA NA 10.76 10.95 090 27734 ......... ............ A Repair lower leg epiphyses ........................... 8.65 NA NA 6.20 6.26 1.35 NA NA 16.20 16.26 090 27740 ......... ............ A Repair of leg epiphyses ................................ 9.41 NA NA 6.65 7.66 1.62 NA NA 17.68 18.69 090 27742 ......... ............ A Repair of leg epiphyses ................................ 10.40 NA NA 5.20 5.47 1.79 NA NA 17.39 17.66 090 27745 ......... ............ A Reinforce tibia ............................................... 10.29 NA NA 7.01 7.88 1.75 NA NA 19.05 19.92 090 27750 ......... ............ A Treatment of tibia fracture ............................. 3.19 4.33 4.65 3.74 3.82 0.55 8.07 8.39 7.48 7.56 090 27752 ......... ............ A Treatment of tibia fracture ............................. 6.07 5.98 6.48 5.14 5.54 1.01 13.06 13.56 12.22 12.62 090 27756 ......... ............ A Treatment of tibia fracture ............................. 7.25 NA NA 5.77 6.29 1.17 NA NA 14.19 14.71 090 27758 ......... ............ A Treatment of tibia fracture ............................. 12.31 NA NA 8.07 8.90 2.03 NA NA 22.41 23.24 090 27759 ......... ............ A Treatment of tibia fracture ............................. 14.23 NA NA 8.73 9.92 2.38 NA NA 25.34 26.53 090 27760 ......... ............ A Treatment of ankle fracture ........................... 3.01 4.29 4.58 3.68 3.61 0.48 7.78 8.07 7.17 7.10 090 27762 ......... ............ A Treatment of ankle fracture ........................... 5.24 5.58 6.14 4.75 5.14 0.85 11.67 12.23 10.84 11.23 090 27766 ......... ............ A Treatment of ankle fracture ........................... 8.65 NA NA 6.29 6.99 1.44 NA NA 16.38 17.08 090 27780 ......... ............ A Treatment of fibula fracture ........................... 2.65 3.89 4.11 3.33 3.24 0.41 6.95 7.17 6.39 6.30 090 27781 ......... ............ A Treatment of fibula fracture ........................... 4.39 4.97 5.36 4.34 4.57 0.73 10.09 10.48 9.46 9.69 090 27784 ......... ............ A Treatment of fibula fracture ........................... 7.34 NA NA 5.62 6.26 1.23 NA NA 14.19 14.83 090 27786 ......... ............ A Treatment of ankle fracture ........................... 2.84 4.07 4.36 3.44 3.36 0.46 7.37 7.66 6.74 6.66 090 27788 ......... ............ A Treatment of ankle fracture ........................... 4.44 5.00 5.48 4.26 4.55 0.74 10.18 10.66 9.44 9.73 090 27792 ......... ............ A Treatment of ankle fracture ........................... 7.83 NA NA 5.95 6.71 1.32 NA NA 15.10 15.86 090 27808 ......... ............ A Treatment of ankle fracture ........................... 2.83 4.40 4.70 3.70 3.70 0.46 7.69 7.99 6.99 6.99 090 27810 ......... ............ A Treatment of ankle fracture ........................... 5.12 5.46 6.05 4.60 5.01 0.82 11.40 11.99 10.54 10.95 090 27814 ......... ............ A Treatment of ankle fracture ........................... 11.02 NA NA 7.28 8.24 1.85 NA NA 20.15 21.11 090 27816 ......... ............ A Treatment of ankle fracture ........................... 2.89 4.03 4.29 3.36 3.40 0.43 7.35 7.61 6.68 6.72 090 27818 ......... ............ A Treatment of ankle fracture ........................... 5.49 5.44 6.14 4.47 5.00 0.82 11.75 12.45 10.78 11.31 090 27822 ......... ............ A Treatment of ankle fracture ........................... 12.04 NA NA 8.87 10.21 1.91 NA NA 22.82 24.16 090 27823 ......... ............ A Treatment of ankle fracture ........................... 14.18 NA NA 9.51 10.98 2.25 NA NA 25.94 27.41 090 27824 ......... ............ A Treat lower leg fracture ................................. 3.14 3.74 3.98 3.55 3.56 0.45 7.33 7.57 7.14 7.15 090 27825 ......... ............ A Treat lower leg fracture ................................. 6.54 5.88 6.42 4.84 5.25 1.02 13.44 13.98 12.40 12.81 090 27826 ......... ............ A Treat lower leg fracture ................................. 8.89 NA NA 7.01 8.37 1.47 NA NA 17.37 18.73 090 27827 ......... ............ A Treat lower leg fracture ................................. 15.65 NA NA 10.82 12.28 2.43 NA NA 28.90 30.36 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49116 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

27828 ......... ............ A Treat lower leg fracture ................................. 18.07 NA NA 12.36 13.54 2.81 NA NA 33.24 34.42 090 27829 ......... ............ A Treat lower leg joint ....................................... 5.60 NA NA 5.53 6.47 0.95 NA NA 12.08 13.02 090 27830 ......... ............ A Treat lower leg dislocation ............................ 3.78 4.32 4.37 3.76 3.83 0.54 8.64 8.69 8.08 8.15 090 27831 ......... ............ A Treat lower leg dislocation ............................ 4.55 NA NA 3.99 4.34 0.73 NA NA 9.27 9.62 090 27832 ......... ............ A Treat lower leg dislocation ............................ 6.60 NA NA 4.75 5.82 1.03 NA NA 12.38 13.45 090 27840 ......... ............ A Treat ankle dislocation .................................. 4.57 NA NA 3.62 3.73 0.46 NA NA 8.65 8.76 090 27842 ......... ............ A Treat ankle dislocation .................................. 6.26 NA NA 4.90 5.07 1.00 NA NA 12.16 12.33 090 27846 ......... ............ A Treat ankle dislocation .................................. 10.08 NA NA 6.87 7.67 1.70 NA NA 18.65 19.45 090 27848 ......... ............ A Treat ankle dislocation .................................. 11.48 NA NA 7.72 9.21 1.94 NA NA 21.14 22.63 090 27860 ......... ............ A Fixation of ankle joint .................................... 2.34 NA NA 1.70 1.91 0.39 NA NA 4.43 4.64 010 27870 ......... ............ A Fusion of ankle joint, open ............................ 15.13 NA NA 9.19 10.19 2.36 NA NA 26.68 27.68 090 27871 ......... ............ A Fusion of tibiofibular joint .............................. 9.34 NA NA 6.54 7.32 1.59 NA NA 17.47 18.25 090 27880 ......... ............ A Amputation of lower leg ................................ 15.18 NA NA 6.78 7.04 1.75 NA NA 23.71 23.97 090 27881 ......... ............ A Amputation of lower leg ................................ 13.22 NA NA 7.45 8.49 1.98 NA NA 22.65 23.69 090 27882 ......... ............ A Amputation of lower leg ................................ 9.59 NA NA 5.55 6.25 1.29 NA NA 16.43 17.13 090 27884 ......... ............ A Amputation follow-up surgery ........................ 8.56 NA NA 5.11 5.59 1.22 NA NA 14.89 15.37 09027886 ......... ............ A Amputation follow-up surgery ........................ 9.79 NA NA 5.75 6.32 1.40 NA NA 16.94 17.51 09027888 ......... ............ A Amputation of foot at ankle ........................... 10.14 NA NA 6.25 7.19 1.51 NA NA 17.90 18.84 090 27889 ......... ............ A Amputation of foot at ankle ........................... 10.63 NA NA 5.35 6.19 1.46 NA NA 17.44 18.28 090 27892 ......... ............ A Decompression of leg ................................... 7.74 NA NA 4.88 5.41 1.10 NA NA 13.72 14.25 090 27893 ......... ............ A Decompression of leg ................................... 7.70 NA NA 5.14 5.38 1.10 NA NA 13.94 14.18 090 27894 ......... ............ A Decompression of leg ................................... 12.32 NA NA 7.36 7.67 1.65 NA NA 21.33 21.64 090 27899 ......... ............ C Leg/ankle surgery procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 28001 ......... ............ A Drainage of bursa of foot .............................. 2.73 4.04 3.25 1.63 1.87 0.33 7.10 6.31 4.69 4.93 010 28002 ......... ............ A Treatment of foot infection ............................ 5.72 6.77 5.44 3.62 3.73 0.61 13.10 11.77 9.95 10.06 010 28003 ......... ............ A Treatment of foot infection ............................ 8.88 7.86 6.64 4.61 5.07 1.12 17.86 16.64 14.61 15.07 090 28005 ......... ............ A Treat foot bone lesion ................................... 9.21 NA NA 5.48 5.90 1.16 NA NA 15.85 16.27 090 28008 ......... ............ A Incision of foot fascia .................................... 4.44 6.22 4.97 3.02 3.16 0.57 11.23 9.98 8.03 8.17 090 28010 ......... ............ A Incision of toe tendon .................................... 2.84 2.87 2.50 2.35 2.37 0.36 6.07 5.70 5.55 5.57 090 28011 ......... ............ A Incision of toe tendons .................................. 4.13 3.83 3.43 3.05 3.24 0.59 8.55 8.15 7.77 7.96 090 28020 ......... ............ A Exploration of foot joint ................................. 5.00 7.57 6.40 3.68 4.02 0.72 13.29 12.12 9.40 9.74 090 28022 ......... ............ A Exploration of foot joint ................................. 4.66 6.94 5.63 3.33 3.72 0.62 12.22 10.91 8.61 9.00 090 28024 ......... ............ A Exploration of toe joint .................................. 4.37 6.71 5.59 3.19 3.74 0.58 11.66 10.54 8.14 8.69 090 28030 ......... ............ A Removal of foot nerve ................................... 6.14 NA NA 3.47 3.61 0.74 NA NA 10.35 10.49 090 28035 ......... ............ A Decompression of tibia nerve ....................... 5.08 7.52 6.27 3.68 3.99 0.70 13.30 12.05 9.46 9.77 090 28043 ......... ............ A Excision of foot lesion ................................... 3.53 4.84 4.07 2.76 3.07 0.46 8.83 8.06 6.75 7.06 090 28045 ......... ............ A Excision of foot lesion ................................... 4.71 7.12 5.81 3.29 3.52 0.63 12.46 11.15 8.63 8.86 090 28046 ......... ............ A Resection of tumor, foot ................................ 10.46 10.49 9.19 5.84 6.31 1.36 22.31 21.01 17.66 18.13 090 28050 ......... ............ A Biopsy of foot joint lining ............................... 4.24 6.93 5.40 3.28 3.51 0.60 11.77 10.24 8.12 8.35 090 28052 ......... ............ A Biopsy of foot joint lining ............................... 3.93 6.49 5.31 2.96 3.31 0.53 10.95 9.77 7.42 7.77 090 28054 ......... ............ A Biopsy of toe joint lining ................................ 3.44 6.25 5.10 2.78 3.12 0.46 10.15 9.00 6.68 7.02 090 28060 ......... ............ A Partial removal, foot fascia ............................ 5.22 7.19 5.90 3.60 3.80 0.70 13.11 11.82 9.52 9.72 090 28062 ......... ............ A Removal of foot fascia .................................. 6.51 7.91 6.86 3.86 3.97 0.83 15.25 14.20 11.20 11.31 090 28070 ......... ............ A Removal of foot joint lining ............................ 5.09 7.27 5.73 3.48 3.73 0.73 13.09 11.55 9.30 9.55 090 28072 ......... ............ A Removal of foot joint lining ............................ 4.57 7.66 6.06 3.65 4.14 0.68 12.91 11.31 8.90 9.39 090 28080 ......... ............ A Removal of foot lesion .................................. 4.57 7.73 5.77 4.22 3.82 0.47 12.77 10.81 9.26 8.86 090 28086 ......... ............ A Excise foot tendon sheath ............................. 4.77 7.85 7.95 3.80 4.46 0.76 13.38 13.48 9.33 9.99 090 28088 ......... ............ A Excise foot tendon sheath ............................. 3.85 7.00 6.06 3.18 3.71 0.61 11.46 10.52 7.64 8.17 090 28090 ......... ............ A Removal of foot lesion .................................. 4.40 6.84 5.57 3.21 3.39 0.59 11.83 10.56 8.20 8.38 090 28092 ......... ............ A Removal of toe lesions .................................. 3.63 6.55 5.55 3.02 3.40 0.49 10.67 9.67 7.14 7.52 090 28100 ......... ............ A Removal of ankle/heel lesion ........................ 5.65 8.29 8.04 4.10 4.54 0.82 14.76 14.51 10.57 11.01 090 28102 ......... ............ A Remove/graft foot lesion ............................... 7.72 NA NA 4.97 5.70 1.14 NA NA 13.83 14.56 090 28103 ......... ............ A Remove/graft foot lesion ............................... 6.49 NA NA 4.17 4.50 0.91 NA NA 11.57 11.90 090 28104 ......... ............ A Removal of foot lesion .................................. 5.11 7.31 5.94 3.50 3.82 0.70 13.12 11.75 9.31 9.63 090 28106 ......... ............ A Remove/graft foot lesion ............................... 7.15 NA NA 4.46 4.44 0.97 NA NA 12.58 12.56 090 28107 ......... ............ A Remove/graft foot lesion ............................... 5.55 7.90 6.87 3.76 4.09 0.74 14.19 13.16 10.05 10.38 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49117 

28108 ......... ............ A Removal of toe lesions .................................. 4.15 6.42 5.05 3.01 3.19 0.53 11.10 9.73 7.69 7.87 090 28110 ......... ............ A Part removal of metatarsal ............................ 4.07 7.02 5.66 3.10 3.19 0.54 11.63 10.27 7.71 7.80 090 28111 ......... ............ A Part removal of metatarsal ............................ 5.00 7.37 6.55 3.33 3.57 0.67 13.04 12.22 9.00 9.24 090 28112 ......... ............ A Part removal of metatarsal ............................ 4.48 7.31 6.18 3.30 3.50 0.61 12.40 11.27 8.39 8.59 090 28113 ......... ............ A Part removal of metatarsal ............................ 5.78 8.48 6.66 4.67 4.40 0.63 14.89 13.07 11.08 10.81 090 28114 ......... ............ A Removal of metatarsal heads ....................... 11.49 13.43 12.07 8.31 8.36 1.42 26.34 24.98 21.22 21.27 090 28116 ......... ............ A Revision of foot ............................................. 8.86 9.58 7.49 5.41 5.23 1.03 19.47 17.38 15.30 15.12 090 28118 ......... ............ A Removal of heel bone ................................... 5.95 8.00 6.68 4.05 4.27 0.84 14.79 13.47 10.84 11.06 090 28119 ......... ............ A Removal of heel spur .................................... 5.38 7.28 5.89 3.60 3.69 0.70 13.36 11.97 9.68 9.77 090 28120 ......... ............ A Part removal of ankle/heel ............................ 5.57 8.14 7.50 3.98 4.30 0.77 14.48 13.84 10.32 10.64 090 28122 ......... ............ A Partial removal of foot bone .......................... 7.46 8.57 7.27 4.83 5.15 0.98 17.01 15.71 13.27 13.59 090 28124 ......... ............ A Partial removal of toe .................................... 4.80 6.82 5.45 3.47 3.61 0.60 12.22 10.85 8.87 9.01 090 28126 ......... ............ A Partial removal of toe .................................... 3.51 6.00 4.66 2.67 2.91 0.45 9.96 8.62 6.63 6.87 090 28130 ......... ............ A Removal of ankle bone ................................. 9.22 NA NA 5.91 6.51 1.26 NA NA 16.39 16.99 090 28140 ......... ............ A Removal of metatarsal .................................. 6.96 7.91 7.39 4.16 4.61 0.92 15.79 15.27 12.04 12.49 090 28150 ......... ............ A Removal of toe .............................................. 4.08 6.46 5.24 3.03 3.22 0.53 11.07 9.85 7.64 7.83 090 28153 ......... ............ A Partial removal of toe .................................... 3.65 6.23 4.79 2.89 2.73 0.47 10.35 8.91 7.01 6.85 090 28160 ......... ............ A Partial removal of toe .................................... 3.73 6.41 5.02 2.97 3.24 0.49 10.63 9.24 7.19 7.46 090 28171 ......... ............ A Extensive foot surgery ................................... 9.77 NA NA 5.34 5.40 1.33 NA NA 16.44 16.50 090 28173 ......... ............ A Extensive foot surgery ................................... 8.97 8.85 7.91 4.68 5.06 1.12 18.94 18.00 14.77 15.15 090 28175 ......... ............ A Extensive foot surgery ................................... 6.10 7.18 6.07 3.64 3.69 0.73 14.01 12.90 10.47 10.52 090 28190 ......... ............ A Removal of foot foreign body ........................ 1.96 4.04 3.55 1.34 1.45 0.22 6.22 5.73 3.52 3.63 010 28192 ......... ............ A Removal of foot foreign body ........................ 4.63 6.79 5.80 3.22 3.54 0.61 12.03 11.04 8.46 8.78 090 28193 ......... ............ A Removal of foot foreign body ........................ 5.72 7.38 6.05 3.64 3.85 0.73 13.83 12.50 10.09 10.30 090 28200 ......... ............ A Repair of foot tendon .................................... 4.59 6.95 5.56 3.26 3.48 0.61 12.15 10.76 8.46 8.68 090 28202 ......... ............ A Repair/graft of foot tendon ............................ 6.89 8.03 7.42 4.09 4.39 0.91 15.83 15.22 11.89 12.19 090 28208 ......... ............ A Repair of foot tendon .................................... 4.36 6.73 5.29 3.19 3.27 0.58 11.67 10.23 8.13 8.21 090 28210 ......... ............ A Repair/graft of foot tendon ............................ 6.34 7.59 6.56 3.91 3.99 0.81 14.74 13.71 11.06 11.14 090 28220 ......... ............ A Release of foot tendon .................................. 4.52 6.45 5.12 3.09 3.34 0.57 11.54 10.21 8.18 8.43 090 28222 ......... ............ A Release of foot tendons ................................ 5.61 6.93 5.66 3.34 3.93 0.69 13.23 11.96 9.64 10.23 090 28225 ......... ............ A Release of foot tendon .................................. 3.65 6.09 4.73 2.75 2.86 0.46 10.20 8.84 6.86 6.97 090 28226 ......... ............ A Release of foot tendons ................................ 4.52 7.01 5.35 3.32 3.64 0.58 12.11 10.45 8.42 8.74 090 28230 ......... ............ A Incision of foot tendon(s) ............................... 4.23 6.34 5.09 2.91 3.48 0.55 11.12 9.87 7.69 8.26 090 28232 ......... ............ A Incision of toe tendon .................................... 3.38 5.99 4.89 2.70 3.16 0.44 9.81 8.71 6.52 6.98 090 28234 ......... ............ A Incision of foot tendon ................................... 3.36 6.32 5.08 3.06 3.28 0.44 10.12 8.88 6.86 7.08 090 28238 ......... ............ A Revision of foot tendon ................................. 7.78 8.40 7.53 4.37 4.79 1.06 17.24 16.37 13.21 13.63 090 28240 ......... ............ A Release of big toe ......................................... 4.35 6.47 5.09 3.00 3.36 0.58 11.40 10.02 7.93 8.29 090 28250 ......... ............ A Revision of foot fascia ................................... 5.91 7.49 6.09 3.78 4.04 0.82 14.22 12.82 10.51 10.77 090 28260 ......... ............ A Release of midfoot joint ................................ 8.01 8.65 6.90 4.73 4.93 1.14 17.80 16.05 13.88 14.08 090 28261 ......... ............ A Revision of foot tendon ................................. 12.83 10.79 9.16 6.40 7.08 1.57 25.19 23.56 20.80 21.48 090 28262 ......... ............ A Revision of foot and ankle ............................ 16.93 15.68 14.08 9.83 10.64 2.59 35.20 33.60 29.35 30.16 090 28264 ......... ............ A Release of midfoot joint ................................ 10.45 10.45 8.41 6.03 6.97 1.54 22.44 20.40 18.02 18.96 090 28270 ......... ............ A Release of foot contracture ........................... 4.75 6.97 5.41 3.46 3.66 0.62 12.34 10.78 8.83 9.03 090 28272 ......... ............ A Release of toe joint, each ............................. 3.79 5.87 4.60 2.66 2.80 0.46 10.12 8.85 6.91 7.05 090 28280 ......... ............ A Fusion of toes ................................................ 5.18 7.41 6.53 3.60 4.26 0.73 13.32 12.44 9.51 10.17 090 28285 ......... ............ A Repair of hammertoe .................................... 4.58 6.77 5.34 3.37 3.41 0.59 11.94 10.51 8.54 8.58 090 28286 ......... ............ A Repair of hammertoe .................................... 4.55 6.54 5.23 3.05 3.20 0.57 11.66 10.35 8.17 8.32 090 28288 ......... ............ A Partial removal of foot bone .......................... 5.73 8.69 6.62 4.74 4.85 0.65 15.07 13.00 11.12 11.23 090 28289 ......... ............ A Repair hallux rigidus ...................................... 8.03 9.52 8.37 5.39 5.67 1.02 18.57 17.42 14.44 14.72 090 28290 ......... ............ A Correction of bunion ...................................... 5.65 8.24 6.75 3.98 4.54 0.82 14.71 13.22 10.45 11.01 090 28292 ......... ............ A Correction of bunion ...................................... 8.60 10.42 8.20 6.19 5.70 0.91 19.93 17.71 15.70 15.21 090 28293 ......... ............ A Correction of bunion ...................................... 10.96 14.60 11.71 6.97 6.32 1.13 26.69 23.80 19.06 18.41 090 28294 ......... ............ A Correction of bunion ...................................... 8.55 9.19 7.87 4.61 4.69 1.09 18.83 17.51 14.25 14.33 090 28296 ......... ............ A Correction of bunion ...................................... 9.23 9.66 8.53 4.83 5.27 1.19 20.08 18.95 15.25 15.69 090 28297 ......... ............ A Correction of bunion ...................................... 9.23 10.54 9.34 5.36 6.03 1.32 21.09 19.89 15.91 16.58 090 28298 ......... ............ A Correction of bunion ...................................... 7.93 9.30 7.73 4.58 4.90 1.05 18.28 16.71 13.56 13.88 090 28299 ......... ............ A Correction of bunion ...................................... 11.31 10.63 9.23 5.77 5.99 1.37 23.31 21.91 18.45 18.67 090 28300 ......... ............ A Incision of heel bone ..................................... 9.53 NA NA 6.11 6.80 1.54 NA NA 17.18 17.87 090 28302 ......... ............ A Incision of ankle bone ................................... 9.54 NA NA 5.72 6.59 1.42 NA NA 16.68 17.55 090 28304 ......... ............ A Incision of midfoot bones .............................. 9.21 9.57 8.35 5.09 5.57 1.27 20.05 18.83 15.57 16.05 090 28305 ......... ............ A Incise/graft midfoot bones ............................. 10.54 NA NA 5.61 6.44 1.27 NA NA 17.42 18.25 090 28306 ......... ............ A Incision of metatarsal .................................... 5.85 8.39 7.22 3.87 4.10 0.84 15.08 13.91 10.56 10.79 090 28307 ......... ............ A Incision of metatarsal .................................... 6.32 9.57 10.66 4.48 5.08 0.90 16.79 17.88 11.70 12.30 090 28308 ......... ............ A Incision of metatarsal .................................... 5.28 7.95 6.29 3.83 3.72 0.70 13.93 12.27 9.81 9.70 090 28309 ......... ............ A Incision of metatarsals .................................. 13.88 NA NA 7.79 7.91 2.04 NA NA 23.71 23.83 090 28310 ......... ............ A Revision of big toe ........................................ 5.42 7.56 6.20 3.42 3.52 0.70 13.68 12.32 9.54 9.64 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49118 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

28312 ......... ............ A Revision of toe .............................................. 4.54 7.41 5.93 3.24 3.53 0.63 12.58 11.10 8.41 8.70 090 28313 ......... ............ A Repair deformity of toe .................................. 5.00 7.39 5.80 3.67 4.54 0.73 13.12 11.53 9.40 10.27 090 28315 ......... ............ A Removal of sesamoid bone .......................... 4.85 6.74 5.35 3.25 3.31 0.63 12.22 10.83 8.73 8.79 090 28320 ......... ............ A Repair of foot bones ...................................... 9.17 NA NA 5.78 6.48 1.43 NA NA 16.38 17.08 090 28322 ......... ............ A Repair of metatarsals .................................... 8.33 10.03 9.39 5.48 6.12 1.27 19.63 18.99 15.08 15.72 090 28340 ......... ............ A Resect enlarged toe tissue ........................... 6.97 8.08 6.85 4.07 4.20 0.84 15.89 14.66 11.88 12.01 090 28341 ......... ............ A Resect enlarged toe ...................................... 8.52 8.70 7.37 4.47 4.73 1.01 18.23 16.90 14.00 14.26 090 28344 ......... ............ A Repair extra toe(s) ........................................ 4.25 6.83 6.01 3.19 3.52 0.51 11.59 10.77 7.95 8.28 090 28345 ......... ............ A Repair webbed toe(s) .................................... 5.91 7.82 6.60 3.89 4.48 0.80 14.53 13.31 10.60 11.19 090 28360 ......... ............ A Reconstruct cleft foot .................................... 14.57 NA NA 6.39 9.47 2.28 NA NA 23.24 26.32 090 28400 ......... ............ A Treatment of heel fracture ............................. 2.16 3.39 3.57 2.93 3.02 0.35 5.90 6.08 5.44 5.53 090 28405 ......... ............ A Treatment of heel fracture ............................. 4.56 4.53 4.76 3.76 4.41 0.73 9.82 10.05 9.05 9.70 090 28406 ......... ............ A Treatment of heel fracture ............................. 6.36 NA NA 5.69 6.52 1.11 NA NA 13.16 13.99 090 28415 ......... ............ A Treat heel fracture ......................................... 17.44 NA NA 10.92 12.69 2.66 NA NA 31.02 32.79 090 28420 ......... ............ A Treat/graft heel fracture ................................. 16.98 NA NA 10.21 12.24 2.80 NA NA 29.99 32.02 090 28430 ......... ............ A Treatment of ankle fracture ........................... 2.09 3.15 3.33 2.59 2.57 0.31 5.55 5.73 4.99 4.97 090 28435 ......... ............ A Treatment of ankle fracture ........................... 3.39 3.76 3.85 3.07 3.57 0.55 7.70 7.79 7.01 7.51 090 28436 ......... ............ A Treatment of ankle fracture ........................... 4.70 NA NA 5.00 5.68 0.81 NA NA 10.51 11.19 090 28445 ......... ............ A Treat ankle fracture ....................................... 16.99 NA NA 9.79 10.72 2.58 NA NA 29.36 30.29 090 28450 ......... ............ A Treat midfoot fracture, each .......................... 1.90 2.95 3.07 2.44 2.46 0.28 5.13 5.25 4.62 4.64 090 28455 ......... ............ A Treat midfoot fracture, each .......................... 3.09 3.68 3.49 3.05 3.33 0.44 7.21 7.02 6.58 6.86 090 28456 ......... ............ A Treat midfoot fracture .................................... 2.68 NA NA 3.63 4.02 0.44 NA NA 6.75 7.14 090 28465 ......... ............ A Treat midfoot fracture, each .......................... 7.06 NA NA 5.09 6.01 1.10 NA NA 13.25 14.17 090 28470 ......... ............ A Treat metatarsal fracture ............................... 1.99 2.84 3.05 2.40 2.43 0.30 5.13 5.34 4.69 4.72 090 28475 ......... ............ A Treat metatarsal fracture ............................... 2.97 3.18 3.29 2.56 3.05 0.44 6.59 6.70 5.97 6.46 090 28476 ......... ............ A Treat metatarsal fracture ............................... 3.37 NA NA 4.35 4.82 0.54 NA NA 8.26 8.73 090 28485 ......... ............ A Treat metatarsal fracture ............................... 5.70 NA NA 4.57 5.22 0.83 NA NA 11.10 11.75 090 28490 ......... ............ A Treat big toe fracture ..................................... 1.09 2.11 2.04 1.69 1.65 0.14 3.34 3.27 2.92 2.88 090 28495 ......... ............ A Treat big toe fracture ..................................... 1.58 2.48 2.25 1.88 2.02 0.20 4.26 4.03 3.66 3.80 090 28496 ......... ............ A Treat big toe fracture ..................................... 2.33 7.22 7.99 2.90 3.12 0.36 9.91 10.68 5.59 5.81 090 28505 ......... ............ A Treat big toe fracture ..................................... 3.80 7.53 7.96 3.28 3.75 0.56 11.89 12.32 7.64 8.11 090 28510 ......... ............ A Treatment of toe fracture .............................. 1.09 1.68 1.57 1.61 1.55 0.14 2.91 2.80 2.84 2.78 090 28515 ......... ............ A Treatment of toe fracture .............................. 1.46 2.25 1.98 1.84 1.88 0.18 3.89 3.62 3.48 3.52 090 28525 ......... ............ A Treat toe fracture ........................................... 3.32 6.93 7.37 2.92 3.30 0.49 10.74 11.18 6.73 7.11 090 28530 ......... ............ A Treat sesamoid bone fracture ....................... 1.06 1.65 1.49 1.36 1.42 0.14 2.85 2.69 2.56 2.62 090 28531 ......... ............ A Treat sesamoid bone fracture ....................... 2.47 5.84 6.91 2.13 2.08 0.34 8.65 9.72 4.94 4.89 090 28540 ......... ............ A Treat foot dislocation ..................................... 2.04 2.78 2.50 2.33 2.38 0.26 5.08 4.80 4.63 4.68 090 28545 ......... ............ A Treat foot dislocation ..................................... 2.45 3.25 2.57 2.66 2.42 0.37 6.07 5.39 5.48 5.24 090 28546 ......... ............ A Treat foot dislocation ..................................... 3.20 7.69 7.11 3.45 4.15 0.52 11.41 10.83 7.17 7.87 090 28555 ......... ............ A Repair foot dislocation ................................... 6.35 9.82 9.88 4.96 5.49 1.04 17.21 17.27 12.35 12.88 090 28570 ......... ............ A Treat foot dislocation ..................................... 1.66 2.59 2.46 2.00 2.25 0.23 4.48 4.35 3.89 4.14 090 28575 ......... ............ A Treat foot dislocation ..................................... 3.31 4.38 3.89 3.68 3.71 0.56 8.25 7.76 7.55 7.58 090 28576 ......... ............ A Treat foot dislocation ..................................... 4.40 NA NA 4.01 4.13 0.69 NA NA 9.10 9.22 090 28585 ......... ............ A Repair foot dislocation ................................... 8.10 9.98 7.99 5.29 5.70 1.25 19.33 17.34 14.64 15.05 090 28600 ......... ............ A Treat foot dislocation ..................................... 1.89 3.06 2.87 2.40 2.61 0.27 5.22 5.03 4.56 4.77 090 28605 ......... ............ A Treat foot dislocation ..................................... 2.71 3.76 3.28 3.16 3.13 0.40 6.87 6.39 6.27 6.24 090 28606 ......... ............ A Treat foot dislocation ..................................... 4.89 NA NA 4.31 4.60 0.82 NA NA 10.02 10.31 090 28615 ......... ............ A Repair foot dislocation ................................... 8.88 NA NA 7.00 7.78 1.30 NA NA 17.18 17.96 090 28630 ......... ............ A Treat toe dislocation ...................................... 1.70 1.96 1.67 0.95 0.99 0.20 3.86 3.57 2.85 2.89 010 28635 ......... ............ A Treat toe dislocation ...................................... 1.91 2.27 2.08 1.33 1.48 0.26 4.44 4.25 3.50 3.65 010 28636 ......... ............ A Treat toe dislocation ...................................... 2.77 4.38 4.00 2.05 2.48 0.43 7.58 7.20 5.25 5.68 010 28645 ......... ............ A Repair toe dislocation .................................... 4.21 6.90 5.44 3.20 3.25 0.57 11.68 10.22 7.98 8.03 090 28660 ......... ............ A Treat toe dislocation ...................................... 1.23 1.31 1.27 0.79 0.79 0.13 2.67 2.63 2.15 2.15 010 28665 ......... ............ A Treat toe dislocation ...................................... 1.92 1.85 1.54 1.34 1.41 0.26 4.03 3.72 3.52 3.59 010 28666 ......... ............ A Treat toe dislocation ...................................... 2.66 NA NA 1.92 2.42 0.43 NA NA 5.01 5.51 010 28675 ......... ............ A Repair of toe dislocation ............................... 2.92 6.72 7.04 2.87 3.23 0.45 10.09 10.41 6.24 6.60 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49119 

28705 ......... ............ A Fusion of foot bones ..................................... 20.04 NA NA 10.77 12.02 3.08 NA NA 33.89 35.14 090 28715 ......... ............ A Fusion of foot bones ..................................... 14.32 NA NA 8.54 9.45 2.16 NA NA 25.02 25.93 090 28725 ......... ............ A Fusion of foot bones ..................................... 11.89 NA NA 6.95 7.92 1.86 NA NA 20.70 21.67 090 28730 ......... ............ A Fusion of foot bones ..................................... 12.11 NA NA 7.79 8.31 1.70 NA NA 21.60 22.12 090 28735 ......... ............ A Fusion of foot bones ..................................... 11.95 NA NA 6.99 7.61 1.68 NA NA 20.62 21.24 090 28737 ......... ............ A Revision of foot bones .................................. 10.75 NA NA 6.13 6.63 1.47 NA NA 18.35 18.85 090 28740 ......... ............ A Fusion of foot bones ..................................... 9.01 10.96 10.89 6.04 6.36 1.22 21.19 21.12 16.27 16.59 090 28750 ......... ............ A Fusion of big toe joint .................................... 8.29 10.90 11.66 5.95 6.48 1.13 20.32 21.08 15.37 15.90 090 28755 ......... ............ A Fusion of big toe joint .................................... 4.73 7.30 6.40 3.37 3.66 0.65 12.68 11.78 8.75 9.04 090 28760 ......... ............ A Fusion of big toe joint .................................... 8.86 10.01 8.48 5.34 5.47 1.05 19.92 18.39 15.25 15.38 090 28800 ......... ............ A Amputation of midfoot ................................... 8.56 NA NA 5.08 5.61 1.15 NA NA 14.79 15.32 090 28805 ......... ............ A Amputation thru metatarsal ........................... 12.47 NA NA 6.02 5.74 1.18 NA NA 19.67 19.39 090 28810 ......... ............ A Amputation toe & metatarsal ......................... 6.44 NA NA 4.13 4.39 0.86 NA NA 11.43 11.69 09028820 ......... ............ A Amputation of toe .......................................... 4.82 7.78 7.61 3.60 3.74 0.61 13.21 13.04 9.03 9.17 090 28825 ......... ............ A Partial amputation of toe ............................... 3.64 7.23 7.05 3.16 3.40 0.50 11.37 11.19 7.30 7.54 090 28890 ......... ............ A High energy eswt, plantar f ........................... 3.30 4.65 5.45 2.31 2.14 0.41 8.36 9.16 6.02 5.85 090 28899 ......... ............ C Foot/toes surgery procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 29000 ......... ............ A Application of body cast ................................ 2.25 4.76 3.41 1.85 1.76 0.41 7.42 6.07 4.51 4.42 000 29010 ......... ............ A Application of body cast ................................ 2.06 3.37 3.30 1.33 1.66 0.45 5.88 5.81 3.84 4.17 000 29015 ......... ............ A Application of body cast ................................ 2.41 3.37 3.07 1.48 1.57 0.28 6.06 5.76 4.17 4.26 000 29020 ......... ............ A Application of body cast ................................ 2.11 3.79 3.33 1.48 1.43 0.28 6.18 5.72 3.87 3.82 000 29025 ......... ............ A Application of body cast ................................ 2.40 3.62 3.26 1.59 1.79 0.44 6.46 6.10 4.43 4.63 000 29035 ......... ............ A Application of body cast ................................ 1.77 3.71 3.64 1.48 1.56 0.28 5.76 5.69 3.53 3.61 000 29040 ......... ............ A Application of body cast ................................ 2.22 3.63 2.75 1.50 1.51 0.36 6.21 5.33 4.08 4.09 000 29044 ......... ............ A Application of body cast ................................ 2.12 3.98 3.97 1.66 1.84 0.35 6.45 6.44 4.13 4.31 000 29046 ......... ............ A Application of body cast ................................ 2.41 4.21 3.48 1.80 2.02 0.42 7.04 6.31 4.63 4.85 000 29049 ......... ............ A Application of figure eight .............................. 0.89 1.13 1.26 0.60 0.55 0.13 2.15 2.28 1.62 1.57 000 29055 ......... ............ A Application of shoulder cast .......................... 1.78 2.92 2.97 1.31 1.43 0.30 5.00 5.05 3.39 3.51 000 29058 ......... ............ A Application of shoulder cast .......................... 1.31 1.25 1.48 0.68 0.71 0.17 2.73 2.96 2.16 2.19 000 29065 ......... ............ A Application of long arm cast .......................... 0.87 1.28 1.32 0.71 0.74 0.15 2.30 2.34 1.73 1.76 000 29075 ......... ............ A Application of forearm cast ........................... 0.77 1.24 1.26 0.67 0.68 0.13 2.14 2.16 1.57 1.58 000 29085 ......... ............ A Apply hand/wrist cast .................................... 0.87 1.26 1.28 0.69 0.65 0.14 2.27 2.29 1.70 1.66 000 29086 ......... ............ A Apply finger cast ............................................ 0.62 1.03 0.98 0.53 0.50 0.07 1.72 1.67 1.22 1.19 000 29105 ......... ............ A Apply long arm splint ..................................... 0.87 1.10 1.20 0.53 0.52 0.12 2.09 2.19 1.52 1.51 000 29125 ......... ............ A Apply forearm splint ...................................... 0.59 0.97 1.01 0.43 0.40 0.07 1.63 1.67 1.09 1.06 000 29126 ......... ............ A Apply forearm splint ...................................... 0.77 1.02 1.16 0.48 0.47 0.07 1.86 2.00 1.32 1.31 000 29130 ......... ............ A Application of finger splint ............................. 0.50 0.43 0.46 0.18 0.17 0.06 0.99 1.02 0.74 0.73 000 29131 ......... ............ A Application of finger splint ............................. 0.55 0.63 0.71 0.26 0.25 0.03 1.21 1.29 0.84 0.83 000 29200 ......... ............ A Strapping of chest ......................................... 0.65 0.62 0.70 0.35 0.34 0.04 1.31 1.39 1.04 1.03 000 29220 ......... ............ A Strapping of low back .................................... 0.64 0.62 0.70 0.35 0.38 0.04 1.30 1.38 1.03 1.06 000 29240 ......... ............ A Strapping of shoulder .................................... 0.71 0.67 0.81 0.39 0.37 0.06 1.44 1.58 1.16 1.14 000 29260 ......... ............ A Strapping of elbow or wrist ........................... 0.55 0.65 0.72 0.36 0.33 0.05 1.25 1.32 0.96 0.93 000 29280 ......... ............ A Strapping of hand or finger ........................... 0.51 0.66 0.77 0.37 0.33 0.03 1.20 1.31 0.91 0.87 000 29305 ......... ............ A Application of hip cast ................................... 2.03 3.40 3.36 1.61 1.72 0.35 5.78 5.74 3.99 4.10 000 29325 ......... ............ A Application of hip casts ................................. 2.32 3.70 3.57 1.75 1.90 0.40 6.42 6.29 4.47 4.62 000 29345 ......... ............ A Application of long leg cast ........................... 1.40 1.67 1.74 0.95 1.03 0.24 3.31 3.38 2.59 2.67 000 29355 ......... ............ A Application of long leg cast ........................... 1.53 1.64 1.69 0.95 1.08 0.26 3.43 3.48 2.74 2.87 000 29358 ......... ............ A Apply long leg cast brace .............................. 1.43 2.06 2.06 0.94 1.05 0.25 3.74 3.74 2.62 2.73 000 29365 ......... ............ A Application of long leg cast ........................... 1.18 1.58 1.64 0.86 0.93 0.20 2.96 3.02 2.24 2.31 000 29405 ......... ............ A Apply short leg cast ....................................... 0.86 1.21 1.22 0.66 0.70 0.14 2.21 2.22 1.66 1.70 000 29425 ......... ............ A Apply short leg cast ....................................... 1.01 1.24 1.23 0.67 0.72 0.15 2.40 2.39 1.83 1.88 000 29435 ......... ............ A Apply short leg cast ....................................... 1.18 1.54 1.56 0.82 0.90 0.20 2.92 2.94 2.20 2.28 000 29440 ......... ............ A Addition of walker to cast .............................. 0.57 0.62 0.67 0.25 0.27 0.08 1.27 1.32 0.90 0.92 000 29445 ......... ............ A Apply rigid leg cast ........................................ 1.78 1.62 1.76 0.93 0.95 0.27 3.67 3.81 2.98 3.00 000 29450 ......... ............ A Application of leg cast ................................... 2.08 1.53 1.49 0.86 1.03 0.27 3.88 3.84 3.21 3.38 000 29505 ......... ............ A Application, long leg splint ............................ 0.69 1.06 1.15 0.45 0.45 0.08 1.83 1.92 1.22 1.22 000 29515 ......... ............ A Application lower leg splint ............................ 0.73 0.96 0.89 0.46 0.46 0.09 1.78 1.71 1.28 1.28 000 29520 ......... ............ A Strapping of hip ............................................. 0.54 0.68 0.81 0.38 0.45 0.03 1.25 1.38 0.95 1.02 000 29530 ......... ............ A Strapping of knee .......................................... 0.57 0.65 0.76 0.36 0.34 0.05 1.27 1.38 0.98 0.96 000 29540 ......... ............ A Strapping of ankle and/or ft ........................... 0.51 0.55 0.45 0.31 0.31 0.06 1.12 1.02 0.88 0.88 000 29550 ......... ............ A Strapping of toes ........................................... 0.47 0.57 0.46 0.30 0.29 0.06 1.10 0.99 0.83 0.82 000 29580 ......... ............ A Application of paste boot ............................... 0.55 0.73 0.67 0.34 0.35 0.07 1.35 1.29 0.96 0.97 000 29590 ......... ............ A Application of foot splint ................................ 0.76 0.60 0.53 0.26 0.28 0.09 1.45 1.38 1.11 1.13 000 29700 ......... ............ A Removal/revision of cast ............................... 0.57 0.97 0.91 0.26 0.28 0.08 1.62 1.56 0.91 0.93 000 29705 ......... ............ A Removal/revision of cast ............................... 0.76 0.77 0.81 0.37 0.38 0.13 1.66 1.70 1.26 1.27 000 29710 ......... ............ A Removal/revision of cast ............................... 1.34 1.45 1.51 0.63 0.68 0.20 2.99 3.05 2.17 2.22 000 

mstockstill on PROD1PC63 with PROPOSAL_2

49120 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

29715 ......... ............ A Removal/revision of cast ............................... 0.94 1.14 1.16 0.41 0.40 0.09 2.17 2.19 1.44 1.43 000 29720 ......... ............ A Repair of body cast ....................................... 0.68 1.15 1.16 0.34 0.38 0.12 1.95 1.96 1.14 1.18 000 29730 ......... ............ A Windowing of cast ......................................... 0.75 0.76 0.80 0.35 0.35 0.12 1.63 1.67 1.22 1.22 000 29740 ......... ............ A Wedging of cast ............................................ 1.12 1.05 1.13 0.49 0.49 0.18 2.35 2.43 1.79 1.79 000 29750 ......... ............ A Wedging of clubfoot cast ............................... 1.26 0.91 1.02 0.44 0.55 0.21 2.38 2.49 1.91 2.02 000 29799 ......... ............ C Casting/strapping procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 29800 ......... ............ A Jaw arthroscopy/surgery ............................... 6.67 NA NA 5.72 6.66 0.99 NA NA 13.38 14.32 090 29804 ......... ............ A Jaw arthroscopy/surgery ............................... 8.63 NA NA 7.34 7.55 1.38 NA NA 17.35 17.56 090 29805 ......... ............ A Shoulder arthroscopy, dx .............................. 5.88 NA NA 4.74 5.44 1.02 NA NA 11.64 12.34 090 29806 ......... ............ A Shoulder arthroscopy/surgery ....................... 14.85 NA NA 9.41 10.72 2.49 NA NA 26.75 28.06 090 29807 ......... ............ A Shoulder arthroscopy/surgery ....................... 14.38 NA NA 9.28 10.56 2.41 NA NA 26.07 27.35 090 29819 ......... ............ A Shoulder arthroscopy/surgery ....................... 7.61 NA NA 5.66 6.51 1.32 NA NA 14.59 15.44 090 29820 ......... ............ A Shoulder arthroscopy/surgery ....................... 7.06 NA NA 5.21 5.97 1.22 NA NA 13.49 14.25 090 29821 ......... ............ A Shoulder arthroscopy/surgery ....................... 7.71 NA NA 5.68 6.52 1.33 NA NA 14.72 15.56 090 29822 ......... ............ A Shoulder arthroscopy/surgery ....................... 7.42 NA NA 5.61 6.42 1.28 NA NA 14.31 15.12 090 29823 ......... ............ A Shoulder arthroscopy/surgery ....................... 8.16 NA NA 6.07 6.93 1.41 NA NA 15.64 16.50 090 29824 ......... ............ A Shoulder arthroscopy/surgery ....................... 8.74 NA NA 6.57 7.29 1.42 NA NA 16.73 17.45 090 29825 ......... ............ A Shoulder arthroscopy/surgery ....................... 7.61 NA NA 5.67 6.49 1.32 NA NA 14.60 15.42 090 29826 ......... ............ A Shoulder arthroscopy/surgery ....................... 8.98 NA NA 6.22 7.20 1.55 NA NA 16.75 17.73 090 29827 ......... ............ A Arthroscop rotator cuff repr ........................... 15.34 NA NA 9.38 10.99 2.66 NA NA 27.38 28.99 090 29830 ......... ............ A Elbow arthroscopy ......................................... 5.75 NA NA 4.52 5.14 0.99 NA NA 11.26 11.88 090 29834 ......... ............ A Elbow arthroscopy/surgery ............................ 6.27 NA NA 4.87 5.59 1.08 NA NA 12.22 12.94 090 29835 ......... ............ A Elbow arthroscopy/surgery ............................ 6.47 NA NA 4.99 5.66 1.13 NA NA 12.59 13.26 090 29836 ......... ............ A Elbow arthroscopy/surgery ............................ 7.54 NA NA 5.59 6.49 1.22 NA NA 14.35 15.25 090 29837 ......... ............ A Elbow arthroscopy/surgery ............................ 6.86 NA NA 5.15 5.89 1.19 NA NA 13.20 13.94 090 29838 ......... ............ A Elbow arthroscopy/surgery ............................ 7.70 NA NA 5.70 6.59 1.30 NA NA 14.70 15.59 090 29840 ......... ............ A Wrist arthroscopy .......................................... 5.53 NA NA 4.62 5.15 0.84 NA NA 10.99 11.52 090 29843 ......... ............ A Wrist arthroscopy/surgery ............................. 6.00 NA NA 4.92 5.45 0.92 NA NA 11.84 12.37 090 29844 ......... ............ A Wrist arthroscopy/surgery ............................. 6.36 NA NA 4.96 5.61 1.04 NA NA 12.36 13.01 090 29845 ......... ............ A Wrist arthroscopy/surgery ............................. 7.51 NA NA 5.51 6.23 0.99 NA NA 14.01 14.73 090 29846 ......... ............ A Wrist arthroscopy/surgery ............................. 6.74 NA NA 5.10 5.81 1.07 NA NA 12.91 13.62 090 29847 ......... ............ A Wrist arthroscopy/surgery ............................. 7.07 NA NA 5.17 5.94 1.08 NA NA 13.32 14.09 090 29848 ......... ............ A Wrist endoscopy/surgery ............................... 6.18 NA NA 5.29 5.52 0.86 NA NA 12.33 12.56 090 29850 ......... ............ A Knee arthroscopy/surgery ............................. 8.18 NA NA 5.13 5.07 1.25 NA NA 14.56 14.50 090 29851 ......... ............ A Knee arthroscopy/surgery ............................. 13.08 NA NA 8.32 9.42 2.34 NA NA 23.74 24.84 090 29855 ......... ............ A Tibial arthroscopy/surgery ............................. 10.60 NA NA 7.39 8.42 1.84 NA NA 19.83 20.86 090 29856 ......... ............ A Tibial arthroscopy/surgery ............................. 14.12 NA NA 8.76 10.19 2.39 NA NA 25.27 26.70 090 29860 ......... ............ A Hip arthroscopy, dx ....................................... 8.79 NA NA 6.23 6.77 1.36 NA NA 16.38 16.92 090 29861 ......... ............ A Hip arthroscopy/surgery ................................ 9.89 NA NA 6.64 7.17 1.59 NA NA 18.12 18.65 090 29862 ......... ............ A Hip arthroscopy/surgery ................................ 10.89 NA NA 7.62 8.33 1.62 NA NA 20.13 20.84 090 29863 ......... ............ A Hip arthroscopy/surgery ................................ 10.89 NA NA 7.53 8.27 1.42 NA NA 19.84 20.58 090 29866 ......... ............ A Autgrft implnt, knee w/scope ......................... 14.38 NA NA 9.54 10.90 2.39 NA NA 26.31 27.67 090 29867 ......... ............ A Allgrft implnt, knee w/scope .......................... 18.08 NA NA 11.24 12.73 2.78 NA NA 32.10 33.59 090 29868 ......... ............ A Meniscal trnspl, knee w/scpe ........................ 24.79 NA NA 13.94 16.08 4.35 NA NA 43.08 45.22 090 29870 ......... ............ A Knee arthroscopy, dx .................................... 5.06 NA NA 4.18 4.71 0.85 NA NA 10.09 10.62 090 29871 ......... ............ A Knee arthroscopy/drainage ........................... 6.54 NA NA 5.03 5.66 1.14 NA NA 12.71 13.34 09029873 ......... ............ A Knee arthroscopy/surgery ............................. 5.99 NA NA 5.61 6.33 1.04 NA NA 12.64 13.36 090 29874 ......... ............ A Knee arthroscopy/surgery ............................. 7.04 NA NA 5.18 5.85 1.11 NA NA 13.33 14.00 090 29875 ......... ............ A Knee arthroscopy/surgery ............................. 6.30 NA NA 4.92 5.62 1.09 NA NA 12.31 13.01 090 29876 ......... ............ A Knee arthroscopy/surgery ............................. 8.66 NA NA 6.23 6.82 1.37 NA NA 16.26 16.85 090 29877 ......... ............ A Knee arthroscopy/surgery ............................. 8.09 NA NA 5.99 6.55 1.28 NA NA 15.36 15.92 090 29879 ......... ............ A Knee arthroscopy/surgery ............................. 8.78 NA NA 6.28 6.91 1.39 NA NA 16.45 17.08 090 29880 ......... ............ A Knee arthroscopy/surgery ............................. 9.24 NA NA 6.48 7.14 1.47 NA NA 17.19 17.85 090 29881 ......... ............ A Knee arthroscopy/surgery ............................. 8.50 NA NA 6.18 6.77 1.34 NA NA 16.02 16.61 090 29882 ......... ............ A Knee arthroscopy/surgery ............................. 9.39 NA NA 6.52 7.06 1.50 NA NA 17.41 17.95 090 29883 ......... ............ A Knee arthroscopy/surgery ............................. 11.53 NA NA 7.65 8.71 1.92 NA NA 21.10 22.16 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49121 

29884 ......... ............ A Knee arthroscopy/surgery ............................. 8.07 NA NA 6.01 6.53 1.27 NA NA 15.35 15.87 090 29885 ......... ............ A Knee arthroscopy/surgery ............................. 9.96 NA NA 7.05 7.74 1.58 NA NA 18.58 19.28 090 29886 ......... ............ A Knee arthroscopy/surgery ............................. 8.28 NA NA 6.08 6.66 1.30 NA NA 15.66 16.24 090 29887 ......... ............ A Knee arthroscopy/surgery ............................. 9.91 NA NA 7.04 7.71 1.57 NA NA 18.52 19.19 090 29888 ......... ............ A Knee arthroscopy/surgery ............................. 14.06 NA NA 8.34 9.74 2.41 NA NA 24.81 26.21 090 29889 ......... ............ A Knee arthroscopy/surgery ............................. 17.05 NA NA 10.75 12.01 2.78 NA NA 30.58 31.84 090 29891 ......... ............ A Ankle arthroscopy/surgery ............................. 9.39 NA NA 6.69 7.31 1.39 NA NA 17.47 18.09 090 29892 ......... ............ A Ankle arthroscopy/surgery ............................. 9.99 NA NA 6.58 7.45 1.41 NA NA 17.98 18.85 090 29893 ......... ............ A Scope, plantar fasciotomy ............................. 5.96 8.86 6.93 4.67 4.16 0.63 15.45 13.52 11.26 10.75 090 29894 ......... ............ A Ankle arthroscopy/surgery ............................. 7.20 NA NA 4.72 5.28 1.15 NA NA 13.07 13.63 090 29895 ......... ............ A Ankle arthroscopy/surgery ............................. 6.98 NA NA 4.54 5.24 1.11 NA NA 12.63 13.33 090 29897 ......... ............ A Ankle arthroscopy/surgery ............................. 7.17 NA NA 4.96 5.65 1.17 NA NA 13.30 13.99 090 29898 ......... ............ A Ankle arthroscopy/surgery ............................. 8.31 NA NA 5.29 5.97 1.28 NA NA 14.88 15.56 090 29899 ......... ............ A Ankle arthroscopy/surgery ............................. 15.13 NA NA 9.30 10.23 2.40 NA NA 26.83 27.76 090 29900 ......... ............ A Mcp joint arthroscopy, dx .............................. 5.66 NA NA 4.74 5.58 0.94 NA NA 11.34 12.18 090 29901 ......... ............ A Mcp joint arthroscopy, surg ........................... 6.37 NA NA 5.50 6.07 1.06 NA NA 12.93 13.50 090 29902 ......... ............ A Mcp joint arthroscopy, surg ........................... 6.94 NA NA 3.68 5.83 1.12 NA NA 11.74 13.89 090 29999 ......... ............ C Arthroscopy of joint ....................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 30000 ......... ............ A Drainage of nose lesion ................................ 1.43 3.73 3.99 1.23 1.35 0.12 5.28 5.54 2.78 2.90 010 30020 ......... ............ A Drainage of nose lesion ................................ 1.43 3.86 3.42 1.26 1.42 0.12 5.41 4.97 2.81 2.97 010 30100 ......... ............ A Intranasal biopsy ........................................... 0.94 2.40 2.08 0.68 0.79 0.07 3.41 3.09 1.69 1.80 000 30110 ......... ............ A Removal of nose polyp(s) ............................. 1.63 3.62 3.34 1.32 1.51 0.14 5.39 5.11 3.09 3.28 010 30115 ......... ............ A Removal of nose polyp(s) ............................. 4.34 NA NA 5.47 5.69 0.41 NA NA 10.22 10.44 090 30117 ......... ............ A Removal of intranasal lesion ......................... 3.16 16.90 14.08 4.51 4.60 0.26 20.32 17.50 7.93 8.02 090 30118 ......... ............ A Removal of intranasal lesion ......................... 9.74 NA NA 7.73 8.83 0.78 NA NA 18.25 19.35 090 30120 ......... ............ A Revision of nose ............................................ 5.26 6.78 6.56 4.84 5.71 0.52 12.56 12.34 10.62 11.49 090 30124 ......... ............ A Removal of nose lesion ................................. 3.10 NA NA 3.59 3.61 0.25 NA NA 6.94 6.96 090 30125 ......... ............ A Removal of nose lesion ................................. 7.15 NA NA 7.00 7.99 0.63 NA NA 14.78 15.77 090 30130 ......... ............ A Excise inferior turbinate ................................. 3.37 NA NA 5.28 5.51 0.31 NA NA 8.96 9.19 090 30140 ......... ............ A Resect inferior turbinate ................................ 3.42 NA NA 6.54 6.28 0.35 NA NA 10.31 10.05 090 30150 ......... ............ A Partial removal of nose ................................. 9.37 NA NA 8.50 10.38 0.93 NA NA 18.80 20.68 090 30160 ......... ............ A Removal of nose ........................................... 9.81 NA NA 8.12 9.69 0.88 NA NA 18.81 20.38 090 30200 ......... ............ A Injection treatment of nose ............................ 0.78 1.87 1.68 0.61 0.71 0.06 2.71 2.52 1.45 1.55 000 30210 ......... ............ A Nasal sinus therapy ....................................... 1.08 2.31 2.15 1.15 1.27 0.09 3.48 3.32 2.32 2.44 010 30220 ......... ............ A Insert nasal septal button .............................. 1.54 5.41 4.53 1.29 1.47 0.12 7.07 6.19 2.95 3.13 010 30300 ......... ............ A Remove nasal foreign body .......................... 1.04 4.14 4.51 1.79 1.88 0.08 5.26 5.63 2.91 3.00 010 30310 ......... ............ A Remove nasal foreign body .......................... 1.96 NA NA 2.71 3.00 0.16 NA NA 4.83 5.12 010 30320 ......... ............ A Remove nasal foreign body .......................... 4.51 NA NA 5.93 6.76 0.39 NA NA 10.83 11.66 090 30400 ......... ............ R Reconstruction of nose ................................. 10.46 NA NA 13.64 15.03 1.04 NA NA 25.14 26.53 090 30410 ......... ............ R Reconstruction of nose ................................. 13.60 NA NA 14.27 17.35 1.42 NA NA 29.29 32.37 090 30420 ......... ............ R Reconstruction of nose ................................. 16.50 NA NA 14.69 17.11 1.46 NA NA 32.65 35.07 090 30430 ......... ............ R Revision of nose ............................................ 7.84 NA NA 12.76 15.20 0.77 NA NA 21.37 23.81 090 30435 ......... ............ R Revision of nose ............................................ 12.33 NA NA 14.67 18.18 1.22 NA NA 28.22 31.73 090 30450 ......... ............ R Revision of nose ............................................ 19.26 NA NA 16.12 20.45 1.96 NA NA 37.34 41.67 090 30460 ......... ............ A Revision of nose ............................................ 10.20 NA NA 7.13 9.24 1.03 NA NA 18.36 20.47 090 30462 ......... ............ A Revision of nose ............................................ 20.04 NA NA 14.29 18.75 2.53 NA NA 36.86 41.32 090 30465 ......... ............ A Repair nasal stenosis .................................... 12.12 NA NA 10.25 11.54 1.06 NA NA 23.43 24.72 090 30520 ......... ............ A Repair of nasal septum ................................. 7.63 NA NA 7.58 6.89 0.46 NA NA 15.67 14.98 090 30540 ......... ............ A Repair nasal defect ....................................... 7.74 NA NA 7.01 8.71 0.67 NA NA 15.42 17.12 090 30545 ......... ............ A Repair nasal defect ....................................... 11.42 NA NA 10.02 11.43 1.70 NA NA 23.14 24.55 090 30560 ......... ............ A Release of nasal adhesions .......................... 1.26 4.93 4.81 1.87 2.07 0.10 6.29 6.17 3.23 3.43 010 30580 ......... ............ A Repair upper jaw fistula ................................ 6.68 8.15 7.87 4.69 5.52 0.89 15.72 15.44 12.26 13.09 090 30600 ......... ............ A Repair mouth/nose fistula ............................. 6.01 7.47 7.51 4.04 4.78 0.70 14.18 14.22 10.75 11.49 090 30620 ......... ............ A Intranasal reconstruction ............................... 5.96 NA NA 8.08 8.64 0.57 NA NA 14.61 15.17 090 30630 ......... ............ A Repair nasal septum defect .......................... 7.11 NA NA 7.05 7.73 0.61 NA NA 14.77 15.45 09030801 ......... ............ A Ablate inf turbinate, superf ............................ 1.09 4.03 4.11 1.97 1.93 0.09 5.21 5.29 3.15 3.11 010 30802 ......... ............ A Cauterization, inner nose .............................. 2.03 4.60 4.61 2.30 2.35 0.16 6.79 6.80 4.49 4.54 010 30901 ......... ............ A Control of nosebleed ..................................... 1.21 1.20 1.32 0.28 0.31 0.11 2.52 2.64 1.60 1.63 000 30903 ......... ............ A Control of nosebleed ..................................... 1.54 3.07 2.80 0.38 0.47 0.13 4.74 4.47 2.05 2.14 000 30905 ......... ............ A Control of nosebleed ..................................... 1.97 3.73 3.57 0.46 0.69 0.17 5.87 5.71 2.60 2.83 000 30906 ......... ............ A Repeat control of nosebleed ......................... 2.45 3.96 3.91 0.66 1.07 0.20 6.61 6.56 3.31 3.72 000 30915 ......... ............ A Ligation, nasal sinus artery ........................... 7.31 NA NA 5.80 6.47 0.58 NA NA 13.69 14.36 090 30920 ......... ............ A Ligation, upper jaw artery .............................. 10.97 NA NA 8.11 8.76 0.80 NA NA 19.88 20.53 090 30930 ......... ............ A Ther fx, nasal inf turbinate ............................ 1.26 NA NA 1.52 1.60 0.12 NA NA 2.90 2.98 010 30999 ......... ............ C Nasal surgery procedure ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 31000 ......... ............ A Irrigation, maxillary sinus ............................... 1.15 3.00 2.88 1.23 1.36 0.09 4.24 4.12 2.47 2.60 010 

mstockstill on PROD1PC63 with PROPOSAL_2

49122 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

31002 ......... ............ A Irrigation, sphenoid sinus .............................. 1.91 NA NA 2.51 3.06 0.15 NA NA 4.57 5.12 010 31020 ......... ............ A Exploration, maxillary sinus ........................... 2.94 8.06 8.41 5.16 5.18 0.29 11.29 11.64 8.39 8.41 090 31030 ......... ............ A Exploration, maxillary sinus ........................... 5.91 9.77 11.07 6.01 6.50 0.60 16.28 17.58 12.52 13.01 090 31032 ......... ............ A Explore sinus, remove polyps ....................... 6.56 NA NA 6.46 7.04 0.59 NA NA 13.61 14.19 090 31040 ......... ............ A Exploration behind upper jaw ........................ 9.59 NA NA 7.26 9.18 0.87 NA NA 17.72 19.64 09031050 ......... ............ A Exploration, sphenoid sinus .......................... 5.27 NA NA 6.12 6.29 0.49 NA NA 11.88 12.05 090 31051 ......... ............ A Sphenoid sinus surgery ................................. 7.10 NA NA 7.68 8.10 0.62 NA NA 15.40 15.82 090 31070 ......... ............ A Exploration of frontal sinus ............................ 4.27 NA NA 5.68 5.87 0.38 NA NA 10.33 10.52 090 31075 ......... ............ A Exploration of frontal sinus ............................ 9.33 NA NA 8.49 9.42 0.75 NA NA 18.57 19.50 090 31080 ......... ............ A Removal of frontal sinus ............................... 12.46 NA NA 10.39 12.75 1.23 NA NA 24.08 26.44 090 31081 ......... ............ A Removal of frontal sinus ............................... 13.91 NA NA 14.59 14.15 2.46 NA NA 30.96 30.52 090 31084 ......... ............ A Removal of frontal sinus ............................... 14.67 NA NA 11.82 13.08 1.19 NA NA 27.68 28.94 090 31085 ......... ............ A Removal of frontal sinus ............................... 15.36 NA NA 12.90 13.70 1.72 NA NA 29.98 30.78 090 31086 ......... ............ A Removal of frontal sinus ............................... 14.08 NA NA 11.66 12.88 1.07 NA NA 26.81 28.03 090 31087 ......... ............ A Removal of frontal sinus ............................... 14.32 NA NA 10.69 12.07 1.44 NA NA 26.45 27.83 090 31090 ......... ............ A Exploration of sinuses ................................... 10.78 NA NA 12.26 12.48 0.94 NA NA 23.98 24.20 090 31200 ......... ............ A Removal of ethmoid sinus ............................. 4.96 NA NA 7.42 8.76 0.29 NA NA 12.67 14.01 090 31201 ......... ............ A Removal of ethmoid sinus ............................. 8.42 NA NA 8.22 8.93 0.82 NA NA 17.46 18.17 090 31205 ......... ............ A Removal of ethmoid sinus ............................. 10.40 NA NA 9.52 11.29 0.67 NA NA 20.59 22.36 090 31225 ......... ............ A Removal of upper jaw ................................... 26.34 NA NA 16.28 17.44 1.59 NA NA 44.21 45.37 090 31230 ......... ............ A Removal of upper jaw ................................... 30.46 NA NA 16.95 18.76 1.77 NA NA 49.18 50.99 090 31231 ......... ............ A Nasal endoscopy, dx ..................................... 1.10 3.34 3.37 0.69 0.83 0.09 4.53 4.56 1.88 2.02 000 31233 ......... ............ A Nasal/sinus endoscopy, dx ........................... 2.18 3.94 4.21 0.99 1.36 0.20 6.32 6.59 3.37 3.74 000 31235 ......... ............ A Nasal/sinus endoscopy, dx ........................... 2.64 4.28 4.75 1.12 1.57 0.26 7.18 7.65 4.02 4.47 000 31237 ......... ............ A Nasal/sinus endoscopy, surg ........................ 2.98 4.51 5.02 1.22 1.72 0.28 7.77 8.28 4.48 4.98 000 31238 ......... ............ A Nasal/sinus endoscopy, surg ........................ 3.26 4.43 5.03 1.30 1.89 0.27 7.96 8.56 4.83 5.42 000 31239 ......... ............ A Nasal/sinus endoscopy, surg ........................ 9.19 NA NA 6.27 7.57 0.62 NA NA 16.08 17.38 010 31240 ......... ............ A Nasal/sinus endoscopy, surg ........................ 2.61 NA NA 1.12 1.58 0.24 NA NA 3.97 4.43 000 31254 ......... ............ A Revision of ethmoid sinus ............................. 4.64 NA NA 1.70 2.56 0.45 NA NA 6.79 7.65 00031255 ......... ............ A Removal of ethmoid sinus ............................. 6.95 NA NA 2.34 3.67 0.73 NA NA 10.02 11.35 000 31256 ......... ............ A Exploration maxillary sinus ............................ 3.29 NA NA 1.31 1.91 0.33 NA NA 4.93 5.53 000 31267 ......... ............ A Endoscopy, maxillary sinus ........................... 5.45 NA NA 1.92 2.95 0.55 NA NA 7.92 8.95 000 31276 ......... ............ A Sinus endoscopy, surgical ............................ 8.84 NA NA 2.87 4.56 0.92 NA NA 12.63 14.32 000 31287 ......... ............ A Nasal/sinus endoscopy, surg ........................ 3.91 NA NA 1.48 2.21 0.39 NA NA 5.78 6.51 000 31288 ......... ............ A Nasal/sinus endoscopy, surg ........................ 4.57 NA NA 1.67 2.53 0.46 NA NA 6.70 7.56 000 31290 ......... ............ A Nasal/sinus endoscopy, surg ........................ 18.46 NA NA 7.99 11.04 1.40 NA NA 27.85 30.90 010 31291 ......... ............ A Nasal/sinus endoscopy, surg ........................ 19.41 NA NA 8.60 11.50 1.68 NA NA 29.69 32.59 010 31292 ......... ............ A Nasal/sinus endoscopy, surg ........................ 15.75 NA NA 7.20 9.76 1.21 NA NA 24.16 26.72 01031293 ......... ............ A Nasal/sinus endoscopy, surg ........................ 17.32 NA NA 7.82 10.49 1.28 NA NA 26.42 29.09 010 31294 ......... ............ A Nasal/sinus endoscopy, surg ........................ 20.16 NA NA 8.72 11.83 1.53 NA NA 30.41 33.52 010 31299 ......... ............ C Sinus surgery procedure ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 31300 ......... ............ A Removal of larynx lesion ............................... 15.63 NA NA 13.43 14.59 1.17 NA NA 30.23 31.39 090 31320 ......... ............ A Diagnostic incision, larynx ............................. 5.55 NA NA 9.17 10.02 0.46 NA NA 15.18 16.03 090 31360 ......... ............ A Removal of larynx ......................................... 27.23 NA NA 17.39 16.89 1.38 NA NA 46.00 45.50 090 31365 ......... ............ A Removal of larynx ......................................... 34.85 NA NA 19.55 20.16 1.97 NA NA 56.37 56.98 090 31367 ......... ............ A Partial removal of larynx ............................... 27.11 NA NA 19.32 21.25 1.78 NA NA 48.21 50.14 090 31368 ......... ............ A Partial removal of larynx ............................... 33.73 NA NA 22.12 24.65 2.20 NA NA 58.05 60.58 090 31370 ......... ............ A Partial removal of larynx ............................... 27.11 NA NA 20.11 21.72 1.74 NA NA 48.96 50.57 090 31375 ......... ............ A Partial removal of larynx ............................... 25.61 NA NA 19.22 20.09 1.63 NA NA 46.46 47.33 090 31380 ......... ............ A Partial removal of larynx ............................... 25.11 NA NA 18.90 20.18 1.70 NA NA 45.71 46.99 090 31382 ......... ............ A Partial removal of larynx ............................... 28.11 NA NA 20.41 21.31 1.67 NA NA 50.19 51.09 090 31390 ......... ............ A Removal of larynx & pharynx ........................ 38.72 NA NA 22.29 23.86 2.23 NA NA 63.24 64.81 090 31395 ......... ............ A Reconstruct larynx & pharynx ....................... 43.34 NA NA 25.53 27.61 2.48 NA NA 71.35 73.43 090 31400 ......... ............ A Revision of larynx .......................................... 11.40 NA NA 11.42 13.18 0.83 NA NA 23.65 25.41 090 31420 ......... ............ A Removal of epiglottis ..................................... 11.25 NA NA 7.82 9.11 0.83 NA NA 19.90 21.19 090 31500 ......... ............ A Insert emergency airway ............................... 2.33 NA NA 0.43 0.52 0.17 NA NA 2.93 3.02 000

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49123 

31502 ......... ............ A Change of windpipe airway ........................... 0.65 NA NA 0.20 0.26 0.05 NA NA 0.90 0.96 000 31505 ......... ............ A Diagnostic laryngoscopy ............................... 0.61 1.33 1.42 0.54 0.59 0.05 1.99 2.08 1.20 1.25 000 31510 ......... ............ A Laryngoscopy with biopsy ............................. 1.92 2.98 3.22 0.91 1.17 0.16 5.06 5.30 2.99 3.25 000 31511 ......... ............ A Remove foreign body, larynx ........................ 2.16 2.75 3.03 0.93 1.03 0.19 5.10 5.38 3.28 3.38 000 31512 ......... ............ A Removal of larynx lesion ............................... 2.07 2.73 3.08 0.95 1.26 0.18 4.98 5.33 3.20 3.51 000 31513 ......... ............ A Injection into vocal cord ................................ 2.10 NA NA 0.97 1.34 0.17 NA NA 3.24 3.61 000 31515 ......... ............ A Laryngoscopy for aspiration .......................... 1.80 3.06 3.42 0.83 1.00 0.14 5.00 5.36 2.77 2.94 000 31520 ......... ............ A Dx laryngoscopy, newborn ............................ 2.56 NA NA 1.09 1.44 0.20 NA NA 3.85 4.20 000 31525 ......... ............ A Dx laryngoscopy excl nb ............................... 2.63 3.22 3.54 1.10 1.52 0.21 6.06 6.38 3.94 4.36 000 31526 ......... ............ A Dx laryngoscopy w/oper scope ..................... 2.57 NA NA 1.10 1.57 0.21 NA NA 3.88 4.35 000 31527 ......... ............ A Laryngoscopy for treatment .......................... 3.27 NA NA 1.29 1.73 0.26 NA NA 4.82 5.26 000 31528 ......... ............ A Laryngoscopy and dilation ............................ 2.37 NA NA 0.97 1.34 0.19 NA NA 3.53 3.90 000 31529 ......... ............ A Laryngoscopy and dilation ............................ 2.68 NA NA 1.09 1.56 0.22 NA NA 3.99 4.46 000 31530 ......... ............ A Laryngoscopy w/fb removal .......................... 3.38 NA NA 1.29 1.79 0.29 NA NA 4.96 5.46 000 31531 ......... ............ A Laryngoscopy w/fb & op scope ..................... 3.58 NA NA 1.39 2.05 0.29 NA NA 5.26 5.92 000 31535 ......... ............ A Laryngoscopy w/biopsy ................................. 3.16 NA NA 1.27 1.81 0.26 NA NA 4.69 5.23 00031536 ......... ............ A Laryngoscopy w/bx & op scope .................... 3.55 NA NA 1.38 2.03 0.29 NA NA 5.22 5.87 000 31540 ......... ............ A Laryngoscopy w/exc of tumor ....................... 4.12 NA NA 1.54 2.29 0.33 NA NA 5.99 6.74 000 31541 ......... ............ A Larynscop w/tumr exc + scope ..................... 4.52 NA NA 1.66 2.50 0.37 NA NA 6.55 7.39 000 31545 ......... ............ A Remove vc lesion w/scope ........................... 6.30 NA NA 2.19 3.15 0.37 NA NA 8.86 9.82 000 31546 ......... ............ A Remove vc lesion scope/graft ....................... 9.73 NA NA 3.71 4.66 0.78 NA NA 14.22 15.17 000 31560 ......... ............ A Laryngoscop w/arytenoidectom ..................... 5.45 NA NA 1.87 2.83 0.43 NA NA 7.75 8.71 000 31561 ......... ............ A Larynscop, remve cart + scop ...................... 5.99 NA NA 2.02 3.03 0.49 NA NA 8.50 9.51 000 31570 ......... ............ A Laryngoscope w/vc inj ................................... 3.86 3.93 5.24 1.46 2.15 0.31 8.10 9.41 5.63 6.32 000 31571 ......... ............ A Laryngoscop w/vc inj + scope ....................... 4.26 NA NA 1.58 2.35 0.35 NA NA 6.19 6.96 000 31575 ......... ............ A Diagnostic laryngoscopy ............................... 1.10 1.56 1.82 0.69 0.84 0.09 2.75 3.01 1.88 2.03 000 31576 ......... ............ A Laryngoscopy with biopsy ............................. 1.97 3.26 3.56 0.94 1.20 0.14 5.37 5.67 3.05 3.31 000 31577 ......... ............ A Remove foreign body, larynx ........................ 2.47 3.22 3.63 1.09 1.42 0.21 5.90 6.31 3.77 4.10 000 31578 ......... ............ A Removal of larynx lesion ............................... 2.84 3.66 4.13 1.18 1.44 0.23 6.73 7.20 4.25 4.51 000 31579 ......... ............ A Diagnostic laryngoscopy ............................... 2.26 2.63 3.49 1.02 1.37 0.18 5.07 5.93 3.46 3.81 000 31580 ......... ............ A Revision of larynx .......................................... 14.38 NA NA 13.35 15.27 1.00 NA NA 28.73 30.65 090 31582 ......... ............ A Revision of larynx .......................................... 22.73 NA NA 20.27 24.42 1.75 NA NA 44.75 48.90 090 31584 ......... ............ A Treat larynx fracture ...................................... 20.27 NA NA 14.11 17.14 1.71 NA NA 36.09 39.12 090 31587 ......... ............ A Revision of larynx .......................................... 15.06 NA NA 7.88 8.92 0.97 NA NA 23.91 24.95 090 31588 ......... ............ A Revision of larynx .......................................... 14.48 NA NA 11.28 13.03 1.06 NA NA 26.82 28.57 090 31590 ......... ............ A Reinnervate larynx ........................................ 7.53 NA NA 11.98 14.64 0.84 NA NA 20.35 23.01 090 31595 ......... ............ A Larynx nerve surgery .................................... 8.69 NA NA 8.86 10.13 0.68 NA NA 18.23 19.50 090 31599 ......... ............ C Larynx surgery procedure ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 31600 ......... ............ A Incision of windpipe ....................................... 7.17 NA NA 2.19 2.94 0.80 NA NA 10.16 10.91 000 31601 ......... ............ A Incision of windpipe ....................................... 4.44 NA NA 1.61 2.20 0.40 NA NA 6.45 7.04 000 31603 ......... ............ A Incision of windpipe ....................................... 4.14 NA NA 1.11 1.56 0.44 NA NA 5.69 6.14 000 31605 ......... ............ A Incision of windpipe ....................................... 3.57 NA NA 0.82 1.10 0.40 NA NA 4.79 5.07 000 31610 ......... ............ A Incision of windpipe ....................................... 9.23 NA NA 7.12 7.98 0.79 NA NA 17.14 18.00 090 31611 ......... ............ A Surgery/speech prosthesis ............................ 5.87 NA NA 6.44 6.91 0.46 NA NA 12.77 13.24 090 31612 ......... ............ A Puncture/clear windpipe ................................ 0.91 1.07 1.09 0.24 0.32 0.08 2.06 2.08 1.23 1.31 000 31613 ......... ............ A Repair windpipe opening ............................... 4.58 NA NA 5.79 5.94 0.42 NA NA 10.79 10.94 090 31614 ......... ............ A Repair windpipe opening ............................... 8.39 NA NA 8.81 8.74 0.58 NA NA 17.78 17.71 090 31615 ......... ............ A Visualization of windpipe ............................... 2.09 2.21 2.50 0.95 1.14 0.16 4.46 4.75 3.20 3.39 000 31620 ......... ............ A Endobronchial us add-on .............................. 1.40 6.04 5.74 0.34 0.50 0.11 7.55 7.25 1.85 2.01 ZZZ 31622 ......... ............ A Dx bronchoscope/wash ................................. 2.78 5.26 5.55 0.90 1.02 0.18 8.22 8.51 3.86 3.98 000 31623 ......... ............ A Dx bronchoscope/brush ................................ 2.88 6.03 6.32 0.90 1.01 0.13 9.04 9.33 3.91 4.02 000 31624 ......... ............ A Dx bronchoscope/lavage ............................... 2.88 5.38 5.67 0.90 1.01 0.13 8.39 8.68 3.91 4.02 000 31625 ......... ............ A Bronchoscopy w/biopsy(s) ............................ 3.36 5.52 5.74 1.02 1.16 0.18 9.06 9.28 4.56 4.70 000 31628 ......... ............ A Bronchoscopy/lung bx, each ......................... 3.80 7.02 7.02 1.11 1.25 0.18 11.00 11.00 5.09 5.23 000 31629 ......... ............ A Bronchoscopy/needle bx, each ..................... 4.09 12.10 13.71 1.19 1.35 0.16 16.35 17.96 5.44 5.60 000 31630 ......... ............ A Bronchoscopy dilate/fx repr ........................... 3.81 NA NA 1.25 1.60 0.32 NA NA 5.38 5.73 00031631 ......... ............ A Bronchoscopy, dilate w/stent ........................ 4.36 NA NA 1.39 1.67 0.34 NA NA 6.09 6.37 000 31632 ......... ............ A Bronchoscopy/lung bx, addIl ......................... 1.03 0.86 0.82 0.24 0.29 0.18 2.07 2.03 1.45 1.50 ZZZ 31633 ......... ............ A Bronchoscopy/needle bx addIl ...................... 1.32 0.99 0.94 0.31 0.38 0.16 2.47 2.42 1.79 1.86 ZZZ 31635 ......... ............ A Bronchoscopy w/fb removal .......................... 3.67 5.20 5.88 1.13 1.36 0.24 9.11 9.79 5.04 5.27 000 31636 ......... ............ A Bronchoscopy, bronch stents ........................ 4.30 NA NA 1.37 1.66 0.31 NA NA 5.98 6.27 000 31637 ......... ............ A Bronchoscopy, stent add-on ......................... 1.58 NA NA 0.42 0.53 0.13 NA NA 2.13 2.24 ZZZ 31638 ......... ............ A Bronchoscopy, revise stent ........................... 4.88 NA NA 1.55 1.87 0.22 NA NA 6.65 6.97 000 31640 ......... ............ A Bronchoscopy w/tumor excise ...................... 4.93 NA NA 1.52 1.93 0.46 NA NA 6.91 7.32 000 31641 ......... ............ A Bronchoscopy, treat blockage ....................... 5.02 NA NA 1.49 1.78 0.35 NA NA 6.86 7.15 000 31643 ......... ............ A Diag bronchoscope/catheter ......................... 3.49 NA NA 1.05 1.19 0.20 NA NA 4.74 4.88 000 

mstockstill on PROD1PC63 with PROPOSAL_2

49124 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

31645 ......... ............ A Bronchoscopy, clear airways ........................ 3.16 4.77 5.05 0.97 1.08 0.16 8.09 8.37 4.29 4.40 000 31646 ......... ............ A Bronchoscopy, reclear airway ....................... 2.72 4.48 4.77 0.86 0.97 0.14 7.34 7.63 3.72 3.83 000 31656 ......... ............ A Bronchoscopy, inj for x-ray ........................... 2.17 5.31 6.80 0.65 0.79 0.15 7.63 9.12 2.97 3.11 000 31700 ......... ............ A Insertion of airway catheter ........................... 1.34 2.30 2.19 0.68 0.68 0.08 3.72 3.61 2.10 2.10 000 31708 ......... ............ A Instill airway contrast dye .............................. 1.41 NA NA 0.40 0.45 0.07 NA NA 1.88 1.93 000 31710 ......... ............ A Insertion of airway catheter ........................... 1.30 NA NA 0.42 0.41 0.12 NA NA 1.84 1.83 000 31715 ......... ............ A Injection for bronchus x-ray ........................... 1.11 NA NA 0.29 0.33 0.07 NA NA 1.47 1.51 000 31717 ......... ............ A Bronchial brush biopsy .................................. 2.12 5.86 7.65 0.76 0.78 0.14 8.12 9.91 3.02 3.04 000 31720 ......... ............ A Clearance of airways ..................................... 1.06 NA NA 0.25 0.31 0.07 NA NA 1.38 1.44 000 31725 ......... ............ A Clearance of airways ..................................... 1.96 NA NA 0.45 0.55 0.14 NA NA 2.55 2.65 000 31730 ......... ............ A Intro, windpipe wire/tube ............................... 2.85 25.67 8.06 0.72 0.93 0.21 28.73 11.12 3.78 3.99 000 31750 ......... ............ A Repair of windpipe ........................................ 15.11 NA NA 16.11 17.19 1.05 NA NA 32.27 33.35 090 31755 ......... ............ A Repair of windpipe ........................................ 17.05 NA NA 22.15 23.93 1.29 NA NA 40.49 42.27 090 31760 ......... ............ A Repair of windpipe ........................................ 23.28 NA NA 9.76 10.47 2.94 NA NA 35.98 36.69 090 31766 ......... ............ A Reconstruction of windpipe ........................... 31.52 NA NA 11.44 13.10 4.52 NA NA 47.48 49.14 090 31770 ......... ............ A Repair/graft of bronchus ................................ 23.44 NA NA 8.83 9.89 2.83 NA NA 35.10 36.16 090 31775 ......... ............ A Reconstruct bronchus ................................... 24.46 NA NA 9.07 11.11 3.01 NA NA 36.54 38.58 090 31780 ......... ............ A Reconstruct windpipe .................................... 19.62 NA NA 7.98 10.28 1.65 NA NA 29.25 31.55 090 31781 ......... ............ A Reconstruct windpipe .................................... 24.72 NA NA 9.17 11.38 2.24 NA NA 36.13 38.34 090 31785 ......... ............ A Remove windpipe lesion ............................... 18.25 NA NA 5.49 9.01 1.59 NA NA 25.33 28.85 090 31786 ......... ............ A Remove windpipe lesion ............................... 25.29 NA NA 9.74 12.25 3.29 NA NA 38.32 40.83 090 31800 ......... ............ A Repair of windpipe injury ............................... 8.05 NA NA 8.35 9.02 0.79 NA NA 17.19 17.86 090 31805 ......... ............ A Repair of windpipe injury ............................... 13.29 NA NA 6.24 6.97 1.82 NA NA 21.35 22.08 090 31820 ......... ............ A Closure of windpipe lesion ............................ 4.54 5.43 5.60 2.98 3.48 0.38 10.35 10.52 7.90 8.40 090 31825 ......... ............ A Repair of windpipe defect ............................. 6.92 6.78 7.44 4.00 5.03 0.53 14.23 14.89 11.45 12.48 090 31830 ......... ............ A Revise windpipe scar .................................... 4.49 5.60 5.72 3.33 3.82 0.44 10.53 10.65 8.26 8.75 090 31899 ......... ............ C Airways surgical procedure ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 32000 ......... ............ A Drainage of chest .......................................... 1.54 2.39 2.89 0.43 0.47 0.08 4.01 4.51 2.05 2.09 000 32002 ......... ............ A Treatment of collapsed lung .......................... 2.19 2.85 3.12 0.99 1.04 0.12 5.16 5.43 3.30 3.35 000 32005 ......... ............ A Treat lung lining chemically ........................... 2.19 5.11 6.12 0.59 0.67 0.23 7.53 8.54 3.01 3.09 000 32019 ......... ............ A Insert pleural catheter ................................... 4.17 15.54 18.86 1.45 1.60 0.42 20.13 23.45 6.04 6.19 000 32020 ......... ............ A Insertion of chest tube ................................... 3.97 NA NA 1.14 1.30 0.43 NA NA 5.54 5.70 000 32035 ......... ............ A Exploration of chest ....................................... 11.14 NA NA 6.11 5.92 1.26 NA NA 18.50 18.32 090 32036 ......... ............ A Exploration of chest ....................................... 12.15 NA NA 6.43 6.43 1.43 NA NA 20.01 20.01 090 32095 ......... ............ A Biopsy through chest wall ............................. 10.03 NA NA 5.22 5.33 1.22 NA NA 16.47 16.58 090 32100 ......... ............ A Exploration/biopsy of chest ........................... 16.04 NA NA 7.09 7.64 2.23 NA NA 25.36 25.91 090 32110 ......... ............ A Explore/repair chest ...................................... 25.11 NA NA 10.03 10.56 3.21 NA NA 38.35 38.88 090 32120 ......... ............ A Re-exploration of chest ................................. 14.24 NA NA 6.91 7.03 1.63 NA NA 22.78 22.90 090 32124 ......... ............ A Explore chest free adhesions ........................ 15.30 NA NA 7.09 7.18 1.89 NA NA 24.28 24.37 090 32140 ......... ............ A Removal of lung lesion(s) ............................. 16.51 NA NA 7.48 7.63 1.96 NA NA 25.95 26.10 090 32141 ......... ............ A Remove/treat lung lesions ............................. 17.14 NA NA 7.69 7.59 2.00 NA NA 26.83 26.73 090 32150 ......... ............ A Removal of lung lesion(s) ............................. 16.67 NA NA 7.54 7.59 2.00 NA NA 26.21 26.26 090 32151 ......... ............ A Remove lung foreign body ............................ 16.79 NA NA 8.73 8.18 2.03 NA NA 27.55 27.00 090 32160 ......... ............ A Open chest heart massage ........................... 13.00 NA NA 5.89 5.42 1.31 NA NA 20.20 19.73 09032200 ......... ............ A Drain, open, lung lesion ................................ 18.43 NA NA 8.91 8.69 2.13 NA NA 29.47 29.25 090 32201 ......... ............ A Drain, percut, lung lesion .............................. 3.99 19.87 20.49 1.26 1.29 0.24 24.10 24.72 5.49 5.52 000 32215 ......... ............ A Treat chest lining ........................................... 12.90 NA NA 6.43 6.78 1.68 NA NA 21.01 21.36 090 32220 ......... ............ A Release of lung ............................................. 26.31 NA NA 12.11 12.74 3.56 NA NA 41.98 42.61 090 32225 ......... ............ A Partial release of lung ................................... 16.60 NA NA 7.54 7.62 2.06 NA NA 26.20 26.28 090 32310 ......... ............ A Removal of chest lining ................................. 15.13 NA NA 6.98 7.29 1.99 NA NA 24.10 24.41 090 32320 ......... ............ A Free/remove chest lining ............................... 26.96 NA NA 11.63 12.02 3.51 NA NA 42.10 42.49 090 32400 ......... ............ A Needle biopsy chest lining ............................ 1.76 2.12 2.12 0.52 0.54 0.10 3.98 3.98 2.38 2.40 000 32402 ......... ............ A Open biopsy chest lining ............................... 8.86 NA NA 4.81 5.04 1.07 NA NA 14.74 14.97 090 32405 ......... ............ A Biopsy, lung or mediastinum ......................... 1.93 0.61 0.66 0.61 0.63 0.11 2.65 2.70 2.65 2.67 000 32420 ......... ............ A Puncture/clear lung ....................................... 2.18 NA NA 0.68 0.68 0.12 NA NA 2.98 2.98 000 32440 ......... ............ A Removal of lung ............................................ 27.11 NA NA 11.11 12.45 3.68 NA NA 41.90 43.24 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49125 

32442 ......... ............ A Sleeve pneumonectomy ................................ 37.74 NA NA 13.28 14.39 3.84 NA NA 54.86 55.97 090 32445 ......... ............ A Removal of lung ............................................ 40.73 NA NA 16.31 14.62 3.71 NA NA 60.75 59.06 090 32480 ......... ............ A Partial removal of lung .................................. 25.65 NA NA 10.37 11.64 3.49 NA NA 39.51 40.78 090 32482 ......... ............ A Bilobectomy ................................................... 27.22 NA NA 11.22 12.49 3.66 NA NA 42.10 43.37 090 32484 ......... ............ A Segmentectomy ............................................ 22.67 NA NA 8.92 10.77 3.03 NA NA 34.62 36.47 090 32486 ......... ............ A Sleeve lobectomy .......................................... 31.72 NA NA 11.89 12.90 3.51 NA NA 47.12 48.13 090 32488 ......... ............ A Completion pneumonectomy ......................... 32.69 NA NA 12.78 13.53 3.80 NA NA 49.27 50.02 09032491 ......... ............ R Lung volume reduction .................................. 25.03 NA NA 10.69 12.14 2.98 NA NA 38.70 40.15 090 32500 ......... ............ A Partial removal of lung .................................. 24.42 NA NA 10.43 11.87 3.25 NA NA 38.10 39.54 090 32501 ......... ............ A Repair bronchus add-on ................................ 4.68 NA NA 1.37 1.50 0.65 NA NA 6.70 6.83 ZZZ32503 ......... ............ A Resect apical lung tumor .............................. 31.55 NA NA 12.31 14.38 4.37 NA NA 48.23 50.30 090 32504 ......... ............ A Resect apical lung tum/chest ........................ 36.35 NA NA 13.73 15.94 5.07 NA NA 55.15 57.36 090 32540 ......... ............ A Removal of lung lesion .................................. 23.68 NA NA 10.25 9.79 2.07 NA NA 36.00 35.54 090 32601 ......... ............ A Thoracoscopy, diagnostic .............................. 5.45 NA NA 2.11 2.29 0.80 NA NA 8.36 8.54 00032602 ......... ............ A Thoracoscopy, diagnostic .............................. 5.95 NA NA 2.25 2.45 0.87 NA NA 9.07 9.27 00032603 ......... ............ A Thoracoscopy, diagnostic .............................. 7.80 NA NA 2.99 3.02 1.14 NA NA 11.93 11.96 000 32604 ......... ............ A Thoracoscopy, diagnostic .............................. 8.77 NA NA 3.08 3.36 1.25 NA NA 13.10 13.38 000 32605 ......... ............ A Thoracoscopy, diagnostic .............................. 6.92 NA NA 2.56 2.82 1.00 NA NA 10.48 10.74 000 32606 ......... ............ A Thoracoscopy, diagnostic .............................. 8.39 NA NA 3.02 3.25 1.22 NA NA 12.63 12.86 000 32650 ......... ............ A Thoracoscopy, surgical ................................. 10.73 NA NA 5.32 6.40 1.58 NA NA 17.63 18.71 090 32651 ......... ............ A Thoracoscopy, surgical ................................. 16.28 NA NA 7.09 7.20 1.86 NA NA 25.23 25.34 090 32652 ......... ............ A Thoracoscopy, surgical ................................. 23.34 NA NA 9.65 10.02 2.72 NA NA 35.71 36.08 090 32653 ......... ............ A Thoracoscopy, surgical ................................. 19.86 NA NA 8.01 7.23 1.88 NA NA 29.75 28.97 090 32654 ......... ............ A Thoracoscopy, surgical ................................. 18.49 NA NA 7.47 7.52 1.63 NA NA 27.59 27.64 090 32655 ......... ............ A Thoracoscopy, surgical ................................. 14.95 NA NA 6.74 7.12 1.89 NA NA 23.58 23.96 090 32656 ......... ............ A Thoracoscopy, surgical ................................. 13.14 NA NA 6.04 7.47 1.89 NA NA 21.07 22.50 090 32657 ......... ............ A Thoracoscopy, surgical ................................. 14.54 NA NA 6.47 7.38 1.99 NA NA 23.00 23.91 090 32658 ......... ............ A Thoracoscopy, surgical ................................. 11.61 NA NA 5.64 6.92 1.69 NA NA 18.94 20.22 090 32659 ......... ............ A Thoracoscopy, surgical ................................. 11.82 NA NA 5.95 7.08 1.62 NA NA 19.39 20.52 090 32660 ......... ............ A Thoracoscopy, surgical ................................. 17.65 NA NA 7.52 8.99 2.08 NA NA 27.25 28.72 090 32661 ......... ............ A Thoracoscopy, surgical ................................. 13.23 NA NA 6.22 7.40 1.92 NA NA 21.37 22.55 090 32662 ......... ............ A Thoracoscopy, surgical ................................. 17.00 NA NA 7.23 8.42 2.17 NA NA 26.40 27.59 090 32663 ......... ............ A Thoracoscopy, surgical ................................. 19.96 NA NA 8.91 10.30 2.72 NA NA 31.59 32.98 090 32664 ......... ............ A Thoracoscopy, surgical ................................. 14.18 NA NA 6.42 7.33 2.32 NA NA 22.92 23.83 090 32665 ......... ............ A Thoracoscopy, surgical ................................. 17.37 NA NA 7.66 8.01 2.15 NA NA 27.18 27.53 090 32800 ......... ............ A Repair lung hernia ......................................... 15.56 NA NA 7.13 7.34 1.98 NA NA 24.67 24.88 090 32810 ......... ............ A Close chest after drainage ............................ 14.80 NA NA 7.12 7.42 1.93 NA NA 23.85 24.15 090 32815 ......... ............ A Close bronchial fistula ................................... 37.94 NA NA 15.43 12.09 3.27 NA NA 56.64 53.30 090 32820 ......... ............ A Reconstruct injured chest .............................. 22.27 NA NA 11.75 12.06 2.52 NA NA 36.54 36.85 090 32851 ......... ............ A Lung transplant, single .................................. 40.72 NA NA 20.99 25.99 5.56 NA NA 67.27 72.27 090 32852 ......... ............ A Lung transplant with bypass ......................... 44.37 NA NA 23.82 30.83 6.00 NA NA 74.19 81.20 090 32853 ......... ............ A Lung transplant, double ................................. 49.89 NA NA 23.39 29.66 7.05 NA NA 80.33 86.60 090 32854 ......... ............ A Lung transplant with bypass ......................... 53.60 NA NA 26.62 32.70 7.20 NA NA 87.42 93.50 090 32855 ......... ............ C Prepare donor lung, single ............................ 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 32900 ......... ............ A Removal of rib(s) ........................................... 23.66 NA NA 9.81 9.86 2.93 NA NA 36.40 36.45 090 32905 ......... ............ A Revise & repair chest wall ............................ 23.14 NA NA 9.64 10.01 3.15 NA NA 35.93 36.30 090 32906 ......... ............ A Revise & repair chest wall ............................ 29.15 NA NA 11.34 11.88 3.97 NA NA 44.46 45.00 090 32940 ......... ............ A Revision of lung ............................................. 21.19 NA NA 8.66 9.27 2.88 NA NA 32.73 33.34 090 32960 ......... ............ A Therapeutic pneumothorax ........................... 1.84 1.59 1.70 0.67 0.59 0.16 3.59 3.70 2.67 2.59 000 32997 ......... ............ A Total lung lavage ........................................... 5.99 NA NA 1.51 1.81 0.55 NA NA 8.05 8.35 000 32999 ......... ............ C Chest surgery procedure ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 33010 ......... ............ A Drainage of heart sac .................................... 2.24 NA NA 1.02 0.84 0.14 NA NA 3.40 3.22 000 33011 ......... ............ A Repeat drainage of heart sac ....................... 2.24 NA NA 1.10 0.88 0.15 NA NA 3.49 3.27 000 33015 ......... ............ A Incision of heart sac ...................................... 8.41 NA NA 5.08 4.98 0.65 NA NA 14.14 14.04 090 33020 ......... ............ A Incision of heart sac ...................................... 14.85 NA NA 6.54 6.72 1.79 NA NA 23.18 23.36 090 33025 ......... ............ A Incision of heart sac ...................................... 13.63 NA NA 5.98 6.26 1.80 NA NA 21.41 21.69 090 33030 ......... ............ A Partial removal of heart sac .......................... 22.24 NA NA 9.26 9.46 2.83 NA NA 34.33 34.53 090 33031 ......... ............ A Partial removal of heart sac .......................... 25.28 NA NA 9.96 10.01 3.13 NA NA 38.37 38.42 090 33050 ......... ............ A Removal of heart sac lesion ......................... 16.82 NA NA 7.63 7.79 2.14 NA NA 26.59 26.75 090 33120 ......... ............ A Removal of heart lesion ................................ 27.30 NA NA 10.79 11.38 3.69 NA NA 41.78 42.37 090 33130 ......... ............ A Removal of heart lesion ................................ 24.02 NA NA 9.48 9.95 3.00 NA NA 36.50 36.97 090 33140 ......... ............ A Heart revascularize (tmr) ............................... 22.72 NA NA 10.09 10.68 2.85 NA NA 35.66 36.25 090 33141 ......... ............ A Heart tmr w/other procedure ......................... 4.83 NA NA 1.52 1.57 0.69 NA NA 7.04 7.09 ZZZ 33200 ......... ............ A Insertion of heart pacemaker ........................ 14.70 NA NA 7.45 6.99 1.70 NA NA 23.85 23.39 090 33201 ......... ............ A Insertion of heart pacemaker ........................ 12.08 NA NA 6.40 6.54 1.36 NA NA 19.84 19.98 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49126 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

33206 ......... ............ A Insertion of heart pacemaker ........................ 7.28 NA NA 5.13 4.63 0.52 NA NA 12.92 12.42 09033207 ......... ............ A Insertion of heart pacemaker ........................ 9.03 NA NA 5.78 4.94 0.59 NA NA 15.40 14.56 09033208 ......... ............ A Insertion of heart pacemaker ........................ 8.12 NA NA 5.43 4.94 0.56 NA NA 14.11 13.62 09033210 ......... ............ A Insertion of heart electrode ........................... 3.30 NA NA 1.70 1.36 0.18 NA NA 5.18 4.84 000 33211 ......... ............ A Insertion of heart electrode ........................... 3.39 NA NA 1.67 1.40 0.21 NA NA 5.27 5.00 000 33212 ......... ............ A Insertion of pulse generator .......................... 5.51 NA NA 3.75 3.46 0.43 NA NA 9.69 9.40 09033213 ......... ............ A Insertion of pulse generator .......................... 6.36 NA NA 4.17 3.83 0.45 NA NA 10.98 10.64 090 33214 ......... ............ A Upgrade of pacemaker system ..................... 7.74 NA NA 5.38 5.01 0.58 NA NA 13.70 13.33 090 33215 ......... ............ A Reposition pacing-defib lead ......................... 4.87 NA NA 3.52 3.27 0.37 NA NA 8.76 8.51 090 33216 ......... ............ A Insert lead pace-defib, one ........................... 5.77 NA NA 4.58 4.30 0.36 NA NA 10.71 10.43 090 33217 ......... ............ A Insert lead pace-defib, dual ........................... 5.74 NA NA 4.50 4.30 0.39 NA NA 10.63 10.43 090 33218 ......... ............ A Repair lead pace-defib, one .......................... 5.93 NA NA 4.83 4.43 0.37 NA NA 11.13 10.73 090 33220 ......... ............ A Repair lead pace-defib, dual ......................... 6.01 NA NA 4.89 4.43 0.37 NA NA 11.27 10.81 090 33222 ......... ............ A Revise pocket, pacemaker ............................ 4.95 NA NA 4.33 4.30 0.42 NA NA 9.70 9.67 090 33223 ......... ............ A Revise pocket, pacing-defib .......................... 6.45 NA NA 4.97 4.69 0.45 NA NA 11.87 11.59 090 33224 ......... ............ A Insert pacing lead & connect ........................ 9.04 NA NA 5.03 4.26 0.54 NA NA 14.61 13.84 00033225 ......... ............ A L ventric pacing lead add-on ......................... 8.33 NA NA 4.45 3.55 0.45 NA NA 13.23 12.33 ZZZ 33226 ......... ............ A Reposition l ventric lead ................................ 8.68 NA NA 4.87 4.08 0.59 NA NA 14.14 13.35 000 33233 ......... ............ A Removal of pacemaker system ..................... 3.29 NA NA 3.29 3.28 0.22 NA NA 6.80 6.79 090 33234 ......... ............ A Removal of pacemaker system ..................... 7.81 NA NA 5.52 5.06 0.56 NA NA 13.89 13.43 090 33235 ......... ............ A Removal pacemaker electrode ..................... 9.85 NA NA 7.32 6.94 0.73 NA NA 17.90 17.52 090 33236 ......... ............ A Remove electrode/thoracotomy .................... 12.58 NA NA 6.70 7.25 1.68 NA NA 20.96 21.51 090 33237 ......... ............ A Remove electrode/thoracotomy .................... 13.69 NA NA 7.68 7.76 1.59 NA NA 22.96 23.04 090 33238 ......... ............ A Remove electrode/thoracotomy .................... 15.20 NA NA 8.35 8.24 2.02 NA NA 25.57 25.46 090 33240 ......... ............ A Insert pulse generator ................................... 7.59 NA NA 5.34 4.77 0.41 NA NA 13.34 12.77 090 33241 ......... ............ A Remove pulse generator ............................... 3.24 NA NA 3.04 2.98 0.18 NA NA 6.46 6.40 090 33243 ......... ............ A Remove eltrd/thoracotomy ............................ 23.36 NA NA 11.00 11.35 2.09 NA NA 36.45 36.80 090 33244 ......... ............ A Remove eltrd, transven ................................. 13.74 NA NA 9.53 9.05 0.99 NA NA 24.26 23.78 090 33245 ......... ............ A Insert epic eltrd pace-defib ............................ 16.82 NA NA 7.96 7.92 2.01 NA NA 26.79 26.75 090 33246 ......... ............ A Insert epic eltrd/generator ............................. 23.11 NA NA 10.73 10.39 2.63 NA NA 36.47 36.13 090 33249 ......... ............ A Eltrd/insert pace-defib ................................... 14.96 NA NA 10.33 8.85 0.77 NA NA 26.06 24.58 090 33250 ......... ............ A Ablate heart dysrhythm focus ....................... 25.75 NA NA 10.16 10.81 3.18 NA NA 39.09 39.74 090 33251 ......... ............ A Ablate heart dysrhythm focus ....................... 28.77 NA NA 11.15 11.53 3.59 NA NA 43.51 43.89 090 33253 ......... ............ A Reconstruct atria ........................................... 31.33 NA NA 12.15 13.40 4.52 NA NA 48.00 49.25 090 33261 ......... ............ A Ablate heart dysrhythm focus ....................... 28.77 NA NA 11.33 11.66 3.45 NA NA 43.55 43.88 090 33282 ......... ............ A Implant pat-active ht record .......................... 4.66 NA NA 4.29 4.09 0.23 NA NA 9.18 8.98 09033284 ......... ............ A Remove pat-active ht record ......................... 3.00 NA NA 3.40 3.50 0.14 NA NA 6.54 6.64 090 33300 ......... ............ A Repair of heart wound ................................... 29.93 NA NA 11.14 9.71 2.65 NA NA 43.72 42.29 090 33305 ......... ............ A Repair of heart wound ................................... 33.67 NA NA 12.24 11.02 3.12 NA NA 49.03 47.81 090 33310 ......... ............ A Exploratory heart surgery .............................. 20.19 NA NA 8.83 9.39 2.58 NA NA 31.60 32.16 090 33315 ......... ............ A Exploratory heart surgery .............................. 26.02 NA NA 10.46 10.78 3.27 NA NA 39.75 40.07 090 33320 ......... ............ A Repair major blood vessel(s) ........................ 18.43 NA NA 8.69 8.34 2.07 NA NA 29.19 28.84 090 33321 ......... ............ A Repair major vessel ...................................... 20.67 NA NA 10.28 9.91 2.90 NA NA 33.85 33.48 090 33322 ......... ............ A Repair major blood vessel(s) ........................ 24.27 NA NA 9.83 10.23 2.85 NA NA 36.95 37.35 090 33330 ......... ............ A Insert major vessel graft ................................ 25.14 NA NA 9.80 10.15 2.81 NA NA 37.75 38.10 090 33332 ......... ............ A Insert major vessel graft ................................ 24.42 NA NA 9.65 10.30 3.02 NA NA 37.09 37.74 090 33335 ......... ............ A Insert major vessel graft ................................ 33.76 NA NA 12.97 13.24 4.27 NA NA 51.00 51.27 090 33400 ......... ............ A Repair of aortic valve .................................... 39.23 NA NA 14.57 15.39 4.10 NA NA 57.90 58.72 090 33401 ......... ............ A Valvuloplasty, open ....................................... 24.33 NA NA 9.83 12.58 3.56 NA NA 37.72 40.47 090 33403 ......... ............ A Valvuloplasty, w/cp bypass ........................... 25.31 NA NA 10.53 13.36 3.54 NA NA 39.38 42.21 090 33404 ......... ............ A Prepare heart-aorta conduit .......................... 31.22 NA NA 12.26 13.97 4.32 NA NA 47.80 49.51 090 33405 ......... ............ A Replacement of aortic valve .......................... 39.97 NA NA 15.12 17.50 5.31 NA NA 60.40 62.78 090 33406 ......... ............ A Replacement of aortic valve .......................... 48.87 NA NA 17.72 18.77 5.43 NA NA 72.02 73.07 090 33410 ......... ............ A Replacement of aortic valve .......................... 38.69 NA NA 14.63 16.09 4.68 NA NA 58.00 59.46 090 33411 ......... ............ A Replacement of aortic valve .......................... 57.11 NA NA 20.12 19.09 5.46 NA NA 82.69 81.66 090 33412 ......... ............ A Replacement of aortic valve .......................... 43.71 NA NA 16.57 19.44 6.37 NA NA 66.65 69.52 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49127 

33413 ......... ............ A Replacement of aortic valve .......................... 55.27 NA NA 19.33 20.44 6.51 NA NA 81.11 82.22 090 33414 ......... ............ A Repair of aortic valve .................................... 39.27 NA NA 15.20 14.40 4.56 NA NA 59.03 58.23 090 33415 ......... ............ A Revision, subvalvular tissue .......................... 29.70 NA NA 11.14 11.80 4.13 NA NA 44.97 45.63 090 33416 ......... ............ A Revise ventricle muscle ................................ 36.39 NA NA 13.63 13.53 4.56 NA NA 54.58 54.48 090 33417 ......... ............ A Repair of aortic valve .................................... 29.13 NA NA 12.14 13.24 4.09 NA NA 45.36 46.46 090 33420 ......... ............ A Revision of mitral valve ................................. 25.64 NA NA 8.85 9.38 1.81 NA NA 36.30 36.83 090 33422 ......... ............ A Revision of mitral valve ................................. 29.58 NA NA 12.50 13.36 3.93 NA NA 46.01 46.87 090 33425 ......... ............ A Repair of mitral valve .................................... 38.37 NA NA 14.50 13.41 4.06 NA NA 56.93 55.84 090 33426 ......... ............ A Repair of mitral valve .................................... 41.28 NA NA 15.51 16.73 5.01 NA NA 61.80 63.02 090 33427 ......... ............ A Repair of mitral valve .................................... 42.78 NA NA 16.33 18.60 6.07 NA NA 65.18 67.45 090 33430 ......... ............ A Replacement of mitral valve .......................... 49.81 NA NA 18.75 17.66 5.08 NA NA 73.64 72.55 090 33460 ......... ............ A Revision of tricuspid valve ............................ 27.97 NA NA 10.98 11.22 3.44 NA NA 42.39 42.63 090 33463 ......... ............ A Valvuloplasty, tricuspid .................................. 42.57 NA NA 15.50 13.56 3.86 NA NA 61.93 59.99 090 33464 ......... ............ A Valvuloplasty, tricuspid .................................. 30.93 NA NA 12.13 13.17 4.14 NA NA 47.20 48.24 090 33465 ......... ............ A Replace tricuspid valve ................................. 33.58 NA NA 12.60 12.87 4.38 NA NA 50.56 50.83 090 33468 ......... ............ A Revision of tricuspid valve ............................ 32.79 NA NA 15.30 14.06 4.06 NA NA 52.15 50.91 090 33470 ......... ............ A Revision of pulmonary valve ......................... 21.24 NA NA 8.74 10.20 1.03 NA NA 31.01 32.47 090 33471 ......... ............ A Valvotomy, pulmonary valve ......................... 22.79 NA NA 7.77 9.26 3.38 NA NA 33.94 35.43 09033472 ......... ............ A Revision of pulmonary valve ......................... 22.86 NA NA 7.28 10.72 3.54 NA NA 33.68 37.12 090 33474 ......... ............ A Revision of pulmonary valve ......................... 25.85 NA NA 12.10 11.19 3.21 NA NA 41.16 40.25 090 33475 ......... ............ A Replacement, pulmonary valve ..................... 44.81 NA NA 16.54 15.66 4.92 NA NA 66.27 65.39 09033476 ......... ............ A Revision of heart chamber ............................ 26.37 NA NA 11.78 11.92 2.41 NA NA 40.56 40.70 090 33478 ......... ............ A Revision of heart chamber ............................ 27.34 NA NA 11.04 12.55 3.88 NA NA 42.26 43.77 090 33496 ......... ............ A Repair, prosth valve clot ............................... 29.67 NA NA 11.51 12.43 4.12 NA NA 45.30 46.22 090 33500 ......... ............ A Repair heart vessel fistula ............................. 27.79 NA NA 11.08 11.37 3.86 NA NA 42.73 43.02 090 33501 ......... ............ A Repair heart vessel fistula ............................. 19.39 NA NA 8.25 8.27 1.90 NA NA 29.54 29.56 090 33502 ......... ............ A Coronary artery correction ............................ 21.65 NA NA 9.32 10.63 2.99 NA NA 33.96 35.27 090 33503 ......... ............ A Coronary artery graft ..................................... 22.21 NA NA 10.61 9.95 1.77 NA NA 34.59 33.93 090 33504 ......... ............ A Coronary artery graft ..................................... 25.26 NA NA 10.18 11.40 3.35 NA NA 38.79 40.01 090 33505 ......... ............ A Repair artery w/tunnel ................................... 38.33 NA NA 12.33 12.76 2.18 NA NA 52.84 53.27 090 33506 ......... ............ A Repair artery, translocation ........................... 37.78 NA NA 15.51 14.80 4.65 NA NA 57.94 57.23 090 33507 ......... ............ A Repair art, intramural .................................... 31.33 NA NA 11.78 13.18 4.05 NA NA 47.16 48.56 090 33508 ......... ............ A Endoscopic vein harvest ............................... 0.31 NA NA 0.10 0.10 0.04 NA NA 0.45 0.45 ZZZ33510 ......... ............ A CABG, vein, single ........................................ 33.45 NA NA 12.81 15.45 4.40 NA NA 50.66 53.30 090 33511 ......... ............ A CABG, vein, two ............................................ 34.59 NA NA 13.37 16.15 4.55 NA NA 52.51 55.29 090 33512 ......... ............ A CABG, vein, three ......................................... 38.73 NA NA 14.72 16.88 4.66 NA NA 58.11 60.27 090 33513 ......... ............ A CABG, vein, four ........................................... 39.69 NA NA 15.13 17.12 4.87 NA NA 59.69 61.68 090 33514 ......... ............ A CABG, vein, five ............................................ 40.50 NA NA 15.38 17.38 4.76 NA NA 60.64 62.64 090 33516 ......... ............ A Cabg, vein, six or more ................................. 41.96 NA NA 16.16 18.14 5.11 NA NA 63.23 65.21 090 33517 ......... ............ A CABG, artery-vein, single .............................. 2.57 NA NA 0.79 0.83 0.39 NA NA 3.75 3.79 ZZZ 33518 ......... ............ A CABG, artery-vein, two ................................. 4.84 NA NA 1.48 1.56 0.73 NA NA 7.05 7.13 ZZZ 33519 ......... ............ A CABG, artery-vein, three ............................... 7.11 NA NA 2.18 2.29 1.04 NA NA 10.33 10.44 ZZZ 33521 ......... ............ A CABG, artery-vein, four ................................. 9.39 NA NA 2.89 3.03 1.37 NA NA 13.65 13.79 ZZZ 33522 ......... ............ A CABG, artery-vein, five ................................. 11.65 NA NA 3.56 3.75 1.77 NA NA 16.98 17.17 ZZZ 33523 ......... ............ A Cabg, art-vein, six or more ........................... 13.93 NA NA 4.29 4.47 2.12 NA NA 20.34 20.52 ZZZ 33530 ......... ............ A Coronary artery, bypass/reop ........................ 5.85 NA NA 1.79 1.88 0.88 NA NA 8.52 8.61 ZZZ 33533 ......... ............ A CABG, arterial, single .................................... 37.38 NA NA 14.00 15.85 4.55 NA NA 55.93 57.78 090 33534 ......... ............ A CABG, arterial, two ....................................... 38.81 NA NA 14.74 16.97 4.69 NA NA 58.24 60.47 090 33535 ......... ............ A CABG, arterial, three ..................................... 41.48 NA NA 15.68 17.52 5.01 NA NA 62.17 64.01 090 33536 ......... ............ A Cabg, arterial, four or more ........................... 40.79 NA NA 15.30 17.54 5.42 NA NA 61.51 63.75 090 33542 ......... ............ A Removal of heart lesion ................................ 32.65 NA NA 12.64 12.90 4.37 NA NA 49.66 49.92 090 33545 ......... ............ A Repair of heart damage ................................ 41.12 NA NA 15.46 15.58 5.19 NA NA 61.77 61.89 090 33548 ......... ............ A Restore/remodel, ventricle ............................ 42.46 NA NA 16.52 18.60 5.51 NA NA 64.49 66.57 090 33572 ......... ............ A Open coronary endarterectomy .................... 4.44 NA NA 1.34 1.42 0.65 NA NA 6.43 6.51 ZZZ 33600 ......... ............ A Closure of valve ............................................ 30.11 NA NA 12.44 12.49 4.41 NA NA 46.96 47.01 090 33602 ......... ............ A Closure of valve ............................................ 29.14 NA NA 13.30 12.66 3.81 NA NA 46.25 45.61 090 33606 ......... ............ A Anastomosis/artery-aorta .............................. 31.33 NA NA 12.17 13.30 4.40 NA NA 47.90 49.03 090 33608 ......... ............ A Repair anomaly w/conduit ............................. 31.68 NA NA 13.41 13.93 4.73 NA NA 49.82 50.34 090 33610 ......... ............ A Repair by enlargement .................................. 31.20 NA NA 11.20 13.00 4.55 NA NA 46.95 48.75 090 33611 ......... ............ A Repair double ventricle ................................. 35.47 NA NA 12.37 13.69 4.36 NA NA 52.20 53.52 090 33612 ......... ............ A Repair double ventricle ................................. 36.47 NA NA 12.97 14.61 5.28 NA NA 54.72 56.36 090 33615 ......... ............ A Repair, modified fontan ................................. 35.72 NA NA 12.49 12.98 4.31 NA NA 52.52 53.01 090 33617 ......... ............ A Repair single ventricle ................................... 38.92 NA NA 16.37 16.09 5.64 NA NA 60.93 60.65 090 33619 ......... ............ A Repair single ventricle ................................... 48.56 NA NA 18.36 20.19 6.44 NA NA 73.36 75.19 090 33641 ......... ............ A Repair heart septum defect ........................... 28.47 NA NA 10.73 9.86 3.22 NA NA 42.42 41.55 090 33645 ......... ............ A Revision of heart veins .................................. 27.95 NA NA 11.02 11.58 3.78 NA NA 42.75 43.31 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49128 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

33647 ......... ............ A Repair heart septum defects ......................... 29.33 NA NA 12.34 13.41 3.31 NA NA 44.98 46.05 090 33660 ......... ............ A Repair of heart defects .................................. 31.73 NA NA 11.49 12.98 4.48 NA NA 47.70 49.19 090 33665 ......... ............ A Repair of heart defects .................................. 34.75 NA NA 12.45 13.49 3.99 NA NA 51.19 52.23 090 33670 ......... ............ A Repair of heart chambers ............................. 36.56 NA NA 12.28 12.95 4.64 NA NA 53.48 54.15 090 33681 ......... ............ A Repair heart septum defect ........................... 32.10 NA NA 13.28 14.33 4.44 NA NA 49.82 50.87 090 33684 ......... ............ A Repair heart septum defect ........................... 34.27 NA NA 19.40 15.07 3.38 NA NA 57.05 52.72 090 33688 ......... ............ A Repair heart septum defect ........................... 34.65 NA NA 9.50 10.23 4.72 NA NA 48.87 49.60 090 33690 ......... ............ A Reinforce pulmonary artery ........................... 20.16 NA NA 8.63 9.78 1.96 NA NA 30.75 31.90 090 33692 ......... ............ A Repair of heart defects .................................. 31.34 NA NA 9.29 12.76 4.57 NA NA 45.20 48.67 090 33694 ......... ............ A Repair of heart defects .................................. 35.47 NA NA 10.16 13.21 5.26 NA NA 50.89 53.94 090 33697 ......... ............ A Repair of heart defects .................................. 37.47 NA NA 21.66 16.57 4.08 NA NA 63.21 58.12 090 33702 ......... ............ A Repair of heart defects .................................. 27.07 NA NA 11.48 12.29 3.67 NA NA 42.22 43.03 090 33710 ......... ............ A Repair of heart defects .................................. 30.24 NA NA 11.69 13.39 4.42 NA NA 46.35 48.05 090 33720 ......... ............ A Repair of heart defect ................................... 27.09 NA NA 11.17 12.00 3.83 NA NA 42.09 42.92 090 33722 ......... ............ A Repair of heart defect ................................... 29.01 NA NA 8.75 12.58 1.30 NA NA 39.06 42.89 090 33730 ......... ............ A Repair heart-vein defect(s) ............................ 35.97 NA NA 13.35 13.93 5.01 NA NA 54.33 54.91 090 33732 ......... ............ A Repair heart-vein defect ................................ 28.76 NA NA 14.75 13.72 3.67 NA NA 47.18 46.15 090 33735 ......... ............ A Revision of heart chamber ............................ 22.00 NA NA 9.50 9.09 1.91 NA NA 33.41 33.00 090 33736 ......... ............ A Revision of heart chamber ............................ 24.12 NA NA 10.80 11.59 3.08 NA NA 38.00 38.79 090 33737 ......... ............ A Revision of heart chamber ............................ 22.30 NA NA 7.62 10.10 3.24 NA NA 33.16 35.64 090 33750 ......... ............ A Major vessel shunt ........................................ 22.02 NA NA 11.30 10.48 1.16 NA NA 34.48 33.66 090 33755 ......... ............ A Major vessel shunt ........................................ 22.40 NA NA 7.87 8.57 3.25 NA NA 33.52 34.22 090 33762 ......... ............ A Major vessel shunt ........................................ 22.40 NA NA 7.21 9.42 3.13 NA NA 32.74 34.95 090 33764 ......... ............ A Major vessel shunt & graft ............................ 22.40 NA NA 9.29 9.99 3.00 NA NA 34.69 35.39 090 33766 ......... ............ A Major vessel shunt ........................................ 23.37 NA NA 8.58 10.90 3.69 NA NA 35.64 37.96 090 33767 ......... ............ A Major vessel shunt ........................................ 25.10 NA NA 9.47 11.16 3.81 NA NA 38.38 40.07 090 33768 ......... ............ A Cavopulmonary shunting ............................... 8.00 NA NA 2.22 2.55 1.19 NA NA 11.41 11.74 ZZZ 33770 ......... ............ A Repair great vessels defect .......................... 39.00 NA NA 10.67 13.68 5.72 NA NA 55.39 58.40 090 33771 ......... ............ A Repair great vessels defect .......................... 40.56 NA NA 10.65 11.95 5.66 NA NA 56.87 58.17 090 33774 ......... ............ A Repair great vessels defect .......................... 31.48 NA NA 12.45 14.11 4.80 NA NA 48.73 50.39 090 33775 ......... ............ A Repair great vessels defect .......................... 32.79 NA NA 10.21 13.80 4.98 NA NA 47.98 51.57 090 33776 ......... ............ A Repair great vessels defect .......................... 34.45 NA NA 13.39 15.20 5.07 NA NA 52.91 54.72 090 33777 ......... ............ A Repair great vessels defect .......................... 33.87 NA NA 10.02 14.21 5.47 NA NA 49.36 53.55 090 33778 ......... ............ A Repair great vessels defect .......................... 42.58 NA NA 15.26 16.48 6.18 NA NA 64.02 65.24 090 33779 ......... ............ A Repair great vessels defect .......................... 43.13 NA NA 11.48 14.40 2.91 NA NA 57.52 60.44 090 33780 ......... ............ A Repair great vessels defect .......................... 43.83 NA NA 11.79 17.26 3.67 NA NA 59.29 64.76 090 33781 ......... ............ A Repair great vessels defect .......................... 43.14 NA NA 14.18 13.54 5.95 NA NA 63.27 62.63 090 33786 ......... ............ A Repair arterial trunk ....................................... 41.70 NA NA 11.53 15.42 5.69 NA NA 58.92 62.81 090 33788 ......... ............ A Revision of pulmonary artery ........................ 27.22 NA NA 9.69 11.39 4.02 NA NA 40.93 42.63 090 33800 ......... ............ A Aortic suspension .......................................... 17.21 NA NA 7.32 7.91 2.45 NA NA 26.98 27.57 090 33802 ......... ............ A Repair vessel defect ...................................... 18.20 NA NA 7.50 8.79 2.26 NA NA 27.96 29.25 090 33803 ......... ............ A Repair vessel defect ...................................... 20.14 NA NA 7.95 9.31 3.19 NA NA 31.28 32.64 090 33813 ......... ............ A Repair septal defect ...................................... 21.19 NA NA 9.00 10.43 3.12 NA NA 33.31 34.74 090 33814 ......... ............ A Repair septal defect ...................................... 26.37 NA NA 10.48 12.10 3.84 NA NA 40.69 42.31 090 33820 ......... ............ A Revise major vessel ...................................... 16.59 NA NA 8.39 8.37 2.34 NA NA 27.32 27.30 090 33822 ......... ............ A Revise major vessel ...................................... 17.61 NA NA 6.00 8.21 2.67 NA NA 26.28 28.49 090 33824 ......... ............ A Revise major vessel ...................................... 20.06 NA NA 8.62 9.64 2.88 NA NA 31.56 32.58 090 33840 ......... ............ A Remove aorta constriction ............................ 21.17 NA NA 8.99 9.97 2.15 NA NA 32.31 33.29 090 33845 ......... ............ A Remove aorta constriction ............................ 22.73 NA NA 9.64 10.92 3.21 NA NA 35.58 36.86 090 33851 ......... ............ A Remove aorta constriction ............................ 21.81 NA NA 9.17 10.30 3.17 NA NA 34.15 35.28 090 33852 ......... ............ A Repair septal defect ...................................... 24.24 NA NA 9.90 11.00 2.15 NA NA 36.29 37.39 090 33853 ......... ............ A Repair septal defect ...................................... 32.31 NA NA 13.03 14.37 4.47 NA NA 49.81 51.15 090 33860 ......... ............ A Ascending aortic graft ................................... 43.13 NA NA 15.73 16.27 5.74 NA NA 64.60 65.14 090 33861 ......... ............ A Ascending aortic graft ................................... 43.88 NA NA 16.12 17.31 6.35 NA NA 66.35 67.54 090 33863 ......... ............ A Ascending aortic graft ................................... 48.52 NA NA 17.69 18.44 6.57 NA NA 72.78 73.53 090 33870 ......... ............ A Transverse aortic arch graft .......................... 45.87 NA NA 16.67 17.95 6.60 NA NA 69.14 70.42 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49129 

33875 ......... ............ A Thoracic aortic graft ...................................... 35.64 NA NA 13.16 13.86 4.88 NA NA 53.68 54.38 090 33877 ......... ............ A Thoracoabdominal graft ................................ 57.75 NA NA 18.83 16.94 5.92 NA NA 82.50 80.61 090 33880 ......... ............ A Endovasc taa repr incl subcl ......................... 34.44 NA NA 10.59 12.75 2.74 NA NA 47.77 49.93 090 33881 ......... ............ A Endovasc taa repr w/o subcl ......................... 29.44 NA NA 9.35 11.31 2.32 NA NA 41.11 43.07 090 33883 ......... ............ A Insert endovasc prosth, taa ........................... 20.95 NA NA 7.01 8.64 2.10 NA NA 30.06 31.69 090 33884 ......... ............ A Endovasc prosth, taa, add-on ....................... 8.20 NA NA 2.01 2.43 0.86 NA NA 11.07 11.49 ZZZ 33886 ......... ............ A Endovasc prosth, delayed ............................. 17.95 NA NA 6.25 7.74 1.79 NA NA 25.99 27.48 090 33889 ......... ............ A Artery transpose/endovas taa ....................... 15.92 NA NA 4.17 4.92 2.17 NA NA 22.26 23.01 00033891 ......... ............ A Car-car bp grft/endovas taa .......................... 20.00 NA NA 6.45 6.83 2.72 NA NA 29.17 29.55 000 33910 ......... ............ A Remove lung artery emboli ........................... 29.56 NA NA 11.34 11.41 3.69 NA NA 44.59 44.66 090 33915 ......... ............ A Remove lung artery emboli ........................... 24.80 NA NA 10.04 9.73 1.44 NA NA 36.28 35.97 090 33916 ......... ............ A Surgery of great vessel ................................. 28.27 NA NA 10.92 11.24 3.66 NA NA 42.85 43.17 090 33917 ......... ............ A Repair pulmonary artery ................................ 25.10 NA NA 10.43 11.74 3.69 NA NA 39.22 40.53 090 33920 ......... ............ A Repair pulmonary atresia .............................. 32.54 NA NA 11.39 13.21 4.37 NA NA 48.30 50.12 090 33922 ......... ............ A Transect pulmonary artery ............................ 24.05 NA NA 11.44 11.04 3.09 NA NA 38.58 38.18 090 33924 ......... ............ A Remove pulmonary shunt ............................. 5.49 NA NA 2.12 1.91 0.82 NA NA 8.43 8.22 ZZZ 33925 ......... ............ A Rpr pul art unifocal w/o cpb .......................... 31.23 NA NA 10.21 13.55 4.60 NA NA 46.04 49.38 090 33926 ......... ............ A Repr pul art, unifocal w/cpb .......................... 44.66 NA NA 14.38 16.86 6.20 NA NA 65.24 67.72 090 33933 ......... ............ C Prepare donor heart/lung .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 33935 ......... ............ R Transplantation, heart/lung ............................ 61.56 NA NA 23.37 27.42 9.03 NA NA 93.96 98.01 090 33944 ......... ............ C Prepare donor heart ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 33945 ......... ............ R Transplantation of heart ................................ 50.14 NA NA 19.01 20.80 6.24 NA NA 75.39 77.18 090 33960 ......... ............ A External circulation assist .............................. 19.33 NA NA 5.60 5.08 2.66 NA NA 27.59 27.07 000 33961 ......... ............ A External circulation assist .............................. 10.91 NA NA 2.91 3.44 0.88 NA NA 14.70 15.23 ZZZ 33967 ......... ............ A Insert ia percut device ................................... 4.84 NA NA 2.44 1.99 0.35 NA NA 7.63 7.18 000 33968 ......... ............ A Remove aortic assist device ......................... 0.64 NA NA 0.27 0.24 0.07 NA NA 0.98 0.95 000 33970 ......... ............ A Aortic circulation assist .................................. 6.74 NA NA 2.54 2.35 0.82 NA NA 10.10 9.91 000 33971 ......... ............ A Aortic circulation assist .................................. 11.89 NA NA 6.09 6.02 1.25 NA NA 19.23 19.16 090 33973 ......... ............ A Insert balloon device ..................................... 9.75 NA NA 3.88 3.45 1.26 NA NA 14.89 14.46 000 33974 ......... ............ A Remove intra-aortic balloon .......................... 14.89 NA NA 7.79 7.86 1.73 NA NA 24.41 24.48 090 33975 ......... ............ A Implant ventricular device ............................. 20.97 NA NA 6.63 6.37 3.06 NA NA 30.66 30.40 XXX 33976 ......... ............ A Implant ventricular device ............................. 22.97 NA NA 7.92 7.64 3.25 NA NA 34.14 33.86 XXX 33977 ......... ............ A Remove ventricular device ............................ 19.99 NA NA 9.37 10.65 2.80 NA NA 32.16 33.44 090 33978 ......... ............ A Remove ventricular device ............................ 22.43 NA NA 10.52 11.44 3.30 NA NA 36.25 37.17 090 33979 ......... ............ A Insert intracorporeal device ........................... 45.93 NA NA 14.38 14.79 6.95 NA NA 67.26 67.67 XXX 33980 ......... ............ A Remove intracorporeal device ...................... 64.76 NA NA 25.09 25.20 8.56 NA NA 98.41 98.52 090 33999 ......... ............ C Cardiac surgery procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 34001 ......... ............ A Removal of artery clot ................................... 17.74 NA NA 6.68 6.70 1.84 NA NA 26.26 26.28 090 34051 ......... ............ A Removal of artery clot ................................... 16.86 NA NA 6.93 7.57 2.20 NA NA 25.99 26.63 090 34101 ......... ............ A Removal of artery clot ................................... 10.81 NA NA 4.44 5.12 1.41 NA NA 16.66 17.34 090 34111 ......... ............ A Removal of arm artery clot ............................ 10.81 NA NA 4.50 5.14 1.40 NA NA 16.71 17.35 090 34151 ......... ............ A Removal of artery clot ................................... 26.35 NA NA 8.87 10.02 3.55 NA NA 38.77 39.92 090 34201 ......... ............ A Removal of artery clot ................................... 18.40 NA NA 6.57 5.70 1.45 NA NA 26.42 25.55 090 34203 ......... ............ A Removal of leg artery clot ............................. 17.67 NA NA 6.57 7.69 2.35 NA NA 26.59 27.71 090 34401 ......... ............ A Removal of vein clot ...................................... 26.35 NA NA 9.64 10.41 3.09 NA NA 39.08 39.85 090 34421 ......... ............ A Removal of vein clot ...................................... 13.25 NA NA 5.36 6.06 1.55 NA NA 20.16 20.86 090 34451 ......... ............ A Removal of vein clot ...................................... 28.35 NA NA 9.71 11.01 3.83 NA NA 41.89 43.19 090 34471 ......... ............ A Removal of vein clot ...................................... 20.94 NA NA 7.73 5.91 1.18 NA NA 29.85 28.03 090 34490 ......... ............ A Removal of vein clot ...................................... 10.79 NA NA 4.54 5.20 1.41 NA NA 16.74 17.40 090 34501 ......... ............ A Repair valve, femoral vein ............................ 16.68 NA NA 6.96 8.11 2.34 NA NA 25.98 27.13 090 34502 ......... ............ A Reconstruct vena cava .................................. 27.80 NA NA 10.78 11.91 3.62 NA NA 42.20 43.33 090 34510 ......... ............ A Transposition of vein valve ........................... 19.74 NA NA 7.25 8.87 2.32 NA NA 29.31 30.93 090 34520 ......... ............ A Cross-over vein graft ..................................... 18.99 NA NA 9.19 8.64 2.28 NA NA 30.46 29.91 090 34530 ......... ............ A Leg vein fusion .............................................. 17.69 NA NA 7.88 8.43 1.73 NA NA 27.30 27.85 090 34800 ......... ............ A Endovas aaa repr w/sm tube ........................ 21.42 NA NA 7.49 8.74 2.45 NA NA 31.36 32.61 090 34802 ......... ............ A Endovas aaa repr w/2-p part ........................ 23.67 NA NA 8.32 9.42 2.32 NA NA 34.31 35.41 09034803 ......... ............ A Endovas aaa repr w/3-p part ........................ 24.70 NA NA 8.25 9.72 2.00 NA NA 34.95 36.42 09034804 ......... ............ A Endovas aaa repr w/1-p part ........................ 23.67 NA NA 8.18 9.40 2.29 NA NA 34.14 35.36 09034805 ......... ............ A Endovas aaa repr w/long tube ...................... 22.55 NA NA 7.34 9.07 2.00 NA NA 31.89 33.62 090 34808 ......... ............ A Endovas iliac a device addon ....................... 4.12 NA NA 1.11 1.31 0.59 NA NA 5.82 6.02 ZZZ 34812 ......... ............ A Xpose for endoprosth, femorl ........................ 6.74 NA NA 1.73 2.11 1.18 NA NA 9.65 10.03 000 34813 ......... ............ A Femoral endovas graft add-on ...................... 4.79 NA NA 1.21 1.48 0.67 NA NA 6.67 6.94 ZZZ 34820 ......... ............ A Xpose for endoprosth, iliac ........................... 9.74 NA NA 2.47 3.04 1.50 NA NA 13.71 14.28 000 34825 ......... ............ A Endovasc extend prosth, init ......................... 12.68 NA NA 5.23 5.91 1.28 NA NA 19.19 19.87 090 34826 ......... ............ A Endovasc exten prosth, addIl ........................ 4.12 NA NA 1.16 1.32 0.44 NA NA 5.72 5.88 ZZZ 34830 ......... ............ A Open aortic tube prosth repr ......................... 35.04 NA NA 10.82 12.97 4.54 NA NA 50.40 52.55 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49130 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

34831 ......... ............ A Open aortoiliac prosth repr ........................... 37.79 NA NA 12.15 11.84 4.88 NA NA 54.82 54.51 090 34832 ......... ............ A Open aortofemor prosth repr ........................ 37.79 NA NA 11.68 13.89 4.84 NA NA 54.31 56.52 090 34833 ......... ............ A Xpose for endoprosth, iliac ........................... 11.98 NA NA 3.32 4.15 1.69 NA NA 16.99 17.82 000 34834 ......... ............ A Xpose, endoprosth, brachial ......................... 5.34 NA NA 1.62 2.05 0.76 NA NA 7.72 8.15 000 34900 ......... ............ A Endovasc iliac repr w/graft ............................ 16.73 NA NA 6.34 7.27 1.99 NA NA 25.06 25.99 090 35001 ......... ............ A Repair defect of artery .................................. 20.63 NA NA 7.64 9.07 2.80 NA NA 31.07 32.50 090 35002 ......... ............ A Repair artery rupture, neck ........................... 22.05 NA NA 7.82 9.22 2.99 NA NA 32.86 34.26 090 35005 ......... ............ A Repair defect of artery .................................. 19.11 NA NA 8.14 8.67 1.76 NA NA 29.01 29.54 090 35011 ......... ............ A Repair defect of artery .................................. 18.46 NA NA 6.43 7.59 2.54 NA NA 27.43 28.59 090 35013 ......... ............ A Repair artery rupture, arm ............................. 23.04 NA NA 7.96 9.24 3.09 NA NA 34.09 35.37 090 35021 ......... ............ A Repair defect of artery .................................. 22.04 NA NA 8.70 9.23 2.86 NA NA 33.60 34.13 090 35022 ......... ............ A Repair artery rupture, chest .......................... 25.57 NA NA 9.50 9.76 3.16 NA NA 38.23 38.49 090 35045 ......... ............ A Repair defect of arm artery ........................... 17.91 NA NA 6.42 7.23 2.44 NA NA 26.77 27.58 090 35081 ......... ............ A Repair defect of artery .................................. 33.31 NA NA 11.10 11.37 4.00 NA NA 48.41 48.68 090 35082 ......... ............ A Repair artery rupture, aorta ........................... 41.87 NA NA 13.19 14.77 5.42 NA NA 60.48 62.06 090 35091 ......... ............ A Repair defect of artery .................................. 35.35 NA NA 10.46 12.79 5.12 NA NA 50.93 53.26 090 35092 ......... ............ A Repair artery rupture, aorta ........................... 50.75 NA NA 15.09 17.00 6.38 NA NA 72.22 74.13 090 35102 ......... ............ A Repair defect of artery .................................. 36.31 NA NA 11.68 12.18 4.47 NA NA 52.46 52.96 090 35103 ......... ............ A Repair artery rupture, groin ........................... 43.43 NA NA 13.31 15.21 5.74 NA NA 62.48 64.38 090 35111 ......... ............ A Repair defect of artery .................................. 26.11 NA NA 8.62 10.00 3.46 NA NA 38.19 39.57 090 35112 ......... ............ A Repair artery rupture,spleen ......................... 32.38 NA NA 10.53 11.60 4.07 NA NA 46.98 48.05 090 35121 ......... ............ A Repair defect of artery .................................. 31.35 NA NA 10.51 11.90 4.29 NA NA 46.15 47.54 090 35122 ......... ............ A Repair artery rupture, belly ........................... 37.70 NA NA 12.17 13.39 4.74 NA NA 54.61 55.83 090 35131 ......... ............ A Repair defect of artery .................................. 26.23 NA NA 8.92 10.29 3.79 NA NA 38.94 40.31 090 35132 ......... ............ A Repair artery rupture, groin ........................... 32.38 NA NA 10.33 11.86 4.29 NA NA 47.00 48.53 090 35141 ......... ............ A Repair defect of artery .................................. 20.79 NA NA 7.15 8.47 2.89 NA NA 30.83 32.15 090 35142 ......... ............ A Repair artery rupture, thigh ........................... 24.97 NA NA 8.46 9.89 3.35 NA NA 36.78 38.21 090 35151 ......... ............ A Repair defect of artery .................................. 23.55 NA NA 7.96 9.48 3.23 NA NA 34.74 36.26 090 35152 ......... ............ A Repair artery rupture, knee ........................... 27.47 NA NA 9.15 10.82 3.60 NA NA 40.22 41.89 090 35180 ......... ............ A Repair blood vessel lesion ............................ 14.95 NA NA 6.15 6.74 1.00 NA NA 22.10 22.69 090 35182 ......... ............ A Repair blood vessel lesion ............................ 31.52 NA NA 11.82 12.55 4.35 NA NA 47.69 48.42 090 35184 ......... ............ A Repair blood vessel lesion ............................ 18.67 NA NA 6.96 7.96 2.52 NA NA 28.15 29.15 090 35188 ......... ............ A Repair blood vessel lesion ............................ 14.98 NA NA 6.23 7.28 2.15 NA NA 23.36 24.41 090 35189 ......... ............ A Repair blood vessel lesion ............................ 29.79 NA NA 10.15 11.50 4.00 NA NA 43.94 45.29 090 35190 ......... ............ A Repair blood vessel lesion ............................ 13.27 NA NA 5.34 6.19 1.79 NA NA 20.40 21.25 090 35201 ......... ............ A Repair blood vessel lesion ............................ 16.78 NA NA 6.45 7.61 2.33 NA NA 25.56 26.72 090 35206 ......... ............ A Repair blood vessel lesion ............................ 13.72 NA NA 5.42 6.27 1.86 NA NA 21.00 21.85 090 35207 ......... ............ A Repair blood vessel lesion ............................ 10.79 NA NA 6.60 7.16 1.48 NA NA 18.87 19.43 090 35211 ......... ............ A Repair blood vessel lesion ............................ 24.45 NA NA 10.11 10.49 3.19 NA NA 37.75 38.13 090 35216 ......... ............ A Repair blood vessel lesion ............................ 36.43 NA NA 13.90 10.20 2.64 NA NA 52.97 49.27 090 35221 ......... ............ A Repair blood vessel lesion ............................ 26.50 NA NA 8.59 9.60 3.36 NA NA 38.45 39.46 090 35226 ......... ............ A Repair blood vessel lesion ............................ 15.18 NA NA 5.91 7.05 2.01 NA NA 23.10 24.24 090 35231 ......... ............ A Repair blood vessel lesion ............................ 21.04 NA NA 7.70 9.25 2.88 NA NA 31.62 33.17 090 35236 ......... ............ A Repair blood vessel lesion ............................ 17.90 NA NA 6.50 7.54 2.42 NA NA 26.82 27.86 090 35241 ......... ............ A Repair blood vessel lesion ............................ 25.45 NA NA 9.97 10.83 3.52 NA NA 38.94 39.80 090 35246 ......... ............ A Repair blood vessel lesion ............................ 28.11 NA NA 11.95 11.55 3.85 NA NA 43.91 43.51 090 35251 ......... ............ A Repair blood vessel lesion ............................ 31.79 NA NA 9.83 11.30 4.12 NA NA 45.74 47.21 090 35256 ......... ............ A Repair blood vessel lesion ............................ 18.94 NA NA 6.65 7.93 2.62 NA NA 28.21 29.49 090 35261 ......... ............ A Repair blood vessel lesion ............................ 18.84 NA NA 7.26 7.82 2.60 NA NA 28.70 29.26 090 35266 ......... ............ A Repair blood vessel lesion ............................ 15.71 NA NA 5.72 6.68 2.09 NA NA 23.52 24.48 090 35271 ......... ............ A Repair blood vessel lesion ............................ 24.45 NA NA 9.69 10.31 3.15 NA NA 37.29 37.91 090 35276 ......... ............ A Repair blood vessel lesion ............................ 25.67 NA NA 9.66 10.82 3.48 NA NA 38.81 39.97 090 35281 ......... ............ A Repair blood vessel lesion ............................ 29.87 NA NA 9.81 11.23 3.96 NA NA 43.64 45.06 090 35286 ......... ............ A Repair blood vessel lesion ............................ 17.00 NA NA 6.47 7.66 2.34 NA NA 25.81 27.00 090 35301 ......... ............ A Rechanneling of artery .................................. 19.49 NA NA 6.90 8.05 2.67 NA NA 29.06 30.21 090 35311 ......... ............ A Rechanneling of artery .................................. 28.48 NA NA 9.69 11.23 3.41 NA NA 41.58 43.12 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49131 

35321 ......... ............ A Rechanneling of artery .................................. 16.47 NA NA 6.00 7.04 2.24 NA NA 24.71 25.75 090 35331 ......... ............ A Rechanneling of artery .................................. 27.55 NA NA 9.04 10.68 3.82 NA NA 40.41 42.05 090 35341 ......... ............ A Rechanneling of artery .................................. 26.03 NA NA 8.58 10.29 3.77 NA NA 38.38 40.09 090 35351 ......... ............ A Rechanneling of artery .................................. 24.49 NA NA 7.98 9.19 3.34 NA NA 35.81 37.02 090 35355 ......... ............ A Rechanneling of artery .................................. 19.74 NA NA 6.57 7.70 2.66 NA NA 28.97 30.10 090 35361 ......... ............ A Rechanneling of artery .................................. 30.05 NA NA 9.75 11.21 4.14 NA NA 43.94 45.40 090 35363 ......... ............ A Rechanneling of artery .................................. 32.16 NA NA 10.60 12.09 4.32 NA NA 47.08 48.57 090 35371 ......... ............ A Rechanneling of artery .................................. 15.19 NA NA 5.51 6.59 2.13 NA NA 22.83 23.91 090 35372 ......... ............ A Rechanneling of artery .................................. 18.46 NA NA 6.33 7.61 2.62 NA NA 27.41 28.69 090 35381 ......... ............ A Rechanneling of artery .................................. 16.63 NA NA 6.33 7.44 2.25 NA NA 25.21 26.32 090 35390 ......... ............ A Reoperation, carotid add-on .......................... 3.19 NA NA 0.85 1.01 0.46 NA NA 4.50 4.66 ZZZ 35400 ......... ............ A Angioscopy .................................................... 3.00 NA NA 0.75 1.02 0.43 NA NA 4.18 4.45 ZZZ 35450 ......... ............ A Repair arterial blockage ................................ 10.05 NA NA 3.22 3.48 1.25 NA NA 14.52 14.78 000 35452 ......... ............ A Repair arterial blockage ................................ 6.90 NA NA 2.12 2.48 0.94 NA NA 9.96 10.32 000 35454 ......... ............ A Repair arterial blockage ................................ 6.03 NA NA 1.83 2.19 0.87 NA NA 8.73 9.09 000 35456 ......... ............ A Repair arterial blockage ................................ 7.34 NA NA 2.30 2.65 1.04 NA NA 10.68 11.03 000 35458 ......... ............ A Repair arterial blockage ................................ 9.48 NA NA 2.91 3.33 1.26 NA NA 13.65 14.07 000 35459 ......... ............ A Repair arterial blockage ................................ 8.62 NA NA 2.53 3.01 1.21 NA NA 12.36 12.84 000 35460 ......... ............ A Repair venous blockage ................................ 6.03 NA NA 1.79 2.15 0.83 NA NA 8.65 9.01 00035470 ......... ............ A Repair arterial blockage ................................ 8.62 62.11 82.17 3.47 3.38 0.69 71.42 91.48 12.78 12.69 000 35471 ......... ............ A Repair arterial blockage ................................ 10.05 66.97 91.94 4.70 4.14 0.67 77.69 102.7 15.42 14.86 000 35472 ......... ............ A Repair arterial blockage ................................ 6.90 48.34 60.35 2.81 2.76 0.58 55.82 67.83 10.29 10.24 000 35473 ......... ............ A Repair arterial blockage ................................ 6.03 47.23 56.69 2.51 2.44 0.51 53.77 63.23 9.05 8.98 000 35474 ......... ............ A Repair arterial blockage ................................ 7.35 61.24 81.11 3.00 2.92 0.57 69.16 89.03 10.92 10.84 000 35475 ......... ............ R Repair arterial blockage ................................ 9.48 49.26 54.39 3.40 3.52 0.62 59.36 64.49 13.50 13.62 000 35476 ......... ............ A Repair venous blockage ................................ 6.03 37.43 42.91 2.13 2.30 0.34 43.80 49.28 8.50 8.67 000 35480 ......... ............ A Atherectomy, open ........................................ 11.06 NA NA 3.96 4.02 1.28 NA NA 16.30 16.36 000 35481 ......... ............ A Atherectomy, open ........................................ 7.60 NA NA 2.50 2.78 1.13 NA NA 11.23 11.51 000 35482 ......... ............ A Atherectomy, open ........................................ 6.64 NA NA 2.13 2.45 0.89 NA NA 9.66 9.98 000 35483 ......... ............ A Atherectomy, open ........................................ 8.09 NA NA 2.79 2.96 1.15 NA NA 12.03 12.20 000 35484 ......... ............ A Atherectomy, open ........................................ 10.42 NA NA 3.08 3.60 1.27 NA NA 14.77 15.29 000 35485 ......... ............ A Atherectomy, open ........................................ 9.48 NA NA 3.00 3.40 1.35 NA NA 13.83 14.23 000 35490 ......... ............ A Atherectomy, percutaneous .......................... 11.06 NA NA 6.27 5.09 0.71 NA NA 18.04 16.86 00035491 ......... ............ A Atherectomy, percutaneous .......................... 7.60 NA NA 3.97 3.46 0.74 NA NA 12.31 11.80 000 35492 ......... ............ A Atherectomy, percutaneous .......................... 6.64 NA NA 3.63 3.30 0.43 NA NA 10.70 10.37 000 35493 ......... ............ A Atherectomy, percutaneous .......................... 8.09 NA NA 4.15 3.89 0.56 NA NA 12.80 12.54 000 35494 ......... ............ A Atherectomy, percutaneous .......................... 10.42 NA NA 5.23 4.65 0.59 NA NA 16.24 15.66 00035495 ......... ............ A Atherectomy, percutaneous .......................... 9.48 NA NA 4.64 4.45 0.69 NA NA 14.81 14.62 000 35500 ......... ............ A Harvest vein for bypass ................................ 6.44 NA NA 1.69 1.94 0.93 NA NA 9.06 9.31 ZZZ 35501 ......... ............ A Artery bypass graft ........................................ 19.70 NA NA 7.29 8.17 2.80 NA NA 29.79 30.67 090 35506 ......... ............ A Artery bypass graft ........................................ 25.19 NA NA 8.48 9.22 2.86 NA NA 36.53 37.27 090 35507 ......... ............ A Artery bypass graft ........................................ 20.60 NA NA 7.54 8.95 2.84 NA NA 30.98 32.39 090 35508 ......... ............ A Artery bypass graft ........................................ 25.95 NA NA 9.15 9.37 2.77 NA NA 37.87 38.09 090 35509 ......... ............ A Artery bypass graft ........................................ 18.94 NA NA 6.78 8.27 2.61 NA NA 28.33 29.82 090 35510 ......... ............ A Artery bypass graft ........................................ 24.25 NA NA 7.80 9.58 2.11 NA NA 34.16 35.94 090 35511 ......... ............ A Artery bypass graft ........................................ 22.08 NA NA 7.33 8.85 2.90 NA NA 32.31 33.83 090 35512 ......... ............ A Artery bypass graft ........................................ 23.75 NA NA 7.53 9.38 2.11 NA NA 33.39 35.24 090 35515 ......... ............ A Artery bypass graft ........................................ 25.95 NA NA 8.45 9.07 2.77 NA NA 37.17 37.79 090 35516 ......... ............ A Artery bypass graft ........................................ 24.07 NA NA 7.80 7.05 2.33 NA NA 34.20 33.45 090 35518 ......... ............ A Artery bypass graft ........................................ 22.53 NA NA 7.54 8.61 3.02 NA NA 33.09 34.16 090 35521 ......... ............ A Artery bypass graft ........................................ 23.94 NA NA 8.15 9.41 3.12 NA NA 35.21 36.47 090 35522 ......... ............ A Artery bypass graft ........................................ 23.01 NA NA 7.51 9.19 2.11 NA NA 32.63 34.31 090 35525 ......... ............ A Artery bypass graft ........................................ 21.55 NA NA 7.19 8.83 2.11 NA NA 30.85 32.49 090 35526 ......... ............ A Artery bypass graft ........................................ 31.43 NA NA 18.22 13.93 3.62 NA NA 53.27 48.98 090 35531 ......... ............ A Artery bypass graft ........................................ 38.92 NA NA 11.95 13.84 5.16 NA NA 56.03 57.92 090 35533 ......... ............ A Artery bypass graft ........................................ 29.73 NA NA 9.99 11.29 3.84 NA NA 43.56 44.86 090 35536 ......... ............ A Artery bypass graft ........................................ 33.54 NA NA 10.69 12.38 4.61 NA NA 48.84 50.53 090 35541 ......... ............ A Artery bypass graft ........................................ 26.90 NA NA 9.26 10.72 3.70 NA NA 39.86 41.32 090 35546 ......... ............ A Artery bypass graft ........................................ 26.40 NA NA 9.07 10.41 3.69 NA NA 39.16 40.50 090 35548 ......... ............ A Artery bypass graft ........................................ 22.50 NA NA 7.97 9.06 2.97 NA NA 33.44 34.53 090 35549 ......... ............ A Artery bypass graft ........................................ 24.27 NA NA 9.18 10.07 3.29 NA NA 36.74 37.63 090 35551 ......... ............ A Artery bypass graft ........................................ 27.65 NA NA 9.90 11.09 3.74 NA NA 41.29 42.48 090 35556 ......... ............ A Artery bypass graft ........................................ 26.56 NA NA 8.93 9.52 3.09 NA NA 38.58 39.17 090 35558 ......... ............ A Artery bypass graft ........................................ 22.94 NA NA 8.09 9.18 2.99 NA NA 34.02 35.11 090 35560 ......... ............ A Artery bypass graft ........................................ 33.84 NA NA 10.79 12.68 4.74 NA NA 49.37 51.26 090 35563 ......... ............ A Artery bypass graft ........................................ 25.93 NA NA 8.62 10.05 3.51 NA NA 38.06 39.49 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49132 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

35565 ......... ............ A Artery bypass graft ........................................ 24.94 NA NA 8.51 9.73 3.29 NA NA 36.74 37.96 090 35566 ......... ............ A Artery bypass graft ........................................ 32.16 NA NA 10.20 11.09 3.82 NA NA 46.18 47.07 090 35571 ......... ............ A Artery bypass graft ........................................ 25.33 NA NA 8.45 10.24 3.42 NA NA 37.20 38.99 090 35572 ......... ............ A Harvest femoropopliteal vein ......................... 6.81 NA NA 1.88 2.15 0.99 NA NA 9.68 9.95 ZZZ 35583 ......... ............ A Vein bypass graft .......................................... 27.56 NA NA 9.01 9.87 3.16 NA NA 39.73 40.59 090 35585 ......... ............ A Vein bypass graft .......................................... 32.16 NA NA 10.15 11.70 4.01 NA NA 46.32 47.87 090 35587 ......... ............ A Vein bypass graft .......................................... 26.02 NA NA 8.69 10.76 3.51 NA NA 38.22 40.29 090 35600 ......... ............ A Harvest artery for cabg ................................. 4.94 NA NA 1.54 1.60 0.73 NA NA 7.21 7.27 ZZZ 35601 ......... ............ A Artery bypass graft ........................................ 18.31 NA NA 6.63 8.12 2.49 NA NA 27.43 28.92 090 35606 ......... ............ A Artery bypass graft ........................................ 22.32 NA NA 7.68 8.68 2.69 NA NA 32.69 33.69 090 35612 ......... ............ A Artery bypass graft ........................................ 16.64 NA NA 6.40 7.51 2.08 NA NA 25.12 26.23 090 35616 ......... ............ A Artery bypass graft ........................................ 21.70 NA NA 7.14 7.86 2.19 NA NA 31.03 31.75 090 35621 ......... ............ A Artery bypass graft ........................................ 20.91 NA NA 7.04 8.26 2.91 NA NA 30.86 32.08 090 35623 ......... ............ A Bypass graft, not vein ................................... 25.73 NA NA 8.65 10.03 3.45 NA NA 37.83 39.21 090 35626 ......... ............ A Artery bypass graft ........................................ 29.02 NA NA 10.25 11.54 4.07 NA NA 43.34 44.63 090 35631 ......... ............ A Artery bypass graft ........................................ 35.84 NA NA 11.04 13.13 4.95 NA NA 51.83 53.92 090 35636 ......... ............ A Artery bypass graft ........................................ 31.56 NA NA 9.94 11.70 4.09 NA NA 45.59 47.35 090 35641 ......... ............ A Artery bypass graft ........................................ 26.24 NA NA 9.23 10.60 3.53 NA NA 39.00 40.37 090 35642 ......... ............ A Artery bypass graft ........................................ 18.79 NA NA 7.70 8.44 2.27 NA NA 28.76 29.50 090 35645 ......... ............ A Artery bypass graft ........................................ 18.28 NA NA 7.32 8.03 2.49 NA NA 28.09 28.80 090 35646 ......... ............ A Artery bypass graft ........................................ 32.78 NA NA 10.78 12.52 4.43 NA NA 47.99 49.73 090 35647 ......... ............ A Artery bypass graft ........................................ 29.56 NA NA 9.79 11.28 3.98 NA NA 43.33 44.82 090 35650 ......... ............ A Artery bypass graft ........................................ 20.04 NA NA 6.80 7.97 2.71 NA NA 29.55 30.72 090 35651 ......... ............ A Artery bypass graft ........................................ 25.90 NA NA 8.84 10.25 3.35 NA NA 38.09 39.50 090 35654 ......... ............ A Artery bypass graft ........................................ 26.11 NA NA 8.59 10.14 3.52 NA NA 38.22 39.77 090 35656 ......... ............ A Artery bypass graft ........................................ 20.35 NA NA 7.05 8.21 2.79 NA NA 30.19 31.35 090 35661 ......... ............ A Artery bypass graft ........................................ 20.16 NA NA 7.30 8.52 2.71 NA NA 30.17 31.39 090 35663 ......... ............ A Artery bypass graft ........................................ 23.74 NA NA 8.13 9.51 3.10 NA NA 34.97 36.35 090 35665 ......... ............ A Artery bypass graft ........................................ 22.16 NA NA 7.65 8.99 3.00 NA NA 32.81 34.15 090 35666 ......... ............ A Artery bypass graft ........................................ 23.47 NA NA 8.78 10.18 3.15 NA NA 35.40 36.80 090 35671 ......... ............ A Artery bypass graft ........................................ 20.58 NA NA 7.98 9.02 2.77 NA NA 31.33 32.37 090 35681 ......... ............ A Composite bypass graft ................................ 1.60 NA NA 0.42 0.50 0.23 NA NA 2.25 2.33 ZZZ35682 ......... ............ A Composite bypass graft ................................ 7.19 NA NA 1.78 2.23 1.03 NA NA 10.00 10.45 ZZZ 35683 ......... ............ A Composite bypass graft ................................ 8.49 NA NA 2.12 2.65 1.20 NA NA 11.81 12.34 ZZZ 35685 ......... ............ A Bypass graft patency/patch ........................... 4.04 NA NA 1.01 1.27 0.58 NA NA 5.63 5.89 ZZZ 35686 ......... ............ A Bypass graft/av fist patency .......................... 3.34 NA NA 0.85 1.06 0.47 NA NA 4.66 4.87 ZZZ35691 ......... ............ A Arterial transposition ...................................... 18.26 NA NA 6.33 7.88 2.58 NA NA 27.17 28.72 090 35693 ......... ............ A Arterial transposition ...................................... 15.58 NA NA 6.09 7.31 2.21 NA NA 23.88 25.10 090 35694 ......... ............ A Arterial transposition ...................................... 19.13 NA NA 6.59 8.10 2.69 NA NA 28.41 29.92 090 35695 ......... ............ A Arterial transposition ...................................... 19.91 NA NA 6.64 8.07 2.73 NA NA 29.28 30.71 090 35697 ......... ............ A Reimplant artery each ................................... 3.00 NA NA 0.77 0.96 0.41 NA NA 4.18 4.37 ZZZ 35700 ......... ............ A Reoperation, bypass graft ............................. 3.08 NA NA 0.80 0.97 0.44 NA NA 4.32 4.49 ZZZ35701 ......... ............ A Exploration, carotid artery ............................. 9.07 NA NA 4.26 4.93 1.12 NA NA 14.45 15.12 090 35721 ......... ............ A Exploration, femoral artery ............................ 7.62 NA NA 3.76 4.26 1.03 NA NA 12.41 12.91 090 35741 ......... ............ A Exploration popliteal artery ............................ 8.57 NA NA 3.98 4.49 1.12 NA NA 13.67 14.18 090 35761 ......... ............ A Exploration of artery/vein .............................. 5.78 NA NA 3.49 3.88 0.75 NA NA 10.02 10.41 090 35800 ......... ............ A Explore neck vessels .................................... 7.94 NA NA 3.96 4.48 0.95 NA NA 12.85 13.37 090 35820 ......... ............ A Explore chest vessels ................................... 30.08 NA NA 11.17 8.19 1.94 NA NA 43.19 40.21 090 35840 ......... ............ A Explore abdominal vessels ........................... 10.81 NA NA 4.89 5.18 1.34 NA NA 17.04 17.33 090 35860 ......... ............ A Explore limb vessels ..................................... 6.67 NA NA 3.49 3.90 0.78 NA NA 10.94 11.35 090 35870 ......... ............ A Repair vessel graft defect ............................. 24.32 NA NA 8.25 9.38 3.00 NA NA 35.57 36.70 090 35875 ......... ............ A Removal of clot in graft ................................. 10.60 NA NA 4.43 4.99 1.41 NA NA 16.44 17.00 090 35876 ......... ............ A Removal of clot in graft ................................. 17.70 NA NA 6.16 7.17 2.39 NA NA 26.25 27.26 090 35879 ......... ............ A Revise graft w/vein ........................................ 17.24 NA NA 6.17 7.31 2.27 NA NA 25.68 26.82 090 35881 ......... ............ A Revise graft w/vein ........................................ 19.16 NA NA 6.72 8.18 2.55 NA NA 28.43 29.89 090 35901 ......... ............ A Excision, graft, neck ...................................... 8.18 NA NA 4.32 5.06 1.15 NA NA 13.65 14.39 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49133 

35903 ......... ............ A Excision, graft, extremity ............................... 9.38 NA NA 4.72 5.79 1.30 NA NA 15.40 16.47 090 35905 ......... ............ A Excision, graft, thorax .................................... 33.33 NA NA 10.76 12.58 4.43 NA NA 48.52 50.34 090 35907 ......... ............ A Excision, graft, abdomen ............................... 37.08 NA NA 11.35 13.46 4.91 NA NA 53.34 55.45 090 36000 ......... ............ A Place needle in vein ...................................... 0.18 0.46 0.54 0.06 0.05 0.01 0.65 0.73 0.25 0.24 XXX 36002 ......... ............ A Pseudoaneurysm injection trt ........................ 1.96 2.23 2.70 0.82 0.93 0.17 4.36 4.83 2.95 3.06 000 36005 ......... ............ A Injection ext venography ............................... 0.95 8.54 7.87 0.37 0.33 0.05 9.54 8.87 1.37 1.33 000 36010 ......... ............ A Place catheter in vein .................................... 2.43 11.23 17.28 0.75 0.78 0.20 13.86 19.91 3.38 3.41 XXX 36011 ......... ............ A Place catheter in vein .................................... 3.14 19.70 25.79 0.97 1.04 0.27 23.11 29.20 4.38 4.45 XXX 36012 ......... ............ A Place catheter in vein .................................... 3.51 20.46 19.33 1.20 1.19 0.23 24.20 23.07 4.94 4.93 XXX 36013 ......... ............ A Place catheter in artery ................................. 2.52 19.36 20.86 0.96 0.76 0.25 22.13 23.63 3.73 3.53 XXX 36014 ......... ............ A Place catheter in artery ................................. 3.02 19.16 19.88 1.03 1.03 0.19 22.37 23.09 4.24 4.24 XXX 36015 ......... ............ A Place catheter in artery ................................. 3.51 18.23 22.30 0.94 1.13 0.21 21.95 26.02 4.66 4.85 XXX 36100 ......... ............ A Establish access to artery ............................. 3.02 11.30 11.88 1.20 1.13 0.26 14.58 15.16 4.48 4.41 XXX 36120 ......... ............ A Establish access to artery ............................. 2.01 9.35 10.36 0.58 0.63 0.14 11.50 12.51 2.73 2.78 XXX 36140 ......... ............ A Establish access to artery ............................. 2.01 10.55 12.22 0.70 0.66 0.16 12.72 14.39 2.87 2.83 XXX 36145 ......... ............ A Artery to vein shunt ....................................... 2.01 10.36 12.00 0.62 0.65 0.11 12.48 14.12 2.74 2.77 XXX 36160 ......... ............ A Establish access to aorta .............................. 2.52 11.88 13.08 0.76 0.82 0.26 14.66 15.86 3.54 3.60 XXX 36200 ......... ............ A Place catheter in aorta .................................. 3.02 13.76 15.82 1.00 1.01 0.24 17.02 19.08 4.26 4.27 XXX 36215 ......... ............ A Place catheter in artery ................................. 4.67 26.10 26.80 1.83 1.67 0.27 31.04 31.74 6.77 6.61 XXX 36216 ......... ............ A Place catheter in artery ................................. 5.27 28.11 28.84 1.99 1.84 0.31 33.69 34.42 7.57 7.42 XXX 36217 ......... ............ A Place catheter in artery ................................. 6.29 46.29 53.15 2.30 2.20 0.44 53.02 59.88 9.03 8.93 XXX 36218 ......... ............ A Place catheter in artery ................................. 1.01 3.78 4.76 0.36 0.35 0.07 4.86 5.84 1.44 1.43 ZZZ 36245 ......... ............ A Place catheter in artery ................................. 4.67 29.09 31.34 2.09 1.78 0.31 34.07 36.32 7.07 6.76 XXX 36246 ......... ............ A Place catheter in artery ................................. 5.27 27.75 29.41 1.96 1.86 0.38 33.40 35.06 7.61 7.51 XXX 36247 ......... ............ A Place catheter in artery ................................. 6.29 45.77 48.58 2.34 2.19 0.47 52.53 55.34 9.10 8.95 XXX 36248 ......... ............ A Place catheter in artery ................................. 1.01 3.21 3.83 0.37 0.35 0.07 4.29 4.91 1.45 1.43 ZZZ 36260 ......... ............ A Insertion of infusion pump ............................. 9.76 NA NA 4.86 4.88 1.29 NA NA 15.91 15.93 090 36261 ......... ............ A Revision of infusion pump ............................. 5.50 NA NA 3.25 3.56 0.70 NA NA 9.45 9.76 09036262 ......... ............ A Removal of infusion pump ............................ 4.01 NA NA 2.69 2.74 0.54 NA NA 7.24 7.29 090 36299 ......... ............ C Vessel injection procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 36400 ......... ............ A Bl draw < 3 yrs fem/jugular ........................... 0.38 0.33 0.29 0.11 0.10 0.03 0.74 0.70 0.52 0.51 XXX 36405 ......... ............ A Bl draw < 3 yrs scalp vein ............................ 0.31 0.29 0.27 0.08 0.08 0.03 0.63 0.61 0.42 0.42 XXX 36406 ......... ............ A Bl draw < 3 yrs other vein ............................. 0.18 0.30 0.29 0.08 0.06 0.01 0.49 0.48 0.27 0.25 XXX 36410 ......... ............ A Non-routine bl draw > 3 yrs .......................... 0.18 0.32 0.30 0.05 0.05 0.01 0.51 0.49 0.24 0.24 XXX 36420 ......... ............ A Vein access cutdown < 1 yr .......................... 1.01 NA NA 0.21 0.26 0.07 NA NA 1.29 1.34 XXX 36425 ......... ............ A Vein access cutdown > 1 yr .......................... 0.76 NA NA 0.22 0.22 0.06 NA NA 1.04 1.04 XXX 36430 ......... ............ A Blood transfusion service .............................. 0.00 0.93 0.99 0.00 0.76 0.06 0.99 1.05 0.06 0.82 XXX 36440 ......... ............ A Bl push transfuse, 2 yr or < .......................... 1.03 NA NA 0.43 0.33 0.10 NA NA 1.56 1.46 XXX36450 ......... ............ A Bl exchange/transfuse, nb ............................. 2.23 NA NA 0.78 0.73 0.21 NA NA 3.22 3.17 XXX36455 ......... ............ A Bl exchange/transfuse non-nb ...................... 2.43 NA NA 0.74 0.94 0.15 NA NA 3.32 3.52 XXX 36460 ......... ............ A Transfusion service, fetal .............................. 6.58 NA NA 1.70 2.11 0.79 NA NA 9.07 9.48 XXX 36470 ......... ............ A Injection therapy of vein ................................ 1.09 2.46 2.63 0.66 0.71 0.12 3.67 3.84 1.87 1.92 010 36471 ......... ............ A Injection therapy of veins .............................. 1.57 2.58 2.95 0.80 0.92 0.19 4.34 4.71 2.56 2.68 010 36475 ......... ............ A Endovenous rf, 1st vein ................................ 6.72 36.90 47.77 1.97 2.39 0.37 43.99 54.86 9.06 9.48 000 36476 ......... ............ A Endovenous rf, vein add-on .......................... 3.38 6.04 7.42 0.89 1.08 0.18 9.60 10.98 4.45 4.64 ZZZ 36478 ......... ............ A Endovenous laser, 1st vein ........................... 6.72 33.79 43.53 2.08 2.42 0.37 40.88 50.62 9.17 9.51 000 36479 ......... ............ A Endovenous laser vein addon ....................... 3.38 6.55 7.63 1.01 1.11 0.18 10.11 11.19 4.57 4.67 ZZZ 36481 ......... ............ A Insertion of catheter, vein .............................. 6.98 NA NA 2.14 2.48 0.55 NA NA 9.67 10.01 000 36500 ......... ............ A Insertion of catheter, vein .............................. 3.51 NA NA 1.25 1.34 0.20 NA NA 4.96 5.05 000 36510 ......... ............ A Insertion of catheter, vein .............................. 1.09 1.09 3.19 0.31 0.54 0.10 2.28 4.38 1.50 1.73 000 36511 ......... ............ A Apheresis wbc ............................................... 1.74 NA NA 0.58 0.69 0.08 NA NA 2.40 2.51 000 36512 ......... ............ A Apheresis rbc ................................................ 1.74 NA NA 0.61 0.71 0.08 NA NA 2.43 2.53 000 36513 ......... ............ A Apheresis platelets ........................................ 1.74 NA NA 0.52 0.68 0.17 NA NA 2.43 2.59 000 36514 ......... ............ A Apheresis plasma .......................................... 1.74 10.54 15.36 0.53 0.67 0.08 12.36 17.18 2.35 2.49 000 36515 ......... ............ A Apheresis, adsorp/reinfuse ............................ 1.74 45.31 61.05 0.51 0.62 0.08 47.13 62.87 2.33 2.44 000 36516 ......... ............ A Apheresis, selective ...................................... 1.22 49.90 75.51 0.38 0.46 0.08 51.20 76.81 1.68 1.76 000 36522 ......... ............ A Photopheresis ............................................... 1.67 35.02 33.03 0.85 0.93 0.13 36.82 34.83 2.65 2.73 000 36550 ......... ............ A Declot vascular device .................................. 0.00 0.33 0.38 0.06 0.31 0.37 0.70 0.75 0.43 0.68 XXX 36555 ......... ............ A Insert non-tunnel cv cath ............................... 2.68 4.16 5.35 0.62 0.76 0.11 6.95 8.14 3.41 3.55 000 36556 ......... ............ A Insert non-tunnel cv cath ............................... 2.50 2.91 4.94 0.57 0.70 0.19 5.60 7.63 3.26 3.39 000 36557 ......... ............ A Insert tunneled cv cath .................................. 5.09 14.96 19.60 2.37 2.58 0.57 20.62 25.26 8.03 8.24 010 36558 ......... ............ A Insert tunneled cv cath .................................. 4.79 15.00 19.53 2.30 2.49 0.57 20.36 24.89 7.66 7.85 010 36560 ......... ............ A Insert tunneled cv cath .................................. 6.24 21.22 27.56 2.55 2.91 0.57 28.03 34.37 9.36 9.72 010 36561 ......... ............ A Insert tunneled cv cath .................................. 5.99 22.48 27.81 2.61 2.87 0.57 29.04 34.37 9.17 9.43 010 36563 ......... ............ A Insert tunneled cv cath .................................. 6.19 23.25 25.87 2.62 2.89 0.84 30.28 32.90 9.65 9.92 010 36565 ......... ............ A Insert tunneled cv cath .................................. 5.99 17.83 22.98 2.51 2.84 0.57 24.39 29.54 9.07 9.40 010 

mstockstill on PROD1PC63 with PROPOSAL_2

49134 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

36566 ......... ............ A Insert tunneled cv cath .................................. 6.49 114.71 47.80 2.67 3.00 0.57 121.77 54.86 9.73 10.06 010 36568 ......... ............ A Insert picc cath .............................................. 1.92 5.73 7.08 0.57 0.58 0.11 7.76 9.11 2.60 2.61 000 36569 ......... ............ A Insert picc cath .............................................. 1.82 4.46 6.62 0.61 0.58 0.19 6.47 8.63 2.62 2.59 000 36570 ......... ............ A Insert picvad cath .......................................... 5.31 23.19 30.68 2.34 2.63 0.57 29.07 36.56 8.22 8.51 010 36571 ......... ............ A Insert picvad cath .......................................... 5.29 25.04 31.19 2.42 2.64 0.57 30.90 37.05 8.28 8.50 010 36575 ......... ............ A Repair tunneled cv cath ................................ 0.67 3.33 3.87 0.23 0.25 0.20 4.20 4.74 1.10 1.12 000 36576 ......... ............ A Repair tunneled cv cath ................................ 3.19 5.88 6.68 1.55 1.77 0.19 9.26 10.06 4.93 5.15 010 36578 ......... ............ A Replace tunneled cv cath .............................. 3.49 9.11 10.63 1.91 2.20 0.19 12.79 14.31 5.59 5.88 010 36580 ......... ............ A Replace cvad cath ......................................... 1.31 3.99 6.20 0.41 0.41 0.19 5.49 7.70 1.91 1.91 000 36581 ......... ............ A Replace tunneled cv cath .............................. 3.43 15.64 18.53 1.66 1.86 0.19 19.26 22.15 5.28 5.48 010 36582 ......... ............ A Replace tunneled cv cath .............................. 5.19 20.79 24.71 2.29 2.72 0.19 26.17 30.09 7.67 8.10 010 36583 ......... ............ A Replace tunneled cv cath .............................. 5.24 21.00 24.77 2.41 2.76 0.19 26.43 30.20 7.84 8.19 010 36584 ......... ............ A Replace picc cath .......................................... 1.20 3.97 6.22 0.57 0.56 0.19 5.36 7.61 1.96 1.95 000 36585 ......... ............ A Replace picvad cath ...................................... 4.79 22.75 26.55 2.30 2.62 0.19 27.73 31.53 7.28 7.60 010 36589 ......... ............ A Removal tunneled cv cath ............................. 2.27 1.86 2.15 1.22 1.35 0.24 4.37 4.66 3.73 3.86 010 36590 ......... ............ A Removal tunneled cv cath ............................. 3.30 3.64 3.44 1.59 1.69 0.44 7.38 7.18 5.33 5.43 010 36595 ......... ............ A Mech remov tunneled cv cath ....................... 3.59 10.85 15.65 1.31 1.42 0.21 14.65 19.45 5.11 5.22 000 36596 ......... ............ A Mech remov tunneled cv cath ....................... 0.75 2.59 3.42 0.42 0.48 0.05 3.39 4.22 1.22 1.28 000 36597 ......... ............ A Reposition venous catheter ........................... 1.21 2.02 2.31 0.42 0.44 0.07 3.30 3.59 1.70 1.72 000 36598 ......... ............ T Inj w/fluor, eval cv device .............................. 0.74 2.25 2.54 0.26 2.05 0.05 3.04 3.33 1.05 2.84 000 36600 ......... ............ A Withdrawal of arterial blood .......................... 0.32 0.50 0.49 0.08 0.09 0.02 0.84 0.83 0.42 0.43 XXX 36620 ......... ............ A Insertion catheter, artery ............................... 1.15 NA NA 0.17 0.22 0.07 NA NA 1.39 1.44 000 36625 ......... ............ A Insertion catheter, artery ............................... 2.11 NA NA 0.49 0.52 0.26 NA NA 2.86 2.89 000 36640 ......... ............ A Insertion catheter, artery ............................... 2.10 NA NA 0.91 1.01 0.21 NA NA 3.22 3.32 000 36660 ......... ............ A Insertion catheter, artery ............................... 1.40 NA NA 0.20 0.38 0.14 NA NA 1.74 1.92 000 36680 ......... ............ A Insert needle, bone cavity ............................. 1.20 NA NA 0.33 0.45 0.11 NA NA 1.64 1.76 000 36800 ......... ............ A Insertion of cannula ....................................... 2.43 NA NA 1.55 1.74 0.25 NA NA 4.23 4.42 000 36810 ......... ............ A Insertion of cannula ....................................... 3.96 NA NA 1.36 1.60 0.45 NA NA 5.77 6.01 000 36815 ......... ............ A Insertion of cannula ....................................... 2.62 NA NA 1.04 1.14 0.35 NA NA 4.01 4.11 000 36818 ......... ............ A Av fuse, uppr arm, cephalic .......................... 11.77 NA NA 4.88 5.74 1.89 NA NA 18.54 19.40 090 36819 ......... ............ A Av fuse, uppr arm, basilic ............................. 14.35 NA NA 5.26 6.09 1.95 NA NA 21.56 22.39 090 36820 ......... ............ A Av fusion/forearm vein .................................. 14.35 NA NA 5.34 6.12 1.94 NA NA 21.63 22.41 090 36821 ......... ............ A Av fusion direct any site ................................ 9.10 NA NA 4.04 4.50 1.23 NA NA 14.37 14.83 090 36822 ......... ............ A Insertion of cannula(s) ................................... 5.47 NA NA 3.82 4.24 0.79 NA NA 10.08 10.50 090 36823 ......... ............ A Insertion of cannula(s) ................................... 22.74 NA NA 8.91 9.26 2.88 NA NA 34.53 34.88 090 36825 ......... ............ A Artery-vein autograft ...................................... 9.95 NA NA 4.34 4.87 1.35 NA NA 15.64 16.17 090 36830 ......... ............ A Artery-vein nonautograft ................................ 11.98 NA NA 4.25 4.99 1.66 NA NA 17.89 18.63 090 36831 ......... ............ A Open thrombect av fistula ............................. 7.99 NA NA 3.28 3.78 1.09 NA NA 12.36 12.86 090 36832 ......... ............ A Av fistula revision, open ................................ 10.48 NA NA 3.87 4.51 1.44 NA NA 15.79 16.43 090 36833 ......... ............ A Av fistula revision .......................................... 11.93 NA NA 4.25 4.96 1.65 NA NA 17.83 18.54 090 36834 ......... ............ A Repair A-V aneurysm .................................... 11.07 NA NA 4.35 4.68 1.37 NA NA 16.79 17.12 090 36835 ......... ............ A Artery to vein shunt ....................................... 7.38 NA NA 3.90 4.22 0.98 NA NA 12.26 12.58 090 36838 ......... ............ A Dist revas ligation, hemo ............................... 21.55 NA NA 7.14 8.82 3.01 NA NA 31.70 33.38 090 36860 ......... ............ A External cannula declotting ........................... 2.01 3.35 2.17 0.62 0.67 0.11 5.47 4.29 2.74 2.79 000 36861 ......... ............ A Cannula declotting ......................................... 2.52 NA NA 1.25 1.43 0.27 NA NA 4.04 4.22 000 36870 ......... ............ A Percut thrombect av fistula ........................... 5.15 41.10 50.05 2.67 3.03 0.29 46.54 55.49 8.11 8.47 090 37140 ......... ............ A Revision of circulation ................................... 25.05 NA NA 9.04 10.12 2.01 NA NA 36.10 37.18 090 37145 ......... ............ A Revision of circulation ................................... 26.06 NA NA 9.10 10.42 3.25 NA NA 38.41 39.73 090 37160 ......... ............ A Revision of circulation ................................... 23.06 NA NA 8.16 8.98 2.81 NA NA 34.03 34.85 090 37180 ......... ............ A Revision of circulation ................................... 26.06 NA NA 9.00 9.97 3.34 NA NA 38.40 39.37 090 37181 ......... ............ A Splice spleen/kidney veins ............................ 28.19 NA NA 9.34 10.59 3.40 NA NA 40.92 42.17 090 37182 ......... ............ A Insert hepatic shunt (tips) .............................. 16.97 NA NA 5.73 5.98 1.00 NA NA 23.70 23.95 000 37183 ......... ............ A Remove hepatic shunt (tips) ......................... 7.99 NA NA 2.80 2.96 0.47 NA NA 11.26 11.42 00037184 ......... ............ A Prim art mech thrombectomy ........................ 8.66 49.86 66.23 3.00 3.26 0.55 59.07 75.44 12.21 12.47 000 37185 ......... ............ A Prim art m-thrombect add-on ........................ 3.28 16.20 21.21 1.02 1.09 0.21 19.69 24.70 4.51 4.58 ZZZ 37186 ......... ............ A Sec art m-thrombect add-on ......................... 4.92 34.21 45.60 1.53 1.63 0.32 39.45 50.84 6.77 6.87 ZZZ 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49135 

37187 ......... ............ A Venous mech thrombectomy ........................ 8.03 48.71 64.81 2.81 3.06 0.51 57.25 73.35 11.35 11.60 000 37188 ......... ............ A Venous m-thrombectomy add-on .................. 5.71 42.51 57.11 2.09 2.29 0.37 48.59 63.19 8.17 8.37 000 37195 ......... ............ C Thrombolytic therapy, stroke ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 37200 ......... ............ A Transcatheter biopsy ..................................... 4.55 NA NA 1.49 1.50 0.27 NA NA 6.31 6.32 000 37201 ......... ............ A Transcatheter therapy infuse ........................ 4.99 NA NA 2.25 2.47 0.33 NA NA 7.57 7.79 000 37202 ......... ............ A Transcatheter therapy infuse ........................ 5.67 NA NA 3.40 3.12 0.43 NA NA 9.50 9.22 000 37203 ......... ............ A Transcatheter retrieval .................................. 5.02 30.34 32.24 1.95 2.01 0.29 35.65 37.55 7.26 7.32 000 37204 ......... ............ A Transcatheter occlusion ................................ 18.11 NA NA 5.79 5.87 1.48 NA NA 25.38 25.46 000 37205 ......... ............ A Transcath iv stent, percut .............................. 8.27 NA NA 3.90 3.79 0.60 NA NA 12.77 12.66 000 37206 ......... ............ A Transcath iv stent/perc addl .......................... 4.12 NA NA 1.59 1.47 0.31 NA NA 6.02 5.90 ZZZ37207 ......... ............ A Transcath iv stent, open ................................ 8.27 NA NA 2.45 2.98 1.17 NA NA 11.89 12.42 000 37208 ......... ............ A Transcath iv stent/open addl ......................... 4.12 NA NA 1.05 1.30 0.59 NA NA 5.76 6.01 ZZZ 37209 ......... ............ A Change iv cath at thromb tx .......................... 2.27 NA NA 0.73 0.74 0.15 NA NA 3.15 3.16 000 37215 ......... ............ R Transcath stent, cca w/eps ........................... 19.54 NA NA 10.12 9.35 1.09 NA NA 30.75 29.98 090 37216 ......... ............ N Transcath stent, cca w/o eps ........................ 18.81 NA NA 8.74 8.79 1.04 NA NA 28.59 28.64 090 37250 ......... ............ A Iv us first vessel add-on ................................ 2.10 NA NA 0.81 0.77 0.21 NA NA 3.12 3.08 ZZZ 37251 ......... ............ A Iv us each add vessel add-on ....................... 1.60 NA NA 0.52 0.54 0.19 NA NA 2.31 2.33 ZZZ 37500 ......... ............ A Endoscopy ligate perf veins .......................... 11.48 NA NA 5.46 6.50 1.54 NA NA 18.48 19.52 090 37501 ......... ............ C Vascular endoscopy procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 37565 ......... ............ A Ligation of neck vein ..................................... 11.93 NA NA 5.10 5.49 1.33 NA NA 18.36 18.75 090 37600 ......... ............ A Ligation of neck artery ................................... 12.30 NA NA 4.80 6.17 1.41 NA NA 18.51 19.88 090 37605 ......... ............ A Ligation of neck artery ................................... 14.16 NA NA 5.57 6.57 1.98 NA NA 21.71 22.71 090 37606 ......... ............ A Ligation of neck artery ................................... 8.66 NA NA 4.87 4.64 1.23 NA NA 14.76 14.53 090 37607 ......... ............ A Ligation of a-v fistula ..................................... 6.15 NA NA 3.11 3.45 0.85 NA NA 10.11 10.45 090 37609 ......... ............ A Temporal artery procedure ............................ 3.00 4.24 4.44 1.84 1.93 0.36 7.60 7.80 5.20 5.29 010 37615 ......... ............ A Ligation of neck artery ................................... 7.67 NA NA 3.98 4.08 0.68 NA NA 12.33 12.43 090 37616 ......... ............ A Ligation of chest artery .................................. 18.84 NA NA 7.94 8.05 2.32 NA NA 29.10 29.21 090 37617 ......... ............ A Ligation of abdomen artery ........................... 23.67 NA NA 7.92 8.86 2.97 NA NA 34.56 35.50 090 37618 ......... ............ A Ligation of extremity artery ............................ 5.90 NA NA 3.40 3.56 0.67 NA NA 9.97 10.13 090 37620 ......... ............ A Revision of major vein ................................... 11.44 NA NA 5.24 5.59 0.91 NA NA 17.59 17.94 090 37650 ......... ............ A Revision of major vein ................................... 8.37 NA NA 4.22 4.57 1.01 NA NA 13.60 13.95 090 37660 ......... ............ A Revision of major vein ................................... 22.16 NA NA 8.13 8.82 2.48 NA NA 32.77 33.46 090 37700 ......... ............ A Revise leg vein .............................................. 3.72 NA NA 2.45 2.71 0.53 NA NA 6.70 6.96 090 37718 ......... ............ A Ligate/strip short leg vein .............................. 7.01 NA NA 3.53 3.93 0.14 NA NA 10.68 11.08 090 37722 ......... ............ A Ligate/strip long leg vein ............................... 8.04 NA NA 3.80 4.26 0.86 NA NA 12.70 13.16 090 37735 ......... ............ A Removal of leg veins/lesion .......................... 10.75 NA NA 4.67 5.29 1.48 NA NA 16.90 17.52 090 37760 ......... ............ A Ligation, leg veins, open ............................... 10.63 NA NA 4.55 5.14 1.44 NA NA 16.62 17.21 090 37765 ......... ............ A Phleb veins

—extrem

—to 20 ......................... 7.59 NA NA 3.60 4.37 0.48 NA NA 11.67 12.44 090 

37766 ......... ............ A Phleb veins

—extrem 20+ .............................. 9.54 NA NA 4.15 5.03 0.48 NA NA 14.17 15.05 090 

37780 ......... ............ A Revision of leg vein ....................................... 3.83 NA NA 2.50 2.76 0.53 NA NA 6.86 7.12 090 37785 ......... ............ A Ligate/divide/excise vein ............................... 3.83 4.96 5.13 2.59 2.69 0.54 9.33 9.50 6.96 7.06 090 37788 ......... ............ A Revascularization, penis ............................... 23.13 NA NA 11.95 9.80 2.25 NA NA 37.33 35.18 090 37790 ......... ............ A Penile venous occlusion ................................ 8.33 NA NA 5.09 4.55 0.59 NA NA 14.01 13.47 090 37799 ......... ............ C Vascular surgery procedure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 38100 ......... ............ A Removal of spleen, total ............................... 19.43 NA NA 6.94 6.36 1.91 NA NA 28.28 27.70 090 38101 ......... ............ A Removal of spleen, partial ............................ 19.43 NA NA 7.36 6.73 2.04 NA NA 28.83 28.20 090 38102 ......... ............ A Removal of spleen, total ............................... 4.79 NA NA 1.27 1.55 0.63 NA NA 6.69 6.97 ZZZ 38115 ......... ............ A Repair of ruptured spleen ............................. 21.76 NA NA 7.59 6.88 2.08 NA NA 31.43 30.72 090 38120 ......... ............ A Laparoscopy, splenectomy ............................ 16.97 NA NA 7.00 7.29 2.24 NA NA 26.21 26.50 090 38129 ......... ............ C Laparoscope proc, spleen ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 38200 ......... ............ A Injection for spleen x-ray ............................... 2.64 NA NA 1.00 0.92 0.14 NA NA 3.78 3.70 000 38205 ......... ............ R Harvest allogenic stem cells ......................... 1.50 NA NA 0.54 0.64 0.07 NA NA 2.11 2.21 000 38206 ......... ............ R Harvest auto stem cells ................................. 1.50 NA NA 0.54 0.64 0.07 NA NA 2.11 2.21 000 38220 ......... ............ A Bone marrow aspiration ................................ 1.08 2.67 3.46 0.44 0.50 0.05 3.80 4.59 1.57 1.63 XXX 38221 ......... ............ A Bone marrow biopsy ..................................... 1.37 2.79 3.65 0.57 0.63 0.07 4.23 5.09 2.01 2.07 XXX 38230 ......... ............ R Bone marrow collection ................................. 4.78 NA NA 2.76 3.11 0.48 NA NA 8.02 8.37 010 38240 ......... ............ R Bone marrow/stem transplant ....................... 2.24 NA NA 0.93 1.01 0.11 NA NA 3.28 3.36 XXX 38241 ......... ............ R Bone marrow/stem transplant ....................... 2.24 NA NA 0.93 1.01 0.11 NA NA 3.28 3.36 XXX 38242 ......... ............ A Lymphocyte infuse transplant ....................... 1.71 NA NA 0.69 0.76 0.08 NA NA 2.48 2.55 000 38300 ......... ............ A Drainage, lymph node lesion ........................ 2.24 3.63 4.13 1.75 1.98 0.25 6.12 6.62 4.24 4.47 010 38305 ......... ............ A Drainage, lymph node lesion ........................ 6.49 NA NA 3.42 4.19 0.88 NA NA 10.79 11.56 090 38308 ......... ............ A Incision of lymph channels ............................ 6.69 NA NA 3.59 3.70 0.85 NA NA 11.13 11.24 090 38380 ......... ............ A Thoracic duct procedure ............................... 8.26 NA NA 4.64 5.42 0.74 NA NA 13.64 14.42 090 38381 ......... ............ A Thoracic duct procedure ............................... 13.28 NA NA 6.11 6.69 1.84 NA NA 21.23 21.81 090 38382 ......... ............ A Thoracic duct procedure ............................... 10.42 NA NA 5.47 5.68 1.37 NA NA 17.26 17.47 090 38500 ......... ............ A Biopsy/removal, lymph nodes ....................... 3.74 3.78 3.71 2.04 2.07 0.49 8.01 7.94 6.27 6.30 010 

mstockstill on PROD1PC63 with PROPOSAL_2

49136 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

38505 ......... ............ A Needle biopsy, lymph nodes ......................... 1.14 2.08 2.06 0.70 0.76 0.09 3.31 3.29 1.93 1.99 000 38510 ......... ............ A Biopsy/removal, lymph nodes ....................... 6.67 5.21 5.46 2.96 3.35 0.72 12.60 12.85 10.35 10.74 010 38520 ......... ............ A Biopsy/removal, lymph nodes ....................... 6.91 NA NA 3.71 3.97 0.84 NA NA 11.46 11.72 090 38525 ......... ............ A Biopsy/removal, lymph nodes ....................... 6.31 NA NA 3.50 3.34 0.80 NA NA 10.61 10.45 090 38530 ......... ............ A Biopsy/removal, lymph nodes ....................... 8.22 NA NA 4.12 4.32 1.12 NA NA 13.46 13.66 090 38542 ......... ............ A Explore deep node(s), neck .......................... 6.02 NA NA 3.73 4.29 0.60 NA NA 10.35 10.91 09038550 ......... ............ A Removal, neck/armpit lesion ......................... 6.91 NA NA 4.24 3.99 0.88 NA NA 12.03 11.78 09038555 ......... ............ A Removal, neck/armpit lesion ......................... 15.31 NA NA 7.25 8.21 1.75 NA NA 24.31 25.27 090 38562 ......... ............ A Removal, pelvic lymph nodes ....................... 10.83 NA NA 5.77 5.77 1.20 NA NA 17.80 17.80 090 38564 ......... ............ A Removal, abdomen lymph nodes ................. 11.23 NA NA 5.25 5.24 1.32 NA NA 17.80 17.79 090 38570 ......... ............ A Laparoscopy, lymph node biop ..................... 9.24 NA NA 3.98 3.97 1.13 NA NA 14.35 14.34 010 38571 ......... ............ A Laparoscopy, lymphadenectomy ................... 14.66 NA NA 6.86 5.95 1.15 NA NA 22.67 21.76 010 38572 ......... ............ A Laparoscopy, lymphadenectomy ................... 16.82 NA NA 6.16 6.84 1.90 NA NA 24.88 25.56 010 38589 ......... ............ C Laparoscope proc, lymphatic ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 38700 ......... ............ A Removal of lymph nodes, neck ..................... 12.62 NA NA 5.91 6.15 0.72 NA NA 19.25 19.49 090 38720 ......... ............ A Removal of lymph nodes, neck ..................... 21.64 NA NA 9.21 9.32 1.20 NA NA 32.05 32.16 090 38724 ......... ............ A Removal of lymph nodes, neck ..................... 23.64 NA NA 9.79 9.82 1.28 NA NA 34.71 34.74 090 38740 ......... ............ A Remove armpit lymph nodes ........................ 10.51 NA NA 5.07 4.97 1.32 NA NA 16.90 16.80 090 38745 ......... ............ A Remove armpit lymph nodes ........................ 13.65 NA NA 6.12 6.08 1.73 NA NA 21.50 21.46 090 38746 ......... ............ A Remove thoracic lymph nodes ...................... 4.88 NA NA 1.45 1.57 0.72 NA NA 7.05 7.17 ZZZ 38747 ......... ............ A Remove abdominal lymph nodes .................. 4.88 NA NA 1.28 1.57 0.64 NA NA 6.80 7.09 ZZZ 38760 ......... ............ A Remove groin lymph nodes .......................... 13.43 NA NA 6.01 6.09 1.71 NA NA 21.15 21.23 090 38765 ......... ............ A Remove groin lymph nodes .......................... 21.72 NA NA 8.72 8.78 2.47 NA NA 32.91 32.97 090 38770 ......... ............ A Remove pelvis lymph nodes ......................... 13.93 NA NA 6.91 6.03 1.40 NA NA 22.24 21.36 090 38780 ......... ............ A Remove abdomen lymph nodes ................... 17.47 NA NA 8.00 8.15 1.88 NA NA 27.35 27.50 090 38790 ......... ............ A Inject for lymphatic x-ray ............................... 1.29 NA NA 0.73 0.75 0.13 NA NA 2.15 2.17 000 38792 ......... ............ A Identify sentinel node .................................... 0.52 NA NA 0.48 0.45 0.06 NA NA 1.06 1.03 000 38794 ......... ............ A Access thoracic lymph duct .......................... 4.44 NA NA 3.04 3.35 0.32 NA NA 7.80 8.11 090 38999 ......... ............ C Blood/lymph system procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 39000 ......... ............ A Exploration of chest ....................................... 7.46 NA NA 4.36 4.58 0.89 NA NA 12.71 12.93 090 39010 ......... ............ A Exploration of chest ....................................... 13.08 NA NA 6.17 7.20 1.75 NA NA 21.00 22.03 090 39200 ......... ............ A Removal chest lesion .................................... 15.02 NA NA 6.29 7.22 2.02 NA NA 23.33 24.26 090 39220 ......... ............ A Removal chest lesion .................................... 18.42 NA NA 7.64 8.93 2.45 NA NA 28.51 29.80 090 39400 ......... ............ A Visualization of chest .................................... 5.97 NA NA 3.62 4.54 0.82 NA NA 10.41 11.33 010 39499 ......... ............ C Chest procedure ............................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 39501 ......... ............ A Repair diaphragm laceration ......................... 13.83 NA NA 5.93 6.32 1.77 NA NA 21.53 21.92 090 39502 ......... ............ A Repair paraesophageal hernia ...................... 17.03 NA NA 6.66 7.02 2.16 NA NA 25.85 26.21 090 39503 ......... ............ A Repair of diaphragm hernia .......................... 108.57 NA NA 30.95 32.77 10.95 NA NA 150.47 152.29 090 39520 ......... ............ A Repair of diaphragm hernia .......................... 16.56 NA NA 6.93 7.76 2.23 NA NA 25.72 26.55 090 39530 ......... ............ A Repair of diaphragm hernia .......................... 16.17 NA NA 6.43 6.96 2.10 NA NA 24.70 25.23 090 39531 ......... ............ A Repair of diaphragm hernia .......................... 17.18 NA NA 6.63 7.19 2.21 NA NA 26.02 26.58 090 39540 ......... ............ A Repair of diaphragm hernia .......................... 14.47 NA NA 5.65 6.08 1.79 NA NA 21.91 22.34 090 39541 ......... ............ A Repair of diaphragm hernia .......................... 15.62 NA NA 6.21 6.49 1.92 NA NA 23.75 24.03 090 39545 ......... ............ A Revision of diaphragm .................................. 14.52 NA NA 7.23 7.46 1.83 NA NA 23.58 23.81 090 39560 ......... ............ A Resect diaphragm, simple ............................. 12.91 NA NA 5.58 6.11 1.59 NA NA 20.08 20.61 090 39561 ......... ............ A Resect diaphragm, complex .......................... 19.69 NA NA 9.42 9.35 2.44 NA NA 31.55 31.48 09039599 ......... ............ C Diaphragm surgery procedure ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 40490 ......... ............ A Biopsy of lip ................................................... 1.22 2.02 1.73 0.55 0.60 0.05 3.29 3.00 1.82 1.87 000 40500 ......... ............ A Partial excision of lip ..................................... 4.27 7.65 7.08 4.18 4.29 0.38 12.30 11.73 8.83 8.94 090 40510 ......... ............ A Partial excision of lip ..................................... 4.69 6.52 6.59 3.48 3.88 0.49 11.70 11.77 8.66 9.06 090 40520 ......... ............ A Partial excision of lip ..................................... 4.66 6.79 7.35 3.68 4.00 0.52 11.97 12.53 8.86 9.18 090 40525 ......... ............ A Reconstruct lip with flap ................................ 7.54 NA NA 5.23 6.03 0.85 NA NA 13.62 14.42 090 40527 ......... ............ A Reconstruct lip with flap ................................ 9.12 NA NA 5.84 6.97 0.97 NA NA 15.93 17.06 090 40530 ......... ............ A Partial removal of lip ..................................... 5.39 7.28 7.68 4.07 4.45 0.55 13.22 13.62 10.01 10.39 090 40650 ......... ............ A Repair lip ....................................................... 3.63 5.91 6.57 3.12 3.25 0.38 9.92 10.58 7.13 7.26 090 40652 ......... ............ A Repair lip ....................................................... 4.25 6.97 7.55 3.94 4.18 0.52 11.74 12.32 8.71 8.95 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49137 

40654 ......... ............ A Repair lip ....................................................... 5.30 7.98 8.45 4.60 4.85 0.60 13.88 14.35 10.50 10.75 090 40700 ......... ............ A Repair cleft lip/nasal ...................................... 13.89 NA NA 9.13 9.09 0.95 NA NA 23.97 23.93 090 40701 ......... ............ A Repair cleft lip/nasal ...................................... 16.95 NA NA 11.13 11.28 1.65 NA NA 29.73 29.88 090 40702 ......... ............ A Repair cleft lip/nasal ...................................... 14.02 NA NA 7.21 7.99 1.23 NA NA 22.46 23.24 090 40720 ......... ............ A Repair cleft lip/nasal ...................................... 14.47 NA NA 9.01 9.67 1.79 NA NA 25.27 25.93 090 40761 ......... ............ A Repair cleft lip/nasal ...................................... 15.63 NA NA 8.82 9.91 1.93 NA NA 26.38 27.47 090 40799 ......... ............ C Lip surgery procedure ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 40800 ......... ............ A Drainage of mouth lesion .............................. 1.17 3.84 3.18 1.88 1.80 0.13 5.14 4.48 3.18 3.10 010 40801 ......... ............ A Drainage of mouth lesion .............................. 2.53 4.85 4.23 2.55 2.69 0.31 7.69 7.07 5.39 5.53 010 40804 ......... ............ A Removal, foreign body, mouth ...................... 1.24 3.63 3.45 1.75 1.83 0.11 4.98 4.80 3.10 3.18 010 40805 ......... ............ A Removal, foreign body, mouth ...................... 2.69 5.04 4.62 2.56 2.75 0.32 8.05 7.63 5.57 5.76 010 40806 ......... ............ A Incision of lip fold .......................................... 0.31 2.38 1.97 0.50 0.50 0.04 2.73 2.32 0.85 0.85 000 40808 ......... ............ A Biopsy of mouth lesion .................................. 0.96 3.51 2.87 1.57 1.50 0.10 4.57 3.93 2.63 2.56 010 40810 ......... ............ A Excision of mouth lesion ............................... 1.31 3.57 3.05 1.66 1.66 0.13 5.01 4.49 3.10 3.10 010 40812 ......... ............ A Excise/repair mouth lesion ............................ 2.31 4.51 3.92 2.26 2.37 0.28 7.10 6.51 4.85 4.96 010 40814 ......... ............ A Excise/repair mouth lesion ............................ 3.41 5.62 5.11 3.64 3.83 0.41 9.44 8.93 7.46 7.65 090 40816 ......... ............ A Excision of mouth lesion ............................... 3.66 5.79 5.33 3.68 3.92 0.40 9.85 9.39 7.74 7.98 090 40818 ......... ............ A Excise oral mucosa for graft ......................... 2.66 5.77 5.32 3.70 3.90 0.21 8.64 8.19 6.57 6.77 090 40819 ......... ............ A Excise lip or cheek fold ................................. 2.41 4.87 4.28 3.06 3.08 0.29 7.57 6.98 5.76 5.78 090 40820 ......... ............ A Treatment of mouth lesion ............................ 1.28 5.11 4.23 2.82 2.54 0.11 6.50 5.62 4.21 3.93 010 40830 ......... ............ A Repair mouth laceration ................................ 1.76 4.11 3.82 2.02 2.07 0.19 6.06 5.77 3.97 4.02 010 40831 ......... ............ A Repair mouth laceration ................................ 2.46 5.33 4.83 2.73 2.97 0.30 8.09 7.59 5.49 5.73 010 40840 ......... ............ R Reconstruction of mouth ............................... 8.97 9.99 9.83 5.53 6.61 1.08 20.04 19.88 15.58 16.66 090 40842 ......... ............ R Reconstruction of mouth ............................... 8.97 9.71 9.97 5.32 6.42 1.08 19.76 20.02 15.37 16.47 090 40843 ......... ............ R Reconstruction of mouth ............................... 12.56 11.76 11.90 6.01 7.36 1.39 25.71 25.85 19.96 21.31 090 40844 ......... ............ R Reconstruction of mouth ............................... 16.47 14.78 15.52 8.75 10.86 1.99 33.24 33.98 27.21 29.32 090 40845 ......... ............ R Reconstruction of mouth ............................... 19.03 15.15 16.58 9.55 12.30 2.00 36.18 37.61 30.58 33.33 090 40899 ......... ............ C Mouth surgery procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 41000 ......... ............ A Drainage of mouth lesion .............................. 1.30 2.49 2.36 1.29 1.38 0.12 3.91 3.78 2.71 2.80 010 41005 ......... ............ A Drainage of mouth lesion .............................. 1.26 4.23 3.56 1.71 1.72 0.12 5.61 4.94 3.09 3.10 010 41006 ......... ............ A Drainage of mouth lesion .............................. 3.24 5.29 4.92 2.73 3.06 0.35 8.88 8.51 6.32 6.65 090 41007 ......... ............ A Drainage of mouth lesion .............................. 3.10 5.33 5.19 2.71 2.94 0.31 8.74 8.60 6.12 6.35 090 41008 ......... ............ A Drainage of mouth lesion .............................. 3.36 5.41 4.86 2.78 3.10 0.42 9.19 8.64 6.56 6.88 090 41009 ......... ............ A Drainage of mouth lesion .............................. 3.58 5.80 5.18 3.11 3.46 0.47 9.85 9.23 7.16 7.51 090 41010 ......... ............ A Incision of tongue fold ................................... 1.06 3.44 3.43 1.37 1.54 0.07 4.57 4.56 2.50 2.67 010 41015 ......... ............ A Drainage of mouth lesion .............................. 3.95 6.21 5.60 3.93 4.09 0.46 10.62 10.01 8.34 8.50 090 41016 ......... ............ A Drainage of mouth lesion .............................. 4.06 6.16 5.75 4.02 4.17 0.53 10.75 10.34 8.61 8.76 090 41017 ......... ............ A Drainage of mouth lesion .............................. 4.06 6.31 5.80 4.08 4.25 0.53 10.90 10.39 8.67 8.84 090 41018 ......... ............ A Drainage of mouth lesion .............................. 5.09 6.54 6.23 4.32 4.51 0.68 12.31 12.00 10.09 10.28 090 41100 ......... ............ A Biopsy of tongue ........................................... 1.37 2.57 2.46 1.11 1.34 0.15 4.09 3.98 2.63 2.86 010 41105 ......... ............ A Biopsy of tongue ........................................... 1.42 2.56 2.37 1.13 1.27 0.13 4.11 3.92 2.68 2.82 010 41108 ......... ............ A Biopsy of floor of mouth ................................ 1.05 2.40 2.15 1.02 1.10 0.10 3.55 3.30 2.17 2.25 010 41110 ......... ............ A Excision of tongue lesion .............................. 1.51 3.46 3.10 1.54 1.62 0.13 5.10 4.74 3.18 3.26 010 41112 ......... ............ A Excision of tongue lesion .............................. 2.73 5.11 4.63 3.14 3.20 0.28 8.12 7.64 6.15 6.21 090 41113 ......... ............ A Excision of tongue lesion .............................. 3.19 5.38 4.90 3.29 3.43 0.34 8.91 8.43 6.82 6.96 090 41114 ......... ............ A Excision of tongue lesion .............................. 8.64 NA NA 5.94 6.88 0.83 NA NA 15.41 16.35 090 41115 ......... ............ A Excision of tongue fold .................................. 1.74 4.27 3.54 1.75 1.83 0.18 6.19 5.46 3.67 3.75 010 41116 ......... ............ A Excision of mouth lesion ............................... 2.44 5.31 4.59 2.65 2.76 0.23 7.98 7.26 5.32 5.43 090 41120 ......... ............ A Partial removal of tongue .............................. 10.83 NA NA 13.22 14.79 0.79 NA NA 24.84 26.41 090 41130 ......... ............ A Partial removal of tongue .............................. 15.43 NA NA 14.55 15.78 0.93 NA NA 30.91 32.14 090 41135 ......... ............ A Tongue and neck surgery ............................. 29.71 NA NA 19.86 22.38 1.88 NA NA 51.45 53.97 090 41140 ......... ............ A Removal of tongue ........................................ 28.69 NA NA 21.36 25.34 2.26 NA NA 52.31 56.29 090 41145 ......... ............ A Tongue removal, neck surgery ..................... 37.47 NA NA 26.29 29.48 2.54 NA NA 66.30 69.49 09041150 ......... ............ A Tongue, mouth, jaw surgery ......................... 29.40 NA NA 21.09 23.81 1.94 NA NA 52.43 55.15 090 41153 ......... ............ A Tongue, mouth, neck surgery ....................... 33.16 NA NA 21.82 24.22 2.00 NA NA 56.98 59.38 090 41155 ......... ............ A Tongue, jaw, & neck surgery ........................ 39.84 NA NA 23.98 26.10 2.33 NA NA 66.15 68.27 090 41250 ......... ............ A Repair tongue laceration ............................... 1.91 3.79 3.00 1.58 1.28 0.18 5.88 5.09 3.67 3.37 010 41251 ......... ............ A Repair tongue laceration ............................... 2.27 3.15 3.24 1.63 1.57 0.22 5.64 5.73 4.12 4.06 010 41252 ......... ............ A Repair tongue laceration ............................... 2.97 4.34 4.00 1.96 2.18 0.29 7.60 7.26 5.22 5.44 010 41500 ......... ............ A Fixation of tongue .......................................... 3.70 NA NA 6.54 7.22 0.30 NA NA 10.54 11.22 090 41510 ......... ............ A Tongue to lip surgery .................................... 3.41 NA NA 7.02 7.70 0.20 NA NA 10.63 11.31 090 41520 ......... ............ A Reconstruction, tongue fold .......................... 2.73 5.71 4.89 3.20 3.52 0.27 8.71 7.89 6.20 6.52 090 41599 ......... ............ C Tongue and mouth surgery ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 41800 ......... ............ A Drainage of gum lesion ................................. 1.17 4.76 3.13 2.09 1.48 0.12 6.05 4.42 3.38 2.77 010 41805 ......... ............ A Removal foreign body, gum .......................... 1.24 4.73 3.19 2.75 2.35 0.13 6.10 4.56 4.12 3.72 010 41806 ......... ............ A Removal foreign body,jawbone ..................... 2.69 5.91 4.16 3.39 3.12 0.37 8.97 7.22 6.45 6.18 010 

mstockstill on PROD1PC63 with PROPOSAL_2

49138 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

41822 ......... ............ R Excision of gum lesion .................................. 2.31 4.65 4.08 1.77 1.85 0.31 7.27 6.70 4.39 4.47 010 41823 ......... ............ R Excision of gum lesion .................................. 3.55 6.48 5.79 3.74 3.94 0.47 10.50 9.81 7.76 7.96 090 41825 ......... ............ A Excision of gum lesion .................................. 1.31 3.62 3.20 1.43 2.04 0.15 5.08 4.66 2.89 3.50 010 41826 ......... ............ A Excision of gum lesion .................................. 2.31 5.12 3.10 2.59 2.22 0.30 7.73 5.71 5.20 4.83 010 41827 ......... ............ A Excision of gum lesion .................................. 3.66 6.60 5.78 3.35 3.58 0.35 10.61 9.79 7.36 7.59 090 41828 ......... ............ R Excision of gum lesion .................................. 3.09 4.12 3.88 1.65 2.63 0.44 7.65 7.41 5.18 6.16 010 41830 ......... ............ R Removal of gum tissue ................................. 3.34 6.03 5.23 3.13 3.50 0.44 9.81 9.01 6.91 7.28 010 41872 ......... ............ R Repair gum .................................................... 2.84 5.87 5.23 3.25 3.41 0.30 9.01 8.37 6.39 6.55 090 41874 ......... ............ R Repair tooth socket ....................................... 3.09 5.76 5.07 2.76 3.07 0.45 9.30 8.61 6.30 6.61 090 41899 ......... ............ C Dental surgery procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 42000 ......... ............ A Drainage mouth roof lesion ........................... 1.23 2.34 2.51 1.14 1.22 0.12 3.69 3.86 2.49 2.57 010 42100 ......... ............ A Biopsy roof of mouth ..................................... 1.31 2.18 2.11 1.20 1.32 0.13 3.62 3.55 2.64 2.76 010 42104 ......... ............ A Excision lesion, mouth roof ........................... 1.64 3.43 2.76 1.58 1.56 0.16 5.23 4.56 3.38 3.36 010 42106 ......... ............ A Excision lesion, mouth roof ........................... 2.10 4.41 3.52 2.04 2.34 0.25 6.76 5.87 4.39 4.69 010 42107 ......... ............ A Excision lesion, mouth roof ........................... 4.43 6.31 5.86 3.53 3.85 0.44 11.18 10.73 8.40 8.72 090 42120 ......... ............ A Remove palate/lesion .................................... 11.62 NA NA 11.41 11.68 0.52 NA NA 23.55 23.82 090 42140 ......... ............ A Excision of uvula ........................................... 1.62 4.22 3.85 1.93 2.05 0.13 5.97 5.60 3.68 3.80 090 42145 ......... ............ A Repair palate, pharynx/uvula ........................ 9.57 NA NA 6.75 7.31 0.65 NA NA 16.97 17.53 09042160 ......... ............ A Treatment mouth roof lesion ......................... 1.80 3.61 4.09 1.60 2.12 0.17 5.58 6.06 3.57 4.09 010 42180 ......... ............ A Repair palate ................................................. 2.50 3.21 3.11 1.76 2.02 0.21 5.92 5.82 4.47 4.73 010 42182 ......... ............ A Repair palate ................................................. 3.82 4.01 3.91 2.36 2.86 0.40 8.23 8.13 6.58 7.08 010 42200 ......... ............ A Reconstruct cleft palate ................................. 12.35 NA NA 8.11 9.69 1.27 NA NA 21.73 23.31 090 42205 ......... ............ A Reconstruct cleft palate ................................. 13.51 NA NA 7.46 9.42 1.58 NA NA 22.55 24.51 090 42210 ......... ............ A Reconstruct cleft palate ................................. 14.85 NA NA 9.72 11.03 2.16 NA NA 26.73 28.04 090 42215 ......... ............ A Reconstruct cleft palate ................................. 8.81 NA NA 7.21 8.61 1.31 NA NA 17.33 18.73 090 42220 ......... ............ A Reconstruct cleft palate ................................. 7.01 NA NA 6.71 6.76 0.73 NA NA 14.45 14.50 090 42225 ......... ............ A Reconstruct cleft palate ................................. 9.59 NA NA 12.00 15.80 0.86 NA NA 22.45 26.25 090 42226 ......... ............ A Lengthening of palate .................................... 10.17 NA NA 11.33 13.86 1.01 NA NA 22.51 25.04 090 42227 ......... ............ A Lengthening of palate .................................... 9.75 NA NA 9.68 14.08 0.98 NA NA 20.41 24.81 090 42235 ......... ............ A Repair palate ................................................. 7.86 NA NA 10.27 11.46 0.72 NA NA 18.85 20.04 090 42260 ......... ............ A Repair nose to lip fistula ............................... 10.04 9.54 10.03 5.81 6.75 1.26 20.84 21.33 17.11 18.05 090 42280 ......... ............ A Preparation, palate mold ............................... 1.54 2.25 2.03 0.84 1.07 0.19 3.98 3.76 2.57 2.80 010 42281 ......... ............ A Insertion, palate prosthesis ........................... 1.93 2.82 2.68 1.56 1.79 0.17 4.92 4.78 3.66 3.89 010 42299 ......... ............ C Palate/uvula surgery ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 42300 ......... ............ A Drainage of salivary gland ............................ 1.93 2.92 2.85 1.59 1.76 0.16 5.01 4.94 3.68 3.85 010 42305 ......... ............ A Drainage of salivary gland ............................ 6.18 NA NA 3.65 4.45 0.51 NA NA 10.34 11.14 090 42310 ......... ............ A Drainage of salivary gland ............................ 1.56 2.18 2.24 1.31 1.48 0.13 3.87 3.93 3.00 3.17 010 42320 ......... ............ A Drainage of salivary gland ............................ 2.35 3.54 3.34 1.76 2.01 0.21 6.10 5.90 4.32 4.57 010 42330 ......... ............ A Removal of salivary stone ............................. 2.21 3.19 3.15 1.59 1.78 0.19 5.59 5.55 3.99 4.18 010 42335 ......... ............ A Removal of salivary stone ............................. 3.31 5.43 5.03 2.65 3.02 0.29 9.03 8.63 6.25 6.62 090 42340 ......... ............ A Removal of salivary stone ............................. 4.59 6.27 6.10 3.21 3.75 0.42 11.28 11.11 8.22 8.76 090 42400 ......... ............ A Biopsy of salivary gland ................................ 0.78 1.90 1.71 0.60 0.69 0.06 2.74 2.55 1.44 1.53 000 42405 ......... ............ A Biopsy of salivary gland ................................ 3.29 3.71 3.93 1.99 2.34 0.28 7.28 7.50 5.56 5.91 010 42408 ......... ............ A Excision of salivary cyst ................................ 4.53 6.07 5.95 3.05 3.47 0.45 11.05 10.93 8.03 8.45 090 42409 ......... ............ A Drainage of salivary cyst ............................... 2.81 5.05 4.65 2.37 2.66 0.27 8.13 7.73 5.45 5.74 090 42410 ......... ............ A Excise parotid gland/lesion ........................... 9.39 NA NA 4.90 5.89 0.91 NA NA 15.20 16.19 090 42415 ......... ............ A Excise parotid gland/lesion ........................... 17.92 NA NA 7.69 10.07 1.43 NA NA 27.04 29.42 090 42420 ......... ............ A Excise parotid gland/lesion ........................... 20.80 NA NA 8.50 11.40 1.65 NA NA 30.95 33.85 090 42425 ......... ............ A Excise parotid gland/lesion ........................... 13.24 NA NA 6.03 7.97 1.05 NA NA 20.32 22.26 090 42426 ......... ............ A Excise parotid gland/lesion ........................... 22.46 NA NA 8.77 11.95 1.80 NA NA 33.03 36.21 090 42440 ......... ............ A Excise submaxillary gland ............................. 7.02 NA NA 3.46 4.46 0.59 NA NA 11.07 12.07 090 42450 ......... ............ A Excise sublingual gland ................................. 4.61 5.87 5.89 3.66 4.10 0.42 10.90 10.92 8.69 9.13 090 42500 ......... ............ A Repair salivary duct ....................................... 4.29 5.79 5.71 3.62 4.04 0.41 10.49 10.41 8.32 8.74 090 42505 ......... ............ A Repair salivary duct ....................................... 6.17 6.73 7.02 4.32 5.10 0.55 13.45 13.74 11.04 11.82 090 42507 ......... ............ A Parotid duct diversion .................................... 6.10 NA NA 5.90 6.37 0.49 NA NA 12.49 12.96 090 42508 ......... ............ A Parotid duct diversion .................................... 9.15 NA NA 7.50 8.13 1.04 NA NA 17.69 18.32 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49139 

42509 ......... ............ A Parotid duct diversion .................................... 11.58 NA NA 8.70 9.82 0.93 NA NA 21.21 22.33 090 42510 ......... ............ A Parotid duct diversion .................................... 8.20 NA NA 6.33 7.43 0.66 NA NA 15.19 16.29 090 42550 ......... ............ A Injection for salivary x-ray ............................. 1.25 2.24 2.97 0.39 0.41 0.07 3.56 4.29 1.71 1.73 000 42600 ......... ............ A Closure of salivary fistula .............................. 4.81 6.46 6.55 3.32 3.92 0.43 11.70 11.79 8.56 9.16 090 42650 ......... ............ A Dilation of salivary duct ................................. 0.77 1.20 1.13 0.61 0.69 0.07 2.04 1.97 1.45 1.53 000 42660 ......... ............ A Dilation of salivary duct ................................. 1.13 1.43 1.37 0.73 0.82 0.09 2.65 2.59 1.95 2.04 000 42665 ......... ............ A Ligation of salivary duct ................................ 2.53 4.71 4.31 2.20 2.49 0.23 7.47 7.07 4.96 5.25 090 42699 ......... ............ C Salivary surgery procedure ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 42700 ......... ............ A Drainage of tonsil abscess ............................ 1.62 2.74 2.67 1.51 1.65 0.13 4.49 4.42 3.26 3.40 010 42720 ......... ............ A Drainage of throat abscess ........................... 6.31 4.28 4.69 2.84 3.55 0.44 11.03 11.44 9.59 10.30 010 42725 ......... ............ A Drainage of throat abscess ........................... 12.22 NA NA 6.56 7.81 0.91 NA NA 19.69 20.94 090 42800 ......... ............ A Biopsy of throat ............................................. 1.39 2.27 2.20 1.17 1.34 0.11 3.77 3.70 2.67 2.84 010 42802 ......... ............ A Biopsy of throat ............................................. 1.54 3.83 4.53 1.52 1.93 0.12 5.49 6.19 3.18 3.59 010 42804 ......... ............ A Biopsy of upper nose/throat .......................... 1.24 3.33 3.64 1.37 1.64 0.10 4.67 4.98 2.71 2.98 010 42806 ......... ............ A Biopsy of upper nose/throat .......................... 1.58 3.55 3.94 1.47 1.82 0.13 5.26 5.65 3.18 3.53 010 42808 ......... ............ A Excise pharynx lesion ................................... 2.30 2.96 3.06 1.44 1.81 0.19 5.45 5.55 3.93 4.30 010 42809 ......... ............ A Remove pharynx foreign body ...................... 1.81 2.12 2.28 1.25 1.31 0.16 4.09 4.25 3.22 3.28 010 42810 ......... ............ A Excision of neck cyst ..................................... 3.25 5.73 5.72 3.40 3.51 0.29 9.27 9.26 6.94 7.05 090 42815 ......... ............ A Excision of neck cyst ..................................... 7.18 NA NA 5.70 6.23 0.61 NA NA 13.49 14.02 090 42820 ......... ............ A Remove tonsils and adenoids ....................... 4.15 NA NA 2.53 3.10 0.31 NA NA 6.99 7.56 090 42821 ......... ............ A Remove tonsils and adenoids ....................... 4.28 NA NA 2.68 3.30 0.35 NA NA 7.31 7.93 090 42825 ......... ............ A Removal of tonsils ......................................... 3.41 NA NA 2.42 2.98 0.25 NA NA 6.08 6.64 090 42826 ......... ............ A Removal of tonsils ......................................... 3.37 NA NA 2.42 2.88 0.27 NA NA 6.06 6.52 090 42830 ......... ............ A Removal of adenoids .................................... 2.57 NA NA 2.19 2.47 0.20 NA NA 4.96 5.24 090 42831 ......... ............ A Removal of adenoids .................................... 2.71 NA NA 2.41 2.73 0.22 NA NA 5.34 5.66 090 42835 ......... ............ A Removal of adenoids .................................... 2.30 NA NA 1.79 2.29 0.21 NA NA 4.30 4.80 090 42836 ......... ............ A Removal of adenoids .................................... 3.18 NA NA 2.40 2.82 0.26 NA NA 5.84 6.26 090 42842 ......... ............ A Extensive surgery of throat ........................... 11.94 NA NA 10.96 10.98 0.71 NA NA 23.61 23.63 090 42844 ......... ............ A Extensive surgery of throat ........................... 17.49 NA NA 13.99 15.67 1.16 NA NA 32.64 34.32 090 42845 ......... ............ A Extensive surgery of throat ........................... 32.27 NA NA 19.00 22.14 1.98 NA NA 53.25 56.39 090 42860 ......... ............ A Excision of tonsil tags ................................... 2.22 NA NA 2.10 2.33 0.18 NA NA 4.50 4.73 090 42870 ......... ............ A Excision of lingual tonsil ................................ 5.39 NA NA 7.97 8.42 0.44 NA NA 13.80 14.25 090 42890 ......... ............ A Partial removal of pharynx ............................ 18.84 NA NA 13.79 14.06 1.05 NA NA 33.68 33.95 090 42892 ......... ............ A Revision of pharyngeal walls ........................ 25.67 NA NA 17.34 17.21 1.28 NA NA 44.29 44.16 090 42894 ......... ............ A Revision of pharyngeal walls ........................ 33.49 NA NA 21.04 21.78 1.86 NA NA 56.39 57.13 090 42900 ......... ............ A Repair throat wound ...................................... 5.24 NA NA 2.70 3.42 0.50 NA NA 8.44 9.16 010 42950 ......... ............ A Reconstruction of throat ................................ 8.09 NA NA 10.21 11.46 0.72 NA NA 19.02 20.27 090 42953 ......... ............ A Repair throat, esophagus .............................. 9.25 NA NA 12.87 16.22 0.88 NA NA 23.00 26.35 090 42955 ......... ............ A Surgical opening of throat ............................. 7.86 NA NA 9.37 10.35 0.80 NA NA 18.03 19.01 090 42960 ......... ............ A Control throat bleeding .................................. 2.33 NA NA 1.59 1.87 0.19 NA NA 4.11 4.39 010 42961 ......... ............ A Control throat bleeding .................................. 5.64 NA NA 4.08 4.74 0.45 NA NA 10.17 10.83 090 42962 ......... ............ A Control throat bleeding .................................. 7.25 NA NA 4.69 5.61 0.58 NA NA 12.52 13.44 090 42970 ......... ............ A Control nose/throat bleeding ......................... 5.72 NA NA 3.49 4.01 0.39 NA NA 9.60 10.12 09042971 ......... ............ A Control nose/throat bleeding ......................... 6.50 NA NA 4.08 4.86 0.51 NA NA 11.09 11.87 090 42972 ......... ............ A Control nose/throat bleeding ......................... 7.49 NA NA 4.42 5.38 0.62 NA NA 12.53 13.49 090 42999 ......... ............ C Throat surgery procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 43020 ......... ............ A Incision of esophagus ................................... 8.08 NA NA 4.32 5.14 0.87 NA NA 13.27 14.09 090 43030 ......... ............ A Throat muscle surgery .................................. 7.86 NA NA 4.13 5.15 0.70 NA NA 12.69 13.71 090 43045 ......... ............ A Incision of esophagus ................................... 21.63 NA NA 10.07 10.54 2.58 NA NA 34.28 34.75 090 43100 ......... ............ A Excision of esophagus lesion ........................ 9.48 NA NA 5.07 5.93 0.93 NA NA 15.48 16.34 09043101 ......... ............ A Excision of esophagus lesion ........................ 16.94 NA NA 7.27 7.73 2.31 NA NA 26.52 26.98 090 43107 ......... ............ A Removal of esophagus ................................. 43.89 NA NA 16.66 17.86 5.22 NA NA 65.77 66.97 090 43108 ......... ............ A Removal of esophagus ................................. 63.23 NA NA 20.50 15.78 4.07 NA NA 87.80 83.08 090 43112 ......... ............ A Removal of esophagus ................................. 47.21 NA NA 17.15 18.81 5.79 NA NA 70.15 71.81 090 43113 ......... ............ A Removal of esophagus ................................. 46.95 NA NA 17.99 15.83 4.42 NA NA 69.36 67.20 090 43116 ......... ............ A Partial removal of esophagus ....................... 71.39 NA NA 22.74 18.20 3.05 NA NA 97.18 92.64 090 43117 ......... ............ A Partial removal of esophagus ....................... 43.46 NA NA 15.40 16.80 5.17 NA NA 64.03 65.43 090 43118 ......... ............ A Partial removal of esophagus ....................... 52.07 NA NA 17.39 14.68 4.10 NA NA 73.56 70.85 090 43121 ......... ............ A Partial removal of esophagus ....................... 46.35 NA NA 17.01 14.51 3.90 NA NA 67.26 64.76 090 43122 ......... ............ A Partial removal of esophagus ....................... 43.89 NA NA 15.83 17.00 5.40 NA NA 65.12 66.29 090 43123 ......... ............ A Partial removal of esophagus ....................... 63.83 NA NA 21.00 15.83 4.15 NA NA 88.98 83.81 090 43124 ......... ............ A Removal of esophagus ................................. 64.63 NA NA 22.76 15.50 3.73 NA NA 91.12 83.86 090 43130 ......... ............ A Removal of esophagus pouch ...................... 12.33 NA NA 5.93 7.15 1.16 NA NA 19.42 20.64 090 43135 ......... ............ A Removal of esophagus pouch ...................... 22.37 NA NA 8.93 8.30 2.33 NA NA 33.63 33.00 090 43200 ......... ............ A Esophagus endoscopy .................................. 1.59 3.53 3.98 0.91 1.03 0.13 5.25 5.70 2.63 2.75 000 43201 ......... ............ A Esoph scope w/submucous inj ...................... 2.09 5.56 4.86 1.18 1.12 0.15 7.80 7.10 3.42 3.36 000 

mstockstill on PROD1PC63 with PROPOSAL_2

49140 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

43202 ......... ............ A Esophagus endoscopy, biopsy ..................... 1.89 5.13 5.44 0.97 0.95 0.15 7.17 7.48 3.01 2.99 000 43204 ......... ............ A Esoph scope w/sclerosis inj .......................... 3.76 NA NA 1.93 1.62 0.30 NA NA 5.99 5.68 000 43205 ......... ............ A Esophagus endoscopy/ligation ...................... 3.78 NA NA 2.02 1.65 0.28 NA NA 6.08 5.71 000 43215 ......... ............ A Esophagus endoscopy .................................. 2.60 NA NA 1.25 1.21 0.22 NA NA 4.07 4.03 000 43216 ......... ............ A Esophagus endoscopy/lesion ........................ 2.40 3.00 1.55 1.21 1.10 0.20 5.60 4.15 3.81 3.70 000 43217 ......... ............ A Esophagus endoscopy .................................. 2.90 6.58 6.86 1.40 1.24 0.26 9.74 10.02 4.56 4.40 000 43219 ......... ............ A Esophagus endoscopy .................................. 2.80 NA NA 1.53 1.40 0.24 NA NA 4.57 4.44 000 43220 ......... ............ A Esoph endoscopy, dilation ............................ 2.10 NA NA 1.12 1.01 0.17 NA NA 3.39 3.28 000 43226 ......... ............ A Esoph endoscopy, dilation ............................ 2.34 NA NA 1.27 1.09 0.19 NA NA 3.80 3.62 000 43227 ......... ............ A Esoph endoscopy, repair .............................. 3.59 NA NA 1.81 1.54 0.28 NA NA 5.68 5.41 000 43228 ......... ............ A Esoph endoscopy, ablation ........................... 3.76 NA NA 1.84 1.62 0.34 NA NA 5.94 5.72 000 43231 ......... ............ A Esoph endoscopy w/us exam ....................... 3.19 NA NA 1.72 1.41 0.23 NA NA 5.14 4.83 000 43232 ......... ............ A Esoph endoscopy w/us fn bx ........................ 4.47 NA NA 2.34 1.94 0.34 NA NA 7.15 6.75 000 43234 ......... ............ A Upper GI endoscopy, exam .......................... 2.01 4.98 5.24 1.01 0.91 0.17 7.16 7.42 3.19 3.09 000 43235 ......... ............ A Uppr gi endoscopy, diagnosis ....................... 2.39 5.26 5.19 1.34 1.10 0.19 7.84 7.77 3.92 3.68 000 43236 ......... ............ A Uppr gi scope w/submuc inj .......................... 2.92 6.67 6.47 1.64 1.33 0.21 9.80 9.60 4.77 4.46 000 43237 ......... ............ A Endoscopic us exam, esoph ......................... 3.98 NA NA 2.12 1.72 0.43 NA NA 6.53 6.13 000 43238 ......... ............ A Uppr gi endoscopy w/us fn bx ...................... 5.02 NA NA 2.52 2.10 0.43 NA NA 7.97 7.55 000 43239 ......... ............ A Upper GI endoscopy, biopsy ......................... 2.87 6.01 5.79 1.54 1.28 0.22 9.10 8.88 4.63 4.37 000 43240 ......... ............ A Esoph endoscope w/drain cyst ..................... 6.85 NA NA 3.41 2.80 0.56 NA NA 10.82 10.21 000 43241 ......... ............ A Upper GI endoscopy with tube ..................... 2.59 NA NA 1.40 1.18 0.21 NA NA 4.20 3.98 000 43242 ......... ............ A Uppr gi endoscopy w/us fn bx ...................... 7.30 NA NA 3.65 2.96 0.53 NA NA 11.48 10.79 000 43243 ......... ............ A Upper gi endoscopy & inject ......................... 4.56 NA NA 2.34 1.93 0.33 NA NA 7.23 6.82 000 43244 ......... ............ A Upper GI endoscopy/ligation ......................... 5.04 NA NA 2.62 2.13 0.37 NA NA 8.03 7.54 000 43245 ......... ............ A Uppr gi scope dilate strictr ............................ 3.18 NA NA 1.62 1.38 0.26 NA NA 5.06 4.82 000 43246 ......... ............ A Place gastrostomy tube ................................. 4.32 NA NA 2.10 1.79 0.34 NA NA 6.76 6.45 000 43247 ......... ............ A Operative upper GI endoscopy ..................... 3.38 NA NA 1.77 1.47 0.27 NA NA 5.42 5.12 000 43248 ......... ............ A Uppr gi endoscopy/guide wire ....................... 3.15 NA NA 1.76 1.42 0.23 NA NA 5.14 4.80 000 43249 ......... ............ A Esoph endoscopy, dilation ............................ 2.90 NA NA 1.61 1.31 0.22 NA NA 4.73 4.43 000 43250 ......... ............ A Upper GI endoscopy/tumor ........................... 3.20 NA NA 1.62 1.39 0.26 NA NA 5.08 4.85 000 43251 ......... ............ A Operative upper GI endoscopy ..................... 3.69 NA NA 1.91 1.59 0.29 NA NA 5.89 5.57 000 43255 ......... ............ A Operative upper GI endoscopy ..................... 4.81 NA NA 2.50 2.04 0.35 NA NA 7.66 7.20 000 43256 ......... ............ A Uppr gi endoscopy w/stent ............................ 4.34 NA NA 2.23 1.84 0.32 NA NA 6.89 6.50 000 43257 ......... ............ A Uppr gi scope w/thrml txmnt ......................... 5.50 NA NA 2.05 2.16 0.36 NA NA 7.91 8.02 000 43258 ......... ............ A Operative upper GI endoscopy ..................... 4.54 NA NA 2.36 1.93 0.33 NA NA 7.23 6.80 000 43259 ......... ............ A Endoscopic ultrasound exam ........................ 5.19 NA NA 2.66 2.16 0.35 NA NA 8.20 7.70 000 43260 ......... ............ A Endo cholangiopancreatograph .................... 5.95 NA NA 3.04 2.47 0.43 NA NA 9.42 8.85 000 43261 ......... ............ A Endo cholangiopancreatograph .................... 6.26 NA NA 3.19 2.59 0.46 NA NA 9.91 9.31 000 43262 ......... ............ A Endo cholangiopancreatograph .................... 7.38 NA NA 3.69 3.01 0.54 NA NA 11.61 10.93 000 43263 ......... ............ A Endo cholangiopancreatograph .................... 7.28 NA NA 3.70 3.00 0.54 NA NA 11.52 10.82 000 43264 ......... ............ A Endo cholangiopancreatograph .................... 8.89 NA NA 4.41 3.59 0.65 NA NA 13.95 13.13 000 43265 ......... ............ A Endo cholangiopancreatograph .................... 10.00 NA NA 4.90 3.99 0.73 NA NA 15.63 14.72 000 43267 ......... ............ A Endo cholangiopancreatograph .................... 7.38 NA NA 3.60 2.99 0.54 NA NA 11.52 10.91 000 43268 ......... ............ A Endo cholangiopancreatograph .................... 7.38 NA NA 3.85 3.12 0.54 NA NA 11.77 11.04 000 43269 ......... ............ A Endo cholangiopancreatograph .................... 8.20 NA NA 4.07 3.32 0.60 NA NA 12.87 12.12 000 43271 ......... ............ A Endo cholangiopancreatograph .................... 7.38 NA NA 3.70 3.01 0.54 NA NA 11.62 10.93 000 43272 ......... ............ A Endo cholangiopancreatograph .................... 7.38 NA NA 3.77 3.03 0.54 NA NA 11.69 10.95 000 43280 ......... ............ A Laparoscopy, fundoplasty ............................. 17.96 NA NA 6.73 7.14 2.27 NA NA 26.96 27.37 090 43289 ......... ............ C Laparoscope proc, esoph .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 43300 ......... ............ A Repair of esophagus ..................................... 9.13 NA NA 5.17 6.07 1.12 NA NA 15.42 16.32 090 43305 ......... ............ A Repair esophagus and fistula ....................... 17.90 NA NA 7.46 9.88 1.54 NA NA 26.90 29.32 09043310 ......... ............ A Repair of esophagus ..................................... 26.13 NA NA 10.13 10.83 3.60 NA NA 39.86 40.56 090 43312 ......... ............ A Repair esophagus and fistula ....................... 29.22 NA NA 9.96 11.41 4.00 NA NA 43.18 44.63 090 43313 ......... ............ A Esophagoplasty congenital ........................... 48.07 NA NA 17.38 18.45 5.45 NA NA 70.90 71.97 090 43314 ......... ............ A Tracheo-esophagoplasty cong ...................... 53.05 NA NA 18.43 18.99 6.63 NA NA 78.11 78.67 09043320 ......... ............ A Fuse esophagus & stomach ......................... 23.12 NA NA 8.85 9.11 2.73 NA NA 34.70 34.96 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49141 

43324 ......... ............ A Revise esophagus & stomach ...................... 22.80 NA NA 8.42 8.68 2.75 NA NA 33.97 34.23 090 43325 ......... ............ A Revise esophagus & stomach ...................... 22.41 NA NA 8.39 8.68 2.59 NA NA 33.39 33.68 090 43326 ......... ............ A Revise esophagus & stomach ...................... 22.09 NA NA 9.37 9.31 2.84 NA NA 34.30 34.24 090 43330 ......... ............ A Repair of esophagus ..................................... 22.00 NA NA 8.27 8.47 2.62 NA NA 32.89 33.09 090 43331 ......... ............ A Repair of esophagus ..................................... 22.87 NA NA 9.58 9.73 2.93 NA NA 35.38 35.53 090 43340 ......... ............ A Fuse esophagus & intestine .......................... 22.80 NA NA 9.09 8.99 2.45 NA NA 34.34 34.24 090 43341 ......... ............ A Fuse esophagus & intestine .......................... 24.04 NA NA 10.12 10.04 2.91 NA NA 37.07 36.99 090 43350 ......... ............ A Surgical opening, esophagus ........................ 19.23 NA NA 8.06 8.35 1.42 NA NA 28.71 29.00 09043351 ......... ............ A Surgical opening, esophagus ........................ 21.79 NA NA 9.60 9.74 2.46 NA NA 33.85 33.99 09043352 ......... ............ A Surgical opening, esophagus ........................ 17.62 NA NA 8.19 8.33 2.05 NA NA 27.86 28.00 09043360 ......... ............ A Gastrointestinal repair ................................... 39.82 NA NA 15.81 15.26 4.96 NA NA 60.59 60.04 090 43361 ......... ............ A Gastrointestinal repair ................................... 45.42 NA NA 16.89 16.88 4.49 NA NA 66.80 66.79 090 43400 ......... ............ A Ligate esophagus veins ................................ 25.41 NA NA 13.74 10.51 1.95 NA NA 41.10 37.87 090 43401 ......... ............ A Esophagus surgery for veins ........................ 26.30 NA NA 9.49 9.48 3.04 NA NA 38.83 38.82 09043405 ......... ............ A Ligate/staple esophagus ............................... 24.47 NA NA 10.42 9.79 2.83 NA NA 37.72 37.09 090 43410 ......... ............ A Repair esophagus wound ............................. 16.22 NA NA 7.53 7.61 1.71 NA NA 25.46 25.54 09043415 ......... ............ A Repair esophagus wound ............................. 28.62 NA NA 11.99 11.80 3.52 NA NA 44.13 43.94 090 43420 ......... ............ A Repair esophagus opening ........................... 16.59 NA NA 6.86 7.27 1.43 NA NA 24.88 25.29 09043425 ......... ............ A Repair esophagus opening ........................... 24.85 NA NA 10.38 10.07 3.02 NA NA 38.25 37.94 090 43450 ......... ............ A Dilate esophagus ........................................... 1.38 2.66 2.64 0.92 0.75 0.11 4.15 4.13 2.41 2.24 000 43453 ......... ............ A Dilate esophagus ........................................... 1.51 6.29 6.12 1.00 0.80 0.11 7.91 7.74 2.62 2.42 000 43456 ......... ............ A Dilate esophagus ........................................... 2.57 12.99 13.55 1.45 1.19 0.20 15.76 16.32 4.22 3.96 000 43458 ......... ............ A Dilate esophagus ........................................... 3.06 6.93 6.72 1.61 1.36 0.24 10.23 10.02 4.91 4.66 000 43460 ......... ............ A Pressure treatment esophagus ..................... 3.79 NA NA 1.70 1.54 0.31 NA NA 5.80 5.64 000 43496 ......... ............ C Free jejunum flap, microvasc ........................ 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 YYY 43500 ......... ............ A Surgical opening of stomach ......................... 12.67 NA NA 5.27 5.05 1.45 NA NA 19.39 19.17 090 43501 ......... ............ A Surgical repair of stomach ............................ 22.41 NA NA 8.18 8.27 2.64 NA NA 33.23 33.32 090 43502 ......... ............ A Surgical repair of stomach ............................ 25.50 NA NA 9.04 9.35 3.09 NA NA 37.63 37.94 090 43510 ......... ............ A Surgical opening of stomach ......................... 14.95 NA NA 6.89 6.66 1.48 NA NA 23.32 23.09 090 43520 ......... ............ A Incision of pyloric muscle .............................. 11.17 NA NA 4.89 5.16 1.36 NA NA 17.42 17.69 090 43600 ......... ............ A Biopsy of stomach ......................................... 1.91 NA NA 0.80 0.70 0.14 NA NA 2.85 2.75 000 43605 ......... ............ A Biopsy of stomach ......................................... 13.60 NA NA 5.46 5.33 1.58 NA NA 20.64 20.51 090 43610 ......... ............ A Excision of stomach lesion ............................ 16.22 NA NA 6.11 6.13 1.93 NA NA 24.26 24.28 090 43611 ......... ............ A Excision of stomach lesion ............................ 20.19 NA NA 7.61 7.57 2.35 NA NA 30.15 30.11 090 43620 ......... ............ A Removal of stomach ..................................... 33.85 NA NA 11.16 11.63 3.95 NA NA 48.96 49.43 090 43621 ......... ............ A Removal of stomach ..................................... 39.34 NA NA 12.57 12.12 4.03 NA NA 55.94 55.49 090 43622 ......... ............ A Removal of stomach ..................................... 39.84 NA NA 12.71 12.61 4.29 NA NA 56.84 56.74 090 43631 ......... ............ A Removal of stomach, partial ......................... 24.32 NA NA 8.68 9.03 2.98 NA NA 35.98 36.33 090 43632 ......... ............ A Removal of stomach, partial ......................... 34.95 NA NA 11.43 9.72 2.98 NA NA 49.36 47.65 090 43633 ......... ............ A Removal of stomach, partial ......................... 32.95 NA NA 10.92 9.72 3.05 NA NA 46.92 45.72 090 43634 ......... ............ A Removal of stomach, partial ......................... 36.45 NA NA 11.97 10.55 3.32 NA NA 51.74 50.32 090 43635 ......... ............ A Removal of stomach, partial ......................... 2.06 NA NA 0.53 0.66 0.27 NA NA 2.86 2.99 ZZZ 43640 ......... ............ A Vagotomy & pylorus repair ............................ 19.37 NA NA 7.42 7.29 2.25 NA NA 29.04 28.91 090 43641 ......... ............ A Vagotomy & pylorus repair ............................ 19.62 NA NA 7.72 7.45 2.24 NA NA 29.58 29.31 090 43644 ......... ............ A Lap gastric bypass/roux-en-y ........................ 29.18 NA NA 10.29 10.98 3.15 NA NA 42.62 43.31 090 43645 ......... ............ A Lap gastr bypass incl smll i ........................... 31.31 NA NA 11.27 11.83 3.53 NA NA 46.11 46.67 090 43651 ......... ............ A Laparoscopy, vagus nerve ............................ 10.13 NA NA 4.67 4.74 1.33 NA NA 16.13 16.20 090 43652 ......... ............ A Laparoscopy, vagus nerve ............................ 12.13 NA NA 5.23 5.62 1.55 NA NA 18.91 19.30 090 43653 ......... ............ A Laparoscopy, gastrostomy ............................ 8.34 NA NA 4.43 4.24 1.01 NA NA 13.78 13.59 09043659 ......... ............ C Laparoscope proc, stom ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 43750 ......... ............ A Place gastrostomy tube ................................. 4.60 NA NA 1.96 2.13 0.43 NA NA 6.99 7.16 010 43752 ......... ............ A Nasal/orogastric w/stent ................................ 0.81 NA NA 0.24 0.26 0.02 NA NA 1.07 1.09 000 43760 ......... ............ A Change gastrostomy tube ............................. 1.10 13.09 4.83 0.39 0.44 0.09 14.28 6.02 1.58 1.63 000 43761 ......... ............ A Reposition gastrostomy tube ......................... 2.01 0.98 1.12 0.64 0.66 0.13 3.12 3.26 2.78 2.80 000 43770 ......... ............ A Lap, place gastr adjust band ......................... 17.79 NA NA 7.57 7.68 2.18 NA NA 27.54 27.65 090 43771 ......... ............ A Lap, revise adjust gast band ......................... 20.58 NA NA 8.22 8.50 2.54 NA NA 31.34 31.62 090 43772 ......... ............ A Lap, remove adjust gast band ...................... 15.58 NA NA 6.03 6.32 1.92 NA NA 23.53 23.82 090 43773 ......... ............ A Lap, change adjust gast band ....................... 20.58 NA NA 8.22 8.50 2.55 NA NA 31.35 31.63 09043774 ......... ............ A Lap remov adj gast band/port ....................... 15.62 NA NA 6.22 6.48 1.84 NA NA 23.68 23.94 09043800 ......... ............ A Reconstruction of pylorus .............................. 15.31 NA NA 5.91 5.90 1.81 NA NA 23.03 23.02 090 43810 ......... ............ A Fusion of stomach and bowel ....................... 16.76 NA NA 6.28 6.20 1.93 NA NA 24.97 24.89 090 43820 ......... ............ A Fusion of stomach and bowel ....................... 22.34 NA NA 8.19 6.85 2.03 NA NA 32.56 31.22 090 43825 ......... ............ A Fusion of stomach and bowel ....................... 21.57 NA NA 7.96 8.00 2.53 NA NA 32.06 32.10 090 43830 ......... ............ A Place gastrostomy tube ................................. 10.71 NA NA 5.22 4.94 1.25 NA NA 17.18 16.90 090 43831 ......... ............ A Place gastrostomy tube ................................. 8.31 NA NA 5.17 4.68 1.03 NA NA 14.51 14.02 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49142 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

43832 ......... ............ A Place gastrostomy tube ................................. 17.22 NA NA 7.15 6.92 1.97 NA NA 26.34 26.11 090 43840 ......... ............ A Repair of stomach lesion .............................. 22.64 NA NA 8.26 7.14 2.05 NA NA 32.95 31.83 090 43842 ......... ............ N V-band gastroplasty ...................................... 20.84 NA NA 7.81 7.80 2.44 NA NA 31.09 31.08 090 43843 ......... ............ A Gastroplasty w/o v-band ............................... 21.02 NA NA 7.88 7.79 2.45 NA NA 31.35 31.26 090 43845 ......... ............ A Gastroplasty duodenal switch ....................... 33.04 NA NA 12.63 11.24 4.05 NA NA 49.72 48.33 090 43846 ......... ............ A Gastric bypass for obesity ............................. 27.15 NA NA 10.09 10.04 3.18 NA NA 40.42 40.37 090 43847 ......... ............ A Gastric bypass incl small i ............................ 30.02 NA NA 10.72 10.85 3.55 NA NA 44.29 44.42 090 43848 ......... ............ A Revision gastroplasty .................................... 32.49 NA NA 11.41 11.71 3.87 NA NA 47.77 48.07 090 43850 ......... ............ A Revise stomach-bowel fusion ....................... 27.39 NA NA 9.48 9.73 3.27 NA NA 40.14 40.39 090 43855 ......... ............ A Revise stomach-bowel fusion ....................... 28.50 NA NA 9.83 10.20 3.46 NA NA 41.79 42.16 09043860 ......... ............ A Revise stomach-bowel fusion ....................... 27.70 NA NA 9.57 9.86 3.30 NA NA 40.57 40.86 090 43865 ......... ............ A Revise stomach-bowel fusion ....................... 28.86 NA NA 10.17 10.42 3.50 NA NA 42.53 42.78 090 43870 ......... ............ A Repair stomach opening ............................... 11.32 NA NA 5.05 4.65 1.27 NA NA 17.64 17.24 090 43880 ......... ............ A Repair stomach-bowel fistula ........................ 26.99 NA NA 9.42 9.77 3.26 NA NA 39.67 40.02 090 43886 ......... ............ A Revise gastric port, open .............................. 4.50 NA NA 3.45 3.21 0.25 NA NA 8.20 7.96 090 43887 ......... ............ A Remove gastric port, open ............................ 4.20 NA NA 3.00 2.83 0.51 NA NA 7.71 7.54 090 43888 ......... ............ A Change gastric port, open ............................. 6.30 NA NA 3.94 3.81 0.70 NA NA 10.94 10.81 090 43999 ......... ............ C Stomach surgery procedure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44005 ......... ............ A Freeing of bowel adhesion ............................ 18.34 NA NA 6.67 6.70 2.14 NA NA 27.15 27.18 090 44010 ......... ............ A Incision of small bowel .................................. 14.14 NA NA 5.58 5.48 1.64 NA NA 21.36 21.26 090 44015 ......... ............ A Insert needle cath bowel ............................... 2.62 NA NA 0.69 0.83 0.35 NA NA 3.66 3.80 ZZZ 44020 ......... ............ A Explore small intestine .................................. 16.10 NA NA 6.06 5.96 1.85 NA NA 24.01 23.91 090 44021 ......... ............ A Decompress small bowel .............................. 16.19 NA NA 6.33 6.05 1.86 NA NA 24.38 24.10 090 44025 ......... ............ A Incision of large bowel .................................. 16.39 NA NA 6.19 6.06 1.89 NA NA 24.47 24.34 090 44050 ......... ............ A Reduce bowel obstruction ............................. 15.40 NA NA 5.89 5.94 1.85 NA NA 23.14 23.19 090 44055 ......... ............ A Correct malrotation of bowel ......................... 25.49 NA NA 8.60 8.69 2.90 NA NA 36.99 37.08 090 44100 ......... ............ A Biopsy of bowel ............................................. 2.01 NA NA 0.88 0.75 0.17 NA NA 3.06 2.93 000 44110 ......... ............ A Excise intestine lesion(s) ............................... 13.92 NA NA 5.58 5.31 1.55 NA NA 21.05 20.78 090 44111 ......... ............ A Excision of bowel lesion(s) ............................ 16.40 NA NA 6.20 6.13 1.86 NA NA 24.46 24.39 090 44120 ......... ............ A Removal of small intestine ............................ 20.70 NA NA 7.24 7.11 2.24 NA NA 30.18 30.05 090 44121 ......... ............ A Removal of small intestine ............................ 4.44 NA NA 1.14 1.43 0.58 NA NA 6.16 6.45 ZZZ44125 ......... ............ A Removal of small intestine ............................ 19.89 NA NA 7.10 7.21 2.26 NA NA 29.25 29.36 090 44126 ......... ............ A Enterectomy w/o taper, cong ........................ 41.94 NA NA 13.97 14.08 4.68 NA NA 60.59 60.70 090 44127 ......... ............ A Enterectomy w/taper, cong ........................... 49.01 NA NA 14.84 15.49 5.75 NA NA 69.60 70.25 090 44128 ......... ............ A Enterectomy cong, add-on ............................ 4.44 NA NA 1.07 1.42 0.61 NA NA 6.12 6.47 ZZZ 44130 ......... ............ A Bowel to bowel fusion ................................... 21.92 NA NA 8.05 6.67 1.87 NA NA 31.84 30.46 090 44137 ......... ............ C Remove intestinal allograft ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44139 ......... ............ A Mobilization of colon ...................................... 2.23 NA NA 0.56 0.71 0.28 NA NA 3.07 3.22 ZZZ 44140 ......... ............ A Partial removal of colon ................................ 22.40 NA NA 8.17 8.52 2.70 NA NA 33.27 33.62 090 44141 ......... ............ A Partial removal of colon ................................ 29.69 NA NA 11.96 10.52 2.52 NA NA 44.17 42.73 090 44143 ......... ............ A Partial removal of colon ................................ 27.57 NA NA 10.40 10.61 3.04 NA NA 41.01 41.22 090 44144 ......... ............ A Partial removal of colon ................................ 29.69 NA NA 10.75 9.90 2.85 NA NA 43.29 42.44 090 44145 ......... ............ A Partial removal of colon ................................ 28.39 NA NA 9.58 10.50 3.28 NA NA 41.25 42.17 090 44146 ......... ............ A Partial removal of colon ................................ 35.08 NA NA 13.46 13.00 3.40 NA NA 51.94 51.48 090 44147 ......... ............ A Partial removal of colon ................................ 33.50 NA NA 11.06 9.28 2.55 NA NA 47.11 45.33 090 44150 ......... ............ A Removal of colon .......................................... 29.91 NA NA 12.74 12.20 3.03 NA NA 45.68 45.14 090 44151 ......... ............ A Removal of colon/ileostomy .......................... 34.65 NA NA 14.19 13.59 3.48 NA NA 52.32 51.72 090 44152 ......... ............ A Removal of colon/ileostomy .......................... 29.91 NA NA 10.53 11.33 3.51 NA NA 43.95 44.75 090 44153 ......... ............ A Removal of colon/ileostomy .......................... 33.18 NA NA 14.40 14.38 3.54 NA NA 51.12 51.10 090 44155 ......... ............ A Removal of colon/ileostomy .......................... 34.15 NA NA 13.59 13.37 3.27 NA NA 51.01 50.79 090 44156 ......... ............ A Removal of colon/ileostomy .......................... 37.15 NA NA 14.84 14.98 3.94 NA NA 55.93 56.07 090 44160 ......... ............ A Removal of colon .......................................... 20.72 NA NA 7.60 7.71 2.36 NA NA 30.68 30.79 090 44180 ......... ............ A Lap, enterolysis ............................................. 15.15 NA NA 5.87 6.14 1.85 NA NA 22.87 23.14 090 44186 ......... ............ A Lap, jejunostomy ........................................... 10.26 NA NA 4.63 4.75 1.27 NA NA 16.16 16.28 090 44187 ......... ............ A Lap, ileo/jejuno-stomy ................................... 17.21 NA NA 8.25 8.27 1.95 NA NA 27.41 27.43 090 44188 ......... ............ A Lap, colostomy .............................................. 19.14 NA NA 8.82 8.84 2.23 NA NA 30.19 30.21 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49143 

44202 ......... ............ A Lap, enterectomy ........................................... 23.20 NA NA 8.41 8.79 2.84 NA NA 34.45 34.83 090 44203 ......... ............ A Lap resect s/intestine, addl ........................... 4.44 NA NA 1.14 1.41 0.57 NA NA 6.15 6.42 ZZZ 44204 ......... ............ A Laparo partial colectomy ............................... 26.23 NA NA 9.00 9.71 3.10 NA NA 38.33 39.04 090 44205 ......... ............ A Lap colectomy part w/ileum .......................... 22.80 NA NA 7.89 8.60 2.74 NA NA 33.43 34.14 090 44206 ......... ............ A Lap part colectomy w/stoma ......................... 29.57 NA NA 10.60 11.09 3.45 NA NA 43.62 44.11 090 44207 ......... ............ A L colectomy/coloproctostomy ........................ 31.73 NA NA 10.22 11.17 3.66 NA NA 45.61 46.56 090 44208 ......... ............ A L colectomy/coloproctostomy ........................ 33.80 NA NA 12.15 12.89 3.87 NA NA 49.82 50.56 090 44210 ......... ............ A Laparo total proctocolectomy ........................ 29.80 NA NA 11.27 11.72 3.41 NA NA 44.48 44.93 090 44211 ......... ............ A Laparo total proctocolectomy ........................ 36.79 NA NA 13.90 14.48 4.16 NA NA 54.85 55.43 090 44212 ......... ............ A Laparo total proctocolectomy ........................ 34.29 NA NA 13.27 13.58 3.77 NA NA 51.33 51.64 090 44213 ......... ............ A Lap, mobil splenic fl add-on .......................... 3.50 NA NA 0.89 1.14 0.44 NA NA 4.83 5.08 ZZZ44227 ......... ............ A Lap, close enterostomy ................................. 28.43 NA NA 9.59 10.36 3.37 NA NA 41.39 42.16 090 44238 ......... ............ C Laparoscope proc, intestine .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44300 ......... ............ A Open bowel to skin ....................................... 13.61 NA NA 5.63 5.52 1.60 NA NA 20.84 20.73 090 44310 ......... ............ A Ileostomy/jejunostomy ................................... 17.45 NA NA 6.46 6.63 1.98 NA NA 25.89 26.06 090 44312 ......... ............ A Revision of ileostomy .................................... 9.29 NA NA 4.66 4.16 0.92 NA NA 14.87 14.37 090 44314 ......... ............ A Revision of ileostomy .................................... 16.55 NA NA 6.88 6.63 1.74 NA NA 25.17 24.92 090 44316 ......... ............ A Devise bowel pouch ...................................... 23.40 NA NA 9.34 8.74 2.37 NA NA 35.11 34.51 090 44320 ......... ............ A Colostomy ...................................................... 19.69 NA NA 7.69 7.66 2.25 NA NA 29.63 29.60 090 44322 ......... ............ A Colostomy with biopsies ................................ 13.04 NA NA 9.47 8.80 1.54 NA NA 24.05 23.38 090 44340 ......... ............ A Revision of colostomy ................................... 9.06 NA NA 4.99 4.44 0.99 NA NA 15.04 14.49 090 44345 ......... ............ A Revision of colostomy ................................... 17.00 NA NA 6.98 6.91 1.96 NA NA 25.94 25.87 090 44346 ......... ............ A Revision of colostomy ................................... 19.41 NA NA 7.60 7.44 2.12 NA NA 29.13 28.97 090 44360 ......... ............ A Small bowel endoscopy ................................ 2.59 NA NA 1.50 1.20 0.19 NA NA 4.28 3.98 000 44361 ......... ............ A Small bowel endoscopy/biopsy ..................... 2.87 NA NA 1.63 1.31 0.21 NA NA 4.71 4.39 000 44363 ......... ............ A Small bowel endoscopy ................................ 3.49 NA NA 1.92 1.52 0.27 NA NA 5.68 5.28 000 44364 ......... ............ A Small bowel endoscopy ................................ 3.73 NA NA 2.00 1.62 0.27 NA NA 6.00 5.62 000 44365 ......... ............ A Small bowel endoscopy ................................ 3.31 NA NA 1.77 1.46 0.24 NA NA 5.32 5.01 000 44366 ......... ............ A Small bowel endoscopy ................................ 4.40 NA NA 2.37 1.89 0.32 NA NA 7.09 6.61 000 44369 ......... ............ A Small bowel endoscopy ................................ 4.51 NA NA 2.40 1.90 0.33 NA NA 7.24 6.74 000 44370 ......... ............ A Small bowel endoscopy/stent ........................ 4.79 NA NA 2.53 2.11 0.37 NA NA 7.69 7.27 000 44372 ......... ............ A Small bowel endoscopy ................................ 4.40 NA NA 2.12 1.83 0.35 NA NA 6.87 6.58 000 44373 ......... ............ A Small bowel endoscopy ................................ 3.49 NA NA 1.73 1.50 0.27 NA NA 5.49 5.26 000 44376 ......... ............ A Small bowel endoscopy ................................ 5.25 NA NA 2.44 2.13 0.42 NA NA 8.11 7.80 000 44377 ......... ............ A Small bowel endoscopy/biopsy ..................... 5.52 NA NA 2.77 2.29 0.40 NA NA 8.69 8.21 000 44378 ......... ............ A Small bowel endoscopy ................................ 7.12 NA NA 3.52 2.90 0.52 NA NA 11.16 10.54 000 44379 ......... ............ A S bowel endoscope w/stent .......................... 7.46 NA NA 3.28 3.00 0.62 NA NA 11.36 11.08 000 44380 ......... ............ A Small bowel endoscopy ................................ 1.05 NA NA 0.75 0.60 0.08 NA NA 1.88 1.73 000 44382 ......... ............ A Small bowel endoscopy ................................ 1.27 NA NA 0.79 0.67 0.12 NA NA 2.18 2.06 000 44383 ......... ............ A Ileoscopy w/stent ........................................... 2.94 NA NA 1.63 1.36 0.21 NA NA 4.78 4.51 000 44385 ......... ............ A Endoscopy of bowel pouch ........................... 1.82 4.90 3.74 0.89 0.79 0.15 6.87 5.71 2.86 2.76 000 44386 ......... ............ A Endoscopy, bowel pouch/biop ...................... 2.12 6.75 6.67 1.04 0.92 0.20 9.07 8.99 3.36 3.24 000 44388 ......... ............ A Colonoscopy .................................................. 2.82 6.11 5.34 1.34 1.20 0.26 9.19 8.42 4.42 4.28 000 44389 ......... ............ A Colonoscopy with biopsy ............................... 3.13 7.07 6.73 1.56 1.34 0.27 10.47 10.13 4.96 4.74 000 44390 ......... ............ A Colonoscopy for foreign body ....................... 3.82 7.98 7.33 1.78 1.56 0.32 12.12 11.47 5.92 5.70 000 44391 ......... ............ A Colonoscopy for bleeding .............................. 4.31 8.93 8.77 2.19 1.82 0.34 13.58 13.42 6.84 6.47 000 44392 ......... ............ A Colonoscopy & polypectomy ......................... 3.81 7.38 6.78 1.71 1.55 0.34 11.53 10.93 5.86 5.70 000 44393 ......... ............ A Colonoscopy, lesion removal ........................ 4.83 7.89 7.15 2.04 1.91 0.42 13.14 12.40 7.29 7.16 000 44394 ......... ............ A Colonoscopy w/snare .................................... 4.42 8.47 7.98 2.05 1.80 0.38 13.27 12.78 6.85 6.60 000 44397 ......... ............ A Colonoscopy w/stent ..................................... 4.70 NA NA 2.28 1.91 0.39 NA NA 7.37 7.00 000 44500 ......... ............ A Intro, gastrointestinal tube ............................. 0.49 NA NA 0.15 0.16 0.03 NA NA 0.67 0.68 000 44602 ......... ............ A Suture, small intestine ................................... 24.60 NA NA 7.73 6.73 2.11 NA NA 34.44 33.44 090 44603 ......... ............ A Suture, small intestine ................................... 27.97 NA NA 9.10 7.73 2.41 NA NA 39.48 38.11 090 44604 ......... ............ A Suture, large intestine ................................... 18.02 NA NA 6.14 6.37 2.11 NA NA 26.27 26.50 090 44605 ......... ............ A Repair of bowel lesion ................................... 21.96 NA NA 7.98 8.29 2.51 NA NA 32.45 32.76 090 44615 ......... ............ A Intestinal stricturoplasty ................................. 18.04 NA NA 6.64 6.66 2.06 NA NA 26.74 26.76 090 44620 ......... ............ A Repair bowel opening ................................... 14.31 NA NA 5.55 5.38 1.51 NA NA 21.37 21.20 090 44625 ......... ............ A Repair bowel opening ................................... 17.16 NA NA 6.22 6.28 1.85 NA NA 25.23 25.29 090 44626 ......... ............ A Repair bowel opening ................................... 27.78 NA NA 9.02 9.61 3.26 NA NA 40.06 40.65 090 44640 ......... ............ A Repair bowel-skin fistula ............................... 24.08 NA NA 8.15 8.47 2.77 NA NA 35.00 35.32 090 44650 ......... ............ A Repair bowel fistula ....................................... 25.00 NA NA 8.40 8.76 2.92 NA NA 36.32 36.68 090 44660 ......... ............ A Repair bowel-bladder fistula .......................... 23.79 NA NA 9.72 8.69 2.13 NA NA 35.64 34.61 090 44661 ......... ............ A Repair bowel-bladder fistula .......................... 27.23 NA NA 9.46 9.53 2.80 NA NA 39.49 39.56 090 44680 ......... ............ A Surgical revision, intestine ............................ 17.84 NA NA 6.64 6.49 1.99 NA NA 26.47 26.32 090 44700 ......... ............ A Suspend bowel w/prosthesis ......................... 17.36 NA NA 6.27 6.56 1.83 NA NA 25.46 25.75 09044701 ......... ............ A Intraop colon lavage add-on ......................... 3.10 NA NA 0.78 0.99 0.37 NA NA 4.25 4.46 ZZZ 

mstockstill on PROD1PC63 with PROPOSAL_2

49144 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

44715 ......... ............ C Prepare donor intestine ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 44720 ......... ............ A Prep donor intestine/venous ......................... 5.00 NA NA 1.25 1.60 0.37 NA NA 6.62 6.97 XXX 44721 ......... ............ A Prep donor intestine/artery ............................ 7.00 NA NA 1.81 2.25 0.97 NA NA 9.78 10.22 XXX 44799 ......... ............ C Unlisted procedure intestine .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44800 ......... ............ A Excision of bowel pouch ............................... 11.87 NA NA 5.56 5.43 1.47 NA NA 18.90 18.77 090 44820 ......... ............ A Excision of mesentery lesion ........................ 13.59 NA NA 5.66 5.53 1.59 NA NA 20.84 20.71 090 44850 ......... ............ A Repair of mesentery ...................................... 11.99 NA NA 5.06 5.02 1.39 NA NA 18.44 18.40 090 44899 ......... ............ C Bowel surgery procedure .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 44900 ......... ............ A Drain app abscess, open .............................. 12.38 NA NA 5.07 4.79 1.33 NA NA 18.78 18.50 090 44901 ......... ............ A Drain app abscess, percut ............................ 3.37 19.86 25.88 1.05 1.10 0.22 23.45 29.47 4.64 4.69 000 44950 ......... ............ A Appendectomy ............................................... 10.48 NA NA 4.09 4.26 1.31 NA NA 15.88 16.05 090 44955 ......... ............ A Appendectomy add-on .................................. 1.53 NA NA 0.40 0.51 0.20 NA NA 2.13 2.24 ZZZ 44960 ......... ............ A Appendectomy ............................................... 14.33 NA NA 5.47 5.37 1.63 NA NA 21.43 21.33 090 44970 ......... ............ A Laparoscopy, appendectomy ........................ 9.31 NA NA 4.24 4.12 1.14 NA NA 14.69 14.57 090 44979 ......... ............ C Laparoscope proc, app ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 45000 ......... ............ A Drainage of pelvic abscess ........................... 6.16 NA NA 3.56 3.11 0.52 NA NA 10.24 9.79 09045005 ......... ............ A Drainage of rectal abscess ........................... 1.99 4.00 4.04 1.60 1.59 0.25 6.24 6.28 3.84 3.83 010 45020 ......... ............ A Drainage of rectal abscess ........................... 8.37 NA NA 4.58 3.60 0.55 NA NA 13.50 12.52 090 45100 ......... ............ A Biopsy of rectum ........................................... 3.92 NA NA 2.84 2.48 0.44 NA NA 7.20 6.84 090 45108 ......... ............ A Removal of anorectal lesion .......................... 5.00 NA NA 3.08 2.85 0.59 NA NA 8.67 8.44 090 45110 ......... ............ A Removal of rectum ........................................ 30.49 NA NA 11.98 12.29 3.35 NA NA 45.82 46.13 090 45111 ......... ............ A Partial removal of rectum .............................. 17.81 NA NA 7.08 7.14 2.06 NA NA 26.95 27.01 090 45112 ......... ............ A Removal of rectum ........................................ 32.99 NA NA 10.39 11.42 3.42 NA NA 46.80 47.83 090 45113 ......... ............ A Partial proctectomy ........................................ 33.03 NA NA 11.60 12.34 3.48 NA NA 48.11 48.85 090 45114 ......... ............ A Partial removal of rectum .............................. 30.57 NA NA 10.45 10.77 3.35 NA NA 44.37 44.69 090 45116 ......... ............ A Partial removal of rectum .............................. 27.50 NA NA 9.50 9.89 2.87 NA NA 39.87 40.26 090 45119 ......... ............ A Remove rectum w/reservoir .......................... 33.29 NA NA 11.71 12.27 3.35 NA NA 48.35 48.91 090 45120 ......... ............ A Removal of rectum ........................................ 26.15 NA NA 9.44 9.95 2.89 NA NA 38.48 38.99 090 45121 ......... ............ A Removal of rectum and colon ....................... 28.83 NA NA 10.34 10.91 3.24 NA NA 42.41 42.98 090 45123 ......... ............ A Partial proctectomy ........................................ 18.64 NA NA 7.07 6.91 1.85 NA NA 27.56 27.40 090 45126 ......... ............ A Pelvic exenteration ........................................ 48.81 NA NA 17.39 18.75 4.32 NA NA 70.52 71.88 090 45130 ......... ............ A Excision of rectal prolapse ............................ 18.31 NA NA 6.73 6.75 1.79 NA NA 26.83 26.85 090 45135 ......... ............ A Excision of rectal prolapse ............................ 22.07 NA NA 9.28 8.63 2.35 NA NA 33.70 33.05 090 45136 ......... ............ A Excise ileoanal reservior ............................... 30.55 NA NA 11.86 12.35 2.81 NA NA 45.22 45.71 090 45150 ......... ............ A Excision of rectal stricture ............................. 5.72 NA NA 3.40 3.07 0.61 NA NA 9.73 9.40 090 45160 ......... ............ A Excision of rectal lesion ................................ 16.11 NA NA 6.59 6.63 1.67 NA NA 24.37 24.41 090 45170 ......... ............ A Excision of rectal lesion ................................ 12.42 NA NA 5.41 5.28 1.35 NA NA 19.18 19.05 090 45190 ......... ............ A Destruction, rectal tumor ............................... 10.23 NA NA 5.55 4.85 1.13 NA NA 16.91 16.21 090 45300 ......... ............ A Proctosigmoidoscopy dx ............................... 0.38 2.00 1.65 0.35 0.30 0.04 2.42 2.07 0.77 0.72 000 45303 ......... ............ A Proctosigmoidoscopy dilate ........................... 0.44 19.63 18.92 0.38 0.34 0.05 20.12 19.41 0.87 0.83 000 45305 ......... ............ A Proctosigmoidoscopy w/bx ............................ 1.01 3.31 2.80 0.53 0.51 0.11 4.43 3.92 1.65 1.63 000 45307 ......... ............ A Proctosigmoidoscopy fb ................................ 0.94 3.52 3.15 0.51 0.49 0.11 4.57 4.20 1.56 1.54 000 45308 ......... ............ A Proctosigmoidoscopy removal ...................... 0.83 3.30 2.32 0.49 0.45 0.09 4.22 3.24 1.41 1.37 000 45309 ......... ............ A Proctosigmoidoscopy removal ...................... 2.01 3.73 3.04 0.83 0.84 0.22 5.96 5.27 3.06 3.07 000 45315 ......... ............ A Proctosigmoidoscopy removal ...................... 1.40 3.74 3.08 0.65 0.64 0.15 5.29 4.63 2.20 2.19 000 45317 ......... ............ A Proctosigmoidoscopy bleed .......................... 1.50 3.83 2.78 0.66 0.66 0.15 5.48 4.43 2.31 2.31 000 45320 ......... ............ A Proctosigmoidoscopy ablate ......................... 1.58 4.49 3.31 0.75 0.72 0.16 6.23 5.05 2.49 2.46 000 45321 ......... ............ A Proctosigmoidoscopy volvul .......................... 1.17 NA NA 0.65 0.58 0.13 NA NA 1.95 1.88 000 45327 ......... ............ A Proctosigmoidoscopy w/stent ........................ 1.65 NA NA 0.83 0.73 0.16 NA NA 2.64 2.54 000 45330 ......... ............ A Diagnostic sigmoidoscopy ............................. 0.96 2.49 2.33 0.61 0.53 0.08 3.53 3.37 1.65 1.57 000 45331 ......... ............ A Sigmoidoscopy and biopsy ........................... 1.15 3.24 3.11 0.78 0.64 0.09 4.48 4.35 2.02 1.88 000 45332 ......... ............ A Sigmoidoscopy w/fb removal ........................ 1.79 5.62 5.16 1.02 0.86 0.16 7.57 7.11 2.97 2.81 000 45333 ......... ............ A Sigmoidoscopy & polypectomy ..................... 1.79 5.63 5.06 0.98 0.85 0.15 7.57 7.00 2.92 2.79 000 45334 ......... ............ A Sigmoidoscopy for bleeding .......................... 2.73 NA NA 1.52 1.24 0.20 NA NA 4.45 4.17 000 45335 ......... ............ A Sigmoidoscopy w/submuc inj ........................ 1.46 5.32 3.74 0.90 0.74 0.11 6.89 5.31 2.47 2.31 000 45337 ......... ............ A Sigmoidoscopy & decompress ...................... 2.36 NA NA 1.23 1.06 0.21 NA NA 3.80 3.63 000 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49145 

45338 ......... ............ A Sigmoidoscopy w/tumr remove ..................... 2.34 5.85 5.37 1.26 1.07 0.19 8.38 7.90 3.79 3.60 000 45339 ......... ............ A Sigmoidoscopy w/ablate tumr ....................... 3.14 5.73 4.03 1.66 1.38 0.26 9.13 7.43 5.06 4.78 000 45340 ......... ............ A Sig w/balloon dilation .................................... 1.89 10.25 7.19 1.03 0.88 0.15 12.29 9.23 3.07 2.92 000 45341 ......... ............ A Sigmoidoscopy w/ultrasound ......................... 2.60 NA NA 1.45 1.17 0.19 NA NA 4.24 3.96 000 45342 ......... ............ A Sigmoidoscopy w/us guide bx ....................... 4.05 NA NA 2.15 1.69 0.30 NA NA 6.50 6.04 000 45345 ......... ............ A Sigmoidoscopy w/stent .................................. 2.92 NA NA 1.53 1.25 0.23 NA NA 4.68 4.40 000 45355 ......... ............ A Surgical colonoscopy .................................... 3.51 NA NA 1.55 1.42 0.36 NA NA 5.42 5.29 000 45378 ......... ............ A Diagnostic colonoscopy ................................. 3.69 6.36 6.20 1.81 1.56 0.30 10.35 10.19 5.80 5.55 000 45378 ......... 53 ....... A Diagnostic colonoscopy ................................. 0.96 2.49 2.33 0.61 0.53 0.08 3.53 3.37 1.65 1.57 000 45379 ......... ............ A Colonoscopy w/fb removal ............................ 4.68 8.14 7.78 2.20 1.91 0.39 13.21 12.85 7.27 6.98 000 45380 ......... ............ A Colonoscopy and biopsy ............................... 4.43 7.71 7.32 2.22 1.85 0.35 12.49 12.10 7.00 6.63 000 45381 ......... ............ A Colonoscopy, submucous inj ........................ 4.19 7.68 7.25 2.14 1.77 0.30 12.17 11.74 6.63 6.26 000 45382 ......... ............ A Colonoscopy/control bleeding ....................... 5.68 10.31 10.03 2.87 2.35 0.41 16.40 16.12 8.96 8.44 000 45383 ......... ............ A Lesion removal colonoscopy ......................... 5.86 8.54 8.08 2.63 2.32 0.48 14.88 14.42 8.97 8.66 000 45384 ......... ............ A Lesion remove colonoscopy .......................... 4.69 7.20 6.90 2.19 1.91 0.38 12.27 11.97 7.26 6.98 000 45385 ......... ............ A Lesion removal colonoscopy ......................... 5.30 8.33 7.93 2.57 2.17 0.42 14.05 13.65 8.29 7.89 000 45386 ......... ............ A Colonoscopy dilate stricture .......................... 4.57 12.31 12.38 2.16 1.88 0.39 17.27 17.34 7.12 6.84 000 45387 ......... ............ A Colonoscopy w/stent ..................................... 5.90 NA NA 2.89 2.47 0.48 NA NA 9.27 8.85 000 45391 ......... ............ A Colonoscopy w/endoscope us ...................... 5.09 NA NA 2.54 2.11 0.42 NA NA 8.05 7.62 000 45392 ......... ............ A Colonoscopy w/endoscopic fnb ..................... 6.54 NA NA 3.10 2.64 0.42 NA NA 10.06 9.60 000 45395 ......... ............ A Lap, removal of rectum ................................. 32.71 NA NA 13.06 13.52 3.62 NA NA 49.39 49.85 090 45397 ......... ............ A Lap, remove rectum w/pouch ........................ 36.21 NA NA 13.59 14.09 3.66 NA NA 53.46 53.96 090 45400 ......... ............ A Laparoscopic proctopexy .............................. 19.25 NA NA 7.18 7.67 2.02 NA NA 28.45 28.94 090 45402 ......... ............ A Lap proctopexy w/sig resect ......................... 26.32 NA NA 8.87 9.70 2.81 NA NA 38.00 38.83 090 45499 ......... ............ C Laparoscope proc, rectum ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 45500 ......... ............ A Repair of rectum ............................................ 7.58 NA NA 4.35 3.74 0.75 NA NA 12.68 12.07 090 45505 ......... ............ A Repair of rectum ............................................ 8.14 NA NA 5.11 4.17 0.86 NA NA 14.11 13.17 090 45520 ......... ............ A Treatment of rectal prolapse ......................... 0.55 3.07 2.00 0.41 0.38 0.05 3.67 2.60 1.01 0.98 000 45540 ......... ............ A Correct rectal prolapse .................................. 17.98 NA NA 5.89 6.57 1.84 NA NA 25.71 26.39 090 45541 ......... ............ A Correct rectal prolapse .................................. 14.66 NA NA 6.59 6.10 1.55 NA NA 22.80 22.31 090 45550 ......... ............ A Repair rectum/remove sigmoid ..................... 24.61 NA NA 9.02 9.16 2.61 NA NA 36.24 36.38 090 45560 ......... ............ A Repair of rectocele ........................................ 11.38 NA NA 5.52 5.17 1.13 NA NA 18.03 17.68 090 45562 ......... ............ A Exploration/repair of rectum .......................... 17.74 NA NA 8.17 7.28 1.83 NA NA 27.74 26.85 090 45563 ......... ............ A Exploration/repair of rectum .......................... 26.14 NA NA 10.97 10.63 3.10 NA NA 40.21 39.87 090 45800 ......... ............ A Repair rect/bladder fistula ............................. 20.12 NA NA 9.23 7.87 1.85 NA NA 31.20 29.84 090 45805 ......... ............ A Repair fistula w/colostomy ............................ 23.13 NA NA 9.26 9.44 2.02 NA NA 34.41 34.59 090 45820 ......... ............ A Repair rectourethral fistula ............................ 20.18 NA NA 9.29 8.04 1.58 NA NA 31.05 29.80 090 45825 ......... ............ A Repair fistula w/colostomy ............................ 23.93 NA NA 10.94 10.09 2.31 NA NA 37.18 36.33 090 45900 ......... ............ A Reduction of rectal prolapse ......................... 2.94 NA NA 1.70 1.55 0.30 NA NA 4.94 4.79 010 45905 ......... ............ A Dilation of anal sphincter ............................... 2.30 NA NA 1.65 1.49 0.27 NA NA 4.22 4.06 010 45910 ......... ............ A Dilation of rectal narrowing ........................... 2.80 NA NA 1.80 1.70 0.30 NA NA 4.90 4.80 010 45915 ......... ............ A Remove rectal obstruction ............................ 3.14 4.26 4.31 2.04 2.08 0.30 7.70 7.75 5.48 5.52 010 45990 ......... ............ A Surg dx exam, anorectal ............................... 1.80 NA NA 0.78 0.79 0.17 NA NA 2.75 2.76 00045999 ......... ............ C Rectum surgery procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 46020 ......... ............ A Placement of seton ....................................... 2.90 3.29 2.57 2.37 1.98 0.31 6.50 5.78 5.58 5.19 010 46030 ......... ............ A Removal of rectal marker .............................. 1.23 1.90 1.49 0.81 0.74 0.14 3.27 2.86 2.18 2.11 010 46040 ......... ............ A Incision of rectal abscess .............................. 5.20 6.58 5.76 4.01 3.69 0.62 12.40 11.58 9.83 9.51 090 46045 ......... ............ A Incision of rectal abscess .............................. 5.75 NA NA 3.93 3.15 0.54 NA NA 10.22 9.44 090 46050 ......... ............ A Incision of anal abscess ................................ 1.19 3.21 2.71 0.98 0.88 0.14 4.54 4.04 2.31 2.21 010 46060 ......... ............ A Incision of rectal abscess .............................. 6.18 NA NA 3.99 3.43 0.67 NA NA 10.84 10.28 090 46070 ......... ............ A Incision of anal septum ................................. 2.71 NA NA 2.35 1.96 0.36 NA NA 5.42 5.03 090 46080 ......... ............ A Incision of anal sphincter .............................. 2.49 3.09 2.54 1.13 1.13 0.30 5.88 5.33 3.92 3.92 010 46083 ......... ............ A Incise external hemorrhoid ............................ 1.40 2.36 2.48 0.95 0.93 0.15 3.91 4.03 2.50 2.48 010 46200 ......... ............ A Removal of anal fissure ................................ 3.41 6.32 4.47 3.74 3.08 0.39 10.12 8.27 7.54 6.88 090 46210 ......... ............ A Removal of anal crypt ................................... 2.67 6.00 5.33 3.39 2.81 0.31 8.98 8.31 6.37 5.79 090 46211 ......... ............ A Removal of anal crypts ................................. 4.24 7.18 5.85 4.13 3.66 0.48 11.90 10.57 8.85 8.38 090 46220 ......... ............ A Removal of anal tag ...................................... 1.56 3.01 2.47 1.10 0.99 0.17 4.74 4.20 2.83 2.72 010 46221 ......... ............ A Ligation of hemorrhoid(s) .............................. 2.29 3.75 2.92 2.00 1.81 0.23 6.27 5.44 4.52 4.33 010 46230 ......... ............ A Removal of anal tags .................................... 2.57 3.52 3.18 1.34 1.30 0.30 6.39 6.05 4.21 4.17 010 46250 ......... ............ A Hemorrhoidectomy ........................................ 4.13 6.02 5.48 2.86 2.67 0.48 10.63 10.09 7.47 7.28 090 46255 ......... ............ A Hemorrhoidectomy ........................................ 4.84 6.44 5.98 3.12 2.90 0.58 11.86 11.40 8.54 8.32 090 46257 ......... ............ A Remove hemorrhoids & fissure ..................... 5.64 NA NA 3.80 3.10 0.64 NA NA 10.08 9.38 090 46258 ......... ............ A Remove hemorrhoids & fistula ...................... 6.22 NA NA 4.01 3.46 0.68 NA NA 10.91 10.36 090 46260 ......... ............ A Hemorrhoidectomy ........................................ 6.61 NA NA 4.06 3.40 0.76 NA NA 11.43 10.77 090 46261 ......... ............ A Remove hemorrhoids & fissure ..................... 7.57 NA NA 4.32 3.78 0.79 NA NA 12.68 12.14 090 46262 ......... ............ A Remove hemorrhoids & fistula ...................... 7.74 NA NA 4.68 3.97 0.83 NA NA 13.25 12.54 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49146 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

46270 ......... ............ A Removal of anal fistula .................................. 4.75 6.33 5.33 3.91 3.10 0.46 11.54 10.54 9.12 8.31 090 46275 ......... ............ A Removal of anal fistula .................................. 5.25 6.66 5.14 4.00 3.23 0.52 12.43 10.91 9.77 9.00 090 46280 ......... ............ A Removal of anal fistula .................................. 6.22 NA NA 4.26 3.50 0.66 NA NA 11.14 10.38 090 46285 ......... ............ A Removal of anal fistula .................................. 5.25 6.54 4.46 3.95 3.04 0.44 12.23 10.15 9.64 8.73 090 46288 ......... ............ A Repair anal fistula ......................................... 7.62 NA NA 4.67 3.92 0.79 NA NA 13.08 12.33 090 46320 ......... ............ A Removal of hemorrhoid clot .......................... 1.61 2.42 2.20 0.89 0.86 0.18 4.21 3.99 2.68 2.65 010 46500 ......... ............ A Injection into hemorrhoid(s) ........................... 1.61 3.61 2.49 1.25 1.18 0.16 5.38 4.26 3.02 2.95 010 46505 ......... ............ A Chemodenervation anal musc ...................... 3.11 3.30 3.11 2.31 2.05 0.14 6.55 6.36 5.56 5.30 010 46600 ......... ............ A Diagnostic anoscopy ..................................... 0.50 1.48 1.54 0.37 0.35 0.05 2.03 2.09 0.92 0.90 000 46604 ......... ............ A Anoscopy and dilation ................................... 1.31 12.65 10.00 0.58 0.61 0.12 14.08 11.43 2.01 2.04 000 46606 ......... ............ A Anoscopy and biopsy .................................... 0.81 4.02 3.84 0.48 0.44 0.09 4.92 4.74 1.38 1.34 000 46608 ......... ............ A Anoscopy, remove for body .......................... 1.51 4.06 4.32 0.62 0.64 0.16 5.73 5.99 2.29 2.31 000 46610 ......... ............ A Anoscopy, remove lesion .............................. 1.32 4.29 4.10 0.66 0.62 0.15 5.76 5.57 2.13 2.09 000 46611 ......... ............ A Anoscopy ....................................................... 1.81 2.88 3.22 0.72 0.77 0.19 4.88 5.22 2.72 2.77 000 46612 ......... ............ A Anoscopy, remove lesions ............................ 2.34 5.51 5.26 0.95 0.97 0.28 8.13 7.88 3.57 3.59 000 46614 ......... ............ A Anoscopy, control bleeding ........................... 2.01 2.78 2.44 0.82 0.84 0.20 4.99 4.65 3.03 3.05 000 46615 ......... ............ A Anoscopy ....................................................... 2.68 2.43 2.47 0.97 1.05 0.33 5.44 5.48 3.98 4.06 000 46700 ......... ............ A Repair of anal stricture .................................. 9.62 NA NA 4.72 4.33 0.94 NA NA 15.28 14.89 090 46705 ......... ............ A Repair of anal stricture .................................. 7.25 NA NA 4.08 3.78 0.91 NA NA 12.24 11.94 090 46706 ......... ............ A Repr of anal fistula w/glue ............................ 2.39 NA NA 1.45 1.30 0.28 NA NA 4.12 3.97 010 46710 ......... ............ A Repr per/vag pouch sngl proc ....................... 16.95 NA NA 7.79 7.76 1.38 NA NA 26.12 26.09 09046712 ......... ............ A Repr per/vag pouch dbl proc ........................ 36.26 NA NA 14.16 14.82 3.66 NA NA 54.08 54.74 090 46715 ......... ............ A Rep perf anoper fistu .................................... 7.49 NA NA 3.77 3.62 0.92 NA NA 12.18 12.03 090 46716 ......... ............ A Rep perf anoper/vestib fistu .......................... 17.04 NA NA 9.66 8.39 1.58 NA NA 28.28 27.01 090 46730 ......... ............ A Construction of absent anus ......................... 30.05 NA NA 11.66 11.93 2.46 NA NA 44.17 44.44 090 46735 ......... ............ A Construction of absent anus ......................... 35.54 NA NA 13.36 13.50 3.20 NA NA 52.10 52.24 090 46740 ......... ............ A Construction of absent anus ......................... 33.30 NA NA 14.66 13.58 2.41 NA NA 50.37 49.29 090 46742 ......... ............ A Repair of imperforated anus ......................... 39.54 NA NA 16.19 17.08 3.19 NA NA 58.92 59.81 090 46744 ......... ............ A Repair of cloacal anomaly ............................. 58.34 NA NA 21.08 21.10 6.38 NA NA 85.80 85.82 090 46746 ......... ............ A Repair of cloacal anomaly ............................. 64.79 NA NA 19.85 23.82 7.68 NA NA 92.32 96.29 090 46748 ......... ............ A Repair of cloacal anomaly ............................. 70.77 NA NA 21.25 23.04 3.36 NA NA 95.38 97.17 090 46750 ......... ............ A Repair of anal sphincter ................................ 11.96 NA NA 5.81 5.24 1.10 NA NA 18.87 18.30 090 46751 ......... ............ A Repair of anal sphincter ................................ 9.12 NA NA 4.45 5.17 0.94 NA NA 14.51 15.23 090 46753 ......... ............ A Reconstruction of anus ................................. 8.77 NA NA 4.61 4.03 0.94 NA NA 14.32 13.74 090 46754 ......... ............ A Removal of suture from anus ........................ 2.82 3.73 3.63 2.27 1.82 0.19 6.74 6.64 5.28 4.83 010 46760 ......... ............ A Repair of anal sphincter ................................ 17.11 NA NA 8.26 7.38 1.59 NA NA 26.96 26.08 090 46761 ......... ............ A Repair of anal sphincter ................................ 15.10 NA NA 6.45 6.11 1.43 NA NA 22.98 22.64 090 46762 ......... ............ A Implant artificial sphincter .............................. 14.58 NA NA 6.79 5.83 1.24 NA NA 22.61 21.65 090 46900 ......... ............ A Destruction, anal lesion(s) ............................. 1.91 3.62 2.84 1.30 1.28 0.17 5.70 4.92 3.38 3.36 010 46910 ......... ............ A Destruction, anal lesion(s) ............................. 1.86 3.88 3.15 1.20 1.10 0.19 5.93 5.20 3.25 3.15 010 46916 ......... ............ A Cryosurgery, anal lesion(s) ........................... 1.86 3.70 3.29 1.54 1.43 0.11 5.67 5.26 3.51 3.40 010 46917 ......... ............ A Laser surgery, anal lesions ........................... 1.86 8.73 9.02 1.21 1.14 0.21 10.80 11.09 3.28 3.21 010 46922 ......... ............ A Excision of anal lesion(s) .............................. 1.86 4.15 3.49 1.20 1.10 0.22 6.23 5.57 3.28 3.18 010 46924 ......... ............ A Destruction, anal lesion(s) ............................. 2.76 9.61 8.91 1.52 1.39 0.26 12.63 11.93 4.54 4.41 010 46934 ......... ............ A Destruction of hemorrhoids ........................... 3.75 5.41 5.16 2.80 2.91 0.32 9.48 9.23 6.87 6.98 090 46935 ......... ............ A Destruction of hemorrhoids ........................... 2.43 3.70 3.52 1.08 1.18 0.23 6.36 6.18 3.74 3.84 010 46936 ......... ............ A Destruction of hemorrhoids ........................... 3.68 6.16 5.19 2.60 2.52 0.34 10.18 9.21 6.62 6.54 090 46937 ......... ............ A Cryotherapy of rectal lesion .......................... 2.69 4.01 3.08 1.80 1.37 0.14 6.84 5.91 4.63 4.20 010 46938 ......... ............ A Cryotherapy of rectal lesion .......................... 4.65 5.85 4.46 3.66 3.20 0.58 11.08 9.69 8.89 8.43 090 46940 ......... ............ A Treatment of anal fissure .............................. 2.32 2.85 2.21 1.04 1.08 0.23 5.40 4.76 3.59 3.63 010 46942 ......... ............ A Treatment of anal fissure .............................. 2.04 2.80 2.07 0.95 1.00 0.19 5.03 4.30 3.18 3.23 010 46945 ......... ............ A Ligation of hemorrhoids ................................. 2.09 4.83 3.65 3.00 2.60 0.19 7.11 5.93 5.28 4.88 090 46946 ......... ............ A Ligation of hemorrhoids ................................. 2.58 4.65 3.95 2.66 2.46 0.27 7.50 6.80 5.51 5.31 090 46947 ......... ............ A Hemorrhoidopexy by stapling ........................ 5.45 NA NA 3.12 2.81 0.75 NA NA 9.32 9.01 090 46999 ......... ............ C Anus surgery procedure ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47000 ......... ............ A Needle biopsy of liver .................................... 1.90 7.68 4.22 0.63 0.63 0.12 9.70 6.24 2.65 2.65 000 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49147 

47001 ......... ............ A Needle biopsy, liver add-on .......................... 1.90 NA NA 0.49 0.61 0.25 NA NA 2.64 2.76 ZZZ 47010 ......... ............ A Open drainage, liver lesion ........................... 19.21 NA NA 8.34 8.38 1.80 NA NA 29.35 29.39 090 47011 ......... ............ A Percut drain, liver lesion ................................ 3.69 NA NA 1.18 1.20 0.22 NA NA 5.09 5.11 000 47015 ......... ............ A Inject/aspirate liver cyst ................................. 18.31 NA NA 7.92 7.59 1.83 NA NA 28.06 27.73 090 47100 ......... ............ A Wedge biopsy of liver .................................... 12.72 NA NA 6.39 6.12 1.53 NA NA 20.64 20.37 090 47120 ......... ............ A Partial removal of liver .................................. 38.74 NA NA 14.23 14.91 4.65 NA NA 57.62 58.30 090 47122 ......... ............ A Extensive removal of liver ............................. 59.29 NA NA 19.03 20.84 7.19 NA NA 85.51 87.32 090 47125 ......... ............ A Partial removal of liver .................................. 52.85 NA NA 17.27 18.94 6.45 NA NA 76.57 78.24 090 47130 ......... ............ A Partial removal of liver .................................. 57.00 NA NA 18.28 20.29 6.94 NA NA 82.22 84.23 090 47135 ......... ............ R Transplantation of liver .................................. 83.15 NA NA 28.01 30.63 9.93 NA NA 121.09 123.71 090 47136 ......... ............ R Transplantation of liver .................................. 70.25 NA NA 23.80 26.21 8.41 NA NA 102.46 104.87 090 47140 ......... ............ A Partial removal, donor liver ........................... 59.14 NA NA 21.89 22.18 5.17 NA NA 86.20 86.49 090 47141 ......... ............ A Partial removal, donor liver ........................... 71.17 NA NA 25.67 26.59 5.17 NA NA 102.01 102.93 090 47142 ......... ............ A Partial removal, donor liver ........................... 79.11 NA NA 27.72 29.03 5.17 NA NA 112.00 113.31 090 47143 ......... ............ C Prep donor liver, whole ................................. 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 090 47146 ......... ............ A Prep donor liver/venous ................................ 6.00 NA NA 1.54 1.92 0.83 NA NA 8.37 8.75 XXX 47147 ......... ............ A Prep donor liver/arterial ................................. 7.00 NA NA 1.80 2.24 0.97 NA NA 9.77 10.21 XXX 47300 ......... ............ A Surgery for liver lesion .................................. 17.95 NA NA 7.71 7.34 1.98 NA NA 27.64 27.27 090 47350 ......... ............ A Repair liver wound ........................................ 22.30 NA NA 8.95 8.88 2.58 NA NA 33.83 33.76 090 47360 ......... ............ A Repair liver wound ........................................ 31.12 NA NA 11.51 11.56 3.37 NA NA 46.00 46.05 090 47361 ......... ............ A Repair liver wound ........................................ 52.41 NA NA 16.93 18.12 5.85 NA NA 75.19 76.38 090 47362 ......... ............ A Repair liver wound ........................................ 23.35 NA NA 9.35 8.87 2.50 NA NA 35.20 34.72 090 47370 ......... ............ A Laparo ablate liver tumor rf ........................... 20.61 NA NA 7.75 8.04 2.55 NA NA 30.91 31.20 090 47371 ......... ............ A Laparo ablate liver cryosurg .......................... 20.61 NA NA 8.16 8.15 2.60 NA NA 31.37 31.36 090 47379 ......... ............ C Laparoscope procedure, liver ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47380 ......... ............ A Open ablate liver tumor rf ............................. 24.37 NA NA 8.69 9.19 2.86 NA NA 35.92 36.42 090 47381 ......... ............ A Open ablate liver tumor cryo ......................... 24.64 NA NA 9.23 9.49 2.84 NA NA 36.71 36.97 090 47382 ......... ............ A Percut ablate liver rf ...................................... 15.17 NA NA 5.68 5.97 0.96 NA NA 21.81 22.10 010 47399 ......... ............ C Liver surgery procedure ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47400 ......... ............ A Incision of liver duct ...................................... 36.17 NA NA 13.24 13.38 3.07 NA NA 52.48 52.62 090 47420 ......... ............ A Incision of bile duct ....................................... 21.86 NA NA 8.69 8.74 2.62 NA NA 33.17 33.22 090 47425 ......... ............ A Incision of bile duct ....................................... 22.14 NA NA 8.70 8.78 2.61 NA NA 33.45 33.53 090 47460 ......... ............ A Incise bile duct sphincter ............................... 20.35 NA NA 9.06 8.54 2.20 NA NA 31.61 31.09 090 47480 ......... ............ A Incision of gallbladder ................................... 13.06 NA NA 6.72 6.11 1.42 NA NA 21.20 20.59 090 47490 ......... ............ A Incision of gallbladder ................................... 8.00 NA NA 5.02 5.43 0.43 NA NA 13.45 13.86 090 47500 ......... ............ A Injection for liver x-rays ................................. 1.96 NA NA 0.64 0.64 0.12 NA NA 2.72 2.72 000 47505 ......... ............ A Injection for liver x-rays ................................. 0.76 NA NA 0.25 0.25 0.04 NA NA 1.05 1.05 000 47510 ......... ............ A Insert catheter, bile duct ................................ 7.88 NA NA 4.35 4.85 0.46 NA NA 12.69 13.19 090 47511 ......... ............ A Insert bile duct drain ...................................... 10.72 NA NA 4.67 4.98 0.62 NA NA 16.01 16.32 090 47525 ......... ............ A Change bile duct catheter ............................. 5.54 14.92 15.05 2.51 2.73 0.33 20.79 20.92 8.38 8.60 010 47530 ......... ............ A Revise/reinsert bile tube ................................ 5.90 30.79 33.03 3.26 3.60 0.37 37.06 39.30 9.53 9.87 090 47550 ......... ............ A Bile duct endoscopy add-on .......................... 3.02 NA NA 0.79 0.96 0.40 NA NA 4.21 4.38 ZZZ 47552 ......... ............ A Biliary endoscopy thru skin ........................... 6.03 NA NA 2.32 2.36 0.42 NA NA 8.77 8.81 00047553 ......... ............ A Biliary endoscopy thru skin ........................... 6.34 NA NA 2.05 2.06 0.37 NA NA 8.76 8.77 00047554 ......... ............ A Biliary endoscopy thru skin ........................... 9.05 NA NA 3.12 3.29 0.96 NA NA 13.13 13.30 000 47555 ......... ............ A Biliary endoscopy thru skin ........................... 7.55 NA NA 2.50 2.47 0.45 NA NA 10.50 10.47 000 47556 ......... ............ A Biliary endoscopy thru skin ........................... 8.55 NA NA 2.77 2.78 0.50 NA NA 11.82 11.83 000 47560 ......... ............ A Laparoscopy w/cholangio .............................. 4.88 NA NA 1.26 1.57 0.65 NA NA 6.79 7.10 000 47561 ......... ............ A Laparo w/cholangio/biopsy ............................ 5.17 NA NA 1.57 1.83 0.66 NA NA 7.40 7.66 000 47562 ......... ............ A Laparoscopic cholecystectomy ..................... 11.57 NA NA 5.32 5.07 1.46 NA NA 18.35 18.10 090 47563 ......... ............ A Laparo cholecystectomy/graph ..................... 11.98 NA NA 5.13 5.25 1.58 NA NA 18.69 18.81 090 47564 ......... ............ A Laparo cholecystectomy/explr ....................... 14.21 NA NA 5.50 5.83 1.88 NA NA 21.59 21.92 09047570 ......... ............ A Laparo cholecystoenterostomy ..................... 12.56 NA NA 5.10 5.30 1.65 NA NA 19.31 19.51 090 47579 ......... ............ C Laparoscope proc, biliary .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 47600 ......... ............ A Removal of gallbladder ................................. 15.44 NA NA 6.82 6.30 1.79 NA NA 24.05 23.53 090 47605 ......... ............ A Removal of gallbladder ................................. 15.86 NA NA 6.46 6.48 1.94 NA NA 24.26 24.28 090 47610 ......... ............ A Removal of gallbladder ................................. 20.80 NA NA 7.78 7.89 2.48 NA NA 31.06 31.17 090 47612 ......... ............ A Removal of gallbladder ................................. 21.09 NA NA 7.78 7.85 2.47 NA NA 31.34 31.41 090 47620 ......... ............ A Removal of gallbladder ................................. 22.95 NA NA 8.29 8.46 2.73 NA NA 33.97 34.14 090 47630 ......... ............ A Remove bile duct stone ................................ 9.52 NA NA 4.55 4.80 0.65 NA NA 14.72 14.97 090 47700 ......... ............ A Exploration of bile ducts ................................ 16.32 NA NA 7.33 7.38 2.06 NA NA 25.71 25.76 090 47701 ......... ............ A Bile duct revision ........................................... 28.55 NA NA 10.18 11.15 3.67 NA NA 42.40 43.37 090 47711 ......... ............ A Excision of bile duct tumor ............................ 25.71 NA NA 9.68 9.85 3.04 NA NA 38.43 38.60 090 47712 ......... ............ A Excision of bile duct tumor ............................ 33.53 NA NA 11.69 12.22 3.92 NA NA 49.14 49.67 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49148 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

47715 ......... ............ A Excision of bile duct cyst ............................... 21.36 NA NA 8.64 8.48 2.48 NA NA 32.48 32.32 090 47716 ......... ............ A Fusion of bile duct cyst ................................. 19.01 NA NA 7.99 7.86 2.14 NA NA 29.14 29.01 090 47720 ......... ............ A Fuse gallbladder & bowel .............................. 18.15 NA NA 7.80 7.55 2.10 NA NA 28.05 27.80 090 47721 ......... ............ A Fuse upper gi structures ............................... 21.80 NA NA 8.69 8.59 2.52 NA NA 33.01 32.91 090 47740 ......... ............ A Fuse gallbladder & bowel .............................. 21.04 NA NA 8.56 8.41 2.41 NA NA 32.01 31.86 090 47741 ......... ............ A Fuse gallbladder & bowel .............................. 24.02 NA NA 9.33 9.29 2.82 NA NA 36.17 36.13 090 47760 ......... ............ A Fuse bile ducts and bowel ............................ 38.08 NA NA 13.24 11.43 3.41 NA NA 54.73 52.92 090 47765 ......... ............ A Fuse liver ducts & bowel ............................... 51.95 NA NA 17.09 12.36 3.29 NA NA 72.33 67.60 090 47780 ......... ............ A Fuse bile ducts and bowel ............................ 42.08 NA NA 14.27 11.96 3.49 NA NA 59.84 57.53 090 47785 ......... ............ A Fuse bile ducts and bowel ............................ 55.95 NA NA 18.09 14.19 4.09 NA NA 78.13 74.23 090 47800 ......... ............ A Reconstruction of bile ducts .......................... 25.98 NA NA 9.84 9.99 3.07 NA NA 38.89 39.04 090 47801 ......... ............ A Placement, bile duct support ......................... 17.41 NA NA 8.19 8.15 1.16 NA NA 26.76 26.72 090 47802 ......... ............ A Fuse liver duct & intestine ............................. 24.74 NA NA 9.64 9.65 2.85 NA NA 37.23 37.24 090 47900 ......... ............ A Suture bile duct injury ................................... 22.25 NA NA 8.82 8.84 2.64 NA NA 33.71 33.73 090 47999 ......... ............ C Bile tract surgery procedure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 48000 ......... ............ A Drainage of abdomen .................................... 31.76 NA NA 11.07 11.39 3.47 NA NA 46.30 46.62 090 48001 ......... ............ A Placement of drain, pancreas ....................... 39.50 NA NA 12.81 13.60 4.68 NA NA 56.99 57.78 090 48005 ......... ............ A Resect/debride pancreas .............................. 48.97 NA NA 16.10 16.43 5.54 NA NA 70.61 70.94 090 48020 ......... ............ A Removal of pancreatic stone ........................ 18.90 NA NA 7.68 7.39 2.12 NA NA 28.70 28.41 09048100 ......... ............ A Biopsy of pancreas, open ............................. 14.34 NA NA 5.96 5.68 1.62 NA NA 21.92 21.64 090 48102 ......... ............ A Needle biopsy, pancreas ............................... 4.67 9.57 8.36 1.74 1.89 0.28 14.52 13.31 6.69 6.84 010 48120 ......... ............ A Removal of pancreas lesion .......................... 18.29 NA NA 6.98 6.88 2.09 NA NA 27.36 27.26 090 48140 ......... ............ A Partial removal of pancreas .......................... 26.13 NA NA 9.48 9.51 3.02 NA NA 38.63 38.66 090 48145 ......... ............ A Partial removal of pancreas .......................... 27.20 NA NA 9.83 9.82 3.17 NA NA 40.20 40.19 090 48146 ......... ............ A Pancreatectomy ............................................ 30.34 NA NA 12.02 11.98 3.49 NA NA 45.85 45.81 090 48148 ......... ............ A Removal of pancreatic duct .......................... 20.20 NA NA 8.14 7.73 2.29 NA NA 30.63 30.22 090 48150 ......... ............ A Partial removal of pancreas .......................... 52.55 NA NA 18.29 19.18 6.30 NA NA 77.14 78.03 090 48152 ......... ............ A Pancreatectomy ............................................ 48.39 NA NA 16.84 17.85 5.78 NA NA 71.01 72.02 090 48153 ......... ............ A Pancreatectomy ............................................ 52.53 NA NA 18.15 19.18 6.29 NA NA 76.97 78.00 090 48154 ......... ............ A Pancreatectomy ............................................ 48.62 NA NA 17.15 17.95 5.82 NA NA 71.59 72.39 090 48155 ......... ............ A Removal of pancreas .................................... 29.19 NA NA 12.09 11.76 3.26 NA NA 44.54 44.21 090 48180 ......... ............ A Fuse pancreas and bowel ............................. 27.90 NA NA 10.01 10.11 3.27 NA NA 41.18 41.28 090 48400 ......... ............ A Injection, intraop add-on ................................ 1.95 NA NA 0.84 0.69 0.15 NA NA 2.94 2.79 ZZZ 48500 ......... ............ A Surgery of pancreatic cyst ............................ 17.97 NA NA 8.12 7.52 2.02 NA NA 28.11 27.51 090 48510 ......... ............ A Drain pancreatic pseudocyst ......................... 17.00 NA NA 7.64 7.48 1.82 NA NA 26.46 26.30 090 48511 ......... ............ A Drain pancreatic pseudocyst ......................... 3.99 20.24 20.73 1.27 1.30 0.24 24.47 24.96 5.50 5.53 000 48520 ......... ............ A Fuse pancreas cyst and bowel ..................... 18.03 NA NA 6.85 6.73 2.05 NA NA 26.93 26.81 090 48540 ......... ............ A Fuse pancreas cyst and bowel ..................... 21.82 NA NA 7.81 8.03 2.60 NA NA 32.23 32.45 090 48545 ......... ............ A Pancreatorrhaphy .......................................... 22.04 NA NA 8.16 8.02 2.37 NA NA 32.57 32.43 090 48547 ......... ............ A Duodenal exclusion ....................................... 30.19 NA NA 10.36 10.44 3.41 NA NA 43.96 44.04 090 48551 ......... ............ C Prep donor pancreas ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 48552 ......... ............ A Prep donor pancreas/venous ........................ 4.30 NA NA 1.14 1.38 0.31 NA NA 5.75 5.99 XXX 48554 ......... ............ R Transpl allograft pancreas ............................. 36.77 NA NA 20.69 18.86 4.18 NA NA 61.64 59.81 090 48556 ......... ............ A Removal, allograft pancreas ......................... 19.16 NA NA 9.48 8.42 2.07 NA NA 30.71 29.65 090 48999 ......... ............ C Pancreas surgery procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 49000 ......... ............ A Exploration of abdomen ................................ 12.40 NA NA 5.25 5.34 1.52 NA NA 19.17 19.26 090 49002 ......... ............ A Reopening of abdomen ................................. 17.51 NA NA 6.47 5.38 1.37 NA NA 25.35 24.26 090 49010 ......... ............ A Exploration behind abdomen ........................ 15.94 NA NA 6.36 6.01 1.51 NA NA 23.81 23.46 090 49020 ......... ............ A Drain abdominal abscess .............................. 26.38 NA NA 9.95 10.12 2.84 NA NA 39.17 39.34 090 49021 ......... ............ A Drain abdominal abscess .............................. 3.37 19.73 20.72 1.08 1.10 0.20 23.30 24.29 4.65 4.67 000 49040 ......... ............ A Drain, open, abdom abscess ........................ 16.35 NA NA 6.57 6.45 1.69 NA NA 24.61 24.49 090 49041 ......... ............ A Drain, percut, abdom abscess ...................... 3.99 19.97 19.63 1.28 1.30 0.24 24.20 23.86 5.51 5.53 000 49060 ......... ............ A Drain, open, retrop abscess .......................... 18.36 NA NA 7.30 7.39 1.74 NA NA 27.40 27.49 090 49061 ......... ............ A Drain, percut, retroper absc .......................... 3.69 19.83 19.67 1.18 1.20 0.22 23.74 23.58 5.09 5.11 000 49062 ......... ............ A Drain to peritoneal cavity .............................. 12.08 NA NA 5.26 5.38 1.39 NA NA 18.73 18.85 090 49080 ......... ............ A Puncture, peritoneal cavity ............................ 1.35 2.72 3.67 0.44 0.46 0.08 4.15 5.10 1.87 1.89 000 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49149 

49081 ......... ............ A Removal of abdominal fluid ........................... 1.26 2.93 2.67 0.44 0.43 0.09 4.28 4.02 1.79 1.78 000 49085 ......... ............ A Remove abdomen foreign body .................... 13.97 NA NA 5.61 5.52 1.62 NA NA 21.20 21.11 090 49180 ......... ............ A Biopsy, abdominal mass ............................... 1.73 2.43 2.93 0.55 0.57 0.10 4.26 4.76 2.38 2.40 000 49200 ......... ............ A Removal of abdominal lesion ........................ 10.89 NA NA 4.90 4.99 1.24 NA NA 17.03 17.12 09049201 ......... ............ A Remove abdom lesion, complex ................... 15.60 NA NA 6.48 6.89 1.87 NA NA 23.95 24.36 090 49215 ......... ............ A Excise sacral spine tumor ............................. 37.60 NA NA 12.80 13.73 4.37 NA NA 54.77 55.70 090 49220 ......... ............ A Multiple surgery, abdomen ............................ 15.64 NA NA 6.30 6.54 1.88 NA NA 23.82 24.06 090 49250 ......... ............ A Excision of umbilicus ..................................... 8.88 NA NA 4.32 4.28 1.08 NA NA 14.28 14.24 090 49255 ......... ............ A Removal of omentum .................................... 12.35 NA NA 5.68 5.62 1.43 NA NA 19.46 19.40 090 49320 ......... ............ A Diag laparo separate proc ............................. 5.34 NA NA 2.54 2.61 0.65 NA NA 8.53 8.60 01049321 ......... ............ A Laparoscopy, biopsy ..................................... 5.39 NA NA 2.59 2.63 0.70 NA NA 8.68 8.72 010 49322 ......... ............ A Laparoscopy, aspiration ................................ 5.94 NA NA 2.66 2.91 0.71 NA NA 9.31 9.56 010 49323 ......... ............ A Laparo drain lymphocele ............................... 10.09 NA NA 4.72 4.55 1.20 NA NA 16.01 15.84 090 49329 ......... ............ C Laparo proc, abdm/per/oment ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 49400 ......... ............ A Air injection into abdomen ............................. 1.88 2.44 2.91 0.57 0.61 0.15 4.47 4.94 2.60 2.64 000 49419 ......... ............ A Insrt abdom cath for chemotx ....................... 7.01 NA NA 3.49 3.54 0.81 NA NA 11.31 11.36 090 49420 ......... ............ A Insert abdom drain, temp .............................. 2.22 NA NA 1.16 1.11 0.21 NA NA 3.59 3.54 00049421 ......... ............ A Insert abdom drain, perm .............................. 5.83 NA NA 3.16 3.15 0.74 NA NA 9.73 9.72 09049422 ......... ............ A Remove perm cannula/catheter .................... 6.24 NA NA 2.64 2.83 0.83 NA NA 9.71 9.90 010 49423 ......... ............ A Exchange drainage catheter ......................... 1.46 13.26 13.87 0.51 0.52 0.09 14.81 15.42 2.06 2.07 000 49424 ......... ............ A Assess cyst, contrast inject ........................... 0.76 3.09 3.56 0.28 0.29 0.04 3.89 4.36 1.08 1.09 000 49425 ......... ............ A Insert abdomen-venous drain ....................... 12.07 NA NA 5.32 5.52 1.54 NA NA 18.93 19.13 090 49426 ......... ............ A Revise abdomen-venous shunt ..................... 10.28 NA NA 4.55 4.71 1.28 NA NA 16.11 16.27 090 49427 ......... ............ A Injection, abdominal shunt ............................ 0.89 NA NA 0.28 0.30 0.07 NA NA 1.24 1.26 00049428 ......... ............ A Ligation of shunt ............................................ 6.75 NA NA 3.08 3.71 0.80 NA NA 10.63 11.26 010 49429 ......... ............ A Removal of shunt .......................................... 7.39 NA NA 3.01 3.32 1.02 NA NA 11.42 11.73 010 49491 ......... ............ A Rpr hern preemie reduc ................................ 12.36 NA NA 5.47 5.16 1.40 NA NA 19.23 18.92 090 49492 ......... ............ A Rpr ing hern premie, blocked ........................ 15.26 NA NA 5.86 6.04 1.80 NA NA 22.92 23.10 090 49495 ......... ............ A Rpr ing hernia baby, reduc ........................... 6.13 NA NA 3.00 2.96 0.74 NA NA 9.87 9.83 090 49496 ......... ............ A Rpr ing hernia baby, blocked ........................ 9.28 NA NA 4.39 4.30 1.07 NA NA 14.74 14.65 09049500 ......... ............ A Rpr ing hernia, init, reduce ............................ 5.72 NA NA 3.62 3.24 0.71 NA NA 10.05 9.67 090 49501 ......... ............ A Rpr ing hernia, init blocked ........................... 9.24 NA NA 4.28 4.22 1.12 NA NA 14.64 14.58 090 49505 ......... ............ A Prp i/hern init reduc >5 yr ............................. 7.84 NA NA 3.92 3.79 1.03 NA NA 12.79 12.66 090 49507 ......... ............ A Prp i/hern init block >5 yr .............................. 9.93 NA NA 4.50 4.46 1.27 NA NA 15.70 15.66 090 49520 ......... ............ A Rerepair ing hernia, reduce .......................... 9.87 NA NA 4.42 4.43 1.28 NA NA 15.57 15.58 090 49521 ......... ............ A Rerepair ing hernia, blocked ......................... 12.32 NA NA 5.04 5.18 1.59 NA NA 18.95 19.09 090 49525 ......... ............ A Repair ing hernia, sliding .............................. 8.81 NA NA 4.17 4.10 1.13 NA NA 14.11 14.04 090 49540 ......... ............ A Repair lumbar hernia ..................................... 10.62 NA NA 4.67 4.72 1.37 NA NA 16.66 16.71 090 49550 ......... ............ A Rpr rem hernia, init, reduce .......................... 8.87 NA NA 4.15 4.13 1.14 NA NA 14.16 14.14 090 49553 ......... ............ A Rpr fem hernia, init blocked .......................... 9.80 NA NA 4.45 4.42 1.24 NA NA 15.49 15.46 090 49555 ......... ............ A Rerepair fem hernia, reduce ......................... 9.27 NA NA 4.26 4.26 1.20 NA NA 14.73 14.73 09049557 ......... ............ A Rerepair fem hernia, blocked ........................ 11.50 NA NA 4.90 4.96 1.47 NA NA 17.87 17.93 090 49560 ......... ............ A Rpr ventral hern init, reduc ........................... 11.80 NA NA 4.93 5.09 1.52 NA NA 18.25 18.41 090 49561 ......... ............ A Rpr ventral hern init, block ............................ 15.26 NA NA 5.86 6.00 1.88 NA NA 23.00 23.14 090 49565 ......... ............ A Rerepair ventrl hern, reduce ......................... 12.25 NA NA 5.17 5.20 1.52 NA NA 18.94 18.97 090 49566 ......... ............ A Rerepair ventrl hern, block ............................ 15.41 NA NA 5.92 6.07 1.90 NA NA 23.23 23.38 090 49568 ......... ............ A Hernia repair w/mesh .................................... 4.88 NA NA 1.26 1.57 0.64 NA NA 6.78 7.09 ZZZ 49570 ......... ............ A Rpr epigastric hern, reduce ........................... 5.93 NA NA 3.36 3.21 0.75 NA NA 10.04 9.89 090 49572 ......... ............ A Rpr epigastric hern, blocked ......................... 7.75 NA NA 3.87 3.56 0.88 NA NA 12.50 12.19 090 49580 ......... ............ A Rpr umbil hern, reduc < 5 yr ......................... 4.35 NA NA 3.03 2.70 0.54 NA NA 7.92 7.59 090 49582 ......... ............ A Rpr umbil hern, block < 5 yr ......................... 7.01 NA NA 3.64 3.51 0.88 NA NA 11.53 11.40 090 49585 ......... ............ A Rpr umbil hern, reduc > 5 yr ......................... 6.47 NA NA 3.54 3.35 0.82 NA NA 10.83 10.64 090 49587 ......... ............ A Rpr umbil hern, block > 5 yr ......................... 7.92 NA NA 3.90 3.77 0.99 NA NA 12.81 12.68 090 49590 ......... ............ A Repair spigelian hernia ................................. 8.78 NA NA 4.14 4.10 1.13 NA NA 14.05 14.01 090 49600 ......... ............ A Repair umbilical lesion .................................. 11.42 NA NA 5.20 5.29 1.32 NA NA 17.94 18.03 090 49605 ......... ............ A Repair umbilical lesion .................................. 86.79 NA NA 26.58 28.02 9.36 NA NA 122.73 124.17 090 49606 ......... ............ A Repair umbilical lesion .................................. 18.87 NA NA 6.66 7.43 2.45 NA NA 27.98 28.75 090 49610 ......... ............ A Repair umbilical lesion .................................. 10.78 NA NA 4.73 5.08 1.07 NA NA 16.58 16.93 090 49611 ......... ............ A Repair umbilical lesion .................................. 9.21 NA NA 3.66 6.14 0.78 NA NA 13.65 16.13 090 49650 ......... ............ A Laparo hernia repair initial ............................ 6.26 NA NA 3.37 3.24 0.93 NA NA 10.56 10.43 090 49651 ......... ............ A Laparo hernia repair recur ............................ 8.23 NA NA 4.26 4.10 1.14 NA NA 13.63 13.47 090 49659 ......... ............ C Laparo proc, hernia repair ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 49900 ......... ............ A Repair of abdominal wall ............................... 12.26 NA NA 6.35 6.25 1.62 NA NA 20.23 20.13 090 49904 ......... ............ A Omental flap, extra-abdom ............................ 22.06 NA NA 12.17 14.45 2.69 NA NA 36.92 39.20 090 49905 ......... ............ A Omental flap, intra-abdom ............................. 6.54 NA NA 1.74 2.15 0.75 NA NA 9.03 9.44 ZZZ49906 ......... ............ C Free omental flap, microvasc ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49150 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

49999 ......... ............ C Abdomen surgery procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 50010 ......... ............ A Exploration of kidney ..................................... 12.07 NA NA 6.90 5.63 0.93 NA NA 19.90 18.63 090 50020 ......... ............ A Renal abscess, open drain ........................... 17.80 NA NA 8.63 7.96 1.34 NA NA 27.77 27.10 090 50021 ......... ............ A Renal abscess, percut drain ......................... 3.37 21.26 21.55 1.09 1.10 0.20 24.83 25.12 4.66 4.67 000 50040 ......... ............ A Drainage of kidney ........................................ 16.40 NA NA 8.91 7.33 1.03 NA NA 26.34 24.76 090 50045 ......... ............ A Exploration of kidney ..................................... 16.61 NA NA 8.55 7.08 1.24 NA NA 26.40 24.93 090 50060 ......... ............ A Removal of kidney stone ............................... 20.74 NA NA 11.10 8.64 1.36 NA NA 33.20 30.74 090 50065 ......... ............ A Incision of kidney ........................................... 22.11 NA NA 11.69 7.48 1.59 NA NA 35.39 31.18 090 50070 ......... ............ A Incision of kidney ........................................... 21.64 NA NA 11.49 9.03 1.44 NA NA 34.57 32.11 090 50075 ......... ............ A Removal of kidney stone ............................... 26.84 NA NA 13.79 10.87 1.80 NA NA 42.43 39.51 090 50080 ......... ............ A Removal of kidney stone ............................... 15.56 NA NA 8.64 6.86 1.04 NA NA 25.24 23.46 090 50081 ......... ............ A Removal of kidney stone ............................... 23.25 NA NA 12.32 9.64 1.54 NA NA 37.11 34.43 090 50100 ......... ............ A Revise kidney blood vessels ......................... 17.24 NA NA 7.34 7.67 2.06 NA NA 26.64 26.97 090 50120 ......... ............ A Exploration of kidney ..................................... 17.00 NA NA 8.80 7.27 1.21 NA NA 27.01 25.48 090 50125 ......... ............ A Explore and drain kidney .............................. 17.61 NA NA 9.85 7.68 1.43 NA NA 28.89 26.72 090 50130 ......... ............ A Removal of kidney stone ............................... 18.61 NA NA 10.12 7.90 1.22 NA NA 29.95 27.73 090 50135 ......... ............ A Exploration of kidney ..................................... 20.38 NA NA 10.81 8.53 1.33 NA NA 32.52 30.24 090 50200 ......... ............ A Biopsy of kidney ............................................ 2.63 NA NA 1.13 1.25 0.16 NA NA 3.92 4.04 000 50205 ......... ............ A Biopsy of kidney ............................................ 12.15 NA NA 5.62 5.16 1.30 NA NA 19.07 18.61 090 50220 ......... ............ A Remove kidney, open ................................... 18.47 NA NA 9.64 7.83 1.35 NA NA 29.46 27.65 090 50225 ......... ............ A Removal kidney open, complex .................... 21.67 NA NA 11.14 8.89 1.50 NA NA 34.31 32.06 090 50230 ......... ............ A Removal kidney open, radical ....................... 23.63 NA NA 11.81 9.38 1.55 NA NA 36.99 34.56 090 50234 ......... ............ A Removal of kidney & ureter .......................... 23.84 NA NA 12.20 9.67 1.59 NA NA 37.63 35.10 090 50236 ......... ............ A Removal of kidney & ureter .......................... 26.66 NA NA 14.10 11.21 1.76 NA NA 42.52 39.63 090 50240 ......... ............ A Partial removal of kidney ............................... 23.93 NA NA 12.78 9.95 1.55 NA NA 38.26 35.43 090 50250 ......... ............ A Cryoablate renal mass open ......................... 21.98 NA NA 11.01 9.62 1.39 NA NA 34.38 32.99 090 50280 ......... ............ A Removal of kidney lesion .............................. 16.88 NA NA 9.35 7.35 1.19 NA NA 27.42 25.42 090 50290 ......... ............ A Removal of kidney lesion .............................. 15.94 NA NA 8.19 6.89 1.41 NA NA 25.54 24.24 090 50320 ......... ............ A Remove kidney, living donor ......................... 22.18 NA NA 12.52 11.12 2.35 NA NA 37.05 35.65 090 50323 ......... ............ C Prep cadaver renal allograft .......................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 50327 ......... ............ A Prep renal graft/venous ................................. 4.00 NA NA 1.10 1.29 0.29 NA NA 5.39 5.58 XXX 50328 ......... ............ A Prep renal graft/arterial ................................. 3.50 NA NA 0.98 1.13 0.26 NA NA 4.74 4.89 XXX 50329 ......... ............ A Prep renal graft/ureteral ................................ 3.34 NA NA 0.97 1.09 0.25 NA NA 4.56 4.68 XXX 50340 ......... ............ A Removal of kidney ......................................... 13.79 NA NA 7.70 6.79 1.65 NA NA 23.14 22.23 090 50360 ......... ............ A Transplantation of kidney .............................. 40.27 NA NA 18.95 16.34 3.81 NA NA 63.03 60.42 090 50365 ......... ............ A Transplantation of kidney .............................. 45.50 NA NA 19.63 18.55 4.42 NA NA 69.55 68.47 090 50370 ......... ............ A Remove transplanted kidney ......................... 18.60 NA NA 9.35 7.69 1.67 NA NA 29.62 27.96 09050380 ......... ............ A Reimplantation of kidney ............................... 29.48 NA NA 16.43 13.12 2.50 NA NA 48.41 45.10 090 50382 ......... ............ A Change ureter stent, percut .......................... 5.50 26.41 33.69 1.86 1.86 0.34 32.25 39.53 7.70 7.70 000 50384 ......... ............ A Remove ureter stent, percut ......................... 5.00 20.77 31.61 1.69 1.71 0.31 26.08 36.92 7.00 7.02 000 50387 ......... ............ A Change ext/int ureter stent ............................ 2.00 12.75 16.85 0.66 0.67 0.12 14.87 18.97 2.78 2.79 000 50389 ......... ............ A Remove renal tube w/fluoro .......................... 1.10 6.75 11.24 0.36 0.37 0.07 7.92 12.41 1.53 1.54 000 50390 ......... ............ A Drainage of kidney lesion .............................. 1.96 NA NA 0.64 0.64 0.12 NA NA 2.72 2.72 000 50391 ......... ............ A Instll rx agnt into rnal tub .............................. 1.96 1.51 1.56 0.79 0.67 0.14 3.61 3.66 2.89 2.77 000 50392 ......... ............ A Insert kidney drain ......................................... 3.37 NA NA 1.40 1.49 0.20 NA NA 4.97 5.06 000 50393 ......... ............ A Insert ureteral tube ........................................ 4.15 NA NA 1.66 1.75 0.25 NA NA 6.06 6.15 000 50394 ......... ............ A Injection for kidney x-ray ............................... 0.76 1.88 2.48 0.56 0.64 0.05 2.69 3.29 1.37 1.45 000 50395 ......... ............ A Create passage to kidney ............................. 3.37 NA NA 1.48 1.50 0.21 NA NA 5.06 5.08 000 50396 ......... ............ A Measure kidney pressure .............................. 2.09 NA NA 1.02 1.07 0.13 NA NA 3.24 3.29 000 50398 ......... ............ A Change kidney tube ...................................... 1.46 11.99 15.23 0.52 0.52 0.09 13.54 16.78 2.07 2.07 000 50400 ......... ............ A Revision of kidney/ureter ............................... 21.06 NA NA 11.12 8.68 1.38 NA NA 33.56 31.12 090 50405 ......... ............ A Revision of kidney/ureter ............................... 25.61 NA NA 13.16 10.06 1.78 NA NA 40.55 37.45 090 50500 ......... ............ A Repair of kidney wound ................................ 21.01 NA NA 9.29 8.61 2.01 NA NA 32.31 31.63 090 50520 ......... ............ A Close kidney-skin fistula ................................ 18.67 NA NA 9.40 7.92 1.49 NA NA 29.56 28.08 090 50525 ......... ............ A Repair renal-abdomen fistula ........................ 24.14 NA NA 10.99 9.49 1.83 NA NA 36.96 35.46 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49151 

50526 ......... ............ A Repair renal-abdomen fistula ........................ 26.06 NA NA 8.23 9.45 1.96 NA NA 36.25 37.47 090 50540 ......... ............ A Revision of horseshoe kidney ....................... 20.89 NA NA 10.79 8.94 1.36 NA NA 33.04 31.19 090 50541 ......... ............ A Laparo ablate renal cyst ................................ 16.72 NA NA 8.81 7.06 1.13 NA NA 26.66 24.91 090 50542 ......... ............ A Laparo ablate renal mass ............................. 21.12 NA NA 11.24 8.91 1.39 NA NA 33.75 31.42 090 50543 ......... ............ A Laparo partial nephrectomy .......................... 27.10 NA NA 14.20 11.19 1.80 NA NA 43.10 40.09 090 50544 ......... ............ A Laparoscopy, pyeloplasty .............................. 23.23 NA NA 11.51 9.27 1.58 NA NA 36.32 34.08 090 50545 ......... ............ A Laparo radical nephrectomy .......................... 24.89 NA NA 12.35 9.97 1.70 NA NA 38.94 36.56 090 50546 ......... ............ A Laparoscopic nephrectomy ........................... 21.63 NA NA 11.39 9.12 1.57 NA NA 34.59 32.32 090 50547 ......... ............ A Laparo removal donor kidney ....................... 26.20 NA NA 12.68 11.50 2.76 NA NA 41.64 40.46 090 50548 ......... ............ A Laparo remove w/ureter ................................ 25.22 NA NA 12.27 9.95 1.72 NA NA 39.21 36.89 090 50549 ......... ............ C Laparoscope proc, renal ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 50551 ......... ............ A Kidney endoscopy ......................................... 5.59 4.61 4.26 2.66 2.14 0.40 10.60 10.25 8.65 8.13 000 50553 ......... ............ A Kidney endoscopy ......................................... 5.98 4.45 4.38 2.55 2.27 0.39 10.82 10.75 8.92 8.64 000 50555 ......... ............ A Kidney endoscopy & biopsy .......................... 6.52 5.12 4.89 3.03 2.51 0.45 12.09 11.86 10.00 9.48 000 50557 ......... ............ A Kidney endoscopy & treatment ..................... 6.61 5.28 4.76 3.07 2.49 0.47 12.36 11.84 10.15 9.57 000 50561 ......... ............ A Kidney endoscopy & treatment ..................... 7.58 5.80 5.26 3.42 2.84 0.54 13.92 13.38 11.54 10.96 000 50562 ......... ............ A Renal scope w/tumor resect ......................... 10.90 NA NA 5.42 4.59 0.73 NA NA 17.05 16.22 09050570 ......... ............ A Kidney endoscopy ......................................... 9.53 NA NA 4.27 3.48 0.68 NA NA 14.48 13.69 000 50572 ......... ............ A Kidney endoscopy ......................................... 10.33 NA NA 4.60 3.78 0.85 NA NA 15.78 14.96 000 50574 ......... ............ A Kidney endoscopy & biopsy .......................... 11.00 NA NA 4.78 4.00 0.77 NA NA 16.55 15.77 00050575 ......... ............ A Kidney endoscopy ......................................... 13.96 NA NA 6.06 4.99 0.99 NA NA 21.01 19.94 000 50576 ......... ............ A Kidney endoscopy & treatment ..................... 10.97 NA NA 4.86 3.96 0.78 NA NA 16.61 15.71 000 50580 ......... ............ A Kidney endoscopy & treatment ..................... 11.84 NA NA 5.17 4.26 0.83 NA NA 17.84 16.93 000 50590 ......... ............ A Fragmenting of kidney stone ......................... 9.58 17.26 13.61 6.19 4.63 0.65 27.49 23.84 16.42 14.86 090 50592 ......... ............ A Perc rf ablate renal tumor ............................. 6.75 77.05 131.0 2.81 2.94 0.43 84.23 138.2 9.99 10.12 010 50600 ......... ............ A Exploration of ureter ...................................... 16.99 NA NA 8.60 7.15 1.13 NA NA 26.72 25.27 090 50605 ......... ............ A Insert ureteral support ................................... 16.61 NA NA 8.00 7.05 1.45 NA NA 26.06 25.11 090 50610 ......... ............ A Removal of ureter stone ................................ 17.07 NA NA 9.12 7.50 1.43 NA NA 27.62 26.00 090 50620 ......... ............ A Removal of ureter stone ................................ 16.25 NA NA 8.97 6.99 1.07 NA NA 26.29 24.31 090 50630 ......... ............ A Removal of ureter stone ................................ 16.03 NA NA 8.30 6.78 1.09 NA NA 25.42 23.90 090 50650 ......... ............ A Removal of ureter .......................................... 18.61 NA NA 10.15 7.95 1.23 NA NA 29.99 27.79 090 50660 ......... ............ A Removal of ureter .......................................... 20.81 NA NA 10.87 8.68 1.38 NA NA 33.06 30.87 090 50684 ......... ............ A Injection for ureter x-ray ................................ 0.76 4.12 4.76 0.64 0.51 0.05 4.93 5.57 1.45 1.32 000 50686 ......... ............ A Measure ureter pressure ............................... 1.51 2.07 3.10 0.71 0.79 0.11 3.69 4.72 2.33 2.41 000 50688 ......... ............ A Change of ureter tube/stent .......................... 1.17 NA NA 0.92 1.03 0.07 NA NA 2.16 2.27 010 50690 ......... ............ A Injection for ureter x-ray ................................ 1.16 1.43 1.72 0.72 0.72 0.07 2.66 2.95 1.95 1.95 000 50700 ......... ............ A Revision of ureter .......................................... 16.48 NA NA 8.46 7.45 1.27 NA NA 26.21 25.20 090 50715 ......... ............ A Release of ureter ........................................... 20.43 NA NA 8.65 8.71 2.13 NA NA 31.21 31.27 090 50722 ......... ............ A Release of ureter ........................................... 17.74 NA NA 8.02 7.86 1.90 NA NA 27.66 27.50 090 50725 ......... ............ A Release/revise ureter .................................... 19.99 NA NA 9.70 8.46 1.52 NA NA 31.21 29.97 090 50727 ......... ............ A Revise ureter ................................................. 8.17 NA NA 5.78 4.65 0.61 NA NA 14.56 13.43 090 50728 ......... ............ A Revise ureter ................................................. 12.00 NA NA 7.21 5.97 1.00 NA NA 20.21 18.97 090 50740 ......... ............ A Fusion of ureter & kidney .............................. 19.86 NA NA 9.03 8.06 1.96 NA NA 30.85 29.88 090 50750 ......... ............ A Fusion of ureter & kidney .............................. 21.01 NA NA 9.84 8.45 1.38 NA NA 32.23 30.84 090 50760 ......... ............ A Fusion of ureters ........................................... 19.86 NA NA 9.84 8.21 1.55 NA NA 31.25 29.62 090 50770 ......... ............ A Splicing of ureters ......................................... 21.01 NA NA 10.70 8.65 1.45 NA NA 33.16 31.11 090 50780 ......... ............ A Reimplant ureter in bladder ........................... 19.74 NA NA 10.14 8.22 1.51 NA NA 31.39 29.47 090 50782 ......... ............ A Reimplant ureter in bladder ........................... 19.51 NA NA 8.30 8.65 1.61 NA NA 29.42 29.77 090 50783 ......... ............ A Reimplant ureter in bladder ........................... 20.52 NA NA 10.07 8.68 1.98 NA NA 32.57 31.18 090 50785 ......... ............ A Reimplant ureter in bladder ........................... 22.02 NA NA 11.19 9.02 1.45 NA NA 34.66 32.49 090 50800 ......... ............ A Implant ureter in bowel .................................. 16.16 NA NA 9.32 7.18 1.19 NA NA 26.67 24.53 090 50810 ......... ............ A Fusion of ureter & bowel ............................... 22.29 NA NA 9.65 9.22 2.31 NA NA 34.25 33.82 090 50815 ......... ............ A Urine shunt to intestine ................................. 21.98 NA NA 11.63 9.24 1.54 NA NA 35.15 32.76 090 50820 ......... ............ A Construct bowel bladder ............................... 23.82 NA NA 12.00 9.47 1.89 NA NA 37.71 35.18 090 50825 ......... ............ A Construct bowel bladder ............................... 30.40 NA NA 15.09 12.11 2.07 NA NA 47.56 44.58 090 50830 ......... ............ A Revise urine flow ........................................... 33.49 NA NA 15.92 13.10 2.37 NA NA 51.78 48.96 090 50840 ......... ............ A Replace ureter by bowel ............................... 22.11 NA NA 11.93 9.30 1.47 NA NA 35.51 32.88 090 50845 ......... ............ A Appendico-vesicostomy ................................. 22.11 NA NA 12.42 9.77 1.57 NA NA 36.10 33.45 090 50860 ......... ............ A Transplant ureter to skin ............................... 16.87 NA NA 9.05 7.22 1.29 NA NA 27.21 25.38 090 50900 ......... ............ A Repair of ureter ............................................. 14.83 NA NA 8.10 6.62 1.14 NA NA 24.07 22.59 090 50920 ......... ............ A Closure ureter/skin fistula .............................. 15.60 NA NA 8.54 7.06 1.01 NA NA 25.15 23.67 090 50930 ......... ............ A Closure ureter/bowel fistula ........................... 19.98 NA NA 10.29 8.54 1.28 NA NA 31.55 29.80 090 50940 ......... ............ A Release of ureter ........................................... 15.72 NA NA 8.27 6.86 1.26 NA NA 25.25 23.84 090 50945 ......... ............ A Laparoscopy ureterolithotomy ....................... 17.83 NA NA 8.78 7.47 1.36 NA NA 27.97 26.66 09050947 ......... ............ A Laparo new ureter/bladder ............................ 25.57 NA NA 12.50 10.39 2.16 NA NA 40.23 38.12 090 50948 ......... ............ A Laparo new ureter/bladder ............................ 23.65 NA NA 12.02 9.52 1.70 NA NA 37.37 34.87 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49152 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

50949 ......... ............ C Laparoscope proc, ureter .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 50951 ......... ............ A Endoscopy of ureter ...................................... 5.83 4.87 4.44 2.79 2.24 0.41 11.11 10.68 9.03 8.48 000 50953 ......... ............ A Endoscopy of ureter ...................................... 6.23 5.05 4.56 3.31 2.60 0.43 11.71 11.22 9.97 9.26 000 50955 ......... ............ A Ureter endoscopy & biopsy ........................... 6.74 5.28 6.13 3.52 2.89 0.48 12.50 13.35 10.74 10.11 000 50957 ......... ............ A Ureter endoscopy & treatment ...................... 6.78 5.37 4.76 3.15 2.57 0.48 12.63 12.02 10.41 9.83 000 50961 ......... ............ A Ureter endoscopy & treatment ...................... 6.04 4.85 4.48 2.82 2.34 0.41 11.30 10.93 9.27 8.79 000 50970 ......... ............ A Ureter endoscopy .......................................... 7.13 NA NA 3.30 2.67 0.52 NA NA 10.95 10.32 000 50972 ......... ............ A Ureter endoscopy & catheter ........................ 6.88 NA NA 3.14 2.63 0.49 NA NA 10.51 10.00 000 50974 ......... ............ A Ureter endoscopy & biopsy ........................... 9.16 NA NA 3.97 3.32 0.64 NA NA 13.77 13.12 00050976 ......... ............ A Ureter endoscopy & treatment ...................... 9.03 NA NA 3.76 3.24 0.66 NA NA 13.45 12.93 000 50980 ......... ............ A Ureter endoscopy & treatment ...................... 6.84 NA NA 3.13 2.56 0.48 NA NA 10.45 9.88 000 51000 ......... ............ A Drainage of bladder ....................................... 0.78 0.94 1.69 0.28 0.25 0.05 1.77 2.52 1.11 1.08 000 51005 ......... ............ A Drainage of bladder ....................................... 1.02 2.43 4.13 0.30 0.33 0.10 3.55 5.25 1.42 1.45 000 51010 ......... ............ A Drainage of bladder ....................................... 4.25 4.78 5.40 2.38 2.00 0.28 9.31 9.93 6.91 6.53 010 51020 ......... ............ A Incise & treat bladder .................................... 7.51 NA NA 5.35 4.23 0.47 NA NA 13.33 12.21 090 51030 ......... ............ A Incise & treat bladder .................................... 7.63 NA NA 4.80 4.18 0.58 NA NA 13.01 12.39 090 51040 ......... ............ A Incise & drain bladder ................................... 4.39 NA NA 3.72 3.00 0.31 NA NA 8.42 7.70 090 51045 ......... ............ A Incise bladder/drain ureter ............................ 7.63 NA NA 5.23 4.25 0.52 NA NA 13.38 12.40 090 51050 ......... ............ A Removal of bladder stone ............................. 7.83 NA NA 5.38 4.08 0.49 NA NA 13.70 12.40 090 51060 ......... ............ A Removal of ureter stone ................................ 9.77 NA NA 6.42 4.98 0.62 NA NA 16.81 15.37 090 51065 ......... ............ A Remove ureter calculus ................................ 9.77 NA NA 6.35 4.85 0.63 NA NA 16.75 15.25 090 51080 ......... ............ A Drainage of bladder abscess ........................ 6.57 NA NA 4.35 3.74 0.43 NA NA 11.35 10.74 090 51500 ......... ............ A Removal of bladder cyst ............................... 10.87 NA NA 5.85 5.21 1.03 NA NA 17.75 17.11 090 51520 ......... ............ A Removal of bladder lesion ............................ 10.03 NA NA 6.51 5.13 0.69 NA NA 17.23 15.85 090 51525 ......... ............ A Removal of bladder lesion ............................ 15.24 NA NA 8.66 6.76 0.99 NA NA 24.89 22.99 090 51530 ......... ............ A Removal of bladder lesion ............................ 13.53 NA NA 7.33 6.14 1.05 NA NA 21.91 20.72 090 51535 ......... ............ A Repair of ureter lesion ................................... 13.72 NA NA 7.54 6.46 1.23 NA NA 22.49 21.41 090 51550 ......... ............ A Partial removal of bladder ............................. 17.05 NA NA 8.91 7.27 1.31 NA NA 27.27 25.63 090 51555 ......... ............ A Partial removal of bladder ............................. 22.97 NA NA 11.51 9.37 1.69 NA NA 36.17 34.03 090 51565 ......... ............ A Revise bladder & ureter(s) ............................ 23.43 NA NA 12.07 9.73 1.63 NA NA 37.13 34.79 090 51570 ......... ............ A Removal of bladder ....................................... 27.25 NA NA 13.39 10.65 1.71 NA NA 42.35 39.61 090 51575 ......... ............ A Removal of bladder & nodes ........................ 33.93 NA NA 16.79 13.21 2.16 NA NA 52.88 49.30 090 51580 ......... ............ A Remove bladder/revise tract ......................... 35.05 NA NA 17.64 13.77 2.24 NA NA 54.93 51.06 090 51585 ......... ............ A Removal of bladder & nodes ........................ 39.32 NA NA 19.63 15.18 2.48 NA NA 61.43 56.98 090 51590 ......... ............ A Remove bladder/revise tract ......................... 36.08 NA NA 17.47 13.82 2.27 NA NA 55.82 52.17 090 51595 ......... ............ A Remove bladder/revise tract ......................... 41.04 NA NA 19.79 15.54 2.59 NA NA 63.42 59.17 090 51596 ......... ............ A Remove bladder/create pouch ...................... 43.91 NA NA 21.37 16.76 2.77 NA NA 68.04 63.44 09051597 ......... ............ A Removal of pelvic structures ......................... 42.51 NA NA 20.13 16.15 2.81 NA NA 65.45 61.47 090 51600 ......... ............ A Injection for bladder x-ray ............................. 0.88 4.25 4.85 0.31 0.30 0.06 5.19 5.79 1.25 1.24 000 51605 ......... ............ A Preparation for bladder xray ......................... 0.64 NA NA 0.42 0.37 0.04 NA NA 1.10 1.05 000 51610 ......... ............ A Injection for bladder x-ray ............................. 1.05 1.93 2.19 0.70 0.63 0.07 3.05 3.31 1.82 1.75 000 51700 ......... ............ A Irrigation of bladder ....................................... 0.88 1.52 1.58 0.34 0.30 0.06 2.46 2.52 1.28 1.24 000 51701 ......... ............ A Insert bladder catheter .................................. 0.50 1.05 1.45 0.25 0.21 0.04 1.59 1.99 0.79 0.75 000 51702 ......... ............ A Insert temp bladder cath ............................... 0.50 1.54 1.95 0.34 0.27 0.04 2.08 2.49 0.88 0.81 000 51703 ......... ............ A Insert bladder cath, complex ......................... 1.47 2.29 2.62 0.81 0.62 0.10 3.86 4.19 2.38 2.19 000 51705 ......... ............ A Change of bladder tube ................................ 1.02 2.04 2.21 0.85 0.67 0.07 3.13 3.30 1.94 1.76 010 51710 ......... ............ A Change of bladder tube ................................ 1.49 2.75 3.19 1.19 0.88 0.11 4.35 4.79 2.79 2.48 010 51715 ......... ............ A Endoscopic injection/implant ......................... 3.73 4.47 4.04 1.76 1.45 0.29 8.49 8.06 5.78 5.47 000 51720 ......... ............ A Treatment of bladder lesion .......................... 1.50 1.64 1.72 0.75 0.71 0.14 3.28 3.36 2.39 2.35 000 51725 ......... ............ A Simple cystometrogram ................................. 1.51 4.32 5.27 4.32 5.27 0.16 5.99 6.94 5.99 6.94 000 51725 ......... 26 ....... A Simple cystometrogram ................................. 1.51 0.57 0.51 0.57 0.51 0.12 2.20 2.14 2.20 2.14 000 51725 ......... TC ...... A Simple cystometrogram ................................. 0.00 3.75 4.76 3.75 4.76 0.04 3.79 4.80 3.79 4.80 000 51726 ......... ............ A Complex cystometrogram ............................. 1.71 7.18 7.42 7.18 7.42 0.18 9.07 9.31 9.07 9.31 000 51726 ......... 26 ....... A Complex cystometrogram ............................. 1.71 0.65 0.58 0.65 0.58 0.13 2.49 2.42 2.49 2.42 000 51726 ......... TC ...... A Complex cystometrogram ............................. 0.00 6.53 6.84 6.53 6.84 0.05 6.58 6.89 6.58 6.89 000 51736 ......... ............ A Urine flow measurement ............................... 0.61 0.91 0.66 0.91 0.66 0.06 1.58 1.33 1.58 1.33 000 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49153 

51736 ......... 26 ....... A Urine flow measurement ............................... 0.61 0.23 0.21 0.23 0.21 0.05 0.89 0.87 0.89 0.87 000 51736 ......... TC ...... A Urine flow measurement ............................... 0.00 0.68 0.46 0.68 0.46 0.01 0.69 0.47 0.69 0.47 000 51741 ......... ............ A Electro-uroflowmetry, first .............................. 1.14 1.27 0.91 1.27 0.91 0.11 2.52 2.16 2.52 2.16 000 51741 ......... 26 ....... A Electro-uroflowmetry, first .............................. 1.14 0.44 0.39 0.44 0.39 0.09 1.67 1.62 1.67 1.62 000 51741 ......... TC ...... A Electro-uroflowmetry, first .............................. 0.00 0.83 0.52 0.83 0.52 0.02 0.85 0.54 0.85 0.54 000 51772 ......... ............ A Urethra pressure profile ................................ 1.61 5.09 5.45 5.09 5.45 0.20 6.90 7.26 6.90 7.26 000 51772 ......... 26 ....... A Urethra pressure profile ................................ 1.61 0.55 0.55 0.55 0.55 0.15 2.31 2.31 2.31 2.31 000 51772 ......... TC ...... A Urethra pressure profile ................................ 0.00 4.54 4.91 4.54 4.91 0.05 4.59 4.96 4.59 4.96 000 51784 ......... ............ A Anal/urinary muscle study ............................. 1.53 3.85 3.95 3.85 3.95 0.16 5.54 5.64 5.54 5.64 000 51784 ......... 26 ....... A Anal/urinary muscle study ............................. 1.53 0.52 0.51 0.52 0.51 0.12 2.17 2.16 2.17 2.16 000 51784 ......... TC ...... A Anal/urinary muscle study ............................. 0.00 3.33 3.44 3.33 3.44 0.04 3.37 3.48 3.37 3.48 000 51785 ......... ............ A Anal/urinary muscle study ............................. 1.53 4.54 4.47 4.54 4.47 0.15 6.22 6.15 6.22 6.15 000 51785 ......... 26 ....... A Anal/urinary muscle study ............................. 1.53 0.56 0.52 0.56 0.52 0.11 2.20 2.16 2.20 2.16 000 51785 ......... TC ...... A Anal/urinary muscle study ............................. 0.00 3.97 3.95 3.97 3.95 0.04 4.01 3.99 4.01 3.99 000 51792 ......... ............ A Urinary reflex study ....................................... 1.10 5.01 5.75 5.01 5.75 0.20 6.31 7.05 6.31 7.05 000 51792 ......... 26 ....... A Urinary reflex study ....................................... 1.10 0.40 0.41 0.40 0.41 0.07 1.57 1.58 1.57 1.58 000 51792 ......... TC ...... A Urinary reflex study ....................................... 0.00 4.61 5.34 4.61 5.34 0.13 4.74 5.47 4.74 5.47 000 51795 ......... ............ A Urine voiding pressure study ........................ 1.53 6.78 7.16 6.78 7.16 0.22 8.53 8.91 8.53 8.91 000 51795 ......... 26 ....... A Urine voiding pressure study ........................ 1.53 0.58 0.52 0.58 0.52 0.12 2.23 2.17 2.23 2.17 000 51795 ......... TC ...... A Urine voiding pressure study ........................ 0.00 6.21 6.65 6.21 6.65 0.10 6.31 6.75 6.31 6.75 000 51797 ......... ............ A Intraabdominal pressure test ......................... 1.60 4.88 5.56 4.88 5.56 0.17 6.65 7.33 6.65 7.33 000 51797 ......... 26 ....... A Intraabdominal pressure test ......................... 1.60 0.60 0.55 0.60 0.55 0.12 2.32 2.27 2.32 2.27 000 51797 ......... TC ...... A Intraabdominal pressure test ......................... 0.00 4.28 5.01 4.28 5.01 0.05 4.33 5.06 4.33 5.06 000 51798 ......... ............ A Us urine capacity measure ........................... 0.00 0.60 0.41 NA NA 0.08 0.68 0.49 NA NA XXX 51800 ......... ............ A Revision of bladder/urethra ........................... 18.68 NA NA 10.11 8.20 1.32 NA NA 30.11 28.20 090 51820 ......... ............ A Revision of urinary tract ................................ 19.34 NA NA 10.54 8.85 1.74 NA NA 31.62 29.93 090 51840 ......... ............ A Attach bladder/urethra ................................... 11.23 NA NA 5.81 5.62 1.06 NA NA 18.10 17.91 090 51841 ......... ............ A Attach bladder/urethra ................................... 13.55 NA NA 6.85 6.49 1.24 NA NA 21.64 21.28 090 51845 ......... ............ A Repair bladder neck ...................................... 10.02 NA NA 5.88 5.03 0.79 NA NA 16.69 15.84 090 51860 ......... ............ A Repair of bladder wound ............................... 12.42 NA NA 6.83 6.02 1.16 NA NA 20.41 19.60 090 51865 ......... ............ A Repair of bladder wound ............................... 15.62 NA NA 8.47 7.12 1.23 NA NA 25.32 23.97 090 51880 ......... ............ A Repair of bladder opening ............................. 7.77 NA NA 4.73 4.15 0.72 NA NA 13.22 12.64 090 51900 ......... ............ A Repair bladder/vagina lesion ......................... 14.42 NA NA 8.04 6.56 1.21 NA NA 23.67 22.19 090 51920 ......... ............ A Close bladder-uterus fistula .......................... 13.20 NA NA 7.77 6.17 1.18 NA NA 22.15 20.55 090 51925 ......... ............ A Hysterectomy/bladder repair ......................... 17.28 NA NA 10.27 9.03 2.03 NA NA 29.58 28.34 090 51940 ......... ............ A Correction of bladder defect .......................... 30.41 NA NA 11.41 11.91 2.14 NA NA 43.96 44.46 090 51960 ......... ............ A Revision of bladder & bowel ......................... 25.12 NA NA 13.18 10.52 1.63 NA NA 39.93 37.27 090 51980 ......... ............ A Construct bladder opening ............................ 12.39 NA NA 7.29 5.85 0.86 NA NA 20.54 19.10 090 51990 ......... ............ A Laparo urethral suspension ........................... 13.22 NA NA 5.99 6.10 1.39 NA NA 20.60 20.71 090 51992 ......... ............ A Laparo sling operation ................................... 14.73 NA NA 6.65 6.31 1.41 NA NA 22.79 22.45 090 51999 ......... ............ C Laparoscope proc, bladder ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 52000 ......... ............ A Cystoscopy .................................................... 2.23 3.70 3.40 1.33 0.90 0.14 6.07 5.77 3.70 3.27 000 52001 ......... ............ A Cystoscopy, removal of clots ........................ 5.44 5.14 5.09 2.62 2.05 0.39 10.97 10.92 8.45 7.88 000 52005 ......... ............ A Cystoscopy & ureter catheter ........................ 2.37 5.79 5.62 1.39 1.02 0.17 8.33 8.16 3.93 3.56 000 52007 ......... ............ A Cystoscopy and biopsy ................................. 3.02 10.83 15.04 1.64 1.27 0.22 14.07 18.28 4.88 4.51 000 52010 ......... ............ A Cystoscopy & duct catheter .......................... 3.02 8.20 10.11 1.65 1.28 0.21 11.43 13.34 4.88 4.51 000 52204 ......... ............ A Cystoscopy .................................................... 2.59 8.39 12.98 1.40 1.03 0.17 11.15 15.74 4.16 3.79 000 52214 ......... ............ A Cystoscopy and treatment ............................ 3.70 20.07 33.59 1.86 1.46 0.26 24.03 37.55 5.82 5.42 000 52224 ......... ............ A Cystoscopy and treatment ............................ 3.14 19.25 32.15 1.63 1.27 0.22 22.61 35.51 4.99 4.63 000 52234 ......... ............ A Cystoscopy and treatment ............................ 4.62 NA NA 2.31 1.82 0.33 NA NA 7.26 6.77 000 52235 ......... ............ A Cystoscopy and treatment ............................ 5.44 NA NA 2.68 2.12 0.39 NA NA 8.51 7.95 000 52240 ......... ............ A Cystoscopy and treatment ............................ 9.71 NA NA 4.42 3.58 0.69 NA NA 14.82 13.98 00052250 ......... ............ A Cystoscopy and radiotracer .......................... 4.49 NA NA 2.35 1.83 0.32 NA NA 7.16 6.64 000 52260 ......... ............ A Cystoscopy and treatment ............................ 3.91 NA NA 1.97 1.56 0.28 NA NA 6.16 5.75 000 52265 ......... ............ A Cystoscopy and treatment ............................ 2.94 7.74 11.94 1.53 1.22 0.22 10.90 15.10 4.69 4.38 000 52270 ......... ............ A Cystoscopy & revise urethra ......................... 3.36 7.08 10.04 1.77 1.37 0.24 10.68 13.64 5.37 4.97 000 52275 ......... ............ A Cystoscopy & revise urethra ......................... 4.69 9.39 14.01 2.31 1.82 0.33 14.41 19.03 7.33 6.84 000 52276 ......... ............ A Cystoscopy and treatment ............................ 4.99 NA NA 2.48 1.96 0.35 NA NA 7.82 7.30 000 52277 ......... ............ A Cystoscopy and treatment ............................ 6.16 NA NA 2.91 2.39 0.44 NA NA 9.51 8.99 000 52281 ......... ............ A Cystoscopy and treatment ............................ 2.80 5.34 6.65 1.56 1.20 0.20 8.34 9.65 4.56 4.20 000 52282 ......... ............ A Cystoscopy, implant stent ............................. 6.39 NA NA 3.01 2.43 0.45 NA NA 9.85 9.27 00052283 ......... ............ A Cystoscopy and treatment ............................ 3.73 4.14 3.99 1.90 1.51 0.26 8.13 7.98 5.89 5.50 000 52285 ......... ............ A Cystoscopy and treatment ............................ 3.60 4.40 4.11 1.87 1.47 0.26 8.26 7.97 5.73 5.33 000 52290 ......... ............ A Cystoscopy and treatment ............................ 4.58 NA NA 2.30 1.81 0.32 NA NA 7.20 6.71 000 52300 ......... ............ A Cystoscopy and treatment ............................ 5.30 NA NA 2.65 2.09 0.38 NA NA 8.33 7.77 000 52301 ......... ............ A Cystoscopy and treatment ............................ 5.50 NA NA 2.13 2.02 0.46 NA NA 8.09 7.98 000 

mstockstill on PROD1PC63 with PROPOSAL_2

49154 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

52305 ......... ............ A Cystoscopy and treatment ............................ 5.30 NA NA 2.53 2.02 0.38 NA NA 8.21 7.70 000 52310 ......... ............ A Cystoscopy and treatment ............................ 2.81 4.05 4.53 1.45 1.14 0.20 7.06 7.54 4.46 4.15 000 52315 ......... ............ A Cystoscopy and treatment ............................ 5.20 6.70 8.17 2.51 2.00 0.37 12.27 13.74 8.08 7.57 000 52317 ......... ............ A Remove bladder stone .................................. 6.71 17.25 26.02 3.04 2.47 0.48 24.44 33.21 10.23 9.66 000 52318 ......... ............ A Remove bladder stone .................................. 9.18 NA NA 4.11 3.35 0.65 NA NA 13.94 13.18 000 52320 ......... ............ A Cystoscopy and treatment ............................ 4.69 NA NA 2.24 1.78 0.33 NA NA 7.26 6.80 000 52325 ......... ............ A Cystoscopy, stone removal ........................... 6.15 NA NA 2.86 2.30 0.44 NA NA 9.45 8.89 000 52327 ......... ............ A Cystoscopy, inject material ........................... 5.18 17.98 28.35 2.36 1.95 0.37 23.53 33.90 7.91 7.50 000 52330 ......... ............ A Cystoscopy and treatment ............................ 5.03 20.61 34.27 2.38 1.91 0.36 26.00 39.66 7.77 7.30 000 52332 ......... ............ A Cystoscopy and treatment ............................ 2.83 12.54 7.44 1.58 1.18 0.21 15.58 10.48 4.62 4.22 000 52334 ......... ............ A Create passage to kidney ............................. 4.82 NA NA 2.34 1.88 0.35 NA NA 7.51 7.05 000 52341 ......... ............ A Cysto w/ureter stricture tx ............................. 5.99 NA NA 3.04 2.42 0.43 NA NA 9.46 8.84 000 52342 ......... ............ A Cysto w/up stricture tx ................................... 6.49 NA NA 3.26 2.57 0.46 NA NA 10.21 9.52 000 52343 ......... ............ A Cysto w/renal stricture tx ............................... 7.19 NA NA 3.54 2.82 0.51 NA NA 11.24 10.52 000 52344 ......... ............ A Cysto/uretero, stricture tx .............................. 7.69 NA NA 3.91 3.07 0.55 NA NA 12.15 11.31 000 52345 ......... ............ A Cysto/uretero w/up stricture .......................... 8.19 NA NA 4.12 3.24 0.58 NA NA 12.89 12.01 000 52346 ......... ............ A Cystouretero w/renal strict ............................ 9.22 NA NA 4.52 3.59 0.65 NA NA 14.39 13.46 000 52351 ......... ............ A Cystouretero & or pyeloscope ....................... 5.85 NA NA 3.00 2.36 0.41 NA NA 9.26 8.62 000 52352 ......... ............ A Cystouretero w/stone remove ....................... 6.87 NA NA 3.52 2.76 0.49 NA NA 10.88 10.12 000 52353 ......... ............ A Cystouretero w/lithotripsy .............................. 7.96 NA NA 3.96 3.13 0.57 NA NA 12.49 11.66 000 52354 ......... ............ A Cystouretero w/biopsy ................................... 7.33 NA NA 3.71 2.93 0.52 NA NA 11.56 10.78 000 52355 ......... ............ A Cystouretero w/excise tumor ......................... 8.81 NA NA 4.30 3.43 0.63 NA NA 13.74 12.87 00052400 ......... ............ A Cystouretero w/congen repr .......................... 10.04 NA NA 5.47 4.17 0.68 NA NA 16.19 14.89 090 52402 ......... ............ A Cystourethro cut ejacul duct ......................... 5.27 NA NA 2.20 1.83 0.40 NA NA 7.87 7.50 000 52450 ......... ............ A Incision of prostate ........................................ 7.63 NA NA 5.56 4.14 0.54 NA NA 13.73 12.31 090 52500 ......... ............ A Revision of bladder neck ............................... 9.33 NA NA 6.24 4.50 0.60 NA NA 16.17 14.43 090 52510 ......... ............ A Dilation prostatic urethra ............................... 7.45 NA NA 4.95 3.57 0.48 NA NA 12.88 11.50 090 52601 ......... ............ A Prostatectomy (TURP) .................................. 15.07 NA NA 8.54 5.96 0.87 NA NA 24.48 21.90 090 52606 ......... ............ A Control postop bleeding ................................ 8.80 NA NA 5.57 4.06 0.57 NA NA 14.94 13.43 090 52612 ......... ............ A Prostatectomy, first stage .............................. 9.02 NA NA 5.94 4.28 0.56 NA NA 15.52 13.86 090 52614 ......... ............ A Prostatectomy, second stage ........................ 7.76 NA NA 5.44 3.87 0.48 NA NA 13.68 12.11 090 52620 ......... ............ A Remove residual prostate ............................. 7.16 NA NA 4.64 3.40 0.47 NA NA 12.27 11.03 090 52630 ......... ............ A Remove prostate regrowth ............................ 7.61 NA NA 4.85 3.61 0.51 NA NA 12.97 11.73 09052640 ......... ............ A Relieve bladder contracture .......................... 6.85 NA NA 4.45 3.33 0.47 NA NA 11.77 10.65 090 52647 ......... ............ A Laser surgery of prostate .............................. 11.09 42.33 66.04 6.97 5.14 0.73 54.15 77.86 18.79 16.96 090 52648 ......... ............ A Laser surgery of prostate .............................. 11.94 42.86 66.17 7.30 5.42 0.79 55.59 78.90 20.03 18.15 090 52700 ......... ............ A Drainage of prostate abscess ....................... 7.35 NA NA 5.00 3.64 0.48 NA NA 12.83 11.47 090 53000 ......... ............ A Incision of urethra .......................................... 2.28 NA NA 1.81 1.61 0.16 NA NA 4.25 4.05 010 53010 ......... ............ A Incision of urethra .......................................... 4.31 NA NA 3.83 3.14 0.24 NA NA 8.38 7.69 090 53020 ......... ............ A Incision of urethra .......................................... 1.77 NA NA 0.96 0.74 0.13 NA NA 2.86 2.64 000 53025 ......... ............ A Incision of urethra .......................................... 1.13 NA NA 0.68 0.55 0.08 NA NA 1.89 1.76 000 53040 ......... ............ A Drainage of urethra abscess ......................... 6.45 NA NA 4.45 3.69 0.45 NA NA 11.35 10.59 09053060 ......... ............ A Drainage of urethra abscess ......................... 2.63 2.01 2.06 1.47 1.40 0.28 4.92 4.97 4.38 4.31 010 53080 ......... ............ A Drainage of urinary leakage .......................... 6.78 NA NA 4.94 5.70 0.52 NA NA 12.24 13.00 090 53085 ......... ............ A Drainage of urinary leakage .......................... 11.00 NA NA 4.54 6.69 0.92 NA NA 16.46 18.60 090 53200 ......... ............ A Biopsy of urethra ........................................... 2.59 1.71 1.42 1.30 1.06 0.20 4.50 4.21 4.09 3.85 000 53210 ......... ............ A Removal of urethra ........................................ 13.54 NA NA 7.80 6.32 0.89 NA NA 22.23 20.75 090 53215 ......... ............ A Removal of urethra ........................................ 16.67 NA NA 9.22 7.27 1.10 NA NA 26.99 25.04 090 53220 ......... ............ A Treatment of urethra lesion ........................... 7.49 NA NA 5.04 4.04 0.49 NA NA 13.02 12.02 090 53230 ......... ............ A Removal of urethra lesion ............................. 10.26 NA NA 6.49 5.16 0.73 NA NA 17.48 16.15 090 53235 ......... ............ A Removal of urethra lesion ............................. 10.81 NA NA 6.96 5.42 0.72 NA NA 18.49 16.95 090 53240 ......... ............ A Surgery for urethra pouch ............................. 6.94 NA NA 4.80 3.84 0.52 NA NA 12.26 11.30 090 53250 ......... ............ A Removal of urethra gland .............................. 6.38 NA NA 4.72 3.65 0.49 NA NA 11.59 10.52 090 53260 ......... ............ A Treatment of urethra lesion ........................... 2.98 2.48 2.30 1.86 1.53 0.25 5.71 5.53 5.09 4.76 010 53265 ......... ............ A Treatment of urethra lesion ........................... 3.12 2.98 2.78 2.02 1.57 0.24 6.34 6.14 5.38 4.93 010 53270 ......... ............ A Removal of urethra gland .............................. 3.09 2.31 2.23 1.72 1.59 0.30 5.70 5.62 5.11 4.98 010 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49155 

53275 ......... ............ A Repair of urethra defect ................................ 4.52 NA NA 2.79 2.39 0.32 NA NA 7.63 7.23 010 53400 ......... ............ A Revise urethra, stage 1 ................................. 13.92 NA NA 8.23 6.57 0.98 NA NA 23.13 21.47 090 53405 ......... ............ A Revise urethra, stage 2 ................................. 15.45 NA NA 8.96 6.97 1.10 NA NA 25.51 23.52 090 53410 ......... ............ A Reconstruction of urethra .............................. 17.47 NA NA 9.84 7.75 1.16 NA NA 28.47 26.38 090 53415 ......... ............ A Reconstruction of urethra .............................. 20.49 NA NA 11.00 8.25 1.37 NA NA 32.86 30.11 090 53420 ......... ............ A Reconstruct urethra, stage 1 ......................... 14.99 NA NA 6.51 6.34 0.96 NA NA 22.46 22.29 090 53425 ......... ............ A Reconstruct urethra, stage 2 ......................... 16.89 NA NA 9.30 7.49 1.13 NA NA 27.32 25.51 090 53430 ......... ............ A Reconstruction of urethra .............................. 17.25 NA NA 8.73 7.43 1.15 NA NA 27.13 25.83 090 53431 ......... ............ A Reconstruct urethra/bladder .......................... 20.97 NA NA 11.08 8.81 1.41 NA NA 33.46 31.19 090 53440 ......... ............ A Male sling procedure ..................................... 15.33 NA NA 9.31 6.81 0.96 NA NA 25.60 23.10 090 53442 ......... ............ A Remove/revise male sling ............................. 13.28 NA NA 8.50 6.20 0.82 NA NA 22.60 20.30 090 53444 ......... ............ A Insert tandem cuff ......................................... 14.00 NA NA 8.09 6.43 0.94 NA NA 23.03 21.37 090 53445 ......... ............ A Insert uro/ves nck sphincter .......................... 15.15 NA NA 8.86 7.53 0.99 NA NA 25.00 23.67 090 53446 ......... ............ A Remove uro sphincter ................................... 10.83 NA NA 7.10 5.68 0.72 NA NA 18.65 17.23 090 53447 ......... ............ A Remove/replace ur sphincter ........................ 14.09 NA NA 8.48 6.94 0.95 NA NA 23.52 21.98 09053448 ......... ............ A Remov/replc ur sphinctr comp ...................... 23.20 NA NA 12.52 9.91 1.50 NA NA 37.22 34.61 09053449 ......... ............ A Repair uro sphincter ...................................... 10.38 NA NA 6.70 5.22 0.68 NA NA 17.76 16.28 090 53450 ......... ............ A Revision of urethra ........................................ 6.63 NA NA 4.81 3.67 0.43 NA NA 11.87 10.73 090 53460 ......... ............ A Revision of urethra ........................................ 7.61 NA NA 5.17 4.06 0.50 NA NA 13.28 12.17 090 53500 ......... ............ A Urethrlys, transvag w/scope .......................... 12.81 NA NA 7.47 6.52 0.90 NA NA 21.18 20.23 090 53502 ......... ............ A Repair of urethra injury ................................. 8.12 NA NA 5.06 4.25 0.62 NA NA 13.80 12.99 090 53505 ......... ............ A Repair of urethra injury ................................. 8.12 NA NA 5.45 4.26 0.54 NA NA 14.11 12.92 090 53510 ......... ............ A Repair of urethra injury ................................. 10.78 NA NA 6.78 5.57 0.74 NA NA 18.30 17.08 090 53515 ......... ............ A Repair of urethra injury ................................. 14.04 NA NA 7.89 6.41 1.05 NA NA 22.98 21.50 090 53520 ......... ............ A Repair of urethra defect ................................ 9.30 NA NA 6.17 4.90 0.61 NA NA 16.08 14.81 090 53600 ......... ............ A Dilate urethra stricture ................................... 1.21 1.16 1.15 0.57 0.47 0.09 2.46 2.45 1.87 1.77 000 53601 ......... ............ A Dilate urethra stricture ................................... 0.98 1.38 1.30 0.53 0.41 0.07 2.43 2.35 1.58 1.46 000 53605 ......... ............ A Dilate urethra stricture ................................... 1.28 NA NA 0.52 0.44 0.09 NA NA 1.89 1.81 000 53620 ......... ............ A Dilate urethra stricture ................................... 1.62 1.72 1.92 0.84 0.65 0.11 3.45 3.65 2.57 2.38 000 53621 ......... ............ A Dilate urethra stricture ................................... 1.35 1.83 2.01 0.68 0.54 0.10 3.28 3.46 2.13 1.99 000 53660 ......... ............ A Dilation of urethra .......................................... 0.71 1.33 1.32 0.46 0.35 0.05 2.09 2.08 1.22 1.11 000 53661 ......... ............ A Dilation of urethra .......................................... 0.72 1.31 1.30 0.42 0.32 0.05 2.08 2.07 1.19 1.09 000 53665 ......... ............ A Dilation of urethra .......................................... 0.76 NA NA 0.27 0.26 0.06 NA NA 1.09 1.08 000 53850 ......... ............ A Prostatic microwave thermotx ....................... 9.94 49.68 82.97 5.94 4.44 0.67 60.29 93.58 16.55 15.05 090 53852 ......... ............ A Prostatic rf thermotx ...................................... 10.62 46.82 78.28 6.74 4.96 0.70 58.14 89.60 18.06 16.28 090 53853 ......... ............ A Prostatic water thermother ............................ 5.48 29.37 48.85 4.39 3.24 0.37 35.22 54.70 10.24 9.09 090 53899 ......... ............ C Urology surgery procedure ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 54000 ......... ............ A Slitting of prepuce ......................................... 1.54 2.72 2.86 1.49 1.07 0.11 4.37 4.51 3.14 2.72 010 54001 ......... ............ A Slitting of prepuce ......................................... 2.19 3.07 3.15 1.67 1.25 0.15 5.41 5.49 4.01 3.59 010 54015 ......... ............ A Drain penis lesion .......................................... 5.31 NA NA 3.22 2.72 0.38 NA NA 8.91 8.41 010 54050 ......... ............ A Destruction, penis lesion(s) ........................... 1.24 2.05 1.76 1.35 1.11 0.08 3.37 3.08 2.67 2.43 010 54055 ......... ............ A Destruction, penis lesion(s) ........................... 1.22 1.97 1.67 1.23 0.91 0.08 3.27 2.97 2.53 2.21 010 54056 ......... ............ A Cryosurgery, penis lesion(s) ......................... 1.24 2.29 1.84 1.48 1.22 0.06 3.59 3.14 2.78 2.52 010 54057 ......... ............ A Laser surg, penis lesion(s) ............................ 1.24 2.61 2.31 1.36 0.96 0.09 3.94 3.64 2.69 2.29 010 54060 ......... ............ A Excision of penis lesion(s) ............................ 1.93 3.11 3.10 1.64 1.21 0.13 5.17 5.16 3.70 3.27 010 54065 ......... ............ A Destruction, penis lesion(s) ........................... 2.42 3.22 2.78 1.94 1.41 0.13 5.77 5.33 4.49 3.96 010 54100 ......... ............ A Biopsy of penis .............................................. 1.90 3.30 2.93 1.34 0.95 0.10 5.30 4.93 3.34 2.95 000 54105 ......... ............ A Biopsy of penis .............................................. 3.49 4.03 4.22 2.47 2.07 0.25 7.77 7.96 6.21 5.81 010 54110 ......... ............ A Treatment of penis lesion .............................. 10.74 NA NA 6.58 5.21 0.72 NA NA 18.03 16.67 090 54111 ......... ............ A Treat penis lesion, graft ................................ 14.24 NA NA 8.13 6.35 0.96 NA NA 23.33 21.55 090 54112 ......... ............ A Treat penis lesion, graft ................................ 16.77 NA NA 9.42 7.45 1.11 NA NA 27.30 25.33 090 54115 ......... ............ A Treatment of penis lesion .............................. 6.77 5.87 4.75 5.03 3.85 0.43 13.07 11.95 12.23 11.05 090 54120 ......... ............ A Partial removal of penis ................................ 10.83 NA NA 6.81 5.21 0.68 NA NA 18.32 16.72 090 54125 ......... ............ A Removal of penis .......................................... 14.38 NA NA 8.25 6.43 0.95 NA NA 23.58 21.76 090 54130 ......... ............ A Remove penis & nodes ................................. 21.59 NA NA 11.40 8.98 1.52 NA NA 34.51 32.09 090 54135 ......... ............ A Remove penis & nodes ................................. 27.92 NA NA 14.31 11.20 1.87 NA NA 44.10 40.99 090 54150 ......... ............ A Circumcision .................................................. 1.81 2.56 3.90 0.57 0.67 0.16 4.53 5.87 2.54 2.64 000 54152 ......... ............ A Circumcision .................................................. 2.31 NA NA 1.72 1.33 0.19 NA NA 4.22 3.83 010 54160 ......... ............ A Circumcision .................................................. 2.48 3.69 4.03 1.45 1.18 0.19 6.36 6.70 4.12 3.85 010 54161 ......... ............ A Circumcision .................................................. 3.27 NA NA 2.22 1.73 0.23 NA NA 5.72 5.23 010 54162 ......... ............ A Lysis penil circumic lesion ............................. 3.25 4.02 4.49 2.27 1.65 0.21 7.48 7.95 5.73 5.11 010 54163 ......... ............ A Repair of circumcision ................................... 3.25 NA NA 2.89 2.22 0.21 NA NA 6.35 5.68 010 54164 ......... ............ A Frenulotomy of penis ..................................... 2.75 NA NA 2.65 2.04 0.18 NA NA 5.58 4.97 010 54200 ......... ............ A Treatment of penis lesion .............................. 1.06 2.03 1.85 1.31 1.06 0.08 3.17 2.99 2.45 2.20 010 54205 ......... ............ A Treatment of penis lesion .............................. 8.79 NA NA 6.12 5.04 0.56 NA NA 15.47 14.39 090 54220 ......... ............ A Treatment of penis lesion .............................. 2.42 3.35 3.72 1.37 1.06 0.17 5.94 6.31 3.96 3.65 000 

mstockstill on PROD1PC63 with PROPOSAL_2

49156 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

54230 ......... ............ A Prepare penis study ...................................... 1.34 1.41 1.16 0.91 0.70 0.09 2.84 2.59 2.34 2.13 000 54231 ......... ............ A Dynamic cavernosometry .............................. 2.04 1.87 1.50 1.18 0.95 0.16 4.07 3.70 3.38 3.15 000 54235 ......... ............ A Penile injection .............................................. 1.19 1.40 1.07 0.90 0.66 0.08 2.67 2.34 2.17 1.93 000 54240 ......... ............ A Penis study .................................................... 1.31 1.55 1.16 1.55 1.16 0.17 3.03 2.64 3.03 2.64 000 54240 ......... 26 ....... A Penis study .................................................... 1.31 0.50 0.45 0.50 0.45 0.11 1.92 1.87 1.92 1.87 000 54240 ......... TC ...... A Penis study .................................................... 0.00 1.05 0.71 1.05 0.71 0.06 1.11 0.77 1.11 0.77 000 54250 ......... ............ A Penis study .................................................... 2.22 1.25 1.00 1.25 1.00 0.18 3.65 3.40 3.65 3.40 000 54250 ......... 26 ....... A Penis study .................................................... 2.22 0.88 0.75 0.88 0.75 0.16 3.26 3.13 3.26 3.13 000 54250 ......... TC ...... A Penis study .................................................... 0.00 0.37 0.24 0.37 0.24 0.02 0.39 0.26 0.39 0.26 000 54300 ......... ............ A Revision of penis ........................................... 11.02 NA NA 6.80 5.87 0.76 NA NA 18.58 17.65 090 54304 ......... ............ A Revision of penis ........................................... 13.10 NA NA 7.89 6.71 0.88 NA NA 21.87 20.69 090 54308 ......... ............ A Reconstruction of urethra .............................. 12.44 NA NA 7.58 6.36 0.84 NA NA 20.86 19.64 090 54312 ......... ............ A Reconstruction of urethra .............................. 14.30 NA NA 8.58 7.38 1.24 NA NA 24.12 22.92 090 54316 ......... ............ A Reconstruction of urethra .............................. 17.84 NA NA 10.07 8.47 1.21 NA NA 29.12 27.52 090 54318 ......... ............ A Reconstruction of urethra .............................. 12.22 NA NA 6.25 5.90 1.39 NA NA 19.86 19.51 090 54322 ......... ............ A Reconstruction of urethra .............................. 13.80 NA NA 7.94 6.82 0.92 NA NA 22.66 21.54 090 54324 ......... ............ A Reconstruction of urethra .............................. 17.34 NA NA 9.83 8.42 1.14 NA NA 28.31 26.90 090 54326 ......... ............ A Reconstruction of urethra .............................. 16.81 NA NA 9.65 8.24 1.11 NA NA 27.57 26.16 090 54328 ......... ............ A Revise penis/urethra ..................................... 16.68 NA NA 9.73 7.86 0.98 NA NA 27.39 25.52 090 54332 ......... ............ A Revise penis/urethra ..................................... 18.16 NA NA 10.20 8.34 1.21 NA NA 29.57 27.71 090 54336 ......... ............ A Revise penis/urethra ..................................... 21.37 NA NA 11.88 10.68 2.20 NA NA 35.45 34.25 090 54340 ......... ............ A Secondary urethral surgery ........................... 9.53 NA NA 6.43 5.38 0.63 NA NA 16.58 15.54 090 54344 ......... ............ A Secondary urethral surgery ........................... 16.85 NA NA 9.79 8.25 1.54 NA NA 28.18 26.64 090 54348 ......... ............ A Secondary urethral surgery ........................... 18.11 NA NA 6.40 7.86 1.23 NA NA 25.74 27.20 090 54352 ......... ............ A Reconstruct urethra/penis ............................. 25.88 NA NA 13.72 11.81 2.24 NA NA 41.84 39.93 090 54360 ......... ............ A Penis plastic surgery ..................................... 12.60 NA NA 7.54 6.40 0.84 NA NA 20.98 19.84 090 54380 ......... ............ A Repair penis .................................................. 13.97 NA NA 5.59 6.35 0.93 NA NA 20.49 21.25 090 54385 ......... ............ A Repair penis .................................................. 16.31 NA NA 8.37 8.28 0.86 NA NA 25.54 25.45 090 54390 ......... ............ A Repair penis and bladder .............................. 22.52 NA NA 7.49 8.92 1.54 NA NA 31.55 32.98 090 54400 ......... ............ A Insert semi-rigid prosthesis ........................... 9.04 NA NA 5.80 4.71 0.64 NA NA 15.48 14.39 090 54401 ......... ............ A Insert self-contd prosthesis ........................... 10.26 NA NA 8.26 6.36 0.73 NA NA 19.25 17.35 090 54405 ......... ............ A Insert multi-comp penis pros ......................... 14.34 NA NA 8.22 6.49 0.95 NA NA 23.51 21.78 090 54406 ......... ............ A Remove muti-comp penis pros ..................... 12.70 NA NA 7.70 5.98 0.86 NA NA 21.26 19.54 090 54408 ......... ............ A Repair multi-comp penis pros ....................... 13.67 NA NA 8.31 6.37 0.90 NA NA 22.88 20.94 09054410 ......... ............ A Remove/replace penis prosth ....................... 16.42 NA NA 9.45 7.32 1.10 NA NA 26.97 24.84 090 54411 ......... ............ A Remov/replc penis pros, comp ..................... 18.06 NA NA 10.50 7.90 1.13 NA NA 29.69 27.09 090 54415 ......... ............ A Remove self-contd penis pros ...................... 8.69 NA NA 6.06 4.66 0.58 NA NA 15.33 13.93 090 54416 ......... ............ A Remv/repl penis contain pros ....................... 11.79 NA NA 7.96 6.01 0.77 NA NA 20.52 18.57 09054417 ......... ............ A Remv/replc penis pros, compl ....................... 15.88 NA NA 9.22 6.93 1.00 NA NA 26.10 23.81 09054420 ......... ............ A Revision of penis ........................................... 12.21 NA NA 7.61 6.07 0.81 NA NA 20.63 19.08 090 54430 ......... ............ A Revision of penis ........................................... 10.88 NA NA 6.99 5.57 0.72 NA NA 18.58 17.17 090 54435 ......... ............ A Revision of penis ........................................... 6.67 NA NA 4.98 3.95 0.43 NA NA 12.08 11.05 090 54440 ......... ............ C Repair of penis .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 090 54450 ......... ............ A Preputial stretching ........................................ 1.12 0.86 0.93 0.49 0.45 0.08 2.06 2.13 1.69 1.65 000 54500 ......... ............ A Biopsy of testis .............................................. 1.31 NA NA 0.80 0.62 0.10 NA NA 2.21 2.03 000 54505 ......... ............ A Biopsy of testis .............................................. 3.45 NA NA 2.41 2.04 0.27 NA NA 6.13 5.76 010 54512 ......... ............ A Excise lesion testis ........................................ 9.19 NA NA 5.72 4.52 0.67 NA NA 15.58 14.38 090 54520 ......... ............ A Removal of testis ........................................... 5.22 NA NA 3.76 3.03 0.50 NA NA 9.48 8.75 090 54522 ......... ............ A Orchiectomy, partial ...................................... 10.11 NA NA 5.80 5.10 0.89 NA NA 16.80 16.10 090 54530 ......... ............ A Removal of testis ........................................... 9.26 NA NA 6.13 4.71 0.66 NA NA 16.05 14.63 090 54535 ......... ............ A Extensive testis surgery ................................ 13.01 NA NA 7.59 6.05 0.95 NA NA 21.55 20.01 090 54550 ......... ............ A Exploration for testis ...................................... 8.27 NA NA 5.38 4.20 0.59 NA NA 14.24 13.06 090 54560 ......... ............ A Exploration for testis ...................................... 11.92 NA NA 6.32 5.44 0.90 NA NA 19.14 18.26 090 54600 ......... ............ A Reduce testis torsion ..................................... 7.50 NA NA 5.18 3.95 0.51 NA NA 13.19 11.96 090 54620 ......... ............ A Suspension of testis ...................................... 5.14 NA NA 3.28 2.64 0.37 NA NA 8.79 8.15 010 54640 ......... ............ A Suspension of testis ...................................... 7.53 NA NA 5.50 4.17 0.62 NA NA 13.65 12.32 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49157 

54650 ......... ............ A Orchiopexy (Fowler-Stephens) ...................... 12.18 NA NA 7.72 5.97 1.16 NA NA 21.06 19.31 090 54660 ......... ............ A Revision of testis ........................................... 5.60 NA NA 4.44 3.35 0.44 NA NA 10.48 9.39 090 54670 ......... ............ A Repair testis injury ......................................... 6.52 NA NA 4.84 3.86 0.47 NA NA 11.83 10.85 090 54680 ......... ............ A Relocation of testis(es) .................................. 13.86 NA NA 7.78 6.55 1.16 NA NA 22.80 21.57 090 54690 ......... ............ A Laparoscopy, orchiectomy ............................ 11.56 NA NA 6.20 5.25 1.02 NA NA 18.78 17.83 090 54692 ......... ............ A Laparoscopy, orchiopexy .............................. 13.60 NA NA 7.66 5.98 1.30 NA NA 22.56 20.88 090 54699 ......... ............ C Laparoscope proc, testis ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 54700 ......... ............ A Drainage of scrotum ...................................... 3.42 NA NA 2.40 2.05 0.28 NA NA 6.10 5.75 010 54800 ......... ............ A Biopsy of epididymis ..................................... 2.33 NA NA 1.00 0.93 0.23 NA NA 3.56 3.49 000 54820 ......... ............ A Exploration of epididymis .............................. 5.63 NA NA 4.32 3.28 0.40 NA NA 10.35 9.31 090 54830 ......... ............ A Remove epididymis lesion ............................ 5.87 NA NA 4.48 3.38 0.41 NA NA 10.76 9.66 090 54840 ......... ............ A Remove epididymis lesion ............................ 5.19 NA NA 3.84 3.04 0.37 NA NA 9.40 8.60 090 54860 ......... ............ A Removal of epididymis .................................. 6.81 NA NA 4.92 3.71 0.45 NA NA 12.18 10.97 090 54861 ......... ............ A Removal of epididymis .................................. 9.52 NA NA 6.32 4.81 0.63 NA NA 16.47 14.96 090 54900 ......... ............ A Fusion of spermatic ducts ............................. 13.99 NA NA 5.29 5.66 0.93 NA NA 20.21 20.58 090 54901 ......... ............ A Fusion of spermatic ducts ............................. 18.85 NA NA 6.64 7.29 1.82 NA NA 27.31 27.96 090 55000 ......... ............ A Drainage of hydrocele ................................... 1.43 1.86 2.01 0.92 0.72 0.11 3.40 3.55 2.46 2.26 000 55040 ......... ............ A Removal of hydrocele ................................... 5.35 NA NA 3.98 3.16 0.43 NA NA 9.76 8.94 090 55041 ......... ............ A Removal of hydroceles .................................. 8.36 NA NA 5.74 4.41 0.60 NA NA 14.70 13.37 090 55060 ......... ............ A Repair of hydrocele ....................................... 6.01 NA NA 4.47 3.42 0.46 NA NA 10.94 9.89 090 55100 ......... ............ A Drainage of scrotum abscess ....................... 2.38 3.52 3.63 2.12 1.70 0.17 6.07 6.18 4.67 4.25 010 55110 ......... ............ A Explore scrotum ............................................ 6.19 NA NA 4.52 3.47 0.43 NA NA 11.14 10.09 090 55120 ......... ............ A Removal of scrotum lesion ............................ 5.58 NA NA 4.30 3.28 0.39 NA NA 10.27 9.25 09055150 ......... ............ A Removal of scrotum ...................................... 7.96 NA NA 5.49 4.25 0.56 NA NA 14.01 12.77 090 55175 ......... ............ A Revision of scrotum ....................................... 5.73 NA NA 4.38 3.35 0.37 NA NA 10.48 9.45 090 55180 ......... ............ A Revision of scrotum ....................................... 11.57 NA NA 7.32 5.84 0.90 NA NA 19.79 18.31 090 55200 ......... ............ A Incision of sperm duct ................................... 4.48 8.27 11.30 3.38 2.62 0.33 13.08 16.11 8.19 7.43 090 55250 ......... ............ A Removal of sperm duct(s) ............................. 3.29 7.74 10.54 3.00 2.41 0.25 11.28 14.08 6.54 5.95 090 55300 ......... ............ A Prepare, sperm duct x-ray ............................ 3.50 NA NA 1.63 1.39 0.25 NA NA 5.38 5.14 000 55400 ......... ............ A Repair of sperm duct ..................................... 8.48 NA NA 5.50 4.41 0.64 NA NA 14.62 13.53 090 55450 ......... ............ A Ligation of sperm duct ................................... 4.36 6.00 6.74 2.86 2.11 0.29 10.65 11.39 7.51 6.76 010 55500 ......... ............ A Removal of hydrocele ................................... 6.08 NA NA 4.26 3.38 0.55 NA NA 10.89 10.01 090 55520 ......... ............ A Removal of sperm cord lesion ...................... 6.52 NA NA 3.86 3.40 0.75 NA NA 11.13 10.67 090 55530 ......... ............ A Revise spermatic cord veins ......................... 5.65 NA NA 4.16 3.29 0.45 NA NA 10.26 9.39 090 55535 ......... ............ A Revise spermatic cord veins ......................... 7.05 NA NA 4.88 3.76 0.47 NA NA 12.40 11.28 09055540 ......... ............ A Revise hernia & sperm veins ........................ 8.16 NA NA 4.32 3.92 0.94 NA NA 13.42 13.02 090 55550 ......... ............ A Laparo ligate spermatic vein ......................... 7.06 NA NA 4.58 3.61 0.57 NA NA 12.21 11.24 090 55559 ......... ............ C Laparo proc, spermatic cord ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 55600 ......... ............ A Incise sperm duct pouch ............................... 6.87 NA NA 4.95 3.73 0.62 NA NA 12.44 11.22 090 55605 ......... ............ A Incise sperm duct pouch ............................... 8.58 NA NA 4.94 4.45 0.64 NA NA 14.16 13.67 090 55650 ......... ............ A Remove sperm duct pouch ........................... 12.47 NA NA 7.31 5.77 0.92 NA NA 20.70 19.16 090 55680 ......... ............ A Remove sperm pouch lesion ........................ 5.56 NA NA 3.90 3.20 0.47 NA NA 9.93 9.23 090 55700 ......... ............ A Biopsy of prostate ......................................... 2.58 3.75 4.08 1.34 0.82 0.11 6.44 6.77 4.03 3.51 000 55705 ......... ............ A Biopsy of prostate ......................................... 4.56 NA NA 2.89 2.44 0.32 NA NA 7.77 7.32 010 55720 ......... ............ A Drainage of prostate abscess ....................... 7.63 NA NA 4.84 4.07 0.95 NA NA 13.42 12.65 090 55725 ......... ............ A Drainage of prostate abscess ....................... 9.84 NA NA 6.41 4.96 0.70 NA NA 16.95 15.50 090 55801 ......... ............ A Removal of prostate ...................................... 19.55 NA NA 10.68 8.37 1.34 NA NA 31.57 29.26 090 55810 ......... ............ A Extensive prostate surgery ............................ 24.08 NA NA 12.49 9.81 1.60 NA NA 38.17 35.49 090 55812 ......... ............ A Extensive prostate surgery ............................ 29.61 NA NA 15.07 11.99 2.04 NA NA 46.72 43.64 090 55815 ......... ............ A Extensive prostate surgery ............................ 32.67 NA NA 16.50 13.03 2.16 NA NA 51.33 47.86 090 55821 ......... ............ A Removal of prostate ...................................... 15.58 NA NA 8.79 6.84 1.01 NA NA 25.38 23.43 090 55831 ......... ............ A Removal of prostate ...................................... 17.01 NA NA 9.37 7.32 1.10 NA NA 27.48 25.43 090 55840 ......... ............ A Extensive prostate surgery ............................ 24.38 NA NA 12.82 10.15 1.61 NA NA 38.81 36.14 090 55842 ......... ............ A Extensive prostate surgery ............................ 26.24 NA NA 13.67 10.78 1.72 NA NA 41.63 38.74 090 55845 ......... ............ A Extensive prostate surgery ............................ 30.46 NA NA 14.90 11.91 2.02 NA NA 47.38 44.39 090 55859 ......... ............ A Percut/needle insert, pros ............................. 13.25 NA NA 7.90 6.35 0.89 NA NA 22.04 20.49 090 55860 ......... ............ A Surgical exposure, prostate .......................... 15.66 NA NA 8.73 6.98 1.02 NA NA 25.41 23.66 090 55862 ......... ............ A Extensive prostate surgery ............................ 19.83 NA NA 10.84 8.58 1.49 NA NA 32.16 29.90 090 55865 ......... ............ A Extensive prostate surgery ............................ 24.32 NA NA 12.97 10.17 1.63 NA NA 38.92 36.12 090 55866 ......... ............ A Laparo radical prostatectomy ........................ 32.17 NA NA 16.15 12.81 2.16 NA NA 50.48 47.14 090 55870 ......... ............ A Electroejaculation .......................................... 2.58 2.47 1.77 1.44 1.17 0.16 5.21 4.51 4.18 3.91 000 55873 ......... ............ A Cryoablate prostate ....................................... 20.19 NA NA 11.44 9.56 1.38 NA NA 33.01 31.13 090 55899 ......... ............ C Genital surgery procedure ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 56405 ......... ............ A I & D of vulva/perineum ................................ 1.44 1.18 1.29 1.16 1.15 0.17 2.79 2.90 2.77 2.76 010 56420 ......... ............ A Drainage of gland abscess ........................... 1.39 1.52 2.08 0.78 0.98 0.16 3.07 3.63 2.33 2.53 010 56440 ......... ............ A Surgery for vulva lesion ................................ 2.84 NA NA 1.54 1.67 0.34 NA NA 4.72 4.85 010 

mstockstill on PROD1PC63 with PROPOSAL_2

49158 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

56441 ......... ............ A Lysis of labial lesion(s) .................................. 1.97 1.71 1.79 1.56 1.45 0.20 3.88 3.96 3.73 3.62 010 56501 ......... ............ A Destroy, vulva lesions, sim ........................... 1.53 1.64 1.75 1.22 1.24 0.18 3.35 3.46 2.93 2.95 010 56515 ......... ............ A Destroy vulva lesion/s compl ........................ 3.01 2.37 2.50 1.73 1.79 0.33 5.71 5.84 5.07 5.13 010 56605 ......... ............ A Biopsy of vulva/perineum .............................. 1.10 0.91 1.03 0.35 0.43 0.13 2.14 2.26 1.58 1.66 000 56606 ......... ............ A Biopsy of vulva/perineum .............................. 0.55 0.36 0.46 0.16 0.21 0.07 0.98 1.08 0.78 0.83 ZZZ 56620 ......... ............ A Partial removal of vulva ................................. 8.39 NA NA 4.41 4.70 0.90 NA NA 13.70 13.99 090 56625 ......... ............ A Complete removal of vulva ........................... 9.50 NA NA 4.77 5.18 1.02 NA NA 15.28 15.70 09056630 ......... ............ A Extensive vulva surgery ................................ 14.62 NA NA 6.28 6.69 1.49 NA NA 22.39 22.80 090 56631 ......... ............ A Extensive vulva surgery ................................ 18.75 NA NA 7.74 8.54 1.95 NA NA 28.44 29.24 090 56632 ......... ............ A Extensive vulva surgery ................................ 21.51 NA NA 9.30 9.46 2.38 NA NA 33.19 33.35 090 56633 ......... ............ A Extensive vulva surgery ................................ 19.41 NA NA 7.79 8.39 1.97 NA NA 29.17 29.77 090 56634 ......... ............ A Extensive vulva surgery ................................ 20.42 NA NA 8.18 9.11 2.16 NA NA 30.76 31.69 090 56637 ......... ............ A Extensive vulva surgery ................................ 24.51 NA NA 9.20 10.60 2.60 NA NA 36.31 37.71 090 56640 ......... ............ A Extensive vulva surgery ................................ 24.60 NA NA 9.07 10.23 2.88 NA NA 36.55 37.71 090 56700 ......... ............ A Partial removal of hymen .............................. 2.77 NA NA 1.77 1.82 0.30 NA NA 4.84 4.89 01056720 ......... ............ A Incision of hymen .......................................... 0.68 NA NA 0.52 0.51 0.08 NA NA 1.28 1.27 000 56740 ......... ............ A Remove vagina gland lesion ......................... 4.81 NA NA 2.32 2.50 0.56 NA NA 7.69 7.87 010 56800 ......... ............ A Repair of vagina ............................................ 3.88 NA NA 2.00 2.14 0.44 NA NA 6.32 6.46 010 56805 ......... ............ A Repair clitoris ................................................. 19.69 NA NA 9.28 9.38 2.14 NA NA 31.11 31.21 090 56810 ......... ............ A Repair of perineum ........................................ 4.24 NA NA 2.06 2.23 0.49 NA NA 6.79 6.96 010 56820 ......... ............ A Exam of vulva w/scope ................................. 1.50 1.20 1.28 0.53 0.62 0.18 2.88 2.96 2.21 2.30 000 56821 ......... ............ A Exam/biopsy of vulva w/scope ...................... 2.05 1.55 1.70 0.69 0.86 0.25 3.85 4.00 2.99 3.16 000 57000 ......... ............ A Exploration of vagina ..................................... 2.97 NA NA 1.72 1.72 0.31 NA NA 5.00 5.00 010 57010 ......... ............ A Drainage of pelvic abscess ........................... 6.70 NA NA 3.85 3.81 0.71 NA NA 11.26 11.22 090 57020 ......... ............ A Drainage of pelvic fluid .................................. 1.50 0.76 0.90 0.45 0.56 0.18 2.44 2.58 2.13 2.24 000 57022 ......... ............ A I & d vaginal hematoma, pp .......................... 2.68 NA NA 1.44 1.48 0.26 NA NA 4.38 4.42 010 57023 ......... ............ A I & d vag hematoma, non-ob ........................ 5.11 NA NA 2.40 2.53 0.58 NA NA 8.09 8.22 010 57061 ......... ............ A Destroy vag lesions, simple .......................... 1.25 1.52 1.62 1.12 1.12 0.15 2.92 3.02 2.52 2.52 010 57065 ......... ............ A Destroy vag lesions, complex ....................... 2.61 2.03 2.23 1.49 1.63 0.31 4.95 5.15 4.41 4.55 010 57100 ......... ............ A Biopsy of vagina ............................................ 1.20 0.93 1.04 0.37 0.45 0.14 2.27 2.38 1.71 1.79 000 57105 ......... ............ A Biopsy of vagina ............................................ 1.69 1.59 1.74 1.34 1.40 0.20 3.48 3.63 3.23 3.29 010 57106 ......... ............ A Remove vagina wall, partial .......................... 7.29 NA NA 4.26 4.20 0.73 NA NA 12.28 12.22 090 57107 ......... ............ A Remove vagina tissue, part .......................... 24.37 NA NA 9.11 10.12 2.71 NA NA 36.19 37.20 090 57109 ......... ............ A Vaginectomy partial w/nodes ........................ 28.19 NA NA 10.34 11.02 3.21 NA NA 41.74 42.42 090 57110 ......... ............ A Remove vagina wall, complete ..................... 15.34 NA NA 6.27 7.02 1.73 NA NA 23.34 24.09 090 57111 ......... ............ A Remove vagina tissue, compl ....................... 28.19 NA NA 10.26 12.02 3.17 NA NA 41.62 43.38 090 57112 ......... ............ A Vaginectomy w/nodes, compl ....................... 30.31 NA NA 11.58 11.96 3.07 NA NA 44.96 45.34 09057120 ......... ............ A Closure of vagina .......................................... 8.14 NA NA 4.21 4.50 0.89 NA NA 13.24 13.53 090 57130 ......... ............ A Remove vagina lesion ................................... 2.43 1.99 2.11 1.49 1.53 0.29 4.71 4.83 4.21 4.25 010 57135 ......... ............ A Remove vagina lesion ................................... 2.67 2.03 2.20 1.54 1.62 0.31 5.01 5.18 4.52 4.60 010 57150 ......... ............ A Treat vagina infection .................................... 0.55 0.58 0.97 0.16 0.20 0.07 1.20 1.59 0.78 0.82 000 57155 ......... ............ A Insert uteri tandems/ovoids ........................... 6.75 NA NA 3.11 4.20 0.43 NA NA 10.29 11.38 090 57160 ......... ............ A Insert pessary/other device ........................... 0.89 1.05 1.02 0.26 0.32 0.10 2.04 2.01 1.25 1.31 000 57170 ......... ............ A Fitting of diaphragm/cap ................................ 0.91 0.57 1.25 0.25 0.31 0.11 1.59 2.27 1.27 1.33 000 57180 ......... ............ A Treat vaginal bleeding ................................... 1.58 1.85 2.08 0.92 1.18 0.19 3.62 3.85 2.69 2.95 010 57200 ......... ............ A Repair of vagina ............................................ 4.31 NA NA 2.95 2.91 0.46 NA NA 7.72 7.68 090 57210 ......... ............ A Repair vagina/perineum ................................ 5.60 NA NA 3.28 3.39 0.62 NA NA 9.50 9.61 09057220 ......... ............ A Revision of urethra ........................................ 4.74 NA NA 3.03 3.08 0.51 NA NA 8.28 8.33 090 57230 ......... ............ A Repair of urethral lesion ................................ 6.19 NA NA 3.78 3.50 0.54 NA NA 10.51 10.23 090 57240 ......... ............ A Repair bladder & vagina ............................... 11.38 NA NA 5.47 4.23 0.62 NA NA 17.47 16.23 090 57250 ......... ............ A Repair rectum & vagina ................................ 11.38 NA NA 5.04 3.94 0.65 NA NA 17.07 15.97 090 57260 ......... ............ A Repair of vagina ............................................ 14.32 NA NA 5.86 5.09 0.97 NA NA 21.15 20.38 090 57265 ......... ............ A Extensive repair of vagina ............................. 15.82 NA NA 6.33 6.11 1.32 NA NA 23.47 23.25 090 57267 ......... ............ A Insert mesh/pelvic flr addon .......................... 4.88 NA NA 1.52 1.86 0.64 NA NA 7.04 7.38 ZZZ57268 ......... ............ A Repair of bowel bulge ................................... 7.43 NA NA 4.31 4.22 0.79 NA NA 12.53 12.44 090 57270 ......... ............ A Repair of bowel pouch .................................. 13.53 NA NA 5.71 6.11 1.42 NA NA 20.66 21.06 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49159 

57280 ......... ............ A Suspension of vagina .................................... 16.58 NA NA 7.02 7.28 1.67 NA NA 25.27 25.53 090 57282 ......... ............ A Colpopexy, extraperitoneal ............................ 7.79 NA NA 4.43 4.48 1.02 NA NA 13.24 13.29 090 57283 ......... ............ A Colpopexy, intraperitoneal ............................. 11.54 NA NA 5.24 5.74 1.02 NA NA 17.80 18.30 090 57284 ......... ............ A Repair paravaginal defect ............................. 13.43 NA NA 6.77 7.05 1.41 NA NA 21.61 21.89 090 57287 ......... ............ A Revise/remove sling repair ............................ 11.43 NA NA 6.47 5.72 0.90 NA NA 18.80 18.05 090 57288 ......... ............ A Repair bladder defect .................................... 13.95 NA NA 7.09 6.20 1.12 NA NA 22.16 21.27 090 57289 ......... ............ A Repair bladder & vagina ............................... 12.63 NA NA 6.23 6.08 1.21 NA NA 20.07 19.92 090 57291 ......... ............ A Construction of vagina .................................. 8.50 NA NA 4.39 4.79 0.93 NA NA 13.82 14.22 090 57292 ......... ............ A Construct vagina with graft ........................... 13.87 NA NA 5.99 6.70 1.58 NA NA 21.44 22.15 090 57295 ......... ............ A Change vaginal graft ..................................... 7.70 NA NA 3.77 4.27 0.91 NA NA 12.38 12.88 090 57300 ......... ............ A Repair rectum-vagina fistula ......................... 8.53 NA NA 4.48 4.33 0.87 NA NA 13.88 13.73 090 57305 ......... ............ A Repair rectum-vagina fistula ......................... 15.18 NA NA 6.20 6.25 1.72 NA NA 23.10 23.15 090 57307 ......... ............ A Fistula repair & colostomy ............................. 16.96 NA NA 7.04 7.00 2.01 NA NA 26.01 25.97 090 57308 ......... ............ A Fistula repair, transperine ............................. 10.42 NA NA 4.88 5.04 1.14 NA NA 16.44 16.60 090 57310 ......... ............ A Repair urethrovaginal lesion ......................... 7.51 NA NA 5.05 4.14 0.54 NA NA 13.10 12.19 090 57311 ......... ............ A Repair urethrovaginal lesion ......................... 8.77 NA NA 5.16 4.37 0.65 NA NA 14.58 13.79 090 57320 ......... ............ A Repair bladder-vagina lesion ........................ 8.74 NA NA 5.34 4.61 0.69 NA NA 14.77 14.04 09057330 ......... ............ A Repair bladder-vagina lesion ........................ 13.07 NA NA 7.18 6.07 1.06 NA NA 21.31 20.20 090 57335 ......... ............ A Repair vagina ................................................ 19.81 NA NA 8.80 8.97 1.91 NA NA 30.52 30.69 090 57400 ......... ............ A Dilation of vagina ........................................... 2.27 NA NA 0.99 1.08 0.26 NA NA 3.52 3.61 000 57410 ......... ............ A Pelvic examination ........................................ 1.75 NA NA 0.92 0.90 0.18 NA NA 2.85 2.83 000 57415 ......... ............ A Remove vaginal foreign body ....................... 2.42 NA NA 1.51 1.44 0.24 NA NA 4.17 4.10 010 57420 ......... ............ A Exam of vagina w/scope ............................... 1.60 1.24 1.32 0.57 0.65 0.19 3.03 3.11 2.36 2.44 000 57421 ......... ............ A Exam/biopsy of vag w/scope ........................ 2.20 1.60 1.78 0.73 0.90 0.27 4.07 4.25 3.20 3.37 000 57425 ......... ............ A Laparoscopy, surg, colpopexy ...................... 16.89 NA NA 7.00 6.72 1.75 NA NA 25.64 25.36 090 57452 ......... ............ A Exam of cervix w/scope ................................ 1.50 1.19 1.26 0.75 0.76 0.18 2.87 2.94 2.43 2.44 000 57454 ......... ............ A Bx/curett of cervix w/scope ........................... 2.33 1.41 1.58 0.97 1.11 0.28 4.02 4.19 3.58 3.72 000 57455 ......... ............ A Biopsy of cervix w/scope ............................... 1.99 1.51 1.67 0.67 0.82 0.24 3.74 3.90 2.90 3.05 000 57456 ......... ............ A Endocerv curettage w/scope ......................... 1.85 1.47 1.61 0.63 0.77 0.22 3.54 3.68 2.70 2.84 000 57460 ......... ............ A Bx of cervix w/scope, leep ............................ 2.83 4.33 5.46 1.11 1.31 0.34 7.50 8.63 4.28 4.48 000 57461 ......... ............ A Conz of cervix w/scope, leep ........................ 3.43 4.63 5.73 1.08 1.37 0.41 8.47 9.57 4.92 5.21 000 57500 ......... ............ A Biopsy of cervix ............................................. 1.20 2.03 2.41 0.65 0.64 0.12 3.35 3.73 1.97 1.96 000 57505 ......... ............ A Endocervical curettage .................................. 1.14 1.32 1.43 1.07 1.09 0.14 2.60 2.71 2.35 2.37 010 57510 ......... ............ A Cauterization of cervix ................................... 1.90 1.32 1.50 0.91 1.01 0.23 3.45 3.63 3.04 3.14 010 57511 ......... ............ A Cryocautery of cervix .................................... 1.90 1.61 1.77 1.27 1.35 0.23 3.74 3.90 3.40 3.48 010 57513 ......... ............ A Laser surgery of cervix .................................. 1.90 1.57 1.68 1.28 1.37 0.23 3.70 3.81 3.41 3.50 010 57520 ......... ............ A Conization of cervix ....................................... 4.03 3.39 3.80 2.52 2.78 0.49 7.91 8.32 7.04 7.30 090 57522 ......... ............ A Conization of cervix ....................................... 3.60 2.79 3.06 2.27 2.41 0.41 6.80 7.07 6.28 6.42 090 57530 ......... ............ A Removal of cervix .......................................... 5.16 NA NA 3.12 3.32 0.58 NA NA 8.86 9.06 090 57531 ......... ............ A Removal of cervix, radical ............................. 29.71 NA NA 10.66 12.54 3.34 NA NA 43.71 45.59 090 57540 ......... ............ A Removal of residual cervix ............................ 13.15 NA NA 5.61 6.08 1.49 NA NA 20.25 20.72 090 57545 ......... ............ A Remove cervix/repair pelvis .......................... 13.96 NA NA 6.23 6.56 1.52 NA NA 21.71 22.04 090 57550 ......... ............ A Removal of residual cervix ............................ 6.20 NA NA 3.65 3.78 0.67 NA NA 10.52 10.65 090 57555 ......... ............ A Remove cervix/repair vagina ......................... 9.80 NA NA 4.80 5.01 1.09 NA NA 15.69 15.90 09057556 ......... ............ A Remove cervix, repair bowel ......................... 9.22 NA NA 4.68 4.81 0.92 NA NA 14.82 14.95 09057700 ......... ............ A Revision of cervix .......................................... 4.17 NA NA 3.31 3.15 0.41 NA NA 7.89 7.73 090 57720 ......... ............ A Revision of cervix .......................................... 4.50 NA NA 2.92 3.06 0.49 NA NA 7.91 8.05 090 57800 ......... ............ A Dilation of cervical canal ............................... 0.77 0.71 0.75 0.42 0.46 0.09 1.57 1.61 1.28 1.32 000 57820 ......... ............ A D & c of residual cervix ................................. 1.67 1.35 1.44 1.05 1.12 0.20 3.22 3.31 2.92 2.99 010 58100 ......... ............ A Biopsy of uterus lining ................................... 1.53 1.14 1.28 0.59 0.69 0.18 2.85 2.99 2.30 2.40 000 58110 ......... ............ A Bx done w/colposcopy add-on ...................... 0.77 0.40 0.51 0.21 0.29 0.09 1.26 1.37 1.07 1.15 ZZZ 58120 ......... ............ A Dilation and curettage ................................... 3.52 2.72 2.41 1.67 1.82 0.39 6.63 6.32 5.58 5.73 010 58140 ......... ............ A Myomectomy abdom method ........................ 15.65 NA NA 6.25 6.89 1.81 NA NA 23.71 24.35 090 58145 ......... ............ A Myomectomy vag method ............................. 8.77 NA NA 4.28 4.66 0.97 NA NA 14.02 14.40 090 58146 ......... ............ A Myomectomy abdom complex ...................... 20.20 NA NA 7.36 8.59 2.32 NA NA 29.88 31.11 090 58150 ......... ............ A Total hysterectomy ........................................ 17.17 NA NA 6.59 7.26 1.84 NA NA 25.60 26.27 090 58152 ......... ............ A Total hysterectomy ........................................ 21.68 NA NA 8.18 9.43 2.47 NA NA 32.33 33.58 090 58180 ......... ............ A Partial hysterectomy ...................................... 16.46 NA NA 6.38 7.18 1.64 NA NA 24.48 25.28 090 58200 ......... ............ A Extensive hysterectomy ................................ 22.96 NA NA 8.15 9.53 2.54 NA NA 33.65 35.03 090 58210 ......... ............ A Extensive hysterectomy ................................ 30.70 NA NA 10.71 12.57 3.37 NA NA 44.78 46.64 090 58240 ......... ............ A Removal of pelvis contents ........................... 43.13 NA NA 15.92 17.19 4.22 NA NA 63.27 64.54 090 58260 ......... ............ A Vaginal hysterectomy .................................... 13.98 NA NA 5.83 6.48 1.57 NA NA 21.38 22.03 090 58262 ......... ............ A Vag hyst including t/o .................................... 15.77 NA NA 6.31 7.11 1.79 NA NA 23.87 24.67 090 58263 ......... ............ A Vag hyst w/t/o & vag repair ........................... 17.06 NA NA 6.67 7.58 1.94 NA NA 25.67 26.58 090 58267 ......... ............ A Vag hyst w/urinary repair .............................. 18.18 NA NA 7.06 8.04 2.06 NA NA 27.30 28.28 090 58270 ......... ............ A Vag hyst w/enterocele repair ........................ 15.16 NA NA 5.99 6.79 1.73 NA NA 22.88 23.68 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49160 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

58275 ......... ............ A Hysterectomy/revise vagina .......................... 16.85 NA NA 6.70 7.50 1.91 NA NA 25.46 26.26 090 58280 ......... ............ A Hysterectomy/revise vagina .......................... 18.15 NA NA 7.08 7.96 2.06 NA NA 27.28 28.17 090 58285 ......... ............ A Extensive hysterectomy ................................ 23.26 NA NA 7.96 9.45 2.70 NA NA 33.92 35.41 090 58290 ......... ............ A Vag hyst complex .......................................... 20.13 NA NA 7.44 8.70 2.29 NA NA 29.86 31.12 090 58291 ......... ............ A Vag hyst incl t/o, complex ............................. 21.92 NA NA 7.87 9.37 2.52 NA NA 32.31 33.81 090 58292 ......... ............ A Vag hyst t/o & repair, compl ......................... 23.21 NA NA 8.34 9.86 2.67 NA NA 34.22 35.74 090 58293 ......... ............ A Vag hyst w/uro repair, compl ........................ 24.19 NA NA 8.55 10.13 2.78 NA NA 35.52 37.10 090 58294 ......... ............ A Vag hyst w/enterocele, compl ....................... 21.41 NA NA 7.22 8.97 2.39 NA NA 31.02 32.77 09058300 ......... ............ N Insert intrauterine device ............................... 1.01 0.63 1.22 0.24 0.35 0.12 1.76 2.35 1.37 1.48 XXX 58301 ......... ............ A Remove intrauterine device .......................... 1.27 1.06 1.26 0.35 0.45 0.15 2.48 2.68 1.77 1.87 000 58321 ......... ............ A Artificial insemination ..................................... 0.92 0.98 1.11 0.25 0.34 0.10 2.00 2.13 1.27 1.36 000 58322 ......... ............ A Artificial insemination ..................................... 1.10 1.05 1.16 0.31 0.39 0.13 2.28 2.39 1.54 1.62 000 58323 ......... ............ A Sperm washing .............................................. 0.23 0.15 0.44 0.07 0.09 0.03 0.41 0.70 0.33 0.35 000 58340 ......... ............ A Catheter for hysterography ........................... 0.88 2.17 2.91 0.57 0.63 0.09 3.14 3.88 1.54 1.60 000 58345 ......... ............ A Reopen fallopian tube ................................... 4.65 NA NA 2.08 2.34 0.41 NA NA 7.14 7.40 010 58346 ......... ............ A Insert heyman uteri capsule .......................... 7.44 NA NA 3.34 3.78 0.56 NA NA 11.34 11.78 090 58350 ......... ............ A Reopen fallopian tube ................................... 1.01 1.34 1.45 0.87 0.91 0.12 2.47 2.58 2.00 2.04 010 58353 ......... ............ A Endometr ablate, thermal .............................. 3.55 23.12 32.53 1.72 1.97 0.43 27.10 36.51 5.70 5.95 010 58356 ......... ............ A Endometrial cryoablation ............................... 6.36 43.78 57.02 1.86 2.48 0.82 50.96 64.20 9.04 9.66 010 58400 ......... ............ A Suspension of uterus .................................... 7.03 NA NA 3.85 3.91 0.75 NA NA 11.63 11.69 090 58410 ......... ............ A Suspension of uterus .................................... 13.66 NA NA 5.91 6.30 1.45 NA NA 21.02 21.41 090 58520 ......... ............ A Repair of ruptured uterus .............................. 13.34 NA NA 5.48 5.89 1.47 NA NA 20.29 20.70 090 58540 ......... ............ A Revision of uterus ......................................... 15.57 NA NA 6.25 6.78 1.78 NA NA 23.60 24.13 090 58545 ......... ............ A Laparoscopic myomectomy ........................... 15.65 NA NA 6.03 6.89 1.77 NA NA 23.45 24.31 090 58546 ......... ............ A Laparo-myomectomy, complex ..................... 20.20 NA NA 7.26 8.50 2.30 NA NA 29.76 31.00 090 58550 ......... ............ A Laparo-asst vag hysterectomy ...................... 14.91 NA NA 6.20 7.02 1.72 NA NA 22.83 23.65 090 58552 ......... ............ A Laparo-vag hyst incl t/o ................................. 16.23 NA NA 6.49 7.63 1.72 NA NA 24.44 25.58 090 58553 ......... ............ A Laparo-vag hyst, complex ............................. 20.13 NA NA 7.24 8.49 2.30 NA NA 29.67 30.92 090 58554 ......... ............ A Laparo-vag hyst w/t/o, compl ........................ 23.13 NA NA 8.41 9.90 2.27 NA NA 33.81 35.30 090 58555 ......... ............ A Hysteroscopy, dx, sep proc ........................... 3.33 2.76 2.33 1.25 1.48 0.40 6.49 6.06 4.98 5.21 000 58558 ......... ............ A Hysteroscopy, biopsy .................................... 4.74 3.63 2.54 1.68 2.05 0.57 8.94 7.85 6.99 7.36 000 58559 ......... ............ A Hysteroscopy, lysis ........................................ 6.16 NA NA 2.07 2.57 0.74 NA NA 8.97 9.47 000 58560 ......... ............ A Hysteroscopy, resect septum ........................ 6.99 NA NA 2.31 2.89 0.84 NA NA 10.14 10.72 000 58561 ......... ............ A Hysteroscopy, remove myoma ...................... 9.99 NA NA 3.16 4.00 1.21 NA NA 14.36 15.20 000 58562 ......... ............ A Hysteroscopy, remove fb .............................. 5.20 3.53 2.65 1.78 2.21 0.63 9.36 8.48 7.61 8.04 000 58563 ......... ............ A Hysteroscopy, ablation .................................. 6.16 37.70 51.57 2.08 2.58 0.74 44.60 58.47 8.98 9.48 000 58565 ......... ............ A Hysteroscopy, sterilization ............................. 7.02 34.73 45.85 3.39 3.77 1.19 42.94 54.06 11.60 11.98 090 58578 ......... ............ C Laparo proc, uterus ....................................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 YYY 58600 ......... ............ A Division of fallopian tube ............................... 5.84 NA NA 2.94 3.23 0.66 NA NA 9.44 9.73 090 58605 ......... ............ A Division of fallopian tube ............................... 5.23 NA NA 2.69 3.01 0.59 NA NA 8.51 8.83 090 58611 ......... ............ A Ligate oviduct(s) add-on ................................ 1.45 NA NA 0.40 0.53 0.18 NA NA 2.03 2.16 ZZZ 58615 ......... ............ A Occlude fallopian tube(s) .............................. 3.89 NA NA 2.00 2.53 0.47 NA NA 6.36 6.89 010 58660 ......... ............ A Laparoscopy, lysis ......................................... 11.52 NA NA 4.56 5.08 1.40 NA NA 17.48 18.00 090 58661 ......... ............ A Laparoscopy, remove adnexa ....................... 11.28 NA NA 4.04 4.85 1.34 NA NA 16.66 17.47 010 58662 ......... ............ A Laparoscopy, excise lesions ......................... 12.06 NA NA 4.83 5.54 1.43 NA NA 18.32 19.03 090 58670 ......... ............ A Laparoscopy, tubal cautery ........................... 5.84 NA NA 2.98 3.20 0.67 NA NA 9.49 9.71 090 58671 ......... ............ A Laparoscopy, tubal block .............................. 5.84 NA NA 2.97 3.20 0.68 NA NA 9.49 9.72 09058672 ......... ............ A Laparoscopy, fimbrioplasty ............................ 12.86 NA NA 4.79 5.83 1.60 NA NA 19.25 20.29 090 58673 ......... ............ A Laparoscopy, salpingostomy ......................... 13.97 NA NA 5.23 6.24 1.69 NA NA 20.89 21.90 09058679 ......... ............ C Laparo proc, oviduct-ovary ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 58700 ......... ............ A Removal of fallopian tube ............................. 12.80 NA NA 5.56 5.88 1.51 NA NA 19.87 20.19 090 58720 ......... ............ A Removal of ovary/tube(s) .............................. 12.04 NA NA 5.13 5.61 1.39 NA NA 18.56 19.04 090 58740 ......... ............ A Revise fallopian tube(s) ................................. 14.75 NA NA 6.11 6.88 1.71 NA NA 22.57 23.34 090 58750 ......... ............ A Repair oviduct ............................................... 15.52 NA NA 6.14 7.06 1.84 NA NA 23.50 24.42 090 58752 ......... ............ A Revise ovarian tube(s) .................................. 15.52 NA NA 6.04 6.72 1.80 NA NA 23.36 24.04 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49161 

58760 ......... ............ A Remove tubal obstruction ............................. 13.81 NA NA 5.66 6.45 1.79 NA NA 21.26 22.05 090 58770 ......... ............ A Create new tubal opening ............................. 14.65 NA NA 5.81 6.63 1.73 NA NA 22.19 23.01 090 58800 ......... ............ A Drainage of ovarian cyst(s) ........................... 4.51 3.20 3.53 2.68 2.85 0.43 8.14 8.47 7.62 7.79 090 58805 ......... ............ A Drainage of ovarian cyst(s) ........................... 6.31 NA NA 3.49 3.50 0.69 NA NA 10.49 10.50 090 58820 ......... ............ A Drain ovary abscess, open ........................... 4.59 NA NA 2.89 3.19 0.52 NA NA 8.00 8.30 090 58822 ......... ............ A Drain ovary abscess, percut ......................... 11.67 NA NA 5.18 5.20 1.16 NA NA 18.01 18.03 090 58823 ......... ............ A Drain pelvic abscess, percut ......................... 3.37 20.10 21.02 1.04 1.10 0.24 23.71 24.63 4.65 4.71 000 58825 ......... ............ A Transposition, ovary(s) .................................. 11.66 NA NA 4.98 5.59 1.32 NA NA 17.96 18.57 090 58900 ......... ............ A Biopsy of ovary(s) ......................................... 6.48 NA NA 3.49 3.55 0.69 NA NA 10.66 10.72 090 58920 ......... ............ A Partial removal of ovary(s) ............................ 11.84 NA NA 5.24 5.49 1.43 NA NA 18.51 18.76 090 58925 ......... ............ A Removal of ovarian cyst(s) ........................... 12.29 NA NA 5.31 5.59 1.41 NA NA 19.01 19.29 090 58940 ......... ............ A Removal of ovary(s) ...................................... 8.08 NA NA 4.07 4.09 0.91 NA NA 13.06 13.08 090 58943 ......... ............ A Removal of ovary(s) ...................................... 19.38 NA NA 7.25 8.29 2.22 NA NA 28.85 29.89 090 58950 ......... ............ A Resect ovarian malignancy ........................... 18.18 NA NA 7.29 8.12 2.04 NA NA 27.51 28.34 090 58951 ......... ............ A Resect ovarian malignancy ........................... 24.11 NA NA 8.61 9.98 2.63 NA NA 35.35 36.72 090 58952 ......... ............ A Resect ovarian malignancy ........................... 27.09 NA NA 9.81 11.27 3.02 NA NA 39.92 41.38 090 58953 ......... ............ A Tah, rad dissect for debulk ........................... 33.91 NA NA 11.63 13.81 3.83 NA NA 49.37 51.55 090 58954 ......... ............ A Tah rad debulk/lymph remove ...................... 36.91 NA NA 12.49 14.90 4.17 NA NA 53.57 55.98 09058956 ......... ............ A Bso, omentectomy w/tah ............................... 22.59 NA NA 8.59 9.88 4.00 NA NA 35.18 36.47 090 58960 ......... ............ A Exploration of abdomen ................................ 15.64 NA NA 6.29 7.09 1.79 NA NA 23.72 24.52 090 58970 ......... ............ A Retrieval of oocyte ........................................ 3.52 1.83 2.19 1.26 1.43 0.43 5.78 6.14 5.21 5.38 000 58974 ......... ............ C Transfer of embryo ........................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000 58976 ......... ............ A Transfer of embryo ........................................ 3.82 1.96 2.50 1.22 1.67 0.47 6.25 6.79 5.51 5.96 000 58999 ......... ............ C Genital surgery procedure ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 59000 ......... ............ A Amniocentesis, diagnostic ............................. 1.30 1.75 1.99 0.56 0.64 0.31 3.36 3.60 2.17 2.25 000 59001 ......... ............ A Amniocentesis, therapeutic ........................... 3.00 NA NA 1.09 1.33 0.71 NA NA 4.80 5.04 000 59012 ......... ............ A Fetal cord puncture,prenatal ......................... 3.44 NA NA 1.16 1.45 0.82 NA NA 5.42 5.71 000 59015 ......... ............ A Chorion biopsy .............................................. 2.20 1.43 1.52 0.81 0.98 0.52 4.15 4.24 3.53 3.70 000 59020 ......... ............ A Fetal contract stress test ............................... 0.66 1.08 0.86 1.08 0.86 0.26 2.00 1.78 2.00 1.78 000 59020 ......... 26 ....... A Fetal contract stress test ............................... 0.66 0.19 0.24 0.19 0.24 0.16 1.01 1.06 1.01 1.06 000 59020 ......... TC ...... A Fetal contract stress test ............................... 0.00 0.90 0.62 0.90 0.62 0.10 1.00 0.72 1.00 0.72 000 59025 ......... ............ A Fetal non-stress test ...................................... 0.53 0.63 0.49 0.63 0.49 0.15 1.31 1.17 1.31 1.17 000 59025 ......... 26 ....... A Fetal non-stress test ...................................... 0.53 0.15 0.20 0.15 0.20 0.13 0.81 0.86 0.81 0.86 000 59025 ......... TC ...... A Fetal non-stress test ...................................... 0.00 0.49 0.30 0.49 0.30 0.02 0.51 0.32 0.51 0.32 000 59030 ......... ............ A Fetal scalp blood sample .............................. 1.99 NA NA 0.56 0.72 0.47 NA NA 3.02 3.18 00059050 ......... ............ A Fetal monitor w/report ................................... 0.89 NA NA 0.26 0.33 0.21 NA NA 1.36 1.43 XXX 59051 ......... ............ A Fetal monitor/interpret only ........................... 0.74 NA NA 0.21 0.27 0.17 NA NA 1.12 1.18 XXX 59070 ......... ............ A Transabdom amnioinfus w/us ....................... 5.24 4.48 4.98 1.83 2.19 0.28 10.00 10.50 7.35 7.71 000 59072 ......... ............ A Umbilical cord occlud w/us ............................ 8.99 NA NA 2.88 3.06 0.16 NA NA 12.03 12.21 000 59074 ......... ............ A Fetal fluid drainage w/us ............................... 5.24 3.91 4.41 1.71 2.16 0.28 9.43 9.93 7.23 7.68 000 59076 ......... ............ A Fetal shunt placement, w/us ......................... 8.99 NA NA 2.42 2.95 0.16 NA NA 11.57 12.10 00059100 ......... ............ A Remove uterus lesion ................................... 13.22 NA NA 5.80 6.29 2.94 NA NA 21.96 22.45 090 59120 ......... ............ A Treat ectopic pregnancy ................................ 12.52 NA NA 5.47 6.05 2.72 NA NA 20.71 21.29 090 59121 ......... ............ A Treat ectopic pregnancy ................................ 12.60 NA NA 5.42 6.10 2.78 NA NA 20.80 21.48 090 59130 ......... ............ A Treat ectopic pregnancy ................................ 14.94 NA NA 6.09 5.12 3.38 NA NA 24.41 23.44 090 59135 ......... ............ A Treat ectopic pregnancy ................................ 14.78 NA NA 5.12 6.70 3.30 NA NA 23.20 24.78 090 59136 ......... ............ A Treat ectopic pregnancy ................................ 14.11 NA NA 5.77 6.39 3.13 NA NA 23.01 23.63 090 59140 ......... ............ A Treat ectopic pregnancy ................................ 5.83 NA NA 2.91 2.39 1.29 NA NA 10.03 9.51 090 59150 ......... ............ A Treat ectopic pregnancy ................................ 12.15 NA NA 5.26 5.81 2.78 NA NA 20.19 20.74 090 59151 ......... ............ A Treat ectopic pregnancy ................................ 11.97 NA NA 4.93 5.77 2.73 NA NA 19.63 20.47 090 59160 ......... ............ A D & c after delivery ....................................... 2.71 2.00 2.97 1.19 1.90 0.64 5.35 6.32 4.54 5.25 010 59200 ......... ............ A Insert cervical dilator ..................................... 0.79 0.95 1.13 0.22 0.28 0.19 1.93 2.11 1.20 1.26 000 59300 ......... ............ A Episiotomy or vaginal repair .......................... 2.41 2.21 2.18 1.03 0.98 0.57 5.19 5.16 4.01 3.96 000 59320 ......... ............ A Revision of cervix .......................................... 2.48 NA NA 1.02 1.19 0.59 NA NA 4.09 4.26 000 59325 ......... ............ A Revision of cervix .......................................... 4.06 NA NA 1.24 1.73 0.88 NA NA 6.18 6.67 000 59350 ......... ............ A Repair of uterus ............................................. 4.94 NA NA 1.41 1.76 1.17 NA NA 7.52 7.87 000 59400 ......... ............ A Obstetrical care ............................................. 26.53 NA NA 14.36 15.08 5.48 NA NA 46.37 47.09 MMM 59409 ......... ............ A Obstetrical care ............................................. 13.48 NA NA 3.76 4.92 3.21 NA NA 20.45 21.61 MMM 59410 ......... ............ A Obstetrical care ............................................. 15.26 NA NA 4.97 5.97 3.51 NA NA 23.74 24.74 MMM 59412 ......... ............ A Antepartum manipulation .............................. 1.71 NA NA 0.65 0.77 0.40 NA NA 2.76 2.88 MMM 59414 ......... ............ A Deliver placenta ............................................. 1.61 NA NA 0.44 0.59 0.38 NA NA 2.43 2.58 MMM 59425 ......... ............ A Antepartum care only .................................... 6.12 4.25 4.21 1.68 1.81 1.14 11.51 11.47 8.94 9.07 MMM 59426 ......... ............ A Antepartum care only .................................... 10.84 7.82 7.61 2.97 3.16 1.97 20.63 20.42 15.78 15.97 MMM 59430 ......... ............ A Care after delivery ......................................... 2.13 1.04 1.18 0.66 0.87 0.50 3.67 3.81 3.29 3.50 MMM 59510 ......... ............ A Cesarean delivery ......................................... 30.05 NA NA 16.03 16.95 6.23 NA NA 52.31 53.23 MMM 59514 ......... ............ A Cesarean delivery only .................................. 15.95 NA NA 4.51 5.79 3.79 NA NA 24.25 25.53 MMM 

mstockstill on PROD1PC63 with PROPOSAL_2

49162 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

59515 ......... ............ A Cesarean delivery ......................................... 18.21 NA NA 6.25 7.44 4.12 NA NA 28.58 29.77 MMM 59525 ......... ............ A Remove uterus after cesarean ...................... 8.53 NA NA 2.40 3.08 1.94 NA NA 12.87 13.55 ZZZ 59610 ......... ............ A Vbac delivery ................................................. 27.95 NA NA 14.66 15.56 5.85 NA NA 48.46 49.36 MMM 59612 ......... ............ A Vbac delivery only ......................................... 15.04 NA NA 4.28 5.61 3.58 NA NA 22.90 24.23 MMM 59614 ......... ............ A Vbac care after delivery ................................ 16.57 NA NA 5.19 6.50 3.88 NA NA 25.64 26.95 MMM 59618 ......... ............ A Attempted vbac delivery ................................ 31.48 NA NA 16.38 17.77 6.59 NA NA 54.45 55.84 MMM 59620 ......... ............ A Attempted vbac delivery only ........................ 17.50 NA NA 4.80 6.27 4.16 NA NA 26.46 27.93 MMM 59622 ......... ............ A Attempted vbac after care ............................. 19.64 NA NA 6.69 8.15 4.49 NA NA 30.82 32.28 MMM 59812 ......... ............ A Treatment of miscarriage .............................. 4.37 3.12 2.69 2.38 2.50 0.95 8.44 8.01 7.70 7.82 090 59820 ......... ............ A Care of miscarriage ....................................... 4.64 4.10 4.34 3.49 3.54 0.95 9.69 9.93 9.08 9.13 090 59821 ......... ............ A Treatment of miscarriage .............................. 4.94 3.85 4.17 3.19 3.35 1.06 9.85 10.17 9.19 9.35 090 59830 ......... ............ A Treat uterus infection .................................... 6.48 NA NA 3.47 3.85 1.44 NA NA 11.39 11.77 090 59840 ......... ............ R Abortion ......................................................... 3.01 2.04 2.10 1.81 2.04 0.71 5.76 5.82 5.53 5.76 010 59841 ......... ............ R Abortion ......................................................... 5.55 3.19 3.42 2.61 2.88 1.24 9.98 10.21 9.40 9.67 010 59850 ......... ............ R Abortion ......................................................... 5.90 NA NA 2.66 3.10 1.28 NA NA 9.84 10.28 090 59851 ......... ............ R Abortion ......................................................... 5.92 NA NA 3.33 3.64 1.28 NA NA 10.53 10.84 090 59852 ......... ............ R Abortion ......................................................... 8.23 NA NA 3.84 4.74 1.80 NA NA 13.87 14.77 090 59855 ......... ............ R Abortion ......................................................... 6.36 NA NA 3.00 3.41 1.45 NA NA 10.81 11.22 090 59856 ......... ............ R Abortion ......................................................... 7.72 NA NA 3.85 4.01 1.78 NA NA 13.35 13.51 090 59857 ......... ............ R Abortion ......................................................... 9.28 NA NA 3.17 4.33 2.01 NA NA 14.46 15.62 090 59866 ......... ............ R Abortion (mpr) ............................................... 3.99 NA NA 1.26 1.73 0.87 NA NA 6.12 6.59 000 59870 ......... ............ A Evacuate mole of uterus ............................... 6.32 NA NA 4.31 4.44 1.42 NA NA 12.05 12.18 090 59871 ......... ............ A Remove cerclage suture ............................... 2.13 NA NA 0.94 1.08 0.50 NA NA 3.57 3.71 000 59897 ......... ............ C Fetal invas px w/us ....................................... 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 YYY 60000 ......... ............ A Drain thyroid/tongue cyst .............................. 1.76 2.06 1.96 1.67 1.70 0.15 3.97 3.87 3.58 3.61 010 60001 ......... ............ A Aspirate/inject thyriod cyst ............................ 0.97 1.93 1.54 0.28 0.32 0.07 2.97 2.58 1.32 1.36 000 60100 ......... ............ A Biopsy of thyroid ............................................ 1.56 1.27 1.37 0.47 0.52 0.10 2.93 3.03 2.13 2.18 000 60200 ......... ............ A Remove thyroid lesion ................................... 9.84 NA NA 5.20 5.79 1.01 NA NA 16.05 16.64 090 60210 ......... ............ A Partial thyroid excision .................................. 11.11 NA NA 5.04 5.48 1.23 NA NA 17.38 17.82 090 60212 ......... ............ A Partial thyroid excision .................................. 16.26 NA NA 6.55 7.39 1.94 NA NA 24.75 25.59 090 60220 ......... ............ A Partial removal of thyroid .............................. 12.25 NA NA 5.37 5.95 1.32 NA NA 18.94 19.52 090 60225 ......... ............ A Partial removal of thyroid .............................. 14.59 NA NA 6.65 7.21 1.64 NA NA 22.88 23.44 090 60240 ......... ............ A Removal of thyroid ........................................ 16.16 NA NA 6.14 7.22 1.85 NA NA 24.15 25.23 090 60252 ......... ............ A Removal of thyroid ........................................ 21.82 NA NA 8.38 9.66 2.29 NA NA 32.49 33.77 090 60254 ......... ............ A Extensive thyroid surgery .............................. 28.23 NA NA 10.28 13.18 2.60 NA NA 41.11 44.01 090 60260 ......... ............ A Repeat thyroid surgery .................................. 18.14 NA NA 6.96 8.22 1.93 NA NA 27.03 28.29 090 60270 ......... ............ A Removal of thyroid ........................................ 23.01 NA NA 8.90 10.06 2.32 NA NA 34.23 35.39 090 60271 ......... ............ A Removal of thyroid ........................................ 17.50 NA NA 6.77 8.13 1.74 NA NA 26.01 27.37 090 60280 ......... ............ A Remove thyroid duct lesion ........................... 5.98 NA NA 4.07 4.51 0.54 NA NA 10.59 11.03 090 60281 ......... ............ A Remove thyroid duct lesion ........................... 8.64 NA NA 4.63 5.53 0.73 NA NA 14.00 14.90 090 60500 ......... ............ A Explore parathyroid glands ........................... 16.63 NA NA 6.74 7.24 2.00 NA NA 25.37 25.87 090 60502 ......... ............ A Re-explore parathyroids ................................ 20.92 NA NA 8.47 9.13 2.53 NA NA 31.92 32.58 090 60505 ......... ............ A Explore parathyroid glands ........................... 22.81 NA NA 9.23 10.50 2.64 NA NA 34.68 35.95 090 60512 ......... ............ A Autotransplant parathyroid ............................ 4.44 NA NA 1.18 1.51 0.53 NA NA 6.15 6.48 ZZZ60520 ......... ............ A Removal of thymus gland ............................. 17.03 NA NA 6.97 7.96 2.19 NA NA 26.19 27.18 090 60521 ......... ............ A Removal of thymus gland ............................. 19.09 NA NA 8.31 9.23 2.81 NA NA 30.21 31.13 090 60522 ......... ............ A Removal of thymus gland ............................. 23.31 NA NA 9.80 10.90 3.26 NA NA 36.37 37.47 090 60540 ......... ............ A Explore adrenal gland ................................... 17.84 NA NA 8.14 7.72 1.74 NA NA 27.72 27.30 090 60545 ......... ............ A Explore adrenal gland ................................... 20.75 NA NA 8.92 8.63 2.07 NA NA 31.74 31.45 090 60600 ......... ............ A Remove carotid body lesion .......................... 24.95 NA NA 8.78 10.42 2.19 NA NA 35.92 37.56 090 60605 ......... ............ A Remove carotid body lesion .......................... 31.82 NA NA 12.29 12.26 2.49 NA NA 46.60 46.57 090 60650 ......... ............ A Laparoscopy adrenalectomy ......................... 20.59 NA NA 8.20 8.04 2.28 NA NA 31.07 30.91 090 60659 ......... ............ C Laparo proc, endocrine ................................. 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 YYY 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49163 

61000 ......... ............ A Remove cranial cavity fluid ........................... 1.58 NA NA 1.23 1.02 0.13 NA NA 2.94 2.73 00061001 ......... ............ A Remove cranial cavity fluid ........................... 1.49 NA NA 1.20 1.10 0.16 NA NA 2.85 2.75 00061020 ......... ............ A Remove brain cavity fluid .............................. 1.51 NA NA 1.58 1.40 0.34 NA NA 3.43 3.25 000 61026 ......... ............ A Injection into brain canal ............................... 1.69 NA NA 1.49 1.42 0.33 NA NA 3.51 3.44 000 61050 ......... ............ A Remove brain canal fluid .............................. 1.51 NA NA 1.13 1.24 0.11 NA NA 2.75 2.86 00061055 ......... ............ A Injection into brain canal ............................... 2.10 NA NA 1.29 1.39 0.17 NA NA 3.56 3.66 000 61070 ......... ............ A Brain canal shunt procedure ......................... 0.89 NA NA 1.17 1.05 0.17 NA NA 2.23 2.11 000 61105 ......... ............ A Twist drill hole ............................................... 5.38 NA NA 4.89 4.17 1.32 NA NA 11.59 10.87 090 61107 ......... ............ A Drill skull for implantation .............................. 4.99 NA NA 1.85 2.36 1.29 NA NA 8.13 8.64 000 61108 ......... ............ A Drill skull for drainage ................................... 11.46 NA NA 8.43 7.46 2.63 NA NA 22.52 21.55 090 61120 ......... ............ A Burr hole for puncture ................................... 9.49 NA NA 6.69 6.17 2.09 NA NA 18.27 17.75 090 61140 ......... ............ A Pierce skull for biopsy ................................... 17.05 NA NA 10.39 10.01 4.11 NA NA 31.55 31.17 090 61150 ......... ............ A Pierce skull for drainage ............................... 18.76 NA NA 10.73 10.46 4.31 NA NA 33.80 33.53 090 61151 ......... ............ A Pierce skull for drainage ............................... 13.38 NA NA 8.49 7.98 3.00 NA NA 24.87 24.36 090 61154 ......... ............ A Pierce skull & remove clot ............................ 16.86 NA NA 10.76 9.80 4.20 NA NA 31.82 30.86 090 61156 ......... ............ A Pierce skull for drainage ............................... 17.34 NA NA 9.88 9.84 4.22 NA NA 31.44 31.40 090 61210 ......... ............ A Pierce skull, implant device ........................... 5.83 NA NA 2.18 2.73 1.50 NA NA 9.51 10.06 000 61215 ......... ............ A Insert brain-fluid device ................................. 5.74 NA NA 5.44 4.36 1.26 NA NA 12.44 11.36 090 61250 ......... ............ A Pierce skull & explore ................................... 11.38 NA NA 7.49 7.01 2.76 NA NA 21.63 21.15 090 61253 ......... ............ A Pierce skull & explore ................................... 13.38 NA NA 7.80 7.74 2.61 NA NA 23.79 23.73 090 61304 ......... ............ A Open skull for exploration ............................. 23.27 NA NA 12.61 12.78 5.61 NA NA 41.49 41.66 090 61305 ......... ............ A Open skull for exploration ............................. 28.46 NA NA 15.07 15.25 6.07 NA NA 49.60 49.78 090 61312 ......... ............ A Open skull for drainage ................................. 30.03 NA NA 15.34 15.12 6.34 NA NA 51.71 51.49 090 61313 ......... ............ A Open skull for drainage ................................. 27.88 NA NA 15.48 14.97 6.43 NA NA 49.79 49.28 090 61314 ......... ............ A Open skull for drainage ................................. 25.72 NA NA 14.22 13.33 6.26 NA NA 46.20 45.31 090 61315 ......... ............ A Open skull for drainage ................................. 29.47 NA NA 15.56 15.90 7.14 NA NA 52.17 52.51 090 61316 ......... ............ A Implt cran bone flap to abdo ......................... 1.39 NA NA 0.52 0.58 0.35 NA NA 2.26 2.32 ZZZ 61320 ......... ............ A Open skull for drainage ................................. 27.28 NA NA 14.29 14.64 6.60 NA NA 48.17 48.52 090 61321 ......... ............ A Open skull for drainage ................................. 30.35 NA NA 14.29 15.66 7.12 NA NA 51.76 53.13 090 61322 ......... ............ A Decompressive craniotomy ........................... 34.00 NA NA 17.78 16.19 7.61 NA NA 59.39 57.80 090 61323 ......... ............ A Decompressive lobectomy ............................ 34.87 NA NA 17.00 16.31 8.01 NA NA 59.88 59.19 090 61330 ......... ............ A Decompress eye socket ................................ 25.12 NA NA 11.88 13.26 2.31 NA NA 39.31 40.69 090 61332 ......... ............ A Explore/biopsy eye socket ............................ 28.46 NA NA 13.45 15.06 4.82 NA NA 46.73 48.34 090 61333 ......... ............ A Explore orbit/remove lesion ........................... 29.13 NA NA 13.31 15.01 3.91 NA NA 46.35 48.05 090 61334 ......... ............ A Explore orbit/remove object .......................... 19.46 NA NA 9.11 10.25 1.74 NA NA 30.31 31.45 090 61340 ......... ............ A Subtemporal decompression ......................... 19.97 NA NA 11.40 11.19 4.83 NA NA 36.20 35.99 090 61343 ......... ............ A Incise skull (press relief) ............................... 31.68 NA NA 16.14 16.64 7.62 NA NA 55.44 55.94 090 61345 ......... ............ A Relieve cranial pressure ................................ 29.05 NA NA 15.24 15.35 7.02 NA NA 51.31 51.42 090 61440 ......... ............ A Incise skull for surgery .................................. 28.48 NA NA 14.06 14.17 6.88 NA NA 49.42 49.53 090 61450 ......... ............ A Incise skull for surgery .................................. 27.55 NA NA 12.70 13.89 5.77 NA NA 46.02 47.21 090 61458 ......... ............ A Incise skull for brain wound .......................... 28.66 NA NA 15.01 15.39 7.01 NA NA 50.68 51.06 090 61460 ......... ............ A Incise skull for surgery .................................. 30.06 NA NA 15.14 16.09 6.02 NA NA 51.22 52.17 090 61470 ......... ............ A Incise skull for surgery .................................. 27.48 NA NA 13.11 13.67 5.88 NA NA 46.47 47.03 090 61480 ......... ............ A Incise skull for surgery .................................. 27.91 NA NA 8.23 13.51 6.71 NA NA 42.85 48.13 090 61490 ......... ............ A Incise skull for surgery .................................. 27.08 NA NA 14.34 14.33 6.90 NA NA 48.32 48.31 090 61500 ......... ............ A Removal of skull lesion ................................. 19.00 NA NA 10.64 10.76 4.10 NA NA 33.74 33.86 090 61501 ......... ............ A Remove infected skull bone .......................... 16.17 NA NA 9.52 9.28 3.21 NA NA 28.90 28.66 090 61510 ......... ............ A Removal of brain lesion ................................ 30.55 NA NA 17.08 16.79 7.33 NA NA 54.96 54.67 090 61512 ......... ............ A Remove brain lining lesion ............................ 36.93 NA NA 18.56 19.39 9.05 NA NA 64.54 65.37 090 61514 ......... ............ A Removal of brain abscess ............................. 27.05 NA NA 14.53 14.46 6.52 NA NA 48.10 48.03 090 61516 ......... ............ A Removal of brain lesion ................................ 26.40 NA NA 14.28 14.27 6.33 NA NA 47.01 47.00 090 61517 ......... ............ A Implt brain chemotx add-on .......................... 1.38 NA NA 0.51 0.61 0.35 NA NA 2.24 2.34 ZZZ 61518 ......... ............ A Removal of brain lesion ................................ 39.61 NA NA 20.45 20.93 9.62 NA NA 69.68 70.16 090 61519 ......... ............ A Remove brain lining lesion ............................ 43.22 NA NA 20.82 22.19 10.60 NA NA 74.64 76.01 090 61520 ......... ............ A Removal of brain lesion ................................ 56.81 NA NA 25.64 29.15 11.18 NA NA 93.63 97.14 090 61521 ......... ............ A Removal of brain lesion ................................ 46.78 NA NA 22.16 23.70 11.36 NA NA 80.30 81.84 090 61522 ......... ............ A Removal of brain abscess ............................. 31.36 NA NA 15.56 16.20 7.60 NA NA 54.52 55.16 090 61524 ......... ............ A Removal of brain lesion ................................ 29.71 NA NA 15.78 15.69 7.14 NA NA 52.63 52.54 090 61526 ......... ............ A Removal of brain lesion ................................ 53.84 NA NA 21.66 27.53 7.05 NA NA 82.55 88.42 090 61530 ......... ............ A Removal of brain lesion ................................ 45.38 NA NA 18.18 23.33 6.13 NA NA 69.69 74.84 090 61531 ......... ............ A Implant brain electrodes ................................ 16.24 NA NA 10.26 9.41 3.78 NA NA 30.28 29.43 090 61533 ......... ............ A Implant brain electrodes ................................ 21.32 NA NA 11.76 11.59 5.10 NA NA 38.18 38.01 090 61534 ......... ............ A Removal of brain lesion ................................ 22.83 NA NA 13.21 12.36 5.42 NA NA 41.46 40.61 090 61535 ......... ............ A Remove brain electrodes .............................. 13.01 NA NA 8.93 7.80 3.01 NA NA 24.95 23.82 090 61536 ......... ............ A Removal of brain lesion ................................ 37.54 NA NA 18.46 19.45 9.18 NA NA 65.18 66.17 090 61537 ......... ............ A Removal of brain tissue ................................ 36.31 NA NA 17.52 15.44 6.92 NA NA 60.75 58.67 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49164 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

61538 ......... ............ A Removal of brain tissue ................................ 39.31 NA NA 18.80 16.18 6.92 NA NA 65.03 62.41 090 61539 ......... ............ A Removal of brain tissue ................................ 34.10 NA NA 15.51 17.20 8.30 NA NA 57.91 59.60 090 61540 ......... ............ A Removal of brain tissue ................................ 31.24 NA NA 15.91 16.91 8.30 NA NA 55.45 56.45 090 61541 ......... ............ A Incision of brain tissue .................................. 30.76 NA NA 16.10 16.18 6.58 NA NA 53.44 53.52 090 61542 ......... ............ A Removal of brain tissue ................................ 32.98 NA NA 16.23 17.42 8.01 NA NA 57.22 58.41 090 61543 ......... ............ A Removal of brain tissue ................................ 31.13 NA NA 16.35 16.37 7.54 NA NA 55.02 55.04 090 61544 ......... ............ A Remove & treat brain lesion ......................... 27.22 NA NA 14.39 13.96 5.95 NA NA 47.56 47.13 090 61545 ......... ............ A Excision of brain tumor ................................. 46.15 NA NA 22.36 23.75 10.60 NA NA 79.11 80.50 090 61546 ......... ............ A Removal of pituitary gland ............................ 33.26 NA NA 16.62 17.27 7.65 NA NA 57.53 58.17 090 61548 ......... ............ A Removal of pituitary gland ............................ 23.23 NA NA 11.37 12.43 3.42 NA NA 38.02 39.08 090 61550 ......... ............ A Release of skull seams ................................. 15.38 NA NA 5.70 6.62 0.98 NA NA 22.06 22.98 090 61552 ......... ............ A Release of skull seams ................................. 20.22 NA NA 6.71 8.51 1.06 NA NA 27.99 29.78 090 61556 ......... ............ A Incise skull/sutures ........................................ 23.96 NA NA 12.76 11.71 4.64 NA NA 41.36 40.31 090 61557 ......... ............ A Incise skull/sutures ........................................ 23.10 NA NA 13.73 13.65 5.78 NA NA 42.61 42.53 090 61558 ......... ............ A Excision of skull/sutures ................................ 26.29 NA NA 8.24 12.70 1.36 NA NA 35.89 40.35 090 61559 ......... ............ A Excision of skull/sutures ................................ 33.74 NA NA 18.83 19.19 8.48 NA NA 61.05 61.41 090 61563 ......... ............ A Excision of skull tumor .................................. 28.31 NA NA 14.31 15.01 5.15 NA NA 47.77 48.47 090 61564 ......... ............ A Excision of skull tumor .................................. 34.53 NA NA 16.25 17.77 8.75 NA NA 59.53 61.05 090 61566 ......... ............ A Removal of brain tissue ................................ 32.26 NA NA 16.65 17.49 6.92 NA NA 55.83 56.67 090 61567 ......... ............ A Incision of brain tissue .................................. 36.76 NA NA 16.84 19.71 6.52 NA NA 60.12 62.99 090 61570 ......... ............ A Remove foreign body, brain .......................... 26.33 NA NA 14.16 13.97 5.86 NA NA 46.35 46.16 090 61571 ......... ............ A Incise skull for brain wound .......................... 28.24 NA NA 15.21 15.16 6.77 NA NA 50.22 50.17 090 61575 ......... ............ A Skull base/brainstem surgery ........................ 36.38 NA NA 15.53 18.61 5.32 NA NA 57.23 60.31 090 61576 ......... ............ A Skull base/brainstem surgery ........................ 55.03 NA NA 25.88 32.52 5.56 NA NA 86.47 93.11 090 61580 ......... ............ A Craniofacial approach, skull .......................... 34.26 NA NA 20.69 24.36 3.36 NA NA 58.31 61.98 090 61581 ......... ............ A Craniofacial approach, skull .......................... 38.78 NA NA 24.86 23.80 3.91 NA NA 67.55 66.49 090 61582 ......... ............ A Craniofacial approach, skull .......................... 34.83 NA NA 30.37 28.07 7.19 NA NA 72.39 70.09 090 61583 ......... ............ A Craniofacial approach, skull .......................... 38.37 NA NA 25.79 25.28 9.18 NA NA 73.34 72.83 090 61584 ......... ............ A Orbitocranial approach/skull .......................... 37.57 NA NA 25.56 24.78 8.16 NA NA 71.29 70.51 090 61585 ......... ............ A Orbitocranial approach/skull .......................... 42.40 NA NA 24.83 26.08 7.01 NA NA 74.24 75.49 090 61586 ......... ............ A Resect nasopharynx, skull ............................ 27.20 NA NA 23.97 22.93 4.36 NA NA 55.53 54.49 090 61590 ......... ............ A Infratemporal approach/skull ......................... 46.79 NA NA 23.16 27.26 5.29 NA NA 75.24 79.34 090 61591 ......... ............ A Infratemporal approach/skull ......................... 46.81 NA NA 23.73 28.07 5.64 NA NA 76.18 80.52 090 61592 ......... ............ A Orbitocranial approach/skull .......................... 42.94 NA NA 27.58 26.77 10.04 NA NA 80.56 79.75 090 61595 ......... ............ A Transtemporal approach/skull ....................... 33.49 NA NA 19.29 21.59 3.97 NA NA 56.75 59.05 090 61596 ......... ............ A Transcochlear approach/skull ....................... 39.25 NA NA 18.52 22.96 3.39 NA NA 61.16 65.60 090 61597 ......... ............ A Transcondylar approach/skull ....................... 40.67 NA NA 22.86 22.96 8.81 NA NA 72.34 72.44 090 61598 ......... ............ A Transpetrosal approach/skull ........................ 36.35 NA NA 20.81 22.63 5.68 NA NA 62.84 64.66 090 61600 ......... ............ A Resect/excise cranial lesion .......................... 29.76 NA NA 18.31 19.41 3.78 NA NA 51.85 52.95 090 61601 ......... ............ A Resect/excise cranial lesion .......................... 31.00 NA NA 22.32 20.95 6.61 NA NA 59.93 58.56 090 61605 ......... ............ A Resect/excise cranial lesion .......................... 32.32 NA NA 17.57 20.86 2.85 NA NA 52.74 56.03 090 61606 ......... ............ A Resect/excise cranial lesion .......................... 41.88 NA NA 24.31 24.94 8.94 NA NA 75.13 75.76 090 61607 ......... ............ A Resect/excise cranial lesion .......................... 40.76 NA NA 20.51 22.96 6.88 NA NA 68.15 70.60 090 61608 ......... ............ A Resect/excise cranial lesion .......................... 45.39 NA NA 26.51 26.56 10.72 NA NA 82.62 82.67 090 61609 ......... ............ A Transect artery, sinus .................................... 9.88 NA NA 3.73 4.57 2.55 NA NA 16.16 17.00 ZZZ 61610 ......... ............ A Transect artery, sinus .................................... 29.63 NA NA 11.19 12.65 7.66 NA NA 48.48 49.94 ZZZ 61611 ......... ............ A Transect artery, sinus .................................... 7.41 NA NA 2.80 3.57 1.88 NA NA 12.09 12.86 ZZZ 61612 ......... ............ A Transect artery, sinus .................................... 27.84 NA NA 8.15 12.02 4.30 NA NA 40.29 44.16 ZZZ 61613 ......... ............ A Remove aneurysm, sinus .............................. 44.88 NA NA 27.54 26.58 8.42 NA NA 80.84 79.88 090 61615 ......... ............ A Resect/excise lesion, skull ............................ 35.57 NA NA 19.35 21.88 4.72 NA NA 59.64 62.17 090 61616 ......... ............ A Resect/excise lesion, skull ............................ 46.54 NA NA 26.45 28.10 8.24 NA NA 81.23 82.88 090 61618 ......... ............ A Repair dura .................................................... 18.52 NA NA 10.11 10.36 3.71 NA NA 32.34 32.59 090 61619 ......... ............ A Repair dura .................................................... 21.95 NA NA 10.97 11.92 3.94 NA NA 36.86 37.81 090 61623 ......... ............ A Endovasc tempory vessel occl ...................... 9.95 NA NA 3.40 3.91 1.05 NA NA 14.40 14.91 000 61624 ......... ............ A Transcath occlusion, cns ............................... 20.12 NA NA 6.80 6.87 1.95 NA NA 28.87 28.94 000 61626 ......... ............ A Transcath occlusion, non-cns ....................... 16.60 NA NA 5.43 5.49 1.24 NA NA 23.27 23.33 000

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49165 

61630 ......... ............ N Intracranial angioplasty ................................. 22.03 NA NA 6.50 10.99 2.01 NA NA 30.54 35.03 090 61635 ......... ............ N Intracran angioplsty w/stent .......................... 24.24 NA NA 7.02 11.91 2.20 NA NA 33.46 38.35 090 61680 ......... ............ A Intracranial vessel surgery ............................ 32.34 NA NA 16.85 17.29 7.93 NA NA 57.12 57.56 090 61682 ......... ............ A Intracranial vessel surgery ............................ 63.27 NA NA 27.31 30.99 15.85 NA NA 106.43 110.11 090 61684 ......... ............ A Intracranial vessel surgery ............................ 41.43 NA NA 20.46 21.62 10.28 NA NA 72.17 73.33 090 61686 ......... ............ A Intracranial vessel surgery ............................ 67.26 NA NA 30.29 33.61 16.66 NA NA 114.21 117.53 090 61690 ......... ............ A Intracranial vessel surgery ............................ 31.14 NA NA 15.88 16.51 6.92 NA NA 53.94 54.57 090 61692 ......... ............ A Intracranial vessel surgery ............................ 54.39 NA NA 24.71 26.78 13.39 NA NA 92.49 94.56 090 61697 ......... ............ A Brain aneurysm repr, complx ........................ 63.16 NA NA 28.85 28.22 12.81 NA NA 104.82 104.19 090 61698 ......... ............ A Brain aneurysm repr, complx ........................ 69.39 NA NA 30.92 27.75 12.50 NA NA 112.81 109.64 090 61700 ......... ............ A Brain aneurysm repr, simple ......................... 50.44 NA NA 24.03 26.86 12.98 NA NA 87.45 90.28 090 61702 ......... ............ A Inner skull vessel surgery ............................. 59.80 NA NA 27.94 26.51 10.76 NA NA 98.50 97.07 090 61703 ......... ............ A Clamp neck artery ......................................... 18.66 NA NA 10.84 10.56 4.05 NA NA 33.55 33.27 090 61705 ......... ............ A Revise circulation to head ............................. 37.92 NA NA 17.61 18.84 8.84 NA NA 64.37 65.60 090 61708 ......... ............ A Revise circulation to head ............................. 37.02 NA NA 13.19 14.66 2.50 NA NA 52.71 54.18 090 61710 ......... ............ A Revise circulation to head ............................. 31.15 NA NA 13.35 13.57 4.51 NA NA 49.01 49.23 090 61711 ......... ............ A Fusion of skull arteries .................................. 38.05 NA NA 18.57 19.49 9.39 NA NA 66.01 66.93 090 61720 ......... ............ A Incise skull/brain surgery ............................... 17.48 NA NA 8.13 9.51 2.78 NA NA 28.39 29.77 090 61735 ......... ............ A Incise skull/brain surgery ............................... 22.17 NA NA 11.32 11.95 2.72 NA NA 36.21 36.84 090 61750 ......... ............ A Incise skull/brain biopsy ................................ 19.69 NA NA 10.97 10.70 4.71 NA NA 35.37 35.10 090 61751 ......... ............ A Brain biopsy w/ct/mr guide ............................ 18.58 NA NA 11.42 10.97 4.55 NA NA 34.55 34.10 090 61760 ......... ............ A Implant brain electrodes ................................ 22.24 NA NA 11.94 9.52 5.40 NA NA 39.58 37.16 090 61770 ......... ............ A Incise skull for treatment ............................... 23.05 NA NA 9.87 11.66 3.54 NA NA 36.46 38.25 090 61790 ......... ............ A Treat trigeminal nerve ................................... 11.46 NA NA 7.79 6.38 2.81 NA NA 22.06 20.65 090 61791 ......... ............ A Treat trigeminal tract ..................................... 15.27 NA NA 7.61 8.59 3.39 NA NA 26.27 27.25 090 61793 ......... ............ A Focus radiation beam .................................... 17.71 NA NA 9.79 10.04 4.45 NA NA 31.95 32.20 090 61795 ......... ............ A Brain surgery using computer ....................... 4.03 NA NA 1.37 1.87 0.79 NA NA 6.19 6.69 ZZZ 61850 ......... ............ A Implant neuroelectrodes ................................ 13.23 NA NA 5.56 7.14 3.21 NA NA 22.00 23.58 090 61860 ......... ............ A Implant neuroelectrodes ................................ 22.12 NA NA 11.19 11.84 4.94 NA NA 38.25 38.90 090 61863 ......... ............ A Implant neuroelectrode .................................. 20.50 NA NA 12.48 11.95 5.41 NA NA 38.39 37.86 090 61864 ......... ............ A Implant neuroelectrde, addl ........................... 4.49 NA NA 1.70 2.14 5.41 NA NA 11.60 12.04 ZZZ 61867 ......... ............ A Implant neuroelectrode .................................. 32.82 NA NA 16.69 17.69 5.41 NA NA 54.92 55.92 090 61868 ......... ............ A Implant neuroelectrde, addIl .......................... 7.91 NA NA 2.96 3.75 5.41 NA NA 16.28 17.07 ZZZ 61870 ......... ............ A Implant neuroelectrodes ................................ 16.20 NA NA 8.63 9.43 3.86 NA NA 28.69 29.49 090 61875 ......... ............ A Implant neuroelectrodes ................................ 16.32 NA NA 5.38 7.77 2.94 NA NA 24.64 27.03 090 61880 ......... ............ A Revise/remove neuroelectrode ..................... 6.84 NA NA 5.47 4.80 1.66 NA NA 13.97 13.30 090 61885 ......... ............ A Insrt/redo neurostim 1 array .......................... 7.29 NA NA 7.42 5.83 1.59 NA NA 16.30 14.71 090 61886 ......... ............ A Implant neurostim arrays ............................... 9.65 NA NA 8.74 6.95 1.96 NA NA 20.35 18.56 090 61888 ......... ............ A Revise/remove neuroreceiver ....................... 5.18 NA NA 3.59 3.65 1.33 NA NA 10.10 10.16 010 62000 ......... ............ A Treat skull fracture ........................................ 13.79 NA NA 7.21 5.94 1.06 NA NA 22.06 20.79 090 62005 ......... ............ A Treat skull fracture ........................................ 17.49 NA NA 9.47 8.96 3.86 NA NA 30.82 30.31 090 62010 ......... ............ A Treatment of head injury ............................... 21.25 NA NA 11.91 11.76 5.12 NA NA 38.28 38.13 090 62100 ......... ............ A Repair brain fluid leakage ............................. 23.35 NA NA 11.84 12.55 4.83 NA NA 40.02 40.73 090 62115 ......... ............ A Reduction of skull defect ............................... 22.63 NA NA 13.97 12.22 5.49 NA NA 42.09 40.34 090 62116 ......... ............ A Reduction of skull defect ............................... 24.82 NA NA 13.12 13.30 6.09 NA NA 44.03 44.21 090 62117 ......... ............ A Reduction of skull defect ............................... 28.20 NA NA 14.69 15.20 4.52 NA NA 47.41 47.92 090 62120 ......... ............ A Repair skull cavity lesion ............................... 24.31 NA NA 15.76 17.80 2.99 NA NA 43.06 45.10 090 62121 ......... ............ A Incise skull repair .......................................... 22.89 NA NA 14.03 15.10 4.16 NA NA 41.08 42.15 090 62140 ......... ............ A Repair of skull defect .................................... 14.41 NA NA 8.60 8.39 3.46 NA NA 26.47 26.26 090 62141 ......... ............ A Repair of skull defect .................................... 15.93 NA NA 9.30 9.11 3.75 NA NA 28.98 28.79 090 62142 ......... ............ A Remove skull plate/flap ................................. 11.69 NA NA 7.72 7.17 2.72 NA NA 22.13 21.58 090 62143 ......... ............ A Replace skull plate/flap ................................. 14.01 NA NA 8.79 8.23 3.36 NA NA 26.16 25.60 090 62145 ......... ............ A Repair of skull & brain ................................... 19.95 NA NA 10.20 10.72 4.49 NA NA 34.64 35.16 090 62146 ......... ............ A Repair of skull with graft ............................... 17.14 NA NA 9.04 9.48 3.61 NA NA 29.79 30.23 090 62147 ......... ............ A Repair of skull with graft ............................... 20.53 NA NA 10.59 11.12 4.31 NA NA 35.43 35.96 090 62148 ......... ............ A Retr bone flap to fix skull .............................. 2.00 NA NA 0.76 0.84 0.48 NA NA 3.24 3.32 ZZZ 62160 ......... ............ A Neuroendoscopy add-on ............................... 3.00 NA NA 1.12 1.43 0.77 NA NA 4.89 5.20 ZZZ 62161 ......... ............ A Dissect brain w/scope ................................... 21.04 NA NA 12.12 12.10 5.17 NA NA 38.33 38.31 090 62162 ......... ............ A Remove colloid cyst w/scope ........................ 26.61 NA NA 13.85 14.60 5.89 NA NA 46.35 47.10 090 62163 ......... ............ A Neuroendoscopy w/fb removal ...................... 16.34 NA NA 10.53 10.07 4.00 NA NA 30.87 30.41 09062164 ......... ............ A Remove brain tumor w/scope ....................... 29.19 NA NA 14.93 14.95 5.36 NA NA 49.48 49.50 09062165 ......... ............ A Remove pituit tumor w/scope ........................ 23.04 NA NA 11.46 12.90 3.00 NA NA 37.50 38.94 090 62180 ......... ............ A Establish brain cavity shunt .......................... 22.41 NA NA 12.00 12.21 4.97 NA NA 39.38 39.59 090 62190 ......... ............ A Establish brain cavity shunt .......................... 12.03 NA NA 7.67 7.23 2.79 NA NA 22.49 22.05 090 62192 ......... ............ A Establish brain cavity shunt .......................... 13.21 NA NA 8.40 7.82 3.01 NA NA 24.62 24.04 090 62194 ......... ............ A Replace/irrigate catheter ............................... 5.64 NA NA 3.81 2.78 0.92 NA NA 10.37 9.34 010 

mstockstill on PROD1PC63 with PROPOSAL_2

49166 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

62200 ......... ............ A Establish brain cavity shunt .......................... 19.15 NA NA 10.69 10.80 4.64 NA NA 34.48 34.59 090 62201 ......... ............ A Brain cavity shunt w/scope ........................... 15.83 NA NA 10.52 9.71 3.67 NA NA 30.02 29.21 090 62220 ......... ............ A Establish brain cavity shunt .......................... 13.96 NA NA 8.39 8.08 3.34 NA NA 25.69 25.38 090 62223 ......... ............ A Establish brain cavity shunt .......................... 13.84 NA NA 9.42 8.54 3.13 NA NA 26.39 25.51 090 62225 ......... ............ A Replace/irrigate catheter ............................... 6.08 NA NA 5.49 4.44 1.39 NA NA 12.96 11.91 090 62230 ......... ............ A Replace/revise brain shunt ............................ 11.32 NA NA 7.28 6.68 2.70 NA NA 21.30 20.70 090 62252 ......... ............ A Csf shunt reprogram ..................................... 0.74 1.78 1.55 NA NA 0.21 2.73 2.50 NA NA XXX 62252 ......... 26 ....... A Csf shunt reprogram ..................................... 0.74 0.27 0.35 0.27 0.35 0.19 1.20 1.28 1.20 1.28 XXX 62252 ......... TC ...... A Csf shunt reprogram ..................................... 0.00 1.51 1.20 NA NA 0.02 1.53 1.22 NA NA XXX 62256 ......... ............ A Remove brain cavity shunt ............................ 7.27 NA NA 5.88 4.99 1.71 NA NA 14.86 13.97 090 62258 ......... ............ A Replace brain cavity shunt ............................ 15.50 NA NA 9.25 8.85 3.73 NA NA 28.48 28.08 090 62263 ......... ............ A Epidural lysis mult sessions .......................... 6.37 9.18 11.81 2.88 3.11 0.41 15.96 18.59 9.66 9.89 010 62264 ......... ............ A Epidural lysis on single day .......................... 4.42 5.78 7.24 1.31 1.39 0.27 10.47 11.93 6.00 6.08 010 62268 ......... ............ A Drain spinal cord cyst .................................... 4.73 6.76 10.34 1.74 2.04 0.43 11.92 15.50 6.90 7.20 000 62269 ......... ............ A Needle biopsy, spinal cord ............................ 5.01 6.84 12.72 1.67 1.90 0.37 12.22 18.10 7.05 7.28 000 62270 ......... ............ A Spinal fluid tap, diagnostic ............................ 1.37 2.38 2.84 0.55 0.56 0.08 3.83 4.29 2.00 2.01 000 62272 ......... ............ A Drain cerebro spinal fluid .............................. 1.35 3.14 3.49 0.61 0.69 0.18 4.67 5.02 2.14 2.22 000 62273 ......... ............ A Inject epidural patch ...................................... 2.15 1.70 2.46 0.58 0.68 0.13 3.98 4.74 2.86 2.96 000 62280 ......... ............ A Treat spinal cord lesion ................................. 2.63 4.30 6.27 1.07 1.03 0.30 7.23 9.20 4.00 3.96 010 62281 ......... ............ A Treat spinal cord lesion ................................. 2.66 3.79 5.19 0.91 0.90 0.19 6.64 8.04 3.76 3.75 010 62282 ......... ............ A Treat spinal canal lesion ............................... 2.33 3.97 7.26 1.07 0.96 0.17 6.47 9.76 3.57 3.46 010 62284 ......... ............ A Injection for myelogram ................................. 1.54 3.79 4.67 0.67 0.68 0.13 5.46 6.34 2.34 2.35 000 62287 ......... ............ A Percutaneous diskectomy ............................. 8.82 NA NA 4.24 5.22 0.58 NA NA 13.64 14.62 09062290 ......... ............ A Inject for spine disk x-ray .............................. 3.00 4.46 6.46 1.13 1.32 0.23 7.69 9.69 4.36 4.55 000 62291 ......... ............ A Inject for spine disk x-ray .............................. 2.91 4.25 5.51 1.07 1.19 0.26 7.42 8.68 4.24 4.36 000 62292 ......... ............ A Injection into disk lesion ................................ 9.10 NA NA 3.19 4.15 0.82 NA NA 13.11 14.07 090 62294 ......... ............ A Injection into spinal artery ............................. 12.73 NA NA 5.63 5.59 1.24 NA NA 19.60 19.56 090 62310 ......... ............ A Inject spine c/t ............................................... 1.91 3.06 4.37 0.58 0.63 0.12 5.09 6.40 2.61 2.66 000 62311 ......... ............ A Inject spine l/s (cd) ........................................ 1.54 2.70 4.37 0.54 0.58 0.09 4.33 6.00 2.17 2.21 000 62318 ......... ............ A Inject spine w/cath, c/t ................................... 2.04 3.24 5.10 0.48 0.61 0.12 5.40 7.26 2.64 2.77 000 62319 ......... ............ A Inject spine w/cath l/s (cd) ............................ 1.87 2.90 4.46 0.47 0.58 0.11 4.88 6.44 2.45 2.56 000 62350 ......... ............ A Implant spinal canal cath .............................. 7.96 NA NA 4.19 4.00 1.02 NA NA 13.17 12.98 090 62351 ......... ............ A Implant spinal canal cath .............................. 11.46 NA NA 7.73 7.27 2.24 NA NA 21.43 20.97 090 62355 ......... ............ A Remove spinal canal catheter ....................... 6.54 NA NA 3.61 3.27 0.71 NA NA 10.86 10.52 090 62360 ......... ............ A Insert spine infusion device ........................... 3.60 NA NA 3.46 2.88 0.34 NA NA 7.40 6.82 090 62361 ......... ............ A Implant spine infusion pump ......................... 6.51 NA NA 4.00 3.94 0.80 NA NA 11.31 11.25 09062362 ......... ............ A Implant spine infusion pump ......................... 8.50 NA NA 4.78 4.47 1.18 NA NA 14.46 14.15 09062365 ......... ............ A Remove spine infusion device ...................... 6.51 NA NA 3.85 3.65 0.86 NA NA 11.22 11.02 090 62367 ......... ............ A Analyze spine infusion pump ........................ 0.48 0.41 0.56 0.11 0.10 0.03 0.92 1.07 0.62 0.61 XXX 62368 ......... ............ A Analyze spine infusion pump ........................ 0.75 0.60 0.67 0.19 0.18 0.06 1.41 1.48 1.00 0.99 XXX 63001 ......... ............ A Removal of spinal lamina .............................. 17.47 NA NA 9.89 9.61 3.76 NA NA 31.12 30.84 090 63003 ......... ............ A Removal of spinal lamina .............................. 17.60 NA NA 9.80 9.85 3.72 NA NA 31.12 31.17 090 63005 ......... ............ A Removal of spinal lamina .............................. 16.22 NA NA 9.78 9.92 3.34 NA NA 29.34 29.48 090 63011 ......... ............ A Removal of spinal lamina .............................. 15.73 NA NA 9.22 8.51 3.37 NA NA 28.32 27.61 090 63012 ......... ............ A Removal of spinal lamina .............................. 16.67 NA NA 9.84 10.05 3.48 NA NA 29.99 30.20 090 63015 ......... ............ A Removal of spinal lamina .............................. 20.64 NA NA 12.01 11.91 4.75 NA NA 37.40 37.30 090 63016 ......... ............ A Removal of spinal lamina .............................. 21.85 NA NA 11.95 11.82 4.58 NA NA 38.38 38.25 090 63017 ......... ............ A Removal of spinal lamina .............................. 17.12 NA NA 10.43 10.40 3.63 NA NA 31.18 31.15 090 63020 ......... ............ A Neck spine disk surgery ................................ 15.99 NA NA 9.99 9.75 3.71 NA NA 29.69 29.45 090 63030 ......... ............ A Low back disk surgery .................................. 12.97 NA NA 8.67 8.48 3.00 NA NA 24.64 24.45 090 63035 ......... ............ A Spinal disk surgery add-on ........................... 3.15 NA NA 1.21 1.50 0.79 NA NA 5.15 5.44 ZZZ 63040 ......... ............ A Laminotomy, single cervical .......................... 20.13 NA NA 11.08 11.40 4.67 NA NA 35.88 36.20 090 63042 ......... ............ A Laminotomy, single lumbar ........................... 18.55 NA NA 10.68 11.18 4.25 NA NA 33.48 33.98 090 63043 ......... ............ C Laminotomy, addIl cervical ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 63044 ......... ............ C Laminotomy, addIl lumbar ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 63045 ......... ............ A Removal of spinal lamina .............................. 17.77 NA NA 10.41 10.37 3.98 NA NA 32.16 32.12 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49167 

63046 ......... ............ A Removal of spinal lamina .............................. 17.07 NA NA 9.88 10.11 3.55 NA NA 30.50 30.73 090 63047 ......... ............ A Removal of spinal lamina .............................. 15.16 NA NA 9.41 9.77 3.23 NA NA 27.80 28.16 090 63048 ......... ............ A Remove spinal lamina add-on ...................... 3.26 NA NA 1.25 1.56 0.72 NA NA 5.23 5.54 ZZZ 63050 ......... ............ A Cervical laminoplasty .................................... 21.82 NA NA 8.87 11.10 4.66 NA NA 35.35 37.58 090 63051 ......... ............ A C-laminoplasty w/graft/plate .......................... 25.32 NA NA 11.71 13.03 4.66 NA NA 41.69 43.01 090 63055 ......... ............ A Decompress spinal cord ................................ 23.37 NA NA 12.40 12.95 5.27 NA NA 41.04 41.59 090 63056 ......... ............ A Decompress spinal cord ................................ 21.68 NA NA 11.41 12.27 4.75 NA NA 37.84 38.70 090 63057 ......... ............ A Decompress spine cord add-on .................... 5.25 NA NA 1.97 2.47 1.22 NA NA 8.44 8.94 ZZZ 63064 ......... ............ A Decompress spinal cord ................................ 26.04 NA NA 13.41 14.17 5.69 NA NA 45.14 45.90 090 63066 ......... ............ A Decompress spine cord add-on .................... 3.26 NA NA 1.24 1.56 0.69 NA NA 5.19 5.51 ZZZ 63075 ......... ............ A Neck spine disk surgery ................................ 19.41 NA NA 11.11 11.84 4.62 NA NA 35.14 35.87 090 63076 ......... ............ A Neck spine disk surgery ................................ 4.04 NA NA 1.53 1.92 0.96 NA NA 6.53 6.92 ZZZ 63077 ......... ............ A Spine disk surgery, thorax ............................ 22.70 NA NA 11.20 12.39 3.98 NA NA 37.88 39.07 090 63078 ......... ............ A Spine disk surgery, thorax ............................ 3.28 NA NA 1.20 1.53 0.66 NA NA 5.14 5.47 ZZZ63081 ......... ............ A Removal of vertebral body ............................ 25.92 NA NA 13.62 14.15 5.54 NA NA 45.08 45.61 090 63082 ......... ............ A Remove vertebral body add-on ..................... 4.36 NA NA 1.66 2.08 1.02 NA NA 7.04 7.46 ZZZ 63085 ......... ............ A Removal of vertebral body ............................ 29.29 NA NA 13.77 15.05 4.48 NA NA 47.54 48.82 090 63086 ......... ............ A Remove vertebral body add-on ..................... 3.19 NA NA 1.17 1.49 0.59 NA NA 4.95 5.27 ZZZ 63087 ......... ............ A Removal of vertebral body ............................ 37.32 NA NA 16.85 18.80 6.20 NA NA 60.37 62.32 090 63088 ......... ............ A Remove vertebral body add-on ..................... 4.32 NA NA 1.64 2.04 0.82 NA NA 6.78 7.18 ZZZ 63090 ......... ............ A Removal of vertebral body ............................ 30.72 NA NA 14.16 15.56 4.21 NA NA 49.09 50.49 090 63091 ......... ............ A Remove vertebral body add-on ..................... 3.03 NA NA 1.13 1.38 0.48 NA NA 4.64 4.89 ZZZ 63101 ......... ............ A Removal of vertebral body ............................ 33.84 NA NA 17.18 18.75 5.69 NA NA 56.71 58.28 090 63102 ......... ............ A Removal of vertebral body ............................ 33.84 NA NA 16.90 18.68 5.69 NA NA 56.43 58.21 090 63103 ......... ............ A Remove vertebral body add-on ..................... 4.82 NA NA 1.78 2.32 0.69 NA NA 7.29 7.83 ZZZ 63170 ......... ............ A Incise spinal cord tract(s) .............................. 22.03 NA NA 12.64 12.06 4.86 NA NA 39.53 38.95 090 63172 ......... ............ A Drainage of spinal cyst .................................. 19.62 NA NA 11.31 10.81 4.48 NA NA 35.41 34.91 090 63173 ......... ............ A Drainage of spinal cyst .................................. 24.13 NA NA 13.38 12.95 5.68 NA NA 43.19 42.76 090 63180 ......... ............ A Revise spinal cord ligaments ........................ 20.35 NA NA 10.94 10.97 3.95 NA NA 35.24 35.27 090 63182 ......... ............ A Revise spinal cord ligaments ........................ 22.64 NA NA 7.25 10.03 5.30 NA NA 35.19 37.97 090 63185 ......... ............ A Incise spinal column/nerves .......................... 16.31 NA NA 10.11 8.60 2.79 NA NA 29.21 27.70 090 63190 ......... ............ A Incise spinal column/nerves .......................... 18.71 NA NA 10.16 10.14 3.24 NA NA 32.11 32.09 090 63191 ......... ............ A Incise spinal column/nerves .......................... 18.74 NA NA 10.78 10.55 6.34 NA NA 35.86 35.63 090 63194 ......... ............ A Incise spinal column & cord .......................... 21.92 NA NA 8.65 10.95 3.26 NA NA 33.83 36.13 090 63195 ......... ............ A Incise spinal column & cord .......................... 21.50 NA NA 12.18 11.33 4.87 NA NA 38.55 37.70 090 63196 ......... ............ A Incise spinal column & cord .......................... 25.09 NA NA 13.88 13.51 5.76 NA NA 44.73 44.36 090 63197 ......... ............ A Incise spinal column & cord .......................... 23.90 NA NA 13.43 12.51 5.36 NA NA 42.69 41.77 090 63198 ......... ............ A Incise spinal column & cord .......................... 29.69 NA NA 9.01 8.58 6.43 NA NA 45.13 44.70 090 63199 ......... ............ A Incise spinal column & cord .......................... 31.26 NA NA 9.38 13.62 1.40 NA NA 42.04 46.28 090 63200 ......... ............ A Release of spinal cord .................................. 21.26 NA NA 11.74 11.40 4.96 NA NA 37.96 37.62 090 63250 ......... ............ A Revise spinal cord vessels ............................ 43.68 NA NA 21.09 20.21 9.01 NA NA 73.78 72.90 090 63251 ......... ............ A Revise spinal cord vessels ............................ 44.43 NA NA 21.36 22.28 10.41 NA NA 76.20 77.12 090 63252 ......... ............ A Revise spinal cord vessels ............................ 44.42 NA NA 21.41 22.03 10.64 NA NA 76.47 77.09 090 63265 ......... ............ A Excise intraspinal lesion ................................ 23.64 NA NA 13.10 12.85 5.43 NA NA 42.17 41.92 090 63266 ......... ............ A Excise intraspinal lesion ................................ 24.50 NA NA 13.27 13.20 5.54 NA NA 43.31 43.24 090 63267 ......... ............ A Excise intraspinal lesion ................................ 19.27 NA NA 11.22 11.11 4.37 NA NA 34.86 34.75 090 63268 ......... ............ A Excise intraspinal lesion ................................ 19.84 NA NA 10.84 10.48 3.69 NA NA 34.37 34.01 090 63270 ......... ............ A Excise intraspinal lesion ................................ 29.62 NA NA 15.73 15.53 6.82 NA NA 52.17 51.97 090 63271 ......... ............ A Excise intraspinal lesion ................................ 29.74 NA NA 15.34 15.51 6.90 NA NA 51.98 52.15 090 63272 ......... ............ A Excise intraspinal lesion ................................ 27.32 NA NA 14.33 14.59 6.18 NA NA 47.83 48.09 090 63273 ......... ............ A Excise intraspinal lesion ................................ 26.29 NA NA 13.84 14.21 5.74 NA NA 45.87 46.24 090 63275 ......... ............ A Biopsy/excise spinal tumor ............................ 25.68 NA NA 13.51 13.70 5.80 NA NA 44.99 45.18 090 63276 ......... ............ A Biopsy/excise spinal tumor ............................ 25.51 NA NA 13.73 13.69 5.83 NA NA 45.07 45.03 090 63277 ......... ............ A Biopsy/excise spinal tumor ............................ 22.21 NA NA 12.17 12.43 5.01 NA NA 39.39 39.65 090 63278 ......... ............ A Biopsy/excise spinal tumor ............................ 21.94 NA NA 12.07 12.30 4.55 NA NA 38.56 38.79 090 63280 ......... ............ A Biopsy/excise spinal tumor ............................ 30.08 NA NA 16.02 16.23 7.27 NA NA 53.37 53.58 090 63281 ......... ............ A Biopsy/excise spinal tumor ............................ 29.78 NA NA 15.82 16.08 7.17 NA NA 52.77 53.03 090 63282 ......... ............ A Biopsy/excise spinal tumor ............................ 27.94 NA NA 15.14 15.28 6.76 NA NA 49.84 49.98 090 63283 ......... ............ A Biopsy/excise spinal tumor ............................ 26.55 NA NA 14.20 14.54 6.26 NA NA 47.01 47.35 090 63285 ......... ............ A Biopsy/excise spinal tumor ............................ 37.84 NA NA 19.05 19.71 9.18 NA NA 66.07 66.73 090 63286 ......... ............ A Biopsy/excise spinal tumor ............................ 37.41 NA NA 18.80 19.62 9.21 NA NA 65.42 66.24 090 63287 ......... ............ A Biopsy/excise spinal tumor ............................ 39.87 NA NA 19.48 20.18 9.39 NA NA 68.74 69.43 090 63290 ......... ............ A Biopsy/excise spinal tumor ............................ 40.61 NA NA 20.06 20.45 9.02 NA NA 69.68 70.07 090 63295 ......... ............ A Repair of laminectomy defect ....................... 5.25 NA NA 1.33 1.94 1.03 NA NA 7.61 8.22 ZZZ 63300 ......... ............ A Removal of vertebral body ............................ 26.62 NA NA 13.54 14.10 5.97 NA NA 46.13 46.69 090 63301 ......... ............ A Removal of vertebral body ............................ 31.36 NA NA 15.06 15.42 5.39 NA NA 51.81 52.17 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49168 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

63302 ......... ............ A Removal of vertebral body ............................ 30.94 NA NA 14.83 15.59 5.53 NA NA 51.30 52.06 090 63303 ......... ............ A Removal of vertebral body ............................ 33.37 NA NA 14.68 16.35 4.68 NA NA 52.73 54.40 090 63304 ......... ............ A Removal of vertebral body ............................ 33.64 NA NA 17.05 17.21 6.41 NA NA 57.10 57.26 090 63305 ......... ............ A Removal of vertebral body ............................ 36.03 NA NA 17.60 17.93 5.71 NA NA 59.34 59.67 090 63306 ......... ............ A Removal of vertebral body ............................ 35.34 NA NA 15.77 17.29 8.33 NA NA 59.43 60.96 090 63307 ......... ............ A Removal of vertebral body ............................ 34.75 NA NA 17.66 17.02 4.46 NA NA 56.87 56.23 090 63308 ......... ............ A Remove vertebral body add-on ..................... 5.24 NA NA 1.93 2.43 1.29 NA NA 8.46 8.96 ZZZ 63600 ......... ............ A Remove spinal cord lesion ............................ 14.98 NA NA 4.61 5.20 1.52 NA NA 21.11 21.70 090 63610 ......... ............ A Stimulation of spinal cord .............................. 8.72 14.20 48.31 1.58 2.08 0.86 23.78 57.89 11.16 11.66 000 63615 ......... ............ A Remove lesion of spinal cord ........................ 17.18 NA NA 5.98 8.44 2.84 NA NA 26.00 28.46 090 63650 ......... ............ A Implant neuroelectrodes ................................ 7.53 NA NA 2.98 3.12 0.53 NA NA 11.04 11.18 090 63655 ......... ............ A Implant neuroelectrodes ................................ 11.38 NA NA 7.84 7.13 2.43 NA NA 21.65 20.94 090 63660 ......... ............ A Revise/remove neuroelectrode ..................... 6.83 NA NA 3.36 3.55 0.78 NA NA 10.97 11.16 090 63685 ......... ............ A Insrt/redo spine n generator .......................... 7.83 NA NA 3.74 4.04 1.05 NA NA 12.62 12.92 090 63688 ......... ............ A Revise/remove neuroreceiver ....................... 6.06 NA NA 3.60 3.56 0.89 NA NA 10.55 10.51 090 63700 ......... ............ A Repair of spinal herniation ............................ 17.26 NA NA 9.78 10.17 3.52 NA NA 30.56 30.95 090 63702 ......... ............ A Repair of spinal herniation ............................ 19.20 NA NA 10.93 11.01 4.12 NA NA 34.25 34.33 090 63704 ......... ............ A Repair of spinal herniation ............................ 22.15 NA NA 12.60 12.83 4.57 NA NA 39.32 39.55 090 63706 ......... ............ A Repair of spinal herniation ............................ 25.07 NA NA 15.07 13.95 6.23 NA NA 46.37 45.25 090 63707 ......... ............ A Repair spinal fluid leakage ............................ 12.47 NA NA 7.90 7.75 2.51 NA NA 22.88 22.73 090 63709 ......... ............ A Repair spinal fluid leakage ............................ 15.47 NA NA 9.06 9.31 3.09 NA NA 27.62 27.87 090 63710 ......... ............ A Graft repair of spine defect ........................... 15.22 NA NA 9.26 9.09 3.40 NA NA 27.88 27.71 090 63740 ......... ............ A Install spinal shunt ......................................... 12.45 NA NA 8.25 7.57 2.93 NA NA 23.63 22.95 090 63741 ......... ............ A Install spinal shunt ......................................... 8.98 NA NA 4.85 4.78 1.66 NA NA 15.49 15.42 090 63744 ......... ............ A Revision of spinal shunt ................................ 8.83 NA NA 6.06 5.45 1.89 NA NA 16.78 16.17 090 63746 ......... ............ A Removal of spinal shunt ................................ 7.22 NA NA 4.75 4.02 1.53 NA NA 13.50 12.77 090 64400 ......... ............ A N block inj, trigeminal .................................... 1.11 1.41 1.77 0.45 0.44 0.07 2.59 2.95 1.63 1.62 000 64402 ......... ............ A N block inj, facial ........................................... 1.25 1.46 1.57 0.53 0.58 0.09 2.80 2.91 1.87 1.92 000 64405 ......... ............ A N block inj, occipital ...................................... 1.32 1.17 1.39 0.51 0.47 0.08 2.57 2.79 1.91 1.87 000 64408 ......... ............ A N block inj, vagus .......................................... 1.41 1.45 1.55 0.70 0.81 0.10 2.96 3.06 2.21 2.32 000 64410 ......... ............ A N block inj, phrenic ........................................ 1.43 1.82 2.33 0.52 0.48 0.09 3.34 3.85 2.04 2.00 000 64412 ......... ............ A N block inj, spinal accessor .......................... 1.18 2.05 2.50 0.55 0.46 0.08 3.31 3.76 1.81 1.72 000 64413 ......... ............ A N block inj, cervical plexus ............................ 1.40 1.30 1.71 0.47 0.49 0.08 2.78 3.19 1.95 1.97 000 64415 ......... ............ A N block inj, brachial plexus ........................... 1.48 1.50 2.48 0.34 0.43 0.09 3.07 4.05 1.91 2.00 000 64416 ......... ............ A N block cont infuse, b plex ............................ 3.85 NA NA 0.57 0.74 0.31 NA NA 4.73 4.90 010 64417 ......... ............ A N block inj, axillary ........................................ 1.44 1.51 2.65 0.35 0.46 0.11 3.06 4.20 1.90 2.01 000 64418 ......... ............ A N block inj, suprascapular ............................. 1.32 1.90 2.44 0.52 0.46 0.07 3.29 3.83 1.91 1.85 000 64420 ......... ............ A N block inj, intercost, sng .............................. 1.18 2.40 3.51 0.44 0.43 0.08 3.66 4.77 1.70 1.69 000 64421 ......... ............ A N block inj, intercost, mlt ............................... 1.68 3.55 5.45 0.53 0.52 0.11 5.34 7.24 2.32 2.31 000 64425 ......... ............ A N block inj, ilio-ing/hypogi ............................. 1.75 1.34 1.57 0.56 0.55 0.13 3.22 3.45 2.44 2.43 000 64430 ......... ............ A N block inj, pudendal ..................................... 1.46 2.41 2.49 0.78 0.61 0.10 3.97 4.05 2.34 2.17 000 64435 ......... ............ A N block inj, paracervical ................................ 1.45 2.00 2.39 0.56 0.66 0.16 3.61 4.00 2.17 2.27 000 64445 ......... ............ A N block inj, sciatic, sng ................................. 1.48 1.67 2.42 0.52 0.51 0.10 3.25 4.00 2.10 2.09 000 64446 ......... ............ A N blk inj, sciatic, cont inf ............................... 3.61 NA NA 0.59 0.90 0.20 NA NA 4.40 4.71 010 64447 ......... ............ A N block inj fem, single ................................... 1.50 NA NA 0.21 0.38 0.09 NA NA 1.80 1.97 000 64448 ......... ............ A N block inj fem, cont inf ................................ 3.36 NA NA 0.47 0.73 0.18 NA NA 4.01 4.27 010 64449 ......... ............ A N block inj, lumbar plexus ............................. 3.24 NA NA 0.49 0.84 0.15 NA NA 3.88 4.23 010 64450 ......... ............ A N block, other peripheral ............................... 1.27 1.29 1.25 0.50 0.49 0.13 2.69 2.65 1.90 1.89 000 64470 ......... ............ A Inj paravertebral c/t ....................................... 1.85 3.87 6.39 0.71 0.71 0.11 5.83 8.35 2.67 2.67 000 64472 ......... ............ A Inj paravertebral c/t add-on ........................... 1.29 1.23 2.06 0.34 0.34 0.08 2.60 3.43 1.71 1.71 ZZZ 64475 ......... ............ A Inj paravertebral l/s ........................................ 1.41 3.72 6.09 0.60 0.62 0.10 5.23 7.60 2.11 2.13 000 64476 ......... ............ A Inj paravertebral l/s add-on ........................... 0.98 1.12 1.87 0.23 0.24 0.07 2.17 2.92 1.28 1.29 ZZZ 64479 ......... ............ A Inj foramen epidural c/t ................................. 2.20 3.81 6.57 0.82 0.87 0.12 6.13 8.89 3.14 3.19 000 64480 ......... ............ A Inj foramen epidural add-on .......................... 1.54 1.50 2.51 0.38 0.45 0.10 3.14 4.15 2.02 2.09 ZZZ 64483 ......... ............ A Inj foramen epidural l/s .................................. 1.90 3.85 6.88 0.76 0.81 0.11 5.86 8.89 2.77 2.82 000 64484 ......... ............ A Inj foramen epidural add-on .......................... 1.33 1.63 2.87 0.32 0.36 0.08 3.04 4.28 1.73 1.77 ZZZ 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49169 

64505 ......... ............ A N block, spenopalatine gangl ........................ 1.36 1.11 1.21 0.73 0.68 0.10 2.57 2.67 2.19 2.14 000 64508 ......... ............ A N block, carotid sinus s/p .............................. 1.12 1.89 2.96 0.48 0.68 0.07 3.08 4.15 1.67 1.87 000 64510 ......... ............ A N block, stellate ganglion .............................. 1.22 1.92 3.07 0.44 0.49 0.07 3.21 4.36 1.73 1.78 000 64517 ......... ............ A N block inj, hypogas plxs .............................. 2.20 1.70 2.47 0.67 0.82 0.11 4.01 4.78 2.98 3.13 000 64520 ......... ............ A N block, lumbar/thoracic ................................ 1.35 2.62 4.51 0.52 0.54 0.08 4.05 5.94 1.95 1.97 000 64530 ......... ............ A N block inj, celiac pelus ................................ 1.58 2.65 4.00 0.60 0.64 0.10 4.33 5.68 2.28 2.32 000 64550 ......... ............ A Apply neurostimulator .................................... 0.18 0.20 0.26 0.06 0.05 0.01 0.39 0.45 0.25 0.24 000 64553 ......... ............ A Implant neuroelectrodes ................................ 2.31 2.50 2.75 1.35 1.73 0.18 4.99 5.24 3.84 4.22 010 64555 ......... ............ A Implant neuroelectrodes ................................ 2.27 2.57 2.97 1.36 1.23 0.19 5.03 5.43 3.82 3.69 010 64560 ......... ............ A Implant neuroelectrodes ................................ 2.36 2.49 2.60 1.33 1.29 0.22 5.07 5.18 3.91 3.87 010 64561 ......... ............ A Implant neuroelectrodes ................................ 7.05 20.04 27.55 3.87 3.05 0.51 27.60 35.11 11.43 10.61 010 64565 ......... ............ A Implant neuroelectrodes ................................ 1.76 2.47 3.08 1.28 1.27 0.13 4.36 4.97 3.17 3.16 010 64573 ......... ............ A Implant neuroelectrodes ................................ 8.11 NA NA 5.44 5.29 1.60 NA NA 15.15 15.00 090 64575 ......... ............ A Implant neuroelectrodes ................................ 4.34 NA NA 2.00 2.50 0.61 NA NA 6.95 7.45 090 64577 ......... ............ A Implant neuroelectrodes ................................ 4.61 NA NA 2.87 3.18 1.04 NA NA 8.52 8.83 090 64580 ......... ............ A Implant neuroelectrodes ................................ 4.11 NA NA 2.69 3.34 0.36 NA NA 7.16 7.81 090 64581 ......... ............ A Implant neuroelectrodes ................................ 14.13 NA NA 6.72 5.71 1.05 NA NA 21.90 20.89 090 64585 ......... ............ A Revise/remove neuroelectrode ..................... 2.06 5.79 9.91 2.24 2.16 0.20 8.05 12.17 4.50 4.42 010 64590 ......... ............ A Insrt/redo perph n generator ......................... 2.40 6.44 6.97 2.47 2.33 0.19 9.03 9.56 5.06 4.92 010 64595 ......... ............ A Revise/remove neuroreceiver ....................... 1.73 6.52 9.42 2.20 1.99 0.19 8.44 11.34 4.12 3.91 010 64600 ......... ............ A Injection treatment of nerve .......................... 3.44 5.28 8.33 1.58 1.63 0.34 9.06 12.11 5.36 5.41 010 64605 ......... ............ A Injection treatment of nerve .......................... 5.60 7.65 9.08 2.39 2.23 0.79 14.04 15.47 8.78 8.62 010 64610 ......... ............ A Injection treatment of nerve .......................... 7.15 9.41 9.00 3.52 3.66 1.58 18.14 17.73 12.25 12.39 010 64612 ......... ............ A Destroy nerve, face muscle .......................... 1.96 1.61 2.26 1.36 1.33 0.11 3.68 4.33 3.43 3.40 010 64613 ......... ............ A Destroy nerve, neck muscle .......................... 1.96 1.36 2.54 1.13 1.20 0.11 3.43 4.61 3.20 3.27 010 64614 ......... ............ A Destroy nerve, extrem musc ......................... 2.20 1.62 2.82 1.31 1.31 0.10 3.92 5.12 3.61 3.61 010 64620 ......... ............ A Injection treatment of nerve .......................... 2.84 3.44 4.66 1.17 1.29 0.20 6.48 7.70 4.21 4.33 010 64622 ......... ............ A Destr paravertebrl nerve l/s ........................... 3.00 4.10 6.85 1.27 1.35 0.18 7.28 10.03 4.45 4.53 010 64623 ......... ............ A Destr paravertebral n add-on ........................ 0.99 1.65 2.63 0.22 0.22 0.06 2.70 3.68 1.27 1.27 ZZZ 64626 ......... ............ A Destr paravertebrl nerve c/t .......................... 3.78 4.74 7.02 1.87 1.94 0.20 8.72 11.00 5.85 5.92 010 64627 ......... ............ A Destr paravertebral n add-on ........................ 1.16 2.38 3.99 0.25 0.27 0.07 3.61 5.22 1.48 1.50 ZZZ 64630 ......... ............ A Injection treatment of nerve .......................... 3.00 2.81 2.75 1.88 1.53 0.22 6.03 5.97 5.10 4.75 010 64640 ......... ............ A Injection treatment of nerve .......................... 2.76 2.45 3.75 1.44 1.74 0.29 5.50 6.80 4.49 4.79 010 64650 ......... ............ A Chemodenerv eccrine glands ....................... 0.70 0.78 0.85 0.18 0.27 0.06 1.54 1.61 0.94 1.03 000 64653 ......... ............ A Chemodenerv eccrine glands ....................... 0.88 0.83 0.90 0.22 0.34 0.08 1.79 1.86 1.18 1.30 000 64680 ......... ............ A Injection treatment of nerve .......................... 2.62 4.01 6.04 1.09 1.35 0.18 6.81 8.84 3.89 4.15 010 64681 ......... ............ A Injection treatment of nerve .......................... 3.78 4.92 8.20 1.32 1.88 0.28 8.98 12.26 5.38 5.94 010 64702 ......... ............ A Revise finger/toe nerve ................................. 6.02 NA NA 5.27 4.21 0.61 NA NA 11.90 10.84 090 64704 ......... ............ A Revise hand/foot nerve ................................. 4.56 NA NA 3.20 3.28 0.61 NA NA 8.37 8.45 090 64708 ......... ............ A Revise arm/leg nerve .................................... 6.17 NA NA 4.29 4.72 0.96 NA NA 11.42 11.85 090 64712 ......... ............ A Revision of sciatic nerve ............................... 7.92 NA NA 4.55 4.86 0.95 NA NA 13.42 13.73 090 64713 ......... ............ A Revision of arm nerve(s) ............................... 11.22 NA NA 6.47 6.02 1.82 NA NA 19.51 19.06 090 64714 ......... ............ A Revise low back nerve(s) .............................. 10.37 NA NA 4.91 4.38 1.19 NA NA 16.47 15.94 090 64716 ......... ............ A Revision of cranial nerve ............................... 6.80 NA NA 5.15 5.77 0.63 NA NA 12.58 13.20 090 64718 ......... ............ A Revise ulnar nerve at elbow ......................... 6.98 NA NA 6.23 6.05 1.05 NA NA 14.26 14.08 09064719 ......... ............ A Revise ulnar nerve at wrist ........................... 4.84 NA NA 4.16 4.43 0.77 NA NA 9.77 10.04 090 64721 ......... ............ A Carpal tunnel surgery .................................... 4.78 4.72 5.20 4.66 5.19 0.73 10.23 10.71 10.17 10.70 090 64722 ......... ............ A Relieve pressure on nerve(s) ........................ 4.69 NA NA 2.83 2.99 0.48 NA NA 8.00 8.16 090 64726 ......... ............ A Release foot/toe nerve .................................. 4.17 NA NA 2.73 2.78 0.54 NA NA 7.44 7.49 090 64727 ......... ............ A Internal nerve revision ................................... 3.10 NA NA 1.23 1.43 0.48 NA NA 4.81 5.01 ZZZ 64732 ......... ............ A Incision of brow nerve ................................... 4.78 NA NA 4.27 3.69 0.98 NA NA 10.03 9.45 090 64734 ......... ............ A Incision of cheek nerve ................................. 5.41 NA NA 4.64 4.20 0.89 NA NA 10.94 10.50 090 64736 ......... ............ A Incision of chin nerve .................................... 5.09 NA NA 3.87 3.98 0.52 NA NA 9.48 9.59 090 64738 ......... ............ A Incision of jaw nerve ..................................... 6.22 NA NA 4.22 4.51 1.08 NA NA 11.52 11.81 090 64740 ......... ............ A Incision of tongue nerve ................................ 6.08 NA NA 4.41 4.94 0.69 NA NA 11.18 11.71 090 64742 ......... ............ A Incision of facial nerve .................................. 6.71 NA NA 4.35 4.61 0.73 NA NA 11.79 12.05 090 64744 ......... ............ A Incise nerve, back of head ............................ 5.61 NA NA 4.59 3.98 1.16 NA NA 11.36 10.75 090 64746 ......... ............ A Incise diaphragm nerve ................................. 6.42 NA NA 3.88 4.35 0.82 NA NA 11.12 11.59 090 64752 ......... ............ A Incision of vagus nerve ................................. 7.55 NA NA 4.06 4.23 0.93 NA NA 12.54 12.71 090 64755 ......... ............ A Incision of stomach nerves ........................... 14.93 NA NA 5.84 5.68 1.83 NA NA 22.60 22.44 090 64760 ......... ............ A Incision of vagus nerve ................................. 7.45 NA NA 3.85 3.55 0.81 NA NA 12.11 11.81 090 64761 ......... ............ A Incision of pelvis nerve .................................. 6.90 NA NA 3.99 3.64 0.53 NA NA 11.42 11.07 090 64763 ......... ............ A Incise hip/thigh nerve .................................... 7.42 NA NA 5.07 5.16 0.94 NA NA 13.43 13.52 090 64766 ......... ............ A Incise hip/thigh nerve .................................... 9.29 NA NA 5.31 5.26 1.06 NA NA 15.66 15.61 090 64771 ......... ............ A Sever cranial nerve ....................................... 7.97 NA NA 5.28 5.48 1.23 NA NA 14.48 14.68 090 64772 ......... ............ A Incision of spinal nerve ................................. 7.70 NA NA 5.32 5.02 1.40 NA NA 14.42 14.12 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49170 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

64774 ......... ............ A Remove skin nerve lesion ............................. 5.66 NA NA 3.97 3.87 0.74 NA NA 10.37 10.27 090 64776 ......... ............ A Remove digit nerve lesion ............................. 5.49 NA NA 3.73 3.69 0.76 NA NA 9.98 9.94 09064778 ......... ............ A Digit nerve surgery add-on ............................ 3.11 NA NA 1.19 1.42 0.46 NA NA 4.76 4.99 ZZZ64782 ......... ............ A Remove limb nerve lesion ............................. 6.72 NA NA 4.11 3.86 0.86 NA NA 11.69 11.44 090 64783 ......... ............ A Limb nerve surgery add-on ........................... 3.71 NA NA 1.41 1.73 0.51 NA NA 5.63 5.95 ZZZ 64784 ......... ............ A Remove nerve lesion .................................... 10.44 NA NA 6.20 6.49 1.38 NA NA 18.01 18.30 090 64786 ......... ............ A Remove sciatic nerve lesion ......................... 16.07 NA NA 8.97 9.62 2.60 NA NA 27.64 28.29 090 64787 ......... ............ A Implant nerve end ......................................... 4.29 NA NA 1.60 1.99 0.58 NA NA 6.47 6.86 ZZZ 64788 ......... ............ A Remove skin nerve lesion ............................. 5.10 NA NA 3.87 3.56 0.73 NA NA 9.70 9.39 090 64790 ......... ............ A Removal of nerve lesion ............................... 11.92 NA NA 6.81 7.10 2.10 NA NA 20.83 21.12 090 64792 ......... ............ A Removal of nerve lesion ............................... 15.65 NA NA 8.40 8.72 2.48 NA NA 26.53 26.85 090 64795 ......... ............ A Biopsy of nerve ............................................. 3.01 NA NA 1.44 1.53 0.52 NA NA 4.97 5.06 000 64802 ......... ............ A Remove sympathetic nerves ......................... 10.19 NA NA 4.22 4.90 1.29 NA NA 15.70 16.38 090 64804 ......... ............ A Remove sympathetic nerves ......................... 15.73 NA NA 6.10 6.90 2.14 NA NA 23.97 24.77 090 64809 ......... ............ A Remove sympathetic nerves ......................... 14.57 NA NA 6.60 5.97 1.50 NA NA 22.67 22.04 090 64818 ......... ............ A Remove sympathetic nerves ......................... 11.20 NA NA 4.36 5.05 1.33 NA NA 16.89 17.58 090 64820 ......... ............ A Remove sympathetic nerves ......................... 10.60 NA NA 7.04 7.10 1.49 NA NA 19.13 19.19 090 64821 ......... ............ A Remove sympathetic nerves ......................... 9.11 NA NA 6.64 7.17 1.24 NA NA 16.99 17.52 090 64822 ......... ............ A Remove sympathetic nerves ......................... 9.11 NA NA 6.45 7.04 1.30 NA NA 16.86 17.45 090 64823 ......... ............ A Remove sympathetic nerves ......................... 10.72 NA NA 7.11 7.88 1.57 NA NA 19.40 20.17 090 64831 ......... ............ A Repair of digit nerve ...................................... 10.18 NA NA 6.67 6.97 1.41 NA NA 18.26 18.56 090 64832 ......... ............ A Repair nerve add-on ..................................... 5.65 NA NA 2.36 2.79 0.85 NA NA 8.86 9.29 ZZZ 64834 ......... ............ A Repair of hand or foot nerve ......................... 10.67 NA NA 6.57 6.96 1.54 NA NA 18.78 19.17 090 64835 ......... ............ A Repair of hand or foot nerve ......................... 11.55 NA NA 7.32 7.60 1.73 NA NA 20.60 20.88 090 64836 ......... ............ A Repair of hand or foot nerve ......................... 11.55 NA NA 7.04 7.51 1.67 NA NA 20.26 20.73 090 64837 ......... ............ A Repair nerve add-on ..................................... 6.25 NA NA 2.67 3.09 0.97 NA NA 9.89 10.31 ZZZ 64840 ......... ............ A Repair of leg nerve ........................................ 13.81 NA NA 5.07 7.46 1.37 NA NA 20.25 22.64 090 64856 ......... ............ A Repair/transpose nerve ................................. 14.89 NA NA 8.60 9.04 2.12 NA NA 25.61 26.05 090 64857 ......... ............ A Repair arm/leg nerve ..................................... 15.64 NA NA 8.93 9.46 2.21 NA NA 26.78 27.31 090 64858 ......... ............ A Repair sciatic nerve ....................................... 17.64 NA NA 10.15 10.62 3.33 NA NA 31.12 31.58 090 64859 ......... ............ A Nerve surgery ................................................ 4.25 NA NA 1.88 2.11 0.67 NA NA 6.80 7.03 ZZZ 64861 ......... ............ A Repair of arm nerves .................................... 20.68 NA NA 10.04 11.34 4.08 NA NA 34.80 36.10 090 64862 ......... ............ A Repair of low back nerves ............................ 20.88 NA NA 6.83 10.66 4.31 NA NA 32.02 35.85 090 64864 ......... ............ A Repair of facial nerve .................................... 13.27 NA NA 7.03 8.33 1.26 NA NA 21.56 22.86 090 64865 ......... ............ A Repair of facial nerve .................................... 15.91 NA NA 9.89 12.61 1.50 NA NA 27.30 30.02 090 64866 ......... ............ A Fusion of facial/other nerve ........................... 16.65 NA NA 12.27 12.94 2.04 NA NA 30.96 31.63 090 64868 ......... ............ A Fusion of facial/other nerve ........................... 14.76 NA NA 9.07 10.84 1.43 NA NA 25.26 27.03 090 64870 ......... ............ A Fusion of facial/other nerve ........................... 16.90 NA NA 8.42 8.65 1.30 NA NA 26.62 26.85 090 64872 ......... ............ A Subsequent repair of nerve ........................... 1.99 NA NA 0.81 1.01 0.29 NA NA 3.09 3.29 ZZZ 64874 ......... ............ A Repair & revise nerve add-on ....................... 2.98 NA NA 1.21 1.45 0.42 NA NA 4.61 4.85 ZZZ 64876 ......... ............ A Repair nerve/shorten bone ............................ 3.37 NA NA 0.78 1.50 0.47 NA NA 4.62 5.34 ZZZ 64885 ......... ............ A Nerve graft, head or neck ............................. 17.50 NA NA 8.84 10.91 1.63 NA NA 27.97 30.04 090 64886 ......... ............ A Nerve graft, head or neck ............................. 20.72 NA NA 9.68 12.58 2.08 NA NA 32.48 35.38 090 64890 ......... ............ A Nerve graft, hand or foot ............................... 16.06 NA NA 9.05 9.76 2.29 NA NA 27.40 28.11 090 64891 ......... ............ A Nerve graft, hand or foot ............................... 17.17 NA NA 9.87 8.15 1.63 NA NA 28.67 26.95 090 64892 ......... ............ A Nerve graft, arm or leg .................................. 15.56 NA NA 8.95 8.88 2.47 NA NA 26.98 26.91 090 64893 ......... ............ A Nerve graft, arm or leg .................................. 16.69 NA NA 9.67 9.81 2.61 NA NA 28.97 29.11 090 64895 ......... ............ A Nerve graft, hand or foot ............................... 20.21 NA NA 10.02 9.74 2.57 NA NA 32.80 32.52 090 64896 ......... ............ A Nerve graft, hand or foot ............................... 21.75 NA NA 11.89 11.21 3.16 NA NA 36.80 36.12 090 64897 ......... ............ A Nerve graft, arm or leg .................................. 19.20 NA NA 10.43 10.63 2.54 NA NA 32.17 32.37 090 64898 ......... ............ A Nerve graft, arm or leg .................................. 20.76 NA NA 11.28 11.66 2.77 NA NA 34.81 35.19 090 64901 ......... ............ A Nerve graft add-on ........................................ 10.20 NA NA 3.82 4.90 1.37 NA NA 15.39 16.47 ZZZ 64902 ......... ............ A Nerve graft add-on ........................................ 11.81 NA NA 4.25 5.53 1.55 NA NA 17.61 18.89 ZZZ 64905 ......... ............ A Nerve pedicle transfer ................................... 14.93 NA NA 6.84 8.08 2.00 NA NA 23.77 25.01 090 64907 ......... ............ A Nerve pedicle transfer ................................... 19.85 NA NA 6.41 10.99 3.16 NA NA 29.42 34.00 090 64999 ......... ............ C Nervous system surgery ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49171 

65091 ......... ............ A Revise eye ..................................................... 7.08 NA NA 6.91 7.99 0.32 NA NA 14.31 15.39 090 65093 ......... ............ A Revise eye with implant ................................ 6.86 NA NA 7.00 8.28 0.34 NA NA 14.20 15.48 090 65101 ......... ............ A Removal of eye ............................................. 8.02 NA NA 8.15 9.18 0.35 NA NA 16.52 17.55 090 65103 ......... ............ A Remove eye/insert implant ............................ 8.56 NA NA 8.37 9.39 0.37 NA NA 17.30 18.32 090 65105 ......... ............ A Remove eye/attach implant ........................... 9.61 NA NA 9.06 10.11 0.42 NA NA 19.09 20.14 090 65110 ......... ............ A Removal of eye ............................................. 15.31 NA NA 11.58 13.15 0.81 NA NA 27.70 29.27 090 65112 ......... ............ A Remove eye/revise socket ............................ 18.05 NA NA 13.05 15.36 1.30 NA NA 32.40 34.71 090 65114 ......... ............ A Remove eye/revise socket ............................ 19.19 NA NA 13.69 15.68 1.02 NA NA 33.90 35.89 090 65125 ......... ............ A Revise ocular implant .................................... 3.12 6.82 8.31 3.18 3.50 0.19 10.13 11.62 6.49 6.81 090 65130 ......... ............ A Insert ocular implant ...................................... 8.14 NA NA 7.92 8.85 0.35 NA NA 16.41 17.34 090 65135 ......... ............ A Insert ocular implant ...................................... 8.32 NA NA 7.97 8.98 0.36 NA NA 16.65 17.66 090 65140 ......... ............ A Attach ocular implant ..................................... 9.14 NA NA 8.59 9.55 0.40 NA NA 18.13 19.09 090 65150 ......... ............ A Revise ocular implant .................................... 6.25 NA NA 6.47 7.60 0.31 NA NA 13.03 14.16 090 65155 ......... ............ A Reinsert ocular implant ................................. 9.78 NA NA 8.85 10.07 0.50 NA NA 19.13 20.35 090 65175 ......... ............ A Removal of ocular implant ............................ 7.15 NA NA 7.27 8.18 0.31 NA NA 14.73 15.64 090 65205 ......... ............ A Remove foreign body from eye ..................... 0.71 0.59 0.63 0.33 0.30 0.03 1.33 1.37 1.07 1.04 000 65210 ......... ............ A Remove foreign body from eye ..................... 0.84 0.74 0.79 0.41 0.39 0.04 1.62 1.67 1.29 1.27 000 65220 ......... ............ A Remove foreign body from eye ..................... 0.71 0.60 0.63 0.29 0.28 0.05 1.36 1.39 1.05 1.04 000 65222 ......... ............ A Remove foreign body from eye ..................... 0.93 0.81 0.87 0.43 0.39 0.04 1.78 1.84 1.40 1.36 000 65235 ......... ............ A Remove foreign body from eye ..................... 8.69 NA NA 6.99 6.80 0.37 NA NA 16.05 15.86 090 65260 ......... ............ A Remove foreign body from eye ..................... 12.19 NA NA 9.03 9.50 0.57 NA NA 21.79 22.26 090 65265 ......... ............ A Remove foreign body from eye ..................... 13.95 NA NA 9.90 10.44 0.62 NA NA 24.47 25.01 090 65270 ......... ............ A Repair of eye wound ..................................... 1.90 3.88 4.89 1.22 1.35 0.09 5.87 6.88 3.21 3.34 010 65272 ......... ............ A Repair of eye wound ..................................... 4.44 6.50 7.41 3.27 3.29 0.19 11.13 12.04 7.90 7.92 090 65273 ......... ............ A Repair of eye wound ..................................... 4.98 NA NA 3.43 3.54 0.22 NA NA 8.63 8.74 090 65275 ......... ............ A Repair of eye wound ..................................... 6.08 6.43 6.34 3.99 3.95 0.26 12.77 12.68 10.33 10.29 090 65280 ......... ............ A Repair of eye wound ..................................... 8.78 NA NA 6.02 6.18 0.38 NA NA 15.18 15.34 090 65285 ......... ............ A Repair of eye wound ..................................... 14.32 NA NA 8.70 9.08 0.64 NA NA 23.66 24.04 090 65286 ......... ............ A Repair of eye wound ..................................... 6.38 8.96 10.60 4.53 4.60 0.27 15.61 17.25 11.18 11.25 090 65290 ......... ............ A Repair of eye socket wound ......................... 6.28 NA NA 4.55 4.69 0.31 NA NA 11.14 11.28 090 65400 ......... ............ A Removal of eye lesion ................................... 7.18 7.66 8.16 6.03 6.10 0.30 15.14 15.64 13.51 13.58 090 65410 ......... ............ A Biopsy of cornea ........................................... 1.47 1.72 2.01 0.90 0.95 0.07 3.26 3.55 2.44 2.49 000 65420 ......... ............ A Removal of eye lesion ................................... 4.16 7.03 8.40 4.07 4.35 0.21 11.40 12.77 8.44 8.72 090 65426 ......... ............ A Removal of eye lesion ................................... 5.85 8.41 9.73 4.71 4.87 0.25 14.51 15.83 10.81 10.97 090 65430 ......... ............ A Corneal smear ............................................... 1.47 1.13 1.25 0.90 0.96 0.07 2.67 2.79 2.44 2.50 000 65435 ......... ............ A Curette/treat cornea ...................................... 0.92 0.89 0.97 0.67 0.70 0.04 1.85 1.93 1.63 1.66 000 65436 ......... ............ A Curette/treat cornea ...................................... 4.68 3.88 4.04 3.55 3.64 0.21 8.77 8.93 8.44 8.53 090 65450 ......... ............ A Treatment of corneal lesion .......................... 3.27 3.76 3.99 3.68 3.88 0.16 7.19 7.42 7.11 7.31 090 65600 ......... ............ A Revision of cornea ........................................ 4.02 4.58 4.90 3.51 3.39 0.17 8.77 9.09 7.70 7.58 090 65710 ......... ............ A Corneal transplant ......................................... 13.97 NA NA 10.49 11.02 0.61 NA NA 25.07 25.60 090 65730 ......... ............ A Corneal transplant ......................................... 15.87 NA NA 11.29 11.84 0.70 NA NA 27.86 28.41 090 65750 ......... ............ A Corneal transplant ......................................... 16.48 NA NA 11.00 11.73 0.74 NA NA 28.22 28.95 090 65755 ......... ............ A Corneal transplant ......................................... 16.37 NA NA 10.97 11.66 0.73 NA NA 28.07 28.76 090 65770 ......... ............ A Revise cornea with implant ........................... 19.28 NA NA 12.09 12.92 0.87 NA NA 32.24 33.07 090 65772 ......... ............ A Correction of astigmatism ............................. 4.91 4.99 5.40 4.04 4.11 0.21 10.11 10.52 9.16 9.23 090 65775 ......... ............ A Correction of astigmatism ............................. 6.66 NA NA 5.46 5.83 0.28 NA NA 12.40 12.77 090 65780 ......... ............ A Ocular reconst, transplant ............................. 10.23 NA NA 9.18 10.01 0.44 NA NA 19.85 20.68 090 65781 ......... ............ A Ocular reconst, transplant ............................. 17.64 NA NA 11.94 13.24 0.44 NA NA 30.02 31.32 090 65782 ......... ............ A Ocular reconst, transplant ............................. 14.98 NA NA 10.53 11.63 0.44 NA NA 25.95 27.05 090 65800 ......... ............ A Drainage of eye ............................................. 1.91 1.45 1.71 1.07 1.15 0.09 3.45 3.71 3.07 3.15 000 65805 ......... ............ A Drainage of eye ............................................. 1.91 1.76 2.07 1.07 1.16 0.09 3.76 4.07 3.07 3.16 000 65810 ......... ............ A Drainage of eye ............................................. 5.61 NA NA 4.82 4.73 0.24 NA NA 10.67 10.58 090 65815 ......... ............ A Drainage of eye ............................................. 5.79 8.14 9.54 4.72 4.79 0.25 14.18 15.58 10.76 10.83 090 65820 ......... ............ A Relieve inner eye pressure ........................... 8.62 NA NA 7.88 8.76 0.40 NA NA 16.90 17.78 090 65850 ......... ............ A Incision of eye ............................................... 11.14 NA NA 7.56 8.22 0.52 NA NA 19.22 19.88 090 65855 ......... ............ A Laser surgery of eye ..................................... 3.84 3.59 4.13 2.71 3.00 0.19 7.62 8.16 6.74 7.03 010 65860 ......... ............ A Incise inner eye adhesions ........................... 3.54 3.37 3.87 2.16 2.42 0.18 7.09 7.59 5.88 6.14 090 65865 ......... ............ A Incise inner eye adhesions ........................... 5.59 NA NA 4.84 5.43 0.28 NA NA 10.71 11.30 090 65870 ......... ............ A Incise inner eye adhesions ........................... 7.14 NA NA 5.88 6.28 0.31 NA NA 13.33 13.73 090 65875 ......... ............ A Incise inner eye adhesions ........................... 7.53 NA NA 6.33 6.68 0.32 NA NA 14.18 14.53 090 65880 ......... ............ A Incise inner eye adhesions ........................... 8.08 NA NA 6.54 6.91 0.35 NA NA 14.97 15.34 090 65900 ......... ............ A Remove eye lesion ........................................ 12.16 NA NA 9.15 9.98 0.54 NA NA 21.85 22.68 090 65920 ......... ............ A Remove implant of eye ................................. 9.64 NA NA 7.72 8.06 0.41 NA NA 17.77 18.11 090 65930 ......... ............ A Remove blood clot from eye ......................... 8.18 NA NA 5.98 6.62 0.37 NA NA 14.53 15.17 090 66020 ......... ............ A Injection treatment of eye .............................. 1.59 2.49 2.96 1.31 1.41 0.08 4.16 4.63 2.98 3.08 010 66030 ......... ............ A Injection treatment of eye .............................. 1.25 2.36 2.81 1.18 1.26 0.06 3.67 4.12 2.49 2.57 010 

mstockstill on PROD1PC63 with PROPOSAL_2

49172 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

66130 ......... ............ A Remove eye lesion ........................................ 7.68 7.75 9.15 5.04 5.47 0.38 15.81 17.21 13.10 13.53 090 66150 ......... ............ A Glaucoma surgery ......................................... 10.04 NA NA 9.04 9.31 0.46 NA NA 19.54 19.81 090 66155 ......... ............ A Glaucoma surgery ......................................... 10.03 NA NA 9.02 9.27 0.41 NA NA 19.46 19.71 090 66160 ......... ............ A Glaucoma surgery ......................................... 11.90 NA NA 9.78 10.09 0.50 NA NA 22.18 22.49 090 66165 ......... ............ A Glaucoma surgery ......................................... 9.75 NA NA 8.97 9.17 0.40 NA NA 19.12 19.32 090 66170 ......... ............ A Glaucoma surgery ......................................... 14.39 NA NA 11.90 12.14 0.60 NA NA 26.89 27.13 090 66172 ......... ............ A Incision of eye ............................................... 18.02 NA NA 15.09 15.17 0.74 NA NA 33.85 33.93 090 66180 ......... ............ A Implant eye shunt .......................................... 15.91 NA NA 10.05 10.58 0.71 NA NA 26.67 27.20 090 66185 ......... ............ A Revise eye shunt ........................................... 9.26 NA NA 7.28 7.36 0.40 NA NA 16.94 17.01 090 66220 ......... ............ A Repair eye lesion .......................................... 8.89 NA NA 7.21 7.13 0.40 NA NA 16.50 16.42 090 66225 ......... ............ A Repair/graft eye lesion .................................. 12.28 NA NA 8.41 8.65 0.55 NA NA 21.24 21.48 090 66250 ......... ............ A Follow-up surgery of eye ............................... 6.85 9.51 11.15 5.42 5.47 0.30 16.66 18.30 12.57 12.62 090 66500 ......... ............ A Incision of iris ................................................ 3.70 NA NA 4.07 4.50 0.18 NA NA 7.95 8.38 090 66505 ......... ............ A Incision of iris ................................................ 4.07 NA NA 4.43 4.85 0.20 NA NA 8.70 9.12 090 66600 ......... ............ A Remove iris and lesion .................................. 9.80 NA NA 8.55 8.30 0.43 NA NA 18.78 18.53 090 66605 ......... ............ A Removal of iris .............................................. 13.90 NA NA 9.43 9.87 0.77 NA NA 24.10 24.54 090 66625 ......... ............ A Removal of iris .............................................. 5.12 NA NA 4.34 4.63 0.26 NA NA 9.72 10.01 090 66630 ......... ............ A Removal of iris .............................................. 7.03 NA NA 5.52 5.66 0.31 NA NA 12.86 13.00 090 66635 ......... ............ A Removal of iris .............................................. 7.12 NA NA 5.55 5.69 0.31 NA NA 12.98 13.12 090 66680 ......... ............ A Repair iris & ciliary body ............................... 6.18 NA NA 5.23 5.26 0.27 NA NA 11.68 11.71 090 66682 ......... ............ A Repair iris & ciliary body ............................... 7.08 NA NA 6.92 6.69 0.31 NA NA 14.31 14.08 090 66700 ......... ............ A Destruction, ciliary body ................................ 5.02 4.96 5.17 3.73 3.88 0.24 10.22 10.43 8.99 9.14 090 66710 ......... ............ A Ciliary transsleral therapy .............................. 5.02 4.73 5.06 3.71 3.81 0.23 9.98 10.31 8.96 9.06 090 66711 ......... ............ A Ciliary endoscopic ablation ........................... 7.60 NA NA 6.49 6.48 0.30 NA NA 14.39 14.38 090 66720 ......... ............ A Destruction, ciliary body ................................ 4.77 5.47 5.71 4.40 4.64 0.26 10.50 10.74 9.43 9.67 090 66740 ......... ............ A Destruction, ciliary body ................................ 5.02 4.68 4.99 3.73 3.91 0.23 9.93 10.24 8.98 9.16 090 66761 ......... ............ A Revision of iris ............................................... 4.81 5.17 5.49 4.32 4.31 0.20 10.18 10.50 9.33 9.32 090 66762 ......... ............ A Revision of iris ............................................... 5.20 5.26 5.55 4.20 4.27 0.23 10.69 10.98 9.63 9.70 090 66770 ......... ............ A Removal of inner eye lesion ......................... 5.92 5.71 5.99 4.74 4.79 0.26 11.89 12.17 10.92 10.97 090 66820 ......... ............ A Incision, secondary cataract .......................... 3.88 NA NA 4.76 5.55 0.19 NA NA 8.83 9.62 09066821 ......... ............ A After cataract laser surgery ........................... 3.28 3.93 4.05 3.51 3.59 0.11 7.32 7.44 6.90 6.98 090 66825 ......... ............ A Reposition intraocular lens ............................ 8.72 NA NA 8.01 8.80 0.40 NA NA 17.13 17.92 090 66830 ......... ............ A Removal of lens lesion .................................. 9.19 NA NA 6.57 6.86 0.36 NA NA 16.12 16.41 090 66840 ......... ............ A Removal of lens material .............................. 8.90 NA NA 6.51 6.77 0.39 NA NA 15.80 16.06 090 66850 ......... ............ A Removal of lens material .............................. 10.23 NA NA 7.31 7.56 0.45 NA NA 17.99 18.24 090 66852 ......... ............ A Removal of lens material .............................. 11.09 NA NA 7.65 7.99 0.49 NA NA 19.23 19.57 090 66920 ......... ............ A Extraction of lens ........................................... 9.85 NA NA 6.87 7.19 0.44 NA NA 17.16 17.48 090 66930 ......... ............ A Extraction of lens ........................................... 11.29 NA NA 7.73 8.04 0.49 NA NA 19.51 19.82 090 66940 ......... ............ A Extraction of lens ........................................... 10.05 NA NA 7.25 7.51 0.43 NA NA 17.73 17.99 090 66982 ......... ............ A Cataract surgery, complex ............................ 14.73 NA NA 9.28 9.72 0.63 NA NA 24.64 25.08 090 66983 ......... ............ A Cataract surg w/iol, 1 stage .......................... 10.11 NA NA 6.30 6.16 0.14 NA NA 16.55 16.41 090 66984 ......... ............ A Cataract surg w/iol, 1 stage .......................... 10.28 NA NA 6.62 7.22 0.39 NA NA 17.29 17.89 090 66985 ......... ............ A Insert lens prosthesis .................................... 9.63 NA NA 7.33 7.42 0.36 NA NA 17.32 17.41 090 66986 ......... ............ A Exchange lens prosthesis ............................. 12.26 NA NA 8.38 8.97 0.60 NA NA 21.24 21.83 090 66990 ......... ............ A Ophthalmic endoscope add-on ..................... 1.51 NA NA 0.57 0.66 0.07 NA NA 2.15 2.24 ZZZ 66999 ......... ............ C Eye surgery procedure .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67005 ......... ............ A Partial removal of eye fluid ........................... 5.69 NA NA 4.72 4.83 0.28 NA NA 10.69 10.80 090 67010 ......... ............ A Partial removal of eye fluid ........................... 6.86 NA NA 5.16 5.35 0.34 NA NA 12.36 12.55 090 67015 ......... ............ A Release of eye fluid ...................................... 6.91 NA NA 5.88 6.31 0.34 NA NA 13.13 13.56 090 67025 ......... ............ A Replace eye fluid ........................................... 7.83 8.11 8.94 6.11 6.19 0.34 16.28 17.11 14.28 14.36 090 67027 ......... ............ A Implant eye drug system ............................... 11.33 NA NA 7.61 7.90 0.54 NA NA 19.48 19.77 090 67028 ......... ............ A Injection eye drug .......................................... 2.52 2.23 2.58 1.30 1.42 0.12 4.87 5.22 3.94 4.06 000 67030 ......... ............ A Incise inner eye strands ................................ 5.83 NA NA 5.77 5.83 0.24 NA NA 11.84 11.90 090 67031 ......... ............ A Laser surgery, eye strands ........................... 4.29 4.21 4.50 3.53 3.61 0.18 8.68 8.97 8.00 8.08 090 67036 ......... ............ A Removal of inner eye fluid ............................ 13.00 NA NA 8.35 8.93 0.58 NA NA 21.93 22.51 090 67038 ......... ............ A Strip retinal membrane .................................. 23.15 NA NA 13.97 15.11 1.04 NA NA 38.16 39.30 090 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49173 

67039 ......... ............ A Laser treatment of retina ............................... 16.25 NA NA 11.08 11.91 0.71 NA NA 28.04 28.87 090 67040 ......... ............ A Laser treatment of retina ............................... 19.08 NA NA 12.45 13.37 0.85 NA NA 32.38 33.30 090 67101 ......... ............ A Repair detached retina .................................. 8.52 8.75 9.03 6.38 6.49 0.37 17.64 17.92 15.27 15.38 090 67105 ......... ............ A Repair detached retina .................................. 8.28 7.65 7.97 5.99 6.11 0.37 16.30 16.62 14.64 14.75 090 67107 ......... ............ A Repair detached retina .................................. 16.26 NA NA 10.74 11.16 0.73 NA NA 27.73 28.15 090 67108 ......... ............ A Repair detached retina .................................. 22.39 NA NA 13.45 14.18 1.02 NA NA 36.86 37.59 090 67110 ......... ............ A Repair detached retina .................................. 9.93 9.22 9.98 7.20 7.34 0.44 19.59 20.35 17.57 17.71 090 67112 ......... ............ A Rerepair detached retina ............................... 18.33 NA NA 11.27 11.68 0.83 NA NA 30.43 30.84 090 67115 ......... ............ A Release encircling material ........................... 5.86 NA NA 5.07 5.08 0.25 NA NA 11.18 11.19 090 67120 ......... ............ A Remove eye implant material ....................... 6.85 7.57 8.33 5.45 5.51 0.29 14.71 15.47 12.59 12.65 090 67121 ......... ............ A Remove eye implant material ....................... 11.90 NA NA 8.25 8.46 0.53 NA NA 20.68 20.89 090 67141 ......... ............ A Treatment of retina ........................................ 5.94 5.59 5.79 4.81 4.85 0.26 11.79 11.99 11.01 11.05 090 67145 ......... ............ A Treatment of retina ........................................ 6.11 5.51 5.67 4.87 4.92 0.27 11.89 12.05 11.25 11.30 090 67208 ......... ............ A Treatment of retinal lesion ............................ 7.44 5.84 6.05 5.38 5.48 0.33 13.61 13.82 13.15 13.25 090 67210 ......... ............ A Treatment of retinal lesion ............................ 9.31 6.14 6.46 5.65 5.82 0.44 15.89 16.21 15.40 15.57 090 67218 ......... ............ A Treatment of retinal lesion ............................ 20.14 NA NA 11.08 11.88 0.92 NA NA 32.14 32.94 090 67220 ......... ............ A Treatment of choroid lesion .......................... 14.11 9.55 10.20 8.47 8.88 0.65 24.31 24.96 23.23 23.64 090 67221 ......... ............ R Ocular photodynamic ther ............................. 3.45 3.03 4.01 1.45 1.71 0.20 6.68 7.66 5.10 5.36 000 67225 ......... ............ A Eye photodynamic ther add-on ..................... 0.47 0.24 0.25 0.18 0.20 0.02 0.73 0.74 0.67 0.69 ZZZ 67227 ......... ............ A Treatment of retinal lesion ............................ 7.32 6.19 6.48 5.33 5.47 0.33 13.84 14.13 12.98 13.12 090 67228 ......... ............ A Treatment of retinal lesion ............................ 13.60 10.27 11.18 7.98 8.40 0.63 24.50 25.41 22.21 22.63 090 67250 ......... ............ A Reinforce eye wall ......................................... 9.40 NA NA 7.90 8.85 0.47 NA NA 17.77 18.72 090 67255 ......... ............ A Reinforce/graft eye wall ................................. 9.89 NA NA 8.71 9.60 0.44 NA NA 19.04 19.93 090 67299 ......... ............ C Eye surgery procedure .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67311 ......... ............ A Revise eye muscle ........................................ 7.52 NA NA 5.68 5.94 0.37 NA NA 13.57 13.83 090 67312 ......... ............ A Revise two eye muscles ............................... 9.41 NA NA 6.42 6.67 0.43 NA NA 16.26 16.51 090 67314 ......... ............ A Revise eye muscle ........................................ 8.51 NA NA 6.37 6.51 0.39 NA NA 15.27 15.41 090 67316 ......... ............ A Revise two eye muscles ............................... 10.65 NA NA 7.18 7.42 0.49 NA NA 18.32 18.56 090 67318 ......... ............ A Revise eye muscle(s) .................................... 8.84 NA NA 6.76 6.89 0.41 NA NA 16.01 16.14 090 67320 ......... ............ A Revise eye muscle(s) add-on ....................... 4.32 NA NA 1.62 1.87 0.22 NA NA 6.16 6.41 ZZZ 67331 ......... ............ A Eye surgery follow-up add-on ....................... 4.05 NA NA 1.51 1.75 0.21 NA NA 5.77 6.01 ZZZ 67332 ......... ............ A Rerevise eye muscles add-on ....................... 4.48 NA NA 1.68 1.94 0.23 NA NA 6.39 6.65 ZZZ 67334 ......... ............ A Revise eye muscle w/suture ......................... 3.97 NA NA 1.48 1.71 0.20 NA NA 5.65 5.88 ZZZ 67335 ......... ............ A Eye suture during surgery ............................. 2.49 NA NA 0.93 1.07 0.13 NA NA 3.55 3.69 ZZZ67340 ......... ............ A Revise eye muscle add-on ............................ 4.92 NA NA 1.84 2.11 0.25 NA NA 7.01 7.28 ZZZ 67343 ......... ............ A Release eye tissue ........................................ 8.22 NA NA 6.25 6.45 0.37 NA NA 14.84 15.04 090 67345 ......... ............ A Destroy nerve of eye muscle ........................ 2.96 2.27 2.50 1.77 1.95 0.17 5.40 5.63 4.90 5.08 010 67350 ......... ............ A Biopsy eye muscle ........................................ 2.87 NA NA 1.69 1.83 0.15 NA NA 4.71 4.85 000 67399 ......... ............ C Eye muscle surgery procedure ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67400 ......... ............ A Explore/biopsy eye socket ............................ 10.88 NA NA 9.71 10.87 0.56 NA NA 21.15 22.31 090 67405 ......... ............ A Explore/drain eye socket ............................... 8.92 NA NA 8.48 9.45 0.44 NA NA 17.84 18.81 090 67412 ......... ............ A Explore/treat eye socket ................................ 10.12 NA NA 8.81 10.40 0.48 NA NA 19.41 21.00 090 67413 ......... ............ A Explore/treat eye socket ................................ 9.99 NA NA 8.94 10.31 0.50 NA NA 19.43 20.80 090 67414 ......... ............ A Explr/decompress eye socket ....................... 17.72 NA NA 11.99 12.03 0.65 NA NA 30.36 30.40 090 67415 ......... ............ A Aspiration, orbital contents ............................ 1.76 NA NA 0.63 0.73 0.09 NA NA 2.48 2.58 000 67420 ......... ............ A Explore/treat eye socket ................................ 21.52 NA NA 14.59 16.69 1.15 NA NA 37.26 39.36 090 67430 ......... ............ A Explore/treat eye socket ................................ 14.87 NA NA 12.66 14.33 0.86 NA NA 28.39 30.06 090 67440 ......... ............ A Explore/drain eye socket ............................... 14.45 NA NA 12.12 13.73 0.70 NA NA 27.27 28.88 090 67445 ......... ............ A Explr/decompress eye socket ....................... 18.90 NA NA 12.58 13.58 0.90 NA NA 32.38 33.38 090 67450 ......... ............ A Explore/biopsy eye socket ............................ 14.99 NA NA 12.63 14.18 0.68 NA NA 28.30 29.85 090 67500 ......... ............ A Inject/treat eye socket ................................... 1.44 0.61 0.66 0.48 0.34 0.05 2.10 2.15 1.97 1.83 000 67505 ......... ............ A Inject/treat eye socket ................................... 1.27 0.53 0.65 0.40 0.33 0.05 1.85 1.97 1.72 1.65 000 67515 ......... ............ A Inject/treat eye socket ................................... 1.40 0.81 0.65 0.64 0.45 0.03 2.24 2.08 2.07 1.88 000 67550 ......... ............ A Insert eye socket implant .............................. 11.42 NA NA 10.04 10.99 0.72 NA NA 22.18 23.13 090 67560 ......... ............ A Revise eye socket implant ............................ 11.83 NA NA 10.07 11.05 0.60 NA NA 22.50 23.48 090 67570 ......... ............ A Decompress optic nerve ............................... 14.13 NA NA 11.33 13.02 0.68 NA NA 26.14 27.83 090 67599 ......... ............ C Orbit surgery procedure ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 67700 ......... ............ A Drainage of eyelid abscess ........................... 1.35 4.42 5.62 1.21 1.26 0.07 5.84 7.04 2.63 2.68 010 67710 ......... ............ A Incision of eyelid ............................................ 1.02 3.79 4.98 1.10 1.18 0.05 4.86 6.05 2.17 2.25 010 67715 ......... ............ A Incision of eyelid fold ..................................... 1.22 3.91 5.01 1.18 1.26 0.06 5.19 6.29 2.46 2.54 010 67800 ......... ............ A Remove eyelid lesion .................................... 1.38 1.44 1.58 0.93 1.01 0.07 2.89 3.03 2.38 2.46 010 67801 ......... ............ A Remove eyelid lesions .................................. 1.88 1.73 1.90 1.12 1.23 0.09 3.70 3.87 3.09 3.20 010 67805 ......... ............ A Remove eyelid lesions .................................. 2.22 2.25 2.45 1.46 1.60 0.11 4.58 4.78 3.79 3.93 010 67808 ......... ............ A Remove eyelid lesion(s) ................................ 4.42 NA NA 3.70 3.75 0.19 NA NA 8.31 8.36 090 67810 ......... ............ A Biopsy of eyelid ............................................. 1.48 3.87 3.47 0.66 0.68 0.06 5.41 5.01 2.20 2.22 000 67820 ......... ............ A Revise eyelashes .......................................... 0.71 0.45 0.56 0.52 0.55 0.04 1.20 1.31 1.27 1.30 000 

mstockstill on PROD1PC63 with PROPOSAL_2

49174 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

67825 ......... ............ A Revise eyelashes .......................................... 1.38 1.44 1.66 1.30 1.38 0.07 2.89 3.11 2.75 2.83 010 67830 ......... ............ A Revise eyelashes .......................................... 1.70 4.10 5.17 1.36 1.47 0.08 5.88 6.95 3.14 3.25 010 67835 ......... ............ A Revise eyelashes .......................................... 5.55 NA NA 4.18 4.51 0.28 NA NA 10.01 10.34 090 67840 ......... ............ A Remove eyelid lesion .................................... 2.04 4.01 5.11 1.50 1.61 0.10 6.15 7.25 3.64 3.75 010 67850 ......... ............ A Treat eyelid lesion ......................................... 1.69 3.26 3.34 1.43 1.46 0.07 5.02 5.10 3.19 3.22 010 67875 ......... ............ A Closure of eyelid by suture ........................... 1.35 2.45 3.09 0.86 0.92 0.07 3.87 4.51 2.28 2.34 000 67880 ......... ............ A Revision of eyelid .......................................... 4.42 5.58 6.35 3.67 3.77 0.19 10.19 10.96 8.28 8.38 090 67882 ......... ............ A Revision of eyelid .......................................... 5.81 6.56 7.36 4.62 4.76 0.25 12.62 13.42 10.68 10.82 090 67900 ......... ............ A Repair brow defect ........................................ 6.63 7.52 8.68 4.72 5.12 0.38 14.53 15.69 11.73 12.13 090 67901 ......... ............ A Repair eyelid defect ...................................... 7.39 9.25 6.36 5.46 5.42 0.54 17.18 14.29 13.39 13.35 090 67902 ......... ............ A Repair eyelid defect ...................................... 9.60 NA NA 6.58 5.74 0.60 NA NA 16.78 15.94 090 67903 ......... ............ A Repair eyelid defect ...................................... 6.36 6.82 8.88 4.48 5.25 0.47 13.65 15.71 11.31 12.08 090 67904 ......... ............ A Repair eyelid defect ...................................... 7.75 8.47 9.34 5.54 5.31 0.41 16.63 17.50 13.70 13.47 090 67906 ......... ............ A Repair eyelid defect ...................................... 6.78 NA NA 4.63 4.93 0.46 NA NA 11.87 12.17 090 67908 ......... ............ A Repair eyelid defect ...................................... 5.12 5.71 6.40 4.25 5.07 0.28 11.11 11.80 9.65 10.47 090 67909 ......... ............ A Revise eyelid defect ...................................... 5.39 6.39 7.62 4.31 4.79 0.31 12.09 13.32 10.01 10.49 090 67911 ......... ............ A Revise eyelid defect ...................................... 7.30 NA NA 5.21 4.89 0.31 NA NA 12.82 12.50 090 67912 ......... ............ A Correction eyelid w/implant ........................... 6.17 13.18 17.49 4.74 5.33 0.28 19.63 23.94 11.19 11.78 090 67914 ......... ............ A Repair eyelid defect ...................................... 3.67 4.88 5.98 2.76 2.98 0.19 8.74 9.84 6.62 6.84 090 67915 ......... ............ A Repair eyelid defect ...................................... 3.18 4.54 5.62 2.57 2.74 0.16 7.88 8.96 5.91 6.08 090 67916 ......... ............ A Repair eyelid defect ...................................... 5.30 6.53 7.67 4.26 4.64 0.28 12.11 13.25 9.84 10.22 090 67917 ......... ............ A Repair eyelid defect ...................................... 6.01 6.91 8.07 4.54 4.94 0.36 13.28 14.44 10.91 11.31 090 67921 ......... ............ A Repair eyelid defect ...................................... 3.39 4.75 5.83 2.64 2.83 0.17 8.31 9.39 6.20 6.39 090 67922 ......... ............ A Repair eyelid defect ...................................... 3.06 4.44 5.54 2.51 2.69 0.15 7.65 8.75 5.72 5.90 090 67923 ......... ............ A Repair eyelid defect ...................................... 5.87 6.63 7.75 4.46 4.84 0.30 12.80 13.92 10.63 11.01 090 67924 ......... ............ A Repair eyelid defect ...................................... 5.78 7.11 8.47 4.19 4.56 0.30 13.19 14.55 10.27 10.64 090 67930 ......... ............ A Repair eyelid wound ...................................... 3.60 4.50 5.41 1.85 2.09 0.19 8.29 9.20 5.64 5.88 010 67935 ......... ............ A Repair eyelid wound ...................................... 6.21 6.95 8.13 3.70 4.23 0.39 13.55 14.73 10.30 10.83 090 67938 ......... ............ A Remove eyelid foreign body ......................... 1.33 3.95 5.02 1.27 1.26 0.06 5.34 6.41 2.66 2.65 010 67950 ......... ............ A Revision of eyelid .......................................... 5.81 6.80 8.17 4.47 5.03 0.36 12.97 14.34 10.64 11.20 090 67961 ......... ............ A Revision of eyelid .......................................... 5.68 7.00 8.26 4.43 4.88 0.33 13.01 14.27 10.44 10.89 090 67966 ......... ............ A Revision of eyelid .......................................... 8.75 8.29 8.92 5.93 5.65 0.37 17.41 18.04 15.05 14.77 090 67971 ......... ............ A Reconstruction of eyelid ................................ 9.78 NA NA 6.40 7.06 0.53 NA NA 16.71 17.37 090 67973 ......... ............ A Reconstruction of eyelid ................................ 12.85 NA NA 8.02 8.99 0.75 NA NA 21.62 22.59 090 67974 ......... ............ A Reconstruction of eyelid ................................ 12.82 NA NA 8.04 8.93 0.75 NA NA 21.61 22.50 090 67975 ......... ............ A Reconstruction of eyelid ................................ 9.12 NA NA 6.16 6.75 0.50 NA NA 15.78 16.37 090 67999 ......... ............ C Revision of eyelid .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 68020 ......... ............ A Incise/drain eyelid lining ................................ 1.37 1.28 1.38 1.09 1.18 0.06 2.71 2.81 2.52 2.61 010 68040 ......... ............ A Treatment of eyelid lesions ........................... 0.85 0.62 0.69 0.37 0.42 0.04 1.51 1.58 1.26 1.31 000 68100 ......... ............ A Biopsy of eyelid lining ................................... 1.35 2.41 3.04 0.88 0.93 0.07 3.83 4.46 2.30 2.35 000 68110 ......... ............ A Remove eyelid lining lesion .......................... 1.77 3.15 3.86 1.52 1.62 0.09 5.01 5.72 3.38 3.48 010 68115 ......... ............ A Remove eyelid lining lesion .......................... 2.36 4.44 5.58 1.74 1.87 0.12 6.92 8.06 4.22 4.35 010 68130 ......... ............ A Remove eyelid lining lesion .......................... 4.92 6.84 8.24 4.16 4.49 0.24 12.00 13.40 9.32 9.65 090 68135 ......... ............ A Remove eyelid lining lesion .......................... 1.84 1.63 1.77 1.51 1.62 0.09 3.56 3.70 3.44 3.55 010 68200 ......... ............ A Treat eyelid by injection ................................ 0.49 0.47 0.52 0.30 0.32 0.02 0.98 1.03 0.81 0.83 000 68320 ......... ............ A Revise/graft eyelid lining ............................... 6.36 9.42 10.82 5.47 5.51 0.27 16.05 17.45 12.10 12.14 090 68325 ......... ............ A Revise/graft eyelid lining ............................... 8.35 NA NA 6.16 6.45 0.44 NA NA 14.95 15.24 090 68326 ......... ............ A Revise/graft eyelid lining ............................... 8.14 NA NA 6.12 6.34 0.35 NA NA 14.61 14.83 090 68328 ......... ............ A Revise/graft eyelid lining ............................... 9.17 NA NA 6.66 7.13 0.54 NA NA 16.37 16.84 090 68330 ......... ............ A Revise eyelid lining ....................................... 5.57 7.64 8.97 4.59 4.69 0.24 13.45 14.78 10.40 10.50 090 68335 ......... ............ A Revise/graft eyelid lining ............................... 8.18 NA NA 6.13 6.32 0.36 NA NA 14.67 14.86 090 68340 ......... ............ A Separate eyelid adhesions ............................ 4.79 7.07 8.42 3.99 4.07 0.21 12.07 13.42 8.99 9.07 090 68360 ......... ............ A Revise eyelid lining ....................................... 4.99 6.60 7.68 4.07 4.15 0.22 11.81 12.89 9.28 9.36 090 68362 ......... ............ A Revise eyelid lining ....................................... 8.33 NA NA 6.18 6.35 0.36 NA NA 14.87 15.04 090 68371 ......... ............ A Harvest eye tissue, alograft .......................... 4.89 NA NA 4.18 4.59 0.44 NA NA 9.51 9.92 01068399 ......... ............ C Eyelid lining surgery ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49175 

68400 ......... ............ A Incise/drain tear gland ................................... 1.69 4.44 5.54 1.22 1.67 0.08 6.21 7.31 2.99 3.44 010 68420 ......... ............ A Incise/drain tear sac ...................................... 2.30 4.70 5.82 1.46 1.94 0.11 7.11 8.23 3.87 4.35 010 68440 ......... ............ A Incise tear duct opening ................................ 0.94 1.28 1.88 1.21 1.26 0.05 2.27 2.87 2.20 2.25 010 68500 ......... ............ A Removal of tear gland ................................... 12.38 NA NA 8.97 9.54 0.55 NA NA 21.90 22.47 090 68505 ......... ............ A Partial removal, tear gland ............................ 12.30 NA NA 9.11 10.27 0.55 NA NA 21.96 23.12 090 68510 ......... ............ A Biopsy of tear gland ...................................... 4.60 5.37 6.84 2.11 2.10 0.23 10.20 11.67 6.94 6.93 000 68520 ......... ............ A Removal of tear sac ...................................... 8.50 NA NA 6.68 7.24 0.37 NA NA 15.55 16.11 090 68525 ......... ............ A Biopsy of tear sac ......................................... 4.42 NA NA 1.64 1.93 0.22 NA NA 6.28 6.57 000 68530 ......... ............ A Clearance of tear duct ................................... 3.65 5.75 7.57 2.14 2.52 0.18 9.58 11.40 5.97 6.35 010 68540 ......... ............ A Remove tear gland lesion ............................. 11.83 NA NA 8.71 9.22 0.52 NA NA 21.06 21.57 090 68550 ......... ............ A Remove tear gland lesion ............................. 14.74 NA NA 10.52 11.14 0.80 NA NA 26.06 26.68 090 68700 ......... ............ A Repair tear ducts ........................................... 7.59 NA NA 5.74 5.92 0.32 NA NA 13.65 13.83 090 68705 ......... ............ A Revise tear duct opening .............................. 2.06 3.12 3.91 1.63 1.75 0.10 5.28 6.07 3.79 3.91 010 68720 ......... ............ A Create tear sac drain .................................... 9.70 NA NA 7.10 7.67 0.44 NA NA 17.24 17.81 090 68745 ......... ............ A Create tear duct drain ................................... 9.62 NA NA 7.45 7.76 0.52 NA NA 17.59 17.90 090 68750 ......... ............ A Create tear duct drain ................................... 9.78 NA NA 7.64 8.11 0.43 NA NA 17.85 18.32 090 68760 ......... ............ A Close tear duct opening ................................ 1.73 2.66 3.32 1.50 1.60 0.09 4.48 5.14 3.32 3.42 010 68761 ......... ............ A Close tear duct opening ................................ 1.36 1.88 2.17 1.28 1.31 0.06 3.30 3.59 2.70 2.73 010 68770 ......... ............ A Close tear system fistula ............................... 8.01 NA NA 5.88 3.86 0.35 NA NA 14.24 12.22 090 68801 ......... ............ A Dilate tear duct opening ................................ 0.94 1.82 1.91 1.45 1.47 0.05 2.81 2.90 2.44 2.46 010 68810 ......... ............ A Probe nasolacrimal duct ................................ 2.59 3.49 3.62 2.76 2.69 0.10 6.18 6.31 5.45 5.38 010 68811 ......... ............ A Probe nasolacrimal duct ................................ 2.35 NA NA 2.17 2.35 0.13 NA NA 4.65 4.83 010 68815 ......... ............ A Probe nasolacrimal duct ................................ 3.20 6.57 7.82 2.49 2.73 0.17 9.94 11.19 5.86 6.10 010 68840 ......... ............ A Explore/irrigate tear ducts ............................. 1.25 1.56 1.59 1.32 1.17 0.06 2.87 2.90 2.63 2.48 010 68850 ......... ............ A Injection for tear sac x-ray ............................ 0.80 0.72 0.84 0.60 0.66 0.04 1.56 1.68 1.44 1.50 000 68899 ......... ............ C Tear duct system surgery ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69000 ......... ............ A Drain external ear lesion ............................... 1.45 2.70 2.84 1.24 1.33 0.12 4.27 4.41 2.81 2.90 010 69005 ......... ............ A Drain external ear lesion ............................... 2.11 2.74 2.88 1.45 1.74 0.17 5.02 5.16 3.73 4.02 010 69020 ......... ............ A Drain outer ear canal lesion .......................... 1.48 3.84 3.95 1.76 1.99 0.12 5.44 5.55 3.36 3.59 010 69100 ......... ............ A Biopsy of external ear ................................... 0.81 1.80 1.73 0.38 0.39 0.03 2.64 2.57 1.22 1.23 000 69105 ......... ............ A Biopsy of external ear canal ......................... 0.85 2.47 2.37 0.65 0.74 0.07 3.39 3.29 1.57 1.66 000 69110 ......... ............ A Remove external ear, partial ......................... 3.43 7.50 6.93 4.23 4.41 0.30 11.23 10.66 7.96 8.14 090 69120 ......... ............ A Removal of external ear ................................ 4.04 NA NA 5.09 5.91 0.38 NA NA 9.51 10.33 090 69140 ......... ............ A Remove ear canal lesion(s) .......................... 7.96 NA NA 12.30 13.04 0.65 NA NA 20.91 21.65 090 69145 ......... ............ A Remove ear canal lesion(s) .......................... 2.62 6.53 5.97 3.10 3.25 0.21 9.36 8.80 5.93 6.08 090 69150 ......... ............ A Extensive ear canal surgery .......................... 13.41 NA NA 10.55 12.69 1.22 NA NA 25.18 27.32 090 69155 ......... ............ A Extensive ear/neck surgery ........................... 22.96 NA NA 15.01 18.41 1.92 NA NA 39.89 43.29 090 69200 ......... ............ A Clear outer ear canal .................................... 0.77 2.03 2.29 0.57 0.56 0.06 2.86 3.12 1.40 1.39 000 69205 ......... ............ A Clear outer ear canal .................................... 1.20 NA NA 1.14 1.31 0.10 NA NA 2.44 2.61 010 69210 ......... ............ A Remove impacted ear wax ........................... 0.61 0.55 0.61 0.16 0.21 0.05 1.21 1.27 0.82 0.87 000 69220 ......... ............ A Clean out mastoid cavity ............................... 0.83 2.37 2.36 0.61 0.70 0.07 3.27 3.26 1.51 1.60 000 69222 ......... ............ A Clean out mastoid cavity ............................... 1.40 3.66 3.80 1.73 1.98 0.12 5.18 5.32 3.25 3.50 010 69300 ......... ............ R Revise external ear ....................................... 6.35 9.61 5.57 4.51 4.29 0.72 16.68 12.64 11.58 11.36 YYY 69310 ......... ............ A Rebuild outer ear canal ................................. 10.77 NA NA 14.19 15.76 0.85 NA NA 25.81 27.38 090 69320 ......... ............ A Rebuild outer ear canal ................................. 16.93 NA NA 18.16 20.92 1.37 NA NA 36.46 39.22 090 69399 ......... ............ C Outer ear surgery procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69400 ......... ............ A Inflate middle ear canal ................................. 0.83 2.60 2.27 0.61 0.66 0.07 3.50 3.17 1.51 1.56 000 69401 ......... ............ A Inflate middle ear canal ................................. 0.63 1.46 1.30 0.56 0.63 0.05 2.14 1.98 1.24 1.31 000 69405 ......... ............ A Catheterize middle ear canal ........................ 2.63 3.38 3.47 1.78 2.18 0.21 6.22 6.31 4.62 5.02 010 69420 ......... ............ A Incision of eardrum ........................................ 1.33 3.05 3.13 1.41 1.55 0.11 4.49 4.57 2.85 2.99 010 69421 ......... ............ A Incision of eardrum ........................................ 1.73 NA NA 1.68 2.04 0.15 NA NA 3.56 3.92 010 69424 ......... ............ A Remove ventilating tube ................................ 0.85 2.18 2.18 0.62 0.67 0.07 3.10 3.10 1.54 1.59 000 69433 ......... ............ A Create eardrum opening ............................... 1.52 3.06 3.08 1.44 1.59 0.13 4.71 4.73 3.09 3.24 010 69436 ......... ............ A Create eardrum opening ............................... 1.96 NA NA 1.72 2.15 0.19 NA NA 3.87 4.30 010 69440 ......... ............ A Exploration of middle ear .............................. 7.56 NA NA 8.31 8.66 0.61 NA NA 16.48 16.83 090 69450 ......... ............ A Eardrum revision ........................................... 5.56 NA NA 6.96 7.01 0.45 NA NA 12.97 13.02 090 69501 ......... ............ A Mastoidectomy .............................................. 9.06 NA NA 7.80 8.70 0.73 NA NA 17.59 18.49 090 69502 ......... ............ A Mastoidectomy .............................................. 12.36 NA NA 10.02 11.20 1.00 NA NA 23.38 24.56 090 69505 ......... ............ A Remove mastoid structures .......................... 12.97 NA NA 14.81 16.60 1.05 NA NA 28.83 30.62 090 69511 ......... ............ A Extensive mastoid surgery ............................ 13.50 NA NA 14.89 16.83 1.09 NA NA 29.48 31.42 090 69530 ......... ............ A Extensive mastoid surgery ............................ 20.15 NA NA 17.97 20.72 1.54 NA NA 39.66 42.41 090 69535 ......... ............ A Remove part of temporal bone ..................... 37.17 NA NA 24.19 30.02 2.92 NA NA 64.28 70.11 09069540 ......... ............ A Remove ear lesion ........................................ 1.20 3.62 3.71 1.70 1.90 0.10 4.92 5.01 3.00 3.20 010 69550 ......... ............ A Remove ear lesion ........................................ 10.97 NA NA 13.06 14.41 0.89 NA NA 24.92 26.27 090 69552 ......... ............ A Remove ear lesion ........................................ 19.61 NA NA 16.55 19.64 1.59 NA NA 37.75 40.84 090 69554 ......... ............ A Remove ear lesion ........................................ 35.63 NA NA 22.41 28.35 2.91 NA NA 60.95 66.89 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49176 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

69601 ......... ............ A Mastoid surgery revision ............................... 13.22 NA NA 10.84 12.21 1.07 NA NA 25.13 26.50 090 69602 ......... ............ A Mastoid surgery revision ............................... 13.56 NA NA 11.56 12.81 1.10 NA NA 26.22 27.47 090 69603 ......... ............ A Mastoid surgery revision ............................... 14.00 NA NA 15.03 17.53 1.14 NA NA 30.17 32.67 090 69604 ......... ............ A Mastoid surgery revision ............................... 14.00 NA NA 11.67 13.19 1.14 NA NA 26.81 28.33 090 69605 ......... ............ A Mastoid surgery revision ............................... 18.46 NA NA 17.50 20.09 1.50 NA NA 37.46 40.05 090 69610 ......... ............ A Repair of eardrum ......................................... 4.42 4.47 5.28 2.30 3.03 0.36 9.25 10.06 7.08 7.81 010 69620 ......... ............ A Repair of eardrum ......................................... 5.88 10.04 10.85 5.29 6.04 0.48 16.40 17.21 11.65 12.40 090 69631 ......... ............ A Repair eardrum structures ............................ 9.85 NA NA 10.50 11.03 0.80 NA NA 21.15 21.68 090 69632 ......... ............ A Rebuild eardrum structures ........................... 12.73 NA NA 12.08 13.12 1.03 NA NA 25.84 26.88 090 69633 ......... ............ A Rebuild eardrum structures ........................... 12.08 NA NA 11.91 12.77 0.98 NA NA 24.97 25.83 090 69635 ......... ............ A Repair eardrum structures ............................ 13.31 NA NA 14.83 16.26 1.08 NA NA 29.22 30.65 090 69636 ......... ............ A Rebuild eardrum structures ........................... 15.20 NA NA 16.60 18.63 1.23 NA NA 33.03 35.06 090 69637 ......... ............ A Rebuild eardrum structures ........................... 15.09 NA NA 16.58 18.56 1.22 NA NA 32.89 34.87 090 69641 ......... ............ A Revise middle ear & mastoid ........................ 12.69 NA NA 11.31 12.41 1.03 NA NA 25.03 26.13 090 69642 ......... ............ A Revise middle ear & mastoid ........................ 16.81 NA NA 14.05 15.72 1.36 NA NA 32.22 33.89 090 69643 ......... ............ A Revise middle ear & mastoid ........................ 15.36 NA NA 12.81 14.32 1.24 NA NA 29.41 30.92 090 69644 ......... ............ A Revise middle ear & mastoid ........................ 17.00 NA NA 17.09 19.57 1.37 NA NA 35.46 37.94 090 69645 ......... ............ A Revise middle ear & mastoid ........................ 16.48 NA NA 17.01 19.27 1.33 NA NA 34.82 37.08 090 69646 ......... ............ A Revise middle ear & mastoid ........................ 18.14 NA NA 17.42 19.93 1.46 NA NA 37.02 39.53 090 69650 ......... ............ A Release middle ear bone .............................. 9.65 NA NA 8.64 9.59 0.78 NA NA 19.07 20.02 090 69660 ......... ............ A Revise middle ear bone ................................ 11.88 NA NA 9.52 10.77 0.96 NA NA 22.36 23.61 090 69661 ......... ............ A Revise middle ear bone ................................ 15.72 NA NA 12.17 14.07 1.27 NA NA 29.16 31.06 090 69662 ......... ............ A Revise middle ear bone ................................ 15.42 NA NA 11.29 13.14 1.25 NA NA 27.96 29.81 090 69666 ......... ............ A Repair middle ear structures ......................... 9.74 NA NA 8.92 9.71 0.79 NA NA 19.45 20.24 090 69667 ......... ............ A Repair middle ear structures ......................... 9.75 NA NA 8.83 9.69 0.79 NA NA 19.37 20.23 090 69670 ......... ............ A Remove mastoid air cells .............................. 11.55 NA NA 10.15 11.32 0.93 NA NA 22.63 23.80 090 69676 ......... ............ A Remove middle ear nerve ............................. 9.51 NA NA 9.63 10.47 0.81 NA NA 19.95 20.79 090 69700 ......... ............ A Close mastoid fistula ..................................... 8.22 NA NA 7.65 8.84 0.67 NA NA 16.54 17.73 090 69711 ......... ............ A Remove/repair hearing aid ............................ 10.42 NA NA 9.42 10.45 0.83 NA NA 20.67 21.70 090 69714 ......... ............ A Implant temple bone w/stimul ....................... 14.23 NA NA 10.56 12.14 1.13 NA NA 25.92 27.50 090 69715 ......... ............ A Temple bne implnt w/stimulat ....................... 18.72 NA NA 11.94 14.26 1.48 NA NA 32.14 34.46 090 69717 ......... ............ A Temple bone implant revision ....................... 15.21 NA NA 11.31 13.68 0.90 NA NA 27.42 29.79 090 69718 ......... ............ A Revise temple bone implant .......................... 18.97 NA NA 20.26 16.54 3.21 NA NA 42.44 38.72 090 69720 ......... ............ A Release facial nerve ...................................... 14.48 NA NA 12.75 14.08 1.16 NA NA 28.39 29.72 090 69725 ......... ............ A Release facial nerve ...................................... 27.36 NA NA 16.30 19.17 2.44 NA NA 46.10 48.97 090 69740 ......... ............ A Repair facial nerve ........................................ 16.12 NA NA 11.17 12.85 1.27 NA NA 28.56 30.24 090 69745 ......... ............ A Repair facial nerve ........................................ 16.84 NA NA 11.87 14.20 1.14 NA NA 29.85 32.18 090 69799 ......... ............ C Middle ear surgery procedure ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69801 ......... ............ A Incise inner ear .............................................. 8.55 NA NA 8.75 9.28 0.69 NA NA 17.99 18.52 090 69802 ......... ............ A Incise inner ear .............................................. 13.32 NA NA 10.54 11.88 1.06 NA NA 24.92 26.26 090 69805 ......... ............ A Explore inner ear ........................................... 14.49 NA NA 9.80 11.36 1.12 NA NA 25.41 26.97 090 69806 ......... ............ A Explore inner ear ........................................... 12.45 NA NA 9.37 10.62 1.00 NA NA 22.82 24.07 090 69820 ......... ............ A Establish inner ear window ........................... 10.32 NA NA 9.83 10.87 0.90 NA NA 21.05 22.09 090 69840 ......... ............ A Revise inner ear window ............................... 10.24 NA NA 11.67 12.80 0.79 NA NA 22.70 23.83 090 69905 ......... ............ A Remove inner ear .......................................... 11.08 NA NA 10.08 11.03 0.90 NA NA 22.06 23.01 090 69910 ......... ............ A Remove inner ear & mastoid ........................ 13.73 NA NA 9.79 11.39 1.07 NA NA 24.59 26.19 09069915 ......... ............ A Incise inner ear nerve ................................... 22.57 NA NA 13.38 15.69 1.69 NA NA 37.64 39.95 090 69930 ......... ............ A Implant cochlear device ................................ 17.54 NA NA 11.81 14.02 1.36 NA NA 30.71 32.92 090 69949 ......... ............ C Inner ear surgery procedure ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69950 ......... ............ A Incise inner ear nerve ................................... 27.38 NA NA 15.12 17.96 2.28 NA NA 44.78 47.62 090 69955 ......... ............ A Release facial nerve ...................................... 29.14 NA NA 17.30 20.36 2.48 NA NA 48.92 51.98 090 69960 ......... ............ A Release inner ear canal ................................ 29.14 NA NA 15.41 18.89 2.17 NA NA 46.72 50.20 090 69970 ......... ............ A Remove inner ear lesion ............................... 32.13 NA NA 17.78 21.90 2.41 NA NA 52.32 56.44 090 69979 ......... ............ C Temporal bone surgery ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY 69990 ......... ............ R Microsurgery add-on ..................................... 3.46 NA NA 1.29 1.67 0.89 NA NA 5.64 6.02 ZZZ 70010 ......... ............ A Contrast x-ray of brain .................................. 1.19 2.77 4.23 NA NA 0.27 4.23 5.69 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49177 

70010 ......... 26 ....... A Contrast x-ray of brain .................................. 1.19 0.37 0.39 0.37 0.39 0.05 1.61 1.63 1.61 1.63 XXX 70010 ......... TC ...... A Contrast x-ray of brain .................................. 0.00 2.40 3.85 NA NA 0.22 2.62 4.07 NA NA XXX 70015 ......... ............ A Contrast x-ray of brain .................................. 1.19 2.85 2.01 NA NA 0.16 4.20 3.36 NA NA XXX 70015 ......... 26 ....... A Contrast x-ray of brain .................................. 1.19 0.38 0.39 0.38 0.39 0.08 1.65 1.66 1.65 1.66 XXX 70015 ......... TC ...... A Contrast x-ray of brain .................................. 0.00 2.47 1.63 NA NA 0.08 2.55 1.71 NA NA XXX 70030 ......... ............ A X-ray eye for foreign body ............................ 0.17 0.60 0.51 NA NA 0.03 0.80 0.71 NA NA XXX70030 ......... 26 ....... A X-ray eye for foreign body ............................ 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 70030 ......... TC ...... A X-ray eye for foreign body ............................ 0.00 0.55 0.45 NA NA 0.02 0.57 0.47 NA NA XXX 70100 ......... ............ A X-ray exam of jaw ......................................... 0.18 0.63 0.59 NA NA 0.03 0.84 0.80 NA NA XXX 70100 ......... 26 ....... A X-ray exam of jaw ......................................... 0.18 0.05 0.06 0.05 0.06 0.01 0.24 0.25 0.24 0.25 XXX 70100 ......... TC ...... A X-ray exam of jaw ......................................... 0.00 0.58 0.54 NA NA 0.02 0.60 0.56 NA NA XXX70110 ......... ............ A X-ray exam of jaw ......................................... 0.25 0.80 0.73 NA NA 0.05 1.10 1.03 NA NA XXX 70110 ......... 26 ....... A X-ray exam of jaw ......................................... 0.25 0.08 0.08 0.08 0.08 0.01 0.34 0.34 0.34 0.34 XXX 70110 ......... TC ...... A X-ray exam of jaw ......................................... 0.00 0.72 0.65 NA NA 0.04 0.76 0.69 NA NA XXX70120 ......... ............ A X-ray exam of mastoids ................................ 0.18 0.69 0.68 NA NA 0.05 0.92 0.91 NA NA XXX70120 ......... 26 ....... A X-ray exam of mastoids ................................ 0.18 0.05 0.06 0.05 0.06 0.01 0.24 0.25 0.24 0.25 XXX 70120 ......... TC ...... A X-ray exam of mastoids ................................ 0.00 0.64 0.63 NA NA 0.04 0.68 0.67 NA NA XXX 70130 ......... ............ A X-ray exam of mastoids ................................ 0.34 1.16 0.96 NA NA 0.07 1.57 1.37 NA NA XXX70130 ......... 26 ....... A X-ray exam of mastoids ................................ 0.34 0.10 0.11 0.10 0.11 0.02 0.46 0.47 0.46 0.47 XXX 70130 ......... TC ...... A X-ray exam of mastoids ................................ 0.00 1.06 0.85 NA NA 0.05 1.11 0.90 NA NA XXX 70134 ......... ............ A X-ray exam of middle ear .............................. 0.34 0.92 0.86 NA NA 0.07 1.33 1.27 NA NA XXX70134 ......... 26 ....... A X-ray exam of middle ear .............................. 0.34 0.11 0.11 0.11 0.11 0.02 0.47 0.47 0.47 0.47 XXX 70134 ......... TC ...... A X-ray exam of middle ear .............................. 0.00 0.82 0.75 NA NA 0.05 0.87 0.80 NA NA XXX 70140 ......... ............ A X-ray exam of facial bones ........................... 0.19 0.55 0.65 NA NA 0.05 0.79 0.89 NA NA XXX 70140 ......... 26 ....... A X-ray exam of facial bones ........................... 0.19 0.05 0.06 0.05 0.06 0.01 0.25 0.26 0.25 0.26 XXX 70140 ......... TC ...... A X-ray exam of facial bones ........................... 0.00 0.50 0.59 NA NA 0.04 0.54 0.63 NA NA XXX 70150 ......... ............ A X-ray exam of facial bones ........................... 0.26 0.85 0.86 NA NA 0.06 1.17 1.18 NA NA XXX 70150 ......... 26 ....... A X-ray exam of facial bones ........................... 0.26 0.07 0.08 0.07 0.08 0.01 0.34 0.35 0.34 0.35 XXX 70150 ......... TC ...... A X-ray exam of facial bones ........................... 0.00 0.77 0.78 NA NA 0.05 0.82 0.83 NA NA XXX 70160 ......... ............ A X-ray exam of nasal bones ........................... 0.17 0.70 0.61 NA NA 0.03 0.90 0.81 NA NA XXX 70160 ......... 26 ....... A X-ray exam of nasal bones ........................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 70160 ......... TC ...... A X-ray exam of nasal bones ........................... 0.00 0.65 0.55 NA NA 0.02 0.67 0.57 NA NA XXX 70170 ......... ............ A X-ray exam of tear duct ................................ 0.30 NA NA NA NA 0.07 NA NA NA NA XXX 70170 ......... 26 ....... A X-ray exam of tear duct ................................ 0.30 0.09 0.10 0.09 0.10 0.01 0.40 0.41 0.40 0.41 XXX 70170 ......... TC ...... A X-ray exam of tear duct ................................ 0.00 NA NA NA NA 0.06 NA NA NA NA XXX 70190 ......... ............ A X-ray exam of eye sockets ........................... 0.21 0.72 0.70 NA NA 0.05 0.98 0.96 NA NA XXX 70190 ......... 26 ....... A X-ray exam of eye sockets ........................... 0.21 0.06 0.07 0.06 0.07 0.01 0.28 0.29 0.28 0.29 XXX 70190 ......... TC ...... A X-ray exam of eye sockets ........................... 0.00 0.66 0.63 NA NA 0.04 0.70 0.67 NA NA XXX 70200 ......... ............ A X-ray exam of eye sockets ........................... 0.28 0.87 0.87 NA NA 0.06 1.21 1.21 NA NA XXX 70200 ......... 26 ....... A X-ray exam of eye sockets ........................... 0.28 0.08 0.09 0.08 0.09 0.01 0.37 0.38 0.37 0.38 XXX 70200 ......... TC ...... A X-ray exam of eye sockets ........................... 0.00 0.79 0.78 NA NA 0.05 0.84 0.83 NA NA XXX 70210 ......... ............ A X-ray exam of sinuses .................................. 0.17 0.57 0.65 NA NA 0.05 0.79 0.87 NA NA XXX 70210 ......... 26 ....... A X-ray exam of sinuses .................................. 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 70210 ......... TC ...... A X-ray exam of sinuses .................................. 0.00 0.52 0.60 NA NA 0.04 0.56 0.64 NA NA XXX 70220 ......... ............ A X-ray exam of sinuses .................................. 0.25 0.72 0.83 NA NA 0.06 1.03 1.14 NA NA XXX 70220 ......... 26 ....... A X-ray exam of sinuses .................................. 0.25 0.07 0.08 0.07 0.08 0.01 0.33 0.34 0.33 0.34 XXX 70220 ......... TC ...... A X-ray exam of sinuses .................................. 0.00 0.65 0.75 NA NA 0.05 0.70 0.80 NA NA XXX 70240 ......... ............ A X-ray exam, pituitary saddle ......................... 0.19 0.61 0.51 NA NA 0.03 0.83 0.73 NA NA XXX 70240 ......... 26 ....... A X-ray exam, pituitary saddle ......................... 0.19 0.06 0.06 0.06 0.06 0.01 0.26 0.26 0.26 0.26 XXX 70240 ......... TC ...... A X-ray exam, pituitary saddle ......................... 0.00 0.55 0.45 NA NA 0.02 0.57 0.47 NA NA XXX 70250 ......... ............ A X-ray exam of skull ....................................... 0.24 0.70 0.70 NA NA 0.05 0.99 0.99 NA NA XXX 70250 ......... 26 ....... A X-ray exam of skull ....................................... 0.24 0.07 0.08 0.07 0.08 0.01 0.32 0.33 0.32 0.33 XXX 70250 ......... TC ...... A X-ray exam of skull ....................................... 0.00 0.64 0.63 NA NA 0.04 0.68 0.67 NA NA XXX70260 ......... ............ A X-ray exam of skull ....................................... 0.34 0.88 0.97 NA NA 0.08 1.30 1.39 NA NA XXX 70260 ......... 26 ....... A X-ray exam of skull ....................................... 0.34 0.10 0.11 0.10 0.11 0.02 0.46 0.47 0.46 0.47 XXX 70260 ......... TC ...... A X-ray exam of skull ....................................... 0.00 0.78 0.86 NA NA 0.06 0.84 0.92 NA NA XXX70300 ......... ............ A X-ray exam of teeth ....................................... 0.10 0.24 0.29 NA NA 0.03 0.37 0.42 NA NA XXX 70300 ......... 26 ....... A X-ray exam of teeth ....................................... 0.10 0.03 0.05 0.03 0.05 0.01 0.14 0.16 0.14 0.16 XXX 70300 ......... TC ...... A X-ray exam of teeth ....................................... 0.00 0.21 0.25 NA NA 0.02 0.23 0.27 NA NA XXX70310 ......... ............ A X-ray exam of teeth ....................................... 0.16 0.82 0.58 NA NA 0.03 1.01 0.77 NA NA XXX 70310 ......... 26 ....... A X-ray exam of teeth ....................................... 0.16 0.05 0.07 0.05 0.07 0.01 0.22 0.24 0.22 0.24 XXX 70310 ......... TC ...... A X-ray exam of teeth ....................................... 0.00 0.77 0.51 NA NA 0.02 0.79 0.53 NA NA XXX70320 ......... ............ A Full mouth x-ray of teeth ............................... 0.22 0.98 0.89 NA NA 0.06 1.26 1.17 NA NA XXX 70320 ......... 26 ....... A Full mouth x-ray of teeth ............................... 0.22 0.06 0.08 0.06 0.08 0.01 0.29 0.31 0.29 0.31 XXX 70320 ......... TC ...... A Full mouth x-ray of teeth ............................... 0.00 0.91 0.81 NA NA 0.05 0.96 0.86 NA NA XXX 70328 ......... ............ A X-ray exam of jaw joint ................................. 0.18 0.62 0.57 NA NA 0.03 0.83 0.78 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49178 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

70328 ......... 26 ....... A X-ray exam of jaw joint ................................. 0.18 0.05 0.06 0.05 0.06 0.01 0.24 0.25 0.24 0.25 XXX 70328 ......... TC ...... A X-ray exam of jaw joint ................................. 0.00 0.57 0.51 NA NA 0.02 0.59 0.53 NA NA XXX 70330 ......... ............ A X-ray exam of jaw joints ................................ 0.24 1.01 0.94 NA NA 0.06 1.31 1.24 NA NA XXX 70330 ......... 26 ....... A X-ray exam of jaw joints ................................ 0.24 0.07 0.08 0.07 0.08 0.01 0.32 0.33 0.32 0.33 XXX 70330 ......... TC ...... A X-ray exam of jaw joints ................................ 0.00 0.94 0.87 NA NA 0.05 0.99 0.92 NA NA XXX 70332 ......... ............ A X-ray exam of jaw joint ................................. 0.54 1.46 2.09 NA NA 0.14 2.14 2.77 NA NA XXX 70332 ......... 26 ....... A X-ray exam of jaw joint ................................. 0.54 0.16 0.19 0.16 0.19 0.02 0.72 0.75 0.72 0.75 XXX 70332 ......... TC ...... A X-ray exam of jaw joint ................................. 0.00 1.30 1.90 NA NA 0.12 1.42 2.02 NA NA XXX 70336 ......... ............ A Magnetic image, jaw joint .............................. 1.48 12.60 11.92 NA NA 0.66 14.74 14.06 NA NA XXX 70336 ......... 26 ....... A Magnetic image, jaw joint .............................. 1.48 0.50 0.49 0.50 0.49 0.07 2.05 2.04 2.05 2.04 XXX 70336 ......... TC ...... A Magnetic image, jaw joint .............................. 0.00 12.10 11.43 NA NA 0.59 12.69 12.02 NA NA XXX 70350 ......... ............ A X-ray head for orthodontia ............................ 0.17 0.33 0.42 NA NA 0.03 0.53 0.62 NA NA XXX70350 ......... 26 ....... A X-ray head for orthodontia ............................ 0.17 0.05 0.07 0.05 0.07 0.01 0.23 0.25 0.23 0.25 XXX 70350 ......... TC ...... A X-ray head for orthodontia ............................ 0.00 0.27 0.35 NA NA 0.02 0.29 0.37 NA NA XXX 70355 ......... ............ A Panoramic x-ray of jaws ................................ 0.20 0.30 0.56 NA NA 0.05 0.55 0.81 NA NA XXX 70355 ......... 26 ....... A Panoramic x-ray of jaws ................................ 0.20 0.06 0.07 0.06 0.07 0.01 0.27 0.28 0.27 0.28 XXX 70355 ......... TC ...... A Panoramic x-ray of jaws ................................ 0.00 0.24 0.49 NA NA 0.04 0.28 0.53 NA NA XXX 70360 ......... ............ A X-ray exam of neck ....................................... 0.17 0.58 0.51 NA NA 0.03 0.78 0.71 NA NA XXX 70360 ......... 26 ....... A X-ray exam of neck ....................................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 70360 ......... TC ...... A X-ray exam of neck ....................................... 0.00 0.52 0.45 NA NA 0.02 0.54 0.47 NA NA XXX 70370 ......... ............ A Throat x-ray & fluoroscopy ............................ 0.32 1.65 1.47 NA NA 0.08 2.05 1.87 NA NA XXX70370 ......... 26 ....... A Throat x-ray & fluoroscopy ............................ 0.32 0.09 0.10 0.09 0.10 0.01 0.42 0.43 0.42 0.43 XXX 70370 ......... TC ...... A Throat x-ray & fluoroscopy ............................ 0.00 1.56 1.37 NA NA 0.07 1.63 1.44 NA NA XXX 70371 ......... ............ A Speech evaluation, complex ......................... 0.84 1.50 2.16 NA NA 0.16 2.50 3.16 NA NA XXX 70371 ......... 26 ....... A Speech evaluation, complex ......................... 0.84 0.26 0.28 0.26 0.28 0.04 1.14 1.16 1.14 1.16 XXX 70371 ......... TC ...... A Speech evaluation, complex ......................... 0.00 1.24 1.89 NA NA 0.12 1.36 2.01 NA NA XXX 70373 ......... ............ A Contrast x-ray of larynx ................................. 0.44 1.71 1.87 NA NA 0.13 2.28 2.44 NA NA XXX 70373 ......... 26 ....... A Contrast x-ray of larynx ................................. 0.44 0.13 0.14 0.13 0.14 0.02 0.59 0.60 0.59 0.60 XXX 70373 ......... TC ...... A Contrast x-ray of larynx ................................. 0.00 1.58 1.73 NA NA 0.11 1.69 1.84 NA NA XXX 70380 ......... ............ A X-ray exam of salivary gland ........................ 0.17 0.82 0.75 NA NA 0.05 1.04 0.97 NA NA XXX 70380 ......... 26 ....... A X-ray exam of salivary gland ........................ 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 70380 ......... TC ...... A X-ray exam of salivary gland ........................ 0.00 0.76 0.69 NA NA 0.04 0.80 0.73 NA NA XXX 70390 ......... ............ A X-ray exam of salivary duct .......................... 0.38 2.34 2.01 NA NA 0.13 2.85 2.52 NA NA XXX 70390 ......... 26 ....... A X-ray exam of salivary duct .......................... 0.38 0.12 0.12 0.12 0.12 0.02 0.52 0.52 0.52 0.52 XXX 70390 ......... TC ...... A X-ray exam of salivary duct .......................... 0.00 2.22 1.89 NA NA 0.11 2.33 2.00 NA NA XXX 70450 ......... ............ A Ct head/brain w/o dye ................................... 0.85 4.90 4.98 NA NA 0.29 6.04 6.12 NA NA XXX 70450 ......... 26 ....... A Ct head/brain w/o dye ................................... 0.85 0.27 0.28 0.27 0.28 0.04 1.16 1.17 1.16 1.17 XXX 70450 ......... TC ...... A Ct head/brain w/o dye ................................... 0.00 4.64 4.70 NA NA 0.25 4.89 4.95 NA NA XXX 70460 ......... ............ A Ct head/brain w/dye ...................................... 1.13 6.52 6.15 NA NA 0.35 8.00 7.63 NA NA XXX 70460 ......... 26 ....... A Ct head/brain w/dye ...................................... 1.13 0.36 0.37 0.36 0.37 0.05 1.54 1.55 1.54 1.55 XXX 70460 ......... TC ...... A Ct head/brain w/dye ...................................... 0.00 6.16 5.79 NA NA 0.30 6.46 6.09 NA NA XXX 70470 ......... ............ A Ct head/brain w/o & w/dye ............................ 1.27 7.96 7.61 NA NA 0.43 9.66 9.31 NA NA XXX 70470 ......... 26 ....... A Ct head/brain w/o & w/dye ............................ 1.27 0.40 0.42 0.40 0.42 0.06 1.73 1.75 1.73 1.75 XXX 70470 ......... TC ...... A Ct head/brain w/o & w/dye ............................ 0.00 7.56 7.19 NA NA 0.37 7.93 7.56 NA NA XXX 70480 ......... ............ A Ct orbit/ear/fossa w/o dye ............................. 1.28 8.52 5.99 NA NA 0.31 10.11 7.58 NA NA XXX 70480 ......... 26 ....... A Ct orbit/ear/fossa w/o dye ............................. 1.28 0.41 0.42 0.41 0.42 0.06 1.75 1.76 1.75 1.76 XXX 70480 ......... TC ...... A Ct orbit/ear/fossa w/o dye ............................. 0.00 8.11 5.57 NA NA 0.25 8.36 5.82 NA NA XXX 70481 ......... ............ A Ct orbit/ear/fossa w/dye ................................ 1.38 10.04 7.09 NA NA 0.36 11.78 8.83 NA NA XXX 70481 ......... 26 ....... A Ct orbit/ear/fossa w/dye ................................ 1.38 0.44 0.45 0.44 0.45 0.06 1.88 1.89 1.88 1.89 XXX 70481 ......... TC ...... A Ct orbit/ear/fossa w/dye ................................ 0.00 9.60 6.65 NA NA 0.30 9.90 6.95 NA NA XXX 70482 ......... ............ A Ct orbit/ear/fossa w/o&w/dye ........................ 1.45 11.56 8.55 NA NA 0.43 13.44 10.43 NA NA XXX 70482 ......... 26 ....... A Ct orbit/ear/fossa w/o&w/dye ........................ 1.45 0.47 0.48 0.47 0.48 0.06 1.98 1.99 1.98 1.99 XXX 70482 ......... TC ...... A Ct orbit/ear/fossa w/o&w/dye ........................ 0.00 11.09 8.08 NA NA 0.37 11.46 8.45 NA NA XXX 70486 ......... ............ A Ct maxillofacial w/o dye ................................ 1.14 6.81 5.52 NA NA 0.30 8.25 6.96 NA NA XXX 70486 ......... 26 ....... A Ct maxillofacial w/o dye ................................ 1.14 0.36 0.37 0.36 0.37 0.05 1.55 1.56 1.55 1.56 XXX 70486 ......... TC ...... A Ct maxillofacial w/o dye ................................ 0.00 6.44 5.15 NA NA 0.25 6.69 5.40 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49179 

70487 ......... ............ A Ct maxillofacial w/dye .................................... 1.30 8.39 6.67 NA NA 0.36 10.05 8.33 NA NA XXX 70487 ......... 26 ....... A Ct maxillofacial w/dye .................................... 1.30 0.42 0.43 0.42 0.43 0.06 1.78 1.79 1.78 1.79 XXX 70487 ......... TC ...... A Ct maxillofacial w/dye .................................... 0.00 7.97 6.24 NA NA 0.30 8.27 6.54 NA NA XXX70488 ......... ............ A Ct maxillofacial w/o & w/dye ......................... 1.42 10.48 8.27 NA NA 0.43 12.33 10.12 NA NA XXX 70488 ......... 26 ....... A Ct maxillofacial w/o & w/dye ......................... 1.42 0.46 0.46 0.46 0.46 0.06 1.94 1.94 1.94 1.94 XXX 70488 ......... TC ...... A Ct maxillofacial w/o & w/dye ......................... 0.00 10.03 7.81 NA NA 0.37 10.40 8.18 NA NA XXX 70490 ......... ............ A Ct soft tissue neck w/o dye ........................... 1.28 6.52 5.49 NA NA 0.31 8.11 7.08 NA NA XXX70490 ......... 26 ....... A Ct soft tissue neck w/o dye ........................... 1.28 0.41 0.42 0.41 0.42 0.06 1.75 1.76 1.75 1.76 XXX 70490 ......... TC ...... A Ct soft tissue neck w/o dye ........................... 0.00 6.11 5.07 NA NA 0.25 6.36 5.32 NA NA XXX 70491 ......... ............ A Ct soft tissue neck w/dye .............................. 1.38 8.06 6.60 NA NA 0.36 9.80 8.34 NA NA XXX 70491 ......... 26 ....... A Ct soft tissue neck w/dye .............................. 1.38 0.44 0.45 0.44 0.45 0.06 1.88 1.89 1.88 1.89 XXX 70491 ......... TC ...... A Ct soft tissue neck w/dye .............................. 0.00 7.62 6.15 NA NA 0.30 7.92 6.45 NA NA XXX 70492 ......... ............ A Ct sft tsue nck w/o & w/dye .......................... 1.45 10.18 8.20 NA NA 0.43 12.06 10.08 NA NA XXX 70492 ......... 26 ....... A Ct sft tsue nck w/o & w/dye .......................... 1.45 0.47 0.47 0.47 0.47 0.06 1.98 1.98 1.98 1.98 XXX 70492 ......... TC ...... A Ct sft tsue nck w/o & w/dye .......................... 0.00 9.71 7.73 NA NA 0.37 10.08 8.10 NA NA XXX 70496 ......... ............ A Ct angiography, head .................................... 1.75 17.16 12.67 NA NA 0.66 19.57 15.08 NA NA XXX 70496 ......... 26 ....... A Ct angiography, head .................................... 1.75 0.57 0.57 0.57 0.57 0.08 2.40 2.40 2.40 2.40 XXX 70496 ......... TC ...... A Ct angiography, head .................................... 0.00 16.59 12.10 NA NA 0.58 17.17 12.68 NA NA XXX 70498 ......... ............ A Ct angiography, neck .................................... 1.75 17.26 12.69 NA NA 0.66 19.67 15.10 NA NA XXX 70498 ......... 26 ....... A Ct angiography, neck .................................... 1.75 0.58 0.57 0.58 0.57 0.08 2.41 2.40 2.41 2.40 XXX 70498 ......... TC ...... A Ct angiography, neck .................................... 0.00 16.68 12.12 NA NA 0.58 17.26 12.70 NA NA XXX 70540 ......... ............ A Mri orbit/face/neck w/o dye ........................... 1.35 14.58 12.38 NA NA 0.45 16.38 14.18 NA NA XXX 70540 ......... 26 ....... A Mri orbit/face/neck w/o dye ........................... 1.35 0.45 0.44 0.45 0.44 0.06 1.86 1.85 1.86 1.85 XXX 70540 ......... TC ...... A Mri orbit/face/neck w/o dye ........................... 0.00 14.13 11.93 NA NA 0.39 14.52 12.32 NA NA XXX70542 ......... ............ A Mri orbit/face/neck w/dye .............................. 1.62 15.53 14.36 NA NA 0.54 17.69 16.52 NA NA XXX 70542 ......... 26 ....... A Mri orbit/face/neck w/dye .............................. 1.62 0.53 0.53 0.53 0.53 0.07 2.22 2.22 2.22 2.22 XXX 70542 ......... TC ...... A Mri orbit/face/neck w/dye .............................. 0.00 15.00 13.83 NA NA 0.47 15.47 14.30 NA NA XXX 70543 ......... ............ A Mri orbt/fac/nck w/o & w/dye ......................... 2.15 19.26 24.01 NA NA 0.94 22.35 27.10 NA NA XXX 70543 ......... 26 ....... A Mri orbt/fac/nck w/o & w/dye ......................... 2.15 0.72 0.71 0.72 0.71 0.10 2.97 2.96 2.97 2.96 XXX 70543 ......... TC ...... A Mri orbt/fac/nck w/o & w/dye ......................... 0.00 18.54 23.30 NA NA 0.84 19.38 24.14 NA NA XXX 70544 ......... ............ A Mr angiography head w/o dye ...................... 1.20 16.05 12.71 NA NA 0.64 17.89 14.55 NA NA XXX 70544 ......... 26 ....... A Mr angiography head w/o dye ...................... 1.20 0.39 0.40 0.39 0.40 0.05 1.64 1.65 1.64 1.65 XXX70544 ......... TC ...... A Mr angiography head w/o dye ...................... 0.00 15.67 12.32 NA NA 0.59 16.26 12.91 NA NA XXX 70545 ......... ............ A Mr angiography head w/dye .......................... 1.20 15.97 12.69 NA NA 0.64 17.81 14.53 NA NA XXX 70545 ......... 26 ....... A Mr angiography head w/dye .......................... 1.20 0.38 0.39 0.38 0.39 0.05 1.63 1.64 1.63 1.64 XXX 70545 ......... TC ...... A Mr angiography head w/dye .......................... 0.00 15.59 12.30 NA NA 0.59 16.18 12.89 NA NA XXX 70546 ......... ............ A Mr angiograph head w/o&w/dye ................... 1.80 24.49 23.37 NA NA 0.67 26.96 25.84 NA NA XXX 70546 ......... 26 ....... A Mr angiograph head w/o&w/dye ................... 1.80 0.58 0.59 0.58 0.59 0.08 2.46 2.47 2.46 2.47 XXX 70546 ......... TC ...... A Mr angiograph head w/o&w/dye ................... 0.00 23.91 22.79 NA NA 0.59 24.50 23.38 NA NA XXX 70547 ......... ............ A Mr angiography neck w/o dye ....................... 1.20 16.09 12.72 NA NA 0.64 17.93 14.56 NA NA XXX70547 ......... 26 ....... A Mr angiography neck w/o dye ....................... 1.20 0.39 0.39 0.39 0.39 0.05 1.64 1.64 1.64 1.64 XXX 70547 ......... TC ...... A Mr angiography neck w/o dye ....................... 0.00 15.70 12.33 NA NA 0.59 16.29 12.92 NA NA XXX 70548 ......... ............ A Mr angiography neck w/dye .......................... 1.20 16.79 12.89 NA NA 0.64 18.63 14.73 NA NA XXX 70548 ......... 26 ....... A Mr angiography neck w/dye .......................... 1.20 0.38 0.39 0.38 0.39 0.05 1.63 1.64 1.63 1.64 XXX 70548 ......... TC ...... A Mr angiography neck w/dye .......................... 0.00 16.41 12.50 NA NA 0.59 17.00 13.09 NA NA XXX 70549 ......... ............ A Mr angiograph neck w/o&w/dye .................... 1.80 24.41 23.35 NA NA 0.67 26.88 25.82 NA NA XXX 70549 ......... 26 ....... A Mr angiograph neck w/o&w/dye .................... 1.80 0.58 0.59 0.58 0.59 0.08 2.46 2.47 2.46 2.47 XXX 70549 ......... TC ...... A Mr angiograph neck w/o&w/dye .................... 0.00 23.83 22.77 NA NA 0.59 24.42 23.36 NA NA XXX 70551 ......... ............ A Mri brain w/o dye ........................................... 1.48 14.69 12.44 NA NA 0.66 16.83 14.58 NA NA XXX 70551 ......... 26 ....... A Mri brain w/o dye ........................................... 1.48 0.48 0.49 0.48 0.49 0.07 2.03 2.04 2.03 2.04 XXX 70551 ......... TC ...... A Mri brain w/o dye ........................................... 0.00 14.22 11.96 NA NA 0.59 14.81 12.55 NA NA XXX 70552 ......... ............ A Mri brain w/dye .............................................. 1.78 15.73 14.46 NA NA 0.78 18.29 17.02 NA NA XXX 70552 ......... 26 ....... A Mri brain w/dye .............................................. 1.78 0.57 0.59 0.57 0.59 0.08 2.43 2.45 2.43 2.45 XXX 70552 ......... TC ...... A Mri brain w/dye .............................................. 0.00 15.16 13.87 NA NA 0.70 15.86 14.57 NA NA XXX 70553 ......... ............ A Mri brain w/o & w/dye ................................... 2.36 18.37 23.84 NA NA 1.41 22.14 27.61 NA NA XXX 70553 ......... 26 ....... A Mri brain w/o & w/dye ................................... 2.36 0.76 0.78 0.76 0.78 0.10 3.22 3.24 3.22 3.24 XXX 70553 ......... TC ...... A Mri brain w/o & w/dye ................................... 0.00 17.61 23.06 NA NA 1.31 18.92 24.37 NA NA XXX 70557 ......... ............ C Mri brain w/o dye ........................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 70557 ......... 26 ....... A Mri brain w/o dye ........................................... 2.90 0.92 1.08 0.92 1.08 0.08 3.90 4.06 3.90 4.06 XXX 70557 ......... TC ...... C Mri brain w/o dye ........................................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 70558 ......... 26 ....... A Mri brain w/dye .............................................. 3.20 1.15 1.22 1.15 1.22 0.10 4.45 4.52 4.45 4.52 XXX 70558 ......... TC ...... C Mri brain w/dye .............................................. 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 70559 ......... 26 ....... A Mri brain w/o & w/dye ................................... 3.20 1.03 1.19 1.03 1.19 0.12 4.35 4.51 4.35 4.51 XXX 70559 ......... TC ...... C Mri brain w/o & w/dye ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49180 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

71010 ......... ............ A Chest x-ray .................................................... 0.18 0.43 0.51 NA NA 0.03 0.64 0.72 NA NA XXX 71010 ......... 26 ....... A Chest x-ray .................................................... 0.18 0.05 0.06 0.05 0.06 0.01 0.24 0.25 0.24 0.25 XXX 71010 ......... TC ...... A Chest x-ray .................................................... 0.00 0.37 0.45 NA NA 0.02 0.39 0.47 NA NA XXX 71015 ......... ............ A Chest x-ray .................................................... 0.21 0.57 0.59 NA NA 0.03 0.81 0.83 NA NA XXX 71015 ......... 26 ....... A Chest x-ray .................................................... 0.21 0.07 0.07 0.07 0.07 0.01 0.29 0.29 0.29 0.29 XXX 71015 ......... TC ...... A Chest x-ray .................................................... 0.00 0.51 0.52 NA NA 0.02 0.53 0.54 NA NA XXX 71020 ......... ............ A Chest x-ray .................................................... 0.22 0.57 0.66 NA NA 0.05 0.84 0.93 NA NA XXX 71020 ......... 26 ....... A Chest x-ray .................................................... 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.30 0.30 0.30 XXX 71020 ......... TC ...... A Chest x-ray .................................................... 0.00 0.50 0.59 NA NA 0.04 0.54 0.63 NA NA XXX 71021 ......... ............ A Chest x-ray .................................................... 0.27 0.71 0.79 NA NA 0.06 1.04 1.12 NA NA XXX 71021 ......... 26 ....... A Chest x-ray .................................................... 0.27 0.08 0.09 0.08 0.09 0.01 0.36 0.37 0.36 0.37 XXX 71021 ......... TC ...... A Chest x-ray .................................................... 0.00 0.63 0.71 NA NA 0.05 0.68 0.76 NA NA XXX 71022 ......... ............ A Chest x-ray .................................................... 0.31 0.89 0.85 NA NA 0.06 1.26 1.22 NA NA XXX 71022 ......... 26 ....... A Chest x-ray .................................................... 0.31 0.09 0.10 0.09 0.10 0.01 0.41 0.42 0.41 0.42 XXX 71022 ......... TC ...... A Chest x-ray .................................................... 0.00 0.80 0.75 NA NA 0.05 0.85 0.80 NA NA XXX 71023 ......... ............ A Chest x-ray and fluoroscopy ......................... 0.38 1.57 1.08 NA NA 0.06 2.01 1.52 NA NA XXX 71023 ......... 26 ....... A Chest x-ray and fluoroscopy ......................... 0.38 0.14 0.13 0.14 0.13 0.01 0.53 0.52 0.53 0.52 XXX 71023 ......... TC ...... A Chest x-ray and fluoroscopy ......................... 0.00 1.42 0.94 NA NA 0.05 1.47 0.99 NA NA XXX 71030 ......... ............ A Chest x-ray .................................................... 0.31 0.91 0.89 NA NA 0.06 1.28 1.26 NA NA XXX 71030 ......... 26 ....... A Chest x-ray .................................................... 0.31 0.09 0.10 0.09 0.10 0.01 0.41 0.42 0.41 0.42 XXX 71030 ......... TC ...... A Chest x-ray .................................................... 0.00 0.82 0.79 NA NA 0.05 0.87 0.84 NA NA XXX 71034 ......... ............ A Chest x-ray and fluoroscopy ......................... 0.46 2.04 1.71 NA NA 0.10 2.60 2.27 NA NA XXX 71034 ......... 26 ....... A Chest x-ray and fluoroscopy ......................... 0.46 0.18 0.17 0.18 0.17 0.02 0.66 0.65 0.66 0.65 XXX 71034 ......... TC ...... A Chest x-ray and fluoroscopy ......................... 0.00 1.86 1.55 NA NA 0.08 1.94 1.63 NA NA XXX 71035 ......... ............ A Chest x-ray .................................................... 0.18 0.77 0.63 NA NA 0.03 0.98 0.84 NA NA XXX 71035 ......... 26 ....... A Chest x-ray .................................................... 0.18 0.06 0.06 0.06 0.06 0.01 0.25 0.25 0.25 0.25 XXX 71035 ......... TC ...... A Chest x-ray .................................................... 0.00 0.72 0.57 NA NA 0.02 0.74 0.59 NA NA XXX 71040 ......... ............ A Contrast x-ray of bronchi ............................... 0.58 2.08 1.76 NA NA 0.11 2.77 2.45 NA NA XXX 71040 ......... 26 ....... A Contrast x-ray of bronchi ............................... 0.58 0.16 0.18 0.16 0.18 0.03 0.77 0.79 0.77 0.79 XXX 71040 ......... TC ...... A Contrast x-ray of bronchi ............................... 0.00 1.92 1.58 NA NA 0.08 2.00 1.66 NA NA XXX 71060 ......... ............ A Contrast x-ray of bronchi ............................... 0.74 3.07 2.60 NA NA 0.16 3.97 3.50 NA NA XXX 71060 ......... 26 ....... A Contrast x-ray of bronchi ............................... 0.74 0.23 0.24 0.23 0.24 0.03 1.00 1.01 1.00 1.01 XXX 71060 ......... TC ...... A Contrast x-ray of bronchi ............................... 0.00 2.84 2.36 NA NA 0.13 2.97 2.49 NA NA XXX 71090 ......... ............ A X-ray & pacemaker insertion ......................... 0.54 NA NA NA NA 0.13 NA NA NA NA XXX 71090 ......... 26 ....... A X-ray & pacemaker insertion ......................... 0.54 0.28 0.23 0.28 0.23 0.02 0.84 0.79 0.84 0.79 XXX 71090 ......... TC ...... A X-ray & pacemaker insertion ......................... 0.00 NA NA NA NA 0.11 NA NA NA NA XXX 71100 ......... ............ A X-ray exam of ribs ......................................... 0.22 0.62 0.64 NA NA 0.05 0.89 0.91 NA NA XXX 71100 ......... 26 ....... A X-ray exam of ribs ......................................... 0.22 0.06 0.07 0.06 0.07 0.01 0.29 0.30 0.29 0.30 XXX 71100 ......... TC ...... A X-ray exam of ribs ......................................... 0.00 0.55 0.57 NA NA 0.04 0.59 0.61 NA NA XXX 71101 ......... ............ A X-ray exam of ribs/chest ............................... 0.27 0.76 0.76 NA NA 0.05 1.08 1.08 NA NA XXX 71101 ......... 26 ....... A X-ray exam of ribs/chest ............................... 0.27 0.08 0.09 0.08 0.09 0.01 0.36 0.37 0.36 0.37 XXX 71101 ......... TC ...... A X-ray exam of ribs/chest ............................... 0.00 0.68 0.67 NA NA 0.04 0.72 0.71 NA NA XXX 71110 ......... ............ A X-ray exam of ribs ......................................... 0.27 0.78 0.85 NA NA 0.06 1.11 1.18 NA NA XXX 71110 ......... 26 ....... A X-ray exam of ribs ......................................... 0.27 0.08 0.09 0.08 0.09 0.01 0.36 0.37 0.36 0.37 XXX 71110 ......... TC ...... A X-ray exam of ribs ......................................... 0.00 0.70 0.76 NA NA 0.05 0.75 0.81 NA NA XXX 71111 ......... ............ A X-ray exam of ribs/chest ............................... 0.32 1.06 1.01 NA NA 0.07 1.45 1.40 NA NA XXX 71111 ......... 26 ....... A X-ray exam of ribs/chest ............................... 0.32 0.09 0.10 0.09 0.10 0.01 0.42 0.43 0.42 0.43 XXX 71111 ......... TC ...... A X-ray exam of ribs/chest ............................... 0.00 0.97 0.91 NA NA 0.06 1.03 0.97 NA NA XXX 71120 ......... ............ A X-ray exam of breastbone ............................. 0.20 0.62 0.70 NA NA 0.05 0.87 0.95 NA NA XXX 71120 ......... 26 ....... A X-ray exam of breastbone ............................. 0.20 0.06 0.07 0.06 0.07 0.01 0.27 0.28 0.27 0.28 XXX 71120 ......... TC ...... A X-ray exam of breastbone ............................. 0.00 0.56 0.63 NA NA 0.04 0.60 0.67 NA NA XXX 71130 ......... ............ A X-ray exam of breastbone ............................. 0.22 0.75 0.77 NA NA 0.05 1.02 1.04 NA NA XXX 71130 ......... 26 ....... A X-ray exam of breastbone ............................. 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.30 0.30 0.30 XXX 71130 ......... TC ...... A X-ray exam of breastbone ............................. 0.00 0.68 0.70 NA NA 0.04 0.72 0.74 NA NA XXX 71250 ......... ............ A Ct thorax w/o dye .......................................... 1.16 6.47 6.34 NA NA 0.36 7.99 7.86 NA NA XXX 71250 ......... 26 ....... A Ct thorax w/o dye .......................................... 1.16 0.37 0.38 0.37 0.38 0.05 1.58 1.59 1.58 1.59 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49181 

71250 ......... TC ...... A Ct thorax w/o dye .......................................... 0.00 6.10 5.96 NA NA 0.31 6.41 6.27 NA NA XXX 71260 ......... ............ A Ct thorax w/dye ............................................. 1.24 8.01 7.61 NA NA 0.42 9.67 9.27 NA NA XXX 71260 ......... 26 ....... A Ct thorax w/dye ............................................. 1.24 0.39 0.41 0.39 0.41 0.05 1.68 1.70 1.68 1.70 XXX 71260 ......... TC ...... A Ct thorax w/dye ............................................. 0.00 7.61 7.21 NA NA 0.37 7.98 7.58 NA NA XXX 71270 ......... ............ A Ct thorax w/o & w/dye ................................... 1.38 10.15 9.51 NA NA 0.52 12.05 11.41 NA NA XXX 71270 ......... 26 ....... A Ct thorax w/o & w/dye ................................... 1.38 0.44 0.45 0.44 0.45 0.06 1.88 1.89 1.88 1.89 XXX 71270 ......... TC ...... A Ct thorax w/o & w/dye ................................... 0.00 9.71 9.07 NA NA 0.46 10.17 9.53 NA NA XXX 71275 ......... ............ A Ct angiography, chest ................................... 1.92 11.77 12.70 NA NA 0.48 14.17 15.10 NA NA XXX 71275 ......... 26 ....... A Ct angiography, chest ................................... 1.92 0.62 0.63 0.62 0.63 0.09 2.63 2.64 2.63 2.64 XXX 71275 ......... TC ...... A Ct angiography, chest ................................... 0.00 11.14 12.07 NA NA 0.39 11.53 12.46 NA NA XXX 71550 ......... ............ A Mri chest w/o dye .......................................... 1.46 16.75 12.95 NA NA 0.51 18.72 14.92 NA NA XXX 71550 ......... 26 ....... A Mri chest w/o dye .......................................... 1.46 0.48 0.48 0.48 0.48 0.06 2.00 2.00 2.00 2.00 XXX 71550 ......... TC ...... A Mri chest w/o dye .......................................... 0.00 16.27 12.47 NA NA 0.45 16.72 12.92 NA NA XXX 71551 ......... ............ A Mri chest w/dye ............................................. 1.73 18.16 15.05 NA NA 0.60 20.49 17.38 NA NA XXX 71551 ......... 26 ....... A Mri chest w/dye ............................................. 1.73 0.56 0.57 0.56 0.57 0.08 2.37 2.38 2.37 2.38 XXX 71551 ......... TC ...... A Mri chest w/dye ............................................. 0.00 17.59 14.48 NA NA 0.52 18.11 15.00 NA NA XXX 71552 ......... ............ A Mri chest w/o & w/dye ................................... 2.26 22.91 24.94 NA NA 0.78 25.95 27.98 NA NA XXX 71552 ......... 26 ....... A Mri chest w/o & w/dye ................................... 2.26 0.75 0.74 0.75 0.74 0.10 3.11 3.10 3.11 3.10 XXX 71552 ......... TC ...... A Mri chest w/o & w/dye ................................... 0.00 22.16 24.20 NA NA 0.68 22.84 24.88 NA NA XXX 71555 ......... ............ R Mri angio chest w or w/o dye ........................ 1.81 15.55 12.74 NA NA 0.67 18.03 15.22 NA NA XXX 71555 ......... 26 ....... R Mri angio chest w or w/o dye ........................ 1.81 0.62 0.61 0.62 0.61 0.08 2.51 2.50 2.51 2.50 XXX 71555 ......... TC ...... R Mri angio chest w or w/o dye ........................ 0.00 14.94 12.14 NA NA 0.59 15.53 12.73 NA NA XXX 72010 ......... ............ A X-ray exam of spine ...................................... 0.45 1.45 1.24 NA NA 0.08 1.98 1.77 NA NA XXX 72010 ......... 26 ....... A X-ray exam of spine ...................................... 0.45 0.13 0.15 0.13 0.15 0.02 0.60 0.62 0.60 0.62 XXX 72010 ......... TC ...... A X-ray exam of spine ...................................... 0.00 1.32 1.10 NA NA 0.06 1.38 1.16 NA NA XXX 72020 ......... ............ A X-ray exam of spine ...................................... 0.15 0.46 0.47 NA NA 0.03 0.64 0.65 NA NA XXX 72020 ......... 26 ....... A X-ray exam of spine ...................................... 0.15 0.05 0.05 0.05 0.05 0.01 0.21 0.21 0.21 0.21 XXX 72020 ......... TC ...... A X-ray exam of spine ...................................... 0.00 0.42 0.42 NA NA 0.02 0.44 0.44 NA NA XXX 72040 ......... ............ A X-ray exam of neck spine ............................. 0.22 0.77 0.70 NA NA 0.05 1.04 0.97 NA NA XXX 72040 ......... 26 ....... A X-ray exam of neck spine ............................. 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.30 0.30 0.30 XXX 72040 ......... TC ...... A X-ray exam of neck spine ............................. 0.00 0.70 0.63 NA NA 0.04 0.74 0.67 NA NA XXX 72050 ......... ............ A X-ray exam of neck spine ............................. 0.31 1.07 1.01 NA NA 0.07 1.45 1.39 NA NA XXX 72050 ......... 26 ....... A X-ray exam of neck spine ............................. 0.31 0.10 0.10 0.10 0.10 0.01 0.42 0.42 0.42 0.42 XXX 72050 ......... TC ...... A X-ray exam of neck spine ............................. 0.00 0.97 0.91 NA NA 0.06 1.03 0.97 NA NA XXX 72052 ......... ............ A X-ray exam of neck spine ............................. 0.36 1.39 1.29 NA NA 0.08 1.83 1.73 NA NA XXX 72052 ......... 26 ....... A X-ray exam of neck spine ............................. 0.36 0.11 0.12 0.11 0.12 0.02 0.49 0.50 0.49 0.50 XXX 72052 ......... TC ...... A X-ray exam of neck spine ............................. 0.00 1.27 1.17 NA NA 0.06 1.33 1.23 NA NA XXX 72069 ......... ............ A X-ray exam of trunk spine ............................. 0.22 0.77 0.62 NA NA 0.03 1.02 0.87 NA NA XXX72069 ......... 26 ....... A X-ray exam of trunk spine ............................. 0.22 0.08 0.08 0.08 0.08 0.01 0.31 0.31 0.31 0.31 XXX 72069 ......... TC ...... A X-ray exam of trunk spine ............................. 0.00 0.69 0.54 NA NA 0.02 0.71 0.56 NA NA XXX 72070 ......... ............ A X-ray exam of thoracic spine ........................ 0.22 0.64 0.70 NA NA 0.05 0.91 0.97 NA NA XXX 72070 ......... 26 ....... A X-ray exam of thoracic spine ........................ 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.30 0.30 0.30 XXX 72070 ......... TC ...... A X-ray exam of thoracic spine ........................ 0.00 0.57 0.63 NA NA 0.04 0.61 0.67 NA NA XXX 72072 ......... ............ A X-ray exam of thoracic spine ........................ 0.22 0.77 0.79 NA NA 0.06 1.05 1.07 NA NA XXX 72072 ......... 26 ....... A X-ray exam of thoracic spine ........................ 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.30 0.30 0.30 XXX 72072 ......... TC ...... A X-ray exam of thoracic spine ........................ 0.00 0.70 0.72 NA NA 0.05 0.75 0.77 NA NA XXX 72074 ......... ............ A X-ray exam of thoracic spine ........................ 0.22 0.95 0.97 NA NA 0.07 1.24 1.26 NA NA XXX 72074 ......... 26 ....... A X-ray exam of thoracic spine ........................ 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.30 0.30 0.30 XXX 72074 ......... TC ...... A X-ray exam of thoracic spine ........................ 0.00 0.88 0.90 NA NA 0.06 0.94 0.96 NA NA XXX 72080 ......... ............ A X-ray exam of trunk spine ............................. 0.22 0.70 0.73 NA NA 0.05 0.97 1.00 NA NA XXX72080 ......... 26 ....... A X-ray exam of trunk spine ............................. 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.30 0.30 0.30 XXX 72080 ......... TC ...... A X-ray exam of trunk spine ............................. 0.00 0.62 0.66 NA NA 0.04 0.66 0.70 NA NA XXX 72090 ......... ............ A X-ray exam of trunk spine ............................. 0.28 1.01 0.82 NA NA 0.05 1.34 1.15 NA NA XXX72090 ......... 26 ....... A X-ray exam of trunk spine ............................. 0.28 0.10 0.09 0.10 0.09 0.01 0.39 0.38 0.39 0.38 XXX 72090 ......... TC ...... A X-ray exam of trunk spine ............................. 0.00 0.92 0.73 NA NA 0.04 0.96 0.77 NA NA XXX 72100 ......... ............ A X-ray exam of lower spine ............................ 0.22 0.81 0.76 NA NA 0.05 1.08 1.03 NA NA XXX 72100 ......... 26 ....... A X-ray exam of lower spine ............................ 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.30 0.30 0.30 XXX 72100 ......... TC ...... A X-ray exam of lower spine ............................ 0.00 0.74 0.69 NA NA 0.04 0.78 0.73 NA NA XXX 72110 ......... ............ A X-ray exam of lower spine ............................ 0.31 1.14 1.04 NA NA 0.07 1.52 1.42 NA NA XXX 72110 ......... 26 ....... A X-ray exam of lower spine ............................ 0.31 0.10 0.10 0.10 0.10 0.01 0.42 0.42 0.42 0.42 XXX 72110 ......... TC ...... A X-ray exam of lower spine ............................ 0.00 1.04 0.94 NA NA 0.06 1.10 1.00 NA NA XXX 72114 ......... ............ A X-ray exam of lower spine ............................ 0.36 1.57 1.38 NA NA 0.08 2.01 1.82 NA NA XXX 72114 ......... 26 ....... A X-ray exam of lower spine ............................ 0.36 0.12 0.12 0.12 0.12 0.02 0.50 0.50 0.50 0.50 XXX 72114 ......... TC ...... A X-ray exam of lower spine ............................ 0.00 1.45 1.26 NA NA 0.06 1.51 1.32 NA NA XXX 72120 ......... ............ A X-ray exam of lower spine ............................ 0.22 1.07 0.99 NA NA 0.07 1.36 1.28 NA NA XXX 72120 ......... 26 ....... A X-ray exam of lower spine ............................ 0.22 0.08 0.07 0.08 0.07 0.01 0.31 0.30 0.31 0.30 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49182 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

72120 ......... TC ...... A X-ray exam of lower spine ............................ 0.00 1.00 0.92 NA NA 0.06 1.06 0.98 NA NA XXX 72125 ......... ............ A Ct neck spine w/o dye ................................... 1.16 6.46 6.33 NA NA 0.36 7.98 7.85 NA NA XXX 72125 ......... 26 ....... A Ct neck spine w/o dye ................................... 1.16 0.37 0.38 0.37 0.38 0.05 1.58 1.59 1.58 1.59 XXX 72125 ......... TC ...... A Ct neck spine w/o dye ................................... 0.00 6.09 5.96 NA NA 0.31 6.40 6.27 NA NA XXX 72126 ......... ............ A Ct neck spine w/dye ...................................... 1.22 8.04 7.61 NA NA 0.42 9.68 9.25 NA NA XXX 72126 ......... 26 ....... A Ct neck spine w/dye ...................................... 1.22 0.39 0.40 0.39 0.40 0.05 1.66 1.67 1.66 1.67 XXX 72126 ......... TC ...... A Ct neck spine w/dye ...................................... 0.00 7.65 7.22 NA NA 0.37 8.02 7.59 NA NA XXX 72127 ......... ............ A Ct neck spine w/o & w/dye ........................... 1.27 10.17 9.50 NA NA 0.52 11.96 11.29 NA NA XXX 72127 ......... 26 ....... A Ct neck spine w/o & w/dye ........................... 1.27 0.43 0.42 0.43 0.42 0.06 1.76 1.75 1.76 1.75 XXX 72127 ......... TC ...... A Ct neck spine w/o & w/dye ........................... 0.00 9.73 9.07 NA NA 0.46 10.19 9.53 NA NA XXX 72128 ......... ............ A Ct chest spine w/o dye .................................. 1.16 6.47 6.34 NA NA 0.36 7.99 7.86 NA NA XXX 72128 ......... 26 ....... A Ct chest spine w/o dye .................................. 1.16 0.37 0.38 0.37 0.38 0.05 1.58 1.59 1.58 1.59 XXX 72128 ......... TC ...... A Ct chest spine w/o dye .................................. 0.00 6.10 5.96 NA NA 0.31 6.41 6.27 NA NA XXX 72129 ......... ............ A Ct chest spine w/dye ..................................... 1.22 8.03 7.61 NA NA 0.42 9.67 9.25 NA NA XXX 72129 ......... 26 ....... A Ct chest spine w/dye ..................................... 1.22 0.39 0.40 0.39 0.40 0.05 1.66 1.67 1.66 1.67 XXX 72129 ......... TC ...... A Ct chest spine w/dye ..................................... 0.00 7.64 7.21 NA NA 0.37 8.01 7.58 NA NA XXX 72130 ......... ............ A Ct chest spine w/o & w/dye .......................... 1.27 10.14 9.49 NA NA 0.52 11.93 11.28 NA NA XXX 72130 ......... 26 ....... A Ct chest spine w/o & w/dye .......................... 1.27 0.43 0.42 0.43 0.42 0.06 1.76 1.75 1.76 1.75 XXX 72130 ......... TC ...... A Ct chest spine w/o & w/dye .......................... 0.00 9.70 9.06 NA NA 0.46 10.16 9.52 NA NA XXX 72131 ......... ............ A Ct lumbar spine w/o dye ............................... 1.16 6.47 6.34 NA NA 0.36 7.99 7.86 NA NA XXX72131 ......... 26 ....... A Ct lumbar spine w/o dye ............................... 1.16 0.37 0.38 0.37 0.38 0.05 1.58 1.59 1.58 1.59 XXX 72131 ......... TC ...... A Ct lumbar spine w/o dye ............................... 0.00 6.10 5.96 NA NA 0.31 6.41 6.27 NA NA XXX 72132 ......... ............ A Ct lumbar spine w/dye .................................. 1.22 8.03 7.61 NA NA 0.42 9.67 9.25 NA NA XXX 72132 ......... 26 ....... A Ct lumbar spine w/dye .................................. 1.22 0.39 0.40 0.39 0.40 0.05 1.66 1.67 1.66 1.67 XXX 72132 ......... TC ...... A Ct lumbar spine w/dye .................................. 0.00 7.64 7.21 NA NA 0.37 8.01 7.58 NA NA XXX 72133 ......... ............ A Ct lumbar spine w/o & w/dye ........................ 1.27 10.21 9.51 NA NA 0.52 12.00 11.30 NA NA XXX72133 ......... 26 ....... A Ct lumbar spine w/o & w/dye ........................ 1.27 0.41 0.42 0.41 0.42 0.06 1.74 1.75 1.74 1.75 XXX 72133 ......... TC ...... A Ct lumbar spine w/o & w/dye ........................ 0.00 9.79 9.09 NA NA 0.46 10.25 9.55 NA NA XXX 72141 ......... ............ A Mri neck spine w/o dye ................................. 1.60 12.80 12.00 NA NA 0.66 15.06 14.26 NA NA XXX 72141 ......... 26 ....... A Mri neck spine w/o dye ................................. 1.60 0.53 0.53 0.53 0.53 0.07 2.20 2.20 2.20 2.20 XXX 72141 ......... TC ...... A Mri neck spine w/o dye ................................. 0.00 12.26 11.47 NA NA 0.59 12.85 12.06 NA NA XXX 72142 ......... ............ A Mri neck spine w/dye .................................... 1.92 15.86 14.53 NA NA 0.79 18.57 17.24 NA NA XXX 72142 ......... 26 ....... A Mri neck spine w/dye .................................... 1.92 0.63 0.64 0.63 0.64 0.09 2.64 2.65 2.64 2.65 XXX 72142 ......... TC ...... A Mri neck spine w/dye .................................... 0.00 15.24 13.89 NA NA 0.70 15.94 14.59 NA NA XXX 72146 ......... ............ A Mri chest spine w/o dye ................................ 1.60 12.77 12.92 NA NA 0.71 15.08 15.23 NA NA XXX 72146 ......... 26 ....... A Mri chest spine w/o dye ................................ 1.60 0.53 0.53 0.53 0.53 0.07 2.20 2.20 2.20 2.20 XXX 72146 ......... TC ...... A Mri chest spine w/o dye ................................ 0.00 12.24 12.39 NA NA 0.64 12.88 13.03 NA NA XXX 72147 ......... ............ A Mri chest spine w/dye ................................... 1.92 13.70 13.98 NA NA 0.79 16.41 16.69 NA NA XXX 72147 ......... 26 ....... A Mri chest spine w/dye ................................... 1.92 0.62 0.63 0.62 0.63 0.09 2.63 2.64 2.63 2.64 XXX 72147 ......... TC ...... A Mri chest spine w/dye ................................... 0.00 13.08 13.35 NA NA 0.70 13.78 14.05 NA NA XXX 72148 ......... ............ A Mri lumbar spine w/o dye .............................. 1.48 12.77 12.89 NA NA 0.71 14.96 15.08 NA NA XXX 72148 ......... 26 ....... A Mri lumbar spine w/o dye .............................. 1.48 0.50 0.49 0.50 0.49 0.07 2.05 2.04 2.05 2.04 XXX 72148 ......... TC ...... A Mri lumbar spine w/o dye .............................. 0.00 12.28 12.40 NA NA 0.64 12.92 13.04 NA NA XXX72149 ......... ............ A Mri lumbar spine w/dye ................................. 1.78 15.83 14.49 NA NA 0.78 18.39 17.05 NA NA XXX 72149 ......... 26 ....... A Mri lumbar spine w/dye ................................. 1.78 0.59 0.60 0.59 0.60 0.08 2.45 2.46 2.45 2.46 XXX 72149 ......... TC ...... A Mri lumbar spine w/dye ................................. 0.00 15.25 13.89 NA NA 0.70 15.95 14.59 NA NA XXX 72156 ......... ............ A Mri neck spine w/o & w/dye .......................... 2.57 18.13 23.83 NA NA 1.42 22.12 27.82 NA NA XXX 72156 ......... 26 ....... A Mri neck spine w/o & w/dye .......................... 2.57 0.84 0.85 0.84 0.85 0.11 3.52 3.53 3.52 3.53 XXX 72156 ......... TC ...... A Mri neck spine w/o & w/dye .......................... 0.00 17.29 22.98 NA NA 1.31 18.60 24.29 NA NA XXX 72157 ......... ............ A Mri chest spine w/o & w/dye ......................... 2.57 16.43 23.40 NA NA 1.42 20.42 27.39 NA NA XXX 72157 ......... 26 ....... A Mri chest spine w/o & w/dye ......................... 2.57 0.83 0.84 0.83 0.84 0.11 3.51 3.52 3.51 3.52 XXX 72157 ......... TC ...... A Mri chest spine w/o & w/dye ......................... 0.00 15.60 22.56 NA NA 1.31 16.91 23.87 NA NA XXX 72158 ......... ............ A Mri lumbar spine w/o & w/dye ....................... 2.36 18.10 23.77 NA NA 1.41 21.87 27.54 NA NA XXX 72158 ......... 26 ....... A Mri lumbar spine w/o & w/dye ....................... 2.36 0.78 0.78 0.78 0.78 0.10 3.24 3.24 3.24 3.24 XXX 72158 ......... TC ...... A Mri lumbar spine w/o & w/dye ....................... 0.00 17.32 22.99 NA NA 1.31 18.63 24.30 NA NA XXX 72159 ......... ............ N Mr angio spine w/o&w/dye ............................ 1.80 14.79 13.39 NA NA 0.74 17.33 15.93 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49183 

72159 ......... 26 ....... N Mr angio spine w/o&w/dye ............................ 1.80 0.42 0.62 0.42 0.62 0.10 2.32 2.52 2.32 2.52 XXX 72159 ......... TC ...... N Mr angio spine w/o&w/dye ............................ 0.00 14.37 12.77 NA NA 0.64 15.01 13.41 NA NA XXX 72170 ......... ............ A X-ray exam of pelvis ..................................... 0.17 0.50 0.56 NA NA 0.03 0.70 0.76 NA NA XXX 72170 ......... 26 ....... A X-ray exam of pelvis ..................................... 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 72170 ......... TC ...... A X-ray exam of pelvis ..................................... 0.00 0.44 0.50 NA NA 0.02 0.46 0.52 NA NA XXX 72190 ......... ............ A X-ray exam of pelvis ..................................... 0.21 0.85 0.77 NA NA 0.05 1.11 1.03 NA NA XXX 72190 ......... 26 ....... A X-ray exam of pelvis ..................................... 0.21 0.07 0.07 0.07 0.07 0.01 0.29 0.29 0.29 0.29 XXX 72190 ......... TC ...... A X-ray exam of pelvis ..................................... 0.00 0.78 0.70 NA NA 0.04 0.82 0.74 NA NA XXX 72191 ......... ............ A Ct angiograph pelv w/o&w/dye ..................... 1.81 11.43 12.32 NA NA 0.47 13.71 14.60 NA NA XXX 72191 ......... 26 ....... A Ct angiograph pelv w/o&w/dye ..................... 1.81 0.60 0.60 0.60 0.60 0.08 2.49 2.49 2.49 2.49 XXX72191 ......... TC ...... A Ct angiograph pelv w/o&w/dye ..................... 0.00 10.83 11.73 NA NA 0.39 11.22 12.12 NA NA XXX 72192 ......... ............ A Ct pelvis w/o dye ........................................... 1.09 6.02 6.21 NA NA 0.36 7.47 7.66 NA NA XXX 72192 ......... 26 ....... A Ct pelvis w/o dye ........................................... 1.09 0.34 0.36 0.34 0.36 0.05 1.48 1.50 1.48 1.50 XXX 72192 ......... TC ...... A Ct pelvis w/o dye ........................................... 0.00 5.68 5.85 NA NA 0.31 5.99 6.16 NA NA XXX 72193 ......... ............ A Ct pelvis w/dye .............................................. 1.16 7.55 7.30 NA NA 0.41 9.12 8.87 NA NA XXX 72193 ......... 26 ....... A Ct pelvis w/dye .............................................. 1.16 0.37 0.38 0.37 0.38 0.05 1.58 1.59 1.58 1.59 XXX 72193 ......... TC ...... A Ct pelvis w/dye .............................................. 0.00 7.18 6.93 NA NA 0.36 7.54 7.29 NA NA XXX 72194 ......... ............ A Ct pelvis w/o & w/dye .................................... 1.22 10.18 9.21 NA NA 0.48 11.88 10.91 NA NA XXX 72194 ......... 26 ....... A Ct pelvis w/o & w/dye .................................... 1.22 0.39 0.40 0.39 0.40 0.05 1.66 1.67 1.66 1.67 XXX 72194 ......... TC ...... A Ct pelvis w/o & w/dye .................................... 0.00 9.78 8.81 NA NA 0.43 10.21 9.24 NA NA XXX72195 ......... ............ A Mri pelvis w/o dye ......................................... 1.46 14.74 12.45 NA NA 0.51 16.71 14.42 NA NA XXX 72195 ......... 26 ....... A Mri pelvis w/o dye ......................................... 1.46 0.48 0.48 0.48 0.48 0.06 2.00 2.00 2.00 2.00 XXX 72195 ......... TC ...... A Mri pelvis w/o dye ......................................... 0.00 14.25 11.96 NA NA 0.45 14.70 12.41 NA NA XXX 72196 ......... ............ A Mri pelvis w/dye ............................................. 1.73 15.67 14.43 NA NA 0.60 18.00 16.76 NA NA XXX 72196 ......... 26 ....... A Mri pelvis w/dye ............................................. 1.73 0.56 0.57 0.56 0.57 0.08 2.37 2.38 2.37 2.38 XXX 72196 ......... TC ...... A Mri pelvis w/dye ............................................. 0.00 15.11 13.86 NA NA 0.52 15.63 14.38 NA NA XXX 72197 ......... ............ A Mri pelvis w/o & w/dye .................................. 2.26 19.28 24.04 NA NA 1.02 22.56 27.32 NA NA XXX 72197 ......... 26 ....... A Mri pelvis w/o & w/dye .................................. 2.26 0.74 0.74 0.74 0.74 0.10 3.10 3.10 3.10 3.10 XXX 72197 ......... TC ...... A Mri pelvis w/o & w/dye .................................. 0.00 18.54 23.30 NA NA 0.92 19.46 24.22 NA NA XXX 72198 ......... ............ A Mr angio pelvis w/o & w/dye ......................... 1.80 15.34 12.68 NA NA 0.67 17.81 15.15 NA NA XXX 72198 ......... 26 ....... A Mr angio pelvis w/o & w/dye ......................... 1.80 0.60 0.59 0.60 0.59 0.08 2.48 2.47 2.48 2.47 XXX 72198 ......... TC ...... A Mr angio pelvis w/o & w/dye ......................... 0.00 14.75 12.09 NA NA 0.59 15.34 12.68 NA NA XXX 72200 ......... ............ A X-ray exam sacroiliac joints .......................... 0.17 0.60 0.59 NA NA 0.03 0.80 0.79 NA NA XXX72200 ......... 26 ....... A X-ray exam sacroiliac joints .......................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 72200 ......... TC ...... A X-ray exam sacroiliac joints .......................... 0.00 0.55 0.53 NA NA 0.02 0.57 0.55 NA NA XXX 72202 ......... ............ A X-ray exam sacroiliac joints .......................... 0.19 0.74 0.70 NA NA 0.05 0.98 0.94 NA NA XXX72202 ......... 26 ....... A X-ray exam sacroiliac joints .......................... 0.19 0.06 0.06 0.06 0.06 0.01 0.26 0.26 0.26 0.26 XXX 72202 ......... TC ...... A X-ray exam sacroiliac joints .......................... 0.00 0.68 0.64 NA NA 0.04 0.72 0.68 NA NA XXX 72220 ......... ............ A X-ray exam of tailbone .................................. 0.17 0.58 0.62 NA NA 0.05 0.80 0.84 NA NA XXX 72220 ......... 26 ....... A X-ray exam of tailbone .................................. 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 72220 ......... TC ...... A X-ray exam of tailbone .................................. 0.00 0.53 0.56 NA NA 0.04 0.57 0.60 NA NA XXX 72240 ......... ............ A Contrast x-ray of neck spine ......................... 0.91 2.53 4.41 NA NA 0.29 3.73 5.61 NA NA XXX 72240 ......... 26 ....... A Contrast x-ray of neck spine ......................... 0.91 0.28 0.29 0.28 0.29 0.04 1.23 1.24 1.23 1.24 XXX 72240 ......... TC ...... A Contrast x-ray of neck spine ......................... 0.00 2.25 4.13 NA NA 0.25 2.50 4.38 NA NA XXX 72255 ......... ............ A Contrast x-ray, thorax spine .......................... 0.91 2.27 4.02 NA NA 0.26 3.44 5.19 NA NA XXX72255 ......... 26 ....... A Contrast x-ray, thorax spine .......................... 0.91 0.27 0.27 0.27 0.27 0.04 1.22 1.22 1.22 1.22 XXX 72255 ......... TC ...... A Contrast x-ray, thorax spine .......................... 0.00 2.00 3.75 NA NA 0.22 2.22 3.97 NA NA XXX 72265 ......... ............ A Contrast x-ray, lower spine ........................... 0.83 2.50 3.87 NA NA 0.26 3.59 4.96 NA NA XXX72265 ......... 26 ....... A Contrast x-ray, lower spine ........................... 0.83 0.26 0.25 0.26 0.25 0.04 1.13 1.12 1.13 1.12 XXX 72265 ......... TC ...... A Contrast x-ray, lower spine ........................... 0.00 2.24 3.61 NA NA 0.22 2.46 3.83 NA NA XXX 72270 ......... ............ A Contrast x-ray, spine ..................................... 1.33 3.95 5.88 NA NA 0.39 5.67 7.60 NA NA XXX 72270 ......... 26 ....... A Contrast x-ray, spine ..................................... 1.33 0.43 0.42 0.43 0.42 0.06 1.82 1.81 1.82 1.81 XXX 72270 ......... TC ...... A Contrast x-ray, spine ..................................... 0.00 3.52 5.46 NA NA 0.33 3.85 5.79 NA NA XXX72275 ......... ............ A Epidurography ............................................... 0.76 1.71 2.15 NA NA 0.26 2.73 3.17 NA NA XXX 72275 ......... 26 ....... A Epidurography ............................................... 0.76 0.19 0.20 0.19 0.20 0.04 0.99 1.00 0.99 1.00 XXX 72275 ......... TC ...... A Epidurography ............................................... 0.00 1.52 1.96 NA NA 0.22 1.74 2.18 NA NA XXX 72285 ......... ............ A X-ray c/t spine disk ........................................ 1.16 1.42 6.90 NA NA 0.50 3.08 8.56 NA NA XXX 72285 ......... 26 ....... A X-ray c/t spine disk ........................................ 1.16 0.29 0.34 0.29 0.34 0.07 1.52 1.57 1.52 1.57 XXX 72285 ......... TC ...... A X-ray c/t spine disk ........................................ 0.00 1.13 6.57 NA NA 0.43 1.56 7.00 NA NA XXX 72295 ......... ............ A X-ray of lower spine disk ............................... 0.83 1.41 6.45 NA NA 0.46 2.70 7.74 NA NA XXX 72295 ......... 26 ....... A X-ray of lower spine disk ............................... 0.83 0.23 0.26 0.23 0.26 0.06 1.12 1.15 1.12 1.15 XXX 72295 ......... TC ...... A X-ray of lower spine disk ............................... 0.00 1.18 6.19 NA NA 0.40 1.58 6.59 NA NA XXX 73000 ......... ............ A X-ray exam of collar bone ............................. 0.16 0.56 0.57 NA NA 0.03 0.75 0.76 NA NA XXX73000 ......... 26 ....... A X-ray exam of collar bone ............................. 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX 73000 ......... TC ...... A X-ray exam of collar bone ............................. 0.00 0.50 0.52 NA NA 0.02 0.52 0.54 NA NA XXX 73010 ......... ............ A X-ray exam of shoulder blade ....................... 0.17 0.58 0.58 NA NA 0.03 0.78 0.78 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49184 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

73010 ......... 26 ....... A X-ray exam of shoulder blade ....................... 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 73010 ......... TC ...... A X-ray exam of shoulder blade ....................... 0.00 0.53 0.52 NA NA 0.02 0.55 0.54 NA NA XXX 73020 ......... ............ A X-ray exam of shoulder ................................. 0.15 0.45 0.50 NA NA 0.03 0.63 0.68 NA NA XXX 73020 ......... 26 ....... A X-ray exam of shoulder ................................. 0.15 0.05 0.05 0.05 0.05 0.01 0.21 0.21 0.21 0.21 XXX 73020 ......... TC ...... A X-ray exam of shoulder ................................. 0.00 0.40 0.45 NA NA 0.02 0.42 0.47 NA NA XXX 73030 ......... ............ A X-ray exam of shoulder ................................. 0.18 0.57 0.62 NA NA 0.05 0.80 0.85 NA NA XXX 73030 ......... 26 ....... A X-ray exam of shoulder ................................. 0.18 0.06 0.06 0.06 0.06 0.01 0.25 0.25 0.25 0.25 XXX 73030 ......... TC ...... A X-ray exam of shoulder ................................. 0.00 0.51 0.56 NA NA 0.04 0.55 0.60 NA NA XXX 73040 ......... ............ A Contrast x-ray of shoulder ............................. 0.54 2.24 2.27 NA NA 0.14 2.92 2.95 NA NA XXX 73040 ......... 26 ....... A Contrast x-ray of shoulder ............................. 0.54 0.17 0.18 0.17 0.18 0.02 0.73 0.74 0.73 0.74 XXX 73040 ......... TC ...... A Contrast x-ray of shoulder ............................. 0.00 2.06 2.09 NA NA 0.12 2.18 2.21 NA NA XXX 73050 ......... ............ A X-ray exam of shoulders ............................... 0.20 0.74 0.74 NA NA 0.05 0.99 0.99 NA NA XXX73050 ......... 26 ....... A X-ray exam of shoulders ............................... 0.20 0.07 0.07 0.07 0.07 0.01 0.28 0.28 0.28 0.28 XXX 73050 ......... TC ...... A X-ray exam of shoulders ............................... 0.00 0.66 0.67 NA NA 0.04 0.70 0.71 NA NA XXX 73060 ......... ............ A X-ray exam of humerus ................................. 0.17 0.57 0.62 NA NA 0.05 0.79 0.84 NA NA XXX73060 ......... 26 ....... A X-ray exam of humerus ................................. 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 73060 ......... TC ...... A X-ray exam of humerus ................................. 0.00 0.52 0.56 NA NA 0.04 0.56 0.60 NA NA XXX 73070 ......... ............ A X-ray exam of elbow ..................................... 0.15 0.56 0.57 NA NA 0.03 0.74 0.75 NA NA XXX 73070 ......... 26 ....... A X-ray exam of elbow ..................................... 0.15 0.05 0.05 0.05 0.05 0.01 0.21 0.21 0.21 0.21 XXX 73070 ......... TC ...... A X-ray exam of elbow ..................................... 0.00 0.51 0.52 NA NA 0.02 0.53 0.54 NA NA XXX 73080 ......... ............ A X-ray exam of elbow ..................................... 0.17 0.75 0.66 NA NA 0.05 0.97 0.88 NA NA XXX 73080 ......... 26 ....... A X-ray exam of elbow ..................................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 73080 ......... TC ...... A X-ray exam of elbow ..................................... 0.00 0.70 0.60 NA NA 0.04 0.74 0.64 NA NA XXX 73085 ......... ............ A Contrast x-ray of elbow ................................. 0.54 1.82 2.17 NA NA 0.14 2.50 2.85 NA NA XXX 73085 ......... 26 ....... A Contrast x-ray of elbow ................................. 0.54 0.17 0.19 0.17 0.19 0.02 0.73 0.75 0.73 0.75 XXX 73085 ......... TC ...... A Contrast x-ray of elbow ................................. 0.00 1.65 1.99 NA NA 0.12 1.77 2.11 NA NA XXX 73090 ......... ............ A X-ray exam of forearm .................................. 0.16 0.55 0.57 NA NA 0.03 0.74 0.76 NA NA XXX 73090 ......... 26 ....... A X-ray exam of forearm .................................. 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX 73090 ......... TC ...... A X-ray exam of forearm .................................. 0.00 0.50 0.52 NA NA 0.02 0.52 0.54 NA NA XXX 73092 ......... ............ A X-ray exam of arm, infant ............................. 0.16 0.59 0.55 NA NA 0.03 0.78 0.74 NA NA XXX73092 ......... 26 ....... A X-ray exam of arm, infant ............................. 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX 73092 ......... TC ...... A X-ray exam of arm, infant ............................. 0.00 0.54 0.50 NA NA 0.02 0.56 0.52 NA NA XXX 73100 ......... ............ A X-ray exam of wrist ....................................... 0.16 0.61 0.56 NA NA 0.03 0.80 0.75 NA NA XXX 73100 ......... 26 ....... A X-ray exam of wrist ....................................... 0.16 0.06 0.05 0.06 0.05 0.01 0.23 0.22 0.23 0.22 XXX 73100 ......... TC ...... A X-ray exam of wrist ....................................... 0.00 0.55 0.51 NA NA 0.02 0.57 0.53 NA NA XXX73110 ......... ............ A X-ray exam of wrist ....................................... 0.17 0.78 0.64 NA NA 0.03 0.98 0.84 NA NA XXX 73110 ......... 26 ....... A X-ray exam of wrist ....................................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 73110 ......... TC ...... A X-ray exam of wrist ....................................... 0.00 0.72 0.58 NA NA 0.02 0.74 0.60 NA NA XXX73115 ......... ............ A Contrast x-ray of wrist ................................... 0.54 2.38 1.91 NA NA 0.12 3.04 2.57 NA NA XXX 73115 ......... 26 ....... A Contrast x-ray of wrist ................................... 0.54 0.18 0.18 0.18 0.18 0.02 0.74 0.74 0.74 0.74 XXX 73115 ......... TC ...... A Contrast x-ray of wrist ................................... 0.00 2.20 1.74 NA NA 0.10 2.30 1.84 NA NA XXX73120 ......... ............ A X-ray exam of hand ....................................... 0.16 0.56 0.55 NA NA 0.03 0.75 0.74 NA NA XXX 73120 ......... 26 ....... A X-ray exam of hand ....................................... 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX 73120 ......... TC ...... A X-ray exam of hand ....................................... 0.00 0.51 0.50 NA NA 0.02 0.53 0.52 NA NA XXX 73130 ......... ............ A X-ray exam of hand ....................................... 0.17 0.66 0.61 NA NA 0.03 0.86 0.81 NA NA XXX 73130 ......... 26 ....... A X-ray exam of hand ....................................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 73130 ......... TC ...... A X-ray exam of hand ....................................... 0.00 0.61 0.55 NA NA 0.02 0.63 0.57 NA NA XXX 73140 ......... ............ A X-ray exam of finger(s) ................................. 0.13 0.68 0.52 NA NA 0.03 0.84 0.68 NA NA XXX 73140 ......... 26 ....... A X-ray exam of finger(s) ................................. 0.13 0.04 0.04 0.04 0.04 0.01 0.18 0.18 0.18 0.18 XXX 73140 ......... TC ...... A X-ray exam of finger(s) ................................. 0.00 0.64 0.48 NA NA 0.02 0.66 0.50 NA NA XXX 73200 ......... ............ A Ct upper extremity w/o dye ........................... 1.09 6.45 5.60 NA NA 0.30 7.84 6.99 NA NA XXX 73200 ......... 26 ....... A Ct upper extremity w/o dye ........................... 1.09 0.35 0.36 0.35 0.36 0.05 1.49 1.50 1.49 1.50 XXX 73200 ......... TC ...... A Ct upper extremity w/o dye ........................... 0.00 6.10 5.25 NA NA 0.25 6.35 5.50 NA NA XXX 73201 ......... ............ A Ct upper extremity w/dye .............................. 1.16 7.97 6.71 NA NA 0.36 9.49 8.23 NA NA XXX73201 ......... 26 ....... A Ct upper extremity w/dye .............................. 1.16 0.37 0.38 0.37 0.38 0.05 1.58 1.59 1.58 1.59 XXX 73201 ......... TC ...... A Ct upper extremity w/dye .............................. 0.00 7.60 6.33 NA NA 0.31 7.91 6.64 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49185 

73202 ......... ............ A Ct uppr extremity w/o&w/dye ........................ 1.22 10.74 8.55 NA NA 0.44 12.40 10.21 NA NA XXX73202 ......... 26 ....... A Ct uppr extremity w/o&w/dye ........................ 1.22 0.39 0.40 0.39 0.40 0.05 1.66 1.67 1.66 1.67 XXX 73202 ......... TC ...... A Ct uppr extremity w/o&w/dye ........................ 0.00 10.35 8.15 NA NA 0.39 10.74 8.54 NA NA XXX 73206 ......... ............ A Ct angio upr extrm w/o&w/dye ...................... 1.81 10.85 11.38 NA NA 0.47 13.13 13.66 NA NA XXX73206 ......... 26 ....... A Ct angio upr extrm w/o&w/dye ...................... 1.81 0.60 0.59 0.60 0.59 0.08 2.49 2.48 2.49 2.48 XXX 73206 ......... TC ...... A Ct angio upr extrm w/o&w/dye ...................... 0.00 10.25 10.78 NA NA 0.39 10.64 11.17 NA NA XXX 73218 ......... ............ A Mri upper extremity w/o dye .......................... 1.35 15.03 12.49 NA NA 0.45 16.83 14.29 NA NA XXX 73218 ......... 26 ....... A Mri upper extremity w/o dye .......................... 1.35 0.45 0.44 0.45 0.44 0.06 1.86 1.85 1.86 1.85 XXX 73218 ......... TC ...... A Mri upper extremity w/o dye .......................... 0.00 14.58 12.05 NA NA 0.39 14.97 12.44 NA NA XXX 73219 ......... ............ A Mri upper extremity w/dye ............................. 1.62 15.68 14.41 NA NA 0.54 17.84 16.57 NA NA XXX 73219 ......... 26 ....... A Mri upper extremity w/dye ............................. 1.62 0.53 0.54 0.53 0.54 0.07 2.22 2.23 2.22 2.23 XXX 73219 ......... TC ...... A Mri upper extremity w/dye ............................. 0.00 15.15 13.87 NA NA 0.47 15.62 14.34 NA NA XXX73220 ......... ............ A Mri uppr extremity w/o&w/dye ....................... 2.15 19.37 24.04 NA NA 0.94 22.46 27.13 NA NA XXX 73220 ......... 26 ....... A Mri uppr extremity w/o&w/dye ....................... 2.15 0.70 0.71 0.70 0.71 0.10 2.95 2.96 2.95 2.96 XXX 73220 ......... TC ...... A Mri uppr extremity w/o&w/dye ....................... 0.00 18.67 23.33 NA NA 0.84 19.51 24.17 NA NA XXX 73221 ......... ............ A Mri joint upr extrem w/o dye ......................... 1.35 13.95 12.22 NA NA 0.45 15.75 14.02 NA NA XXX 73221 ......... 26 ....... A Mri joint upr extrem w/o dye ......................... 1.35 0.46 0.45 0.46 0.45 0.06 1.87 1.86 1.87 1.86 XXX 73221 ......... TC ...... A Mri joint upr extrem w/o dye ......................... 0.00 13.49 11.77 NA NA 0.39 13.88 12.16 NA NA XXX 73222 ......... ............ A Mri joint upr extrem w/dye ............................. 1.62 14.71 14.16 NA NA 0.54 16.87 16.32 NA NA XXX 73222 ......... 26 ....... A Mri joint upr extrem w/dye ............................. 1.62 0.55 0.54 0.55 0.54 0.07 2.24 2.23 2.24 2.23 XXX 73222 ......... TC ...... A Mri joint upr extrem w/dye ............................. 0.00 14.16 13.62 NA NA 0.47 14.63 14.09 NA NA XXX 73223 ......... ............ A Mri joint upr extr w/o&w/dye .......................... 2.15 18.04 23.70 NA NA 0.94 21.13 26.79 NA NA XXX 73223 ......... 26 ....... A Mri joint upr extr w/o&w/dye .......................... 2.15 0.71 0.71 0.71 0.71 0.10 2.96 2.96 2.96 2.96 XXX 73223 ......... TC ...... A Mri joint upr extr w/o&w/dye .......................... 0.00 17.33 22.99 NA NA 0.84 18.17 23.83 NA NA XXX73225 ......... ............ N Mr angio upr extr w/o&w/dye ........................ 1.73 14.77 12.45 NA NA 0.69 17.19 14.87 NA NA XXX 73225 ......... 26 ....... N Mr angio upr extr w/o&w/dye ........................ 1.73 0.40 0.60 0.40 0.60 0.10 2.23 2.43 2.23 2.43 XXX 73225 ......... TC ...... N Mr angio upr extr w/o&w/dye ........................ 0.00 14.37 11.85 NA NA 0.59 14.96 12.44 NA NA XXX 73500 ......... ............ A X-ray exam of hip .......................................... 0.17 0.49 0.52 NA NA 0.03 0.69 0.72 NA NA XXX 73500 ......... 26 ....... A X-ray exam of hip .......................................... 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 73500 ......... TC ...... A X-ray exam of hip .......................................... 0.00 0.43 0.46 NA NA 0.02 0.45 0.48 NA NA XXX 73510 ......... ............ A X-ray exam of hip .......................................... 0.21 0.78 0.68 NA NA 0.05 1.04 0.94 NA NA XXX 73510 ......... 26 ....... A X-ray exam of hip .......................................... 0.21 0.07 0.07 0.07 0.07 0.01 0.29 0.29 0.29 0.29 XXX 73510 ......... TC ...... A X-ray exam of hip .......................................... 0.00 0.71 0.61 NA NA 0.04 0.75 0.65 NA NA XXX 73520 ......... ............ A X-ray exam of hips ........................................ 0.26 0.79 0.77 NA NA 0.05 1.10 1.08 NA NA XXX 73520 ......... 26 ....... A X-ray exam of hips ........................................ 0.26 0.08 0.09 0.08 0.09 0.01 0.35 0.36 0.35 0.36 XXX 73520 ......... TC ...... A X-ray exam of hips ........................................ 0.00 0.71 0.68 NA NA 0.04 0.75 0.72 NA NA XXX73525 ......... ............ A Contrast x-ray of hip ...................................... 0.54 1.79 2.16 NA NA 0.15 2.48 2.85 NA NA XXX 73525 ......... 26 ....... A Contrast x-ray of hip ...................................... 0.54 0.17 0.18 0.17 0.18 0.03 0.74 0.75 0.74 0.75 XXX 73525 ......... TC ...... A Contrast x-ray of hip ...................................... 0.00 1.62 1.98 NA NA 0.12 1.74 2.10 NA NA XXX 73530 ......... ............ A X-ray exam of hip .......................................... 0.29 NA NA NA NA 0.03 NA NA NA NA XXX 73530 ......... 26 ....... A X-ray exam of hip .......................................... 0.29 0.09 0.10 0.09 0.10 0.01 0.39 0.40 0.39 0.40 XXX 73530 ......... TC ...... A X-ray exam of hip .......................................... 0.00 NA NA NA NA 0.02 NA NA NA NA XXX 73540 ......... ............ A X-ray exam of pelvis & hips .......................... 0.20 0.80 0.68 NA NA 0.05 1.05 0.93 NA NA XXX 73540 ......... 26 ....... A X-ray exam of pelvis & hips .......................... 0.20 0.07 0.07 0.07 0.07 0.01 0.28 0.28 0.28 0.28 XXX 73540 ......... TC ...... A X-ray exam of pelvis & hips .......................... 0.00 0.73 0.61 NA NA 0.04 0.77 0.65 NA NA XXX 73542 ......... ............ A X-ray exam, sacroiliac joint ........................... 0.59 1.12 1.98 NA NA 0.15 1.86 2.72 NA NA XXX 73542 ......... 26 ....... A X-ray exam, sacroiliac joint ........................... 0.59 0.14 0.16 0.14 0.16 0.03 0.76 0.78 0.76 0.78 XXX 73542 ......... TC ...... A X-ray exam, sacroiliac joint ........................... 0.00 0.98 1.82 NA NA 0.12 1.10 1.94 NA NA XXX 73550 ......... ............ A X-ray exam of thigh ....................................... 0.17 0.54 0.61 NA NA 0.05 0.76 0.83 NA NA XXX 73550 ......... 26 ....... A X-ray exam of thigh ....................................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 73550 ......... TC ...... A X-ray exam of thigh ....................................... 0.00 0.49 0.55 NA NA 0.04 0.53 0.59 NA NA XXX73560 ......... ............ A X-ray exam of knee, 1 or 2 ........................... 0.17 0.59 0.58 NA NA 0.03 0.79 0.78 NA NA XXX 73560 ......... 26 ....... A X-ray exam of knee, 1 or 2 ........................... 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 73560 ......... TC ...... A X-ray exam of knee, 1 or 2 ........................... 0.00 0.53 0.52 NA NA 0.02 0.55 0.54 NA NA XXX 73562 ......... ............ A X-ray exam of knee, 3 ................................... 0.18 0.73 0.66 NA NA 0.05 0.96 0.89 NA NA XXX 73562 ......... 26 ....... A X-ray exam of knee, 3 ................................... 0.18 0.06 0.06 0.06 0.06 0.01 0.25 0.25 0.25 0.25 XXX 73562 ......... TC ...... A X-ray exam of knee, 3 ................................... 0.00 0.67 0.60 NA NA 0.04 0.71 0.64 NA NA XXX 73564 ......... ............ A X-ray exam, knee, 4 or more ........................ 0.22 0.87 0.74 NA NA 0.05 1.14 1.01 NA NA XXX 73564 ......... 26 ....... A X-ray exam, knee, 4 or more ........................ 0.22 0.08 0.07 0.08 0.07 0.01 0.31 0.30 0.31 0.30 XXX 73564 ......... TC ...... A X-ray exam, knee, 4 or more ........................ 0.00 0.79 0.66 NA NA 0.04 0.83 0.70 NA NA XXX 73565 ......... ............ A X-ray exam of knees ..................................... 0.17 0.65 0.58 NA NA 0.03 0.85 0.78 NA NA XXX 73565 ......... 26 ....... A X-ray exam of knees ..................................... 0.17 0.06 0.06 0.06 0.06 0.01 0.24 0.24 0.24 0.24 XXX 73565 ......... TC ...... A X-ray exam of knees ..................................... 0.00 0.59 0.52 NA NA 0.02 0.61 0.54 NA NA XXX 73580 ......... ............ A Contrast x-ray of knee joint ........................... 0.54 2.40 2.69 NA NA 0.17 3.11 3.40 NA NA XXX 73580 ......... 26 ....... A Contrast x-ray of knee joint ........................... 0.54 0.18 0.17 0.18 0.17 0.03 0.75 0.74 0.75 0.74 XXX 73580 ......... TC ...... A Contrast x-ray of knee joint ........................... 0.00 2.22 2.52 NA NA 0.14 2.36 2.66 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49186 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

73590 ......... ............ A X-ray exam of lower leg ................................ 0.17 0.54 0.57 NA NA 0.03 0.74 0.77 NA NA XXX 73590 ......... 26 ....... A X-ray exam of lower leg ................................ 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 73590 ......... TC ...... A X-ray exam of lower leg ................................ 0.00 0.49 0.51 NA NA 0.02 0.51 0.53 NA NA XXX 73592 ......... ............ A X-ray exam of leg, infant ............................... 0.16 0.60 0.56 NA NA 0.03 0.79 0.75 NA NA XXX 73592 ......... 26 ....... A X-ray exam of leg, infant ............................... 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX 73592 ......... TC ...... A X-ray exam of leg, infant ............................... 0.00 0.55 0.51 NA NA 0.02 0.57 0.53 NA NA XXX 73600 ......... ............ A X-ray exam of ankle ...................................... 0.16 0.57 0.55 NA NA 0.03 0.76 0.74 NA NA XXX 73600 ......... 26 ....... A X-ray exam of ankle ...................................... 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX 73600 ......... TC ...... A X-ray exam of ankle ...................................... 0.00 0.51 0.50 NA NA 0.02 0.53 0.52 NA NA XXX 73610 ......... ............ A X-ray exam of ankle ...................................... 0.17 0.67 0.61 NA NA 0.03 0.87 0.81 NA NA XXX 73610 ......... 26 ....... A X-ray exam of ankle ...................................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 73610 ......... TC ...... A X-ray exam of ankle ...................................... 0.00 0.62 0.55 NA NA 0.02 0.64 0.57 NA NA XXX 73615 ......... ............ A Contrast x-ray of ankle .................................. 0.54 1.89 2.18 NA NA 0.15 2.58 2.87 NA NA XXX 73615 ......... 26 ....... A Contrast x-ray of ankle .................................. 0.54 0.17 0.18 0.17 0.18 0.03 0.74 0.75 0.74 0.75 XXX 73615 ......... TC ...... A Contrast x-ray of ankle .................................. 0.00 1.72 2.01 NA NA 0.12 1.84 2.13 NA NA XXX 73620 ......... ............ A X-ray exam of foot ......................................... 0.16 0.53 0.54 NA NA 0.03 0.72 0.73 NA NA XXX 73620 ......... 26 ....... A X-ray exam of foot ......................................... 0.16 0.04 0.05 0.04 0.05 0.01 0.21 0.22 0.21 0.22 XXX 73620 ......... TC ...... A X-ray exam of foot ......................................... 0.00 0.49 0.49 NA NA 0.02 0.51 0.51 NA NA XXX 73630 ......... ............ A X-ray exam of foot ......................................... 0.17 0.66 0.61 NA NA 0.03 0.86 0.81 NA NA XXX 73630 ......... 26 ....... A X-ray exam of foot ......................................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 73630 ......... TC ...... A X-ray exam of foot ......................................... 0.00 0.60 0.55 NA NA 0.02 0.62 0.57 NA NA XXX 73650 ......... ............ A X-ray exam of heel ........................................ 0.16 0.56 0.53 NA NA 0.03 0.75 0.72 NA NA XXX 73650 ......... 26 ....... A X-ray exam of heel ........................................ 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX 73650 ......... TC ...... A X-ray exam of heel ........................................ 0.00 0.51 0.48 NA NA 0.02 0.53 0.50 NA NA XXX73660 ......... ............ A X-ray exam of toe(s) ..................................... 0.13 0.64 0.51 NA NA 0.03 0.80 0.67 NA NA XXX 73660 ......... 26 ....... A X-ray exam of toe(s) ..................................... 0.13 0.04 0.04 0.04 0.04 0.01 0.18 0.18 0.18 0.18 XXX 73660 ......... TC ...... A X-ray exam of toe(s) ..................................... 0.00 0.60 0.47 NA NA 0.02 0.62 0.49 NA NA XXX 73700 ......... ............ A Ct lower extremity w/o dye ............................ 1.09 6.44 5.59 NA NA 0.30 7.83 6.98 NA NA XXX73700 ......... 26 ....... A Ct lower extremity w/o dye ............................ 1.09 0.35 0.36 0.35 0.36 0.05 1.49 1.50 1.49 1.50 XXX 73700 ......... TC ...... A Ct lower extremity w/o dye ............................ 0.00 6.09 5.24 NA NA 0.25 6.34 5.49 NA NA XXX 73701 ......... ............ A Ct lower extremity w/dye ............................... 1.16 7.95 6.71 NA NA 0.36 9.47 8.23 NA NA XXX 73701 ......... 26 ....... A Ct lower extremity w/dye ............................... 1.16 0.36 0.38 0.36 0.38 0.05 1.57 1.59 1.57 1.59 XXX 73701 ......... TC ...... A Ct lower extremity w/dye ............................... 0.00 7.59 6.33 NA NA 0.31 7.90 6.64 NA NA XXX 73702 ......... ............ A Ct lwr extremity w/o&w/dye ........................... 1.22 10.81 8.57 NA NA 0.44 12.47 10.23 NA NA XXX 73702 ......... 26 ....... A Ct lwr extremity w/o&w/dye ........................... 1.22 0.40 0.40 0.40 0.40 0.05 1.67 1.67 1.67 1.67 XXX 73702 ......... TC ...... A Ct lwr extremity w/o&w/dye ........................... 0.00 10.41 8.17 NA NA 0.39 10.80 8.56 NA NA XXX 73706 ......... ............ A Ct angio lwr extr w/o&w/dye ......................... 1.90 12.39 11.78 NA NA 0.47 14.76 14.15 NA NA XXX 73706 ......... 26 ....... A Ct angio lwr extr w/o&w/dye ......................... 1.90 0.66 0.63 0.66 0.63 0.08 2.64 2.61 2.64 2.61 XXX 73706 ......... TC ...... A Ct angio lwr extr w/o&w/dye ......................... 0.00 11.73 11.15 NA NA 0.39 12.12 11.54 NA NA XXX 73718 ......... ............ A Mri lower extremity w/o dye .......................... 1.35 14.74 12.42 NA NA 0.45 16.54 14.22 NA NA XXX 73718 ......... 26 ....... A Mri lower extremity w/o dye .......................... 1.35 0.46 0.45 0.46 0.45 0.06 1.87 1.86 1.87 1.86 XXX 73718 ......... TC ...... A Mri lower extremity w/o dye .......................... 0.00 14.28 11.97 NA NA 0.39 14.67 12.36 NA NA XXX 73719 ......... ............ A Mri lower extremity w/dye ............................. 1.62 15.59 14.38 NA NA 0.54 17.75 16.54 NA NA XXX 73719 ......... 26 ....... A Mri lower extremity w/dye ............................. 1.62 0.52 0.53 0.52 0.53 0.07 2.21 2.22 2.21 2.22 XXX 73719 ......... TC ...... A Mri lower extremity w/dye ............................. 0.00 15.07 13.85 NA NA 0.47 15.54 14.32 NA NA XXX73720 ......... ............ A Mri lwr extremity w/o&w/dye ......................... 2.15 19.28 24.01 NA NA 0.94 22.37 27.10 NA NA XXX 73720 ......... 26 ....... A Mri lwr extremity w/o&w/dye ......................... 2.15 0.69 0.70 0.69 0.70 0.10 2.94 2.95 2.94 2.95 XXX 73720 ......... TC ...... A Mri lwr extremity w/o&w/dye ......................... 0.00 18.59 23.31 NA NA 0.84 19.43 24.15 NA NA XXX 73721 ......... ............ A Mri jnt of lwr extre w/o dye ............................ 1.35 14.27 12.30 NA NA 0.45 16.07 14.10 NA NA XXX 73721 ......... 26 ....... A Mri jnt of lwr extre w/o dye ............................ 1.35 0.46 0.45 0.46 0.45 0.06 1.87 1.86 1.87 1.86 XXX 73721 ......... TC ...... A Mri jnt of lwr extre w/o dye ............................ 0.00 13.81 11.85 NA NA 0.39 14.20 12.24 NA NA XXX 73722 ......... ............ A Mri joint of lwr extr w/dye .............................. 1.62 14.86 14.19 NA NA 0.54 17.02 16.35 NA NA XXX 73722 ......... 26 ....... A Mri joint of lwr extr w/dye .............................. 1.62 0.54 0.53 0.54 0.53 0.07 2.23 2.22 2.23 2.22 XXX 73722 ......... TC ...... A Mri joint of lwr extr w/dye .............................. 0.00 14.32 13.66 NA NA 0.47 14.79 14.13 NA NA XXX 73723 ......... ............ A Mri joint lwr extr w/o&w/dye .......................... 2.15 17.91 23.67 NA NA 0.94 21.00 26.76 NA NA XXX 73723 ......... 26 ....... A Mri joint lwr extr w/o&w/dye .......................... 2.15 0.70 0.71 0.70 0.71 0.10 2.95 2.96 2.95 2.96 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49187 

73723 ......... TC ...... A Mri joint lwr extr w/o&w/dye .......................... 0.00 17.21 22.96 NA NA 0.84 18.05 23.80 NA NA XXX73725 ......... ............ R Mr ang lwr ext w or w/o dye ......................... 1.82 15.34 12.69 NA NA 0.67 17.83 15.18 NA NA XXX 73725 ......... 26 ....... R Mr ang lwr ext w or w/o dye ......................... 1.82 0.60 0.60 0.60 0.60 0.08 2.50 2.50 2.50 2.50 XXX 73725 ......... TC ...... R Mr ang lwr ext w or w/o dye ......................... 0.00 14.75 12.09 NA NA 0.59 15.34 12.68 NA NA XXX 74000 ......... ............ A X-ray exam of abdomen ................................ 0.18 0.46 0.55 NA NA 0.03 0.67 0.76 NA NA XXX 74000 ......... 26 ....... A X-ray exam of abdomen ................................ 0.18 0.05 0.06 0.05 0.06 0.01 0.24 0.25 0.24 0.25 XXX 74000 ......... TC ...... A X-ray exam of abdomen ................................ 0.00 0.40 0.49 NA NA 0.02 0.42 0.51 NA NA XXX 74010 ......... ............ A X-ray exam of abdomen ................................ 0.23 0.79 0.69 NA NA 0.05 1.07 0.97 NA NA XXX 74010 ......... 26 ....... A X-ray exam of abdomen ................................ 0.23 0.07 0.08 0.07 0.08 0.01 0.31 0.32 0.31 0.32 XXX 74010 ......... TC ...... A X-ray exam of abdomen ................................ 0.00 0.72 0.61 NA NA 0.04 0.76 0.65 NA NA XXX 74020 ......... ............ A X-ray exam of abdomen ................................ 0.27 0.80 0.73 NA NA 0.05 1.12 1.05 NA NA XXX 74020 ......... 26 ....... A X-ray exam of abdomen ................................ 0.27 0.08 0.09 0.08 0.09 0.01 0.36 0.37 0.36 0.37 XXX 74020 ......... TC ...... A X-ray exam of abdomen ................................ 0.00 0.71 0.64 NA NA 0.04 0.75 0.68 NA NA XXX 74022 ......... ............ A X-ray exam series, abdomen ........................ 0.32 0.97 0.87 NA NA 0.06 1.35 1.25 NA NA XXX 74022 ......... 26 ....... A X-ray exam series, abdomen ........................ 0.32 0.10 0.10 0.10 0.10 0.01 0.43 0.43 0.43 0.43 XXX 74022 ......... TC ...... A X-ray exam series, abdomen ........................ 0.00 0.87 0.77 NA NA 0.05 0.92 0.82 NA NA XXX 74150 ......... ............ A Ct abdomen w/o dye ..................................... 1.19 6.06 6.05 NA NA 0.35 7.60 7.59 NA NA XXX 74150 ......... 26 ....... A Ct abdomen w/o dye ..................................... 1.19 0.38 0.39 0.38 0.39 0.05 1.62 1.63 1.62 1.63 XXX 74150 ......... TC ...... A Ct abdomen w/o dye ..................................... 0.00 5.68 5.67 NA NA 0.30 5.98 5.97 NA NA XXX 74160 ......... ............ A Ct abdomen w/dye ........................................ 1.27 8.83 7.65 NA NA 0.42 10.52 9.34 NA NA XXX 74160 ......... 26 ....... A Ct abdomen w/dye ........................................ 1.27 0.40 0.42 0.40 0.42 0.06 1.73 1.75 1.73 1.75 XXX 74160 ......... TC ...... A Ct abdomen w/dye ........................................ 0.00 8.43 7.24 NA NA 0.36 8.79 7.60 NA NA XXX 74170 ......... ............ A Ct abdomen w/o & w/dye .............................. 1.40 12.27 9.77 NA NA 0.49 14.16 11.66 NA NA XXX 74170 ......... 26 ....... A Ct abdomen w/o & w/dye .............................. 1.40 0.45 0.46 0.45 0.46 0.06 1.91 1.92 1.91 1.92 XXX 74170 ......... TC ...... A Ct abdomen w/o & w/dye .............................. 0.00 11.82 9.32 NA NA 0.43 12.25 9.75 NA NA XXX 74175 ......... ............ A Ct angio abdom w/o & w/dye ........................ 1.90 12.34 12.57 NA NA 0.47 14.71 14.94 NA NA XXX74175 ......... 26 ....... A Ct angio abdom w/o & w/dye ........................ 1.90 0.63 0.62 0.63 0.62 0.08 2.61 2.60 2.61 2.60 XXX 74175 ......... TC ...... A Ct angio abdom w/o & w/dye ........................ 0.00 11.71 11.95 NA NA 0.39 12.10 12.34 NA NA XXX 74181 ......... ............ A Mri abdomen w/o dye .................................... 1.46 12.60 11.91 NA NA 0.51 14.57 13.88 NA NA XXX 74181 ......... 26 ....... A Mri abdomen w/o dye .................................... 1.46 0.47 0.48 0.47 0.48 0.06 1.99 2.00 1.99 2.00 XXX 74181 ......... TC ...... A Mri abdomen w/o dye .................................... 0.00 12.13 11.43 NA NA 0.45 12.58 11.88 NA NA XXX 74182 ......... ............ A Mri abdomen w/dye ....................................... 1.73 17.59 14.91 NA NA 0.60 19.92 17.24 NA NA XXX 74182 ......... 26 ....... A Mri abdomen w/dye ....................................... 1.73 0.55 0.57 0.55 0.57 0.08 2.36 2.38 2.36 2.38 XXX 74182 ......... TC ...... A Mri abdomen w/dye ....................................... 0.00 17.04 14.34 NA NA 0.52 17.56 14.86 NA NA XXX 74183 ......... ............ A Mri abdomen w/o & w/dye ............................ 2.26 19.27 24.03 NA NA 1.02 22.55 27.31 NA NA XXX 74183 ......... 26 ....... A Mri abdomen w/o & w/dye ............................ 2.26 0.73 0.74 0.73 0.74 0.10 3.09 3.10 3.09 3.10 XXX 74183 ......... TC ...... A Mri abdomen w/o & w/dye ............................ 0.00 18.54 23.30 NA NA 0.92 19.46 24.22 NA NA XXX 74185 ......... ............ R Mri angio, abdom w orw/o dye ...................... 1.80 15.31 12.67 NA NA 0.67 17.78 15.14 NA NA XXX74185 ......... 26 ....... R Mri angio, abdom w orw/o dye ...................... 1.80 0.59 0.59 0.59 0.59 0.08 2.47 2.47 2.47 2.47 XXX 74185 ......... TC ...... R Mri angio, abdom w orw/o dye ...................... 0.00 14.72 12.08 NA NA 0.59 15.31 12.67 NA NA XXX 74190 ......... ............ A X-ray exam of peritoneum ............................. 0.48 NA NA NA NA 0.09 NA NA NA NA XXX 74190 ......... 26 ....... A X-ray exam of peritoneum ............................. 0.48 0.15 0.16 0.15 0.16 0.02 0.65 0.66 0.65 0.66 XXX 74190 ......... TC ...... A X-ray exam of peritoneum ............................. 0.00 NA NA NA NA 0.07 NA NA NA NA XXX 74210 ......... ............ A Contrst x-ray exam of throat ......................... 0.36 1.76 1.42 NA NA 0.08 2.20 1.86 NA NA XXX 74210 ......... 26 ....... A Contrst x-ray exam of throat ......................... 0.36 0.11 0.12 0.11 0.12 0.02 0.49 0.50 0.49 0.50 XXX 74210 ......... TC ...... A Contrst x-ray exam of throat ......................... 0.00 1.65 1.31 NA NA 0.06 1.71 1.37 NA NA XXX 74220 ......... ............ A Contrast x-ray, esophagus ............................ 0.46 2.01 1.51 NA NA 0.08 2.55 2.05 NA NA XXX 74220 ......... 26 ....... A Contrast x-ray, esophagus ............................ 0.46 0.14 0.15 0.14 0.15 0.02 0.62 0.63 0.62 0.63 XXX 74220 ......... TC ...... A Contrast x-ray, esophagus ............................ 0.00 1.87 1.36 NA NA 0.06 1.93 1.42 NA NA XXX 74230 ......... ............ A Cine/vid x-ray, throat/esoph .......................... 0.53 1.93 1.59 NA NA 0.09 2.55 2.21 NA NA XXX74230 ......... 26 ....... A Cine/vid x-ray, throat/esoph .......................... 0.53 0.17 0.17 0.17 0.17 0.02 0.72 0.72 0.72 0.72 XXX 74230 ......... TC ...... A Cine/vid x-ray, throat/esoph .......................... 0.00 1.76 1.42 NA NA 0.07 1.83 1.49 NA NA XXX 74235 ......... ............ C Remove esophagus obstruction .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 74235 ......... 26 ....... A Remove esophagus obstruction .................... 1.19 0.40 0.39 0.40 0.39 0.05 1.64 1.63 1.64 1.63 XXX 74235 ......... TC ...... C Remove esophagus obstruction .................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 74240 ......... ............ A X-ray exam, upper gi tract ............................ 0.69 2.28 1.84 NA NA 0.11 3.08 2.64 NA NA XXX74240 ......... 26 ....... A X-ray exam, upper gi tract ............................ 0.69 0.22 0.23 0.22 0.23 0.03 0.94 0.95 0.94 0.95 XXX 74240 ......... TC ...... A X-ray exam, upper gi tract ............................ 0.00 2.07 1.61 NA NA 0.08 2.15 1.69 NA NA XXX 74241 ......... ............ A X-ray exam, upper gi tract ............................ 0.69 2.55 1.93 NA NA 0.11 3.35 2.73 NA NA XXX74241 ......... 26 ....... A X-ray exam, upper gi tract ............................ 0.69 0.21 0.23 0.21 0.23 0.03 0.93 0.95 0.93 0.95 XXX 74241 ......... TC ...... A X-ray exam, upper gi tract ............................ 0.00 2.34 1.70 NA NA 0.08 2.42 1.78 NA NA XXX 74245 ......... ............ A X-ray exam, upper gi tract ............................ 0.91 3.94 3.00 NA NA 0.17 5.02 4.08 NA NA XXX74245 ......... 26 ....... A X-ray exam, upper gi tract ............................ 0.91 0.29 0.30 0.29 0.30 0.04 1.24 1.25 1.24 1.25 XXX 74245 ......... TC ...... A X-ray exam, upper gi tract ............................ 0.00 3.65 2.70 NA NA 0.13 3.78 2.83 NA NA XXX 74246 ......... ............ A Contrst x-ray uppr gi tract ............................. 0.69 2.78 2.09 NA NA 0.13 3.60 2.91 NA NA XXX 74246 ......... 26 ....... A Contrst x-ray uppr gi tract ............................. 0.69 0.22 0.23 0.22 0.23 0.03 0.94 0.95 0.94 0.95 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49188 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

74246 ......... TC ...... A Contrst x-ray uppr gi tract ............................. 0.00 2.57 1.87 NA NA 0.10 2.67 1.97 NA NA XXX 74247 ......... ............ A Contrst x-ray uppr gi tract ............................. 0.69 3.21 2.23 NA NA 0.14 4.04 3.06 NA NA XXX 74247 ......... 26 ....... A Contrst x-ray uppr gi tract ............................. 0.69 0.22 0.23 0.22 0.23 0.03 0.94 0.95 0.94 0.95 XXX 74247 ......... TC ...... A Contrst x-ray uppr gi tract ............................. 0.00 2.99 2.01 NA NA 0.11 3.10 2.12 NA NA XXX 74249 ......... ............ A Contrst x-ray uppr gi tract ............................. 0.91 4.33 3.24 NA NA 0.18 5.42 4.33 NA NA XXX 74249 ......... 26 ....... A Contrst x-ray uppr gi tract ............................. 0.91 0.29 0.30 0.29 0.30 0.04 1.24 1.25 1.24 1.25 XXX 74249 ......... TC ...... A Contrst x-ray uppr gi tract ............................. 0.00 4.05 2.94 NA NA 0.14 4.19 3.08 NA NA XXX 74250 ......... ............ A X-ray exam of small bowel ............................ 0.47 2.48 1.72 NA NA 0.09 3.04 2.28 NA NA XXX 74250 ......... 26 ....... A X-ray exam of small bowel ............................ 0.47 0.15 0.15 0.15 0.15 0.02 0.64 0.64 0.64 0.64 XXX 74250 ......... TC ...... A X-ray exam of small bowel ............................ 0.00 2.33 1.57 NA NA 0.07 2.40 1.64 NA NA XXX 74251 ......... ............ A X-ray exam of small bowel ............................ 0.69 10.01 3.66 NA NA 0.10 10.80 4.45 NA NA XXX 74251 ......... 26 ....... A X-ray exam of small bowel ............................ 0.69 0.22 0.23 0.22 0.23 0.03 0.94 0.95 0.94 0.95 XXX 74251 ......... TC ...... A X-ray exam of small bowel ............................ 0.00 9.80 3.43 NA NA 0.07 9.87 3.50 NA NA XXX 74260 ......... ............ A X-ray exam of small bowel ............................ 0.50 8.32 3.32 NA NA 0.10 8.92 3.92 NA NA XXX 74260 ......... 26 ....... A X-ray exam of small bowel ............................ 0.50 0.15 0.16 0.15 0.16 0.02 0.67 0.68 0.67 0.68 XXX 74260 ......... TC ...... A X-ray exam of small bowel ............................ 0.00 8.17 3.16 NA NA 0.08 8.25 3.24 NA NA XXX 74270 ......... ............ A Contrast x-ray exam of colon ........................ 0.69 3.57 2.33 NA NA 0.14 4.40 3.16 NA NA XXX 74270 ......... 26 ....... A Contrast x-ray exam of colon ........................ 0.69 0.22 0.23 0.22 0.23 0.03 0.94 0.95 0.94 0.95 XXX 74270 ......... TC ...... A Contrast x-ray exam of colon ........................ 0.00 3.35 2.11 NA NA 0.11 3.46 2.22 NA NA XXX 74280 ......... ............ A Contrast x-ray exam of colon ........................ 0.99 4.94 3.15 NA NA 0.17 6.10 4.31 NA NA XXX 74280 ......... 26 ....... A Contrast x-ray exam of colon ........................ 0.99 0.31 0.32 0.31 0.32 0.04 1.34 1.35 1.34 1.35 XXX 74280 ......... TC ...... A Contrast x-ray exam of colon ........................ 0.00 4.63 2.83 NA NA 0.13 4.76 2.96 NA NA XXX 74283 ......... ............ A Contrast x-ray exam of colon ........................ 2.02 3.42 3.27 NA NA 0.23 5.67 5.52 NA NA XXX 74283 ......... 26 ....... A Contrast x-ray exam of colon ........................ 2.02 0.61 0.65 0.61 0.65 0.09 2.72 2.76 2.72 2.76 XXX 74283 ......... TC ...... A Contrast x-ray exam of colon ........................ 0.00 2.80 2.62 NA NA 0.14 2.94 2.76 NA NA XXX 74290 ......... ............ A Contrast x-ray, gallbladder ............................ 0.32 1.56 1.01 NA NA 0.06 1.94 1.39 NA NA XXX 74290 ......... 26 ....... A Contrast x-ray, gallbladder ............................ 0.32 0.10 0.10 0.10 0.10 0.01 0.43 0.43 0.43 0.43 XXX 74290 ......... TC ...... A Contrast x-ray, gallbladder ............................ 0.00 1.46 0.91 NA NA 0.05 1.51 0.96 NA NA XXX 74291 ......... ............ A Contrast x-rays, gallbladder .......................... 0.20 1.60 0.77 NA NA 0.03 1.83 1.00 NA NA XXX74291 ......... 26 ....... A Contrast x-rays, gallbladder .......................... 0.20 0.06 0.07 0.06 0.07 0.01 0.27 0.28 0.27 0.28 XXX 74291 ......... TC ...... A Contrast x-rays, gallbladder .......................... 0.00 1.54 0.70 NA NA 0.02 1.56 0.72 NA NA XXX 74300 ......... ............ C X-ray bile ducts/pancreas .............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 74300 ......... 26 ....... A X-ray bile ducts/pancreas .............................. 0.36 0.11 0.12 0.11 0.12 0.02 0.49 0.50 0.49 0.50 XXX 74300 ......... TC ...... C X-ray bile ducts/pancreas .............................. 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 ZZZ 74301 ......... 26 ....... A X-rays at surgery add-on .............................. 0.21 0.07 0.07 0.07 0.07 0.01 0.29 0.29 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 0.00 0.00 0.00 0.00 ZZZ 74305 ......... ............ A X-ray bile ducts/pancreas .............................. 0.42 NA NA NA NA 0.07 NA NA NA NA XXX 74305 ......... 26 ....... A X-ray bile ducts/pancreas .............................. 0.42 0.14 0.14 0.14 0.14 0.02 0.58 0.58 0.58 0.58 XXX 74305 ......... TC ...... A X-ray bile ducts/pancreas .............................. 0.00 NA NA NA NA 0.05 NA NA NA NA XXX 74320 ......... ............ A Contrast x-ray of bile ducts ........................... 0.54 2.13 3.03 NA NA 0.19 2.86 3.76 NA NA XXX 74320 ......... 26 ....... A Contrast x-ray of bile ducts ........................... 0.54 0.17 0.18 0.17 0.18 0.02 0.73 0.74 0.73 0.74 XXX 74320 ......... TC ...... A Contrast x-ray of bile ducts ........................... 0.00 1.95 2.85 NA NA 0.17 2.12 3.02 NA NA XXX 74327 ......... ............ A X-ray bile stone removal ............................... 0.70 2.99 2.24 NA NA 0.14 3.83 3.08 NA NA XXX 74327 ......... 26 ....... A X-ray bile stone removal ............................... 0.70 0.23 0.23 0.23 0.23 0.03 0.96 0.96 0.96 0.96 XXX 74327 ......... TC ...... A X-ray bile stone removal ............................... 0.00 2.76 2.01 NA NA 0.11 2.87 2.12 NA NA XXX 74328 ......... ............ A X-ray bile duct endoscopy ............................. 0.70 NA NA NA NA 0.20 NA NA NA NA XXX 74328 ......... 26 ....... A X-ray bile duct endoscopy ............................. 0.70 0.23 0.23 0.23 0.23 0.03 0.96 0.96 0.96 0.96 XXX 74328 ......... TC ...... A X-ray bile duct endoscopy ............................. 0.00 NA NA NA NA 0.17 NA NA NA NA XXX 74329 ......... ............ C X-ray for pancreas endoscopy ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 74329 ......... 26 ....... A X-ray for pancreas endoscopy ...................... 0.70 0.23 0.23 0.23 0.23 0.03 0.96 0.96 0.96 0.96 XXX 74329 ......... TC ...... C X-ray for pancreas endoscopy ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX74330 ......... ............ A X-ray bile/panc endoscopy ............................ 0.90 NA NA NA NA 0.21 NA NA NA NA XXX 74330 ......... 26 ....... A X-ray bile/panc endoscopy ............................ 0.90 0.30 0.29 0.30 0.29 0.04 1.24 1.23 1.24 1.23 XXX 74330 ......... TC ...... A X-ray bile/panc endoscopy ............................ 0.00 NA NA NA NA 0.17 NA NA NA NA XXX 74340 ......... ............ A X-ray guide for GI tube ................................. 0.54 NA NA NA NA 0.16 NA NA NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49189 

74340 ......... 26 ....... A X-ray guide for GI tube ................................. 0.54 0.17 0.18 0.17 0.18 0.02 0.73 0.74 0.73 0.74 XXX 74340 ......... TC ...... A X-ray guide for GI tube ................................. 0.00 NA NA NA NA 0.14 NA NA NA NA XXX 74350 ......... ............ A X-ray guide, stomach tube ............................ 0.76 2.22 3.11 NA NA 0.20 3.18 4.07 NA NA XXX 74350 ......... 26 ....... A X-ray guide, stomach tube ............................ 0.76 0.25 0.25 0.25 0.25 0.03 1.04 1.04 1.04 1.04 XXX 74350 ......... TC ...... A X-ray guide, stomach tube ............................ 0.00 1.97 2.86 NA NA 0.17 2.14 3.03 NA NA XXX 74355 ......... ............ A X-ray guide, intestinal tube ........................... 0.76 NA NA NA NA 0.17 NA NA NA NA XXX 74355 ......... 26 ....... A X-ray guide, intestinal tube ........................... 0.76 0.25 0.25 0.25 0.25 0.03 1.04 1.04 1.04 1.04 XXX 74355 ......... TC ...... A X-ray guide, intestinal tube ........................... 0.00 NA NA NA NA 0.14 NA NA NA NA XXX 74360 ......... ............ A X-ray guide, GI dilation ................................. 0.54 NA NA NA NA 0.19 NA NA NA NA XXX 74360 ......... 26 ....... A X-ray guide, GI dilation ................................. 0.54 0.24 0.20 0.24 0.20 0.02 0.80 0.76 0.80 0.76 XXX 74360 ......... TC ...... A X-ray guide, GI dilation ................................. 0.00 NA NA NA NA 0.17 NA NA NA NA XXX 74363 ......... ............ C X-ray, bile duct dilation .................................. 0.00 NA NA NA NA 0.00 NA NA NA NA XXX 74363 ......... 26 ....... A X-ray, bile duct dilation .................................. 0.88 0.29 0.29 0.29 0.29 0.04 1.21 1.21 1.21 1.21 XXX 74363 ......... TC ...... C X-ray, bile duct dilation .................................. 0.00 NA NA NA NA 0.00 NA NA NA NA XXX 74400 ......... ............ A Contrst x-ray, urinary tract ............................ 0.49 2.60 2.02 NA NA 0.13 3.22 2.64 NA NA XXX 74400 ......... 26 ....... A Contrst x-ray, urinary tract ............................ 0.49 0.16 0.16 0.16 0.16 0.02 0.67 0.67 0.67 0.67 XXX 74400 ......... TC ...... A Contrst x-ray, urinary tract ............................ 0.00 2.44 1.87 NA NA 0.11 2.55 1.98 NA NA XXX 74410 ......... ............ A Contrst x-ray, urinary tract ............................ 0.49 2.73 2.27 NA NA 0.13 3.35 2.89 NA NA XXX 74410 ......... 26 ....... A Contrst x-ray, urinary tract ............................ 0.49 0.17 0.16 0.17 0.16 0.02 0.68 0.67 0.68 0.67 XXX 74410 ......... TC ...... A Contrst x-ray, urinary tract ............................ 0.00 2.56 2.10 NA NA 0.11 2.67 2.21 NA NA XXX 74415 ......... ............ A Contrst x-ray, urinary tract ............................ 0.49 3.29 2.53 NA NA 0.14 3.92 3.16 NA NA XXX 74415 ......... 26 ....... A Contrst x-ray, urinary tract ............................ 0.49 0.16 0.16 0.16 0.16 0.02 0.67 0.67 0.67 0.67 XXX 74415 ......... TC ...... A Contrst x-ray, urinary tract ............................ 0.00 3.13 2.37 NA NA 0.12 3.25 2.49 NA NA XXX 74420 ......... ............ A Contrst x-ray, urinary tract ............................ 0.36 NA NA NA NA 0.16 NA NA NA NA XXX 74420 ......... 26 ....... A Contrst x-ray, urinary tract ............................ 0.36 0.13 0.12 0.13 0.12 0.02 0.51 0.50 0.51 0.50 XXX 74420 ......... TC ...... A Contrst x-ray, urinary tract ............................ 0.00 NA NA NA NA 0.14 NA NA NA NA XXX 74425 ......... ............ A Contrst x-ray, urinary tract ............................ 0.36 NA NA NA NA 0.09 NA NA NA NA XXX 74425 ......... 26 ....... A Contrst x-ray, urinary tract ............................ 0.36 0.12 0.12 0.12 0.12 0.02 0.50 0.50 0.50 0.50 XXX 74425 ......... TC ...... A Contrst x-ray, urinary tract ............................ 0.00 NA NA NA NA 0.07 NA NA NA NA XXX 74430 ......... ............ A Contrast x-ray, bladder .................................. 0.32 1.96 1.35 NA NA 0.08 2.36 1.75 NA NA XXX 74430 ......... 26 ....... A Contrast x-ray, bladder .................................. 0.32 0.11 0.10 0.11 0.10 0.02 0.45 0.44 0.45 0.44 XXX 74430 ......... TC ...... A Contrast x-ray, bladder .................................. 0.00 1.85 1.25 NA NA 0.06 1.91 1.31 NA NA XXX 74440 ......... ............ A X-ray, male genital tract ................................ 0.38 2.20 1.49 NA NA 0.08 2.66 1.95 NA NA XXX 74440 ......... 26 ....... A X-ray, male genital tract ................................ 0.38 0.15 0.13 0.15 0.13 0.02 0.55 0.53 0.55 0.53 XXX 74440 ......... TC ...... A X-ray, male genital tract ................................ 0.00 2.06 1.36 NA NA 0.06 2.12 1.42 NA NA XXX 74445 ......... ............ A X-ray exam of penis ...................................... 1.14 NA NA NA NA 0.13 NA NA NA NA XXX 74445 ......... 26 ....... A X-ray exam of penis ...................................... 1.14 0.44 0.39 0.44 0.39 0.07 1.65 1.60 1.65 1.60 XXX 74445 ......... TC ...... A X-ray exam of penis ...................................... 0.00 NA NA NA NA 0.06 NA NA NA NA XXX 74450 ......... ............ A X-ray, urethra/bladder ................................... 0.33 NA NA NA NA 0.10 NA NA NA NA XXX 74450 ......... 26 ....... A X-ray, urethra/bladder ................................... 0.33 0.11 0.11 0.11 0.11 0.02 0.46 0.46 0.46 0.46 XXX 74450 ......... TC ...... A X-ray, urethra/bladder ................................... 0.00 NA NA NA NA 0.08 NA NA NA NA XXX 74455 ......... ............ A X-ray, urethra/bladder ................................... 0.33 2.18 1.81 NA NA 0.12 2.63 2.26 NA NA XXX 74455 ......... 26 ....... A X-ray, urethra/bladder ................................... 0.33 0.12 0.11 0.12 0.11 0.02 0.47 0.46 0.47 0.46 XXX 74455 ......... TC ...... A X-ray, urethra/bladder ................................... 0.00 2.06 1.70 NA NA 0.10 2.16 1.80 NA NA XXX 74470 ......... ............ A X-ray exam of kidney lesion .......................... 0.54 NA NA NA NA 0.09 NA NA NA NA XXX 74470 ......... 26 ....... A X-ray exam of kidney lesion .......................... 0.54 0.16 0.18 0.16 0.18 0.02 0.72 0.74 0.72 0.74 XXX 74470 ......... TC ...... A X-ray exam of kidney lesion .......................... 0.00 NA NA NA NA 0.07 NA NA NA NA XXX 74475 ......... ............ A X-ray control, cath insert ............................... 0.54 2.12 3.72 NA NA 0.24 2.90 4.50 NA NA XXX 74475 ......... 26 ....... A X-ray control, cath insert ............................... 0.54 0.18 0.18 0.18 0.18 0.02 0.74 0.74 0.74 0.74 XXX 74475 ......... TC ...... A X-ray control, cath insert ............................... 0.00 1.94 3.54 NA NA 0.22 2.16 3.76 NA NA XXX 74480 ......... ............ A X-ray control, cath insert ............................... 0.54 2.13 3.72 NA NA 0.24 2.91 4.50 NA NA XXX 74480 ......... 26 ....... A X-ray control, cath insert ............................... 0.54 0.18 0.18 0.18 0.18 0.02 0.74 0.74 0.74 0.74 XXX 74480 ......... TC ...... A X-ray control, cath insert ............................... 0.00 1.95 3.54 NA NA 0.22 2.17 3.76 NA NA XXX 74485 ......... ............ A X-ray guide, GU dilation ................................ 0.54 2.29 3.06 NA NA 0.20 3.03 3.80 NA NA XXX 74485 ......... 26 ....... A X-ray guide, GU dilation ................................ 0.54 0.19 0.18 0.19 0.18 0.03 0.76 0.75 0.76 0.75 XXX 74485 ......... TC ...... A X-ray guide, GU dilation ................................ 0.00 2.10 2.89 NA NA 0.17 2.27 3.06 NA NA XXX 74710 ......... ............ A X-ray measurement of pelvis ........................ 0.34 0.64 1.03 NA NA 0.08 1.06 1.45 NA NA XXX 74710 ......... 26 ....... A X-ray measurement of pelvis ........................ 0.34 0.11 0.11 0.11 0.11 0.02 0.47 0.47 0.47 0.47 XXX 74710 ......... TC ...... A X-ray measurement of pelvis ........................ 0.00 0.53 0.92 NA NA 0.06 0.59 0.98 NA NA XXX 74740 ......... ............ A X-ray, female genital tract ............................. 0.38 1.77 1.52 NA NA 0.09 2.24 1.99 NA NA XXX 74740 ......... 26 ....... A X-ray, female genital tract ............................. 0.38 0.12 0.13 0.12 0.13 0.02 0.52 0.53 0.52 0.53 XXX 74740 ......... TC ...... A X-ray, female genital tract ............................. 0.00 1.65 1.40 NA NA 0.07 1.72 1.47 NA NA XXX 74742 ......... ............ C X-ray, fallopian tube ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 74742 ......... 26 ....... A X-ray, fallopian tube ...................................... 0.61 0.17 0.19 0.17 0.19 0.03 0.81 0.83 0.81 0.83 XXX 74742 ......... TC ...... C X-ray, fallopian tube ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 74775 ......... ............ A X-ray exam of perineum ................................ 0.62 NA NA NA NA 0.11 NA NA NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49190 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

74775 ......... 26 ....... A X-ray exam of perineum ................................ 0.62 0.19 0.21 0.19 0.21 0.03 0.84 0.86 0.84 0.86 XXX 74775 ......... TC ...... A X-ray exam of perineum ................................ 0.00 NA NA NA NA 0.08 NA NA NA NA XXX 75552 ......... ............ A Heart mri for morph w/o dye ......................... 1.60 19.30 13.62 NA NA 0.66 21.56 15.88 NA NA XXX 75552 ......... 26 ....... A Heart mri for morph w/o dye ......................... 1.60 0.57 0.54 0.57 0.54 0.07 2.24 2.21 2.24 2.21 XXX 75552 ......... TC ...... A Heart mri for morph w/o dye ......................... 0.00 18.73 13.08 NA NA 0.59 19.32 13.67 NA NA XXX 75553 ......... ............ A Heart mri for morph w/dye ............................ 2.00 24.28 14.96 NA NA 0.66 26.94 17.62 NA NA XXX 75553 ......... 26 ....... A Heart mri for morph w/dye ............................ 2.00 0.94 0.72 0.94 0.72 0.07 3.01 2.79 3.01 2.79 XXX 75553 ......... TC ...... A Heart mri for morph w/dye ............................ 0.00 23.34 14.24 NA NA 0.59 23.93 14.83 NA NA XXX 75554 ......... ............ A Cardiac MRI/function ..................................... 1.83 27.20 15.68 NA NA 0.66 29.69 18.17 NA NA XXX 75554 ......... 26 ....... A Cardiac MRI/function ..................................... 1.83 0.79 0.68 0.79 0.68 0.07 2.69 2.58 2.69 2.58 XXX 75554 ......... TC ...... A Cardiac MRI/function ..................................... 0.00 26.41 15.00 NA NA 0.59 27.00 15.59 NA NA XXX 75555 ......... ............ A Cardiac MRI/limited study ............................. 1.74 27.64 15.79 NA NA 0.66 30.04 18.19 NA NA XXX 75555 ......... 26 ....... A Cardiac MRI/limited study ............................. 1.74 0.84 0.69 0.84 0.69 0.07 2.65 2.50 2.65 2.50 XXX 75555 ......... TC ...... A Cardiac MRI/limited study ............................. 0.00 26.80 15.10 NA NA 0.59 27.39 15.69 NA NA XXX75600 ......... ............ A Contrast x-ray exam of aorta ........................ 0.49 6.49 11.22 NA NA 0.67 7.65 12.38 NA NA XXX75600 ......... 26 ....... A Contrast x-ray exam of aorta ........................ 0.49 0.25 0.21 0.25 0.21 0.02 0.76 0.72 0.76 0.72 XXX 75600 ......... TC ...... A Contrast x-ray exam of aorta ........................ 0.00 6.24 11.01 NA NA 0.65 6.89 11.66 NA NA XXX 75605 ......... ............ A Contrast x-ray exam of aorta ........................ 1.14 3.63 10.66 NA NA 0.70 5.47 12.50 NA NA XXX75605 ......... 26 ....... A Contrast x-ray exam of aorta ........................ 1.14 0.51 0.43 0.51 0.43 0.05 1.70 1.62 1.70 1.62 XXX 75605 ......... TC ...... A Contrast x-ray exam of aorta ........................ 0.00 3.13 10.23 NA NA 0.65 3.78 10.88 NA NA XXX 75625 ......... ............ A Contrast x-ray exam of aorta ........................ 1.14 3.38 10.58 NA NA 0.71 5.23 12.43 NA NA XXX75625 ......... 26 ....... A Contrast x-ray exam of aorta ........................ 1.14 0.42 0.39 0.42 0.39 0.06 1.62 1.59 1.62 1.59 XXX 75625 ......... TC ...... A Contrast x-ray exam of aorta ........................ 0.00 2.96 10.19 NA NA 0.65 3.61 10.84 NA NA XXX 75630 ......... ............ A X-ray aorta, leg arteries ................................ 1.79 3.80 11.26 NA NA 0.80 6.39 13.85 NA NA XXX 75630 ......... 26 ....... A X-ray aorta, leg arteries ................................ 1.79 0.72 0.64 0.72 0.64 0.11 2.62 2.54 2.62 2.54 XXX 75630 ......... TC ...... A X-ray aorta, leg arteries ................................ 0.00 3.08 10.62 NA NA 0.69 3.77 11.31 NA NA XXX 75635 ......... ............ A Ct angio abdominal arteries .......................... 2.40 12.87 15.74 NA NA 0.50 15.77 18.64 NA NA XXX 75635 ......... 26 ....... A Ct angio abdominal arteries .......................... 2.40 0.83 0.80 0.83 0.80 0.11 3.34 3.31 3.34 3.31 XXX 75635 ......... TC ...... A Ct angio abdominal arteries .......................... 0.00 12.04 14.94 NA NA 0.39 12.43 15.33 NA NA XXX 75650 ......... ............ A Artery x-rays, head & neck ........................... 1.49 3.53 10.70 NA NA 0.72 5.74 12.91 NA NA XXX 75650 ......... 26 ....... A Artery x-rays, head & neck ........................... 1.49 0.55 0.51 0.55 0.51 0.07 2.11 2.07 2.11 2.07 XXX 75650 ......... TC ...... A Artery x-rays, head & neck ........................... 0.00 2.97 10.19 NA NA 0.65 3.62 10.84 NA NA XXX 75658 ......... ............ A Artery x-rays, arm .......................................... 1.31 3.86 10.77 NA NA 0.72 5.89 12.80 NA NA XXX 75658 ......... 26 ....... A Artery x-rays, arm .......................................... 1.31 0.48 0.47 0.48 0.47 0.07 1.86 1.85 1.86 1.85 XXX 75658 ......... TC ...... A Artery x-rays, arm .......................................... 0.00 3.37 10.29 NA NA 0.65 4.02 10.94 NA NA XXX 75660 ......... ............ A Artery x-rays, head & neck ........................... 1.31 3.94 10.77 NA NA 0.71 5.96 12.79 NA NA XXX 75660 ......... 26 ....... A Artery x-rays, head & neck ........................... 1.31 0.49 0.45 0.49 0.45 0.06 1.86 1.82 1.86 1.82 XXX 75660 ......... TC ...... A Artery x-rays, head & neck ........................... 0.00 3.45 10.31 NA NA 0.65 4.10 10.96 NA NA XXX 75662 ......... ............ A Artery x-rays, head & neck ........................... 1.66 5.11 11.17 NA NA 0.71 7.48 13.54 NA NA XXX 75662 ......... 26 ....... A Artery x-rays, head & neck ........................... 1.66 0.72 0.62 0.72 0.62 0.06 2.44 2.34 2.44 2.34 XXX 75662 ......... TC ...... A Artery x-rays, head & neck ........................... 0.00 4.39 10.55 NA NA 0.65 5.04 11.20 NA NA XXX 75665 ......... ............ A Artery x-rays, head & neck ........................... 1.31 4.10 10.81 NA NA 0.74 6.15 12.86 NA NA XXX 75665 ......... 26 ....... A Artery x-rays, head & neck ........................... 1.31 0.46 0.45 0.46 0.45 0.09 1.86 1.85 1.86 1.85 XXX 75665 ......... TC ...... A Artery x-rays, head & neck ........................... 0.00 3.64 10.36 NA NA 0.65 4.29 11.01 NA NA XXX 75671 ......... ............ A Artery x-rays, head & neck ........................... 1.66 5.09 11.14 NA NA 0.72 7.47 13.52 NA NA XXX 75671 ......... 26 ....... A Artery x-rays, head & neck ........................... 1.66 0.61 0.57 0.61 0.57 0.07 2.34 2.30 2.34 2.30 XXX 75671 ......... TC ...... A Artery x-rays, head & neck ........................... 0.00 4.48 10.57 NA NA 0.65 5.13 11.22 NA NA XXX 75676 ......... ............ A Artery x-rays, neck ........................................ 1.31 3.86 10.75 NA NA 0.72 5.89 12.78 NA NA XXX 75676 ......... 26 ....... A Artery x–rays, neck ....................................... 1.31 0.47 0.45 0.47 0.45 0.07 1.85 1.83 1.85 1.83 XXX 75676 ......... TC ...... A Artery x-rays, neck ........................................ 0.00 3.40 10.30 NA NA 0.65 4.05 10.95 NA NA XXX 75680 ......... ............ A Artery x-rays, neck ........................................ 1.66 4.61 11.02 NA NA 0.72 6.99 13.40 NA NA XXX 75680 ......... 26 ....... A Artery x-rays, neck ........................................ 1.66 0.64 0.57 0.64 0.57 0.07 2.37 2.30 2.37 2.30 XXX 75680 ......... TC ...... A Artery x-rays, neck ........................................ 0.00 3.98 10.45 NA NA 0.65 4.63 11.10 NA NA XXX 75685 ......... ............ A Artery x-rays, spine ....................................... 1.31 3.90 10.75 NA NA 0.71 5.92 12.77 NA NA XXX 75685 ......... 26 ....... A Artery x-rays, spine ....................................... 1.31 0.49 0.45 0.49 0.45 0.06 1.86 1.82 1.86 1.82 XXX 75685 ......... TC ...... A Artery x-rays, spine ....................................... 0.00 3.41 10.30 NA NA 0.65 4.06 10.95 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49191 

75705 ......... ............ A Artery x-rays, spine ....................................... 2.18 4.07 11.02 NA NA 0.78 7.03 13.98 NA NA XXX 75705 ......... 26 ....... A Artery x-rays, spine ....................................... 2.18 0.72 0.73 0.72 0.73 0.13 3.03 3.04 3.03 3.04 XXX 75705 ......... TC ...... A Artery x-rays, spine ....................................... 0.00 3.35 10.29 NA NA 0.65 4.00 10.94 NA NA XXX 75710 ......... ............ A Artery x-rays, arm/leg .................................... 1.14 3.99 10.74 NA NA 0.72 5.85 12.60 NA NA XXX 75710 ......... 26 ....... A Artery x-rays, arm/leg .................................... 1.14 0.42 0.40 0.42 0.40 0.07 1.63 1.61 1.63 1.61 XXX 75710 ......... TC ...... A Artery x-rays, arm/leg .................................... 0.00 3.57 10.34 NA NA 0.65 4.22 10.99 NA NA XXX 75716 ......... ............ A Artery x-rays, arms/legs ................................ 1.31 4.94 11.01 NA NA 0.72 6.97 13.04 NA NA XXX 75716 ......... 26 ....... A Artery x-rays, arms/legs ................................ 1.31 0.49 0.45 0.49 0.45 0.07 1.87 1.83 1.87 1.83 XXX 75716 ......... TC ...... A Artery x-rays, arms/legs ................................ 0.00 4.45 10.56 NA NA 0.65 5.10 11.21 NA NA XXX75722 ......... ............ A Artery x-rays, kidney ..................................... 1.14 3.89 10.72 NA NA 0.70 5.73 12.56 NA NA XXX 75722 ......... 26 ....... A Artery x-rays, kidney ..................................... 1.14 0.47 0.42 0.47 0.42 0.05 1.66 1.61 1.66 1.61 XXX 75722 ......... TC ...... A Artery x-rays, kidney ..................................... 0.00 3.42 10.31 NA NA 0.65 4.07 10.96 NA NA XXX 75724 ......... ............ A Artery x-rays, kidneys .................................... 1.49 5.20 11.17 NA NA 0.70 7.39 13.36 NA NA XXX 75724 ......... 26 ....... A Artery x-rays, kidneys .................................... 1.49 0.75 0.61 0.75 0.61 0.05 2.29 2.15 2.29 2.15 XXX 75724 ......... TC ...... A Artery x-rays, kidneys .................................... 0.00 4.44 10.56 NA NA 0.65 5.09 11.21 NA NA XXX 75726 ......... ............ A Artery x-rays, abdomen ................................. 1.14 3.73 10.66 NA NA 0.70 5.57 12.50 NA NA XXX 75726 ......... 26 ....... A Artery x-rays, abdomen ................................. 1.14 0.38 0.37 0.38 0.37 0.05 1.57 1.56 1.57 1.56 XXX 75726 ......... TC ...... A Artery x-rays, abdomen ................................. 0.00 3.35 10.29 NA NA 0.65 4.00 10.94 NA NA XXX 75731 ......... ............ A Artery x-rays, adrenal gland .......................... 1.14 3.90 10.70 NA NA 0.71 5.75 12.55 NA NA XXX 75731 ......... 26 ....... A Artery x-rays, adrenal gland .......................... 1.14 0.42 0.38 0.42 0.38 0.06 1.62 1.58 1.62 1.58 XXX 75731 ......... TC ...... A Artery x-rays, adrenal gland .......................... 0.00 3.48 10.32 NA NA 0.65 4.13 10.97 NA NA XXX 75733 ......... ............ A Artery x-rays, adrenals .................................. 1.31 5.27 11.10 NA NA 0.71 7.29 13.12 NA NA XXX 75733 ......... 26 ....... A Artery x-rays, adrenals .................................. 1.31 0.59 0.48 0.59 0.48 0.06 1.96 1.85 1.96 1.85 XXX 75733 ......... TC ...... A Artery x-rays, adrenals .................................. 0.00 4.68 10.62 NA NA 0.65 5.33 11.27 NA NA XXX 75736 ......... ............ A Artery x-rays, pelvis ....................................... 1.14 3.87 10.70 NA NA 0.71 5.72 12.55 NA NA XXX 75736 ......... 26 ....... A Artery x-rays, pelvis ....................................... 1.14 0.41 0.39 0.41 0.39 0.06 1.61 1.59 1.61 1.59 XXX 75736 ......... TC ...... A Artery x-rays, pelvis ....................................... 0.00 3.46 10.32 NA NA 0.65 4.11 10.97 NA NA XXX 75741 ......... ............ A Artery x-rays, lung ......................................... 1.31 3.14 10.56 NA NA 0.71 5.16 12.58 NA NA XXX 75741 ......... 26 ....... A Artery x-rays, lung ......................................... 1.31 0.45 0.44 0.45 0.44 0.06 1.82 1.81 1.82 1.81 XXX 75741 ......... TC ...... A Artery x-rays, lung ......................................... 0.00 2.70 10.13 NA NA 0.65 3.35 10.78 NA NA XXX 75743 ......... ............ A Artery x-rays, lungs ....................................... 1.66 3.53 10.74 NA NA 0.72 5.91 13.12 NA NA XXX 75743 ......... 26 ....... A Artery x-rays, lungs ....................................... 1.66 0.57 0.55 0.57 0.55 0.07 2.30 2.28 2.30 2.28 XXX 75743 ......... TC ...... A Artery x-rays, lungs ....................................... 0.00 2.96 10.19 NA NA 0.65 3.61 10.84 NA NA XXX 75746 ......... ............ A Artery x-rays, lung ......................................... 1.14 3.46 10.60 NA NA 0.70 5.30 12.44 NA NA XXX 75746 ......... 26 ....... A Artery x-rays, lung ......................................... 1.14 0.36 0.38 0.36 0.38 0.05 1.55 1.57 1.55 1.57 XXX 75746 ......... TC ...... A Artery x-rays, lung ......................................... 0.00 3.10 10.23 NA NA 0.65 3.75 10.88 NA NA XXX 75756 ......... ............ A Artery x-rays, chest ....................................... 1.14 4.45 10.90 NA NA 0.69 6.28 12.73 NA NA XXX 75756 ......... 26 ....... A Artery x-rays, chest ....................................... 1.14 0.60 0.49 0.60 0.49 0.04 1.78 1.67 1.78 1.67 XXX 75756 ......... TC ...... A Artery x-rays, chest ....................................... 0.00 3.84 10.41 NA NA 0.65 4.49 11.06 NA NA XXX 75774 ......... ............ A Artery x-ray, each vessel .............................. 0.36 2.53 10.17 2.53 10.17 0.67 3.56 11.20 3.56 11.20 ZZZ 75774 ......... 26 ....... A Artery x-ray, each vessel .............................. 0.36 0.13 0.12 0.13 0.12 0.02 0.51 0.50 0.51 0.50 ZZZ 75774 ......... TC ...... A Artery x-ray, each vessel .............................. 0.00 2.40 10.05 2.40 10.05 0.65 3.05 10.70 3.05 10.70 ZZZ 75790 ......... ............ A Visualize A-V shunt ....................................... 1.84 3.11 2.23 NA NA 0.17 5.12 4.24 NA NA XXX 75790 ......... 26 ....... A Visualize A-V shunt ....................................... 1.84 0.57 0.59 0.57 0.59 0.09 2.50 2.52 2.50 2.52 XXX 75790 ......... TC ...... A Visualize A-V shunt ....................................... 0.00 2.54 1.65 NA NA 0.08 2.62 1.73 NA NA XXX75801 ......... ............ A Lymph vessel x-ray, arm/leg ......................... 0.81 NA NA NA NA 0.37 NA NA NA NA XXX 75801 ......... 26 ....... A Lymph vessel x-ray, arm/leg ......................... 0.81 0.22 0.26 0.22 0.26 0.08 1.11 1.15 1.11 1.15 XXX 75801 ......... TC ...... A Lymph vessel x-ray, arm/leg ......................... 0.00 NA NA NA NA 0.29 NA NA NA NA XXX 75803 ......... ............ A Lymph vessel x-ray,arms/legs ....................... 1.17 NA NA NA NA 0.34 NA NA NA NA XXX 75803 ......... 26 ....... A Lymph vessel x-ray,arms/legs ....................... 1.17 0.35 0.37 0.35 0.37 0.05 1.57 1.59 1.57 1.59 XXX 75803 ......... TC ...... A Lymph vessel x-ray,arms/legs ....................... 0.00 NA NA NA NA 0.29 NA NA NA NA XXX 75805 ......... ............ A Lymph vessel x-ray, trunk ............................. 0.81 NA NA NA NA 0.38 NA NA NA NA XXX 75805 ......... 26 ....... A Lymph vessel x-ray, trunk ............................. 0.81 0.23 0.26 0.23 0.26 0.05 1.09 1.12 1.09 1.12 XXX 75805 ......... TC ...... A Lymph vessel x-ray, trunk ............................. 0.00 NA NA NA NA 0.33 NA NA NA NA XXX 75807 ......... ............ C Lymph vessel x-ray, trunk ............................. 0.00 NA NA NA NA 0.00 NA NA NA NA XXX 75807 ......... 26 ....... A Lymph vessel x-ray, trunk ............................. 1.17 0.37 0.38 0.37 0.38 0.05 1.59 1.60 1.59 1.60 XXX 75807 ......... TC ...... C Lymph vessel x-ray, trunk ............................. 0.00 NA NA NA NA 0.00 NA NA NA NA XXX 75809 ......... ............ A Nonvascular shunt, x-ray .............................. 0.47 2.18 1.24 NA NA 0.07 2.72 1.78 NA NA XXX75809 ......... 26 ....... A Nonvascular shunt, x-ray .............................. 0.47 0.15 0.15 0.15 0.15 0.02 0.64 0.64 0.64 0.64 XXX 75809 ......... TC ...... A Nonvascular shunt, x-ray .............................. 0.00 2.03 1.09 NA NA 0.05 2.08 1.14 NA NA XXX 75810 ......... ............ A Vein x-ray, spleen/liver .................................. 1.14 NA NA NA NA 0.70 NA NA NA NA XXX 75810 ......... 26 ....... A Vein x-ray, spleen/liver .................................. 1.14 0.39 0.38 0.39 0.38 0.05 1.58 1.57 1.58 1.57 XXX 75810 ......... TC ...... A Vein x-ray, spleen/liver .................................. 0.00 NA NA NA NA 0.65 NA NA NA NA XXX 75820 ......... ............ A Vein x-ray, arm/leg ........................................ 0.70 3.02 1.64 NA NA 0.09 3.81 2.43 NA NA XXX 75820 ......... 26 ....... A Vein x-ray, arm/leg ........................................ 0.70 0.28 0.24 0.28 0.24 0.03 1.01 0.97 1.01 0.97 XXX 75820 ......... TC ...... A Vein x-ray, arm/leg ........................................ 0.00 2.74 1.40 NA NA 0.06 2.80 1.46 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49192 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

75822 ......... ............ A Vein x-ray, arms/legs .................................... 1.06 3.18 2.16 NA NA 0.13 4.37 3.35 NA NA XXX 75822 ......... 26 ....... A Vein x-ray, arms/legs .................................... 1.06 0.35 0.35 0.35 0.35 0.05 1.46 1.46 1.46 1.46 XXX 75822 ......... TC ...... A Vein x-ray, arms/legs .................................... 0.00 2.83 1.82 NA NA 0.08 2.91 1.90 NA NA XXX 75825 ......... ............ A Vein x-ray, trunk ............................................ 1.14 2.93 10.46 NA NA 0.72 4.79 12.32 NA NA XXX 75825 ......... 26 ....... A Vein x-ray, trunk ............................................ 1.14 0.36 0.37 0.36 0.37 0.07 1.57 1.58 1.57 1.58 XXX 75825 ......... TC ...... A Vein x-ray, trunk ............................................ 0.00 2.57 10.09 NA NA 0.65 3.22 10.74 NA NA XXX 75827 ......... ............ A Vein x-ray, chest ........................................... 1.14 2.98 10.47 NA NA 0.70 4.82 12.31 NA NA XXX 75827 ......... 26 ....... A Vein x-ray, chest ........................................... 1.14 0.36 0.37 0.36 0.37 0.05 1.55 1.56 1.55 1.56 XXX 75827 ......... TC ...... A Vein x-ray, chest ........................................... 0.00 2.61 10.10 NA NA 0.65 3.26 10.75 NA NA XXX 75831 ......... ............ A Vein x-ray, kidney .......................................... 1.14 3.05 10.49 NA NA 0.71 4.90 12.34 NA NA XXX 75831 ......... 26 ....... A Vein x-ray, kidney .......................................... 1.14 0.36 0.37 0.36 0.37 0.06 1.56 1.57 1.56 1.57 XXX 75831 ......... TC ...... A Vein x-ray, kidney .......................................... 0.00 2.69 10.12 NA NA 0.65 3.34 10.77 NA NA XXX 75833 ......... ............ A Vein x-ray, kidneys ........................................ 1.49 3.71 10.75 NA NA 0.74 5.94 12.98 NA NA XXX 75833 ......... 26 ....... A Vein x-ray, kidneys ........................................ 1.49 0.48 0.49 0.48 0.49 0.09 2.06 2.07 2.06 2.07 XXX 75833 ......... TC ...... A Vein x-ray, kidneys ........................................ 0.00 3.23 10.26 NA NA 0.65 3.88 10.91 NA NA XXX 75840 ......... ............ A Vein x-ray, adrenal gland .............................. 1.14 3.29 10.56 NA NA 0.72 5.15 12.42 NA NA XXX 75840 ......... 26 ....... A Vein x-ray, adrenal gland .............................. 1.14 0.45 0.40 0.45 0.40 0.07 1.66 1.61 1.66 1.61 XXX 75840 ......... TC ...... A Vein x-ray, adrenal gland .............................. 0.00 2.84 10.16 NA NA 0.65 3.49 10.81 NA NA XXX 75842 ......... ............ A Vein x-ray, adrenal glands ............................ 1.49 3.68 10.73 NA NA 0.72 5.89 12.94 NA NA XXX 75842 ......... 26 ....... A Vein x-ray, adrenal glands ............................ 1.49 0.49 0.48 0.49 0.48 0.07 2.05 2.04 2.05 2.04 XXX 75842 ......... TC ...... A Vein x-ray, adrenal glands ............................ 0.00 3.19 10.25 NA NA 0.65 3.84 10.90 NA NA XXX 75860 ......... ............ A Vein x-ray, neck ............................................ 1.14 3.45 10.61 NA NA 0.69 5.28 12.44 NA NA XXX 75860 ......... 26 ....... A Vein x-ray, neck ............................................ 1.14 0.50 0.42 0.50 0.42 0.04 1.68 1.60 1.68 1.60 XXX 75860 ......... TC ...... A Vein x-ray, neck ............................................ 0.00 2.96 10.19 NA NA 0.65 3.61 10.84 NA NA XXX 75870 ......... ............ A Vein x-ray, skull ............................................. 1.14 3.23 10.55 NA NA 0.70 5.07 12.39 NA NA XXX 75870 ......... 26 ....... A Vein x-ray, skull ............................................. 1.14 0.39 0.39 0.39 0.39 0.05 1.58 1.58 1.58 1.58 XXX 75870 ......... TC ...... A Vein x-ray, skull ............................................. 0.00 2.84 10.16 NA NA 0.65 3.49 10.81 NA NA XXX 75872 ......... ............ A Vein x-ray, skull ............................................. 1.14 3.91 10.71 NA NA 0.79 5.84 12.64 NA NA XXX 75872 ......... 26 ....... A Vein x-ray, skull ............................................. 1.14 0.42 0.38 0.42 0.38 0.14 1.70 1.66 1.70 1.66 XXX 75872 ......... TC ...... A Vein x-ray, skull ............................................. 0.00 3.48 10.32 NA NA 0.65 4.13 10.97 NA NA XXX 75880 ......... ............ A Vein x-ray, eye socket ................................... 0.70 2.99 1.63 NA NA 0.09 3.78 2.42 NA NA XXX 75880 ......... 26 ....... A Vein x-ray, eye socket ................................... 0.70 0.23 0.23 0.23 0.23 0.03 0.96 0.96 0.96 0.96 XXX 75880 ......... TC ...... A Vein x-ray, eye socket ................................... 0.00 2.76 1.40 NA NA 0.06 2.82 1.46 NA NA XXX 75885 ......... ............ A Vein x-ray, liver ............................................. 1.44 3.17 10.60 NA NA 0.71 5.32 12.75 NA NA XXX 75885 ......... 26 ....... A Vein x-ray, liver ............................................. 1.44 0.47 0.47 0.47 0.47 0.06 1.97 1.97 1.97 1.97 XXX 75885 ......... TC ...... A Vein x-ray, liver ............................................. 0.00 2.70 10.13 NA NA 0.65 3.35 10.78 NA NA XXX 75887 ......... ............ A Vein x-ray, liver ............................................. 1.44 3.35 10.64 NA NA 0.71 5.50 12.79 NA NA XXX 75887 ......... 26 ....... A Vein x-ray, liver ............................................. 1.44 0.51 0.48 0.51 0.48 0.06 2.01 1.98 2.01 1.98 XXX 75887 ......... TC ...... A Vein x-ray, liver ............................................. 0.00 2.84 10.16 NA NA 0.65 3.49 10.81 NA NA XXX 75889 ......... ............ A Vein x-ray, liver ............................................. 1.14 3.07 10.50 NA NA 0.70 4.91 12.34 NA NA XXX 75889 ......... 26 ....... A Vein x-ray, liver ............................................. 1.14 0.38 0.37 0.38 0.37 0.05 1.57 1.56 1.57 1.56 XXX 75889 ......... TC ...... A Vein x-ray, liver ............................................. 0.00 2.70 10.13 NA NA 0.65 3.35 10.78 NA NA XXX 75891 ......... ............ A Vein x-ray, liver ............................................. 1.14 3.05 10.49 NA NA 0.70 4.89 12.33 NA NA XXX 75891 ......... 26 ....... A Vein x-ray, liver ............................................. 1.14 0.37 0.37 0.37 0.37 0.05 1.56 1.56 1.56 1.56 XXX 75891 ......... TC ...... A Vein x-ray, liver ............................................. 0.00 2.68 10.12 NA NA 0.65 3.33 10.77 NA NA XXX 75893 ......... ............ A Venous sampling by catheter ........................ 0.54 2.87 10.30 NA NA 0.67 4.08 11.51 NA NA XXX 75893 ......... 26 ....... A Venous sampling by catheter ........................ 0.54 0.18 0.18 0.18 0.18 0.02 0.74 0.74 0.74 0.74 XXX 75893 ......... TC ...... A Venous sampling by catheter ........................ 0.00 2.69 10.12 NA NA 0.65 3.34 10.77 NA NA XXX 75894 ......... ............ A X-rays, transcath therapy .............................. 1.31 NA NA NA NA 1.35 NA NA NA NA XXX 75894 ......... 26 ....... A X-rays, transcath therapy .............................. 1.31 0.42 0.43 0.42 0.43 0.08 1.81 1.82 1.81 1.82 XXX 75894 ......... TC ...... A X-rays, transcath therapy .............................. 0.00 NA NA NA NA 1.27 NA NA NA NA XXX 75896 ......... ............ A X-rays, transcath therapy .............................. 1.31 NA NA NA NA 1.15 NA NA NA NA XXX 75896 ......... 26 ....... A X-rays, transcath therapy .............................. 1.31 0.51 0.47 0.51 0.47 0.05 1.87 1.83 1.87 1.83 XXX 75896 ......... TC ...... A X-rays, transcath therapy .............................. 0.00 NA NA NA NA 1.10 NA NA NA NA XXX 75898 ......... ............ A Follow-up angiography .................................. 1.65 NA NA NA NA 0.13 NA NA NA NA XXX 75898 ......... 26 ....... A Follow-up angiography .................................. 1.65 0.60 0.56 0.60 0.56 0.07 2.32 2.28 2.32 2.28 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49193 

75898 ......... TC ...... A Follow-up angiography .................................. 0.00 NA NA NA NA 0.06 NA NA NA NA XXX 75900 ......... ............ C Intravascular cath exchange ......................... 0.00 NA NA NA NA 0.00 NA NA NA NA XXX 75900 ......... 26 ....... A Intravascular cath exchange ......................... 0.49 0.16 0.16 0.16 0.16 0.03 0.68 0.68 0.68 0.68 XXX 75900 ......... TC ...... C Intravascular cath exchange ......................... 0.00 NA NA NA NA 0.00 NA NA NA NA XXX 75901 ......... ............ A Remove cva device obstruct ......................... 0.49 4.20 2.15 NA NA 0.85 5.54 3.49 NA NA XXX 75901 ......... 26 ....... A Remove cva device obstruct ......................... 0.49 0.16 0.16 0.16 0.16 0.02 0.67 0.67 0.67 0.67 XXX 75901 ......... TC ...... A Remove cva device obstruct ......................... 0.00 4.04 1.99 NA NA 0.83 4.87 2.82 NA NA XXX 75902 ......... ............ A Remove cva lumen obstruct ......................... 0.39 1.64 1.49 NA NA 0.85 2.88 2.73 NA NA XXX 75902 ......... 26 ....... A Remove cva lumen obstruct ......................... 0.39 0.13 0.13 0.13 0.13 0.02 0.54 0.54 0.54 0.54 XXX 75902 ......... TC ...... A Remove cva lumen obstruct ......................... 0.00 1.52 1.36 NA NA 0.83 2.35 2.19 NA NA XXX 75940 ......... ............ A X-ray placement, vein filter ........................... 0.54 NA NA NA NA 0.69 NA NA NA NA XXX 75940 ......... 26 ....... A X-ray placement, vein filter ........................... 0.54 0.17 0.18 0.17 0.18 0.04 0.75 0.76 0.75 0.76 XXX 75940 ......... TC ...... A X-ray placement, vein filter ........................... 0.00 NA NA NA NA 0.65 NA NA NA NA XXX 75945 ......... ............ A Intravascular us ............................................. 0.40 NA NA NA NA 0.28 NA NA NA NA XXX 75945 ......... 26 ....... A Intravascular us ............................................. 0.40 0.15 0.14 0.15 0.14 0.04 0.59 0.58 0.59 0.58 XXX 75945 ......... TC ...... A Intravascular us ............................................. 0.00 NA NA NA NA 0.24 NA NA NA NA XXX 75946 ......... ............ C Intravascular us add-on ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 75946 ......... 26 ....... A Intravascular us add-on ................................. 0.40 0.13 0.14 0.13 0.14 0.05 0.58 0.59 0.58 0.59 ZZZ 75946 ......... TC ...... C Intravascular us add-on ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 75952 ......... ............ C Endovasc repair abdom aorta ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75952 ......... 26 ....... A Endovasc repair abdom aorta ....................... 4.49 1.31 1.45 1.31 1.45 0.43 6.23 6.37 6.23 6.37 XXX 75952 ......... TC ...... C Endovasc repair abdom aorta ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX75953 ......... ............ C Abdom aneurysm endovas rpr ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75953 ......... 26 ....... A Abdom aneurysm endovas rpr ...................... 1.36 0.40 0.44 0.40 0.44 0.13 1.89 1.93 1.89 1.93 XXX 75953 ......... TC ...... C Abdom aneurysm endovas rpr ...................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 75954 ......... 26 ....... A Iliac aneurysm endovas rpr ........................... 2.25 0.66 0.75 0.66 0.75 0.15 3.06 3.15 3.06 3.15 XXX 75954 ......... TC ...... C Iliac aneurysm endovas rpr ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75956 ......... ............ C Xray, endovasc thor ao repr ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75956 ......... 26 ....... A Xray, endovasc thor ao repr ......................... 7.00 1.63 2.43 1.63 2.43 0.69 9.32 10.12 9.32 10.12 XXX 75956 ......... TC ...... C Xray, endovasc thor ao repr ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75957 ......... ............ C Xray, endovasc thor ao repr ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75957 ......... 26 ....... A Xray, endovasc thor ao repr ......................... 6.00 1.40 2.08 1.40 2.08 0.59 7.99 8.67 7.99 8.67 XXX 75957 ......... TC ...... C Xray, endovasc thor ao repr ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75958 ......... ............ C Xray, place prox ext thor ao .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75958 ......... 26 ....... A Xray, place prox ext thor ao .......................... 4.00 0.93 1.40 0.93 1.40 0.39 5.32 5.79 5.32 5.79 XXX 75958 ......... TC ...... C Xray, place prox ext thor ao .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75959 ......... ............ C Xray, place dist ext thor ao ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75959 ......... 26 ....... A Xray, place dist ext thor ao ........................... 3.50 0.82 1.23 0.82 1.23 0.34 4.66 5.07 4.66 5.07 XXX 75959 ......... TC ...... C Xray, place dist ext thor ao ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 75960 ......... ............ A Transcath iv stent rs&i .................................. 0.82 NA NA NA NA 0.82 NA NA NA NA XXX 75960 ......... 26 ....... A Transcath iv stent rs&i .................................. 0.82 0.32 0.29 0.32 0.29 0.05 1.19 1.16 1.19 1.16 XXX 75960 ......... TC ...... A Transcath iv stent rs&i .................................. 0.00 NA NA NA NA 0.77 NA NA NA NA XXX 75961 ......... ............ A Retrieval, broken catheter ............................. 4.24 4.59 10.07 NA NA 0.73 9.56 15.04 NA NA XXX 75961 ......... 26 ....... A Retrieval, broken catheter ............................. 4.24 1.38 1.39 1.38 1.39 0.18 5.80 5.81 5.80 5.81 XXX 75961 ......... TC ...... A Retrieval, broken catheter ............................. 0.00 3.20 8.68 NA NA 0.55 3.75 9.23 NA NA XXX 75962 ......... ............ A Repair arterial blockage ................................ 0.54 3.54 12.83 NA NA 0.86 4.94 14.23 NA NA XXX 75962 ......... 26 ....... A Repair arterial blockage ................................ 0.54 0.20 0.19 0.20 0.19 0.03 0.77 0.76 0.77 0.76 XXX 75962 ......... TC ...... A Repair arterial blockage ................................ 0.00 3.34 12.64 NA NA 0.83 4.17 13.47 NA NA XXX75964 ......... ............ A Repair artery blockage, each ........................ 0.36 2.38 6.98 2.38 6.98 0.46 3.20 7.80 3.20 7.80 ZZZ 75964 ......... 26 ....... A Repair artery blockage, each ........................ 0.36 0.13 0.12 0.13 0.12 0.03 0.52 0.51 0.52 0.51 ZZZ 75964 ......... TC ...... A Repair artery blockage, each ........................ 0.00 2.26 6.86 2.26 6.86 0.43 2.69 7.29 2.69 7.29 ZZZ 75966 ......... ............ A Repair arterial blockage ................................ 1.31 4.21 13.20 NA NA 0.89 6.41 15.40 NA NA XXX 75966 ......... 26 ....... A Repair arterial blockage ................................ 1.31 0.57 0.49 0.57 0.49 0.06 1.94 1.86 1.94 1.86 XXX 75966 ......... TC ...... A Repair arterial blockage ................................ 0.00 3.64 12.72 NA NA 0.83 4.47 13.55 NA NA XXX75968 ......... ............ A Repair artery blockage, each ........................ 0.36 2.44 7.00 2.44 7.00 0.45 3.25 7.81 3.25 7.81 ZZZ 75968 ......... 26 ....... A Repair artery blockage, each ........................ 0.36 0.16 0.14 0.16 0.14 0.02 0.54 0.52 0.54 0.52 ZZZ 75968 ......... TC ...... A Repair artery blockage, each ........................ 0.00 2.29 6.87 2.29 6.87 0.43 2.72 7.30 2.72 7.30 ZZZ 75970 ......... ............ A Vascular biopsy ............................................. 0.83 NA NA NA NA 0.64 NA NA NA NA XXX 75970 ......... 26 ....... A Vascular biopsy ............................................. 0.83 0.28 0.28 0.28 0.28 0.04 1.15 1.15 1.15 1.15 XXX 75970 ......... TC ...... A Vascular biopsy ............................................. 0.00 NA NA NA NA 0.60 NA NA NA NA XXX 75978 ......... ............ A Repair venous blockage ................................ 0.54 3.27 12.76 NA NA 0.85 4.66 14.15 NA NA XXX 75978 ......... 26 ....... A Repair venous blockage ................................ 0.54 0.17 0.18 0.17 0.18 0.02 0.73 0.74 0.73 0.74 XXX 75978 ......... TC ...... A Repair venous blockage ................................ 0.00 3.11 12.58 NA NA 0.83 3.94 13.41 NA NA XXX 75980 ......... ............ A Contrast xray exam bile duct ........................ 1.44 NA NA NA NA 0.35 NA NA NA NA XXX 75980 ......... 26 ....... A Contrast xray exam bile duct ........................ 1.44 0.47 0.47 0.47 0.47 0.06 1.97 1.97 1.97 1.97 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49194 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

75980 ......... TC ...... A Contrast xray exam bile duct ........................ 0.00 NA NA NA NA 0.29 NA NA NA NA XXX 75982 ......... ............ C Contrast xray exam bile duct ........................ 0.00 NA NA NA NA 0.00 NA NA NA NA XXX 75982 ......... 26 ....... A Contrast xray exam bile duct ........................ 1.44 0.47 0.47 0.47 0.47 0.06 1.97 1.97 1.97 1.97 XXX 75982 ......... TC ...... C Contrast xray exam bile duct ........................ 0.00 NA NA NA NA 0.00 NA NA NA NA XXX 75984 ......... ............ A Xray control catheter change ........................ 0.72 2.31 2.21 NA NA 0.14 3.17 3.07 NA NA XXX 75984 ......... 26 ....... A Xray control catheter change ........................ 0.72 0.24 0.23 0.24 0.23 0.03 0.99 0.98 0.99 0.98 XXX 75984 ......... TC ...... A Xray control catheter change ........................ 0.00 2.08 1.98 NA NA 0.11 2.19 2.09 NA NA XXX 75989 ......... ............ A Abscess drainage under x-ray ...................... 1.19 2.21 3.21 NA NA 0.22 3.62 4.62 NA NA XXX 75989 ......... 26 ....... A Abscess drainage under x-ray ...................... 1.19 0.38 0.39 0.38 0.39 0.05 1.62 1.63 1.62 1.63 XXX 75989 ......... TC ...... A Abscess drainage under x-ray ...................... 0.00 1.83 2.82 NA NA 0.17 2.00 2.99 NA NA XXX 75992 ......... ............ A Atherectomy, x-ray exam .............................. 0.54 NA NA NA NA 0.86 NA NA NA NA XXX 75992 ......... 26 ....... A Atherectomy, x-ray exam .............................. 0.54 0.23 0.20 0.23 0.20 0.03 0.80 0.77 0.80 0.77 XXX 75992 ......... TC ...... A Atherectomy, x-ray exam .............................. 0.00 NA NA NA NA 0.83 NA NA NA NA XXX 75993 ......... ............ C Atherectomy, x-ray exam .............................. 0.00 NA NA NA NA 0.00 NA NA NA NA ZZZ 75993 ......... 26 ....... A Atherectomy, x-ray exam .............................. 0.36 0.15 0.14 0.15 0.14 0.02 0.53 0.52 0.53 0.52 ZZZ 75993 ......... TC ...... C Atherectomy, x-ray exam .............................. 0.00 NA NA NA NA 0.00 NA NA NA NA ZZZ 75994 ......... ............ C Atherectomy, x-ray exam .............................. 0.00 NA NA NA NA 0.00 NA NA NA NA XXX 75994 ......... 26 ....... A Atherectomy, x-ray exam .............................. 1.31 0.62 0.50 0.62 0.50 0.07 2.00 1.88 2.00 1.88 XXX 75994 ......... TC ...... C Atherectomy, x-ray exam .............................. 0.00 NA NA NA NA 0.00 NA NA NA NA XXX 75995 ......... ............ C Atherectomy, x-ray exam .............................. 0.00 NA NA NA NA 0.00 NA NA NA NA XXX 75995 ......... 26 ....... A Atherectomy, x-ray exam .............................. 1.31 0.51 0.48 0.51 0.48 0.05 1.87 1.84 1.87 1.84 XXX 75995 ......... TC ...... C Atherectomy, x-ray exam .............................. 0.00 NA NA NA NA 0.00 NA NA NA NA XXX 75996 ......... ............ C Atherectomy, x-ray exam .............................. 0.00 NA NA NA NA 0.00 NA NA NA NA ZZZ 75996 ......... 26 ....... A Atherectomy, x-ray exam .............................. 0.36 0.15 0.13 0.15 0.13 0.02 0.53 0.51 0.53 0.51 ZZZ 75996 ......... TC ...... C Atherectomy, x-ray exam .............................. 0.00 NA NA NA NA 0.00 NA NA NA NA ZZZ 75998 ......... ............ A Fluoroguide for vein device ........................... 0.38 2.73 1.76 NA NA 0.11 3.22 2.25 NA NA ZZZ75998 ......... 26 ....... A Fluoroguide for vein device ........................... 0.38 0.12 0.13 0.12 0.13 0.01 0.51 0.52 0.51 0.52 ZZZ 75998 ......... TC ...... A Fluoroguide for vein device ........................... 0.00 2.61 1.64 NA NA 0.10 2.71 1.74 NA NA ZZZ 76000 ......... ............ A Fluoroscope examination .............................. 0.17 2.75 1.71 NA NA 0.08 3.00 1.96 NA NA XXX 76000 ......... 26 ....... A Fluoroscope examination .............................. 0.17 0.06 0.05 0.06 0.05 0.01 0.24 0.23 0.24 0.23 XXX 76000 ......... TC ...... A Fluoroscope examination .............................. 0.00 2.70 1.66 NA NA 0.07 2.77 1.73 NA NA XXX 76001 ......... ............ A Fluoroscope exam, extensive ....................... 0.67 NA NA NA NA 0.19 NA NA NA NA XXX 76001 ......... 26 ....... A Fluoroscope exam, extensive ....................... 0.67 0.22 0.22 0.22 0.22 0.05 0.94 0.94 0.94 0.94 XXX 76001 ......... TC ...... A Fluoroscope exam, extensive ....................... 0.00 NA NA NA NA 0.14 NA NA NA NA XXX 76003 ......... ............ A Needle localization by x-ray .......................... 0.54 1.21 1.41 NA NA 0.09 1.84 2.04 NA NA XXX76003 ......... 26 ....... A Needle localization by x-ray .......................... 0.54 0.15 0.17 0.15 0.17 0.02 0.71 0.73 0.71 0.73 XXX 76003 ......... TC ...... A Needle localization by x-ray .......................... 0.00 1.06 1.25 NA NA 0.07 1.13 1.32 NA NA XXX 76005 ......... ............ A Fluoroguide for spine inject ........................... 0.60 0.76 1.29 NA NA 0.10 1.46 1.99 NA NA XXX 76005 ......... 26 ....... A Fluoroguide for spine inject ........................... 0.60 0.14 0.15 0.14 0.15 0.03 0.77 0.78 0.77 0.78 XXX 76005 ......... TC ...... A Fluoroguide for spine inject ........................... 0.00 0.62 1.14 NA NA 0.07 0.69 1.21 NA NA XXX 76006 ......... ............ A X-ray stress view ........................................... 0.41 0.77 0.33 0.77 0.33 0.06 1.24 0.80 1.24 0.80 XXX 76010 ......... ............ A X-ray, nose to rectum .................................... 0.18 0.55 0.57 NA NA 0.03 0.76 0.78 NA NA XXX 76010 ......... 26 ....... A X-ray, nose to rectum .................................... 0.18 0.06 0.06 0.06 0.06 0.01 0.25 0.25 0.25 0.25 XXX 76010 ......... TC ...... A X-ray, nose to rectum .................................... 0.00 0.49 0.51 NA NA 0.02 0.51 0.53 NA NA XXX 76012 ......... ............ C Percut vertebroplasty fluor ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76012 ......... 26 ....... A Percut vertebroplasty fluor ............................ 1.31 0.44 0.46 0.44 0.46 0.10 1.85 1.87 1.85 1.87 XXX 76012 ......... TC ...... C Percut vertebroplasty fluor ............................ 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 76013 ......... 26 ....... A Percut vertebroplasty, ct ............................... 1.38 0.45 0.47 0.45 0.47 0.07 1.90 1.92 1.90 1.92 XXX 76013 ......... TC ...... C Percut vertebroplasty, ct ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76020 ......... ............ A X-rays for bone age ...................................... 0.19 0.42 0.54 NA NA 0.03 0.64 0.76 NA NA XXX 76020 ......... 26 ....... A X-rays for bone age ...................................... 0.19 0.06 0.06 0.06 0.06 0.01 0.26 0.26 0.26 0.26 XXX 76020 ......... TC ...... A X-rays for bone age ...................................... 0.00 0.36 0.48 NA NA 0.02 0.38 0.50 NA NA XXX 76040 ......... ............ A X-rays, bone evaluation ................................ 0.27 0.67 0.82 NA NA 0.06 1.00 1.15 NA NA XXX 76040 ......... 26 ....... A X-rays, bone evaluation ................................ 0.27 0.10 0.09 0.10 0.09 0.01 0.38 0.37 0.38 0.37 XXX 76040 ......... TC ...... A X-rays, bone evaluation ................................ 0.00 0.57 0.73 NA NA 0.05 0.62 0.78 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49195 

76061 ......... ............ A X-rays, bone survey ...................................... 0.45 1.43 1.22 NA NA 0.08 1.96 1.75 NA NA XXX 76061 ......... 26 ....... A X-rays, bone survey ...................................... 0.45 0.14 0.15 0.14 0.15 0.02 0.61 0.62 0.61 0.62 XXX 76061 ......... TC ...... A X-rays, bone survey ...................................... 0.00 1.28 1.07 NA NA 0.06 1.34 1.13 NA NA XXX 76062 ......... ............ A X-rays, bone survey ...................................... 0.54 2.28 1.79 NA NA 0.10 2.92 2.43 NA NA XXX 76062 ......... 26 ....... A X-rays, bone survey ...................................... 0.54 0.17 0.18 0.17 0.18 0.02 0.73 0.74 0.73 0.74 XXX 76062 ......... TC ...... A X-rays, bone survey ...................................... 0.00 2.10 1.61 NA NA 0.08 2.18 1.69 NA NA XXX 76065 ......... ............ A X-rays, bone evaluation ................................ 0.70 2.01 1.22 NA NA 0.08 2.79 2.00 NA NA XXX 76065 ......... 26 ....... A X-rays, bone evaluation ................................ 0.70 0.20 0.22 0.20 0.22 0.03 0.93 0.95 0.93 0.95 XXX 76065 ......... TC ...... A X-rays, bone evaluation ................................ 0.00 1.81 1.00 NA NA 0.05 1.86 1.05 NA NA XXX 76066 ......... ............ A Joint survey, single view ............................... 0.31 0.65 1.07 NA NA 0.08 1.04 1.46 NA NA XXX 76066 ......... 26 ....... A Joint survey, single view ............................... 0.31 0.11 0.10 0.11 0.10 0.02 0.44 0.43 0.44 0.43 XXX 76066 ......... TC ...... A Joint survey, single view ............................... 0.00 0.55 0.97 NA NA 0.06 0.61 1.03 NA NA XXX 76070 ......... ............ A Ct bone density, axial .................................... 0.25 4.78 3.47 NA NA 0.17 5.20 3.89 NA NA XXX 76070 ......... 26 ....... A Ct bone density, axial .................................... 0.25 0.08 0.08 0.08 0.08 0.01 0.34 0.34 0.34 0.34 XXX 76070 ......... TC ...... A Ct bone density, axial .................................... 0.00 4.70 3.39 NA NA 0.16 4.86 3.55 NA NA XXX76071 ......... ............ A Ct bone density, peripheral ........................... 0.22 0.78 2.46 NA NA 0.06 1.06 2.74 NA NA XXX76071 ......... 26 ....... A Ct bone density, peripheral ........................... 0.22 0.07 0.07 0.07 0.07 0.01 0.30 0.30 0.30 0.30 XXX 76071 ......... TC ...... A Ct bone density, peripheral ........................... 0.00 0.71 2.39 NA NA 0.05 0.76 2.44 NA NA XXX 76075 ......... ............ A Dxa bone density, axial ................................. 0.20 0.53 2.53 NA NA 0.18 0.91 2.91 NA NA XXX 76075 ......... 26 ....... A Dxa bone density, axial ................................. 0.20 0.06 0.09 0.06 0.09 0.01 0.27 0.30 0.27 0.30 XXX 76075 ......... TC ...... A Dxa bone density, axial ................................. 0.00 0.47 2.44 NA NA 0.17 0.64 2.61 NA NA XXX 76076 ......... ............ A Dxa bone density/peripheral ......................... 0.22 0.57 0.77 NA NA 0.06 0.85 1.05 NA NA XXX 76076 ......... 26 ....... A Dxa bone density/peripheral ......................... 0.22 0.06 0.08 0.06 0.08 0.01 0.29 0.31 0.29 0.31 XXX 76076 ......... TC ...... A Dxa bone density/peripheral ......................... 0.00 0.50 0.69 NA NA 0.05 0.55 0.74 NA NA XXX 76077 ......... ............ A Dxa bone density/v-fracture .......................... 0.17 0.41 0.71 NA NA 0.06 0.64 0.94 NA NA XXX 76077 ......... 26 ....... A Dxa bone density/v-fracture .......................... 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX 76077 ......... TC ...... A Dxa bone density/v-fracture .......................... 0.00 0.36 0.65 NA NA 0.05 0.41 0.70 NA NA XXX 76078 ......... ............ A Radiographic absorptiometry ........................ 0.20 0.38 0.71 NA NA 0.06 0.64 0.97 NA NA XXX 76078 ......... 26 ....... A Radiographic absorptiometry ........................ 0.20 0.05 0.07 0.05 0.07 0.01 0.26 0.28 0.26 0.28 XXX 76078 ......... TC ...... A Radiographic absorptiometry ........................ 0.00 0.33 0.65 NA NA 0.05 0.38 0.70 NA NA XXX 76080 ......... ............ A X-ray exam of fistula ..................................... 0.54 1.08 1.19 NA NA 0.08 1.70 1.81 NA NA XXX 76080 ......... 26 ....... A X-ray exam of fistula ..................................... 0.54 0.17 0.18 0.17 0.18 0.02 0.73 0.74 0.73 0.74 XXX 76080 ......... TC ...... A X-ray exam of fistula ..................................... 0.00 0.90 1.01 NA NA 0.06 0.96 1.07 NA NA XXX76082 ......... ............ A Computer mammogram add-on .................... 0.06 0.20 0.38 0.20 0.38 0.02 0.28 0.46 0.28 0.46 ZZZ 76082 ......... 26 ....... A Computer mammogram add-on .................... 0.06 0.02 0.02 0.02 0.02 0.01 0.09 0.09 0.09 0.09 ZZZ 76082 ......... TC ...... A Computer mammogram add-on .................... 0.00 0.18 0.36 0.18 0.36 0.01 0.19 0.37 0.19 0.37 ZZZ 76083 ......... ............ A Computer mammogram add-on .................... 0.06 0.20 0.38 0.20 0.38 0.02 0.28 0.46 0.28 0.46 ZZZ 76083 ......... 26 ....... A Computer mammogram add-on .................... 0.06 0.02 0.02 0.02 0.02 0.01 0.09 0.09 0.09 0.09 ZZZ 76083 ......... TC ...... A Computer mammogram add-on .................... 0.00 0.18 0.36 0.18 0.36 0.01 0.19 0.37 0.19 0.37 ZZZ 76086 ......... ............ A X-ray of mammary duct ................................. 0.36 1.22 2.36 NA NA 0.16 1.74 2.88 NA NA XXX76086 ......... 26 ....... A X-ray of mammary duct ................................. 0.36 0.11 0.12 0.11 0.12 0.02 0.49 0.50 0.49 0.50 XXX 76086 ......... TC ...... A X-ray of mammary duct ................................. 0.00 1.11 2.24 NA NA 0.14 1.25 2.38 NA NA XXX 76088 ......... ............ A X-ray of mammary ducts ............................... 0.45 1.66 3.27 NA NA 0.21 2.32 3.93 NA NA XXX 76088 ......... 26 ....... A X-ray of mammary ducts ............................... 0.45 0.14 0.15 0.14 0.15 0.02 0.61 0.62 0.61 0.62 XXX 76088 ......... TC ...... A X-ray of mammary ducts ............................... 0.00 1.52 3.13 NA NA 0.19 1.71 3.32 NA NA XXX 76090 ......... ............ A Mammogram, one breast .............................. 0.70 1.62 1.37 NA NA 0.09 2.41 2.16 NA NA XXX 76090 ......... 26 ....... A Mammogram, one breast .............................. 0.70 0.22 0.23 0.22 0.23 0.03 0.95 0.96 0.95 0.96 XXX 76090 ......... TC ...... A Mammogram, one breast .............................. 0.00 1.40 1.14 NA NA 0.06 1.46 1.20 NA NA XXX 76091 ......... ............ A Mammogram, both breasts ........................... 0.87 2.11 1.72 NA NA 0.11 3.09 2.70 NA NA XXX 76091 ......... 26 ....... A Mammogram, both breasts ........................... 0.87 0.27 0.28 0.27 0.28 0.04 1.18 1.19 1.18 1.19 XXX 76091 ......... TC ...... A Mammogram, both breasts ........................... 0.00 1.84 1.44 NA NA 0.07 1.91 1.51 NA NA XXX 76092 ......... ............ A Mammogram, screening ................................ 0.70 1.42 1.45 NA NA 0.10 2.22 2.25 NA NA XXX 76092 ......... 26 ....... A Mammogram, screening ................................ 0.70 0.22 0.23 0.22 0.23 0.03 0.95 0.96 0.95 0.96 XXX 76092 ......... TC ...... A Mammogram, screening ................................ 0.00 1.20 1.22 NA NA 0.07 1.27 1.29 NA NA XXX 76093 ......... ............ A Magnetic image, breast ................................. 1.63 22.03 19.12 NA NA 0.99 24.65 21.74 NA NA XXX 76093 ......... 26 ....... A Magnetic image, breast ................................. 1.63 0.53 0.53 0.53 0.53 0.07 2.23 2.23 2.23 2.23 XXX 76093 ......... TC ...... A Magnetic image, breast ................................. 0.00 21.50 18.59 NA NA 0.92 22.42 19.51 NA NA XXX 76094 ......... ............ A Magnetic image, both breasts ....................... 1.63 22.03 23.84 NA NA 1.31 24.97 26.78 NA NA XXX 76094 ......... 26 ....... A Magnetic image, both breasts ....................... 1.63 0.53 0.53 0.53 0.53 0.07 2.23 2.23 2.23 2.23 XXX 76094 ......... TC ...... A Magnetic image, both breasts ....................... 0.00 21.50 23.31 NA NA 1.24 22.74 24.55 NA NA XXX 76095 ......... ............ A Stereotactic breast biopsy ............................. 1.59 1.82 6.22 NA NA 0.46 3.87 8.27 NA NA XXX 76095 ......... 26 ....... A Stereotactic breast biopsy ............................. 1.59 0.48 0.51 0.48 0.51 0.09 2.16 2.19 2.16 2.19 XXX 76095 ......... TC ...... A Stereotactic breast biopsy ............................. 0.00 1.34 5.71 NA NA 0.37 1.71 6.08 NA NA XXX 76096 ......... ............ A X-ray of needle wire, breast .......................... 0.56 0.82 1.32 NA NA 0.09 1.47 1.97 NA NA XXX76096 ......... 26 ....... A X-ray of needle wire, breast .......................... 0.56 0.18 0.18 0.18 0.18 0.02 0.76 0.76 0.76 0.76 XXX 76096 ......... TC ...... A X-ray of needle wire, breast .......................... 0.00 0.64 1.14 NA NA 0.07 0.71 1.21 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49196 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

76098 ......... ............ A X-ray exam, breast specimen ....................... 0.16 0.32 0.43 NA NA 0.03 0.51 0.62 NA NA XXX 76098 ......... 26 ....... A X-ray exam, breast specimen ....................... 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX 76098 ......... TC ...... A X-ray exam, breast specimen ....................... 0.00 0.27 0.38 NA NA 0.02 0.29 0.40 NA NA XXX 76100 ......... ............ A X-ray exam of body section .......................... 0.58 3.54 1.97 NA NA 0.10 4.22 2.65 NA NA XXX 76100 ......... 26 ....... A X-ray exam of body section .......................... 0.58 0.20 0.19 0.20 0.19 0.03 0.81 0.80 0.81 0.80 XXX 76100 ......... TC ...... A X-ray exam of body section .......................... 0.00 3.35 1.78 NA NA 0.07 3.42 1.85 NA NA XXX 76101 ......... ............ A Complex body section x-ray .......................... 0.58 5.35 2.55 NA NA 0.11 6.04 3.24 NA NA XXX 76101 ......... 26 ....... A Complex body section x-ray .......................... 0.58 0.19 0.19 0.19 0.19 0.03 0.80 0.80 0.80 0.80 XXX 76101 ......... TC ...... A Complex body section x-ray .......................... 0.00 5.16 2.36 NA NA 0.08 5.24 2.44 NA NA XXX 76102 ......... ............ A Complex body section x-rays ........................ 0.58 7.74 3.38 NA NA 0.14 8.46 4.10 NA NA XXX 76102 ......... 26 ....... A Complex body section x-rays ........................ 0.58 0.18 0.19 0.18 0.19 0.03 0.79 0.80 0.79 0.80 XXX 76102 ......... TC ...... A Complex body section x-rays ........................ 0.00 7.56 3.19 NA NA 0.11 7.67 3.30 NA NA XXX 76120 ......... ............ A Cine/video x-rays ........................................... 0.38 2.00 1.39 NA NA 0.08 2.46 1.85 NA NA XXX 76120 ......... 26 ....... A Cine/video x-rays ........................................... 0.38 0.15 0.14 0.15 0.14 0.02 0.55 0.54 0.55 0.54 XXX 76120 ......... TC ...... A Cine/video x-rays ........................................... 0.00 1.85 1.25 NA NA 0.06 1.91 1.31 NA NA XXX 76125 ......... ............ A Cine/video x-rays add-on .............................. 0.27 NA NA NA NA 0.06 NA NA NA NA ZZZ 76125 ......... 26 ....... A Cine/video x-rays add-on .............................. 0.27 0.10 0.09 0.10 0.09 0.01 0.38 0.37 0.38 0.37 ZZZ 76125 ......... TC ...... A Cine/video x-rays add-on .............................. 0.00 NA NA NA NA 0.05 NA NA NA NA ZZZ 76150 ......... ............ A X-ray exam, dry process ............................... 0.00 0.68 0.49 NA NA 0.02 0.70 0.51 NA NA XXX76350 ......... ............ C Special x-ray contrast study .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76355 ......... ............ A Ct scan for localization .................................. 1.21 20.46 11.60 NA NA 0.47 22.14 13.28 NA NA XXX 76355 ......... 26 ....... A Ct scan for localization .................................. 1.21 0.37 0.39 0.37 0.39 0.05 1.63 1.65 1.63 1.65 XXX 76355 ......... TC ...... A Ct scan for localization .................................. 0.00 20.09 11.22 NA NA 0.42 20.51 11.64 NA NA XXX 76360 ......... ............ A Ct scan for needle biopsy ............................. 1.16 2.30 7.05 NA NA 0.47 3.93 8.68 NA NA XXX76360 ......... 26 ....... A Ct scan for needle biopsy ............................. 1.16 0.37 0.38 0.37 0.38 0.05 1.58 1.59 1.58 1.59 XXX 76360 ......... TC ...... A Ct scan for needle biopsy ............................. 0.00 1.93 6.68 NA NA 0.42 2.35 7.10 NA NA XXX 76362 ......... ............ A Ct guide for tissue ablation ........................... 3.99 NA NA NA NA 1.64 NA NA NA NA XXX 76362 ......... 26 ....... A Ct guide for tissue ablation ........................... 3.99 1.25 1.29 1.25 1.29 0.18 5.42 5.46 5.42 5.46 XXX 76362 ......... TC ...... A Ct guide for tissue ablation ........................... 0.00 NA NA NA NA 1.46 NA NA NA NA XXX 76370 ......... ............ A Ct scan for therapy guide .............................. 0.85 4.43 3.53 NA NA 0.20 5.48 4.58 NA NA XXX 76370 ......... 26 ....... A Ct scan for therapy guide .............................. 0.85 0.24 0.27 0.24 0.27 0.04 1.13 1.16 1.13 1.16 XXX 76370 ......... TC ...... A Ct scan for therapy guide .............................. 0.00 4.19 3.26 NA NA 0.16 4.35 3.42 NA NA XXX 76376 ......... ............ A 3d render w/o postprocess ............................ 0.20 1.40 2.97 NA NA 0.10 1.70 3.27 NA NA XXX 76376 ......... 26 ....... A 3d render w/o postprocess ............................ 0.20 0.06 0.07 0.06 0.07 0.02 0.28 0.29 0.28 0.29 XXX 76376 ......... TC ...... A 3d render w/o postprocess ............................ 0.00 1.34 2.90 NA NA 0.08 1.42 2.98 NA NA XXX 76377 ......... ............ A 3d rendering w/postprocess .......................... 0.79 1.38 3.11 NA NA 0.39 2.56 4.29 NA NA XXX 76377 ......... 26 ....... A 3d rendering w/postprocess .......................... 0.79 0.25 0.27 0.25 0.27 0.08 1.12 1.14 1.12 1.14 XXX 76377 ......... TC ...... A 3d rendering w/postprocess .......................... 0.00 1.13 2.85 NA NA 0.31 1.44 3.16 NA NA XXX 76380 ......... ............ A CAT scan follow-up study ............................. 0.98 4.72 4.05 NA NA 0.22 5.92 5.25 NA NA XXX 76380 ......... 26 ....... A CAT scan follow-up study ............................. 0.98 0.31 0.32 0.31 0.32 0.04 1.33 1.34 1.33 1.34 XXX 76380 ......... TC ...... A CAT scan follow-up study ............................. 0.00 4.42 3.73 NA NA 0.18 4.60 3.91 NA NA XXX 76390 ......... ............ N Mr spectroscopy ............................................ 1.40 9.51 10.99 NA NA 0.66 11.57 13.05 NA NA XXX 76390 ......... 26 ....... N Mr spectroscopy ............................................ 1.40 0.33 0.44 0.33 0.44 0.07 1.80 1.91 1.80 1.91 XXX 76390 ......... TC ...... N Mr spectroscopy ............................................ 0.00 9.19 10.56 NA NA 0.59 9.78 11.15 NA NA XXX 76393 ......... ............ A Mr guidance for needle place ....................... 1.50 9.83 11.23 NA NA 0.64 11.97 13.37 NA NA XXX76393 ......... 26 ....... A Mr guidance for needle place ....................... 1.50 0.49 0.50 0.49 0.50 0.09 2.08 2.09 2.08 2.09 XXX 76393 ......... TC ...... A Mr guidance for needle place ....................... 0.00 9.34 10.74 NA NA 0.55 9.89 11.29 NA NA XXX 76394 ......... ............ A Mri for tissue ablation .................................... 4.24 NA NA NA NA 1.81 NA NA NA NA XXX 76394 ......... 26 ....... A Mri for tissue ablation .................................... 4.24 1.34 1.37 1.34 1.37 0.24 5.82 5.85 5.82 5.85 XXX 76394 ......... TC ...... A Mri for tissue ablation .................................... 0.00 NA NA NA NA 1.57 NA NA NA NA XXX 76400 ......... ............ A Magnetic image, bone marrow ...................... 1.60 14.85 12.50 NA NA 0.66 17.11 14.76 NA NA XXX 76400 ......... 26 ....... A Magnetic image, bone marrow ...................... 1.60 0.56 0.53 0.56 0.53 0.07 2.23 2.20 2.23 2.20 XXX76400 ......... TC ...... A Magnetic image, bone marrow ...................... 0.00 14.30 11.98 NA NA 0.59 14.89 12.57 NA NA XXX 76496 ......... ............ C Fluoroscopic procedure ................................. 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49197 

76497 ......... ............ C Ct procedure .................................................. 0.00 0.00 0.00 0.00 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 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 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 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 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 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 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 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 0.00 0.00 0.00 0.00 XXX 76506 ......... ............ A Echo exam of head ....................................... 0.63 2.83 1.95 NA NA 0.14 3.60 2.72 NA NA XXX 76506 ......... 26 ....... A Echo exam of head ....................................... 0.63 0.20 0.23 0.20 0.23 0.06 0.89 0.92 0.89 0.92 XXX 76506 ......... TC ...... A Echo exam of head ....................................... 0.00 2.63 1.72 NA NA 0.08 2.71 1.80 NA NA XXX 76510 ......... ............ A Ophth us, b & quant a ................................... 1.55 2.31 2.72 NA NA 0.10 3.96 4.37 NA NA XXX 76510 ......... 26 ....... A Ophth us, b & quant a ................................... 1.55 0.58 0.66 0.58 0.66 0.03 2.16 2.24 2.16 2.24 XXX 76510 ......... TC ...... A Ophth us, b & quant a ................................... 0.00 1.73 2.07 NA NA 0.07 1.80 2.14 NA NA XXX 76511 ......... ............ A Ophth us, quant a only .................................. 0.94 1.39 2.17 NA NA 0.10 2.43 3.21 NA NA XXX 76511 ......... 26 ....... A Ophth us, quant a only .................................. 0.94 0.35 0.39 0.35 0.39 0.03 1.32 1.36 1.32 1.36 XXX 76511 ......... TC ...... A Ophth us, quant a only .................................. 0.00 1.05 1.79 NA NA 0.07 1.12 1.86 NA NA XXX 76512 ......... ............ A Ophth us, b w/non-quant a ........................... 0.94 1.19 1.97 NA NA 0.12 2.25 3.03 NA NA XXX 76512 ......... 26 ....... A Ophth us, b w/non-quant a ........................... 0.94 0.35 0.40 0.35 0.40 0.02 1.31 1.36 1.31 1.36 XXX 76512 ......... TC ...... A Ophth us, b w/non-quant a ........................... 0.00 0.85 1.57 NA NA 0.10 0.95 1.67 NA NA XXX 76513 ......... ............ A Echo exam of eye, water bath ...................... 0.66 1.58 1.75 NA NA 0.12 2.36 2.53 NA NA XXX 76513 ......... 26 ....... A Echo exam of eye, water bath ...................... 0.66 0.25 0.28 0.25 0.28 0.02 0.93 0.96 0.93 0.96 XXX 76513 ......... TC ...... A Echo exam of eye, water bath ...................... 0.00 1.33 1.47 NA NA 0.10 1.43 1.57 NA NA XXX 76514 ......... ............ A Echo exam of eye, thickness ........................ 0.17 0.17 0.14 NA NA 0.02 0.36 0.33 NA NA XXX 76514 ......... 26 ....... A Echo exam of eye, thickness ........................ 0.17 0.06 0.08 0.06 0.08 0.01 0.24 0.26 0.24 0.26 XXX 76514 ......... TC ...... A Echo exam of eye, thickness ........................ 0.00 0.11 0.07 NA NA 0.01 0.12 0.08 NA NA XXX 76516 ......... ............ A Echo exam of eye ......................................... 0.54 1.19 1.39 NA NA 0.08 1.81 2.01 NA NA XXX 76516 ......... 26 ....... A Echo exam of eye ......................................... 0.54 0.19 0.23 0.19 0.23 0.01 0.74 0.78 0.74 0.78 XXX 76516 ......... TC ...... A Echo exam of eye ......................................... 0.00 1.00 1.17 NA NA 0.07 1.07 1.24 NA NA XXX 76519 ......... ............ A Echo exam of eye ......................................... 0.54 1.33 1.50 NA NA 0.08 1.95 2.12 NA NA XXX 76519 ......... 26 ....... A Echo exam of eye ......................................... 0.54 0.20 0.23 0.20 0.23 0.01 0.75 0.78 0.75 0.78 XXX 76519 ......... TC ...... A Echo exam of eye ......................................... 0.00 1.12 1.26 NA NA 0.07 1.19 1.33 NA NA XXX 76529 ......... ............ A Echo exam of eye ......................................... 0.57 1.19 1.33 NA NA 0.10 1.86 2.00 NA NA XXX 76529 ......... 26 ....... A Echo exam of eye ......................................... 0.57 0.21 0.23 0.21 0.23 0.02 0.80 0.82 0.80 0.82 XXX 76529 ......... TC ...... A Echo exam of eye ......................................... 0.00 0.98 1.09 NA NA 0.08 1.06 1.17 NA NA XXX 76536 ......... ............ A Us exam of head and neck ........................... 0.56 2.69 1.87 NA NA 0.10 3.35 2.53 NA NA XXX 76536 ......... 26 ....... A Us exam of head and neck ........................... 0.56 0.17 0.18 0.17 0.18 0.02 0.75 0.76 0.75 0.76 XXX 76536 ......... TC ...... A Us exam of head and neck ........................... 0.00 2.52 1.70 NA NA 0.08 2.60 1.78 NA NA XXX 76604 ......... ............ A Us exam, chest, b-scan ................................ 0.55 1.81 1.57 NA NA 0.09 2.45 2.21 NA NA XXX76604 ......... 26 ....... A Us exam, chest, b-scan ................................ 0.55 0.17 0.18 0.17 0.18 0.02 0.74 0.75 0.74 0.75 XXX 76604 ......... TC ...... A Us exam, chest, b-scan ................................ 0.00 1.64 1.39 NA NA 0.07 1.71 1.46 NA NA XXX 76645 ......... ............ A Us exam, breast(s) ........................................ 0.54 2.11 1.45 NA NA 0.08 2.73 2.07 NA NA XXX 76645 ......... 26 ....... A Us exam, breast(s) ........................................ 0.54 0.17 0.18 0.17 0.18 0.02 0.73 0.74 0.73 0.74 XXX 76645 ......... TC ...... A Us exam, breast(s) ........................................ 0.00 1.94 1.27 NA NA 0.06 2.00 1.33 NA NA XXX76700 ......... ............ A Us exam, abdom, complete .......................... 0.81 3.04 2.44 NA NA 0.15 4.00 3.40 NA NA XXX 76700 ......... 26 ....... A Us exam, abdom, complete .......................... 0.81 0.26 0.27 0.26 0.27 0.04 1.11 1.12 1.11 1.12 XXX 76700 ......... TC ...... A Us exam, abdom, complete .......................... 0.00 2.78 2.17 NA NA 0.11 2.89 2.28 NA NA XXX 76705 ......... ............ A Echo exam of abdomen ................................ 0.59 2.34 1.79 NA NA 0.11 3.04 2.49 NA NA XXX 76705 ......... 26 ....... A Echo exam of abdomen ................................ 0.59 0.19 0.19 0.19 0.19 0.03 0.81 0.81 0.81 0.81 XXX 76705 ......... TC ...... A Echo exam of abdomen ................................ 0.00 2.16 1.61 NA NA 0.08 2.24 1.69 NA NA XXX 76770 ......... ............ A Us exam abdo back wall, comp .................... 0.74 2.94 2.39 NA NA 0.14 3.82 3.27 NA NA XXX 76770 ......... 26 ....... A Us exam abdo back wall, comp .................... 0.74 0.24 0.24 0.24 0.24 0.03 1.01 1.01 1.01 1.01 XXX 76770 ......... TC ...... A Us exam abdo back wall, comp .................... 0.00 2.70 2.15 NA NA 0.11 2.81 2.26 NA NA XXX 76775 ......... ............ A Us exam abdo back wall, lim ........................ 0.58 2.42 1.81 NA NA 0.11 3.11 2.50 NA NA XXX 76775 ......... 26 ....... A Us exam abdo back wall, lim ........................ 0.58 0.19 0.19 0.19 0.19 0.03 0.80 0.80 0.80 0.80 XXX 76775 ......... TC ...... A Us exam abdo back wall, lim ........................ 0.00 2.23 1.62 NA NA 0.08 2.31 1.70 NA NA XXX 76778 ......... ............ A Us exam kidney transplant ............................ 0.74 3.21 2.46 NA NA 0.14 4.09 3.34 NA NA XXX 76778 ......... 26 ....... A Us exam kidney transplant ............................ 0.74 0.23 0.24 0.23 0.24 0.03 1.00 1.01 1.00 1.01 XXX 76778 ......... TC ...... A Us exam kidney transplant ............................ 0.00 2.98 2.22 NA NA 0.11 3.09 2.33 NA NA XXX 76800 ......... ............ A Us exam, spinal canal ................................... 1.13 2.34 1.90 NA NA 0.13 3.60 3.16 NA NA XXX 76800 ......... 26 ....... A Us exam, spinal canal ................................... 1.13 0.30 0.33 0.30 0.33 0.05 1.48 1.51 1.48 1.51 XXX 76800 ......... TC ...... A Us exam, spinal canal ................................... 0.00 2.04 1.58 NA NA 0.08 2.12 1.66 NA NA XXX 76801 ......... ............ A Ob us < 14 wks, single fetus ........................ 0.99 2.46 2.45 NA NA 0.16 3.61 3.60 NA NA XXX 76801 ......... 26 ....... A Ob us < 14 wks, single fetus ........................ 0.99 0.30 0.33 0.30 0.33 0.04 1.33 1.36 1.33 1.36 XXX 76801 ......... TC ...... A Ob us < 14 wks, single fetus ........................ 0.00 2.16 2.12 NA NA 0.12 2.28 2.24 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49198 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

76802 ......... ............ A Ob us < 14 wks, addIl fetus .......................... 0.83 0.97 1.25 0.97 1.25 0.16 1.96 2.24 1.96 2.24 ZZZ 76802 ......... 26 ....... A Ob us < 14 wks, addIl fetus .......................... 0.83 0.25 0.28 0.25 0.28 0.04 1.12 1.15 1.12 1.15 ZZZ 76802 ......... TC ...... A Ob us < 14 wks, addIl fetus .......................... 0.00 0.72 0.97 0.72 0.97 0.12 0.84 1.09 0.84 1.09 ZZZ 76805 ......... ............ A Ob us >/= 14 wks, sngl fetus ........................ 0.99 3.05 2.59 NA NA 0.16 4.20 3.74 NA NA XXX 76805 ......... 26 ....... A Ob us >/= 14 wks, sngl fetus ........................ 0.99 0.29 0.33 0.29 0.33 0.04 1.32 1.36 1.32 1.36 XXX 76805 ......... TC ...... A Ob us >/= 14 wks, sngl fetus ........................ 0.00 2.75 2.26 NA NA 0.12 2.87 2.38 NA NA XXX 76810 ......... ............ A Ob us >/= 14 wks, addl fetus ........................ 0.98 1.66 1.46 1.66 1.46 0.26 2.90 2.70 2.90 2.70 ZZZ 76810 ......... 26 ....... A Ob us >/= 14 wks, addl fetus ........................ 0.98 0.29 0.33 0.29 0.33 0.04 1.31 1.35 1.31 1.35 ZZZ 76810 ......... TC ...... A Ob us >/= 14 wks, addl fetus ........................ 0.00 1.37 1.13 1.37 1.13 0.22 1.59 1.35 1.59 1.35 ZZZ 76811 ......... ............ A Ob us, detailed, sngl fetus ............................ 1.90 3.07 3.95 NA NA 0.52 5.49 6.37 NA NA XXX 76811 ......... 26 ....... A Ob us, detailed, sngl fetus ............................ 1.90 0.54 0.67 0.54 0.67 0.09 2.53 2.66 2.53 2.66 XXX 76811 ......... TC ...... A Ob us, detailed, sngl fetus ............................ 0.00 2.53 3.28 NA NA 0.43 2.96 3.71 NA NA XXX 76812 ......... ............ A Ob us, detailed, addl fetus ............................ 1.78 3.98 2.28 3.98 2.28 0.49 6.25 4.55 6.25 4.55 ZZZ 76812 ......... 26 ....... A Ob us, detailed, addl fetus ............................ 1.78 0.51 0.62 0.51 0.62 0.08 2.37 2.48 2.37 2.48 ZZZ 76812 ......... TC ...... A Ob us, detailed, addl fetus ............................ 0.00 3.47 1.66 3.47 1.66 0.41 3.88 2.07 3.88 2.07 ZZZ 76815 ......... ............ A Ob us, limited, fetus(s) .................................. 0.65 1.80 1.69 NA NA 0.11 2.56 2.45 NA NA XXX 76815 ......... 26 ....... A Ob us, limited, fetus(s) .................................. 0.65 0.19 0.22 0.19 0.22 0.03 0.87 0.90 0.87 0.90 XXX 76815 ......... TC ...... A Ob us, limited, fetus(s) .................................. 0.00 1.61 1.47 NA NA 0.08 1.69 1.55 NA NA XXX76816 ......... ............ A Ob us, follow-up, per fetus ............................ 0.85 2.40 1.67 NA NA 0.10 3.35 2.62 NA NA XXX 76816 ......... 26 ....... A Ob us, follow-up, per fetus ............................ 0.85 0.24 0.30 0.24 0.30 0.04 1.13 1.19 1.13 1.19 XXX 76816 ......... TC ...... A Ob us, follow-up, per fetus ............................ 0.00 2.15 1.37 NA NA 0.06 2.21 1.43 NA NA XXX 76817 ......... ............ A Transvaginal us, obstetric ............................. 0.75 2.02 1.83 NA NA 0.09 2.86 2.67 NA NA XXX 76817 ......... 26 ....... A Transvaginal us, obstetric ............................. 0.75 0.22 0.25 0.22 0.25 0.03 1.00 1.03 1.00 1.03 XXX 76817 ......... TC ...... A Transvaginal us, obstetric ............................. 0.00 1.80 1.59 NA NA 0.06 1.86 1.65 NA NA XXX 76818 ......... ............ A Fetal biophys profile w/nst ............................ 1.05 2.22 2.05 NA NA 0.15 3.42 3.25 NA NA XXX 76818 ......... 26 ....... A Fetal biophys profile w/nst ............................ 1.05 0.30 0.37 0.30 0.37 0.05 1.40 1.47 1.40 1.47 XXX 76818 ......... TC ...... A Fetal biophys profile w/nst ............................ 0.00 1.92 1.69 NA NA 0.10 2.02 1.79 NA NA XXX 76819 ......... ............ A Fetal biophys profil w/o nst ........................... 0.77 1.63 1.82 NA NA 0.13 2.53 2.72 NA NA XXX 76819 ......... 26 ....... A Fetal biophys profil w/o nst ........................... 0.77 0.23 0.27 0.23 0.27 0.03 1.03 1.07 1.03 1.07 XXX 76819 ......... TC ...... A Fetal biophys profil w/o nst ........................... 0.00 1.41 1.56 NA NA 0.10 1.51 1.66 NA NA XXX 76820 ......... ............ A Umbilical artery echo ..................................... 0.50 0.57 1.49 NA NA 0.15 1.22 2.14 NA NA XXX 76820 ......... 26 ....... A Umbilical artery echo ..................................... 0.50 0.14 0.18 0.14 0.18 0.03 0.67 0.71 0.67 0.71 XXX 76820 ......... TC ...... A Umbilical artery echo ..................................... 0.00 0.43 1.32 NA NA 0.12 0.55 1.44 NA NA XXX76821 ......... ............ A Middle cerebral artery echo .......................... 0.70 1.88 1.87 NA NA 0.15 2.73 2.72 NA NA XXX 76821 ......... 26 ....... A Middle cerebral artery echo .......................... 0.70 0.20 0.25 0.20 0.25 0.03 0.93 0.98 0.93 0.98 XXX 76821 ......... TC ...... A Middle cerebral artery echo .......................... 0.00 1.68 1.63 NA NA 0.12 1.80 1.75 NA NA XXX 76825 ......... ............ A Echo exam of fetal heart ............................... 1.67 4.37 3.02 NA NA 0.18 6.22 4.87 NA NA XXX 76825 ......... 26 ....... A Echo exam of fetal heart ............................... 1.67 0.49 0.57 0.49 0.57 0.07 2.23 2.31 2.23 2.31 XXX 76825 ......... TC ...... A Echo exam of fetal heart ............................... 0.00 3.88 2.45 NA NA 0.11 3.99 2.56 NA NA XXX 76826 ......... ............ A Echo exam of fetal heart ............................... 0.83 2.75 1.44 NA NA 0.08 3.66 2.35 NA NA XXX 76826 ......... 26 ....... A Echo exam of fetal heart ............................... 0.83 0.24 0.28 0.24 0.28 0.03 1.10 1.14 1.10 1.14 XXX 76826 ......... TC ...... A Echo exam of fetal heart ............................... 0.00 2.51 1.16 NA NA 0.05 2.56 1.21 NA NA XXX 76827 ......... ............ A Echo exam of fetal heart ............................... 0.58 1.07 1.71 NA NA 0.14 1.79 2.43 NA NA XXX 76827 ......... 26 ....... A Echo exam of fetal heart ............................... 0.58 0.17 0.20 0.17 0.20 0.02 0.77 0.80 0.77 0.80 XXX 76827 ......... TC ...... A Echo exam of fetal heart ............................... 0.00 0.90 1.52 NA NA 0.12 1.02 1.64 NA NA XXX 76828 ......... ............ A Echo exam of fetal heart ............................... 0.56 0.64 1.16 NA NA 0.11 1.31 1.83 NA NA XXX 76828 ......... 26 ....... A Echo exam of fetal heart ............................... 0.56 0.16 0.21 0.16 0.21 0.03 0.75 0.80 0.75 0.80 XXX 76828 ......... TC ...... A Echo exam of fetal heart ............................... 0.00 0.48 0.95 NA NA 0.08 0.56 1.03 NA NA XXX 76830 ......... ............ A Transvaginal us, non-ob ................................ 0.69 2.77 2.00 NA NA 0.13 3.59 2.82 NA NA XXX 76830 ......... 26 ....... A Transvaginal us, non-ob ................................ 0.69 0.21 0.23 0.21 0.23 0.03 0.93 0.95 0.93 0.95 XXX 76830 ......... TC ...... A Transvaginal us, non-ob ................................ 0.00 2.56 1.78 NA NA 0.10 2.66 1.88 NA NA XXX 76831 ......... ............ A Echo exam, uterus ........................................ 0.72 2.76 2.01 NA NA 0.13 3.61 2.86 NA NA XXX 76831 ......... 26 ....... A Echo exam, uterus ........................................ 0.72 0.21 0.24 0.21 0.24 0.03 0.96 0.99 0.96 0.99 XXX 76831 ......... TC ...... A Echo exam, uterus ........................................ 0.00 2.55 1.78 NA NA 0.10 2.65 1.88 NA NA XXX 76856 ......... ............ A Us exam, pelvic, complete ............................ 0.69 2.81 2.01 NA NA 0.13 3.63 2.83 NA NA XXX 76856 ......... 26 ....... A Us exam, pelvic, complete ............................ 0.69 0.22 0.23 0.22 0.23 0.03 0.94 0.95 0.94 0.95 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49199 

76856 ......... TC ...... A Us exam, pelvic, complete ............................ 0.00 2.59 1.79 NA NA 0.10 2.69 1.89 NA NA XXX 76857 ......... ............ A Us exam, pelvic, limited ................................ 0.38 2.53 2.00 NA NA 0.08 2.99 2.46 NA NA XXX 76857 ......... 26 ....... A Us exam, pelvic, limited ................................ 0.38 0.14 0.13 0.14 0.13 0.02 0.54 0.53 0.54 0.53 XXX 76857 ......... TC ...... A Us exam, pelvic, limited ................................ 0.00 2.38 1.88 NA NA 0.06 2.44 1.94 NA NA XXX 76870 ......... ............ A Us exam, scrotum ......................................... 0.64 2.83 2.00 NA NA 0.13 3.60 2.77 NA NA XXX 76870 ......... 26 ....... A Us exam, scrotum ......................................... 0.64 0.21 0.21 0.21 0.21 0.03 0.88 0.88 0.88 0.88 XXX 76870 ......... TC ...... A Us exam, scrotum ......................................... 0.00 2.62 1.80 NA NA 0.10 2.72 1.90 NA NA XXX 76872 ......... ............ A Us, transrectal ............................................... 0.69 3.43 2.54 NA NA 0.14 4.26 3.37 NA NA XXX 76872 ......... 26 ....... A Us, transrectal ............................................... 0.69 0.27 0.23 0.27 0.23 0.04 1.00 0.96 1.00 0.96 XXX 76872 ......... TC ...... A Us, transrectal ............................................... 0.00 3.16 2.31 NA NA 0.10 3.26 2.41 NA NA XXX 76873 ......... ............ A Echograp trans r, pros study ......................... 1.55 3.39 2.80 NA NA 0.25 5.19 4.60 NA NA XXX 76873 ......... 26 ....... A Echograp trans r, pros study ......................... 1.55 0.51 0.50 0.51 0.50 0.09 2.15 2.14 2.15 2.14 XXX 76873 ......... TC ...... A Echograp trans r, pros study ......................... 0.00 2.87 2.29 NA NA 0.16 3.03 2.45 NA NA XXX 76880 ......... ............ A Us exam, extremity ....................................... 0.59 3.19 2.01 NA NA 0.11 3.89 2.71 NA NA XXX 76880 ......... 26 ....... A Us exam, extremity ....................................... 0.59 0.18 0.19 0.18 0.19 0.03 0.80 0.81 0.80 0.81 XXX 76880 ......... TC ...... A Us exam, extremity ....................................... 0.00 3.01 1.82 NA NA 0.08 3.09 1.90 NA NA XXX 76885 ......... ............ A Us exam infant hips, dynamic ....................... 0.74 3.21 2.12 NA NA 0.13 4.08 2.99 NA NA XXX 76885 ......... 26 ....... A Us exam infant hips, dynamic ....................... 0.74 0.22 0.24 0.22 0.24 0.03 0.99 1.01 0.99 1.01 XXX 76885 ......... TC ...... A Us exam infant hips, dynamic ....................... 0.00 2.99 1.89 NA NA 0.10 3.09 1.99 NA NA XXX 76886 ......... ............ A Us exam infant hips, static ............................ 0.62 2.30 1.79 NA NA 0.11 3.03 2.52 NA NA XXX 76886 ......... 26 ....... A Us exam infant hips, static ............................ 0.62 0.18 0.20 0.18 0.20 0.03 0.83 0.85 0.83 0.85 XXX 76886 ......... TC ...... A Us exam infant hips, static ............................ 0.00 2.12 1.60 NA NA 0.08 2.20 1.68 NA NA XXX 76930 ......... ............ A Echo guide, cardiocentesis ........................... 0.67 2.11 1.85 NA NA 0.12 2.90 2.64 NA NA XXX 76930 ......... 26 ....... A Echo guide, cardiocentesis ........................... 0.67 0.34 0.27 0.34 0.27 0.02 1.03 0.96 1.03 0.96 XXX 76930 ......... TC ...... A Echo guide, cardiocentesis ........................... 0.00 1.76 1.58 NA NA 0.10 1.86 1.68 NA NA XXX 76932 ......... ............ A Echo guide for heart biopsy .......................... 0.67 NA NA NA NA 0.12 NA NA NA NA XXX 76932 ......... 26 ....... A Echo guide for heart biopsy .......................... 0.67 0.35 0.28 0.35 0.28 0.02 1.04 0.97 1.04 0.97 XXX 76932 ......... TC ...... A Echo guide for heart biopsy .......................... 0.00 NA NA NA NA 0.10 NA NA NA NA XXX 76936 ......... ............ A Echo guide for artery repair .......................... 1.99 6.05 6.73 NA NA 0.47 8.51 9.19 NA NA XXX76936 ......... 26 ....... A Echo guide for artery repair .......................... 1.99 0.67 0.66 0.67 0.66 0.13 2.79 2.78 2.79 2.78 XXX 76936 ......... TC ...... A Echo guide for artery repair .......................... 0.00 5.38 6.06 NA NA 0.34 5.72 6.40 NA NA XXX 76937 ......... ............ A Us guide, vascular access ............................ 0.30 0.61 0.51 0.61 0.51 0.13 1.04 0.94 1.04 0.94 ZZZ 76937 ......... 26 ....... A Us guide, vascular access ............................ 0.30 0.09 0.10 0.09 0.10 0.03 0.42 0.43 0.42 0.43 ZZZ 76937 ......... TC ...... A Us guide, vascular access ............................ 0.00 0.52 0.42 0.52 0.42 0.10 0.62 0.52 0.62 0.52 ZZZ 76940 ......... ............ A Us guide, tissue ablation ............................... 2.00 NA NA NA NA 0.60 NA NA NA NA XXX 76940 ......... 26 ....... A Us guide, tissue ablation ............................... 2.00 0.60 0.64 0.60 0.64 0.31 2.91 2.95 2.91 2.95 XXX 76940 ......... TC ...... A Us guide, tissue ablation ............................... 0.00 NA NA NA NA 0.29 NA NA NA NA XXX 76941 ......... ............ A Echo guide for transfusion ............................ 1.34 NA NA NA NA 0.15 NA NA NA NA XXX 76941 ......... 26 ....... A Echo guide for transfusion ............................ 1.34 0.44 0.46 0.44 0.46 0.07 1.85 1.87 1.85 1.87 XXX 76941 ......... TC ...... A Echo guide for transfusion ............................ 0.00 NA NA NA NA 0.08 NA NA NA NA XXX 76942 ......... ............ A Echo guide for biopsy ................................... 0.67 4.83 3.48 NA NA 0.13 5.63 4.28 NA NA XXX 76942 ......... 26 ....... A Echo guide for biopsy ................................... 0.67 0.23 0.22 0.23 0.22 0.03 0.93 0.92 0.93 0.92 XXX 76942 ......... TC ...... A Echo guide for biopsy ................................... 0.00 4.60 3.26 NA NA 0.10 4.70 3.36 NA NA XXX 76945 ......... ............ A Echo guide, villus sampling ........................... 0.67 NA NA NA NA 0.11 NA NA NA NA XXX 76945 ......... 26 ....... A Echo guide, villus sampling ........................... 0.67 0.21 0.22 0.21 0.22 0.03 0.91 0.92 0.91 0.92 XXX 76945 ......... TC ...... A Echo guide, villus sampling ........................... 0.00 NA NA NA NA 0.08 NA NA NA NA XXX 76946 ......... ............ A Echo guide for amniocentesis ....................... 0.38 0.45 1.36 NA NA 0.12 0.95 1.86 NA NA XXX 76946 ......... 26 ....... A Echo guide for amniocentesis ....................... 0.38 0.11 0.13 0.11 0.13 0.02 0.51 0.53 0.51 0.53 XXX 76946 ......... TC ...... A Echo guide for amniocentesis ....................... 0.00 0.34 1.23 NA NA 0.10 0.44 1.33 NA NA XXX 76948 ......... ............ A Echo guide, ova aspiration ............................ 0.38 0.45 1.35 NA NA 0.12 0.95 1.85 NA NA XXX76948 ......... 26 ....... A Echo guide, ova aspiration ............................ 0.38 0.11 0.13 0.11 0.13 0.02 0.51 0.53 0.51 0.53 XXX 76948 ......... TC ...... A Echo guide, ova aspiration ............................ 0.00 0.34 1.23 NA NA 0.10 0.44 1.33 NA NA XXX 76950 ......... ............ A Echo guidance radiotherapy ......................... 0.58 1.16 1.42 NA NA 0.10 1.84 2.10 NA NA XXX 76950 ......... 26 ....... A Echo guidance radiotherapy ......................... 0.58 0.16 0.18 0.16 0.18 0.03 0.77 0.79 0.77 0.79 XXX 76950 ......... TC ...... A Echo guidance radiotherapy ......................... 0.00 1.00 1.23 NA NA 0.07 1.07 1.30 NA NA XXX 76965 ......... ............ A Echo guidance radiotherapy ......................... 1.34 1.18 4.80 NA NA 0.37 2.89 6.51 NA NA XXX 76965 ......... 26 ....... A Echo guidance radiotherapy ......................... 1.34 0.48 0.44 0.48 0.44 0.08 1.90 1.86 1.90 1.86 XXX 76965 ......... TC ...... A Echo guidance radiotherapy ......................... 0.00 0.70 4.35 NA NA 0.29 0.99 4.64 NA NA XXX 76970 ......... ............ A Ultrasound exam follow-up ............................ 0.40 2.14 1.42 NA NA 0.08 2.62 1.90 NA NA XXX 76970 ......... 26 ....... A Ultrasound exam follow-up ............................ 0.40 0.11 0.13 0.11 0.13 0.02 0.53 0.55 0.53 0.55 XXX 76970 ......... TC ...... A Ultrasound exam follow-up ............................ 0.00 2.03 1.30 NA NA 0.06 2.09 1.36 NA NA XXX 76975 ......... ............ A GI endoscopic ultrasound ............................. 0.81 NA NA NA NA 0.14 NA NA NA NA XXX 76975 ......... 26 ....... A GI endoscopic ultrasound ............................. 0.81 0.29 0.28 0.29 0.28 0.04 1.14 1.13 1.14 1.13 XXX 76975 ......... TC ...... A GI endoscopic ultrasound ............................. 0.00 NA NA NA NA 0.10 NA NA NA NA XXX 76977 ......... ............ A Us bone density measure ............................. 0.05 0.11 0.66 NA NA 0.06 0.22 0.77 NA NA XXX 76977 ......... 26 ....... A Us bone density measure ............................. 0.05 0.01 0.02 0.01 0.02 0.01 0.07 0.08 0.07 0.08 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49200 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

76977 ......... TC ...... A Us bone density measure ............................. 0.00 0.09 0.64 NA NA 0.05 0.14 0.69 NA NA XXX 76986 ......... ............ A Ultrasound guide intraoper ............................ 1.20 NA NA NA NA 0.27 NA NA NA NA XXX 76986 ......... 26 ....... A Ultrasound guide intraoper ............................ 1.20 0.35 0.39 0.35 0.39 0.13 1.68 1.72 1.68 1.72 XXX 76986 ......... TC ...... A Ultrasound guide intraoper ............................ 0.00 NA NA NA NA 0.14 NA NA NA NA XXX 76999 ......... ............ C Echo examination procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 76999 ......... 26 ....... C Echo examination procedure ........................ 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX77261 ......... ............ A Radiation therapy planning ........................... 1.39 0.41 0.49 0.41 0.49 0.07 1.87 1.95 1.87 1.95 XXX 77262 ......... ............ A Radiation therapy planning ........................... 2.11 0.58 0.71 0.58 0.71 0.11 2.80 2.93 2.80 2.93 XXX 77263 ......... ............ A Radiation therapy planning ........................... 3.14 0.86 1.05 0.86 1.05 0.16 4.16 4.35 4.16 4.35 XXX 77280 ......... ............ A Set radiation therapy field ............................. 0.70 4.35 3.86 NA NA 0.22 5.27 4.78 NA NA XXX 77280 ......... 26 ....... A Set radiation therapy field ............................. 0.70 0.19 0.21 0.19 0.21 0.04 0.93 0.95 0.93 0.95 XXX 77280 ......... TC ...... A Set radiation therapy field ............................. 0.00 4.16 3.64 NA NA 0.18 4.34 3.82 NA NA XXX 77285 ......... ............ A Set radiation therapy field ............................. 1.05 7.91 6.41 NA NA 0.35 9.31 7.81 NA NA XXX 77285 ......... 26 ....... A Set radiation therapy field ............................. 1.05 0.29 0.33 0.29 0.33 0.05 1.39 1.43 1.39 1.43 XXX 77285 ......... TC ...... A Set radiation therapy field ............................. 0.00 7.62 6.08 NA NA 0.30 7.92 6.38 NA NA XXX 77290 ......... ............ A Set radiation therapy field ............................. 1.56 13.23 8.57 NA NA 0.43 15.22 10.56 NA NA XXX 77290 ......... 26 ....... A Set radiation therapy field ............................. 1.56 0.43 0.48 0.43 0.48 0.08 2.07 2.12 2.07 2.12 XXX 77290 ......... TC ...... A Set radiation therapy field ............................. 0.00 12.81 8.09 NA NA 0.35 13.16 8.44 NA NA XXX77295 ......... ............ A Set radiation therapy field ............................. 4.56 6.90 23.76 NA NA 1.71 13.17 30.03 NA NA XXX 77295 ......... 26 ....... A Set radiation therapy field ............................. 4.56 1.25 1.41 1.25 1.41 0.23 6.04 6.20 6.04 6.20 XXX 77295 ......... TC ...... A Set radiation therapy field ............................. 0.00 5.65 22.36 NA NA 1.48 7.13 23.84 NA NA XXX77299 ......... ............ C Radiation therapy planning ........................... 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 XXX 77300 ......... ............ A Radiation therapy dose plan ......................... 0.62 1.08 1.43 NA NA 0.10 1.80 2.15 NA NA XXX 77300 ......... 26 ....... A Radiation therapy dose plan ......................... 0.62 0.17 0.19 0.17 0.19 0.03 0.82 0.84 0.82 0.84 XXX 77300 ......... TC ...... A Radiation therapy dose plan ......................... 0.00 0.91 1.23 NA NA 0.07 0.98 1.30 NA NA XXX 77301 ......... ............ A Radiotherapy dose plan, imrt ........................ 7.99 53.43 36.23 NA NA 1.88 63.30 46.10 NA NA XXX 77301 ......... 26 ....... A Radiotherapy dose plan, imrt ........................ 7.99 2.19 2.47 2.19 2.47 0.40 10.58 10.86 10.58 10.86 XXX 77301 ......... TC ...... A Radiotherapy dose plan, imrt ........................ 0.00 51.24 33.76 NA NA 1.48 52.72 35.24 NA NA XXX 77305 ......... ............ A Teletx isodose plan simple ............................ 0.70 0.85 1.78 NA NA 0.15 1.70 2.63 NA NA XXX77305 ......... 26 ....... A Teletx isodose plan simple ............................ 0.70 0.19 0.22 0.19 0.22 0.04 0.93 0.96 0.93 0.96 XXX 77305 ......... TC ...... A Teletx isodose plan simple ............................ 0.00 0.65 1.56 NA NA 0.11 0.76 1.67 NA NA XXX 77310 ......... ............ A Teletx isodose plan intermed ........................ 1.05 1.17 2.30 NA NA 0.18 2.40 3.53 NA NA XXX 77310 ......... 26 ....... A Teletx isodose plan intermed ........................ 1.05 0.28 0.33 0.28 0.33 0.05 1.38 1.43 1.38 1.43 XXX 77310 ......... TC ...... A Teletx isodose plan intermed ........................ 0.00 0.89 1.97 NA NA 0.13 1.02 2.10 NA NA XXX 77315 ......... ............ A Teletx isodose plan complex ......................... 1.56 1.97 2.86 NA NA 0.22 3.75 4.64 NA NA XXX 77315 ......... 26 ....... A Teletx isodose plan complex ......................... 1.56 0.43 0.48 0.43 0.48 0.08 2.07 2.12 2.07 2.12 XXX 77315 ......... TC ...... A Teletx isodose plan complex ......................... 0.00 1.54 2.38 NA NA 0.14 1.68 2.52 NA NA XXX 77321 ......... ............ A Special teletx port plan .................................. 0.95 1.38 3.60 NA NA 0.26 2.59 4.81 NA NA XXX 77321 ......... 26 ....... A Special teletx port plan .................................. 0.95 0.26 0.29 0.26 0.29 0.05 1.26 1.29 1.26 1.29 XXX 77321 ......... TC ...... A Special teletx port plan .................................. 0.00 1.12 3.31 NA NA 0.21 1.33 3.52 NA NA XXX77326 ......... ............ A Brachytx isodose calc simp ........................... 0.93 2.78 2.69 NA NA 0.18 3.89 3.80 NA NA XXX 77326 ......... 26 ....... A Brachytx isodose calc simp ........................... 0.93 0.25 0.29 0.25 0.29 0.05 1.23 1.27 1.23 1.27 XXX 77326 ......... TC ...... A Brachytx isodose calc simp ........................... 0.00 2.53 2.40 NA NA 0.13 2.66 2.53 NA NA XXX 77327 ......... ............ A Brachytx isodose calc interm ........................ 1.39 3.84 3.89 NA NA 0.25 5.48 5.53 NA NA XXX 77327 ......... 26 ....... A Brachytx isodose calc interm ........................ 1.39 0.38 0.43 0.38 0.43 0.07 1.84 1.89 1.84 1.89 XXX 77327 ......... TC ...... A Brachytx isodose calc interm ........................ 0.00 3.46 3.47 NA NA 0.18 3.64 3.65 NA NA XXX 77328 ......... ............ A Brachytx isodose plan compl ........................ 2.09 4.93 5.45 NA NA 0.36 7.38 7.90 NA NA XXX 77328 ......... 26 ....... A Brachytx isodose plan compl ........................ 2.09 0.57 0.65 0.57 0.65 0.11 2.77 2.85 2.77 2.85 XXX 77328 ......... TC ...... A Brachytx isodose plan compl ........................ 0.00 4.36 4.81 NA NA 0.25 4.61 5.06 NA NA XXX 77331 ......... ............ A Special radiation dosimetry ........................... 0.87 0.72 0.77 NA NA 0.06 1.65 1.70 NA NA XXX77331 ......... 26 ....... A Special radiation dosimetry ........................... 0.87 0.24 0.27 0.24 0.27 0.04 1.15 1.18 1.15 1.18 XXX 77331 ......... TC ...... A Special radiation dosimetry ........................... 0.00 0.49 0.50 NA NA 0.02 0.51 0.52 NA NA XXX 77332 ......... ............ A Radiation treatment aid(s) ............................. 0.54 1.52 1.51 NA NA 0.10 2.16 2.15 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49201 

77332 ......... 26 ....... A Radiation treatment aid(s) ............................. 0.54 0.15 0.17 0.15 0.17 0.03 0.72 0.74 0.72 0.74 XXX 77332 ......... TC ...... A Radiation treatment aid(s) ............................. 0.00 1.37 1.35 NA NA 0.07 1.44 1.42 NA NA XXX 77333 ......... ............ A Radiation treatment aid(s) ............................. 0.84 0.46 1.74 NA NA 0.15 1.45 2.73 NA NA XXX 77333 ......... 26 ....... A Radiation treatment aid(s) ............................. 0.84 0.23 0.26 0.23 0.26 0.04 1.11 1.14 1.11 1.14 XXX 77333 ......... TC ...... A Radiation treatment aid(s) ............................. 0.00 0.23 1.48 NA NA 0.11 0.34 1.59 NA NA XXX 77334 ......... ............ A Radiation treatment aid(s) ............................. 1.24 2.61 3.39 NA NA 0.23 4.08 4.86 NA NA XXX 77334 ......... 26 ....... A Radiation treatment aid(s) ............................. 1.24 0.34 0.39 0.34 0.39 0.06 1.64 1.69 1.64 1.69 XXX 77334 ......... TC ...... A Radiation treatment aid(s) ............................. 0.00 2.27 3.01 NA NA 0.17 2.44 3.18 NA NA XXX 77336 ......... ............ A Radiation physics consult .............................. 0.00 0.92 2.47 NA NA 0.16 1.08 2.63 NA NA XXX 77370 ......... ............ A Radiation physics consult .............................. 0.00 2.33 3.20 NA NA 0.18 2.51 3.38 NA NA XXX 77399 ......... ............ C External radiation dosimetry .......................... 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 XXX 77401 ......... ............ A Radiation treatment delivery ......................... 0.00 0.49 1.45 NA NA 0.11 0.60 1.56 NA NA XXX 77402 ......... ............ A Radiation treatment delivery ......................... 0.00 4.15 2.37 NA NA 0.11 4.26 2.48 NA NA XXX 77403 ......... ............ A Radiation treatment delivery ......................... 0.00 3.73 2.26 NA NA 0.11 3.84 2.37 NA NA XXX 77404 ......... ............ A Radiation treatment delivery ......................... 0.00 4.19 2.38 NA NA 0.11 4.30 2.49 NA NA XXX 77406 ......... ............ A Radiation treatment delivery ......................... 0.00 4.18 2.37 NA NA 0.11 4.29 2.48 NA NA XXX 77407 ......... ............ A Radiation treatment delivery ......................... 0.00 5.39 2.92 NA NA 0.12 5.51 3.04 NA NA XXX 77408 ......... ............ A Radiation treatment delivery ......................... 0.00 5.18 2.86 NA NA 0.12 5.30 2.98 NA NA XXX 77409 ......... ............ A Radiation treatment delivery ......................... 0.00 5.78 3.01 NA NA 0.12 5.90 3.13 NA NA XXX 77411 ......... ............ A Radiation treatment delivery ......................... 0.00 5.68 2.99 NA NA 0.12 5.80 3.11 NA NA XXX 77412 ......... ............ A Radiation treatment delivery ......................... 0.00 6.78 3.44 NA NA 0.13 6.91 3.57 NA NA XXX 77413 ......... ............ A Radiation treatment delivery ......................... 0.00 6.80 3.45 NA NA 0.13 6.93 3.58 NA NA XXX 77414 ......... ............ A Radiation treatment delivery ......................... 0.00 7.66 3.66 NA NA 0.13 7.79 3.79 NA NA XXX 77416 ......... ............ A Radiation treatment delivery ......................... 0.00 7.65 3.66 NA NA 0.13 7.78 3.79 NA NA XXX 77417 ......... ............ A Radiology port film(s) .................................... 0.00 0.35 0.53 NA NA 0.04 0.39 0.57 NA NA XXX 77418 ......... ............ A Radiation tx delivery, imrt .............................. 0.00 13.02 16.77 NA NA 0.13 13.15 16.90 NA NA XXX 77421 ......... ............ A Stereoscopic x-ray guidance ......................... 0.39 1.95 3.10 NA NA 0.12 2.46 3.61 NA NA XXX 77421 ......... 26 ....... A Stereoscopic x-ray guidance ......................... 0.39 0.11 0.13 0.11 0.13 0.02 0.52 0.54 0.52 0.54 XXX 77421 ......... TC ...... A Stereoscopic x-ray guidance ......................... 0.00 1.84 2.97 NA NA 0.10 1.94 3.07 NA NA XXX 77422 ......... ............ A Neutron beam tx, simple ............................... 0.00 11.79 4.23 NA NA 0.13 11.92 4.36 NA NA XXX 77423 ......... ............ A Neutron beam tx, complex ............................ 0.00 7.83 3.65 NA NA 0.13 7.96 3.78 NA NA XXX 77427 ......... ............ A Radiation tx management, x5 ....................... 3.31 1.08 1.07 1.08 1.07 0.17 4.56 4.55 4.56 4.55 XXX 77431 ......... ............ A Radiation therapy management .................... 1.81 0.68 0.68 0.68 0.68 0.09 2.58 2.58 2.58 2.58 XXX 77432 ......... ............ A Stereotactic radiation trmt ............................. 7.92 2.17 2.72 2.17 2.72 0.41 10.50 11.05 10.50 11.05 XXX 77470 ......... ............ A Special radiation treatment ........................... 2.09 1.76 9.31 NA NA 0.70 4.55 12.10 NA NA XXX 77470 ......... 26 ....... A Special radiation treatment ........................... 2.09 0.57 0.65 0.57 0.65 0.11 2.77 2.85 2.77 2.85 XXX 77470 ......... TC ...... A Special radiation treatment ........................... 0.00 1.19 8.66 NA NA 0.59 1.78 9.25 NA NA XXX 77499 ......... ............ C Radiation therapy management .................... 0.00 0.00 0.00 0.00 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 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 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 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 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 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 0.00 0.00 0.00 0.00 XXX 77600 ......... ............ R Hyperthermia treatment ................................. 1.56 9.32 4.99 NA NA 0.24 11.12 6.79 NA NA XXX 77600 ......... 26 ....... R Hyperthermia treatment ................................. 1.56 0.35 0.46 0.35 0.46 0.08 1.99 2.10 1.99 2.10 XXX 77600 ......... TC ...... R Hyperthermia treatment ................................. 0.00 8.97 4.53 NA NA 0.16 9.13 4.69 NA NA XXX 77605 ......... ............ R Hyperthermia treatment ................................. 2.09 16.90 7.77 NA NA 0.38 19.37 10.24 NA NA XXX 77605 ......... 26 ....... R Hyperthermia treatment ................................. 2.09 0.53 0.63 0.53 0.63 0.16 2.78 2.88 2.78 2.88 XXX 77605 ......... TC ...... R Hyperthermia treatment ................................. 0.00 16.36 7.14 NA NA 0.22 16.58 7.36 NA NA XXX 77610 ......... ............ R Hyperthermia treatment ................................. 1.56 16.54 6.81 NA NA 0.24 18.34 8.61 NA NA XXX 77610 ......... 26 ....... R Hyperthermia treatment ................................. 1.56 0.43 0.49 0.43 0.49 0.08 2.07 2.13 2.07 2.13 XXX 77610 ......... TC ...... R Hyperthermia treatment ................................. 0.00 16.12 6.32 NA NA 0.16 16.28 6.48 NA NA XXX 77615 ......... ............ R Hyperthermia treatment ................................. 2.09 24.51 9.67 NA NA 0.33 26.93 12.09 NA NA XXX 77615 ......... 26 ....... R Hyperthermia treatment ................................. 2.09 0.55 0.63 0.55 0.63 0.11 2.75 2.83 2.75 2.83 XXX 77615 ......... TC ...... R Hyperthermia treatment ................................. 0.00 23.95 9.03 NA NA 0.22 24.17 9.25 NA NA XXX 77620 ......... ............ R Hyperthermia treatment ................................. 1.56 9.58 5.07 NA NA 0.36 11.50 6.99 NA NA XXX 77620 ......... 26 ....... R Hyperthermia treatment ................................. 1.56 0.41 0.49 0.41 0.49 0.20 2.17 2.25 2.17 2.25 XXX 77620 ......... TC ...... R Hyperthermia treatment ................................. 0.00 9.18 4.58 NA NA 0.16 9.34 4.74 NA NA XXX 77750 ......... ............ A Infuse radioactive materials .......................... 4.90 4.19 3.22 4.19 3.22 0.32 9.41 8.44 9.41 8.44 090 77750 ......... 26 ....... A Infuse radioactive materials .......................... 4.90 1.35 1.52 1.35 1.52 0.25 6.50 6.67 6.50 6.67 090 77750 ......... TC ...... A Infuse radioactive materials .......................... 0.00 2.84 1.71 2.84 1.71 0.07 2.91 1.78 2.91 1.78 090 77761 ......... ............ A Apply intrcav radiat simple ............................ 3.80 5.59 4.09 5.59 4.09 0.33 9.72 8.22 9.72 8.22 090 77761 ......... 26 ....... A Apply intrcav radiat simple ............................ 3.80 1.05 1.08 1.05 1.08 0.19 5.04 5.07 5.04 5.07 090 

mstockstill on PROD1PC63 with PROPOSAL_2

49202 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

77761 ......... TC ...... A Apply intrcav radiat simple ............................ 0.00 4.54 3.01 4.54 3.01 0.14 4.68 3.15 4.68 3.15 090 77762 ......... ............ A Apply intrcav radiat interm ............................ 5.71 6.58 5.73 6.58 5.73 0.48 12.77 11.92 12.77 11.92 090 77762 ......... 26 ....... A Apply intrcav radiat interm ............................ 5.71 1.56 1.76 1.56 1.76 0.29 7.56 7.76 7.56 7.76 090 77762 ......... TC ...... A Apply intrcav radiat interm ............................ 0.00 5.03 3.97 5.03 3.97 0.19 5.22 4.16 5.22 4.16 090 77763 ......... ............ A Apply intrcav radiat compl ............................. 8.56 8.87 7.64 8.87 7.64 0.66 18.09 16.86 18.09 16.86 090 77763 ......... 26 ....... A Apply intrcav radiat compl ............................. 8.56 2.33 2.64 2.33 2.64 0.43 11.32 11.63 11.32 11.63 090 77763 ......... TC ...... A Apply intrcav radiat compl ............................. 0.00 6.54 5.00 6.54 5.00 0.23 6.77 5.23 6.77 5.23 090 77776 ......... ............ A Apply interstit radiat simpl ............................. 4.65 6.66 4.01 6.66 4.01 0.57 11.88 9.23 11.88 9.23 090 77776 ......... 26 ....... A Apply interstit radiat simpl ............................. 4.65 1.54 1.10 1.54 1.10 0.44 6.63 6.19 6.63 6.19 090 77776 ......... TC ...... A Apply interstit radiat simpl ............................. 0.00 5.12 2.92 5.12 2.92 0.13 5.25 3.05 5.25 3.05 090 77777 ......... ............ A Apply interstit radiat inter .............................. 7.47 6.93 6.68 6.93 6.68 0.61 15.01 14.76 15.01 14.76 090 77777 ......... 26 ....... A Apply interstit radiat inter .............................. 7.47 2.18 2.32 2.18 2.32 0.39 10.04 10.18 10.04 10.18 090 77778 ......... ............ A Apply interstit radiat compl ............................ 11.17 9.61 8.92 9.61 8.92 0.84 21.62 20.93 21.62 20.93 090 77778 ......... 26 ....... A Apply interstit radiat compl ............................ 11.17 3.08 3.45 3.08 3.45 0.57 14.82 15.19 14.82 15.19 090 77778 ......... TC ...... A Apply interstit radiat compl ............................ 0.00 6.54 5.48 6.54 5.48 0.27 6.81 5.75 6.81 5.75 090 77781 ......... ............ A High intensity brachytherapy ......................... 1.21 4.23 16.68 NA NA 1.14 6.58 19.03 NA NA XXX 77781 ......... 26 ....... A High intensity brachytherapy ......................... 1.21 0.33 0.48 0.33 0.48 0.08 1.62 1.77 1.62 1.77 XXX 77781 ......... TC ...... A High intensity brachytherapy ......................... 0.00 3.90 16.20 NA NA 1.06 4.96 17.26 NA NA XXX 77782 ......... ............ A High intensity brachytherapy ......................... 2.04 12.03 18.83 NA NA 1.19 15.26 22.06 NA NA XXX 77782 ......... 26 ....... A High intensity brachytherapy ......................... 2.04 0.55 0.74 0.55 0.74 0.13 2.72 2.91 2.72 2.91 XXX 77782 ......... TC ...... A High intensity brachytherapy ......................... 0.00 11.48 18.10 NA NA 1.06 12.54 19.16 NA NA XXX 77783 ......... ............ A High intensity brachytherapy ......................... 3.27 23.55 22.01 NA NA 1.25 28.07 26.53 NA NA XXX 77783 ......... 26 ....... A High intensity brachytherapy ......................... 3.27 0.89 1.12 0.89 1.12 0.19 4.35 4.58 4.35 4.58 XXX 77783 ......... TC ...... A High intensity brachytherapy ......................... 0.00 22.67 20.89 NA NA 1.06 23.73 21.95 NA NA XXX 77784 ......... ............ A High intensity brachytherapy ......................... 5.15 44.52 27.71 NA NA 1.35 51.02 34.21 NA NA XXX 77784 ......... 26 ....... A High intensity brachytherapy ......................... 5.15 1.40 1.69 1.40 1.69 0.29 6.84 7.13 6.84 7.13 XXX 77784 ......... TC ...... A High intensity brachytherapy ......................... 0.00 43.12 26.01 NA NA 1.06 44.18 27.07 NA NA XXX 77789 ......... ............ A Apply surface radiation .................................. 1.12 1.95 1.10 1.95 1.10 0.08 3.15 2.30 3.15 2.30 000 77789 ......... 26 ....... A Apply surface radiation .................................. 1.12 0.35 0.37 0.35 0.37 0.06 1.53 1.55 1.53 1.55 000 77789 ......... TC ...... A Apply surface radiation .................................. 0.00 1.60 0.74 1.60 0.74 0.02 1.62 0.76 1.62 0.76 000 77790 ......... ............ A Radiation handling ......................................... 1.05 1.16 0.92 NA NA 0.07 2.28 2.04 NA NA XXX 77790 ......... 26 ....... A Radiation handling ......................................... 1.05 0.29 0.33 0.29 0.33 0.05 1.39 1.43 1.39 1.43 XXX 77790 ......... TC ...... A Radiation handling ......................................... 0.00 0.87 0.59 NA NA 0.02 0.89 0.61 NA NA XXX 77799 ......... ............ C Radium/radioisotope therapy ........................ 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 77799 ......... TC ...... C Radium/radioisotope therapy ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78000 ......... ............ A Thyroid, single uptake ................................... 0.19 1.85 1.24 NA NA 0.07 2.11 1.50 NA NA XXX 78000 ......... 26 ....... A Thyroid, single uptake ................................... 0.19 0.06 0.06 0.06 0.06 0.01 0.26 0.26 0.26 0.26 XXX 78000 ......... TC ...... A Thyroid, single uptake ................................... 0.00 1.79 1.18 NA NA 0.06 1.85 1.24 NA NA XXX 78001 ......... ............ A Thyroid, multiple uptakes .............................. 0.26 2.27 1.62 NA NA 0.08 2.61 1.96 NA NA XXX 78001 ......... 26 ....... A Thyroid, multiple uptakes .............................. 0.26 0.08 0.09 0.08 0.09 0.01 0.35 0.36 0.35 0.36 XXX 78001 ......... TC ...... A Thyroid, multiple uptakes .............................. 0.00 2.19 1.53 NA NA 0.07 2.26 1.60 NA NA XXX 78003 ......... ............ A Thyroid suppress/stimul ................................ 0.33 1.89 1.28 NA NA 0.07 2.29 1.68 NA NA XXX 78003 ......... 26 ....... A Thyroid suppress/stimul ................................ 0.33 0.10 0.11 0.10 0.11 0.01 0.44 0.45 0.44 0.45 XXX 78003 ......... TC ...... A Thyroid suppress/stimul ................................ 0.00 1.78 1.17 NA NA 0.06 1.84 1.23 NA NA XXX 78006 ......... ............ A Thyroid imaging with uptake ......................... 0.49 6.24 3.47 NA NA 0.15 6.88 4.11 NA NA XXX 78006 ......... 26 ....... A Thyroid imaging with uptake ......................... 0.49 0.15 0.16 0.15 0.16 0.02 0.66 0.67 0.66 0.67 XXX 78006 ......... TC ...... A Thyroid imaging with uptake ......................... 0.00 6.08 3.31 NA NA 0.13 6.21 3.44 NA NA XXX 78007 ......... ............ A Thyroid image, mult uptakes ......................... 0.50 3.02 2.81 NA NA 0.16 3.68 3.47 NA NA XXX 78007 ......... 26 ....... A Thyroid image, mult uptakes ......................... 0.50 0.16 0.17 0.16 0.17 0.02 0.68 0.69 0.68 0.69 XXX 78007 ......... TC ...... A Thyroid image, mult uptakes ......................... 0.00 2.86 2.64 NA NA 0.14 3.00 2.78 NA NA XXX 78010 ......... ............ A Thyroid imaging ............................................. 0.39 4.20 2.51 NA NA 0.13 4.72 3.03 NA NA XXX 78010 ......... 26 ....... A Thyroid imaging ............................................. 0.39 0.12 0.13 0.12 0.13 0.02 0.53 0.54 0.53 0.54 XXX 78010 ......... TC ...... A Thyroid imaging ............................................. 0.00 4.08 2.39 NA NA 0.11 4.19 2.50 NA NA XXX 78011 ......... ............ A Thyroid imaging with flow .............................. 0.45 4.55 3.06 NA NA 0.15 5.15 3.66 NA NA XXX 78011 ......... 26 ....... A Thyroid imaging with flow .............................. 0.45 0.14 0.15 0.14 0.15 0.02 0.61 0.62 0.61 0.62 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49203 

78011 ......... TC ...... A Thyroid imaging with flow .............................. 0.00 4.41 2.91 NA NA 0.13 4.54 3.04 NA NA XXX 78015 ......... ............ A Thyroid met imaging ...................................... 0.67 5.43 3.46 NA NA 0.17 6.27 4.30 NA NA XXX 78015 ......... 26 ....... A Thyroid met imaging ...................................... 0.67 0.21 0.23 0.21 0.23 0.03 0.91 0.93 0.91 0.93 XXX 78015 ......... TC ...... A Thyroid met imaging ...................................... 0.00 5.22 3.23 NA NA 0.14 5.36 3.37 NA NA XXX 78016 ......... ............ A Thyroid met imaging/studies ......................... 0.82 8.63 4.98 NA NA 0.21 9.66 6.01 NA NA XXX 78016 ......... 26 ....... A Thyroid met imaging/studies ......................... 0.82 0.26 0.28 0.26 0.28 0.03 1.11 1.13 1.11 1.13 XXX 78016 ......... TC ...... A Thyroid met imaging/studies ......................... 0.00 8.37 4.70 NA NA 0.18 8.55 4.88 NA NA XXX 78018 ......... ............ A Thyroid met imaging, body ............................ 0.86 7.96 6.28 NA NA 0.33 9.15 7.47 NA NA XXX 78018 ......... 26 ....... A Thyroid met imaging, body ............................ 0.86 0.27 0.29 0.27 0.29 0.04 1.17 1.19 1.17 1.19 XXX 78018 ......... TC ...... A Thyroid met imaging, body ............................ 0.00 7.69 5.99 NA NA 0.29 7.98 6.28 NA NA XXX 78020 ......... ............ A Thyroid met uptake ....................................... 0.60 1.79 1.59 1.79 1.59 0.16 2.55 2.35 2.55 2.35 ZZZ 78020 ......... 26 ....... A Thyroid met uptake ....................................... 0.60 0.18 0.20 0.18 0.20 0.02 0.80 0.82 0.80 0.82 ZZZ 78020 ......... TC ...... A Thyroid met uptake ....................................... 0.00 1.60 1.38 1.60 1.38 0.14 1.74 1.52 1.74 1.52 ZZZ 78070 ......... ............ A Parathyroid nuclear imaging ......................... 0.82 3.43 4.27 NA NA 0.15 4.40 5.24 NA NA XXX 78070 ......... 26 ....... A Parathyroid nuclear imaging ......................... 0.82 0.26 0.28 0.26 0.28 0.04 1.12 1.14 1.12 1.14 XXX 78070 ......... TC ...... A Parathyroid nuclear imaging ......................... 0.00 3.17 4.00 NA NA 0.11 3.28 4.11 NA NA XXX 78075 ......... ............ A Adrenal nuclear imaging ............................... 0.74 11.67 7.18 NA NA 0.32 12.73 8.24 NA NA XXX 78075 ......... 26 ....... A Adrenal nuclear imaging ............................... 0.74 0.23 0.25 0.23 0.25 0.03 1.00 1.02 1.00 1.02 XXX 78075 ......... TC ...... A Adrenal nuclear imaging ............................... 0.00 11.44 6.93 NA NA 0.29 11.73 7.22 NA NA XXX 78099 ......... ............ C Endocrine nuclear procedure ........................ 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 XXX 78102 ......... ............ A Bone marrow imaging, ltd ............................. 0.55 4.17 2.72 NA NA 0.14 4.86 3.41 NA NA XXX 78102 ......... 26 ....... A Bone marrow imaging, ltd ............................. 0.55 0.17 0.19 0.17 0.19 0.02 0.74 0.76 0.74 0.76 XXX 78102 ......... TC ...... A Bone marrow imaging, ltd ............................. 0.00 4.00 2.53 NA NA 0.12 4.12 2.65 NA NA XXX 78103 ......... ............ A Bone marrow imaging, mult .......................... 0.75 5.43 3.93 NA NA 0.20 6.38 4.88 NA NA XXX 78103 ......... 26 ....... A Bone marrow imaging, mult .......................... 0.75 0.23 0.25 0.23 0.25 0.03 1.01 1.03 1.01 1.03 XXX 78103 ......... TC ...... A Bone marrow imaging, mult .......................... 0.00 5.20 3.68 NA NA 0.17 5.37 3.85 NA NA XXX 78104 ......... ............ A Bone marrow imaging, body ......................... 0.80 6.30 4.83 NA NA 0.25 7.35 5.88 NA NA XXX 78104 ......... 26 ....... A Bone marrow imaging, body ......................... 0.80 0.27 0.27 0.27 0.27 0.03 1.10 1.10 1.10 1.10 XXX 78104 ......... TC ...... A Bone marrow imaging, body ......................... 0.00 6.02 4.56 NA NA 0.22 6.24 4.78 NA NA XXX 78110 ......... ............ A Plasma volume, single .................................. 0.19 2.16 1.31 NA NA 0.07 2.42 1.57 NA NA XXX 78110 ......... 26 ....... A Plasma volume, single .................................. 0.19 0.06 0.07 0.06 0.07 0.01 0.26 0.27 0.26 0.27 XXX 78110 ......... TC ...... A Plasma volume, single .................................. 0.00 2.10 1.24 NA NA 0.06 2.16 1.30 NA NA XXX 78111 ......... ............ A Plasma volume, multiple ............................... 0.22 2.16 2.53 NA NA 0.15 2.53 2.90 NA NA XXX78111 ......... 26 ....... A Plasma volume, multiple ............................... 0.22 0.07 0.08 0.07 0.08 0.01 0.30 0.31 0.30 0.31 XXX 78111 ......... TC ...... A Plasma volume, multiple ............................... 0.00 2.09 2.45 NA NA 0.14 2.23 2.59 NA NA XXX 78120 ......... ............ A Red cell mass, single .................................... 0.23 2.09 1.88 NA NA 0.12 2.44 2.23 NA NA XXX 78120 ......... 26 ....... A Red cell mass, single .................................... 0.23 0.07 0.08 0.07 0.08 0.01 0.31 0.32 0.31 0.32 XXX 78120 ......... TC ...... A Red cell mass, single .................................... 0.00 2.02 1.80 NA NA 0.11 2.13 1.91 NA NA XXX 78121 ......... ............ A Red cell mass, multiple ................................. 0.32 2.19 2.81 NA NA 0.15 2.66 3.28 NA NA XXX 78121 ......... 26 ....... A Red cell mass, multiple ................................. 0.32 0.10 0.11 0.10 0.11 0.01 0.43 0.44 0.43 0.44 XXX 78121 ......... TC ...... A Red cell mass, multiple ................................. 0.00 2.10 2.71 NA NA 0.14 2.24 2.85 NA NA XXX 78122 ......... ............ A Blood volume ................................................. 0.45 2.25 4.13 NA NA 0.26 2.96 4.84 NA NA XXX 78122 ......... 26 ....... A Blood volume ................................................. 0.45 0.14 0.16 0.14 0.16 0.02 0.61 0.63 0.61 0.63 XXX 78122 ......... TC ...... A Blood volume ................................................. 0.00 2.11 3.98 NA NA 0.24 2.35 4.22 NA NA XXX 78130 ......... ............ A Red cell survival study .................................. 0.61 3.55 3.18 NA NA 0.17 4.33 3.96 NA NA XXX 78130 ......... 26 ....... A Red cell survival study .................................. 0.61 0.20 0.21 0.20 0.21 0.03 0.84 0.85 0.84 0.85 XXX 78130 ......... TC ...... A Red cell survival study .................................. 0.00 3.35 2.98 NA NA 0.14 3.49 3.12 NA NA XXX 78135 ......... ............ A Red cell survival kinetics ............................... 0.64 8.59 5.97 NA NA 0.28 9.51 6.89 NA NA XXX 78135 ......... 26 ....... A Red cell survival kinetics ............................... 0.64 0.20 0.22 0.20 0.22 0.03 0.87 0.89 0.87 0.89 XXX 78135 ......... TC ...... A Red cell survival kinetics ............................... 0.00 8.39 5.75 NA NA 0.25 8.64 6.00 NA NA XXX 78140 ......... ............ A Red cell sequestration ................................... 0.61 2.87 3.82 NA NA 0.24 3.72 4.67 NA NA XXX 78140 ......... 26 ....... A Red cell sequestration ................................... 0.61 0.19 0.20 0.19 0.20 0.03 0.83 0.84 0.83 0.84 XXX 78140 ......... TC ...... A Red cell sequestration ................................... 0.00 2.68 3.62 NA NA 0.21 2.89 3.83 NA NA XXX 78185 ......... ............ A Spleen imaging .............................................. 0.40 5.22 3.18 NA NA 0.15 5.77 3.73 NA NA XXX 78185 ......... 26 ....... A Spleen imaging .............................................. 0.40 0.12 0.14 0.12 0.14 0.02 0.54 0.56 0.54 0.56 XXX 78185 ......... TC ...... A Spleen imaging .............................................. 0.00 5.10 3.05 NA NA 0.13 5.23 3.18 NA NA XXX 78190 ......... ............ A Platelet survival, kinetics ............................... 1.09 9.05 6.84 NA NA 0.38 10.52 8.31 NA NA XXX 78190 ......... 26 ....... A Platelet survival, kinetics ............................... 1.09 0.34 0.38 0.34 0.38 0.08 1.51 1.55 1.51 1.55 XXX 78190 ......... TC ...... A Platelet survival, kinetics ............................... 0.00 8.71 6.46 NA NA 0.30 9.01 6.76 NA NA XXX78191 ......... ............ A Platelet survival ............................................. 0.61 3.43 6.51 NA NA 0.40 4.44 7.52 NA NA XXX 78191 ......... 26 ....... A Platelet survival ............................................. 0.61 0.19 0.20 0.19 0.20 0.03 0.83 0.84 0.83 0.84 XXX 78191 ......... TC ...... A Platelet survival ............................................. 0.00 3.24 6.32 NA NA 0.37 3.61 6.69 NA NA XXX 78195 ......... ............ A Lymph system imaging ................................. 1.20 8.66 5.53 NA NA 0.28 10.14 7.01 NA NA XXX78195 ......... 26 ....... A Lymph system imaging ................................. 1.20 0.37 0.40 0.37 0.40 0.06 1.63 1.66 1.63 1.66 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49204 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

78195 ......... TC ...... A Lymph system imaging ................................. 0.00 8.29 5.13 NA NA 0.22 8.51 5.35 NA NA XXX 78199 ......... ............ C Blood/lymph nuclear exam ............................ 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 XXX 78201 ......... ............ A Liver imaging ................................................. 0.44 4.75 3.07 NA NA 0.15 5.34 3.66 NA NA XXX 78201 ......... 26 ....... A Liver imaging ................................................. 0.44 0.13 0.15 0.13 0.15 0.02 0.59 0.61 0.59 0.61 XXX 78201 ......... TC ...... A Liver imaging ................................................. 0.00 4.61 2.92 NA NA 0.13 4.74 3.05 NA NA XXX 78202 ......... ............ A Liver imaging with flow .................................. 0.51 5.34 3.62 NA NA 0.16 6.01 4.29 NA NA XXX 78202 ......... 26 ....... A Liver imaging with flow .................................. 0.51 0.16 0.17 0.16 0.17 0.02 0.69 0.70 0.69 0.70 XXX 78202 ......... TC ...... A Liver imaging with flow .................................. 0.00 5.19 3.46 NA NA 0.14 5.33 3.60 NA NA XXX 78205 ......... ............ A Liver imaging (3D) ......................................... 0.71 5.26 5.93 NA NA 0.34 6.31 6.98 NA NA XXX 78205 ......... 26 ....... A Liver imaging (3D) ......................................... 0.71 0.22 0.24 0.22 0.24 0.03 0.96 0.98 0.96 0.98 XXX 78205 ......... TC ...... A Liver imaging (3D) ......................................... 0.00 5.04 5.69 NA NA 0.31 5.35 6.00 NA NA XXX 78206 ......... ............ A Liver image (3d) with flow ............................. 0.96 14.57 8.32 NA NA 0.15 15.68 9.43 NA NA XXX 78206 ......... 26 ....... A Liver image (3d) with flow ............................. 0.96 0.30 0.32 0.30 0.32 0.04 1.30 1.32 1.30 1.32 XXX 78206 ......... TC ...... A Liver image (3d) with flow ............................. 0.00 14.26 8.00 NA NA 0.11 14.37 8.11 NA NA XXX 78215 ......... ............ A Liver and spleen imaging .............................. 0.49 4.81 3.53 NA NA 0.16 5.46 4.18 NA NA XXX78215 ......... 26 ....... A Liver and spleen imaging .............................. 0.49 0.15 0.16 0.15 0.16 0.02 0.66 0.67 0.66 0.67 XXX 78215 ......... TC ...... A Liver and spleen imaging .............................. 0.00 4.66 3.37 NA NA 0.14 4.80 3.51 NA NA XXX 78216 ......... ............ A Liver & spleen image/flow ............................. 0.57 2.82 3.46 NA NA 0.20 3.59 4.23 NA NA XXX78216 ......... 26 ....... A Liver & spleen image/flow ............................. 0.57 0.18 0.19 0.18 0.19 0.02 0.77 0.78 0.77 0.78 XXX 78216 ......... TC ...... A Liver & spleen image/flow ............................. 0.00 2.64 3.27 NA NA 0.18 2.82 3.45 NA NA XXX 78220 ......... ............ A Liver function study ....................................... 0.49 3.04 3.67 NA NA 0.21 3.74 4.37 NA NA XXX 78220 ......... 26 ....... A Liver function study ....................................... 0.49 0.15 0.16 0.15 0.16 0.02 0.66 0.67 0.66 0.67 XXX 78220 ......... TC ...... A Liver function study ....................................... 0.00 2.89 3.51 NA NA 0.19 3.08 3.70 NA NA XXX 78223 ......... ............ A Hepatobiliary imaging .................................... 0.84 8.49 5.08 NA NA 0.23 9.56 6.15 NA NA XXX 78223 ......... 26 ....... A Hepatobiliary imaging .................................... 0.84 0.26 0.28 0.26 0.28 0.04 1.14 1.16 1.14 1.16 XXX 78223 ......... TC ...... A Hepatobiliary imaging .................................... 0.00 8.23 4.80 NA NA 0.19 8.42 4.99 NA NA XXX 78230 ......... ............ A Salivary gland imaging .................................. 0.45 4.16 2.79 NA NA 0.15 4.76 3.39 NA NA XXX 78230 ......... 26 ....... A Salivary gland imaging .................................. 0.45 0.14 0.15 0.14 0.15 0.02 0.61 0.62 0.61 0.62 XXX 78230 ......... TC ...... A Salivary gland imaging .................................. 0.00 4.02 2.64 NA NA 0.13 4.15 2.77 NA NA XXX 78231 ......... ............ A Serial salivary imaging .................................. 0.52 2.81 3.22 NA NA 0.19 3.52 3.93 NA NA XXX 78231 ......... 26 ....... A Serial salivary imaging .................................. 0.52 0.16 0.18 0.16 0.18 0.02 0.70 0.72 0.70 0.72 XXX 78231 ......... TC ...... A Serial salivary imaging .................................. 0.00 2.64 3.04 NA NA 0.17 2.81 3.21 NA NA XXX 78232 ......... ............ A Salivary gland function exam ........................ 0.47 2.78 3.47 NA NA 0.20 3.45 4.14 NA NA XXX 78232 ......... 26 ....... A Salivary gland function exam ........................ 0.47 0.15 0.16 0.15 0.16 0.02 0.64 0.65 0.64 0.65 XXX 78232 ......... TC ...... A Salivary gland function exam ........................ 0.00 2.64 3.32 NA NA 0.18 2.82 3.50 NA NA XXX 78258 ......... ............ A Esophageal motility study ............................. 0.74 5.83 3.81 NA NA 0.17 6.74 4.72 NA NA XXX78258 ......... 26 ....... A Esophageal motility study ............................. 0.74 0.27 0.26 0.27 0.26 0.03 1.04 1.03 1.04 1.03 XXX 78258 ......... TC ...... A Esophageal motility study ............................. 0.00 5.56 3.55 NA NA 0.14 5.70 3.69 NA NA XXX 78261 ......... ............ A Gastric mucosa imaging ................................ 0.69 6.07 4.77 NA NA 0.25 7.01 5.71 NA NA XXX78261 ......... 26 ....... A Gastric mucosa imaging ................................ 0.69 0.22 0.24 0.22 0.24 0.03 0.94 0.96 0.94 0.96 XXX 78261 ......... TC ...... A Gastric mucosa imaging ................................ 0.00 5.85 4.54 NA NA 0.22 6.07 4.76 NA NA XXX 78262 ......... ............ A Gastroesophageal reflux exam ..................... 0.68 5.94 4.85 NA NA 0.25 6.87 5.78 NA NA XXX 78262 ......... 26 ....... A Gastroesophageal reflux exam ..................... 0.68 0.20 0.22 0.20 0.22 0.03 0.91 0.93 0.91 0.93 XXX78262 ......... TC ...... A Gastroesophageal reflux exam ..................... 0.00 5.74 4.62 NA NA 0.22 5.96 4.84 NA NA XXX 78264 ......... ............ A Gastric emptying study .................................. 0.78 7.16 5.08 NA NA 0.25 8.19 6.11 NA NA XXX 78264 ......... 26 ....... A Gastric emptying study .................................. 0.78 0.25 0.26 0.25 0.26 0.03 1.06 1.07 1.06 1.07 XXX 78264 ......... TC ...... A Gastric emptying study .................................. 0.00 6.91 4.83 NA NA 0.22 7.13 5.05 NA NA XXX 78270 ......... ............ A Vit B-12 absorption exam .............................. 0.20 1.94 1.70 NA NA 0.11 2.25 2.01 NA NA XXX78270 ......... 26 ....... A Vit B-12 absorption exam .............................. 0.20 0.06 0.07 0.06 0.07 0.01 0.27 0.28 0.27 0.28 XXX 78270 ......... TC ...... A Vit B-12 absorption exam .............................. 0.00 1.88 1.63 NA NA 0.10 1.98 1.73 NA NA XXX 78271 ......... ............ A Vit b-12 absrp exam, int fac .......................... 0.20 1.90 1.76 NA NA 0.11 2.21 2.07 NA NA XXX78271 ......... 26 ....... A Vit b-12 absrp exam, int fac .......................... 0.20 0.05 0.07 0.05 0.07 0.01 0.26 0.28 0.26 0.28 XXX 78271 ......... TC ...... A Vit b-12 absrp exam, int fac .......................... 0.00 1.85 1.69 NA NA 0.10 1.95 1.79 NA NA XXX 78272 ......... ............ A Vit B-12 absorp, combined ............................ 0.27 2.02 2.31 NA NA 0.14 2.43 2.72 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49205 

78272 ......... 26 ....... A Vit B-12 absorp, combined ............................ 0.27 0.07 0.09 0.07 0.09 0.01 0.35 0.37 0.35 0.37 XXX 78272 ......... TC ...... A Vit B-12 absorp, combined ............................ 0.00 1.95 2.23 NA NA 0.13 2.08 2.36 NA NA XXX 78278 ......... ............ A Acute GI blood loss imaging ......................... 0.99 8.57 6.04 NA NA 0.29 9.85 7.32 NA NA XXX 78278 ......... 26 ....... A Acute GI blood loss imaging ......................... 0.99 0.31 0.33 0.31 0.33 0.04 1.34 1.36 1.34 1.36 XXX 78278 ......... TC ...... A Acute GI blood loss imaging ......................... 0.00 8.26 5.72 NA NA 0.25 8.51 5.97 NA NA XXX 78282 ......... ............ C GI protein loss exam ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78282 ......... 26 ....... A GI protein loss exam ..................................... 0.38 0.12 0.13 0.12 0.13 0.02 0.52 0.53 0.52 0.53 XXX 78282 ......... TC ...... C GI protein loss exam ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78290 ......... ............ A MeckelIs divert exam .................................... 0.68 8.46 4.58 NA NA 0.19 9.33 5.45 NA NA XXX 78290 ......... 26 ....... A MeckelIs divert exam .................................... 0.68 0.21 0.23 0.21 0.23 0.03 0.92 0.94 0.92 0.94 XXX 78290 ......... TC ...... A MeckelIs divert exam .................................... 0.00 8.25 4.35 NA NA 0.16 8.41 4.51 NA NA XXX 78291 ......... ............ A Leveen/shunt patency exam ......................... 0.88 6.17 4.06 NA NA 0.20 7.25 5.14 NA NA XXX 78291 ......... 26 ....... A Leveen/shunt patency exam ......................... 0.88 0.27 0.29 0.27 0.29 0.04 1.19 1.21 1.19 1.21 XXX 78291 ......... TC ...... A Leveen/shunt patency exam ......................... 0.00 5.90 3.77 NA NA 0.16 6.06 3.93 NA NA XXX 78299 ......... ............ C GI nuclear procedure .................................... 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 XXX 78300 ......... ............ A Bone imaging, limited area ........................... 0.62 4.20 3.07 NA NA 0.17 4.99 3.86 NA NA XXX 78300 ......... 26 ....... A Bone imaging, limited area ........................... 0.62 0.19 0.21 0.19 0.21 0.03 0.84 0.86 0.84 0.86 XXX 78300 ......... TC ...... A Bone imaging, limited area ........................... 0.00 4.01 2.86 NA NA 0.14 4.15 3.00 NA NA XXX 78305 ......... ............ A Bone imaging, multiple areas ........................ 0.83 5.46 4.32 NA NA 0.23 6.52 5.38 NA NA XXX 78305 ......... 26 ....... A Bone imaging, multiple areas ........................ 0.83 0.26 0.28 0.26 0.28 0.04 1.13 1.15 1.13 1.15 XXX 78305 ......... TC ...... A Bone imaging, multiple areas ........................ 0.00 5.20 4.05 NA NA 0.19 5.39 4.24 NA NA XXX 78306 ......... ............ A Bone imaging, whole body ............................ 0.86 6.05 4.93 NA NA 0.26 7.17 6.05 NA NA XXX 78306 ......... 26 ....... A Bone imaging, whole body ............................ 0.86 0.27 0.29 0.27 0.29 0.04 1.17 1.19 1.17 1.19 XXX 78306 ......... TC ...... A Bone imaging, whole body ............................ 0.00 5.78 4.65 NA NA 0.22 6.00 4.87 NA NA XXX 78315 ......... ............ A Bone imaging, 3 phase ................................. 1.02 8.59 5.99 NA NA 0.29 9.90 7.30 NA NA XXX78315 ......... 26 ....... A Bone imaging, 3 phase ................................. 1.02 0.32 0.34 0.32 0.34 0.04 1.38 1.40 1.38 1.40 XXX 78315 ......... TC ...... A Bone imaging, 3 phase ................................. 0.00 8.27 5.65 NA NA 0.25 8.52 5.90 NA NA XXX 78320 ......... ............ A Bone imaging (3D) ........................................ 1.04 5.36 6.04 NA NA 0.35 6.75 7.43 NA NA XXX 78320 ......... 26 ....... A Bone imaging (3D) ........................................ 1.04 0.33 0.35 0.33 0.35 0.04 1.41 1.43 1.41 1.43 XXX 78320 ......... TC ...... A Bone imaging (3D) ........................................ 0.00 5.03 5.69 NA NA 0.31 5.34 6.00 NA NA XXX 78350 ......... ............ A Bone mineral, single photon ......................... 0.22 0.56 0.76 NA NA 0.06 0.84 1.04 NA NA XXX 78350 ......... 26 ....... A Bone mineral, single photon ......................... 0.22 0.06 0.07 0.06 0.07 0.01 0.29 0.30 0.29 0.30 XXX 78350 ......... TC ...... A Bone mineral, single photon ......................... 0.00 0.49 0.69 NA NA 0.05 0.54 0.74 NA NA XXX 78351 ......... ............ N Bone mineral, dual photon ............................ 0.30 2.80 1.99 0.07 0.11 0.01 3.11 2.30 0.38 0.42 XXX 78399 ......... ............ C Musculoskeletal nuclear exam ...................... 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 XXX78414 ......... ............ C Non-imaging heart function ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78414 ......... 26 ....... A Non-imaging heart function ........................... 0.45 0.14 0.16 0.14 0.16 0.02 0.61 0.63 0.61 0.63 XXX 78414 ......... TC ...... C Non-imaging heart function ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78428 ......... ............ A Cardiac shunt imaging .................................. 0.78 5.36 3.25 NA NA 0.16 6.30 4.19 NA NA XXX 78428 ......... 26 ....... A Cardiac shunt imaging .................................. 0.78 0.38 0.31 0.38 0.31 0.03 1.19 1.12 1.19 1.12 XXX 78428 ......... TC ...... A Cardiac shunt imaging .................................. 0.00 4.98 2.93 NA NA 0.13 5.11 3.06 NA NA XXX 78445 ......... ............ A Vascular flow imaging ................................... 0.49 4.63 2.68 NA NA 0.13 5.25 3.30 NA NA XXX 78445 ......... 26 ....... A Vascular flow imaging ................................... 0.49 0.18 0.17 0.18 0.17 0.02 0.69 0.68 0.69 0.68 XXX 78445 ......... TC ...... A Vascular flow imaging ................................... 0.00 4.45 2.51 NA NA 0.11 4.56 2.62 NA NA XXX 78456 ......... ............ A Acute venous thrombus image ..................... 1.00 10.04 5.75 NA NA 0.33 11.37 7.08 NA NA XXX 78456 ......... 26 ....... A Acute venous thrombus image ..................... 1.00 0.50 0.38 0.50 0.38 0.04 1.54 1.42 1.54 1.42 XXX 78456 ......... TC ...... A Acute venous thrombus image ..................... 0.00 9.54 5.37 NA NA 0.29 9.83 5.66 NA NA XXX 78457 ......... ............ A Venous thrombosis imaging .......................... 0.77 4.73 3.38 NA NA 0.17 5.67 4.32 NA NA XXX 78457 ......... 26 ....... A Venous thrombosis imaging .......................... 0.77 0.24 0.26 0.24 0.26 0.03 1.04 1.06 1.04 1.06 XXX 78457 ......... TC ...... A Venous thrombosis imaging .......................... 0.00 4.49 3.12 NA NA 0.14 4.63 3.26 NA NA XXX 78458 ......... ............ A Ven thrombosis images, bilat ........................ 0.90 4.59 4.40 NA NA 0.25 5.74 5.55 NA NA XXX 78458 ......... 26 ....... A Ven thrombosis images, bilat ........................ 0.90 0.28 0.31 0.28 0.31 0.04 1.22 1.25 1.22 1.25 XXX 78458 ......... TC ...... A Ven thrombosis images, bilat ........................ 0.00 4.31 4.09 NA NA 0.21 4.52 4.30 NA NA XXX 78459 ......... ............ C Heart muscle imaging (PET) ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78459 ......... 26 ....... A Heart muscle imaging (PET) ......................... 1.50 0.55 0.57 0.55 0.57 0.05 2.10 2.12 2.10 2.12 XXX 78459 ......... TC ...... C Heart muscle imaging (PET) ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78460 ......... ............ A Heart muscle blood, single ............................ 0.86 4.68 3.16 NA NA 0.17 5.71 4.19 NA NA XXX78460 ......... 26 ....... A Heart muscle blood, single ............................ 0.86 0.29 0.29 0.29 0.29 0.04 1.19 1.19 1.19 1.19 XXX 78460 ......... TC ...... A Heart muscle blood, single ............................ 0.00 4.39 2.87 NA NA 0.13 4.52 3.00 NA NA XXX 78461 ......... ............ A Heart muscle blood, multiple ......................... 1.23 4.01 4.87 NA NA 0.30 5.54 6.40 NA NA XXX 78461 ......... 26 ....... A Heart muscle blood, multiple ......................... 1.23 0.42 0.43 0.42 0.43 0.05 1.70 1.71 1.70 1.71 XXX 78461 ......... TC ...... A Heart muscle blood, multiple ......................... 0.00 3.59 4.44 NA NA 0.25 3.84 4.69 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49206 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

78464 ......... ............ A Heart image (3d), single ................................ 1.09 5.91 7.07 NA NA 0.41 7.41 8.57 NA NA XXX 78464 ......... 26 ....... A Heart image (3d), single ................................ 1.09 0.49 0.41 0.49 0.41 0.04 1.62 1.54 1.62 1.54 XXX 78464 ......... TC ...... A Heart image (3d), single ................................ 0.00 5.42 6.66 NA NA 0.37 5.79 7.03 NA NA XXX 78465 ......... ............ A Heart image (3d), multiple ............................. 1.46 11.58 12.12 NA NA 0.67 13.71 14.25 NA NA XXX 78465 ......... 26 ....... A Heart image (3d), multiple ............................. 1.46 0.71 0.57 0.71 0.57 0.05 2.22 2.08 2.22 2.08 XXX 78465 ......... TC ...... A Heart image (3d), multiple ............................. 0.00 10.87 11.56 NA NA 0.62 11.49 12.18 NA NA XXX 78466 ......... ............ A Heart infarct image ........................................ 0.69 4.52 3.28 NA NA 0.17 5.38 4.14 NA NA XXX 78466 ......... 26 ....... A Heart infarct image ........................................ 0.69 0.25 0.24 0.25 0.24 0.03 0.97 0.96 0.97 0.96 XXX 78466 ......... TC ...... A Heart infarct image ........................................ 0.00 4.27 3.03 NA NA 0.14 4.41 3.17 NA NA XXX 78468 ......... ............ A Heart infarct image (ef) ................................. 0.80 6.06 4.46 NA NA 0.22 7.08 5.48 NA NA XXX 78468 ......... 26 ....... A Heart infarct image (ef) ................................. 0.80 0.42 0.31 0.42 0.31 0.03 1.25 1.14 1.25 1.14 XXX 78468 ......... TC ...... A Heart infarct image (ef) ................................. 0.00 5.64 4.16 NA NA 0.19 5.83 4.35 NA NA XXX 78469 ......... ............ A Heart infarct image (3D) ................................ 0.92 6.29 5.72 NA NA 0.31 7.52 6.95 NA NA XXX 78469 ......... 26 ....... A Heart infarct image (3D) ................................ 0.92 0.43 0.34 0.43 0.34 0.03 1.38 1.29 1.38 1.29 XXX 78469 ......... TC ...... A Heart infarct image (3D) ................................ 0.00 5.85 5.38 NA NA 0.28 6.13 5.66 NA NA XXX 78472 ......... ............ A Gated heart, planar, single ............................ 0.98 6.15 5.93 NA NA 0.34 7.47 7.25 NA NA XXX 78472 ......... 26 ....... A Gated heart, planar, single ............................ 0.98 0.40 0.36 0.40 0.36 0.04 1.42 1.38 1.42 1.38 XXX 78472 ......... TC ...... A Gated heart, planar, single ............................ 0.00 5.75 5.57 NA NA 0.30 6.05 5.87 NA NA XXX 78473 ......... ............ A Gated heart, multiple ..................................... 1.47 7.79 8.52 NA NA 0.48 9.74 10.47 NA NA XXX 78473 ......... 26 ....... A Gated heart, multiple ..................................... 1.47 0.62 0.54 0.62 0.54 0.06 2.15 2.07 2.15 2.07 XXX 78473 ......... TC ...... A Gated heart, multiple ..................................... 0.00 7.17 7.99 NA NA 0.42 7.59 8.41 NA NA XXX78478 ......... ............ A Heart wall motion add-on .............................. 0.50 0.81 1.54 NA NA 0.12 1.43 2.16 NA NA XXX78478 ......... 26 ....... A Heart wall motion add-on .............................. 0.50 0.24 0.23 0.24 0.23 0.02 0.76 0.75 0.76 0.75 XXX 78478 ......... TC ...... A Heart wall motion add-on .............................. 0.00 0.57 1.31 NA NA 0.10 0.67 1.41 NA NA XXX 78480 ......... ............ A Heart function add-on .................................... 0.30 0.71 1.51 NA NA 0.12 1.13 1.93 NA NA XXX 78480 ......... 26 ....... A Heart function add-on .................................... 0.30 0.15 0.20 0.15 0.20 0.02 0.47 0.52 0.47 0.52 XXX 78480 ......... TC ...... A Heart function add-on .................................... 0.00 0.57 1.31 NA NA 0.10 0.67 1.41 NA NA XXX 78481 ......... ............ A Heart first pass, single .................................. 0.98 5.12 5.47 NA NA 0.31 6.41 6.76 NA NA XXX 78481 ......... 26 ....... A Heart first pass, single .................................. 0.98 0.49 0.39 0.49 0.39 0.03 1.50 1.40 1.50 1.40 XXX 78481 ......... TC ...... A Heart first pass, single .................................. 0.00 4.62 5.07 NA NA 0.28 4.90 5.35 NA NA XXX78483 ......... ............ A Heart first pass, multiple ............................... 1.47 6.93 8.04 NA NA 0.46 8.86 9.97 NA NA XXX 78483 ......... 26 ....... A Heart first pass, multiple ............................... 1.47 0.79 0.60 0.79 0.60 0.05 2.31 2.12 2.31 2.12 XXX 78483 ......... TC ...... A Heart first pass, multiple ............................... 0.00 6.14 7.44 NA NA 0.41 6.55 7.85 NA NA XXX 78491 ......... ............ C Heart image (pet), single ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78491 ......... 26 ....... A Heart image (pet), single ............................... 1.50 0.62 0.60 0.62 0.60 0.06 2.18 2.16 2.18 2.16 XXX 78491 ......... TC ...... C Heart image (pet), single ............................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 78492 ......... 26 ....... A Heart image (pet), multiple ............................ 1.87 0.91 0.78 0.91 0.78 0.07 2.85 2.72 2.85 2.72 XXX 78492 ......... TC ...... C Heart image (pet), multiple ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78494 ......... ............ A Heart image, spect ........................................ 1.19 6.30 7.19 NA NA 0.35 7.84 8.73 NA NA XXX 78494 ......... 26 ....... A Heart image, spect ........................................ 1.19 0.54 0.45 0.54 0.45 0.05 1.78 1.69 1.78 1.69 XXX 78494 ......... TC ...... A Heart image, spect ........................................ 0.00 5.75 6.74 NA NA 0.30 6.05 7.04 NA NA XXX78496 ......... ............ A Heart first pass add-on .................................. 0.50 0.93 5.67 0.93 5.67 0.32 1.75 6.49 1.75 6.49 ZZZ 78496 ......... 26 ....... A Heart first pass add-on .................................. 0.50 0.25 0.20 0.25 0.20 0.02 0.77 0.72 0.77 0.72 ZZZ 78496 ......... TC ...... A Heart first pass add-on .................................. 0.00 0.68 5.47 0.68 5.47 0.30 0.98 5.77 0.98 5.77 ZZZ 78499 ......... ............ C Cardiovascular nuclear exam ........................ 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 XXX 78580 ......... ............ A Lung perfusion imaging ................................. 0.74 5.12 4.04 NA NA 0.21 6.07 4.99 NA NA XXX 78580 ......... 26 ....... A Lung perfusion imaging ................................. 0.74 0.24 0.25 0.24 0.25 0.03 1.01 1.02 1.01 1.02 XXX 78580 ......... TC ...... A Lung perfusion imaging ................................. 0.00 4.88 3.79 NA NA 0.18 5.06 3.97 NA NA XXX 78584 ......... ............ A Lung V/Q image single breath ...................... 0.99 2.93 3.38 NA NA 0.21 4.13 4.58 NA NA XXX 78584 ......... 26 ....... A Lung V/Q image single breath ...................... 0.99 0.31 0.33 0.31 0.33 0.04 1.34 1.36 1.34 1.36 XXX 78584 ......... TC ...... A Lung V/Q image single breath ...................... 0.00 2.62 3.06 NA NA 0.17 2.79 3.23 NA NA XXX 78585 ......... ............ A Lung V/Q imaging ......................................... 1.09 8.60 6.65 NA NA 0.35 10.04 8.09 NA NA XXX 78585 ......... 26 ....... A Lung V/Q imaging ......................................... 1.09 0.34 0.36 0.34 0.36 0.05 1.48 1.50 1.48 1.50 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49207 

78585 ......... TC ...... A Lung V/Q imaging ......................................... 0.00 8.26 6.30 NA NA 0.30 8.56 6.60 NA NA XXX 78586 ......... ............ A Aerosol lung image, single ............................ 0.40 4.13 3.07 NA NA 0.16 4.69 3.63 NA NA XXX78586 ......... 26 ....... A Aerosol lung image, single ............................ 0.40 0.12 0.13 0.12 0.13 0.02 0.54 0.55 0.54 0.55 XXX 78586 ......... TC ...... A Aerosol lung image, single ............................ 0.00 4.01 2.95 NA NA 0.14 4.15 3.09 NA NA XXX 78587 ......... ............ A Aerosol lung image, multiple ......................... 0.49 5.43 3.59 NA NA 0.16 6.08 4.24 NA NA XXX 78587 ......... 26 ....... A Aerosol lung image, multiple ......................... 0.49 0.15 0.17 0.15 0.17 0.02 0.66 0.68 0.66 0.68 XXX 78587 ......... TC ...... A Aerosol lung image, multiple ......................... 0.00 5.27 3.42 NA NA 0.14 5.41 3.56 NA NA XXX 78588 ......... ............ A Perfusion lung image .................................... 1.09 8.63 4.83 NA NA 0.23 9.95 6.15 NA NA XXX 78588 ......... 26 ....... A Perfusion lung image .................................... 1.09 0.34 0.36 0.34 0.36 0.05 1.48 1.50 1.48 1.50 XXX 78588 ......... TC ...... A Perfusion lung image .................................... 0.00 8.29 4.47 NA NA 0.18 8.47 4.65 NA NA XXX 78591 ......... ............ A Vent image, 1 breath, 1 proj ......................... 0.40 4.12 3.27 NA NA 0.16 4.68 3.83 NA NA XXX 78591 ......... 26 ....... A Vent image, 1 breath, 1 proj ......................... 0.40 0.12 0.13 0.12 0.13 0.02 0.54 0.55 0.54 0.55 XXX 78591 ......... TC ...... A Vent image, 1 breath, 1 proj ......................... 0.00 4.00 3.14 NA NA 0.14 4.14 3.28 NA NA XXX 78593 ......... ............ A Vent image, 1 proj, gas ................................. 0.49 4.79 3.91 NA NA 0.20 5.48 4.60 NA NA XXX 78593 ......... 26 ....... A Vent image, 1 proj, gas ................................. 0.49 0.15 0.16 0.15 0.16 0.02 0.66 0.67 0.66 0.67 XXX 78593 ......... TC ...... A Vent image, 1 proj, gas ................................. 0.00 4.64 3.75 NA NA 0.18 4.82 3.93 NA NA XXX 78594 ......... ............ A Vent image, mult proj, gas ............................ 0.53 5.29 5.19 NA NA 0.27 6.09 5.99 NA NA XXX78594 ......... 26 ....... A Vent image, mult proj, gas ............................ 0.53 0.16 0.18 0.16 0.18 0.02 0.71 0.73 0.71 0.73 XXX 78594 ......... TC ...... A Vent image, mult proj, gas ............................ 0.00 5.13 5.02 NA NA 0.25 5.38 5.27 NA NA XXX 78596 ......... ............ A Lung differential function ............................... 1.27 8.73 7.80 NA NA 0.42 10.42 9.49 NA NA XXX 78596 ......... 26 ....... A Lung differential function ............................... 1.27 0.37 0.41 0.37 0.41 0.05 1.69 1.73 1.69 1.73 XXX 78596 ......... TC ...... A Lung differential function ............................... 0.00 8.36 7.39 NA NA 0.37 8.73 7.76 NA NA XXX 78599 ......... ............ C Respiratory nuclear exam ............................. 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 XXX 78600 ......... ............ A Brain imaging, ltd static ................................. 0.44 7.30 4.10 NA NA 0.16 7.90 4.70 NA NA XXX 78600 ......... 26 ....... A Brain imaging, ltd static ................................. 0.44 0.14 0.15 0.14 0.15 0.02 0.60 0.61 0.60 0.61 XXX 78600 ......... TC ...... A Brain imaging, ltd static ................................. 0.00 7.16 3.95 NA NA 0.14 7.30 4.09 NA NA XXX78601 ......... ............ A Brain imaging, ltd w/flow ............................... 0.51 5.35 4.02 NA NA 0.20 6.06 4.73 NA NA XXX 78601 ......... 26 ....... A Brain imaging, ltd w/flow ............................... 0.51 0.16 0.17 0.16 0.17 0.02 0.69 0.70 0.69 0.70 XXX 78601 ......... TC ...... A Brain imaging, ltd w/flow ............................... 0.00 5.19 3.85 NA NA 0.18 5.37 4.03 NA NA XXX 78605 ......... ............ A Brain imaging, complete ................................ 0.53 4.75 3.87 NA NA 0.20 5.48 4.60 NA NA XXX 78605 ......... 26 ....... A Brain imaging, complete ................................ 0.53 0.17 0.18 0.17 0.18 0.02 0.72 0.73 0.72 0.73 XXX 78605 ......... TC ...... A Brain imaging, complete ................................ 0.00 4.59 3.70 NA NA 0.18 4.77 3.88 NA NA XXX 78606 ......... ............ A Brain imaging, compl w/flow ......................... 0.64 8.54 5.20 NA NA 0.24 9.42 6.08 NA NA XXX 78606 ......... 26 ....... A Brain imaging, compl w/flow ......................... 0.64 0.20 0.21 0.20 0.21 0.03 0.87 0.88 0.87 0.88 XXX 78606 ......... TC ...... A Brain imaging, compl w/flow ......................... 0.00 8.34 4.99 NA NA 0.21 8.55 5.20 NA NA XXX 78607 ......... ............ A Brain imaging (3D) ........................................ 1.23 15.23 9.04 NA NA 0.40 16.86 10.67 NA NA XXX 78607 ......... 26 ....... A Brain imaging (3D) ........................................ 1.23 0.38 0.42 0.38 0.42 0.05 1.66 1.70 1.66 1.70 XXX 78607 ......... TC ...... A Brain imaging (3D) ........................................ 0.00 14.85 8.63 NA NA 0.35 15.20 8.98 NA NA XXX 78608 ......... ............ C Brain imaging (PET) ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78608 ......... 26 ....... A Brain imaging (PET) ...................................... 1.50 0.47 0.50 0.47 0.50 0.06 2.03 2.06 2.03 2.06 XXX 78608 ......... TC ...... C Brain imaging (PET) ...................................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 78609 ......... 26 ....... A Brain imaging (PET) ...................................... 1.50 0.47 0.50 0.47 0.50 0.06 2.03 2.06 2.03 2.06 XXX 78609 ......... TC ...... C Brain imaging (PET) ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78610 ......... ............ A Brain flow imaging only ................................. 0.30 4.44 2.38 NA NA 0.11 4.85 2.79 NA NA XXX 78610 ......... 26 ....... A Brain flow imaging only ................................. 0.30 0.09 0.11 0.09 0.11 0.01 0.40 0.42 0.40 0.42 XXX 78610 ......... TC ...... A Brain flow imaging only ................................. 0.00 4.35 2.27 NA NA 0.10 4.45 2.37 NA NA XXX 78615 ......... ............ A Cerebral vascular flow image ........................ 0.42 5.34 4.34 NA NA 0.23 5.99 4.99 NA NA XXX 78615 ......... 26 ....... A Cerebral vascular flow image ........................ 0.42 0.13 0.15 0.13 0.15 0.02 0.57 0.59 0.57 0.59 XXX 78615 ......... TC ...... A Cerebral vascular flow image ........................ 0.00 5.21 4.19 NA NA 0.21 5.42 4.40 NA NA XXX 78630 ......... ............ A Cerebrospinal fluid scan ................................ 0.68 8.61 6.10 NA NA 0.30 9.59 7.08 NA NA XXX 78630 ......... 26 ....... A Cerebrospinal fluid scan ................................ 0.68 0.21 0.23 0.21 0.23 0.03 0.92 0.94 0.92 0.94 XXX 78630 ......... TC ...... A Cerebrospinal fluid scan ................................ 0.00 8.40 5.88 NA NA 0.27 8.67 6.15 NA NA XXX 78635 ......... ............ A CSF ventriculography .................................... 0.61 8.54 4.21 NA NA 0.16 9.31 4.98 NA NA XXX 78635 ......... 26 ....... A CSF ventriculography .................................... 0.61 0.19 0.22 0.19 0.22 0.02 0.82 0.85 0.82 0.85 XXX 78635 ......... TC ...... A CSF ventriculography .................................... 0.00 8.35 3.99 NA NA 0.14 8.49 4.13 NA NA XXX 78645 ......... ............ A CSF shunt evaluation .................................... 0.57 8.43 4.82 NA NA 0.20 9.20 5.59 NA NA XXX 78645 ......... 26 ....... A CSF shunt evaluation .................................... 0.57 0.18 0.19 0.18 0.19 0.02 0.77 0.78 0.77 0.78 XXX 78645 ......... TC ...... A CSF shunt evaluation .................................... 0.00 8.25 4.64 NA NA 0.18 8.43 4.82 NA NA XXX 78647 ......... ............ A Cerebrospinal fluid scan ................................ 0.90 14.31 8.24 NA NA 0.35 15.56 9.49 NA NA XXX 78647 ......... 26 ....... A Cerebrospinal fluid scan ................................ 0.90 0.27 0.30 0.27 0.30 0.04 1.21 1.24 1.21 1.24 XXX 78647 ......... TC ...... A Cerebrospinal fluid scan ................................ 0.00 14.05 7.95 NA NA 0.31 14.36 8.26 NA NA XXX78650 ......... ............ A CSF leakage imaging .................................... 0.61 8.62 5.79 NA NA 0.27 9.50 6.67 NA NA XXX 78650 ......... 26 ....... A CSF leakage imaging .................................... 0.61 0.19 0.21 0.19 0.21 0.03 0.83 0.85 0.83 0.85 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49208 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

78650 ......... TC ...... A CSF leakage imaging .................................... 0.00 8.43 5.59 NA NA 0.24 8.67 5.83 NA NA XXX 78660 ......... ............ A Nuclear exam of tear flow ............................. 0.53 4.24 2.79 NA NA 0.14 4.91 3.46 NA NA XXX78660 ......... 26 ....... A Nuclear exam of tear flow ............................. 0.53 0.17 0.18 0.17 0.18 0.02 0.72 0.73 0.72 0.73 XXX 78660 ......... TC ...... A Nuclear exam of tear flow ............................. 0.00 4.07 2.61 NA NA 0.12 4.19 2.73 NA NA XXX 78699 ......... ............ C Nervous system nuclear exam ...................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX78699 ......... TC ...... C Nervous system nuclear exam ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78700 ......... ............ A Kidney imaging, static ................................... 0.45 4.47 3.52 NA NA 0.18 5.10 4.15 NA NA XXX 78700 ......... 26 ....... A Kidney imaging, static ................................... 0.45 0.15 0.15 0.15 0.15 0.02 0.62 0.62 0.62 0.62 XXX 78700 ......... TC ...... A Kidney imaging, static ................................... 0.00 4.32 3.37 NA NA 0.16 4.48 3.53 NA NA XXX 78701 ......... ............ A Kidney imaging with flow ............................... 0.49 5.36 4.13 NA NA 0.20 6.05 4.82 NA NA XXX 78701 ......... 26 ....... A Kidney imaging with flow ............................... 0.49 0.15 0.16 0.15 0.16 0.02 0.66 0.67 0.66 0.67 XXX 78701 ......... TC ...... A Kidney imaging with flow ............................... 0.00 5.21 3.97 NA NA 0.18 5.39 4.15 NA NA XXX 78704 ......... ............ A Imaging renogram ......................................... 0.74 5.42 4.51 NA NA 0.24 6.40 5.49 NA NA XXX 78704 ......... 26 ....... A Imaging renogram ......................................... 0.74 0.23 0.25 0.23 0.25 0.03 1.00 1.02 1.00 1.02 XXX 78704 ......... TC ...... A Imaging renogram ......................................... 0.00 5.19 4.26 NA NA 0.21 5.40 4.47 NA NA XXX 78707 ......... ............ A Kidney flow/function image ........................... 0.96 5.48 4.96 NA NA 0.27 6.71 6.19 NA NA XXX 78707 ......... 26 ....... A Kidney flow/function image ........................... 0.96 0.30 0.32 0.30 0.32 0.04 1.30 1.32 1.30 1.32 XXX 78707 ......... TC ...... A Kidney flow/function image ........................... 0.00 5.18 4.65 NA NA 0.23 5.41 4.88 NA NA XXX 78708 ......... ............ A Kidney flow/function image ........................... 1.21 3.41 4.51 NA NA 0.28 4.90 6.00 NA NA XXX 78708 ......... 26 ....... A Kidney flow/function image ........................... 1.21 0.38 0.40 0.38 0.40 0.05 1.64 1.66 1.64 1.66 XXX 78708 ......... TC ...... A Kidney flow/function image ........................... 0.00 3.03 4.11 NA NA 0.23 3.26 4.34 NA NA XXX 78709 ......... ............ A Kidney flow/function image ........................... 1.41 8.88 5.93 NA NA 0.29 10.58 7.63 NA NA XXX78709 ......... 26 ....... A Kidney flow/function image ........................... 1.41 0.45 0.47 0.45 0.47 0.06 1.92 1.94 1.92 1.94 XXX 78709 ......... TC ...... A Kidney flow/function image ........................... 0.00 8.43 5.46 NA NA 0.23 8.66 5.69 NA NA XXX 78710 ......... ............ A Kidney imaging (3D) ...................................... 0.66 5.29 5.92 NA NA 0.34 6.29 6.92 NA NA XXX 78710 ......... 26 ....... A Kidney imaging (3D) ...................................... 0.66 0.21 0.22 0.21 0.22 0.03 0.90 0.91 0.90 0.91 XXX 78710 ......... TC ...... A Kidney imaging (3D) ...................................... 0.00 5.08 5.70 NA NA 0.31 5.39 6.01 NA NA XXX 78715 ......... ............ A Renal vascular flow exam ............................. 0.30 4.82 2.47 NA NA 0.11 5.23 2.88 NA NA XXX 78715 ......... 26 ....... A Renal vascular flow exam ............................. 0.30 0.13 0.12 0.13 0.12 0.01 0.44 0.43 0.44 0.43 XXX 78715 ......... TC ...... A Renal vascular flow exam ............................. 0.00 4.69 2.36 NA NA 0.10 4.79 2.46 NA NA XXX 78725 ......... ............ A Kidney function study .................................... 0.38 2.35 2.02 NA NA 0.13 2.86 2.53 NA NA XXX 78725 ......... 26 ....... A Kidney function study .................................... 0.38 0.12 0.13 0.12 0.13 0.02 0.52 0.53 0.52 0.53 XXX 78725 ......... TC ...... A Kidney function study .................................... 0.00 2.23 1.89 NA NA 0.11 2.34 2.00 NA NA XXX 78730 ......... ............ A Urinary bladder retention ............................... 0.36 1.85 1.65 1.85 1.65 0.10 2.31 2.11 2.31 2.11 XXX 78730 ......... 26 ....... A Urinary bladder retention ............................... 0.36 0.14 0.13 0.14 0.13 0.02 0.52 0.51 0.52 0.51 XXX 78730 ......... TC ...... A Urinary bladder retention ............................... 0.00 1.71 1.52 1.71 1.52 0.08 1.79 1.60 1.79 1.60 XXX 78740 ......... ............ A Ureteral reflux study ...................................... 0.57 5.48 3.10 NA NA 0.15 6.20 3.82 NA NA XXX 78740 ......... 26 ....... A Ureteral reflux study ...................................... 0.57 0.18 0.19 0.18 0.19 0.03 0.78 0.79 0.78 0.79 XXX 78740 ......... TC ...... A Ureteral reflux study ...................................... 0.00 5.30 2.92 NA NA 0.12 5.42 3.04 NA NA XXX 78760 ......... ............ A Testicular imaging ......................................... 0.66 4.52 3.31 NA NA 0.17 5.35 4.14 NA NA XXX 78760 ......... 26 ....... A Testicular imaging ......................................... 0.66 0.22 0.22 0.22 0.22 0.03 0.91 0.91 0.91 0.91 XXX 78760 ......... TC ...... A Testicular imaging ......................................... 0.00 4.30 3.09 NA NA 0.14 4.44 3.23 NA NA XXX 78761 ......... ............ A Testicular imaging/flow .................................. 0.71 4.96 3.82 NA NA 0.20 5.87 4.73 NA NA XXX 78761 ......... 26 ....... A Testicular imaging/flow .................................. 0.71 0.23 0.24 0.23 0.24 0.03 0.97 0.98 0.97 0.98 XXX 78761 ......... TC ...... A Testicular imaging/flow .................................. 0.00 4.72 3.58 NA NA 0.17 4.89 3.75 NA NA XXX 78799 ......... ............ C Genitourinary nuclear exam .......................... 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 XXX 78800 ......... ............ A Tumor imaging, limited area ......................... 0.66 4.29 3.79 NA NA 0.22 5.17 4.67 NA NA XXX 78800 ......... 26 ....... A Tumor imaging, limited area ......................... 0.66 0.20 0.22 0.20 0.22 0.04 0.90 0.92 0.90 0.92 XXX 78800 ......... TC ...... A Tumor imaging, limited area ......................... 0.00 4.09 3.57 NA NA 0.18 4.27 3.75 NA NA XXX 78801 ......... ............ A Tumor imaging, mult areas ........................... 0.79 6.10 4.89 NA NA 0.27 7.16 5.95 NA NA XXX 78801 ......... 26 ....... A Tumor imaging, mult areas ........................... 0.79 0.24 0.26 0.24 0.26 0.05 1.08 1.10 1.08 1.10 XXX 78801 ......... TC ...... A Tumor imaging, mult areas ........................... 0.00 5.86 4.63 NA NA 0.22 6.08 4.85 NA NA XXX 78802 ......... ............ A Tumor imaging, whole body .......................... 0.86 8.17 6.41 NA NA 0.34 9.37 7.61 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49209 

78802 ......... 26 ....... A Tumor imaging, whole body .......................... 0.86 0.27 0.29 0.27 0.29 0.04 1.17 1.19 1.17 1.19 XXX 78802 ......... TC ...... A Tumor imaging, whole body .......................... 0.00 7.90 6.12 NA NA 0.30 8.20 6.42 NA NA XXX 78803 ......... ............ A Tumor imaging (3D) ...................................... 1.09 15.02 8.95 NA NA 0.40 16.51 10.44 NA NA XXX 78803 ......... 26 ....... A Tumor imaging (3D) ...................................... 1.09 0.34 0.37 0.34 0.37 0.05 1.48 1.51 1.48 1.51 XXX 78803 ......... TC ...... A Tumor imaging (3D) ...................................... 0.00 14.67 8.58 NA NA 0.35 15.02 8.93 NA NA XXX78804 ......... ............ A Tumor imaging, whole body .......................... 1.07 14.91 12.30 NA NA 0.34 16.32 13.71 NA NA XXX 78804 ......... 26 ....... A Tumor imaging, whole body .......................... 1.07 0.34 0.36 0.34 0.36 0.04 1.45 1.47 1.45 1.47 XXX 78804 ......... TC ...... A Tumor imaging, whole body .......................... 0.00 14.58 11.94 NA NA 0.30 14.88 12.24 NA NA XXX 78805 ......... ............ A Abscess imaging, ltd area ............................. 0.73 4.20 3.79 NA NA 0.21 5.14 4.73 NA NA XXX78805 ......... 26 ....... A Abscess imaging, ltd area ............................. 0.73 0.23 0.25 0.23 0.25 0.03 0.99 1.01 0.99 1.01 XXX 78805 ......... TC ...... A Abscess imaging, ltd area ............................. 0.00 3.97 3.54 NA NA 0.18 4.15 3.72 NA NA XXX 78806 ......... ............ A Abscess imaging, whole body ....................... 0.86 8.35 7.13 NA NA 0.39 9.60 8.38 NA NA XXX 78806 ......... 26 ....... A Abscess imaging, whole body ....................... 0.86 0.27 0.29 0.27 0.29 0.04 1.17 1.19 1.17 1.19 XXX 78806 ......... TC ...... A Abscess imaging, whole body ....................... 0.00 8.08 6.84 NA NA 0.35 8.43 7.19 NA NA XXX 78807 ......... ............ A Nuclear localization/abscess ......................... 1.09 14.28 8.78 NA NA 0.39 15.76 10.26 NA NA XXX 78807 ......... 26 ....... A Nuclear localization/abscess ......................... 1.09 0.34 0.38 0.34 0.38 0.04 1.47 1.51 1.47 1.51 XXX 78807 ......... TC ...... A Nuclear localization/abscess ......................... 0.00 13.94 8.40 NA NA 0.35 14.29 8.75 NA NA XXX 78811 ......... ............ C Tumor imaging (pet), limited ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78811 ......... 26 ....... A Tumor imaging (pet), limited ......................... 1.54 0.48 0.52 0.48 0.52 0.11 2.13 2.17 2.13 2.17 XXX 78811 ......... TC ...... C Tumor imaging (pet), limited ......................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 78812 ......... 26 ....... A Tumor image (pet)/skul-thigh ........................ 1.93 0.61 0.65 0.61 0.65 0.11 2.65 2.69 2.65 2.69 XXX 78812 ......... TC ...... C Tumor image (pet)/skul-thigh ........................ 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 78813 ......... 26 ....... A Tumor image (pet) full body .......................... 2.00 0.62 0.67 0.62 0.67 0.11 2.73 2.78 2.73 2.78 XXX 78813 ......... TC ...... C Tumor image (pet) full body .......................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 78814 ......... 26 ....... A Tumor image pet/ct, limited ........................... 2.20 0.68 0.74 0.68 0.74 0.11 2.99 3.05 2.99 3.05 XXX 78814 ......... TC ...... C Tumor image pet/ct, limited ........................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 78815 ......... 26 ....... A Tumorimage pet/ct skul-thigh ........................ 2.44 0.77 0.82 0.77 0.82 0.11 3.32 3.37 3.32 3.37 XXX 78815 ......... TC ...... C Tumorimage pet/ct skul-thigh ........................ 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 78816 ......... 26 ....... A Tumor image pet/ct full body ........................ 2.50 0.78 0.84 0.78 0.84 0.11 3.39 3.45 3.39 3.45 XXX 78816 ......... TC ...... C Tumor image pet/ct full body ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78890 ......... ............ B Nuclear medicine data proc .......................... 0.05 0.39 1.10 NA NA 0.07 0.51 1.22 NA NA XXX 78890 ......... 26 ....... B Nuclear medicine data proc .......................... 0.05 0.01 0.02 0.01 0.02 0.01 0.07 0.08 0.07 0.08 XXX 78890 ......... TC ...... B Nuclear medicine data proc .......................... 0.00 0.38 1.08 NA NA 0.06 0.44 1.14 NA NA XXX 78891 ......... ............ B Nuclear med data proc .................................. 0.10 0.89 2.22 NA NA 0.14 1.13 2.46 NA NA XXX 78891 ......... 26 ....... B Nuclear med data proc .................................. 0.10 0.02 0.04 0.02 0.04 0.01 0.13 0.15 0.13 0.15 XXX 78891 ......... TC ...... B Nuclear med data proc .................................. 0.00 0.86 2.18 NA NA 0.13 0.99 2.31 NA NA XXX 78999 ......... ............ C Nuclear diagnostic exam ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 78999 ......... 26 ....... C Nuclear diagnostic exam ............................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 79005 ......... ............ A Nuclear rx, oral admin ................................... 1.80 1.78 2.86 NA NA 0.22 3.80 4.88 NA NA XXX 79005 ......... 26 ....... A Nuclear rx, oral admin ................................... 1.80 0.53 0.58 0.53 0.58 0.08 2.41 2.46 2.41 2.46 XXX 79005 ......... TC ...... A Nuclear rx, oral admin ................................... 0.00 1.25 2.28 NA NA 0.14 1.39 2.42 NA NA XXX 79101 ......... ............ A Nuclear rx, iv admin ...................................... 1.96 2.10 2.99 NA NA 0.22 4.28 5.17 NA NA XXX 79101 ......... 26 ....... A Nuclear rx, iv admin ...................................... 1.96 0.68 0.67 0.68 0.67 0.08 2.72 2.71 2.72 2.71 XXX 79101 ......... TC ...... A Nuclear rx, iv admin ...................................... 0.00 1.41 2.32 NA NA 0.14 1.55 2.46 NA NA XXX79200 ......... ............ A Nuclear rx, intracav admin ............................ 1.99 2.18 3.03 NA NA 0.23 4.40 5.25 NA NA XXX79200 ......... 26 ....... A Nuclear rx, intracav admin ............................ 1.99 0.59 0.67 0.59 0.67 0.09 2.67 2.75 2.67 2.75 XXX 79200 ......... TC ...... A Nuclear rx, intracav admin ............................ 0.00 1.60 2.37 NA NA 0.14 1.74 2.51 NA NA XXX 79300 ......... ............ C Nuclr rx, interstit colloid ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79300 ......... 26 ....... A Nuclr rx, interstit colloid ................................. 1.60 0.46 0.54 0.46 0.54 0.13 2.19 2.27 2.19 2.27 XXX 79300 ......... TC ...... C Nuclr rx, interstit colloid ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79403 ......... ............ A Hematopoietic nuclear tx ............................... 2.25 2.83 4.58 NA NA 0.24 5.32 7.07 NA NA XXX 79403 ......... 26 ....... A Hematopoietic nuclear tx ............................... 2.25 0.68 0.84 0.68 0.84 0.10 3.03 3.19 3.03 3.19 XXX 79403 ......... TC ...... A Hematopoietic nuclear tx ............................... 0.00 2.15 3.74 NA NA 0.14 2.29 3.88 NA NA XXX 79440 ......... ............ A Nuclear rx, intra-articular ............................... 1.99 1.77 2.95 NA NA 0.22 3.98 5.16 NA NA XXX 79440 ......... 26 ....... A Nuclear rx, intra-articular ............................... 1.99 0.61 0.69 0.61 0.69 0.08 2.68 2.76 2.68 2.76 XXX 79440 ......... TC ...... A Nuclear rx, intra-articular ............................... 0.00 1.16 2.26 NA NA 0.14 1.30 2.40 NA NA XXX79445 ......... ............ C Nuclear rx, intra-arterial ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79445 ......... 26 ....... A Nuclear rx, intra-arterial ................................. 2.40 0.77 0.81 0.77 0.81 0.12 3.29 3.33 3.29 3.33 XXX 79445 ......... TC ...... C Nuclear rx, intra-arterial ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 79999 ......... ............ C Nuclear medicine therapy ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49210 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

79999 ......... 26 ....... C Nuclear medicine therapy ............................. 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 80500 ......... ............ A Lab pathology consultation ........................... 0.37 0.20 0.21 0.11 0.15 0.01 0.58 0.59 0.49 0.53 XXX 80502 ......... ............ A Lab pathology consultation ........................... 1.33 0.31 0.48 0.25 0.47 0.04 1.68 1.85 1.62 1.84 XXX 83020 ......... 26 ....... A Hemoglobin electrophoresis .......................... 0.37 0.12 0.14 0.12 0.14 0.01 0.50 0.52 0.50 0.52 XXX 83912 ......... 26 ....... A Genetic examination ...................................... 0.37 0.11 0.12 0.11 0.12 0.01 0.49 0.50 0.49 0.50 XXX 84165 ......... 26 ....... A Protein e-phoresis, serum ............................. 0.37 0.12 0.14 0.12 0.14 0.01 0.50 0.52 0.50 0.52 XXX 84166 ......... 26 ....... A Protein e-phoresis/urine/csf ........................... 0.37 0.12 0.14 0.12 0.14 0.01 0.50 0.52 0.50 0.52 XXX 84181 ......... 26 ....... A Western blot test ........................................... 0.37 0.12 0.14 0.12 0.14 0.01 0.50 0.52 0.50 0.52 XXX 84182 ......... 26 ....... A Protein, western blot test .............................. 0.37 0.12 0.15 0.12 0.15 0.02 0.51 0.54 0.51 0.54 XXX 85060 ......... ............ A Blood smear interpretation ............................ 0.45 0.14 0.17 0.14 0.17 0.02 0.61 0.64 0.61 0.64 XXX 85097 ......... ............ A Bone marrow interpretation ........................... 0.94 1.30 1.76 0.28 0.38 0.04 2.28 2.74 1.26 1.36 XXX 85390 ......... 26 ....... A Fibrinolysins screen ....................................... 0.37 0.12 0.13 0.12 0.13 0.01 0.50 0.51 0.50 0.51 XXX 85396 ......... ............ A Clotting assay, whole blood .......................... 0.37 NA NA 0.05 0.13 0.04 NA NA 0.46 0.54 XXX 85576 ......... 26 ....... A Blood platelet aggregation ............................ 0.37 0.12 0.15 0.12 0.15 0.01 0.50 0.53 0.50 0.53 XXX 86077 ......... ............ A Physician blood bank service ........................ 0.94 0.38 0.39 0.29 0.37 0.03 1.35 1.36 1.26 1.34 XXX 86078 ......... ............ A Physician blood bank service ........................ 0.94 0.38 0.44 0.29 0.37 0.03 1.35 1.41 1.26 1.34 XXX 86079 ......... ............ A Physician blood bank service ........................ 0.94 0.38 0.43 0.30 0.38 0.03 1.35 1.40 1.27 1.35 XXX 86255 ......... 26 ....... A Fluorescent antibody, screen ........................ 0.37 0.12 0.14 0.12 0.14 0.01 0.50 0.52 0.50 0.52 XXX 86256 ......... 26 ....... A Fluorescent antibody, titer ............................. 0.37 0.12 0.14 0.12 0.14 0.01 0.50 0.52 0.50 0.52 XXX 86320 ......... 26 ....... A Serum immunoelectrophoresis ...................... 0.37 0.12 0.14 0.12 0.14 0.01 0.50 0.52 0.50 0.52 XXX86325 ......... 26 ....... A Other immunoelectrophoresis ....................... 0.37 0.11 0.13 0.11 0.13 0.01 0.49 0.51 0.49 0.51 XXX 86327 ......... 26 ....... A Immunoelectrophoresis assay ....................... 0.42 0.13 0.17 0.13 0.17 0.02 0.57 0.61 0.57 0.61 XXX 86334 ......... 26 ....... A Immunofix e-phoresis, serum ........................ 0.37 0.12 0.14 0.12 0.14 0.01 0.50 0.52 0.50 0.52 XXX 86335 ......... 26 ....... A Immunfix e-phorsis/urine/csf ......................... 0.37 0.12 0.14 0.12 0.14 0.01 0.50 0.52 0.50 0.52 XXX 86485 ......... ............ C Skin test, candida .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 86490 ......... ............ A Coccidioidomycosis skin test ........................ 0.00 0.12 0.25 NA NA 0.02 0.14 0.27 NA NA XXX 86510 ......... ............ A Histoplasmosis skin test ................................ 0.00 0.14 0.28 NA NA 0.02 0.16 0.30 NA NA XXX 86580 ......... ............ A TB intradermal test ........................................ 0.00 0.16 0.23 NA NA 0.02 0.18 0.25 NA NA XXX 87164 ......... 26 ....... A Dark field examination ................................... 0.37 0.12 0.12 0.12 0.12 0.01 0.50 0.50 0.50 0.50 XXX 87207 ......... 26 ....... A Smear, special stain ...................................... 0.37 0.11 0.15 0.11 0.15 0.01 0.49 0.53 0.49 0.53 XXX 88104 ......... ............ A Cytopathology, fluids ..................................... 0.56 1.16 0.93 NA NA 0.04 1.76 1.53 NA NA XXX 88104 ......... 26 ....... A Cytopathology, fluids ..................................... 0.56 0.16 0.22 0.16 0.22 0.02 0.74 0.80 0.74 0.80 XXX 88104 ......... TC ...... A Cytopathology, fluids ..................................... 0.00 1.01 0.71 NA NA 0.02 1.03 0.73 NA NA XXX88106 ......... ............ A Cytopathology, fluids ..................................... 0.56 1.52 1.39 NA NA 0.04 2.12 1.99 NA NA XXX 88106 ......... 26 ....... A Cytopathology, fluids ..................................... 0.56 0.15 0.22 0.15 0.22 0.02 0.73 0.80 0.73 0.80 XXX 88106 ......... TC ...... A Cytopathology, fluids ..................................... 0.00 1.36 1.17 NA NA 0.02 1.38 1.19 NA NA XXX88107 ......... ............ A Cytopathology, fluids ..................................... 0.76 2.02 1.66 NA NA 0.05 2.83 2.47 NA NA XXX 88107 ......... 26 ....... A Cytopathology, fluids ..................................... 0.76 0.23 0.31 0.23 0.31 0.03 1.02 1.10 1.02 1.10 XXX 88107 ......... TC ...... A Cytopathology, fluids ..................................... 0.00 1.79 1.36 NA NA 0.02 1.81 1.38 NA NA XXX88108 ......... ............ A Cytopath, concentrate tech ........................... 0.56 1.49 1.28 NA NA 0.04 2.09 1.88 NA NA XXX 88108 ......... 26 ....... A Cytopath, concentrate tech ........................... 0.56 0.16 0.22 0.16 0.22 0.02 0.74 0.80 0.74 0.80 XXX 88108 ......... TC ...... A Cytopath, concentrate tech ........................... 0.00 1.33 1.06 NA NA 0.02 1.35 1.08 NA NA XXX 88112 ......... ............ A Cytopath, cell enhance tech .......................... 1.18 1.53 1.85 NA NA 0.04 2.75 3.07 NA NA XXX 88112 ......... 26 ....... A Cytopath, cell enhance tech .......................... 1.18 0.31 0.46 0.31 0.46 0.02 1.51 1.66 1.51 1.66 XXX 88112 ......... TC ...... A Cytopath, cell enhance tech .......................... 0.00 1.22 1.40 NA NA 0.02 1.24 1.42 NA NA XXX 88125 ......... ............ A Forensic cytopathology ................................. 0.26 0.25 0.27 NA NA 0.02 0.53 0.55 NA NA XXX 88125 ......... 26 ....... A Forensic cytopathology ................................. 0.26 0.06 0.10 0.06 0.10 0.01 0.33 0.37 0.33 0.37 XXX 88125 ......... TC ...... A Forensic cytopathology ................................. 0.00 0.20 0.17 NA NA 0.01 0.21 0.18 NA NA XXX 88141 ......... ............ A Cytopath, c/v, interpret .................................. 0.42 0.38 0.21 0.38 0.21 0.02 0.82 0.65 0.82 0.65 XXX 88160 ......... ............ A Cytopath smear, other source ....................... 0.50 0.91 0.85 NA NA 0.04 1.45 1.39 NA NA XXX 88160 ......... 26 ....... A Cytopath smear, other source ....................... 0.50 0.13 0.19 0.13 0.19 0.02 0.65 0.71 0.65 0.71 XXX 88160 ......... TC ...... A Cytopath smear, other source ....................... 0.00 0.78 0.66 NA NA 0.02 0.80 0.68 NA NA XXX 88161 ......... ............ A Cytopath smear, other source ....................... 0.50 1.13 0.99 NA NA 0.04 1.67 1.53 NA NA XXX 88161 ......... 26 ....... A Cytopath smear, other source ....................... 0.50 0.15 0.20 0.15 0.20 0.02 0.67 0.72 0.67 0.72 XXX 88161 ......... TC ...... A Cytopath smear, other source ....................... 0.00 0.98 0.79 NA NA 0.02 1.00 0.81 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49211 

88162 ......... ............ A Cytopath smear, other source ....................... 0.76 1.18 1.06 NA NA 0.05 1.99 1.87 NA NA XXX 88162 ......... 26 ....... A Cytopath smear, other source ....................... 0.76 0.17 0.29 0.17 0.29 0.03 0.96 1.08 0.96 1.08 XXX 88162 ......... TC ...... A Cytopath smear, other source ....................... 0.00 1.01 0.77 NA NA 0.02 1.03 0.79 NA NA XXX 88172 ......... ............ A Cytopathology eval of fna ............................. 0.60 0.86 0.76 NA NA 0.04 1.50 1.40 NA NA XXX88172 ......... 26 ....... A Cytopathology eval of fna ............................. 0.60 0.18 0.24 0.18 0.24 0.02 0.80 0.86 0.80 0.86 XXX 88172 ......... TC ...... A Cytopathology eval of fna ............................. 0.00 0.68 0.52 NA NA 0.02 0.70 0.54 NA NA XXX 88173 ......... ............ A Cytopath eval, fna, report .............................. 1.39 2.33 2.18 NA NA 0.07 3.79 3.64 NA NA XXX 88173 ......... 26 ....... A Cytopath eval, fna, report .............................. 1.39 0.40 0.54 0.40 0.54 0.05 1.84 1.98 1.84 1.98 XXX 88173 ......... TC ...... A Cytopath eval, fna, report .............................. 0.00 1.93 1.65 NA NA 0.02 1.95 1.67 NA NA XXX 88182 ......... ............ A Cell marker study .......................................... 0.77 1.97 1.97 NA NA 0.07 2.81 2.81 NA NA XXX 88182 ......... 26 ....... A Cell marker study .......................................... 0.77 0.13 0.28 0.13 0.28 0.03 0.93 1.08 0.93 1.08 XXX 88182 ......... TC ...... A Cell marker study .......................................... 0.00 1.85 1.70 NA NA 0.04 1.89 1.74 NA NA XXX 88184 ......... ............ A Flowcytometry/tc, 1 marker ........................... 0.00 2.51 1.62 NA NA 0.02 2.53 1.64 NA NA XXX 88185 ......... ............ A Flowcytometry/tc, add-on .............................. 0.00 1.52 0.86 NA NA 0.02 1.54 0.88 NA NA ZZZ88187 ......... ............ A Flowcytometry/read, 2-8 ................................ 1.36 0.39 0.44 0.39 0.44 0.01 1.76 1.81 1.76 1.81 XXX 88188 ......... ............ A Flowcytometry/read, 9-15 .............................. 1.69 0.44 0.54 0.44 0.54 0.01 2.14 2.24 2.14 2.24 XXX 88189 ......... ............ A Flowcytometry/read, 16 & > .......................... 2.23 0.49 0.69 0.49 0.69 0.01 2.73 2.93 2.73 2.93 XXX 88199 ......... ............ C Cytopathology procedure .............................. 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 XXX 88291 ......... ............ A Cyto/molecular report .................................... 0.52 0.28 0.20 0.28 0.20 0.02 0.82 0.74 0.82 0.74 XXX 88299 ......... ............ C Cytogenetic study .......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88300 ......... ............ A Surgical path, gross ...................................... 0.08 0.60 0.49 NA NA 0.02 0.70 0.59 NA NA XXX 88300 ......... 26 ....... A Surgical path, gross ...................................... 0.08 0.02 0.03 0.02 0.03 0.01 0.11 0.12 0.11 0.12 XXX 88300 ......... TC ...... A Surgical path, gross ...................................... 0.00 0.57 0.46 NA NA 0.01 0.58 0.47 NA NA XXX88302 ......... ............ A Tissue exam by pathologist .......................... 0.13 1.30 1.10 NA NA 0.03 1.46 1.26 NA NA XXX 88302 ......... 26 ....... A Tissue exam by pathologist .......................... 0.13 0.04 0.06 0.04 0.06 0.01 0.18 0.20 0.18 0.20 XXX 88302 ......... TC ...... A Tissue exam by pathologist .......................... 0.00 1.27 1.05 NA NA 0.02 1.29 1.07 NA NA XXX 88304 ......... ............ A Tissue exam by pathologist .......................... 0.22 1.57 1.38 NA NA 0.03 1.82 1.63 NA NA XXX 88304 ......... 26 ....... A Tissue exam by pathologist .......................... 0.22 0.06 0.08 0.06 0.08 0.01 0.29 0.31 0.29 0.31 XXX 88304 ......... TC ...... A Tissue exam by pathologist .......................... 0.00 1.50 1.30 NA NA 0.02 1.52 1.32 NA NA XXX 88305 ......... ............ A Tissue exam by pathologist .......................... 0.75 2.20 1.98 NA NA 0.07 3.02 2.80 NA NA XXX 88305 ......... 26 ....... A Tissue exam by pathologist .......................... 0.75 0.21 0.30 0.21 0.30 0.03 0.99 1.08 0.99 1.08 XXX 88305 ......... TC ...... A Tissue exam by pathologist .......................... 0.00 1.99 1.68 NA NA 0.04 2.03 1.72 NA NA XXX 88307 ......... ............ A Tissue exam by pathologist .......................... 1.59 4.54 3.50 NA NA 0.12 6.25 5.21 NA NA XXX 88307 ......... 26 ....... A Tissue exam by pathologist .......................... 1.59 0.48 0.63 0.48 0.63 0.06 2.13 2.28 2.13 2.28 XXX 88307 ......... TC ...... A Tissue exam by pathologist .......................... 0.00 4.06 2.87 NA NA 0.06 4.12 2.93 NA NA XXX 88309 ......... ............ A Tissue exam by pathologist .......................... 2.80 6.37 4.89 NA NA 0.14 9.31 7.83 NA NA XXX 88309 ......... 26 ....... A Tissue exam by pathologist .......................... 2.80 0.84 0.94 0.84 0.94 0.08 3.72 3.82 3.72 3.82 XXX 88309 ......... TC ...... A Tissue exam by pathologist .......................... 0.00 5.52 3.95 NA NA 0.06 5.58 4.01 NA NA XXX 88311 ......... ............ A Decalcify tissue ............................................. 0.24 0.26 0.24 NA NA 0.02 0.52 0.50 NA NA XXX 88311 ......... 26 ....... A Decalcify tissue ............................................. 0.24 0.07 0.09 0.07 0.09 0.01 0.32 0.34 0.32 0.34 XXX 88311 ......... TC ...... A Decalcify tissue ............................................. 0.00 0.18 0.14 NA NA 0.01 0.19 0.15 NA NA XXX 88312 ......... ............ A Special stains ................................................ 0.54 2.51 1.77 NA NA 0.03 3.08 2.34 NA NA XXX 88312 ......... 26 ....... A Special stains ................................................ 0.54 0.15 0.21 0.15 0.21 0.02 0.71 0.77 0.71 0.77 XXX 88312 ......... TC ...... A Special stains ................................................ 0.00 2.36 1.56 NA NA 0.01 2.37 1.57 NA NA XXX 88313 ......... ............ A Special stains ................................................ 0.24 1.96 1.43 NA NA 0.02 2.22 1.69 NA NA XXX 88313 ......... 26 ....... A Special stains ................................................ 0.24 0.06 0.09 0.06 0.09 0.01 0.31 0.34 0.31 0.34 XXX 88313 ......... TC ...... A Special stains ................................................ 0.00 1.90 1.34 NA NA 0.01 1.91 1.35 NA NA XXX 88314 ......... ............ A Histochemical stain ....................................... 0.45 1.96 2.04 NA NA 0.04 2.45 2.53 NA NA XXX 88314 ......... 26 ....... A Histochemical stain ....................................... 0.45 0.14 0.18 0.14 0.18 0.02 0.61 0.65 0.61 0.65 XXX 88314 ......... TC ...... A Histochemical stain ....................................... 0.00 1.83 1.86 NA NA 0.02 1.85 1.88 NA NA XXX88318 ......... ............ A Chemical histochemistry ............................... 0.42 3.01 1.99 NA NA 0.03 3.46 2.44 NA NA XXX88318 ......... 26 ....... A Chemical histochemistry ............................... 0.42 0.13 0.17 0.13 0.17 0.02 0.57 0.61 0.57 0.61 XXX 88318 ......... TC ...... A Chemical histochemistry ............................... 0.00 2.89 1.83 NA NA 0.01 2.90 1.84 NA NA XXX 88319 ......... ............ A Enzyme histochemistry ................................. 0.53 3.29 3.38 NA NA 0.04 3.86 3.95 NA NA XXX88319 ......... 26 ....... A Enzyme histochemistry ................................. 0.53 0.15 0.20 0.15 0.20 0.02 0.70 0.75 0.70 0.75 XXX 88319 ......... TC ...... A Enzyme histochemistry ................................. 0.00 3.14 3.18 NA NA 0.02 3.16 3.20 NA NA XXX 88321 ......... ............ A Microslide consultation .................................. 1.63 0.74 0.78 0.48 0.54 0.05 2.42 2.46 2.16 2.22 XXX 88323 ......... ............ A Microslide consultation .................................. 1.83 2.23 1.89 NA NA 0.07 4.13 3.79 NA NA XXX 88323 ......... 26 ....... A Microslide consultation .................................. 1.83 0.47 0.55 0.47 0.55 0.05 2.35 2.43 2.35 2.43 XXX 88323 ......... TC ...... A Microslide consultation .................................. 0.00 1.77 1.35 NA NA 0.02 1.79 1.37 NA NA XXX 88325 ......... ............ A Comprehensive review of data ..................... 2.50 2.27 2.77 0.63 0.87 0.07 4.84 5.34 3.20 3.44 XXX 88329 ......... ............ A Path consult introp ........................................ 0.67 0.69 0.66 0.21 0.27 0.02 1.38 1.35 0.90 0.96 XXX 88331 ......... ............ A Path consult intraop, 1 bloc .......................... 1.19 1.25 1.14 NA NA 0.08 2.52 2.41 NA NA XXX88331 ......... 26 ....... A Path consult intraop, 1 bloc .......................... 1.19 0.37 0.48 0.37 0.48 0.04 1.60 1.71 1.60 1.71 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49212 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

88331 ......... TC ...... A Path consult intraop, 1 bloc .......................... 0.00 0.88 0.66 NA NA 0.04 0.92 0.70 NA NA XXX 88332 ......... ............ A Path consult intraop, addIl ............................ 0.59 0.48 0.47 NA NA 0.04 1.11 1.10 NA NA XXX 88332 ......... 26 ....... A Path consult intraop, addIl ............................ 0.59 0.18 0.23 0.18 0.23 0.02 0.79 0.84 0.79 0.84 XXX 88332 ......... TC ...... A Path consult intraop, addIl ............................ 0.00 0.30 0.23 NA NA 0.02 0.32 0.25 NA NA XXX 88333 ......... ............ A Intraop cyto path consult, 1 ........................... 1.20 1.36 1.15 NA NA 0.08 2.64 2.43 NA NA XXX 88333 ......... 26 ....... A Intraop cyto path consult, 1 ........................... 1.20 0.38 0.49 0.38 0.49 0.04 1.62 1.73 1.62 1.73 XXX 88333 ......... TC ...... A Intraop cyto path consult, 1 ........................... 0.00 0.98 0.66 NA NA 0.04 1.02 0.70 NA NA XXX 88334 ......... ............ A Intraop cyto path consult, 2 ........................... 0.59 0.75 0.64 NA NA 0.04 1.38 1.27 NA NA XXX 88334 ......... 26 ....... A Intraop cyto path consult, 2 ........................... 0.59 0.18 0.24 0.18 0.24 0.02 0.79 0.85 0.79 0.85 XXX 88334 ......... TC ...... A Intraop cyto path consult, 2 ........................... 0.00 0.57 0.40 NA NA 0.02 0.59 0.42 NA NA XXX 88342 ......... ............ A Immunohistochemistry ................................... 0.85 2.05 1.61 NA NA 0.05 2.95 2.51 NA NA XXX 88342 ......... 26 ....... A Immunohistochemistry ................................... 0.85 0.23 0.33 0.23 0.33 0.03 1.11 1.21 1.11 1.21 XXX 88342 ......... TC ...... A Immunohistochemistry ................................... 0.00 1.82 1.28 NA NA 0.02 1.84 1.30 NA NA XXX 88346 ......... ............ A Immunofluorescent study .............................. 0.86 1.97 1.67 NA NA 0.05 2.88 2.58 NA NA XXX 88346 ......... 26 ....... A Immunofluorescent study .............................. 0.86 0.23 0.33 0.23 0.33 0.03 1.12 1.22 1.12 1.22 XXX 88346 ......... TC ...... A Immunofluorescent study .............................. 0.00 1.74 1.34 NA NA 0.02 1.76 1.36 NA NA XXX 88347 ......... ............ A Immunofluorescent study .............................. 0.86 1.30 1.27 NA NA 0.05 2.21 2.18 NA NA XXX 88347 ......... 26 ....... A Immunofluorescent study .............................. 0.86 0.18 0.31 0.18 0.31 0.03 1.07 1.20 1.07 1.20 XXX 88347 ......... TC ...... A Immunofluorescent study .............................. 0.00 1.12 0.96 NA NA 0.02 1.14 0.98 NA NA XXX 88348 ......... ............ A Electron microscopy ...................................... 1.51 18.27 11.58 NA NA 0.13 19.91 13.22 NA NA XXX 88348 ......... 26 ....... A Electron microscopy ...................................... 1.51 0.42 0.59 0.42 0.59 0.06 1.99 2.16 1.99 2.16 XXX 88348 ......... TC ...... A Electron microscopy ...................................... 0.00 17.85 11.00 NA NA 0.07 17.92 11.07 NA NA XXX 88349 ......... ............ A Scanning electron microscopy ...................... 0.76 8.97 4.91 NA NA 0.09 9.82 5.76 NA NA XXX 88349 ......... 26 ....... A Scanning electron microscopy ...................... 0.76 0.22 0.30 0.22 0.30 0.03 1.01 1.09 1.01 1.09 XXX 88349 ......... TC ...... A Scanning electron microscopy ...................... 0.00 8.75 4.61 NA NA 0.06 8.81 4.67 NA NA XXX 88355 ......... ............ A Analysis, skeletal muscle .............................. 1.85 3.40 7.42 NA NA 0.13 5.38 9.40 NA NA XXX 88355 ......... 26 ....... A Analysis, skeletal muscle .............................. 1.85 0.40 0.69 0.40 0.69 0.07 2.32 2.61 2.32 2.61 XXX 88355 ......... TC ...... A Analysis, skeletal muscle .............................. 0.00 2.99 6.73 NA NA 0.06 3.05 6.79 NA NA XXX 88356 ......... ............ A Analysis, nerve .............................................. 3.02 6.75 4.82 NA NA 0.19 9.96 8.03 NA NA XXX 88356 ......... 26 ....... A Analysis, nerve .............................................. 3.02 0.79 1.14 0.79 1.14 0.12 3.93 4.28 3.93 4.28 XXX 88356 ......... TC ...... A Analysis, nerve .............................................. 0.00 5.96 3.68 NA NA 0.07 6.03 3.75 NA NA XXX 88358 ......... ............ A Analysis, tumor .............................................. 0.95 1.14 0.92 NA NA 0.17 2.26 2.04 NA NA XXX 88358 ......... 26 ....... A Analysis, tumor .............................................. 0.95 0.17 0.34 0.17 0.34 0.10 1.22 1.39 1.22 1.39 XXX 88358 ......... TC ...... A Analysis, tumor .............................................. 0.00 0.97 0.57 NA NA 0.07 1.04 0.64 NA NA XXX 88360 ......... ............ A Tumor immunohistochem/manual ................. 1.10 2.33 1.87 NA NA 0.08 3.51 3.05 NA NA XXX 88360 ......... 26 ....... A Tumor immunohistochem/manual ................. 1.10 0.28 0.42 0.28 0.42 0.06 1.44 1.58 1.44 1.58 XXX 88360 ......... TC ...... A Tumor immunohistochem/manual ................. 0.00 2.04 1.46 NA NA 0.02 2.06 1.48 NA NA XXX 88361 ......... ............ A Tumor immunohistochem/comput ................. 1.18 2.79 2.96 NA NA 0.17 4.14 4.31 NA NA XXX 88361 ......... 26 ....... A Tumor immunohistochem/comput ................. 1.18 0.26 0.43 0.26 0.43 0.10 1.54 1.71 1.54 1.71 XXX 88361 ......... TC ...... A Tumor immunohistochem/comput ................. 0.00 2.53 2.53 NA NA 0.07 2.60 2.60 NA NA XXX 88362 ......... ............ A Nerve teasing preparations ........................... 2.17 5.31 4.85 NA NA 0.15 7.63 7.17 NA NA XXX 88362 ......... 26 ....... A Nerve teasing preparations ........................... 2.17 0.61 0.84 0.61 0.84 0.09 2.87 3.10 2.87 3.10 XXX 88362 ......... TC ...... A Nerve teasing preparations ........................... 0.00 4.71 4.01 NA NA 0.06 4.77 4.07 NA NA XXX 88365 ......... ............ A Insitu hybridization (fish) ............................... 1.20 2.99 2.34 NA NA 0.05 4.24 3.59 NA NA XXX 88365 ......... 26 ....... A Insitu hybridization (fish) ............................... 1.20 0.25 0.45 0.25 0.45 0.03 1.48 1.68 1.48 1.68 XXX 88365 ......... TC ...... A Insitu hybridization (fish) ............................... 0.00 2.74 1.90 NA NA 0.02 2.76 1.92 NA NA XXX88367 ......... ............ A Insitu hybridization, auto ............................... 1.30 5.30 4.35 NA NA 0.12 6.72 5.77 NA NA XXX 88367 ......... 26 ....... A Insitu hybridization, auto ............................... 1.30 0.23 0.46 0.23 0.46 0.06 1.59 1.82 1.59 1.82 XXX 88367 ......... TC ...... A Insitu hybridization, auto ............................... 0.00 5.06 3.88 NA NA 0.06 5.12 3.94 NA NA XXX 88368 ......... ............ A Insitu hybridization, manual ........................... 1.40 4.83 3.00 NA NA 0.12 6.35 4.52 NA NA XXX 88368 ......... 26 ....... A Insitu hybridization, manual ........................... 1.40 0.22 0.51 0.22 0.51 0.06 1.68 1.97 1.68 1.97 XXX 88368 ......... TC ...... A Insitu hybridization, manual ........................... 0.00 4.60 2.49 NA NA 0.06 4.66 2.55 NA NA XXX 88371 ......... 26 ....... A Protein, western blot tissue ........................... 0.37 0.10 0.12 0.10 0.12 0.01 0.48 0.50 0.48 0.50 XXX 88372 ......... 26 ....... A Protein analysis w/probe ............................... 0.37 0.11 0.15 0.11 0.15 0.01 0.49 0.53 0.49 0.53 XXX 88380 ......... ............ C Microdissection .............................................. 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49213 

88380 ......... TC ...... C Microdissection .............................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88384 ......... ............ C Eval molecular probes, 11–50 ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88384 ......... 26 ....... C Eval molecular probes, 11–50 ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88384 ......... TC ...... C Eval molecular probes, 11–50 ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 88385 ......... ............ A Eval molecul probes, 51–250 ........................ 1.50 14.75 9.00 NA NA 0.12 16.37 10.62 NA NA XXX 88385 ......... 26 ....... A Eval molecul probes, 51–250 ........................ 1.50 0.24 0.55 0.24 0.55 0.06 1.80 2.11 1.80 2.11 XXX 88385 ......... TC ...... A Eval molecul probes, 51–250 ........................ 0.00 14.51 8.45 NA NA 0.06 14.57 8.51 NA NA XXX 88386 ......... ............ A Eval molecul probes, 251–500 ...................... 1.88 14.65 8.94 NA NA 0.16 16.69 10.98 NA NA XXX 88386 ......... 26 ....... A Eval molecul probes, 251–500 ...................... 1.88 0.30 0.69 0.30 0.69 0.08 2.26 2.65 2.26 2.65 XXX 88386 ......... TC ...... A Eval molecul probes, 251–500 ...................... 0.00 14.35 8.25 NA NA 0.08 14.43 8.33 NA NA XXX 88399 ......... ............ C Surgical pathology procedure ....................... 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 XXX 89049 ......... ............ A Chct for mal hyperthermia ............................. 1.40 3.62 3.57 0.20 0.25 0.06 5.08 5.03 1.66 1.71 XXX 89060 ......... 26 ....... A Exam,synovial fluid crystals .......................... 0.37 0.12 0.15 0.12 0.15 0.01 0.50 0.53 0.50 0.53 XXX 89100 ......... ............ A Sample intestinal contents ............................ 0.60 8.87 3.59 0.59 0.31 0.03 9.50 4.22 1.22 0.94 XXX 89105 ......... ............ A Sample intestinal contents ............................ 0.50 7.68 3.59 0.45 0.24 0.02 8.20 4.11 0.97 0.76 XXX 89130 ......... ............ A Sample stomach contents ............................. 0.45 6.95 3.04 0.39 0.20 0.02 7.42 3.51 0.86 0.67 XXX 89132 ......... ............ A Sample stomach contents ............................. 0.19 6.51 2.79 0.29 0.12 0.01 6.71 2.99 0.49 0.32 XXX 89135 ......... ............ A Sample stomach contents ............................. 0.79 8.87 3.64 0.67 0.36 0.04 9.70 4.47 1.50 1.19 XXX 89136 ......... ............ A Sample stomach contents ............................. 0.21 7.13 3.08 0.32 0.15 0.01 7.35 3.30 0.54 0.37 XXX 89140 ......... ............ A Sample stomach contents ............................. 0.94 6.89 3.28 0.50 0.33 0.04 7.87 4.26 1.48 1.31 XXX 89141 ......... ............ A Sample stomach contents ............................. 0.85 5.54 3.48 0.40 0.35 0.03 6.42 4.36 1.28 1.23 XXX 89220 ......... ............ A Sputum specimen collection ......................... 0.00 0.36 0.41 NA NA 0.02 0.38 0.43 NA NA XXX 89230 ......... ............ A Collect sweat for test ..................................... 0.00 0.08 0.10 NA NA 0.02 0.10 0.12 NA NA XXX 89240 ......... ............ C Pathology lab procedure ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90465 ......... ............ A Immune admin 1 inj, < 8 yrs ......................... 0.17 0.45 0.35 NA NA 0.01 0.63 0.53 NA NA XXX 90466 ......... ............ A Immune admin addl inj, < 8 y ....................... 0.15 0.12 0.13 0.04 0.11 0.01 0.28 0.29 0.20 0.27 ZZZ 90467 ......... ............ R Immune admin o or n, < 8 yrs ...................... 0.17 0.17 0.17 0.07 0.09 0.01 0.35 0.35 0.25 0.27 XXX 90468 ......... ............ R Immune admin o/n, addl < 8 y ...................... 0.15 0.10 0.11 0.03 0.05 0.01 0.26 0.27 0.19 0.21 ZZZ 90471 ......... ............ A Immunization admin ...................................... 0.17 0.45 0.35 NA NA 0.01 0.63 0.53 NA NA XXX 90472 ......... ............ A Immunization admin, each add ..................... 0.15 0.12 0.13 0.04 0.11 0.01 0.28 0.29 0.20 0.27 ZZZ 90473 ......... ............ R Immune admin oral/nasal .............................. 0.17 0.16 0.18 0.04 0.06 0.01 0.34 0.36 0.22 0.24 XXX 90474 ......... ............ R Immune admin oral/nasal addl ...................... 0.15 0.08 0.10 0.03 0.05 0.01 0.24 0.26 0.19 0.21 ZZZ 90760 ......... ............ A Hydration iv infusion, init ............................... 0.17 1.31 1.40 NA NA 0.07 1.55 1.64 NA NA XXX 90761 ......... ............ A Hydrate iv infusion, add-on ........................... 0.09 0.32 0.38 NA NA 0.04 0.45 0.51 NA NA ZZZ90765 ......... ............ A Ther/proph/diag iv inf, init .............................. 0.21 1.62 1.72 NA NA 0.07 1.90 2.00 NA NA XXX 90766 ......... ............ A Ther/proph/dg iv inf, add-on .......................... 0.18 0.37 0.44 NA NA 0.04 0.59 0.66 NA NA ZZZ90767 ......... ............ A Tx/proph/dg addl seq iv inf ............................ 0.19 0.69 0.84 NA NA 0.04 0.92 1.07 NA NA ZZZ 90768 ......... ............ A Ther/diag concurrent inf ................................ 0.17 0.33 0.41 NA NA 0.04 0.54 0.62 NA NA ZZZ 90772 ......... ............ A Ther/proph/diag inj, sc/im .............................. 0.17 0.45 0.35 NA NA 0.01 0.63 0.53 NA NA XXX 90773 ......... ............ A Ther/proph/diag inj, ia ................................... 0.17 0.30 0.31 NA NA 0.02 0.49 0.50 NA NA XXX 90774 ......... ............ A Ther/proph/diag inj, iv push ........................... 0.18 1.34 1.31 NA NA 0.04 1.56 1.53 NA NA XXX 90775 ......... ............ A Ther/proph/diag inj add-on ............................ 0.10 0.51 0.56 NA NA 0.04 0.65 0.70 NA NA ZZZ90779 ......... ............ C Ther/prop/diag inj/inf proc ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90801 ......... ............ A Psy dx interview ............................................ 2.80 1.47 1.25 0.59 0.85 0.06 4.33 4.11 3.45 3.71 XXX 90802 ......... ............ A Intac psy dx interview .................................... 3.01 1.51 1.28 0.65 0.90 0.07 4.59 4.36 3.73 3.98 XXX 90804 ......... ............ A Psytx, office, 20–30 min ................................ 1.21 0.54 0.50 0.21 0.34 0.03 1.78 1.74 1.45 1.58 XXX 90805 ......... ............ A Psytx, off, 20–30 min w/e&m ........................ 1.37 0.59 0.52 0.24 0.38 0.03 1.99 1.92 1.64 1.78 XXX 90806 ......... ............ A Psytx, off, 45–50 min .................................... 1.86 0.51 0.65 0.32 0.53 0.04 2.41 2.55 2.22 2.43 XXX 90807 ......... ............ A Psytx, off, 45–50 min w/e&m ........................ 2.02 0.70 0.70 0.35 0.56 0.05 2.77 2.77 2.42 2.63 XXX 90808 ......... ............ A Psytx, office, 75–80 min ................................ 2.79 0.67 0.94 0.48 0.80 0.06 3.52 3.79 3.33 3.65 XXX 90809 ......... ............ A Psytx, off, 75–80, w/e&m .............................. 2.95 0.85 0.96 0.51 0.82 0.07 3.87 3.98 3.53 3.84 XXX 90810 ......... ............ A Intac psytx, off, 20–30 min ............................ 1.32 0.51 0.51 0.23 0.37 0.04 1.87 1.87 1.59 1.73 XXX 90811 ......... ............ A Intac psytx, 20–30, w/e&m ............................ 1.48 0.72 0.61 0.26 0.41 0.04 2.24 2.13 1.78 1.93 XXX 90812 ......... ............ A Intac psytx, off, 45–50 min ............................ 1.97 0.63 0.75 0.33 0.56 0.04 2.64 2.76 2.34 2.57 XXX 90813 ......... ............ A Intac psytx, 45–50 min w/e&m ...................... 2.13 0.82 0.78 0.37 0.60 0.05 3.00 2.96 2.55 2.78 XXX 90814 ......... ............ A Intac psytx, off, 75–80 min ............................ 2.90 0.77 1.02 0.50 0.86 0.06 3.73 3.98 3.46 3.82 XXX 90815 ......... ............ A Intac psytx, 75–80 w/e&m ............................. 3.06 0.98 1.03 0.53 0.85 0.07 4.11 4.16 3.66 3.98 XXX 90816 ......... ............ A Psytx, hosp, 20–30 min ................................. 1.25 NA NA 0.31 0.42 0.03 NA NA 1.59 1.70 XXX 90817 ......... ............ A Psytx, hosp, 20–30 min w/e&m .................... 1.41 NA NA 0.35 0.43 0.03 NA NA 1.79 1.87 XXX 90818 ......... ............ A Psytx, hosp, 45–50 min ................................. 1.89 NA NA 0.42 0.62 0.04 NA NA 2.35 2.55 XXX 90819 ......... ............ A Psytx, hosp, 45–50 min w/e&m .................... 2.05 NA NA 0.46 0.60 0.05 NA NA 2.56 2.70 XXX 90821 ......... ............ A Psytx, hosp, 75–80 min ................................. 2.83 NA NA 0.58 0.90 0.06 NA NA 3.47 3.79 XXX 90822 ......... ............ A Psytx, hosp, 75–80 min w/e&m .................... 2.99 NA NA 0.62 0.87 0.08 NA NA 3.69 3.94 XXX 90823 ......... ............ A Intac psytx, hosp, 20–30 min ........................ 1.36 NA NA 0.33 0.44 0.03 NA NA 1.72 1.83 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49214 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

90824 ......... ............ A Intac psytx, hsp 20–30 w/e&m ...................... 1.52 NA NA 0.37 0.46 0.04 NA NA 1.93 2.02 XXX 90826 ......... ............ A Intac psytx, hosp, 45–50 min ........................ 2.01 NA NA 0.44 0.65 0.05 NA NA 2.50 2.71 XXX 90827 ......... ............ A Intac psytx, hsp 45–50 w/e&m ...................... 2.16 NA NA 0.48 0.63 0.05 NA NA 2.69 2.84 XXX 90828 ......... ............ A Intac psytx, hosp, 75–80 min ........................ 2.94 NA NA 0.60 0.95 0.06 NA NA 3.60 3.95 XXX 90829 ......... ............ A Intac psytx, hsp 75–80 w/e&m ...................... 3.10 NA NA 0.64 0.90 0.07 NA NA 3.81 4.07 XXX 90845 ......... ............ A Psychoanalysis .............................................. 1.79 0.38 0.53 0.31 0.49 0.04 2.21 2.36 2.14 2.32 XXX 90846 ......... ............ R Family psytx w/o patient ................................ 1.83 0.50 0.61 0.42 0.59 0.04 2.37 2.48 2.29 2.46 XXX 90847 ......... ............ R Family psytx w/patient ................................... 2.21 0.72 0.80 0.48 0.69 0.05 2.98 3.06 2.74 2.95 XXX 90849 ......... ............ R Multiple family group psytx ............................ 0.59 0.30 0.28 0.20 0.23 0.02 0.91 0.89 0.81 0.84 XXX 90853 ......... ............ A Group psychotherapy .................................... 0.59 0.27 0.26 0.20 0.22 0.01 0.87 0.86 0.80 0.82 XXX 90857 ......... ............ A Intac group psytx ........................................... 0.63 0.36 0.31 0.20 0.24 0.01 1.00 0.95 0.84 0.88 XXX 90862 ......... ............ A Medication management ............................... 0.95 0.62 0.46 0.27 0.31 0.02 1.59 1.43 1.24 1.28 XXX 90865 ......... ............ A Narcosynthesis .............................................. 2.84 1.18 1.32 0.63 0.84 0.12 4.14 4.28 3.59 3.80 XXX 90870 ......... ............ A Electroconvulsive therapy ............................. 1.88 1.90 1.92 0.38 0.54 0.04 3.82 3.84 2.30 2.46 000 90875 ......... ............ N Psychophysiological therapy ......................... 1.20 0.53 0.81 0.28 0.42 0.04 1.77 2.05 1.52 1.66 XXX 90876 ......... ............ N Psychophysiological therapy ......................... 1.90 0.68 1.04 0.44 0.66 0.05 2.63 2.99 2.39 2.61 XXX 90880 ......... ............ A Hypnotherapy ................................................ 2.19 0.56 0.92 0.37 0.61 0.05 2.80 3.16 2.61 2.85 XXX 90885 ......... ............ B Psy evaluation of records .............................. 0.97 0.23 0.34 0.23 0.34 0.02 1.22 1.33 1.22 1.33 XXX 90887 ......... ............ B Consultation with family ................................ 1.48 0.62 0.77 0.34 0.51 0.04 2.14 2.29 1.86 2.03 XXX 90899 ......... ............ C Psychiatric service/therapy ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 90901 ......... ............ A Biofeedback train, any meth ......................... 0.41 0.48 0.61 0.11 0.13 0.02 0.91 1.04 0.54 0.56 000 90911 ......... ............ A Biofeedback peri/uro/rectal ............................ 0.89 1.38 1.52 0.30 0.31 0.06 2.33 2.47 1.25 1.26 000 90918 ......... ............ I ESRD related services, month ...................... 11.16 4.75 5.77 3.78 5.53 0.36 16.27 17.29 15.30 17.05 XXX 90919 ......... ............ I ESRD related services, month ...................... 8.53 3.06 3.77 2.58 3.65 0.29 11.88 12.59 11.40 12.47 XXX 90920 ......... ............ I ESRD related services, month ...................... 7.26 2.77 3.51 2.29 3.39 0.23 10.26 11.00 9.78 10.88 XXX 90921 ......... ............ I ESRD related services, month ...................... 4.46 1.73 2.26 1.63 2.24 0.14 6.33 6.86 6.23 6.84 XXX 90922 ......... ............ I ESRD related services, day .......................... 0.37 0.16 0.20 0.13 0.19 0.01 0.54 0.58 0.51 0.57 XXX 90923 ......... ............ I Esrd related services, day ............................. 0.28 0.10 0.12 0.08 0.12 0.01 0.39 0.41 0.37 0.41 XXX 90924 ......... ............ I Esrd related services, day ............................. 0.24 0.09 0.11 0.08 0.11 0.01 0.34 0.36 0.33 0.36 XXX 90925 ......... ............ I Esrd related services, day ............................. 0.15 0.06 0.08 0.05 0.07 0.01 0.22 0.24 0.21 0.23 XXX 90935 ......... ............ A Hemodialysis, one evaluation ....................... 1.22 NA NA 0.54 0.64 0.04 NA NA 1.80 1.90 000 90937 ......... ............ A Hemodialysis, repeated eval ......................... 2.11 NA NA 0.78 0.92 0.07 NA NA 2.96 3.10 000 90945 ......... ............ A Dialysis, one evaluation ................................ 1.28 NA NA 0.56 0.66 0.04 NA NA 1.88 1.98 000 90947 ......... ............ A Dialysis, repeated eval .................................. 2.16 NA NA 0.80 0.94 0.07 NA NA 3.03 3.17 000 90997 ......... ............ A Hemoperfusion .............................................. 1.84 NA NA 0.50 0.62 0.06 NA NA 2.40 2.52 000 90999 ......... ............ C Dialysis procedure ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91000 ......... ............ A Esophageal intubation ................................... 0.73 2.22 0.80 2.22 0.80 0.04 2.99 1.57 2.99 1.57 000 91000 ......... 26 ....... A Esophageal intubation ................................... 0.73 0.24 0.25 0.24 0.25 0.03 1.00 1.01 1.00 1.01 000 91000 ......... TC ...... A Esophageal intubation ................................... 0.00 1.98 0.56 1.98 0.56 0.01 1.99 0.57 1.99 0.57 000 91010 ......... ............ A Esophagus motility study .............................. 1.25 3.66 4.22 3.66 4.22 0.12 5.03 5.59 5.03 5.59 000 91010 ......... 26 ....... A Esophagus motility study .............................. 1.25 0.55 0.47 0.55 0.47 0.06 1.86 1.78 1.86 1.78 000 91010 ......... TC ...... A Esophagus motility study .............................. 0.00 3.11 3.76 3.11 3.76 0.06 3.17 3.82 3.17 3.82 000 91011 ......... ............ A Esophagus motility study .............................. 1.50 5.31 5.24 5.31 5.24 0.13 6.94 6.87 6.94 6.87 000 91011 ......... 26 ....... A Esophagus motility study .............................. 1.50 0.70 0.57 0.70 0.57 0.07 2.27 2.14 2.27 2.14 000 91011 ......... TC ...... A Esophagus motility study .............................. 0.00 4.61 4.68 4.61 4.68 0.06 4.67 4.74 4.67 4.74 000 91012 ......... ............ A Esophagus motility study .............................. 1.46 5.49 5.69 5.49 5.69 0.13 7.08 7.28 7.08 7.28 000 91012 ......... 26 ....... A Esophagus motility study .............................. 1.46 0.68 0.55 0.68 0.55 0.06 2.20 2.07 2.20 2.07 000 91012 ......... TC ...... A Esophagus motility study .............................. 0.00 4.81 5.13 4.81 5.13 0.07 4.88 5.20 4.88 5.20 000 91020 ......... ............ A Gastric motility studies .................................. 1.44 4.79 4.59 4.79 4.59 0.13 6.36 6.16 6.36 6.16 000 91020 ......... 26 ....... A Gastric motility studies .................................. 1.44 0.61 0.52 0.61 0.52 0.07 2.12 2.03 2.12 2.03 000 91020 ......... TC ...... A Gastric motility studies .................................. 0.00 4.19 4.07 4.19 4.07 0.06 4.25 4.13 4.25 4.13 000 91022 ......... ............ A Duodenal motility study ................................. 1.44 3.09 4.07 3.09 4.07 0.13 4.66 5.64 4.66 5.64 000 91022 ......... 26 ....... A Duodenal motility study ................................. 1.44 0.61 0.54 0.61 0.54 0.07 2.12 2.05 2.12 2.05 000 91022 ......... TC ...... A Duodenal motility study ................................. 0.00 2.48 3.54 2.48 3.54 0.06 2.54 3.60 2.54 3.60 000 91030 ......... ............ A Acid perfusion of esophagus ......................... 0.91 2.92 2.55 2.92 2.55 0.06 3.89 3.52 3.89 3.52 000 91030 ......... 26 ....... A Acid perfusion of esophagus ......................... 0.91 0.43 0.35 0.43 0.35 0.04 1.38 1.30 1.38 1.30 000 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49215 

91030 ......... TC ...... A Acid perfusion of esophagus ......................... 0.00 2.49 2.21 2.49 2.21 0.02 2.51 2.23 2.51 2.23 000 91034 ......... ............ A Gastroesophageal reflux test ........................ 0.97 4.12 4.95 4.12 4.95 0.12 5.21 6.04 5.21 6.04 000 91034 ......... 26 ....... A Gastroesophageal reflux test ........................ 0.97 0.41 0.36 0.41 0.36 0.06 1.44 1.39 1.44 1.39 000 91034 ......... TC ...... A Gastroesophageal reflux test ........................ 0.00 3.70 4.60 3.70 4.60 0.06 3.76 4.66 3.76 4.66 000 91035 ......... ............ A G-esoph reflx tst w/electrod .......................... 1.59 11.33 10.93 11.33 10.93 0.12 13.04 12.64 13.04 12.64 000 91035 ......... 26 ....... A G-esoph reflx tst w/electrod .......................... 1.59 0.70 0.60 0.70 0.60 0.06 2.35 2.25 2.35 2.25 000 91035 ......... TC ...... A G-esoph reflx tst w/electrod .......................... 0.00 10.63 10.34 10.63 10.34 0.06 10.69 10.40 10.69 10.40 000 91037 ......... ............ A Esoph imped function test ............................. 0.97 3.41 3.05 3.41 3.05 0.12 4.50 4.14 4.50 4.14 000 91037 ......... 26 ....... A Esoph imped function test ............................. 0.97 0.42 0.36 0.42 0.36 0.06 1.45 1.39 1.45 1.39 000 91037 ......... TC ...... A Esoph imped function test ............................. 0.00 2.99 2.69 2.99 2.69 0.06 3.05 2.75 3.05 2.75 000 91038 ......... ............ A Esoph imped funct test > 1h ......................... 1.10 2.78 2.36 2.78 2.36 0.12 4.00 3.58 4.00 3.58 000 91038 ......... 26 ....... A Esoph imped funct test > 1h ......................... 1.10 0.50 0.42 0.50 0.42 0.06 1.66 1.58 1.66 1.58 000 91038 ......... TC ...... A Esoph imped funct test > 1h ......................... 0.00 2.28 1.94 2.28 1.94 0.06 2.34 2.00 2.34 2.00 000 91040 ......... ............ A Esoph balloon distension tst ......................... 0.97 9.35 10.69 9.35 10.69 0.12 10.44 11.78 10.44 11.78 000 91040 ......... 26 ....... A Esoph balloon distension tst ......................... 0.97 0.37 0.35 0.37 0.35 0.06 1.40 1.38 1.40 1.38 000 91040 ......... TC ...... A Esoph balloon distension tst ......................... 0.00 8.97 10.34 8.97 10.34 0.06 9.03 10.40 9.03 10.40 000 91052 ......... ............ A Gastric analysis test ...................................... 0.79 2.99 2.59 2.99 2.59 0.05 3.83 3.43 3.83 3.43 000 91052 ......... 26 ....... A Gastric analysis test ...................................... 0.79 0.37 0.30 0.37 0.30 0.03 1.19 1.12 1.19 1.12 000 91052 ......... TC ...... A Gastric analysis test ...................................... 0.00 2.62 2.28 2.62 2.28 0.02 2.64 2.30 2.64 2.30 000 91055 ......... ............ A Gastric intubation for smear .......................... 0.94 2.44 2.82 2.44 2.82 0.07 3.45 3.83 3.45 3.83 000 91055 ......... 26 ....... A Gastric intubation for smear .......................... 0.94 0.27 0.27 0.27 0.27 0.05 1.26 1.26 1.26 1.26 000 91055 ......... TC ...... A Gastric intubation for smear .......................... 0.00 2.17 2.55 2.17 2.55 0.02 2.19 2.57 2.19 2.57 000 91060 ......... ............ A Gastric saline load test .................................. 0.45 1.65 1.88 1.65 1.88 0.05 2.15 2.38 2.15 2.38 000 91060 ......... 26 ....... A Gastric saline load test .................................. 0.45 0.11 0.13 0.11 0.13 0.03 0.59 0.61 0.59 0.61 000 91060 ......... TC ...... A Gastric saline load test .................................. 0.00 1.54 1.75 1.54 1.75 0.02 1.56 1.77 1.56 1.77 000 91065 ......... ............ A Breath hydrogen test ..................................... 0.20 1.41 1.45 1.41 1.45 0.03 1.64 1.68 1.64 1.68 000 91065 ......... 26 ....... A Breath hydrogen test ..................................... 0.20 0.07 0.07 0.07 0.07 0.01 0.28 0.28 0.28 0.28 000 91065 ......... TC ...... A Breath hydrogen test ..................................... 0.00 1.34 1.38 1.34 1.38 0.02 1.36 1.40 1.36 1.40 000 91100 ......... ............ A Pass intestine bleeding tube ......................... 1.08 2.15 2.63 0.37 0.30 0.07 3.30 3.78 1.52 1.45 000 91105 ......... ............ A Gastric intubation treatment .......................... 0.37 1.76 2.02 0.07 0.09 0.03 2.16 2.42 0.47 0.49 000 91110 ......... ............ A Gi tract capsule endoscopy ........................... 3.64 20.55 21.77 NA NA 0.16 24.35 25.57 NA NA XXX 91110 ......... 26 ....... A Gi tract capsule endoscopy ........................... 3.64 1.66 1.38 1.66 1.38 0.09 5.39 5.11 5.39 5.11 XXX 91110 ......... TC ...... A Gi tract capsule endoscopy ........................... 0.00 18.90 20.40 NA NA 0.07 18.97 20.47 NA NA XXX 91120 ......... ............ A Rectal sensation test ..................................... 0.97 9.12 10.52 9.12 10.52 0.11 10.20 11.60 10.20 11.60 XXX 91120 ......... 26 ....... A Rectal sensation test ..................................... 0.97 0.30 0.33 0.30 0.33 0.07 1.34 1.37 1.34 1.37 XXX 91120 ......... TC ...... A Rectal sensation test ..................................... 0.00 8.82 10.19 8.82 10.19 0.04 8.86 10.23 8.86 10.23 XXX 91122 ......... ............ A Anal pressure record ..................................... 1.77 3.76 4.77 3.76 4.77 0.21 5.74 6.75 5.74 6.75 000 91122 ......... 26 ....... A Anal pressure record ..................................... 1.77 0.52 0.58 0.52 0.58 0.13 2.42 2.48 2.42 2.48 000 91122 ......... TC ...... A Anal pressure record ..................................... 0.00 3.24 4.19 3.24 4.19 0.08 3.32 4.27 3.32 4.27 000 91132 ......... ............ C Electrogastrography ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 91132 ......... 26 ....... A Electrogastrography ...................................... 0.52 0.25 0.20 0.25 0.20 0.02 0.79 0.74 0.79 0.74 XXX 91132 ......... TC ...... C Electrogastrography ...................................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 91133 ......... 26 ....... A Electrogastrography w/test ............................ 0.66 0.30 0.25 0.30 0.25 0.03 0.99 0.94 0.99 0.94 XXX 91133 ......... TC ...... C Electrogastrography w/test ............................ 0.00 0.00 0.00 0.00 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 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 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 0.00 0.00 0.00 0.00 XXX 92002 ......... ............ A Eye exam, new patient .................................. 0.88 0.97 0.97 0.27 0.32 0.02 1.87 1.87 1.17 1.22 XXX 92004 ......... ............ A Eye exam, new patient .................................. 1.67 1.59 1.67 0.54 0.65 0.04 3.30 3.38 2.25 2.36 XXX 92012 ......... ............ A Eye exam established pat ............................. 0.67 0.94 1.01 0.24 0.28 0.02 1.63 1.70 0.93 0.97 XXX 92014 ......... ............ A Eye exam & treatment .................................. 1.10 1.32 1.39 0.38 0.45 0.03 2.45 2.52 1.51 1.58 XXX 92015 ......... ............ N Refraction ...................................................... 0.38 0.10 1.14 0.09 0.14 0.01 0.49 1.53 0.48 0.53 XXX 92018 ......... ............ A New eye exam & treatment .......................... 2.50 NA NA 0.91 1.03 0.07 NA NA 3.48 3.60 XXX 92019 ......... ............ A Eye exam & treatment .................................. 1.31 NA NA 0.44 0.53 0.03 NA NA 1.78 1.87 XXX92020 ......... ............ A Special eye evaluation .................................. 0.37 0.26 0.32 0.13 0.15 0.01 0.64 0.70 0.51 0.53 XXX 92060 ......... ............ A Special eye evaluation .................................. 0.69 0.79 0.75 NA NA 0.03 1.51 1.47 NA NA XXX 92060 ......... 26 ....... A Special eye evaluation .................................. 0.69 0.23 0.28 0.23 0.28 0.02 0.94 0.99 0.94 0.99 XXX 92060 ......... TC ...... A Special eye evaluation .................................. 0.00 0.56 0.47 NA NA 0.01 0.57 0.48 NA NA XXX 92065 ......... ............ A Orthoptic/pleoptic training .............................. 0.37 0.89 0.62 NA NA 0.02 1.28 1.01 NA NA XXX 92065 ......... 26 ....... A Orthoptic/pleoptic training .............................. 0.37 0.09 0.14 0.09 0.14 0.01 0.47 0.52 0.47 0.52 XXX 92065 ......... TC ...... A Orthoptic/pleoptic training .............................. 0.00 0.79 0.48 NA NA 0.01 0.80 0.49 NA NA XXX 92070 ......... ............ A Fitting of contact lens .................................... 0.70 0.94 1.04 0.24 0.30 0.02 1.66 1.76 0.96 1.02 XXX 92081 ......... ............ A Visual field examination(s) ............................ 0.36 0.97 0.95 NA NA 0.02 1.35 1.33 NA NA XXX 92081 ......... 26 ....... A Visual field examination(s) ............................ 0.36 0.11 0.14 0.11 0.14 0.01 0.48 0.51 0.48 0.51 XXX 92081 ......... TC ...... A Visual field examination(s) ............................ 0.00 0.86 0.81 NA NA 0.01 0.87 0.82 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49216 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

92082 ......... ............ A Visual field examination(s) ............................ 0.44 1.36 1.26 NA NA 0.02 1.82 1.72 NA NA XXX 92082 ......... 26 ....... A Visual field examination(s) ............................ 0.44 0.14 0.18 0.14 0.18 0.01 0.59 0.63 0.59 0.63 XXX 92082 ......... TC ...... A Visual field examination(s) ............................ 0.00 1.22 1.09 NA NA 0.01 1.23 1.10 NA NA XXX 92083 ......... ............ A Visual field examination(s) ............................ 0.50 1.56 1.46 NA NA 0.02 2.08 1.98 NA NA XXX 92083 ......... 26 ....... A Visual field examination(s) ............................ 0.50 0.17 0.21 0.17 0.21 0.01 0.68 0.72 0.68 0.72 XXX 92083 ......... TC ...... A Visual field examination(s) ............................ 0.00 1.39 1.26 NA NA 0.01 1.40 1.27 NA NA XXX 92100 ......... ............ A Serial tonometry exam(s) .............................. 0.92 1.28 1.33 0.29 0.34 0.02 2.22 2.27 1.23 1.28 XXX 92120 ......... ............ A Tonography & eye evaluation ....................... 0.81 1.00 1.05 0.26 0.31 0.02 1.83 1.88 1.09 1.14 XXX 92130 ......... ............ A Water provocation tonography ...................... 0.81 1.21 1.26 0.28 0.35 0.02 2.04 2.09 1.11 1.18 XXX 92135 ......... ............ A Opthalmic dx imaging .................................... 0.35 0.81 0.80 NA NA 0.02 1.18 1.17 NA NA XXX 92135 ......... 26 ....... A Opthalmic dx imaging .................................... 0.35 0.12 0.14 0.12 0.14 0.01 0.48 0.50 0.48 0.50 XXX 92135 ......... TC ...... A Opthalmic dx imaging .................................... 0.00 0.69 0.65 NA NA 0.01 0.70 0.66 NA NA XXX 92136 ......... ............ A Ophthalmic biometry ..................................... 0.54 1.46 1.60 NA NA 0.08 2.08 2.22 NA NA XXX 92136 ......... 26 ....... A Ophthalmic biometry ..................................... 0.54 0.20 0.23 0.20 0.23 0.01 0.75 0.78 0.75 0.78 XXX 92136 ......... TC ...... A Ophthalmic biometry ..................................... 0.00 1.26 1.37 NA NA 0.07 1.33 1.44 NA NA XXX 92140 ......... ............ A Glaucoma provocative tests .......................... 0.50 0.92 0.97 0.15 0.20 0.01 1.43 1.48 0.66 0.71 XXX 92225 ......... ............ A Special eye exam, initial ............................... 0.38 0.25 0.23 0.13 0.15 0.01 0.64 0.62 0.52 0.54 XXX 92226 ......... ............ A Special eye exam, subsequent ..................... 0.33 0.24 0.22 0.12 0.14 0.01 0.58 0.56 0.46 0.48 XXX 92230 ......... ............ A Eye exam with photos ................................... 0.60 0.73 1.33 0.21 0.20 0.02 1.35 1.95 0.83 0.82 XXX 92235 ......... ............ A Eye exam with photos ................................... 0.81 2.33 2.54 NA NA 0.08 3.22 3.43 NA NA XXX 92235 ......... 26 ....... A Eye exam with photos ................................... 0.81 0.30 0.35 0.30 0.35 0.02 1.13 1.18 1.13 1.18 XXX 92235 ......... TC ...... A Eye exam with photos ................................... 0.00 2.02 2.19 NA NA 0.06 2.08 2.25 NA NA XXX 92240 ......... ............ A Icg angiography ............................................. 1.10 4.51 5.70 NA NA 0.09 5.70 6.89 NA NA XXX 92240 ......... 26 ....... A Icg angiography ............................................. 1.10 0.41 0.48 0.41 0.48 0.03 1.54 1.61 1.54 1.61 XXX 92240 ......... TC ...... A Icg angiography ............................................. 0.00 4.09 5.22 NA NA 0.06 4.15 5.28 NA NA XXX 92250 ......... ............ A Eye exam with photos ................................... 0.44 1.34 1.48 NA NA 0.02 1.80 1.94 NA NA XXX 92250 ......... 26 ....... A Eye exam with photos ................................... 0.44 0.15 0.18 0.15 0.18 0.01 0.60 0.63 0.60 0.63 XXX 92250 ......... TC ...... A Eye exam with photos ................................... 0.00 1.19 1.30 NA NA 0.01 1.20 1.31 NA NA XXX 92260 ......... ............ A Ophthalmoscopy/dynamometry ..................... 0.20 0.23 0.25 0.07 0.09 0.01 0.44 0.46 0.28 0.30 XXX 92265 ......... ............ A Eye muscle evaluation .................................. 0.81 1.01 1.37 NA NA 0.06 1.88 2.24 NA NA XXX 92265 ......... 26 ....... A Eye muscle evaluation .................................. 0.81 0.24 0.27 0.24 0.27 0.04 1.09 1.12 1.09 1.12 XXX 92265 ......... TC ...... A Eye muscle evaluation .................................. 0.00 0.76 1.10 NA NA 0.02 0.78 1.12 NA NA XXX 92270 ......... ............ A Electro-oculography ....................................... 0.81 1.42 1.50 NA NA 0.05 2.28 2.36 NA NA XXX 92270 ......... 26 ....... A Electro-oculography ....................................... 0.81 0.24 0.31 0.24 0.31 0.03 1.08 1.15 1.08 1.15 XXX 92270 ......... TC ...... A Electro-oculography ....................................... 0.00 1.17 1.19 NA NA 0.02 1.19 1.21 NA NA XXX92275 ......... ............ A Electroretinography ....................................... 1.01 2.48 2.07 NA NA 0.05 3.54 3.13 NA NA XXX 92275 ......... 26 ....... A Electroretinography ....................................... 1.01 0.36 0.41 0.36 0.41 0.03 1.40 1.45 1.40 1.45 XXX 92275 ......... TC ...... A Electroretinography ....................................... 0.00 2.12 1.66 NA NA 0.02 2.14 1.68 NA NA XXX92283 ......... ............ A Color vision examination ............................... 0.17 1.02 0.89 NA NA 0.02 1.21 1.08 NA NA XXX 92283 ......... 26 ....... A Color vision examination ............................... 0.17 0.05 0.07 0.05 0.07 0.01 0.23 0.25 0.23 0.25 XXX 92283 ......... TC ...... A Color vision examination ............................... 0.00 0.96 0.82 NA NA 0.01 0.97 0.83 NA NA XXX 92284 ......... ............ A Dark adaptation eye exam ............................ 0.24 1.25 1.72 NA NA 0.02 1.51 1.98 NA NA XXX 92284 ......... 26 ....... A Dark adaptation eye exam ............................ 0.24 0.09 0.08 0.09 0.08 0.01 0.34 0.33 0.34 0.33 XXX 92284 ......... TC ...... A Dark adaptation eye exam ............................ 0.00 1.16 1.64 NA NA 0.01 1.17 1.65 NA NA XXX 92285 ......... ............ A Eye photography ........................................... 0.20 0.82 0.95 NA NA 0.02 1.04 1.17 NA NA XXX 92285 ......... 26 ....... A Eye photography ........................................... 0.20 0.07 0.09 0.07 0.09 0.01 0.28 0.30 0.28 0.30 XXX 92285 ......... TC ...... A Eye photography ........................................... 0.00 0.75 0.86 NA NA 0.01 0.76 0.87 NA NA XXX92286 ......... ............ A Internal eye photography .............................. 0.66 2.16 2.83 NA NA 0.04 2.86 3.53 NA NA XXX92286 ......... 26 ....... A Internal eye photography .............................. 0.66 0.24 0.28 0.24 0.28 0.02 0.92 0.96 0.92 0.96 XXX 92286 ......... TC ...... A Internal eye photography .............................. 0.00 1.92 2.55 NA NA 0.02 1.94 2.57 NA NA XXX 92287 ......... ............ A Internal eye photography .............................. 0.81 1.98 2.28 0.30 0.31 0.02 2.81 3.11 1.13 1.14 XXX 92310 ......... ............ N Contact lens fitting ......................................... 1.17 1.07 1.11 0.27 0.41 0.04 2.28 2.32 1.48 1.62 XXX 92311 ......... ............ A Contact lens fitting ......................................... 1.08 1.31 1.15 0.32 0.34 0.03 2.42 2.26 1.43 1.45 XXX 92312 ......... ............ A Contact lens fitting ......................................... 1.26 1.51 1.19 0.36 0.47 0.03 2.80 2.48 1.65 1.76 XXX 92313 ......... ............ A Contact lens fitting ......................................... 0.92 1.49 1.17 0.33 0.30 0.02 2.43 2.11 1.27 1.24 XXX 92314 ......... ............ N Prescription of contact lens ........................... 0.69 1.15 0.99 0.16 0.24 0.01 1.85 1.69 0.86 0.94 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49217 

92315 ......... ............ A Prescription of contact lens ........................... 0.45 1.35 0.98 0.13 0.15 0.01 1.81 1.44 0.59 0.61 XXX 92316 ......... ............ A Prescription of contact lens ........................... 0.68 1.69 1.11 0.24 0.28 0.02 2.39 1.81 0.94 0.98 XXX 92317 ......... ............ A Prescription of contact lens ........................... 0.45 1.46 1.07 0.14 0.15 0.01 1.92 1.53 0.60 0.61 XXX 92325 ......... ............ A Modification of contact lens ........................... 0.00 0.85 0.51 NA NA 0.01 0.86 0.52 NA NA XXX 92326 ......... ............ A Replacement of contact lens ......................... 0.00 0.76 1.41 NA NA 0.06 0.82 1.47 NA NA XXX 92340 ......... ............ N Fitting of spectacles ...................................... 0.37 0.45 0.64 0.09 0.13 0.01 0.83 1.02 0.47 0.51 XXX 92341 ......... ............ N Fitting of spectacles ...................................... 0.47 0.47 0.67 0.11 0.16 0.01 0.95 1.15 0.59 0.64 XXX 92342 ......... ............ N Fitting of spectacles ...................................... 0.53 0.48 0.69 0.12 0.19 0.01 1.02 1.23 0.66 0.73 XXX 92352 ......... ............ B Special spectacles fitting ............................... 0.37 0.57 0.65 0.09 0.13 0.01 0.95 1.03 0.47 0.51 XXX 92353 ......... ............ B Special spectacles fitting ............................... 0.50 0.60 0.70 0.12 0.17 0.02 1.12 1.22 0.64 0.69 XXX 92354 ......... ............ B Special spectacles fitting ............................... 0.00 0.29 6.72 NA NA 0.10 0.39 6.82 NA NA XXX 92355 ......... ............ B Special spectacles fitting ............................... 0.00 0.45 3.36 NA NA 0.01 0.46 3.37 NA NA XXX 92358 ......... ............ B Eye prosthesis service .................................. 0.00 0.24 0.79 NA NA 0.05 0.29 0.84 NA NA XXX 92370 ......... ............ N Repair & adjust spectacles ........................... 0.32 0.39 0.51 0.07 0.12 0.02 0.73 0.85 0.41 0.46 XXX 92371 ......... ............ B Repair & adjust spectacles ........................... 0.00 0.24 0.53 NA NA 0.02 0.26 0.55 NA NA XXX 92499 ......... ............ C Eye service or procedure .............................. 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 XXX 92502 ......... ............ A Ear and throat examination ........................... 1.51 NA NA 0.77 1.03 0.05 NA NA 2.33 2.59 000 92504 ......... ............ A Ear microscopy examination ......................... 0.18 0.55 0.51 0.05 0.08 0.01 0.74 0.70 0.24 0.27 XXX 92506 ......... ............ A Speech/hearing evaluation ............................ 0.86 3.28 2.76 0.24 0.36 0.03 4.17 3.65 1.13 1.25 XXX 92507 ......... ............ A Speech/hearing therapy ................................ 0.52 1.19 1.13 0.14 0.21 0.02 1.73 1.67 0.68 0.75 XXX 92508 ......... ............ A Speech/hearing therapy ................................ 0.26 0.52 0.51 0.08 0.11 0.01 0.79 0.78 0.35 0.38 XXX 92511 ......... ............ A Nasopharyngoscopy ...................................... 0.84 2.92 3.21 0.61 0.74 0.03 3.79 4.08 1.48 1.61 000 92512 ......... ............ A Nasal function studies ................................... 0.55 0.93 1.09 0.15 0.17 0.02 1.50 1.66 0.72 0.74 XXX 92516 ......... ............ A Facial nerve function test .............................. 0.43 1.15 1.19 0.12 0.20 0.01 1.59 1.63 0.56 0.64 XXX 92520 ......... ............ A Laryngeal function studies ............................ 0.75 0.91 0.61 0.23 0.35 0.03 1.69 1.39 1.01 1.13 XXX 92526 ......... ............ A Oral function therapy ..................................... 0.55 1.68 1.65 0.16 0.19 0.02 2.25 2.22 0.73 0.76 XXX 92541 ......... ............ A Spontaneous nystagmus test ........................ 0.40 1.16 1.06 NA NA 0.04 1.60 1.50 NA NA XXX 92541 ......... 26 ....... A Spontaneous nystagmus test ........................ 0.40 0.12 0.17 0.12 0.17 0.02 0.54 0.59 0.54 0.59 XXX 92541 ......... TC ...... A Spontaneous nystagmus test ........................ 0.00 1.04 0.89 NA NA 0.02 1.06 0.91 NA NA XXX 92542 ......... ............ A Positional nystagmus test ............................. 0.33 1.30 1.18 NA NA 0.03 1.66 1.54 NA NA XXX92542 ......... 26 ....... A Positional nystagmus test ............................. 0.33 0.10 0.15 0.10 0.15 0.01 0.44 0.49 0.44 0.49 XXX 92542 ......... TC ...... A Positional nystagmus test ............................. 0.00 1.20 1.04 NA NA 0.02 1.22 1.06 NA NA XXX 92543 ......... ............ A Caloric vestibular test .................................... 0.10 0.66 0.59 NA NA 0.02 0.78 0.71 NA NA XXX 92543 ......... 26 ....... A Caloric vestibular test .................................... 0.10 0.03 0.05 0.03 0.05 0.01 0.14 0.16 0.14 0.16 XXX 92543 ......... TC ...... A Caloric vestibular test .................................... 0.00 0.63 0.55 NA NA 0.01 0.64 0.56 NA NA XXX 92544 ......... ............ A Optokinetic nystagmus test ........................... 0.26 1.06 0.94 NA NA 0.03 1.35 1.23 NA NA XXX 92544 ......... 26 ....... A Optokinetic nystagmus test ........................... 0.26 0.08 0.11 0.08 0.11 0.01 0.35 0.38 0.35 0.38 XXX 92544 ......... TC ...... A Optokinetic nystagmus test ........................... 0.00 0.98 0.83 NA NA 0.02 1.00 0.85 NA NA XXX 92545 ......... ............ A Oscillating tracking test ................................. 0.23 1.03 0.86 NA NA 0.03 1.29 1.12 NA NA XXX 92545 ......... 26 ....... A Oscillating tracking test ................................. 0.23 0.07 0.10 0.07 0.10 0.01 0.31 0.34 0.31 0.34 XXX 92545 ......... TC ...... A Oscillating tracking test ................................. 0.00 0.96 0.76 NA NA 0.02 0.98 0.78 NA NA XXX92546 ......... ............ A Sinusoidal rotational test ............................... 0.29 1.90 1.96 NA NA 0.03 2.22 2.28 NA NA XXX 92546 ......... 26 ....... A Sinusoidal rotational test ............................... 0.29 0.09 0.12 0.09 0.12 0.01 0.39 0.42 0.39 0.42 XXX 92546 ......... TC ...... A Sinusoidal rotational test ............................... 0.00 1.81 1.84 NA NA 0.02 1.83 1.86 NA NA XXX 92547 ......... ............ A Supplemental electrical test .......................... 0.00 0.11 0.09 0.11 0.09 0.06 0.17 0.15 0.17 0.15 ZZZ 92548 ......... ............ A Posturography ............................................... 0.50 1.72 2.12 NA NA 0.15 2.37 2.77 NA NA XXX 92548 ......... 26 ....... A Posturography ............................................... 0.50 0.15 0.23 0.15 0.23 0.02 0.67 0.75 0.67 0.75 XXX 92548 ......... TC ...... A Posturography ............................................... 0.00 1.57 1.89 NA NA 0.13 1.70 2.02 NA NA XXX 92552 ......... ............ A Pure tone audiometry, air .............................. 0.00 0.56 0.47 NA NA 0.04 0.60 0.51 NA NA XXX 92553 ......... ............ A Audiometry, air & bone ................................. 0.00 0.71 0.67 NA NA 0.06 0.77 0.73 NA NA XXX 92555 ......... ............ A Speech threshold audiometry ....................... 0.00 0.38 0.38 NA NA 0.04 0.42 0.42 NA NA XXX 92556 ......... ............ A Speech audiometry, complete ....................... 0.00 0.52 0.56 NA NA 0.06 0.58 0.62 NA NA XXX 92557 ......... ............ A Comprehensive hearing test ......................... 0.00 1.27 1.21 NA NA 0.12 1.39 1.33 NA NA XXX 92561 ......... ............ A Bekesy audiometry, diagnosis ...................... 0.00 0.79 0.74 NA NA 0.06 0.85 0.80 NA NA XXX 92562 ......... ............ A Loudness balance test .................................. 0.00 0.67 0.48 NA NA 0.04 0.71 0.52 NA NA XXX 92563 ......... ............ A Tone decay hearing test ............................... 0.00 0.53 0.42 NA NA 0.04 0.57 0.46 NA NA XXX92564 ......... ............ A Sisi hearing test ............................................. 0.00 0.51 0.48 NA NA 0.05 0.56 0.53 NA NA XXX 92565 ......... ............ A Stenger test, pure tone ................................. 0.00 0.27 0.37 NA NA 0.04 0.31 0.41 NA NA XXX 92567 ......... ............ A Tympanometry ............................................... 0.00 0.50 0.52 NA NA 0.06 0.56 0.58 NA NA XXX 92568 ......... ............ A Acoustic refl threshold tst .............................. 0.00 0.15 0.32 NA NA 0.04 0.19 0.36 NA NA XXX 92569 ......... ............ A Acoustic reflex decay test ............................. 0.00 0.16 0.35 NA NA 0.04 0.20 0.39 NA NA XXX 92571 ......... ............ A Filtered speech hearing test .......................... 0.00 0.40 0.39 NA NA 0.04 0.44 0.43 NA NA XXX92572 ......... ............ A Staggered spondaic word test ...................... 0.00 0.61 0.22 NA NA 0.01 0.62 0.23 NA NA XXX 92573 ......... ............ A Lombard test ................................................. 0.00 0.49 0.39 NA NA 0.04 0.53 0.43 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49218 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

92575 ......... ............ A Sensorineural acuity test ............................... 0.00 1.10 0.50 NA NA 0.02 1.12 0.52 NA NA XXX 92576 ......... ............ A Synthetic sentence test ................................. 0.00 0.54 0.47 NA NA 0.05 0.59 0.52 NA NA XXX 92577 ......... ............ A Stenger test, speech ..................................... 0.00 0.28 0.61 NA NA 0.07 0.35 0.68 NA NA XXX 92579 ......... ............ A Visual audiometry (vra) ................................. 0.00 0.84 0.76 NA NA 0.06 0.90 0.82 NA NA XXX 92582 ......... ............ A Conditioning play audiometry ........................ 0.00 1.08 0.82 NA NA 0.06 1.14 0.88 NA NA XXX 92583 ......... ............ A Select picture audiometry .............................. 0.00 0.70 0.84 NA NA 0.08 0.78 0.92 NA NA XXX 92584 ......... ............ A Electrocochleography .................................... 0.00 1.28 2.17 NA NA 0.21 1.49 2.38 NA NA XXX 92585 ......... ............ A Auditor evoke potent, compre ....................... 0.50 2.01 2.05 NA NA 0.17 2.68 2.72 NA NA XXX 92585 ......... 26 ....... A Auditor evoke potent, compre ....................... 0.50 0.15 0.20 0.15 0.20 0.03 0.68 0.73 0.68 0.73 XXX 92585 ......... TC ...... A Auditor evoke potent, compre ....................... 0.00 1.86 1.85 NA NA 0.14 2.00 1.99 NA NA XXX 92586 ......... ............ A Auditor evoke potent, limit ............................. 0.00 1.41 1.74 NA NA 0.14 1.55 1.88 NA NA XXX 92587 ......... ............ A Evoked auditory test ...................................... 0.13 0.61 1.18 NA NA 0.12 0.86 1.43 NA NA XXX 92587 ......... 26 ....... A Evoked auditory test ...................................... 0.13 0.04 0.06 0.04 0.06 0.01 0.18 0.20 0.18 0.20 XXX 92587 ......... TC ...... A Evoked auditory test ...................................... 0.00 0.58 1.13 NA NA 0.11 0.69 1.24 NA NA XXX92588 ......... ............ A Evoked auditory test ...................................... 0.36 1.05 1.49 NA NA 0.14 1.55 1.99 NA NA XXX 92588 ......... 26 ....... A Evoked auditory test ...................................... 0.36 0.11 0.15 0.11 0.15 0.01 0.48 0.52 0.48 0.52 XXX 92588 ......... TC ...... A Evoked auditory test ...................................... 0.00 0.95 1.34 NA NA 0.13 1.08 1.47 NA NA XXX92596 ......... ............ A Ear protector evaluation ................................ 0.00 0.93 0.68 NA NA 0.06 0.99 0.74 NA NA XXX 92597 ......... ............ A Oral speech device eval ................................ 0.86 1.69 1.69 0.24 0.40 0.03 2.58 2.58 1.13 1.29 XXX 92601 ......... ............ A Cochlear implt f/up exam < 7 ........................ 0.00 4.87 3.84 NA NA 0.07 4.94 3.91 NA NA XXX 92602 ......... ............ A Reprogram cochlear implt < 7 ...................... 0.00 3.34 2.62 NA NA 0.07 3.41 2.69 NA NA XXX 92603 ......... ............ A Cochlear implt f/up exam 7 > ........................ 0.00 3.17 2.40 NA NA 0.07 3.24 2.47 NA NA XXX 92604 ......... ............ A Reprogram cochlear implt 7 > ...................... 0.00 2.09 1.54 NA NA 0.07 2.16 1.61 NA NA XXX 92607 ......... ............ A Ex for speech device rx, 1hr ......................... 0.00 4.28 3.38 NA NA 0.05 4.33 3.43 NA NA XXX 92608 ......... ............ A Ex for speech device rx addl ........................ 0.00 0.87 0.63 NA NA 0.05 0.92 0.68 NA NA XXX 92609 ......... ............ A Use of speech device service ....................... 0.00 2.30 1.77 NA NA 0.04 2.34 1.81 NA NA XXX 92610 ......... ............ A Evaluate swallowing function ........................ 0.00 1.62 2.98 NA NA 0.08 1.70 3.06 NA NA XXX 92611 ......... ............ A Motion fluoroscopy/swallow ........................... 0.00 1.90 3.05 NA NA 0.08 1.98 3.13 NA NA XXX 92612 ......... ............ A Endoscopy swallow tst (fees) ........................ 1.27 2.74 2.74 0.36 0.59 0.04 4.05 4.05 1.67 1.90 XXX 92613 ......... ............ A Endoscopy swallow tst (fees) ........................ 0.71 0.22 0.36 0.22 0.35 0.05 0.98 1.12 0.98 1.11 XXX 92614 ......... ............ A Laryngoscopic sensory test ........................... 1.27 2.23 2.43 0.36 0.59 0.04 3.54 3.74 1.67 1.90 XXX 92615 ......... ............ A Eval laryngoscopy sense tst ......................... 0.63 0.18 0.31 0.18 0.31 0.05 0.86 0.99 0.86 0.99 XXX 92616 ......... ............ A Fees w/laryngeal sense test ......................... 1.88 2.91 3.27 0.53 0.88 0.06 4.85 5.21 2.47 2.82 XXX 92617 ......... ............ A Interprt fees/laryngeal test ............................. 0.79 0.22 0.39 0.22 0.39 0.05 1.06 1.23 1.06 1.23 XXX 92620 ......... ............ A Auditory function, 60 min .............................. 0.00 1.87 1.32 NA NA 0.06 1.93 1.38 NA NA XXX 92621 ......... ............ A Auditory function, + 15 min ........................... 0.00 0.40 0.29 NA NA 0.06 0.46 0.35 NA NA ZZZ92625 ......... ............ A Tinnitus assessment ...................................... 0.00 1.82 1.30 1.82 1.30 0.06 1.88 1.36 1.88 1.36 XXX 92626 ......... ............ A Eval aud rehab status ................................... 0.00 1.85 2.11 NA NA 0.06 1.91 2.17 NA NA XXX 92627 ......... ............ A Eval aud status rehab add-on ....................... 0.00 0.42 0.52 0.42 0.52 0.02 0.44 0.54 0.44 0.54 ZZZ 92700 ......... ............ C Ent procedure/service ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 92950 ......... ............ A Heart/lung resuscitation cpr .......................... 3.79 3.24 3.96 0.77 0.92 0.28 7.31 8.03 4.84 4.99 000 92953 ......... ............ A Temporary external pacing ........................... 0.23 NA NA 0.07 0.07 0.02 NA NA 0.32 0.32 000 92960 ......... ............ A Cardioversion electric, ext ............................. 2.25 4.42 5.84 1.47 1.25 0.07 6.74 8.16 3.79 3.57 000 92961 ......... ............ A Cardioversion, electric, int ............................. 4.59 NA NA 2.49 2.18 0.29 NA NA 7.37 7.06 000 92970 ......... ............ A Cardioassist, internal ..................................... 3.51 NA NA 1.61 1.20 0.16 NA NA 5.28 4.87 000 92971 ......... ............ A Cardioassist, external .................................... 1.77 NA NA 1.08 0.91 0.06 NA NA 2.91 2.74 000 92973 ......... ............ A Percut coronary thrombectomy ..................... 3.28 NA NA 1.79 1.42 0.23 NA NA 5.30 4.93 ZZZ 92974 ......... ............ A Cath place, cardio brachytx .......................... 3.00 NA NA 1.67 1.30 0.21 NA NA 4.88 4.51 ZZZ 92975 ......... ............ A Dissolve clot, heart vessel ............................ 7.24 NA NA 3.88 3.08 0.50 NA NA 11.62 10.82 000 92977 ......... ............ A Dissolve clot, heart vessel ............................ 0.00 1.73 6.47 NA NA 0.46 2.19 6.93 NA NA XXX 92978 ......... ............ A Intravasc us, heart add-on ............................ 1.80 NA NA NA NA 0.30 NA NA NA NA ZZZ 92978 ......... 26 ....... A Intravasc us, heart add-on ............................ 1.80 0.98 0.78 0.98 0.78 0.06 2.84 2.64 2.84 2.64 ZZZ 92978 ......... TC ...... A Intravasc us, heart add-on ............................ 0.00 NA NA NA NA 0.24 NA NA NA NA ZZZ 92979 ......... ............ A Intravasc us, heart add-on ............................ 1.44 NA NA NA NA 0.19 NA NA NA NA ZZZ 92979 ......... 26 ....... A Intravasc us, heart add-on ............................ 1.44 0.78 0.62 0.78 0.62 0.06 2.28 2.12 2.28 2.12 ZZZ 92979 ......... TC ...... A Intravasc us, heart add-on ............................ 0.00 NA NA NA NA 0.13 NA NA NA NA ZZZ 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49219 

92980 ......... ............ A Insert intracoronary stent .............................. 14.82 NA NA 8.29 6.61 1.03 NA NA 24.14 22.46 000 92981 ......... ............ A Insert intracoronary stent .............................. 4.16 NA NA 2.27 1.79 0.29 NA NA 6.72 6.24 ZZZ 92982 ......... ............ A Coronary artery dilation ................................. 10.96 NA NA 6.20 4.95 0.76 NA NA 17.92 16.67 000 92984 ......... ............ A Coronary artery dilation ................................. 2.97 NA NA 1.61 1.27 0.21 NA NA 4.79 4.45 ZZZ 92986 ......... ............ A Revision of aortic valve ................................. 22.64 NA NA 15.66 12.79 1.51 NA NA 39.81 36.94 090 92987 ......... ............ A Revision of mitral valve ................................. 23.42 NA NA 16.09 13.18 1.59 NA NA 41.10 38.19 090 92990 ......... ............ A Revision of pulmonary valve ......................... 18.06 NA NA 11.18 10.14 1.20 NA NA 30.44 29.40 090 92992 ......... ............ C Revision of heart chamber ............................ 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 090 92995 ......... ............ A Coronary atherectomy ................................... 12.07 NA NA 6.81 5.42 0.84 NA NA 19.72 18.33 000 92996 ......... ............ A Coronary atherectomy add-on ...................... 3.26 NA NA 1.78 1.40 0.10 NA NA 5.14 4.76 ZZZ 92997 ......... ............ A Pul art balloon repr, percut ........................... 11.98 NA NA 5.18 4.91 0.40 NA NA 17.56 17.29 000 92998 ......... ............ A Pul art balloon repr, percut ........................... 5.99 NA NA 2.74 2.34 0.28 NA NA 9.01 8.61 ZZZ 93000 ......... ............ A Electrocardiogram, complete ......................... 0.17 0.35 0.47 0.35 0.47 0.03 0.55 0.67 0.55 0.67 XXX 93005 ......... ............ A Electrocardiogram, tracing ............................ 0.00 0.28 0.41 NA NA 0.02 0.30 0.43 NA NA XXX93010 ......... ............ A Electrocardiogram report ............................... 0.17 0.07 0.06 0.07 0.06 0.01 0.25 0.24 0.25 0.24 XXX 93012 ......... ............ A Transmission of ecg ...................................... 0.00 1.65 4.92 NA NA 0.18 1.83 5.10 NA NA XXX 93014 ......... ............ A Report on transmitted ecg ............................. 0.52 0.21 0.20 0.21 0.20 0.02 0.75 0.74 0.75 0.74 XXX 93015 ......... ............ A Cardiovascular stress test ............................. 0.75 1.93 1.95 1.93 1.95 0.14 2.82 2.84 2.82 2.84 XXX 93016 ......... ............ A Cardiovascular stress test ............................. 0.45 0.23 0.19 0.23 0.19 0.02 0.70 0.66 0.70 0.66 XXX 93017 ......... ............ A Cardiovascular stress test ............................. 0.00 1.55 1.65 NA NA 0.11 1.66 1.76 NA NA XXX 93018 ......... ............ A Cardiovascular stress test ............................. 0.30 0.15 0.12 0.15 0.12 0.01 0.46 0.43 0.46 0.43 XXX 93024 ......... ............ A Cardiac drug stress test ................................ 1.17 2.42 1.78 NA NA 0.12 3.71 3.07 NA NA XXX 93024 ......... 26 ....... A Cardiac drug stress test ................................ 1.17 0.59 0.49 0.59 0.49 0.04 1.80 1.70 1.80 1.70 XXX 93024 ......... TC ...... A Cardiac drug stress test ................................ 0.00 1.84 1.30 NA NA 0.08 1.92 1.38 NA NA XXX 93025 ......... ............ A Microvolt t-wave assess ................................ 0.75 3.94 6.68 NA NA 0.14 4.83 7.57 NA NA XXX 93025 ......... 26 ....... A Microvolt t-wave assess ................................ 0.75 0.38 0.31 0.38 0.31 0.03 1.16 1.09 1.16 1.09 XXX 93025 ......... TC ...... A Microvolt t-wave assess ................................ 0.00 3.56 6.37 NA NA 0.11 3.67 6.48 NA NA XXX 93040 ......... ............ A Rhythm ECG with report ............................... 0.16 0.19 0.20 0.19 0.20 0.02 0.37 0.38 0.37 0.38 XXX 93041 ......... ............ A Rhythm ECG, tracing .................................... 0.00 0.14 0.15 NA NA 0.01 0.15 0.16 NA NA XXX 93042 ......... ............ A Rhythm ECG, report ...................................... 0.16 0.05 0.05 0.05 0.05 0.01 0.22 0.22 0.22 0.22 XXX 93224 ......... ............ A ECG monitor/report, 24 hrs ........................... 0.52 1.99 3.21 1.99 3.21 0.24 2.75 3.97 2.75 3.97 XXX 93225 ......... ............ A ECG monitor/record, 24 hrs .......................... 0.00 1.08 1.20 NA NA 0.08 1.16 1.28 NA NA XXX 93226 ......... ............ A ECG monitor/report, 24 hrs ........................... 0.00 0.62 1.79 NA NA 0.14 0.76 1.93 NA NA XXX 93227 ......... ............ A ECG monitor/review, 24 hrs .......................... 0.52 0.28 0.21 0.28 0.21 0.02 0.82 0.75 0.82 0.75 XXX 93230 ......... ............ A ECG monitor/report, 24 hrs ........................... 0.52 1.79 3.37 1.79 3.37 0.26 2.57 4.15 2.57 4.15 XXX 93231 ......... ............ A Ecg monitor/record, 24 hrs ............................ 0.00 0.94 1.38 NA NA 0.11 1.05 1.49 NA NA XXX93232 ......... ............ A ECG monitor/report, 24 hrs ........................... 0.00 0.62 1.79 NA NA 0.13 0.75 1.92 NA NA XXX 93233 ......... ............ A ECG monitor/review, 24 hrs .......................... 0.52 0.23 0.20 0.23 0.20 0.02 0.77 0.74 0.77 0.74 XXX 93235 ......... ............ A ECG monitor/report, 24 hrs ........................... 0.45 0.21 2.14 0.21 2.14 0.16 0.82 2.75 0.82 2.75 XXX 93236 ......... ............ C ECG monitor/report, 24 hrs ........................... 0.00 0.00 0.00 NA NA 0.00 0.00 0.00 NA NA XXX 93237 ......... ............ A ECG monitor/review, 24 hrs .......................... 0.45 0.21 0.17 0.21 0.17 0.02 0.68 0.64 0.68 0.64 XXX 93268 ......... ............ A ECG record/review ........................................ 0.52 0.83 5.79 0.83 5.79 0.28 1.63 6.59 1.63 6.59 XXX 93270 ......... ............ A ECG recording ............................................... 0.00 0.31 1.01 NA NA 0.08 0.39 1.09 NA NA XXX 93271 ......... ............ A Ecg/monitoring and analysis ......................... 0.00 1.99 5.01 NA NA 0.18 2.17 5.19 NA NA XXX 93272 ......... ............ A Ecg/review, interpret only .............................. 0.52 0.24 0.20 0.24 0.20 0.02 0.78 0.74 0.78 0.74 XXX 93278 ......... ............ A ECG/signal-averaged .................................... 0.25 0.59 1.09 NA NA 0.12 0.96 1.46 NA NA XXX 93278 ......... 26 ....... A ECG/signal-averaged .................................... 0.25 0.10 0.10 0.10 0.10 0.01 0.36 0.36 0.36 0.36 XXX 93278 ......... TC ...... A ECG/signal-averaged .................................... 0.00 0.49 0.99 NA NA 0.11 0.60 1.10 NA NA XXX 93303 ......... ............ A Echo transthoracic ......................................... 1.30 4.65 4.42 NA NA 0.27 6.22 5.99 NA NA XXX 93303 ......... 26 ....... A Echo transthoracic ......................................... 1.30 0.57 0.50 0.57 0.50 0.04 1.91 1.84 1.91 1.84 XXX 93303 ......... TC ...... A Echo transthoracic ......................................... 0.00 4.07 3.91 NA NA 0.23 4.30 4.14 NA NA XXX 93304 ......... ............ A Echo transthoracic ......................................... 0.75 3.18 2.46 NA NA 0.15 4.08 3.36 NA NA XXX 93304 ......... 26 ....... A Echo transthoracic ......................................... 0.75 0.31 0.29 0.31 0.29 0.02 1.08 1.06 1.08 1.06 XXX 93304 ......... TC ...... A Echo transthoracic ......................................... 0.00 2.87 2.17 NA NA 0.13 3.00 2.30 NA NA XXX 93307 ......... ............ A Echo exam of heart ....................................... 0.92 3.78 4.10 NA NA 0.26 4.96 5.28 NA NA XXX 93307 ......... 26 ....... A Echo exam of heart ....................................... 0.92 0.46 0.38 0.46 0.38 0.03 1.41 1.33 1.41 1.33 XXX 93307 ......... TC ...... A Echo exam of heart ....................................... 0.00 3.32 3.73 NA NA 0.23 3.55 3.96 NA NA XXX 93308 ......... ............ A Echo exam of heart ....................................... 0.53 2.65 2.27 NA NA 0.15 3.33 2.95 NA NA XXX 93308 ......... 26 ....... A Echo exam of heart ....................................... 0.53 0.27 0.22 0.27 0.22 0.02 0.82 0.77 0.82 0.77 XXX 93308 ......... TC ...... A Echo exam of heart ....................................... 0.00 2.38 2.05 NA NA 0.13 2.51 2.18 NA NA XXX 93312 ......... ............ A Echo transesophageal ................................... 2.20 7.55 5.32 NA NA 0.37 10.12 7.89 NA NA XXX 93312 ......... 26 ....... A Echo transesophageal .................................. 2.20 1.01 0.85 1.01 0.85 0.08 3.29 3.13 3.29 3.13 XXX 93312 ......... TC ...... A Echo transesophageal ................................... 0.00 6.54 4.47 NA NA 0.29 6.83 4.76 NA NA XXX 93313 ......... ............ A Echo transesophageal ................................... 0.95 NA NA 0.14 0.19 0.06 NA NA 1.15 1.20 XXX 93314 ......... ............ A Echo transesophageal ................................... 1.25 7.28 5.01 NA NA 0.33 8.86 6.59 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49220 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

93314 ......... 26 ....... A Echo transesophageal .................................. 1.25 0.57 0.50 0.57 0.50 0.04 1.86 1.79 1.86 1.79 XXX 93314 ......... TC ...... A Echo transesophageal ................................... 0.00 6.71 4.51 NA NA 0.29 7.00 4.80 NA NA XXX 93315 ......... ............ C Echo transesophageal .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93315 ......... 26 ....... A Echo transesophageal .................................. 2.78 1.32 1.09 1.32 1.09 0.09 4.19 3.96 4.19 3.96 XXX 93315 ......... TC ...... C Echo transesophageal ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93316 ......... ............ A Echo transesophageal ................................... 0.95 NA NA 0.26 0.25 0.05 NA NA 1.26 1.25 XXX 93317 ......... ............ C Echo transesophageal .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 93317 ......... 26 ....... A Echo transesophageal .................................. 1.83 0.74 0.69 0.74 0.69 0.08 2.65 2.60 2.65 2.60 XXX 93317 ......... TC ...... C Echo transesophageal ................................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 93318 ......... 26 ....... A Echo transesophageal intraop ...................... 2.20 0.89 0.58 0.89 0.58 0.14 3.23 2.92 3.23 2.92 XXX 93318 ......... TC ...... C Echo transesophageal intraop ...................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX93320 ......... ............ A Doppler echo exam, heart ............................. 0.38 1.70 1.81 1.70 1.81 0.13 2.21 2.32 2.21 2.32 ZZZ 93320 ......... 26 ....... A Doppler echo exam, heart ............................. 0.38 0.19 0.16 0.19 0.16 0.01 0.58 0.55 0.58 0.55 ZZZ 93320 ......... TC ...... A Doppler echo exam, heart ............................. 0.00 1.51 1.66 1.51 1.66 0.12 1.63 1.78 1.63 1.78 ZZZ 93321 ......... ............ A Doppler echo exam, heart ............................. 0.15 0.62 1.03 0.62 1.03 0.09 0.86 1.27 0.86 1.27 ZZZ 93321 ......... 26 ....... A Doppler echo exam, heart ............................. 0.15 0.08 0.07 0.08 0.07 0.01 0.24 0.23 0.24 0.23 ZZZ 93321 ......... TC ...... A Doppler echo exam, heart ............................. 0.00 0.55 0.97 0.55 0.97 0.08 0.63 1.05 0.63 1.05 ZZZ 93325 ......... ............ A Doppler color flow add-on ............................. 0.07 0.67 2.37 0.67 2.37 0.22 0.96 2.66 0.96 2.66 ZZZ 93325 ......... 26 ....... A Doppler color flow add-on ............................. 0.07 0.04 0.03 0.04 0.03 0.01 0.12 0.11 0.12 0.11 ZZZ 93325 ......... TC ...... A Doppler color flow add-on ............................. 0.00 0.64 2.34 0.64 2.34 0.21 0.85 2.55 0.85 2.55 ZZZ 93350 ......... ............ A Echo transthoracic ......................................... 1.48 5.16 3.04 NA NA 0.18 6.82 4.70 NA NA XXX 93350 ......... 26 ....... A Echo transthoracic ......................................... 1.48 0.78 0.62 0.78 0.62 0.05 2.31 2.15 2.31 2.15 XXX 93350 ......... TC ...... A Echo transthoracic ......................................... 0.00 4.38 2.42 NA NA 0.13 4.51 2.55 NA NA XXX 93501 ......... ............ A Right heart catheterization ............................ 3.02 23.11 19.32 23.11 19.32 1.26 27.39 23.60 27.39 23.60 000 93501 ......... 26 ....... A Right heart catheterization ............................ 3.02 1.61 1.27 1.61 1.27 0.21 4.84 4.50 4.84 4.50 000 93501 ......... TC ...... A Right heart catheterization ............................ 0.00 21.49 18.05 21.49 18.05 1.05 22.54 19.10 22.54 19.10 000 93503 ......... ............ A Insert/place heart catheter ............................ 2.91 NA NA 0.49 0.63 0.20 NA NA 3.60 3.74 000 93505 ......... ............ A Biopsy of heart lining ..................................... 4.37 25.12 9.03 25.12 9.03 0.46 29.95 13.86 29.95 13.86 000 93505 ......... 26 ....... A Biopsy of heart lining ..................................... 4.37 2.33 1.84 2.33 1.84 0.30 7.00 6.51 7.00 6.51 000 93505 ......... TC ...... A Biopsy of heart lining ..................................... 0.00 22.78 7.18 22.78 7.18 0.16 22.94 7.34 22.94 7.34 000 93508 ......... ............ A Cath placement, angiography ....................... 4.09 18.46 15.63 18.46 15.63 0.93 23.48 20.65 23.48 20.65 000 93508 ......... 26 ....... A Cath placement, angiography ....................... 4.09 2.23 2.12 2.23 2.12 0.28 6.60 6.49 6.60 6.49 000 93508 ......... TC ...... A Cath placement, angiography ....................... 0.00 16.23 13.51 16.23 13.51 0.65 16.88 14.16 16.88 14.16 000 93510 ......... ............ C Left heart catheterization ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000 93510 ......... 26 ....... A Left heart catheterization ............................... 4.32 2.35 2.22 2.35 2.22 0.30 6.97 6.84 6.97 6.84 000 93510 ......... TC ...... C Left heart catheterization ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000 93511 ......... ............ C Left heart catheterization ............................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 000 93511 ......... 26 ....... A Left heart catheterization ............................... 5.02 2.66 2.50 2.66 2.50 0.35 8.03 7.87 8.03 7.87 000 93511 ......... TC ...... C Left heart catheterization ............................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 000 93514 ......... ............ C Left heart catheterization ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000 93514 ......... 26 ....... A Left heart catheterization ............................... 7.04 3.22 3.15 3.22 3.15 0.49 10.75 10.68 10.75 10.68 000 93514 ......... TC ...... C Left heart catheterization ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000 93524 ......... ............ C Left heart catheterization ............................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 000 93524 ......... 26 ....... A Left heart catheterization ............................... 6.94 3.72 3.31 3.72 3.31 0.48 11.14 10.73 11.14 10.73 000 93524 ......... TC ...... C Left heart catheterization ............................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 000 93526 ......... ............ C Rt & Lt heart catheters .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000 93526 ......... 26 ....... A Rt & Lt heart catheters .................................. 5.98 3.25 2.92 3.25 2.92 0.42 9.65 9.32 9.65 9.32 000 93526 ......... TC ...... C Rt & Lt heart catheters .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000 93527 ......... ............ C Rt & Lt heart catheters .................................. 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 000 93527 ......... 26 ....... A Rt & Lt heart catheters .................................. 7.27 3.99 3.48 3.99 3.48 0.51 11.77 11.26 11.77 11.26 000 93527 ......... TC ...... C Rt & Lt heart catheters .................................. 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 000 93528 ......... ............ C Rt & Lt heart catheters .................................. 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 000 93528 ......... 26 ....... A Rt & Lt heart catheters .................................. 8.99 4.69 4.20 4.69 4.20 0.62 14.30 13.81 14.30 13.81 000 93528 ......... TC ...... C Rt & Lt heart catheters .................................. 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 000 93529 ......... ............ C Rt, lt heart catheterization ............................. 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 000 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49221 

93529 ......... 26 ....... A Rt, lt heart catheterization ............................. 4.79 2.62 2.36 2.62 2.36 0.33 7.74 7.48 7.74 7.48 000 93529 ......... TC ...... C Rt, lt heart catheterization ............................. 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 000 93530 ......... ............ C Rt heart cath, congenital ............................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 000 93530 ......... 26 ....... A Rt heart cath, congenital ............................... 4.22 1.84 1.91 1.84 1.91 0.29 6.35 6.42 6.35 6.42 000 93530 ......... TC ...... C Rt heart cath, congenital ............................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 000 93531 ......... ............ C R & l heart cath, congenital .......................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 00093531 ......... 26 ....... A R & l heart cath, congenital .......................... 8.34 3.72 3.62 3.72 3.62 0.58 12.64 12.54 12.64 12.54 000 93531 ......... TC ...... C R & l heart cath, congenital .......................... 0.00 NA NA 0.00 0.00 0.00 NA NA 0.00 0.00 000 93532 ......... ............ C R & l heart cath, congenital .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000 93532 ......... 26 ....... A R & l heart cath, congenital .......................... 9.99 4.60 4.34 4.60 4.34 0.69 15.28 15.02 15.28 15.02 000 93532 ......... TC ...... C R & l heart cath, congenital .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000 93533 ......... ............ C R & l heart cath, congenital .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000 93533 ......... 26 ....... A R & l heart cath, congenital .......................... 6.69 3.03 2.85 3.03 2.85 0.47 10.19 10.01 10.19 10.01 000 93533 ......... TC ...... C R & l heart cath, congenital .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000 93539 ......... ............ A Injection, cardiac cath ................................... 0.40 NA NA 0.22 0.18 0.01 NA NA 0.63 0.59 000 93540 ......... ............ A Injection, cardiac cath ................................... 0.43 NA NA 0.24 0.19 0.01 NA NA 0.68 0.63 000 93541 ......... ............ A Injection for lung angiogram .......................... 0.29 NA NA 0.15 0.12 0.01 NA NA 0.45 0.42 00093542 ......... ............ A Injection for heart x-rays ............................... 0.29 NA NA 0.15 0.12 0.01 NA NA 0.45 0.42 000 93543 ......... ............ A Injection for heart x-rays ............................... 0.29 NA NA 0.16 0.12 0.01 NA NA 0.46 0.42 000 93544 ......... ............ A Injection for aortography ............................... 0.25 NA NA 0.14 0.11 0.01 NA NA 0.40 0.37 000 93545 ......... ............ A Inject for coronary x-rays .............................. 0.40 NA NA 0.22 0.18 0.01 NA NA 0.63 0.59 000 93555 ......... ............ A Imaging, cardiac cath .................................... 0.81 0.65 5.11 NA NA 0.37 1.83 6.29 NA NA XXX 93555 ......... 26 ....... A Imaging, cardiac cath .................................... 0.81 0.44 0.35 0.44 0.35 0.03 1.28 1.19 1.28 1.19 XXX 93555 ......... TC ...... A Imaging, cardiac cath .................................... 0.00 0.21 4.76 NA NA 0.34 0.55 5.10 NA NA XXX 93556 ......... ............ A Imaging, cardiac cath .................................... 0.83 0.93 7.89 NA NA 0.54 2.30 9.26 NA NA XXX 93556 ......... 26 ....... A Imaging, cardiac cath .................................... 0.83 0.45 0.35 0.45 0.35 0.03 1.31 1.21 1.31 1.21 XXX 93556 ......... TC ...... A Imaging, cardiac cath .................................... 0.00 0.48 7.54 NA NA 0.51 0.99 8.05 NA NA XXX 93561 ......... ............ A Cardiac output measurement ........................ 0.50 NA NA NA NA 0.08 NA NA NA NA 000 93561 ......... 26 ....... A Cardiac output measurement ........................ 0.50 0.14 0.16 0.14 0.16 0.02 0.66 0.68 0.66 0.68 000 93561 ......... TC ...... A Cardiac output measurement ........................ 0.00 NA NA NA NA 0.06 NA NA NA NA 000 93562 ......... ............ A Cardiac output measurement ........................ 0.16 NA NA NA NA 0.05 NA NA NA NA 000 93562 ......... 26 ....... A Cardiac output measurement ........................ 0.16 0.03 0.05 0.03 0.05 0.01 0.20 0.22 0.20 0.22 000 93562 ......... TC ...... A Cardiac output measurement ........................ 0.00 NA NA NA NA 0.04 NA NA NA NA 000 93571 ......... ............ A Heart flow reserve measure .......................... 1.80 NA NA NA NA 0.30 NA NA NA NA ZZZ 93571 ......... 26 ....... A Heart flow reserve measure .......................... 1.80 0.98 0.76 0.98 0.76 0.06 2.84 2.62 2.84 2.62 ZZZ 93571 ......... TC ...... A Heart flow reserve measure .......................... 0.00 NA NA NA NA 0.24 NA NA NA NA ZZZ 93572 ......... ............ C Heart flow reserve measure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93572 ......... 26 ....... A Heart flow reserve measure .......................... 1.44 0.74 0.56 0.74 0.56 0.04 2.22 2.04 2.22 2.04 ZZZ 93572 ......... TC ...... C Heart flow reserve measure .......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93580 ......... ............ A Transcath closure of asd ............................... 17.97 NA NA 9.50 7.91 1.25 NA NA 28.72 27.13 000 93581 ......... ............ A Transcath closure of vsd ............................... 24.39 NA NA 13.17 10.34 1.71 NA NA 39.27 36.44 000 93600 ......... ............ A Bundle of His recording ................................. 2.12 NA NA NA NA 0.29 NA NA NA NA 000 93600 ......... 26 ....... A Bundle of His recording ................................. 2.12 1.09 0.90 1.09 0.90 0.16 3.37 3.18 3.37 3.18 000 93600 ......... TC ...... A Bundle of His recording ................................. 0.00 NA NA NA NA 0.13 NA NA NA NA 000 93602 ......... ............ A Intra-atrial recording ...................................... 2.12 NA NA NA NA 0.24 NA NA NA NA 000 93602 ......... 26 ....... A Intra-atrial recording ...................................... 2.12 1.07 0.88 1.07 0.88 0.17 3.36 3.17 3.36 3.17 000 93602 ......... TC ...... A Intra-atrial recording ...................................... 0.00 NA NA NA NA 0.07 NA NA NA NA 000 93603 ......... ............ A Right ventricular recording ............................ 2.12 NA NA NA NA 0.29 NA NA NA NA 000 93603 ......... 26 ....... A Right ventricular recording ............................ 2.12 1.06 0.87 1.06 0.87 0.18 3.36 3.17 3.36 3.17 000 93603 ......... TC ...... A Right ventricular recording ............................ 0.00 NA NA NA NA 0.11 NA NA NA NA 000 93609 ......... ............ A Map tachycardia, add-on ............................... 4.99 NA NA NA NA 0.52 NA NA NA NA ZZZ 93609 ......... 26 ....... A Map tachycardia, add-on ............................... 4.99 2.68 2.13 2.68 2.13 0.35 8.02 7.47 8.02 7.47 ZZZ 93609 ......... TC ...... A Map tachycardia, add-on ............................... 0.00 NA NA NA NA 0.17 NA NA NA NA ZZZ 93610 ......... ............ A Intra-atrial pacing ........................................... 3.02 NA NA NA NA 0.34 NA NA NA NA 00093610 ......... 26 ....... A Intra-atrial pacing ........................................... 3.02 1.50 1.25 1.50 1.25 0.24 4.76 4.51 4.76 4.51 000 93610 ......... TC ...... A Intra-atrial pacing ........................................... 0.00 NA NA NA NA 0.10 NA NA NA NA 000 93612 ......... ............ A Intraventricular pacing ................................... 3.02 NA NA NA NA 0.36 NA NA NA NA 000 93612 ......... 26 ....... A Intraventricular pacing ................................... 3.02 1.45 1.23 1.45 1.23 0.25 4.72 4.50 4.72 4.50 000 93612 ......... TC ...... A Intraventricular pacing ................................... 0.00 NA NA NA NA 0.11 NA NA NA NA 000 93613 ......... ............ A Electrophys map 3d, add-on ......................... 6.99 NA NA 3.78 3.02 0.49 NA NA 11.26 10.50 ZZZ 93615 ......... ............ A Esophageal recording ................................... 0.99 NA NA NA NA 0.05 NA NA NA NA 000 93615 ......... 26 ....... A Esophageal recording ................................... 0.99 0.49 0.33 0.49 0.33 0.03 1.51 1.35 1.51 1.35 000 93615 ......... TC ...... A Esophageal recording ................................... 0.00 NA NA NA NA 0.02 NA NA NA NA 000 93616 ......... ............ C Esophageal recording ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000 93616 ......... 26 ....... A Esophageal recording ................................... 1.49 0.37 0.42 0.37 0.42 0.09 1.95 2.00 1.95 2.00 000 93616 ......... TC ...... C Esophageal recording ................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000 

mstockstill on PROD1PC63 with PROPOSAL_2

49222 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

93618 ......... ............ A Heart rhythm pacing ...................................... 4.25 NA NA NA NA 0.54 NA NA NA NA 000 93618 ......... 26 ....... A Heart rhythm pacing ...................................... 4.25 2.32 1.83 2.32 1.83 0.30 6.87 6.38 6.87 6.38 000 93618 ......... TC ...... A Heart rhythm pacing ...................................... 0.00 NA NA NA NA 0.24 NA NA NA NA 000 93619 ......... ............ A Electrophysiology evaluation ......................... 7.31 NA NA NA NA 0.98 NA NA NA NA 000 93619 ......... 26 ....... A Electrophysiology evaluation ......................... 7.31 3.87 3.35 3.87 3.35 0.51 11.69 11.17 11.69 11.17 000 93619 ......... TC ...... A Electrophysiology evaluation ......................... 0.00 NA NA NA NA 0.47 NA NA NA NA 000 93620 ......... ............ C Electrophysiology evaluation ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000 93620 ......... 26 ....... A Electrophysiology evaluation ......................... 11.57 6.24 5.19 6.24 5.19 0.80 18.61 17.56 18.61 17.56 000 93620 ......... TC ...... C Electrophysiology evaluation ......................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 ZZZ 93621 ......... 26 ....... A Electrophysiology evaluation ......................... 2.10 1.13 0.90 1.13 0.90 0.15 3.38 3.15 3.38 3.15 ZZZ 93621 ......... TC ...... C Electrophysiology evaluation ......................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 ZZZ 93622 ......... 26 ....... A Electrophysiology evaluation ......................... 3.10 1.68 1.33 1.68 1.33 0.22 5.00 4.65 5.00 4.65 ZZZ 93622 ......... TC ...... C Electrophysiology evaluation ......................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 ZZZ 93623 ......... 26 ....... A Stimulation, pacing heart ............................... 2.85 1.54 1.22 1.54 1.22 0.20 4.59 4.27 4.59 4.27 ZZZ 93623 ......... TC ...... C Stimulation, pacing heart ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93624 ......... ............ A Electrophysiologic study ................................ 4.80 NA NA . 4.18 0.46 NA NA 5.26 9.44 000 93624 ......... 26 ....... A Electrophysiologic study ................................ 4.80 2.63 2.30 2.63 2.30 0.33 7.76 7.43 7.76 7.43 000 93624 ......... TC ...... A Electrophysiologic study ................................ 0.00 NA NA . 1.98 0.13 NA NA 0.13 2.11 000 93631 ......... ............ C Heart pacing, mapping .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000 93631 ......... 26 ....... A Heart pacing, mapping .................................. 7.59 2.74 2.76 2.74 2.76 0.97 11.30 11.32 11.30 11.32 000 93631 ......... TC ...... C Heart pacing, mapping .................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 000 93640 ......... ............ A Evaluation heart device ................................. 3.51 NA NA NA NA 0.66 NA NA NA NA 000 93640 ......... 26 ....... A Evaluation heart device ................................. 3.51 1.89 1.49 1.89 1.49 0.24 5.64 5.24 5.64 5.24 000 93640 ......... TC ...... A Evaluation heart device ................................. 0.00 NA NA NA NA 0.42 NA NA NA NA 000 93641 ......... ............ A Electrophysiology evaluation ......................... 5.92 NA NA NA NA 0.83 NA NA NA NA 000 93641 ......... 26 ....... A Electrophysiology evaluation ......................... 5.92 3.18 2.53 3.18 2.53 0.41 9.51 8.86 9.51 8.86 000 93641 ......... TC ...... A Electrophysiology evaluation ......................... 0.00 NA NA NA NA 0.42 NA NA NA NA 000 93642 ......... ............ A Electrophysiology evaluation ......................... 4.88 7.45 8.90 7.45 8.90 0.57 12.90 14.35 12.90 14.35 000 93642 ......... 26 ....... A Electrophysiology evaluation ......................... 4.88 2.63 2.32 2.63 2.32 0.15 7.66 7.35 7.66 7.35 000 93642 ......... TC ...... A Electrophysiology evaluation ......................... 0.00 4.81 6.58 4.81 6.58 0.42 5.23 7.00 5.23 7.00 000 93650 ......... ............ A Ablate heart dysrhythm focus ....................... 10.49 NA NA 5.97 4.82 0.73 NA NA 17.19 16.04 00093651 ......... ............ A Ablate heart dysrhythm focus ....................... 16.23 NA NA 8.75 6.93 1.13 NA NA 26.11 24.29 00093652 ......... ............ A Ablate heart dysrhythm focus ....................... 17.65 NA NA 9.52 7.54 1.23 NA NA 28.40 26.42 00093660 ......... ............ A Tilt table evaluation ....................................... 1.89 3.05 2.57 3.05 2.57 0.08 5.02 4.54 5.02 4.54 000 93660 ......... 26 ....... A Tilt table evaluation ....................................... 1.89 0.99 0.80 0.99 0.80 0.06 2.94 2.75 2.94 2.75 000 93660 ......... TC ...... A Tilt table evaluation ....................................... 0.00 2.06 1.78 2.06 1.78 0.02 2.08 1.80 2.08 1.80 000 93662 ......... ............ C Intracardiac ecg (ice) ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93662 ......... 26 ....... A Intracardiac ecg (ice) ..................................... 2.80 1.51 1.21 1.51 1.21 0.09 4.40 4.10 4.40 4.10 ZZZ 93662 ......... TC ...... C Intracardiac ecg (ice) ..................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 93701 ......... ............ A Bioimpedance, thoracic ................................. 0.17 0.70 0.91 NA NA 0.02 0.89 1.10 NA NA XXX 93701 ......... 26 ....... A Bioimpedance, thoracic ................................. 0.17 0.06 0.07 0.06 0.07 0.01 0.24 0.25 0.24 0.25 XXX 93701 ......... TC ...... A Bioimpedance, thoracic ................................. 0.00 0.64 0.84 NA NA 0.01 0.65 0.85 NA NA XXX 93720 ......... ............ A Total body plethysmography ......................... 0.17 1.30 0.90 1.30 0.90 0.07 1.54 1.14 1.54 1.14 XXX 93721 ......... ............ A Plethysmography tracing ............................... 0.00 1.15 0.82 NA NA 0.06 1.21 0.88 NA NA XXX93722 ......... ............ A Plethysmography report ................................ 0.17 0.04 0.05 0.04 0.05 0.01 0.22 0.23 0.22 0.23 XXX 93724 ......... ............ A Analyze pacemaker system .......................... 4.88 3.49 5.28 3.49 5.28 0.39 8.76 10.55 8.76 10.55 000 93724 ......... 26 ....... A Analyze pacemaker system .......................... 4.88 2.58 2.08 2.58 2.08 0.15 7.61 7.11 7.61 7.11 000 93724 ......... TC ...... A Analyze pacemaker system .......................... 0.00 0.92 3.20 0.92 3.20 0.24 1.16 3.44 1.16 3.44 00093727 ......... ............ A Analyze ilr system ......................................... 0.52 0.65 0.31 0.65 0.31 0.02 1.19 0.85 1.19 0.85 XXX 93731 ......... ............ A Analyze pacemaker system .......................... 0.45 0.80 0.70 NA NA 0.05 1.30 1.20 NA NA XXX 93731 ......... 26 ....... A Analyze pacemaker system .......................... 0.45 0.24 0.19 0.24 0.19 0.01 0.70 0.65 0.70 0.65 XXX 93731 ......... TC ...... A Analyze pacemaker system .......................... 0.00 0.56 0.51 NA NA 0.04 0.60 0.55 NA NA XXX 93732 ......... ............ A Analyze pacemaker system .......................... 0.92 1.17 0.94 NA NA 0.07 2.16 1.93 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49223 

93732 ......... 26 ....... A Analyze pacemaker system .......................... 0.92 0.49 0.39 0.49 0.39 0.03 1.44 1.34 1.44 1.34 XXX 93732 ......... TC ...... A Analyze pacemaker system .......................... 0.00 0.68 0.55 NA NA 0.04 0.72 0.59 NA NA XXX 93733 ......... ............ A Telephone analy, pacemaker ........................ 0.17 0.32 0.68 NA NA 0.07 0.56 0.92 NA NA XXX 93733 ......... 26 ....... A Telephone analy, pacemaker ........................ 0.17 0.09 0.08 0.09 0.08 0.01 0.27 0.26 0.27 0.26 XXX 93733 ......... TC ...... A Telephone analy, pacemaker ........................ 0.00 0.23 0.61 NA NA 0.06 0.29 0.67 NA NA XXX 93734 ......... ............ A Analyze pacemaker system .......................... 0.38 0.71 0.55 NA NA 0.03 1.12 0.96 NA NA XXX 93734 ......... 26 ....... A Analyze pacemaker system .......................... 0.38 0.20 0.16 0.20 0.16 0.01 0.59 0.55 0.59 0.55 XXX 93734 ......... TC ...... A Analyze pacemaker system .......................... 0.00 0.51 0.39 NA NA 0.02 0.53 0.41 NA NA XXX 93735 ......... ............ A Analyze pacemaker system .......................... 0.74 0.97 0.78 NA NA 0.06 1.77 1.58 NA NA XXX 93735 ......... 26 ....... A Analyze pacemaker system .......................... 0.74 0.39 0.31 0.39 0.31 0.02 1.15 1.07 1.15 1.07 XXX 93735 ......... TC ...... A Analyze pacemaker system .......................... 0.00 0.58 0.48 NA NA 0.04 0.62 0.52 NA NA XXX 93736 ......... ............ A Telephonic analy, pacemaker ....................... 0.15 0.28 0.59 NA NA 0.07 0.50 0.81 NA NA XXX 93736 ......... 26 ....... A Telephonic analy, pacemaker ....................... 0.15 0.08 0.07 0.08 0.07 0.01 0.24 0.23 0.24 0.23 XXX 93736 ......... TC ...... A Telephonic analy, pacemaker ....................... 0.00 0.21 0.53 NA NA 0.06 0.27 0.59 NA NA XXX 93740 ......... ............ B Temperature gradient studies ....................... 0.16 0.04 0.15 NA NA 0.02 0.22 0.33 NA NA XXX 93740 ......... 26 ....... B Temperature gradient studies ....................... 0.16 0.04 0.04 0.04 0.04 0.01 0.21 0.21 0.21 0.21 XXX 93740 ......... TC ...... B Temperature gradient studies ....................... 0.00 0.00 0.11 NA NA 0.01 0.01 0.12 NA NA XXX 93741 ......... ............ A Analyze ht pace device sngl ......................... 0.80 1.04 1.00 NA NA 0.07 1.91 1.87 NA NA XXX 93741 ......... 26 ....... A Analyze ht pace device sngl ......................... 0.80 0.43 0.34 0.43 0.34 0.03 1.26 1.17 1.26 1.17 XXX 93741 ......... TC ...... A Analyze ht pace device sngl ......................... 0.00 0.60 0.65 NA NA 0.04 0.64 0.69 NA NA XXX 93742 ......... ............ A Analyze ht pace device sngl ......................... 0.91 1.17 1.07 NA NA 0.07 2.15 2.05 NA NA XXX 93742 ......... 26 ....... A Analyze ht pace device sngl ......................... 0.91 0.50 0.40 0.50 0.40 0.03 1.44 1.34 1.44 1.34 XXX 93742 ......... TC ...... A Analyze ht pace device sngl ......................... 0.00 0.68 0.67 NA NA 0.04 0.72 0.71 NA NA XXX 93743 ......... ............ A Analyze ht pace device dual ......................... 1.03 1.21 1.15 NA NA 0.07 2.31 2.25 NA NA XXX 93743 ......... 26 ....... A Analyze ht pace device dual ......................... 1.03 0.56 0.44 0.56 0.44 0.03 1.62 1.50 1.62 1.50 XXX 93743 ......... TC ...... A Analyze ht pace device dual ......................... 0.00 0.65 0.71 NA NA 0.04 0.69 0.75 NA NA XXX 93744 ......... ............ A Analyze ht pace device dual ......................... 1.18 1.36 1.19 NA NA 0.08 2.62 2.45 NA NA XXX 93744 ......... 26 ....... A Analyze ht pace device dual ......................... 1.18 0.64 0.51 0.64 0.51 0.04 1.86 1.73 1.86 1.73 XXX 93744 ......... TC ...... A Analyze ht pace device dual ......................... 0.00 0.73 0.69 NA NA 0.04 0.77 0.73 NA NA XXX 93745 ......... ............ C Set-up cardiovert-defibrill .............................. 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 XXX 93770 ......... ............ B Measure venous pressure ............................. 0.16 0.04 0.07 NA NA 0.02 0.22 0.25 NA NA XXX 93770 ......... 26 ....... B Measure venous pressure ............................. 0.16 0.04 0.05 0.04 0.05 0.01 0.21 0.22 0.21 0.22 XXX 93770 ......... TC ...... B Measure venous pressure ............................. 0.00 0.00 0.02 NA NA 0.01 0.01 0.03 NA NA XXX 93784 ......... ............ A Ambulatory BP monitoring ............................ 0.38 1.36 1.50 1.36 1.50 0.03 1.77 1.91 1.77 1.91 XXX 93786 ......... ............ A Ambulatory BP recording .............................. 0.00 1.09 0.96 NA NA 0.01 1.10 0.97 NA NA XXX 93788 ......... ............ A Ambulatory BP analysis ................................ 0.00 0.73 0.57 NA NA 0.01 0.74 0.58 NA NA XXX93790 ......... ............ A Review/report BP recording .......................... 0.38 0.14 0.13 0.14 0.13 0.01 0.53 0.52 0.53 0.52 XXX 93797 ......... ............ A Cardiac rehab ................................................ 0.18 0.32 0.31 0.09 0.08 0.01 0.51 0.50 0.28 0.27 000 93798 ......... ............ A Cardiac rehab/monitor ................................... 0.28 0.44 0.46 0.13 0.12 0.01 0.73 0.75 0.42 0.41 000 93799 ......... ............ C Cardiovascular procedure ............................. 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 XXX 93875 ......... ............ A Extracranial study .......................................... 0.22 2.65 2.41 NA NA 0.12 2.99 2.75 NA NA XXX 93875 ......... 26 ....... A Extracranial study .......................................... 0.22 0.08 0.08 0.08 0.08 0.01 0.31 0.31 0.31 0.31 XXX 93875 ......... TC ...... A Extracranial study .......................................... 0.00 2.57 2.33 NA NA 0.11 2.68 2.44 NA NA XXX 93880 ......... ............ A Extracranial study .......................................... 0.60 6.23 5.72 NA NA 0.39 7.22 6.71 NA NA XXX 93880 ......... 26 ....... A Extracranial study .......................................... 0.60 0.21 0.20 0.21 0.20 0.04 0.85 0.84 0.85 0.84 XXX 93880 ......... TC ...... A Extracranial study .......................................... 0.00 6.03 5.52 NA NA 0.35 6.38 5.87 NA NA XXX 93882 ......... ............ A Extracranial study .......................................... 0.40 4.17 3.67 NA NA 0.26 4.83 4.33 NA NA XXX 93882 ......... 26 ....... A Extracranial study .......................................... 0.40 0.12 0.14 0.12 0.14 0.04 0.56 0.58 0.56 0.58 XXX 93882 ......... TC ...... A Extracranial study .......................................... 0.00 4.05 3.53 NA NA 0.22 4.27 3.75 NA NA XXX 93886 ......... ............ A Intracranial study ........................................... 0.94 7.31 6.88 NA NA 0.45 8.70 8.27 NA NA XXX 93886 ......... 26 ....... A Intracranial study ........................................... 0.94 0.31 0.36 0.31 0.36 0.06 1.31 1.36 1.31 1.36 XXX 93886 ......... TC ...... A Intracranial study ........................................... 0.00 7.00 6.53 NA NA 0.39 7.39 6.92 NA NA XXX 93888 ......... ............ A Intracranial study ........................................... 0.62 4.91 4.41 NA NA 0.32 5.85 5.35 NA NA XXX 93888 ......... 26 ....... A Intracranial study ........................................... 0.62 0.20 0.22 0.20 0.22 0.05 0.87 0.89 0.87 0.89 XXX 93888 ......... TC ...... A Intracranial study ........................................... 0.00 4.71 4.19 NA NA 0.27 4.98 4.46 NA NA XXX 93890 ......... ............ A Tcd, vasoreactivity study ............................... 1.00 6.47 5.29 NA NA 0.45 7.92 6.74 NA NA XXX 93890 ......... 26 ....... A Tcd, vasoreactivity study ............................... 1.00 0.33 0.38 0.33 0.38 0.06 1.39 1.44 1.39 1.44 XXX 93890 ......... TC ...... A Tcd, vasoreactivity study ............................... 0.00 6.13 4.91 NA NA 0.39 6.52 5.30 NA NA XXX 93892 ......... ............ A Tcd, emboli detect w/o inj ............................. 1.15 7.00 5.62 NA NA 0.45 8.60 7.22 NA NA XXX 93892 ......... 26 ....... A Tcd, emboli detect w/o inj ............................. 1.15 0.38 0.44 0.38 0.44 0.06 1.59 1.65 1.59 1.65 XXX 93892 ......... TC ...... A Tcd, emboli detect w/o inj ............................. 0.00 6.62 5.18 NA NA 0.39 7.01 5.57 NA NA XXX 93893 ......... ............ A Tcd, emboli detect w/inj ................................ 1.15 6.67 5.44 NA NA 0.45 8.27 7.04 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49224 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

93893 ......... 26 ....... A Tcd, emboli detect w/inj ................................ 1.15 0.38 0.44 0.38 0.44 0.06 1.59 1.65 1.59 1.65 XXX 93893 ......... TC ...... A Tcd, emboli detect w/inj ................................ 0.00 6.29 5.00 NA NA 0.39 6.68 5.39 NA NA XXX 93922 ......... ............ A Extremity study .............................................. 0.25 3.16 2.80 NA NA 0.15 3.56 3.20 NA NA XXX 93922 ......... 26 ....... A Extremity study .............................................. 0.25 0.08 0.08 0.08 0.08 0.02 0.35 0.35 0.35 0.35 XXX 93922 ......... TC ...... A Extremity study .............................................. 0.00 3.08 2.72 NA NA 0.13 3.21 2.85 NA NA XXX 93923 ......... ............ A Extremity study .............................................. 0.45 4.80 4.22 NA NA 0.26 5.51 4.93 NA NA XXX 93923 ......... 26 ....... A Extremity study .............................................. 0.45 0.14 0.15 0.14 0.15 0.04 0.63 0.64 0.63 0.64 XXX 93923 ......... TC ...... A Extremity study .............................................. 0.00 4.66 4.08 NA NA 0.22 4.88 4.30 NA NA XXX 93924 ......... ............ A Extremity study .............................................. 0.50 6.06 5.11 NA NA 0.30 6.86 5.91 NA NA XXX 93924 ......... 26 ....... A Extremity study .............................................. 0.50 0.17 0.17 0.17 0.17 0.05 0.72 0.72 0.72 0.72 XXX 93924 ......... TC ...... A Extremity study .............................................. 0.00 5.89 4.94 NA NA 0.25 6.14 5.19 NA NA XXX 93925 ......... ............ A Lower extremity study ................................... 0.58 8.24 7.15 NA NA 0.39 9.21 8.12 NA NA XXX 93925 ......... 26 ....... A Lower extremity study ................................... 0.58 0.20 0.20 0.20 0.20 0.04 0.82 0.82 0.82 0.82 XXX 93925 ......... TC ...... A Lower extremity study ................................... 0.00 8.04 6.95 NA NA 0.35 8.39 7.30 NA NA XXX 93926 ......... ............ A Lower extremity study ................................... 0.39 5.25 4.35 NA NA 0.27 5.91 5.01 NA NA XXX 93926 ......... 26 ....... A Lower extremity study ................................... 0.39 0.12 0.13 0.12 0.13 0.04 0.55 0.56 0.55 0.56 XXX 93926 ......... TC ...... A Lower extremity study ................................... 0.00 5.13 4.22 NA NA 0.23 5.36 4.45 NA NA XXX 93930 ......... ............ A Upper extremity study ................................... 0.46 6.35 5.60 NA NA 0.41 7.22 6.47 NA NA XXX 93930 ......... 26 ....... A Upper extremity study ................................... 0.46 0.15 0.16 0.15 0.16 0.04 0.65 0.66 0.65 0.66 XXX 93930 ......... TC ...... A Upper extremity study ................................... 0.00 6.20 5.44 NA NA 0.37 6.57 5.81 NA NA XXX 93931 ......... ............ A Upper extremity study ................................... 0.31 4.32 3.69 NA NA 0.27 4.90 4.27 NA NA XXX 93931 ......... 26 ....... A Upper extremity study ................................... 0.31 0.10 0.10 0.10 0.10 0.03 0.44 0.44 0.44 0.44 XXX 93931 ......... TC ...... A Upper extremity study ................................... 0.00 4.22 3.59 NA NA 0.24 4.46 3.83 NA NA XXX 93965 ......... ............ A Extremity study .............................................. 0.35 3.13 2.88 NA NA 0.14 3.62 3.37 NA NA XXX 93965 ......... 26 ....... A Extremity study .............................................. 0.35 0.12 0.12 0.12 0.12 0.02 0.49 0.49 0.49 0.49 XXX 93965 ......... TC ...... A Extremity study .............................................. 0.00 3.02 2.76 NA NA 0.12 3.14 2.88 NA NA XXX 93970 ......... ............ A Extremity study .............................................. 0.68 6.32 5.51 NA NA 0.46 7.46 6.65 NA NA XXX 93970 ......... 26 ....... A Extremity study .............................................. 0.68 0.21 0.23 0.21 0.23 0.06 0.95 0.97 0.95 0.97 XXX 93970 ......... TC ...... A Extremity study .............................................. 0.00 6.11 5.29 NA NA 0.40 6.51 5.69 NA NA XXX 93971 ......... ............ A Extremity study .............................................. 0.45 4.12 3.72 NA NA 0.30 4.87 4.47 NA NA XXX 93971 ......... 26 ....... A Extremity study .............................................. 0.45 0.14 0.15 0.14 0.15 0.03 0.62 0.63 0.62 0.63 XXX 93971 ......... TC ...... A Extremity study .............................................. 0.00 3.98 3.58 NA NA 0.27 4.25 3.85 NA NA XXX 93975 ......... ............ A Vascular study ............................................... 1.80 8.56 7.86 NA NA 0.56 10.92 10.22 NA NA XXX 93975 ......... 26 ....... A Vascular study ............................................... 1.80 0.62 0.61 0.62 0.61 0.13 2.55 2.54 2.55 2.54 XXX 93975 ......... TC ...... A Vascular study ............................................... 0.00 7.95 7.26 NA NA 0.43 8.38 7.69 NA NA XXX 93976 ......... ............ A Vascular study ............................................... 1.21 4.57 4.39 NA NA 0.35 6.13 5.95 NA NA XXX 93976 ......... 26 ....... A Vascular study ............................................... 1.21 0.39 0.40 0.39 0.40 0.05 1.65 1.66 1.65 1.66 XXX 93976 ......... TC ...... A Vascular study ............................................... 0.00 4.18 3.99 NA NA 0.30 4.48 4.29 NA NA XXX 93978 ......... ............ A Vascular study ............................................... 0.65 6.15 4.92 NA NA 0.43 7.23 6.00 NA NA XXX 93978 ......... 26 ....... A Vascular study ............................................... 0.65 0.23 0.22 0.23 0.22 0.06 0.94 0.93 0.94 0.93 XXX 93978 ......... TC ...... A Vascular study ............................................... 0.00 5.93 4.70 NA NA 0.37 6.30 5.07 NA NA XXX 93979 ......... ............ A Vascular study ............................................... 0.44 4.40 3.51 NA NA 0.27 5.11 4.22 NA NA XXX 93979 ......... 26 ....... A Vascular study ............................................... 0.44 0.16 0.15 0.16 0.15 0.03 0.63 0.62 0.63 0.62 XXX 93979 ......... TC ...... A Vascular study ............................................... 0.00 4.23 3.35 NA NA 0.24 4.47 3.59 NA NA XXX 93980 ......... ............ A Penile vascular study .................................... 1.25 3.49 3.01 NA NA 0.42 5.16 4.68 NA NA XXX 93980 ......... 26 ....... A Penile vascular study .................................... 1.25 0.44 0.42 0.44 0.42 0.08 1.77 1.75 1.77 1.75 XXX 93980 ......... TC ...... A Penile vascular study .................................... 0.00 3.05 2.59 NA NA 0.34 3.39 2.93 NA NA XXX 93981 ......... ............ A Penile vascular study .................................... 0.44 2.88 2.87 NA NA 0.33 3.65 3.64 NA NA XXX 93981 ......... 26 ....... A Penile vascular study .................................... 0.44 0.16 0.15 0.16 0.15 0.02 0.62 0.61 0.62 0.61 XXX 93981 ......... TC ...... A Penile vascular study .................................... 0.00 2.71 2.73 NA NA 0.31 3.02 3.04 NA NA XXX 93990 ......... ............ A Doppler flow testing ....................................... 0.25 5.34 4.33 NA NA 0.26 5.85 4.84 NA NA XXX 93990 ......... 26 ....... A Doppler flow testing ....................................... 0.25 0.07 0.09 0.07 0.09 0.03 0.35 0.37 0.35 0.37 XXX 93990 ......... TC ...... A Doppler flow testing ....................................... 0.00 5.27 4.24 NA NA 0.23 5.50 4.47 NA NA XXX 94010 ......... ............ A Breathing capacity test .................................. 0.17 0.74 0.69 NA NA 0.03 0.94 0.89 NA NA XXX 94010 ......... 26 ....... A Breathing capacity test .................................. 0.17 0.04 0.05 0.04 0.05 0.01 0.22 0.23 0.22 0.23 XXX 94010 ......... TC ...... A Breathing capacity test .................................. 0.00 0.70 0.64 NA NA 0.02 0.72 0.66 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49225 

94014 ......... ............ A Patient recorded spirometry .......................... 0.52 0.93 0.80 0.93 0.80 0.03 1.48 1.35 1.48 1.35 XXX 94015 ......... ............ A Patient recorded spirometry .......................... 0.00 0.76 0.63 NA NA 0.01 0.77 0.64 NA NA XXX 94016 ......... ............ A Review patient spirometry ............................. 0.52 0.17 0.17 0.17 0.17 0.02 0.71 0.71 0.71 0.71 XXX 94060 ......... ............ A Evaluation of wheezing ................................. 0.31 1.32 1.13 1.32 1.13 0.07 1.70 1.51 1.70 1.51 XXX 94060 ......... 26 ....... A Evaluation of wheezing ................................. 0.31 0.08 0.09 0.08 0.09 0.01 0.40 0.41 0.40 0.41 XXX 94060 ......... TC ...... A Evaluation of wheezing ................................. 0.00 1.24 1.05 1.24 1.05 0.06 1.30 1.11 1.30 1.11 XXX 94070 ......... ............ A Evaluation of wheezing ................................. 0.60 1.01 0.87 NA NA 0.13 1.74 1.60 NA NA XXX 94070 ......... 26 ....... A Evaluation of wheezing ................................. 0.60 0.15 0.17 0.15 0.17 0.03 0.78 0.80 0.78 0.80 XXX 94070 ......... TC ...... A Evaluation of wheezing ................................. 0.00 0.85 0.69 NA NA 0.10 0.95 0.79 NA NA XXX 94150 ......... ............ B Vital capacity test .......................................... 0.07 0.48 0.47 NA NA 0.02 0.57 0.56 NA NA XXX 94150 ......... 26 ....... B Vital capacity test .......................................... 0.07 0.02 0.03 0.02 0.03 0.01 0.10 0.11 0.10 0.11 XXX 94150 ......... TC ...... B Vital capacity test .......................................... 0.00 0.47 0.45 NA NA 0.01 0.48 0.46 NA NA XXX 94200 ......... ............ A Lung function test (MBC/MVV) ..................... 0.11 0.51 0.46 NA NA 0.03 0.65 0.60 NA NA XXX 94200 ......... 26 ....... A Lung function test (MBC/MVV) ..................... 0.11 0.03 0.03 0.03 0.03 0.01 0.15 0.15 0.15 0.15 XXX94200 ......... TC ...... A Lung function test (MBC/MVV) ..................... 0.00 0.48 0.43 NA NA 0.02 0.50 0.45 NA NA XXX 94240 ......... ............ A Residual lung capacity .................................. 0.26 0.84 0.71 NA NA 0.06 1.16 1.03 NA NA XXX 94240 ......... 26 ....... A Residual lung capacity .................................. 0.26 0.07 0.08 0.07 0.08 0.01 0.34 0.35 0.34 0.35 XXX 94240 ......... TC ...... A Residual lung capacity .................................. 0.00 0.77 0.63 NA NA 0.05 0.82 0.68 NA NA XXX 94250 ......... ............ A Expired gas collection ................................... 0.11 0.57 0.62 NA NA 0.02 0.70 0.75 NA NA XXX 94250 ......... 26 ....... A Expired gas collection ................................... 0.11 0.04 0.03 0.04 0.03 0.01 0.16 0.15 0.16 0.15 XXX 94250 ......... TC ...... A Expired gas collection ................................... 0.00 0.53 0.59 NA NA 0.01 0.54 0.60 NA NA XXX 94260 ......... ............ A Thoracic gas volume ..................................... 0.13 0.77 0.63 NA NA 0.05 0.95 0.81 NA NA XXX 94260 ......... 26 ....... A Thoracic gas volume ..................................... 0.13 0.03 0.04 0.03 0.04 0.01 0.17 0.18 0.17 0.18 XXX 94260 ......... TC ...... A Thoracic gas volume ..................................... 0.00 0.74 0.59 NA NA 0.04 0.78 0.63 NA NA XXX 94350 ......... ............ A Lung nitrogen washout curve ........................ 0.26 0.67 0.74 NA NA 0.05 0.98 1.05 NA NA XXX 94350 ......... 26 ....... A Lung nitrogen washout curve ........................ 0.26 0.08 0.08 0.08 0.08 0.01 0.35 0.35 0.35 0.35 XXX 94350 ......... TC ...... A Lung nitrogen washout curve ........................ 0.00 0.59 0.66 NA NA 0.04 0.63 0.70 NA NA XXX 94360 ......... ............ A Measure airflow resistance ........................... 0.26 0.99 0.77 NA NA 0.07 1.32 1.10 NA NA XXX 94360 ......... 26 ....... A Measure airflow resistance ........................... 0.26 0.07 0.08 0.07 0.08 0.01 0.34 0.35 0.34 0.35 XXX 94360 ......... TC ...... A Measure airflow resistance ........................... 0.00 0.92 0.70 NA NA 0.06 0.98 0.76 NA NA XXX 94370 ......... ............ A Breath airway closing volume ....................... 0.26 0.67 0.71 NA NA 0.03 0.96 1.00 NA NA XXX 94370 ......... 26 ....... A Breath airway closing volume ....................... 0.26 0.09 0.08 0.09 0.08 0.01 0.36 0.35 0.36 0.35 XXX 94370 ......... TC ...... A Breath airway closing volume ....................... 0.00 0.58 0.63 NA NA 0.02 0.60 0.65 NA NA XXX 94375 ......... ............ A Respiratory flow volume loop ........................ 0.31 0.75 0.64 NA NA 0.03 1.09 0.98 NA NA XXX 94375 ......... 26 ....... A Respiratory flow volume loop ........................ 0.31 0.08 0.09 0.08 0.09 0.01 0.40 0.41 0.40 0.41 XXX 94375 ......... TC ...... A Respiratory flow volume loop ........................ 0.00 0.66 0.55 NA NA 0.02 0.68 0.57 NA NA XXX 94400 ......... ............ A CO2 breathing response curve ..................... 0.40 1.03 0.89 NA NA 0.09 1.52 1.38 NA NA XXX 94400 ......... 26 ....... A CO2 breathing response curve ..................... 0.40 0.10 0.12 0.10 0.12 0.03 0.53 0.55 0.53 0.55 XXX94400 ......... TC ...... A CO2 breathing response curve ..................... 0.00 0.93 0.77 NA NA 0.06 0.99 0.83 NA NA XXX 94450 ......... ............ A Hypoxia response curve ................................ 0.40 1.03 0.90 NA NA 0.04 1.47 1.34 NA NA XXX94450 ......... 26 ....... A Hypoxia response curve ................................ 0.40 0.09 0.11 0.09 0.11 0.02 0.51 0.53 0.51 0.53 XXX 94450 ......... TC ...... A Hypoxia response curve ................................ 0.00 0.95 0.79 NA NA 0.02 0.97 0.81 NA NA XXX 94452 ......... ............ A Hast w/report ................................................. 0.31 1.21 1.07 NA NA 0.04 1.56 1.42 NA NA XXX 94452 ......... 26 ....... A Hast w/report ................................................. 0.31 0.09 0.09 0.09 0.09 0.02 0.42 0.42 0.42 0.42 XXX 94452 ......... TC ...... A Hast w/report ................................................. 0.00 1.12 0.98 NA NA 0.02 1.14 1.00 NA NA XXX 94453 ......... ............ A Hast w/oxygen titrate ..................................... 0.40 1.69 1.56 NA NA 0.04 2.13 2.00 NA NA XXX 94453 ......... 26 ....... A Hast w/oxygen titrate ..................................... 0.40 0.11 0.12 0.11 0.12 0.02 0.53 0.54 0.53 0.54 XXX 94453 ......... TC ...... A Hast w/oxygen titrate ..................................... 0.00 1.58 1.44 NA NA 0.02 1.60 1.46 NA NA XXX94620 ......... ............ A Pulmonary stress test/simple ........................ 0.64 0.88 2.09 NA NA 0.13 1.65 2.86 NA NA XXX 94620 ......... 26 ....... A Pulmonary stress test/simple ........................ 0.64 0.20 0.20 0.20 0.20 0.03 0.87 0.87 0.87 0.87 XXX 94620 ......... TC ...... A Pulmonary stress test/simple ........................ 0.00 0.68 1.89 NA NA 0.10 0.78 1.99 NA NA XXX 94621 ......... ............ A Pulm stress test/complex .............................. 1.42 3.18 2.45 NA NA 0.16 4.76 4.03 NA NA XXX94621 ......... 26 ....... A Pulm stress test/complex .............................. 1.42 0.45 0.44 0.45 0.44 0.06 1.93 1.92 1.93 1.92 XXX 94621 ......... TC ...... A Pulm stress test/complex .............................. 0.00 2.73 2.00 NA NA 0.10 2.83 2.10 NA NA XXX 94640 ......... ............ A Airway inhalation treatment ........................... 0.00 0.37 0.32 NA NA 0.02 0.39 0.34 NA NA XXX94642 ......... ............ C Aerosol inhalation treatment ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 94656 ......... ............ A Initial ventilator mgmt .................................... 1.22 1.12 1.15 0.24 0.30 0.06 2.40 2.43 1.52 1.58 XXX 94657 ......... ............ A Continued ventilator mgmt ............................ 0.83 1.15 1.02 0.19 0.24 0.04 2.02 1.89 1.06 1.11 XXX 94660 ......... ............ A Pos airway pressure, CPAP .......................... 0.76 0.82 0.69 0.20 0.22 0.04 1.62 1.49 1.00 1.02 XXX 94662 ......... ............ A Neg press ventilation, cnp ............................. 0.76 NA NA 0.18 0.22 0.03 NA NA 0.97 1.01 XXX 94664 ......... ............ A Evaluate pt use of inhaler ............................. 0.00 0.40 0.33 NA NA 0.04 0.44 0.37 NA NA XXX 94667 ......... ............ A Chest wall manipulation ................................ 0.00 0.55 0.53 NA NA 0.05 0.60 0.58 NA NA XXX 94668 ......... ............ A Chest wall manipulation ................................ 0.00 0.51 0.47 NA NA 0.02 0.53 0.49 NA NA XXX 94680 ......... ............ A Exhaled air analysis, o2 ................................ 0.26 1.11 1.67 1.11 1.67 0.07 1.44 2.00 1.44 2.00 XXX 94680 ......... 26 ....... A Exhaled air analysis, o2 ................................ 0.26 0.07 0.08 0.07 0.08 0.01 0.34 0.35 0.34 0.35 XXX 94680 ......... TC ...... A Exhaled air analysis, o2 ................................ 0.00 1.04 1.60 1.04 1.60 0.06 1.10 1.66 1.10 1.66 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49226 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

94681 ......... ............ A Exhaled air analysis, o2/co2 ......................... 0.20 1.10 2.17 NA NA 0.13 1.43 2.50 NA NA XXX 94681 ......... 26 ....... A Exhaled air analysis, o2/co2 ......................... 0.20 0.05 0.06 0.05 0.06 0.01 0.26 0.27 0.26 0.27 XXX 94681 ......... TC ...... A Exhaled air analysis, o2/co2 ......................... 0.00 1.04 2.11 NA NA 0.12 1.16 2.23 NA NA XXX 94690 ......... ............ A Exhaled air analysis ...................................... 0.07 0.89 1.72 NA NA 0.05 1.01 1.84 NA NA XXX 94690 ......... 26 ....... A Exhaled air analysis ...................................... 0.07 0.02 0.02 0.02 0.02 0.01 0.10 0.10 0.10 0.10 XXX 94690 ......... TC ...... A Exhaled air analysis ...................................... 0.00 0.87 1.70 NA NA 0.04 0.91 1.74 NA NA XXX94720 ......... ............ A Monoxide diffusing capacity .......................... 0.26 1.18 1.05 NA NA 0.07 1.51 1.38 NA NA XXX 94720 ......... 26 ....... A Monoxide diffusing capacity .......................... 0.26 0.06 0.08 0.06 0.08 0.01 0.33 0.35 0.33 0.35 XXX 94720 ......... TC ...... A Monoxide diffusing capacity .......................... 0.00 1.11 0.97 NA NA 0.06 1.17 1.03 NA NA XXX 94725 ......... ............ A Membrane diffusion capacity ........................ 0.26 1.10 2.46 NA NA 0.13 1.49 2.85 NA NA XXX 94725 ......... 26 ....... A Membrane diffusion capacity ........................ 0.26 0.09 0.08 0.09 0.08 0.01 0.36 0.35 0.36 0.35 XXX 94725 ......... TC ...... A Membrane diffusion capacity ........................ 0.00 1.01 2.38 NA NA 0.12 1.13 2.50 NA NA XXX 94750 ......... ............ A Pulmonary compliance study ........................ 0.23 1.90 1.48 NA NA 0.05 2.18 1.76 NA NA XXX 94750 ......... 26 ....... A Pulmonary compliance study ........................ 0.23 0.08 0.07 0.08 0.07 0.01 0.32 0.31 0.32 0.31 XXX 94750 ......... TC ...... A Pulmonary compliance study ........................ 0.00 1.82 1.41 NA NA 0.04 1.86 1.45 NA NA XXX 94760 ......... ............ T Measure blood oxygen level ......................... 0.00 0.06 0.05 NA NA 0.02 0.08 0.07 NA NA XXX 94761 ......... ............ T Measure blood oxygen level ......................... 0.00 0.12 0.08 NA NA 0.06 0.18 0.14 NA NA XXX 94762 ......... ............ A Measure blood oxygen level ......................... 0.00 0.96 0.59 NA NA 0.10 1.06 0.69 NA NA XXX 94770 ......... ............ A Exhaled carbon dioxide test .......................... 0.15 0.85 0.78 NA NA 0.08 1.08 1.01 NA NA XXX 94770 ......... 26 ....... A Exhaled carbon dioxide test .......................... 0.15 0.04 0.04 0.04 0.04 0.01 0.20 0.20 0.20 0.20 XXX 94770 ......... TC ...... A Exhaled carbon dioxide test .......................... 0.00 0.81 0.74 NA NA 0.07 0.88 0.81 NA NA XXX 94772 ......... ............ C Breath recording, infant ................................. 0.00 0.00 0.00 0.00 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 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 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 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 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 0.00 0.00 0.00 0.00 XXX 95004 ......... ............ A Percut allergy skin tests ................................ 0.00 0.16 0.12 NA NA 0.01 0.17 0.13 NA NA XXX 95010 ......... ............ A Percut allergy titrate test ............................... 0.15 0.30 0.32 0.04 0.06 0.01 0.46 0.48 0.20 0.22 XXX 95015 ......... ............ A Id allergy titrate-drug/bug .............................. 0.15 0.20 0.16 0.04 0.06 0.01 0.36 0.32 0.20 0.22 XXX 95024 ......... ............ A Id allergy test, drug/bug ................................ 0.00 0.21 0.17 NA NA 0.01 0.22 0.18 NA NA XXX 95027 ......... ............ A Id allergy titrate-airborne ............................... 0.00 0.24 0.17 NA NA 0.01 0.25 0.18 NA NA XXX 95028 ......... ............ A Id allergy test-delayed type ........................... 0.00 0.29 0.25 NA NA 0.01 0.30 0.26 NA NA XXX 95044 ......... ............ A Allergy patch tests ......................................... 0.00 0.15 0.19 NA NA 0.01 0.16 0.20 NA NA XXX 95052 ......... ............ A Photo patch test ............................................ 0.00 0.15 0.23 NA NA 0.01 0.16 0.24 NA NA XXX 95056 ......... ............ A Photosensitivity tests ..................................... 0.00 1.18 0.42 NA NA 0.01 1.19 0.43 NA NA XXX 95060 ......... ............ A Eye allergy tests ............................................ 0.00 0.75 0.45 NA NA 0.02 0.77 0.47 NA NA XXX 95065 ......... ............ A Nose allergy test ........................................... 0.00 0.67 0.32 NA NA 0.01 0.68 0.33 NA NA XXX 95070 ......... ............ A Bronchial allergy tests ................................... 0.00 0.80 1.91 NA NA 0.02 0.82 1.93 NA NA XXX 95071 ......... ............ A Bronchial allergy tests ................................... 0.00 0.89 2.41 NA NA 0.02 0.91 2.43 NA NA XXX 95075 ......... ............ A Ingestion challenge test ................................ 0.95 0.67 0.78 0.25 0.35 0.03 1.65 1.76 1.23 1.33 XXX 95078 ......... ............ A Provocative testing ........................................ 0.00 0.33 0.27 NA NA 0.02 0.35 0.29 NA NA XXX 95115 ......... ............ A Immunotherapy, one injection ....................... 0.00 0.22 0.35 0.00 0.29 0.02 0.24 0.37 0.02 0.31 XXX 95117 ......... ............ A Immunotherapy injections ............................. 0.00 0.27 0.44 0.00 0.38 0.02 0.29 0.46 0.02 0.40 XXX 95144 ......... ............ A Antigen therapy services ............................... 0.06 0.26 0.21 0.02 0.02 0.01 0.33 0.28 0.09 0.09 XXX 95145 ......... ............ A Antigen therapy services ............................... 0.06 0.35 0.33 0.02 0.02 0.01 0.42 0.40 0.09 0.09 XXX 95146 ......... ............ A Antigen therapy services ............................... 0.06 0.66 0.50 0.02 0.03 0.01 0.73 0.57 0.09 0.10 XXX 95147 ......... ............ A Antigen therapy services ............................... 0.06 0.64 0.48 0.02 0.02 0.01 0.71 0.55 0.09 0.09 XXX 95148 ......... ............ A Antigen therapy services ............................... 0.06 0.94 0.67 0.02 0.03 0.01 1.01 0.74 0.09 0.10 XXX 95149 ......... ............ A Antigen therapy services ............................... 0.06 1.25 0.91 0.02 0.03 0.01 1.32 0.98 0.09 0.10 XXX 95165 ......... ............ A Antigen therapy services ............................... 0.06 0.25 0.21 0.02 0.02 0.01 0.32 0.28 0.09 0.09 XXX 95170 ......... ............ A Antigen therapy services ............................... 0.06 0.20 0.15 0.02 0.03 0.01 0.27 0.22 0.09 0.10 XXX 95180 ......... ............ A Rapid desensitization .................................... 2.01 1.57 1.92 0.71 0.88 0.04 3.62 3.97 2.76 2.93 XXX 95199 ......... ............ C Allergy immunology services ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95250 ......... ............ A Glucose monitoring, cont .............................. 0.00 3.53 3.96 NA NA 0.01 3.54 3.97 NA NA XXX95251 ......... ............ A Gluc monitor, cont, phys i&r .......................... 0.52 0.16 0.18 0.16 0.18 0.02 0.70 0.72 0.70 0.72 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49227 

95805 ......... ............ A Multiple sleep latency test ............................. 1.88 7.27 14.76 NA NA 0.43 9.58 17.07 NA NA XXX 95805 ......... 26 ....... A Multiple sleep latency test ............................. 1.88 0.51 0.62 0.51 0.62 0.09 2.48 2.59 2.48 2.59 XXX 95805 ......... TC ...... A Multiple sleep latency test ............................. 0.00 6.76 14.14 NA NA 0.34 7.10 14.48 NA NA XXX95806 ......... ............ A Sleep study, unattended ............................... 1.66 4.02 3.50 NA NA 0.39 6.07 5.55 NA NA XXX95806 ......... 26 ....... A Sleep study, unattended ............................... 1.66 0.50 0.53 0.50 0.53 0.08 2.24 2.27 2.24 2.27 XXX 95806 ......... TC ...... A Sleep study, unattended ............................... 0.00 3.52 2.97 NA NA 0.31 3.83 3.28 NA NA XXX 95807 ......... ............ A Sleep study, attended ................................... 1.66 12.81 12.09 NA NA 0.50 14.97 14.25 NA NA XXX 95807 ......... 26 ....... A Sleep study, attended ................................... 1.66 0.51 0.53 0.51 0.53 0.08 2.25 2.27 2.25 2.27 XXX 95807 ......... TC ...... A Sleep study, attended ................................... 0.00 12.30 11.57 NA NA 0.42 12.72 11.99 NA NA XXX 95808 ......... ............ A Polysomnography, 1–3 .................................. 2.65 15.72 13.82 NA NA 0.55 18.92 17.02 NA NA XXX 95808 ......... 26 ....... A Polysomnography, 1–3 .................................. 2.65 0.69 0.86 0.69 0.86 0.13 3.47 3.64 3.47 3.64 XXX 95808 ......... TC ...... A Polysomnography, 1–3 .................................. 0.00 15.03 12.96 NA NA 0.42 15.45 13.38 NA NA XXX 95810 ......... ............ A Polysomnography, 4 or more ........................ 3.52 18.60 17.77 NA NA 0.59 22.71 21.88 NA NA XXX95810 ......... 26 ....... A Polysomnography, 4 or more ........................ 3.52 0.98 1.13 0.98 1.13 0.17 4.67 4.82 4.67 4.82 XXX 95810 ......... TC ...... A Polysomnography, 4 or more ........................ 0.00 17.62 16.64 NA NA 0.42 18.04 17.06 NA NA XXX 95811 ......... ............ A Polysomnography w/cpap ............................. 3.79 20.70 19.56 NA NA 0.61 25.10 23.96 NA NA XXX 95811 ......... 26 ....... A Polysomnography w/cpap ............................. 3.79 1.05 1.22 1.05 1.22 0.18 5.02 5.19 5.02 5.19 XXX 95811 ......... TC ...... A Polysomnography w/cpap ............................. 0.00 19.66 18.36 NA NA 0.43 20.09 18.79 NA NA XXX 95812 ......... ............ A Eeg, 41–60 minutes ...................................... 1.08 5.90 4.50 NA NA 0.17 7.15 5.75 NA NA XXX 95812 ......... 26 ....... A Eeg, 41–60 minutes ...................................... 1.08 0.31 0.42 0.31 0.42 0.06 1.45 1.56 1.45 1.56 XXX 95812 ......... TC ...... A Eeg, 41–60 minutes ...................................... 0.00 5.59 4.08 NA NA 0.11 5.70 4.19 NA NA XXX 95813 ......... ............ A Eeg, over 1 hour ........................................... 1.73 6.64 5.43 NA NA 0.20 8.57 7.36 NA NA XXX 95813 ......... 26 ....... A Eeg, over 1 hour ........................................... 1.73 0.50 0.65 0.50 0.65 0.09 2.32 2.47 2.32 2.47 XXX 95813 ......... TC ...... A Eeg, over 1 hour ........................................... 0.00 6.14 4.78 NA NA 0.11 6.25 4.89 NA NA XXX 95816 ......... ............ A Eeg, awake and drowsy ................................ 1.08 5.30 4.11 NA NA 0.16 6.54 5.35 NA NA XXX 95816 ......... 26 ....... A Eeg, awake and drowsy ................................ 1.08 0.30 0.42 0.30 0.42 0.06 1.44 1.56 1.44 1.56 XXX 95816 ......... TC ...... A Eeg, awake and drowsy ................................ 0.00 4.99 3.69 NA NA 0.10 5.09 3.79 NA NA XXX 95819 ......... ............ A Eeg, awake and asleep ................................. 1.08 6.15 3.77 NA NA 0.16 7.39 5.01 NA NA XXX95819 ......... 26 ....... A Eeg, awake and asleep ................................. 1.08 0.30 0.42 0.30 0.42 0.06 1.44 1.56 1.44 1.56 XXX 95819 ......... TC ...... A Eeg, awake and asleep ................................. 0.00 5.84 3.35 NA NA 0.10 5.94 3.45 NA NA XXX 95822 ......... ............ A Eeg, coma or sleep only ............................... 1.08 5.53 4.83 NA NA 0.19 6.80 6.10 NA NA XXX95822 ......... 26 ....... A Eeg, coma or sleep only ............................... 1.08 0.30 0.42 0.30 0.42 0.06 1.44 1.56 1.44 1.56 XXX 95822 ......... TC ...... A Eeg, coma or sleep only ............................... 0.00 5.23 4.41 NA NA 0.13 5.36 4.54 NA NA XXX 95824 ......... ............ C Eeg, cerebral death only ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95824 ......... 26 ....... A Eeg, cerebral death only ............................... 0.74 0.21 0.29 0.21 0.29 0.04 0.99 1.07 0.99 1.07 XXX 95824 ......... TC ...... C Eeg, cerebral death only ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95827 ......... ............ A Eeg, all night recording ................................. 1.08 11.57 4.92 NA NA 0.19 12.84 6.19 NA NA XXX 95827 ......... 26 ....... A Eeg, all night recording ................................. 1.08 0.29 0.38 0.29 0.38 0.05 1.42 1.51 1.42 1.51 XXX 95827 ......... TC ...... A Eeg, all night recording ................................. 0.00 11.28 4.54 NA NA 0.14 11.42 4.68 NA NA XXX 95829 ......... ............ A Surgery electrocorticogram ........................... 6.20 25.44 29.61 NA NA 0.50 32.14 36.31 NA NA XXX 95829 ......... 26 ....... A Surgery electrocorticogram ........................... 6.20 1.79 2.18 1.79 2.18 0.48 8.47 8.86 8.47 8.86 XXX 95829 ......... TC ...... A Surgery electrocorticogram ........................... 0.00 23.65 27.43 NA NA 0.02 23.67 27.45 NA NA XXX 95830 ......... ............ A Insert electrodes for EEG .............................. 1.70 2.99 3.22 0.42 0.65 0.11 4.80 5.03 2.23 2.46 XXX 95831 ......... ............ A Limb muscle testing, manual ........................ 0.28 0.39 0.44 0.09 0.12 0.01 0.68 0.73 0.38 0.41 XXX 95832 ......... ............ A Hand muscle testing, manual ........................ 0.29 0.37 0.34 0.10 0.12 0.02 0.68 0.65 0.41 0.43 XXX 95833 ......... ............ A Body muscle testing, manual ........................ 0.47 0.47 0.55 0.13 0.21 0.02 0.96 1.04 0.62 0.70 XXX 95834 ......... ............ A Body muscle testing, manual ........................ 0.60 0.55 0.61 0.18 0.26 0.03 1.18 1.24 0.81 0.89 XXX 95851 ......... ............ A Range of motion measurements ................... 0.16 0.26 0.34 0.04 0.07 0.01 0.43 0.51 0.21 0.24 XXX 95852 ......... ............ A Range of motion measurements ................... 0.11 0.21 0.25 0.03 0.05 0.01 0.33 0.37 0.15 0.17 XXX 95857 ......... ............ A Tensilon test .................................................. 0.53 0.59 0.60 0.16 0.21 0.02 1.14 1.15 0.71 0.76 XXX 95860 ......... ............ A Muscle test, one limb .................................... 0.96 1.16 1.36 NA NA 0.07 2.19 2.39 NA NA XXX 95860 ......... 26 ....... A Muscle test, one limb .................................... 0.96 0.32 0.40 0.32 0.40 0.05 1.33 1.41 1.33 1.41 XXX 95860 ......... TC ...... A Muscle test, one limb .................................... 0.00 0.84 0.96 NA NA 0.02 0.86 0.98 NA NA XXX 95861 ......... ............ A Muscle test, 2 limbs ...................................... 1.54 1.67 1.48 NA NA 0.13 3.34 3.15 NA NA XXX 95861 ......... 26 ....... A Muscle test, 2 limbs ...................................... 1.54 0.51 0.64 0.51 0.64 0.07 2.12 2.25 2.12 2.25 XXX 95861 ......... TC ...... A Muscle test, 2 limbs ...................................... 0.00 1.16 0.84 NA NA 0.06 1.22 0.90 NA NA XXX95863 ......... ............ A Muscle test, 3 limbs ...................................... 1.87 1.94 1.78 NA NA 0.15 3.96 3.80 NA NA XXX 95863 ......... 26 ....... A Muscle test, 3 limbs ...................................... 1.87 0.58 0.75 0.58 0.75 0.09 2.54 2.71 2.54 2.71 XXX 95863 ......... TC ...... A Muscle test, 3 limbs ...................................... 0.00 1.36 1.05 NA NA 0.06 1.42 1.11 NA NA XXX95864 ......... ............ A Muscle test, 4 limbs ...................................... 1.99 2.20 2.54 NA NA 0.21 4.40 4.74 NA NA XXX 95864 ......... 26 ....... A Muscle test, 4 limbs ...................................... 1.99 0.63 0.81 0.63 0.81 0.09 2.71 2.89 2.71 2.89 XXX 95864 ......... TC ...... A Muscle test, 4 limbs ...................................... 0.00 1.57 1.73 NA NA 0.12 1.69 1.85 NA NA XXX95865 ......... ............ A Muscle test, larynx ........................................ 1.57 1.34 1.42 NA NA 0.11 3.02 3.10 NA NA XXX 95865 ......... 26 ....... A Muscle test, larynx ........................................ 1.57 0.46 0.69 0.46 0.69 0.08 2.11 2.34 2.11 2.34 XXX 95865 ......... TC ...... A Muscle test, larynx ........................................ 0.00 0.88 0.73 NA NA 0.03 0.91 0.76 NA NA XXX 95866 ......... ............ A Muscle test, hemidiaphragm ......................... 1.25 1.34 0.91 NA NA 0.10 2.69 2.26 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49228 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

95866 ......... 26 ....... A Muscle test, hemidiaphragm ......................... 1.25 0.40 0.52 0.40 0.52 0.07 1.72 1.84 1.72 1.84 XXX 95866 ......... TC ...... A Muscle test, hemidiaphragm ......................... 0.00 0.94 0.39 NA NA 0.03 0.97 0.42 NA NA XXX 95867 ......... ............ A Muscle test cran nerv unilat .......................... 0.79 1.12 0.98 NA NA 0.07 1.98 1.84 NA NA XXX95867 ......... 26 ....... A Muscle test cran nerv unilat .......................... 0.79 0.23 0.32 0.23 0.32 0.03 1.05 1.14 1.05 1.14 XXX 95867 ......... TC ...... A Muscle test cran nerv unilat .......................... 0.00 0.89 0.66 NA NA 0.04 0.93 0.70 NA NA XXX 95868 ......... ............ A Muscle test cran nerve bilat .......................... 1.18 1.43 1.27 NA NA 0.10 2.71 2.55 NA NA XXX95868 ......... 26 ....... A Muscle test cran nerve bilat .......................... 1.18 0.35 0.47 0.35 0.47 0.05 1.58 1.70 1.58 1.70 XXX 95868 ......... TC ...... A Muscle test cran nerve bilat .......................... 0.00 1.08 0.80 NA NA 0.05 1.13 0.85 NA NA XXX 95869 ......... ............ A Muscle test, thor paraspinal .......................... 0.37 1.03 0.54 NA NA 0.04 1.44 0.95 NA NA XXX95869 ......... 26 ....... A Muscle test, thor paraspinal .......................... 0.37 0.12 0.15 0.12 0.15 0.02 0.51 0.54 0.51 0.54 XXX 95869 ......... TC ...... A Muscle test, thor paraspinal .......................... 0.00 0.91 0.39 NA NA 0.02 0.93 0.41 NA NA XXX 95870 ......... ............ A Muscle test, nonparaspinal ........................... 0.37 1.00 0.53 NA NA 0.04 1.41 0.94 NA NA XXX 95870 ......... 26 ....... A Muscle test, nonparaspinal ........................... 0.37 0.12 0.15 0.12 0.15 0.02 0.51 0.54 0.51 0.54 XXX 95870 ......... TC ...... A Muscle test, nonparaspinal ........................... 0.00 0.88 0.38 NA NA 0.02 0.90 0.40 NA NA XXX 95872 ......... ............ A Muscle test, one fiber .................................... 2.00 1.42 1.28 NA NA 0.13 3.55 3.41 NA NA XXX 95872 ......... 26 ....... A Muscle test, one fiber .................................... 2.00 0.65 0.64 0.65 0.64 0.08 2.73 2.72 2.73 2.72 XXX 95872 ......... TC ...... A Muscle test, one fiber .................................... 0.00 0.78 0.65 NA NA 0.05 0.83 0.70 NA NA XXX95873 ......... ............ A Guide nerv destr, elec stim ........................... 0.37 0.95 0.51 0.95 0.51 0.04 1.36 0.92 1.36 0.92 ZZZ 95873 ......... 26 ....... A Guide nerv destr, elec stim ........................... 0.37 0.12 0.15 0.12 0.15 0.02 0.51 0.54 0.51 0.54 ZZZ 95873 ......... TC ...... A Guide nerv destr, elec stim ........................... 0.00 0.83 0.36 0.83 0.36 0.02 0.85 0.38 0.85 0.38 ZZZ 95874 ......... ............ A Guide nerv destr, needle emg ...................... 0.37 0.96 0.52 0.96 0.52 0.04 1.37 0.93 1.37 0.93 ZZZ 95874 ......... 26 ....... A Guide nerv destr, needle emg ...................... 0.37 0.12 0.16 0.12 0.16 0.02 0.51 0.55 0.51 0.55 ZZZ 95874 ......... TC ...... A Guide nerv destr, needle emg ...................... 0.00 0.84 0.36 0.84 0.36 0.02 0.86 0.38 0.86 0.38 ZZZ95875 ......... ............ A Limb exercise test ......................................... 1.10 1.31 1.42 NA NA 0.11 2.52 2.63 NA NA XXX 95875 ......... 26 ....... A Limb exercise test ......................................... 1.10 0.31 0.43 0.31 0.43 0.05 1.46 1.58 1.46 1.58 XXX 95875 ......... TC ...... A Limb exercise test ......................................... 0.00 1.00 0.99 NA NA 0.06 1.06 1.05 NA NA XXX 95900 ......... ............ A Motor nerve conduction test .......................... 0.42 0.94 1.18 NA NA 0.04 1.40 1.64 NA NA XXX 95900 ......... 26 ....... A Motor nerve conduction test .......................... 0.42 0.14 0.17 0.14 0.17 0.02 0.58 0.61 0.58 0.61 XXX 95900 ......... TC ...... A Motor nerve conduction test .......................... 0.00 0.80 1.01 NA NA 0.02 0.82 1.03 NA NA XXX 95903 ......... ............ A Motor nerve conduction test .......................... 0.60 1.04 1.15 NA NA 0.05 1.69 1.80 NA NA XXX 95903 ......... 26 ....... A Motor nerve conduction test .......................... 0.60 0.18 0.24 0.18 0.24 0.03 0.81 0.87 0.81 0.87 XXX 95903 ......... TC ...... A Motor nerve conduction test .......................... 0.00 0.86 0.91 NA NA 0.02 0.88 0.93 NA NA XXX 95904 ......... ............ A Sense nerve conduction test ......................... 0.34 0.88 1.04 NA NA 0.04 1.26 1.42 NA NA XXX 95904 ......... 26 ....... A Sense nerve conduction test ......................... 0.34 0.11 0.14 0.11 0.14 0.02 0.47 0.50 0.47 0.50 XXX 95904 ......... TC ...... A Sense nerve conduction test ......................... 0.00 0.77 0.90 NA NA 0.02 0.79 0.92 NA NA XXX 95920 ......... ............ A Intraop nerve test add-on .............................. 2.11 1.80 2.12 1.80 2.12 0.23 4.14 4.46 4.14 4.46 ZZZ 95920 ......... 26 ....... A Intraop nerve test add-on .............................. 2.11 0.66 0.86 0.66 0.86 0.16 2.93 3.13 2.93 3.13 ZZZ 95920 ......... TC ...... A Intraop nerve test add-on .............................. 0.00 1.14 1.27 1.14 1.27 0.07 1.21 1.34 1.21 1.34 ZZZ 95921 ......... ............ A Autonomic nerv function test ......................... 0.90 1.14 0.82 NA NA 0.06 2.10 1.78 NA NA XXX 95921 ......... 26 ....... A Autonomic nerv function test ......................... 0.90 0.24 0.31 0.24 0.31 0.04 1.18 1.25 1.18 1.25 XXX 95921 ......... TC ...... A Autonomic nerv function test ......................... 0.00 0.89 0.51 NA NA 0.02 0.91 0.53 NA NA XXX 95922 ......... ............ A Autonomic nerv function test ......................... 0.96 1.65 1.00 NA NA 0.07 2.68 2.03 NA NA XXX 95922 ......... 26 ....... A Autonomic nerv function test ......................... 0.96 0.27 0.37 0.27 0.37 0.05 1.28 1.38 1.28 1.38 XXX 95922 ......... TC ...... A Autonomic nerv function test ......................... 0.00 1.38 0.63 NA NA 0.02 1.40 0.65 NA NA XXX 95923 ......... ............ A Autonomic nerv function test ......................... 0.90 2.12 1.98 NA NA 0.07 3.09 2.95 NA NA XXX 95923 ......... 26 ....... A Autonomic nerv function test ......................... 0.90 0.24 0.35 0.24 0.35 0.05 1.19 1.30 1.19 1.30 XXX 95923 ......... TC ...... A Autonomic nerv function test ......................... 0.00 1.88 1.64 NA NA 0.02 1.90 1.66 NA NA XXX 95925 ......... ............ A Somatosensory testing .................................. 0.54 3.19 1.65 NA NA 0.10 3.83 2.29 NA NA XXX 95925 ......... 26 ....... A Somatosensory testing .................................. 0.54 0.17 0.21 0.17 0.21 0.04 0.75 0.79 0.75 0.79 XXX 95925 ......... TC ...... A Somatosensory testing .................................. 0.00 3.02 1.44 NA NA 0.06 3.08 1.50 NA NA XXX 95926 ......... ............ A Somatosensory testing .................................. 0.54 3.06 1.62 NA NA 0.09 3.69 2.25 NA NA XXX 95926 ......... 26 ....... A Somatosensory testing .................................. 0.54 0.16 0.21 0.16 0.21 0.03 0.73 0.78 0.73 0.78 XXX 95926 ......... TC ...... A Somatosensory testing .................................. 0.00 2.90 1.41 NA NA 0.06 2.96 1.47 NA NA XXX 95927 ......... ............ A Somatosensory testing .................................. 0.54 3.08 1.64 NA NA 0.10 3.72 2.28 NA NA XXX 95927 ......... 26 ....... A Somatosensory testing .................................. 0.54 0.16 0.23 0.16 0.23 0.04 0.74 0.81 0.74 0.81 XXX 95927 ......... TC ...... A Somatosensory testing .................................. 0.00 2.93 1.42 NA NA 0.06 2.99 1.48 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49229 

95928 ......... ............ A C motor evoked, uppr limbs .......................... 1.50 3.98 3.26 NA NA 0.09 5.57 4.85 NA NA XXX 95928 ......... 26 ....... A C motor evoked, uppr limbs .......................... 1.50 0.46 0.60 0.46 0.60 0.06 2.02 2.16 2.02 2.16 XXX 95928 ......... TC ...... A C motor evoked, uppr limbs .......................... 0.00 3.53 2.66 NA NA 0.03 3.56 2.69 NA NA XXX 95929 ......... ............ A C motor evoked, lwr limbs ............................ 1.50 4.30 3.48 NA NA 0.09 5.89 5.07 NA NA XXX 95929 ......... 26 ....... A C motor evoked, lwr limbs ............................ 1.50 0.46 0.60 0.46 0.60 0.06 2.02 2.16 2.02 2.16 XXX 95930 ......... ............ A Visual evoked potential test .......................... 0.35 2.64 2.34 NA NA 0.03 3.02 2.72 NA NA XXX95930 ......... 26 ....... A Visual evoked potential test .......................... 0.35 0.10 0.14 0.10 0.14 0.02 0.47 0.51 0.47 0.51 XXX 95930 ......... TC ...... A Visual evoked potential test .......................... 0.00 2.54 2.20 NA NA 0.01 2.55 2.21 NA NA XXX 95933 ......... ............ A Blink reflex test .............................................. 0.59 1.10 1.04 NA NA 0.10 1.79 1.73 NA NA XXX 95933 ......... 26 ....... A Blink reflex test .............................................. 0.59 0.17 0.22 0.17 0.22 0.04 0.80 0.85 0.80 0.85 XXX 95933 ......... TC ...... A Blink reflex test .............................................. 0.00 0.93 0.82 NA NA 0.06 0.99 0.88 NA NA XXX 95934 ......... ............ A H-reflex test ................................................... 0.51 0.90 0.55 NA NA 0.04 1.45 1.10 NA NA XXX 95934 ......... 26 ....... A H-reflex test ................................................... 0.51 0.16 0.21 0.16 0.21 0.02 0.69 0.74 0.69 0.74 XXX 95934 ......... TC ...... A H-reflex test ................................................... 0.00 0.73 0.34 NA NA 0.02 0.75 0.36 NA NA XXX 95936 ......... ............ A H-reflex test ................................................... 0.55 0.62 0.49 NA NA 0.05 1.22 1.09 NA NA XXX 95936 ......... 26 ....... A H-reflex test ................................................... 0.55 0.17 0.22 0.17 0.22 0.03 0.75 0.80 0.75 0.80 XXX 95936 ......... TC ...... A H-reflex test ................................................... 0.00 0.44 0.27 NA NA 0.02 0.46 0.29 NA NA XXX 95937 ......... ............ A Neuromuscular junction test .......................... 0.65 0.92 0.69 NA NA 0.10 1.67 1.44 NA NA XXX 95937 ......... 26 ....... A Neuromuscular junction test .......................... 0.65 0.20 0.25 0.20 0.25 0.08 0.93 0.98 0.93 0.98 XXX 95937 ......... TC ...... A Neuromuscular junction test .......................... 0.00 0.72 0.44 NA NA 0.02 0.74 0.46 NA NA XXX 95950 ......... ............ A Ambulatory eeg monitoring ........................... 1.51 4.93 4.18 NA NA 0.51 6.95 6.20 NA NA XXX 95950 ......... 26 ....... A Ambulatory eeg monitoring ........................... 1.51 0.42 0.59 0.42 0.59 0.08 2.01 2.18 2.01 2.18 XXX 95950 ......... TC ...... A Ambulatory eeg monitoring ........................... 0.00 4.52 3.60 NA NA 0.43 4.95 4.03 NA NA XXX 95951 ......... ............ C EEG monitoring/videorecord ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95951 ......... 26 ....... A EEG monitoring/videorecord ......................... 5.99 1.69 2.34 1.69 2.34 0.32 8.00 8.65 8.00 8.65 XXX 95951 ......... TC ...... C EEG monitoring/videorecord ......................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95953 ......... ............ A EEG monitoring/computer ............................. 3.30 7.24 7.53 NA NA 0.60 11.14 11.43 NA NA XXX95953 ......... 26 ....... A EEG monitoring/computer ............................. 3.30 0.93 1.20 0.93 1.20 0.17 4.40 4.67 4.40 4.67 XXX 95953 ......... TC ...... A EEG monitoring/computer ............................. 0.00 6.31 6.33 NA NA 0.43 6.74 6.76 NA NA XXX 95954 ......... ............ A EEG monitoring/giving drugs ........................ 2.45 4.90 4.39 NA NA 0.19 7.54 7.03 NA NA XXX 95954 ......... 26 ....... A EEG monitoring/giving drugs ........................ 2.45 0.51 0.91 0.51 0.91 0.13 3.09 3.49 3.09 3.49 XXX 95954 ......... TC ...... A EEG monitoring/giving drugs ........................ 0.00 4.39 3.48 NA NA 0.06 4.45 3.54 NA NA XXX 95955 ......... ............ A EEG during surgery ....................................... 1.01 2.83 2.45 2.83 2.45 0.22 4.06 3.68 4.06 3.68 XXX 95955 ......... 26 ....... A EEG during surgery ....................................... 1.01 0.29 0.34 0.29 0.34 0.05 1.35 1.40 1.35 1.40 XXX 95955 ......... TC ...... A EEG during surgery ....................................... 0.00 2.54 2.11 2.54 2.11 0.17 2.71 2.28 2.71 2.28 XXX 95956 ......... ............ A Eeg monitoring, cable/radio .......................... 3.08 17.21 15.86 NA NA 0.59 20.88 19.53 NA NA XXX 95956 ......... 26 ....... A Eeg monitoring, cable/radio .......................... 3.08 1.03 1.23 1.03 1.23 0.16 4.27 4.47 4.27 4.47 XXX 95956 ......... TC ...... A Eeg monitoring, cable/radio .......................... 0.00 16.18 14.63 NA NA 0.43 16.61 15.06 NA NA XXX 95957 ......... ............ A EEG digital analysis ...................................... 1.98 5.88 3.38 NA NA 0.23 8.09 5.59 NA NA XXX 95957 ......... 26 ....... A EEG digital analysis ...................................... 1.98 0.55 0.78 0.55 0.78 0.11 2.64 2.87 2.64 2.87 XXX 95957 ......... TC ...... A EEG digital analysis ...................................... 0.00 5.32 2.61 NA NA 0.12 5.44 2.73 NA NA XXX95958 ......... ............ A EEG monitoring/function test ........................ 4.24 6.67 4.29 NA NA 0.34 11.25 8.87 NA NA XXX 95958 ......... 26 ....... A EEG monitoring/function test ........................ 4.24 1.21 1.61 1.21 1.61 0.21 5.66 6.06 5.66 6.06 XXX 95958 ......... TC ...... A EEG monitoring/function test ........................ 0.00 5.46 2.67 NA NA 0.13 5.59 2.80 NA NA XXX 95961 ......... ............ A Electrode stimulation, brain ........................... 2.97 3.12 2.75 NA NA 0.55 6.64 6.27 NA NA XXX 95961 ......... 26 ....... A Electrode stimulation, brain ........................... 2.97 0.90 1.22 0.90 1.22 0.48 4.35 4.67 4.35 4.67 XXX 95961 ......... TC ...... A Electrode stimulation, brain ........................... 0.00 2.22 1.54 NA NA 0.07 2.29 1.61 NA NA XXX 95962 ......... ............ A Electrode stim, brain add-on ......................... 3.21 2.21 2.57 2.21 2.57 0.39 5.81 6.17 5.81 6.17 ZZZ 95962 ......... 26 ....... A Electrode stim, brain add-on ......................... 3.21 0.91 1.27 0.91 1.27 0.32 4.44 4.80 4.44 4.80 ZZZ 95962 ......... TC ...... A Electrode stim, brain add-on ......................... 0.00 1.30 1.31 1.30 1.31 0.07 1.37 1.38 1.37 1.38 ZZZ 95965 ......... ............ C Meg, spontaneous ......................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95965 ......... 26 ....... A Meg, spontaneous ......................................... 7.99 2.29 3.14 2.29 3.14 0.46 10.74 11.59 10.74 11.59 XXX 95965 ......... TC ...... C Meg, spontaneous ......................................... 0.00 0.00 0.00 0.00 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 0.00 0.00 0.00 0.00 XXX 95966 ......... 26 ....... A Meg, evoked, single ...................................... 3.99 1.22 1.59 1.22 1.59 0.19 5.40 5.77 5.40 5.77 XXX 95966 ......... TC ...... C Meg, evoked, single ...................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 95967 ......... ............ C Meg, evoked, each addIl ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 95967 ......... 26 ....... A Meg, evoked, each addIl ............................... 3.49 1.04 1.15 1.04 1.15 0.16 4.69 4.80 4.69 4.80 ZZZ 95967 ......... TC ...... C Meg, evoked, each addIl ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 95970 ......... ............ A Analyze neurostim, no prog .......................... 0.45 0.89 0.86 0.13 0.14 0.03 1.37 1.34 0.61 0.62 XXX 95971 ......... ............ A Analyze neurostim, simple ............................ 0.78 0.62 0.67 0.20 0.22 0.07 1.47 1.52 1.05 1.07 XXX 95972 ......... ............ A Analyze neurostim, complex ......................... 1.50 1.20 1.21 0.46 0.48 0.14 2.84 2.85 2.10 2.12 XXX 95973 ......... ............ A Analyze neurostim, complex ......................... 0.92 0.56 0.61 0.24 0.32 0.07 1.55 1.60 1.23 1.31 ZZZ 95974 ......... ............ A Cranial neurostim, complex ........................... 3.00 1.48 1.65 0.85 1.19 0.16 4.64 4.81 4.01 4.35 XXX 95975 ......... ............ A Cranial neurostim, complex ........................... 1.70 0.74 0.85 0.48 0.67 0.12 2.56 2.67 2.30 2.49 ZZZ 95978 ......... ............ A Analyze neurostim brain/1h ........................... 3.50 1.84 1.91 1.04 1.24 0.18 5.52 5.59 4.72 4.92 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49230 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

95979 ......... ............ A Analyz neurostim brain addon ...................... 1.64 0.73 0.84 0.47 0.64 0.08 2.45 2.56 2.19 2.36 ZZZ 95990 ......... ............ A Spin/brain pump refil & main ......................... 0.00 1.67 1.54 NA NA 0.06 1.73 1.60 NA NA XXX 95991 ......... ............ A Spin/brain pump refil & main ......................... 0.77 1.67 1.54 NA NA 0.06 2.50 2.37 NA NA XXX 95999 ......... ............ C Neurological procedure ................................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 96000 ......... ............ A Motion analysis, video/3d .............................. 1.80 NA NA 0.58 0.54 0.11 NA NA 2.49 2.45 XXX 96001 ......... ............ A Motion test w/ft press meas .......................... 2.15 NA NA 0.53 0.63 0.10 NA NA 2.78 2.88 XXX 96002 ......... ............ A Dynamic surface emg ................................... 0.41 NA NA 0.11 0.14 0.02 NA NA 0.54 0.57 XXX96003 ......... ............ A Dynamic fine wire emg .................................. 0.37 NA NA 0.14 0.13 0.02 NA NA 0.53 0.52 XXX 96004 ......... ............ A Phys review of motion tests .......................... 2.14 0.54 0.84 0.54 0.84 0.11 2.79 3.09 2.79 3.09 XXX 96101 ......... ............ A Psycho testing by psych/phys ....................... 1.86 0.34 0.57 0.33 0.56 0.05 2.25 2.48 2.24 2.47 XXX 96102 ......... ............ A Psycho testing by technician ......................... 0.50 1.20 0.80 0.09 0.15 0.01 1.71 1.31 0.60 0.66 XXX 96103 ......... ............ A Psycho testing admin by comp ..................... 0.51 1.31 0.49 0.09 0.15 0.02 1.84 1.02 0.62 0.68 XXX 96105 ......... ............ A Assessment of aphasia ................................. 0.00 2.06 1.84 NA NA 0.18 2.24 2.02 NA NA XXX96110 ......... ............ A Developmental test, lim ................................. 0.00 0.18 0.18 NA NA 0.18 0.36 0.36 NA NA XXX 96111 ......... ............ A Developmental test, extend ........................... 2.60 0.66 0.95 0.53 0.92 0.18 3.44 3.73 3.31 3.70 XXX 96116 ......... ............ A Neurobehavioral status exam ....................... 1.86 0.53 0.76 0.42 0.59 0.18 2.57 2.80 2.46 2.63 XXX 96118 ......... ............ A Neuropsych tst by psych/phys ...................... 1.86 0.81 1.25 0.32 0.55 0.18 2.85 3.29 2.36 2.59 XXX 96119 ......... ............ A Neuropsych testing by tech ........................... 0.55 1.53 1.15 0.09 0.17 0.18 2.26 1.88 0.82 0.90 XXX 96120 ......... ............ A Neuropsych tst admin w/comp ...................... 0.51 1.91 1.03 0.09 0.15 0.02 2.44 1.56 0.62 0.68 XXX 96150 ......... ............ A Assess hlth/behave, init ................................ 0.50 0.10 0.16 0.09 0.16 0.01 0.61 0.67 0.60 0.67 XXX 96151 ......... ............ A Assess hlth/behave, subseq ......................... 0.48 0.09 0.16 0.09 0.15 0.01 0.58 0.65 0.58 0.64 XXX 96152 ......... ............ A Intervene hlth/behave, indiv .......................... 0.46 0.09 0.15 0.08 0.14 0.01 0.56 0.62 0.55 0.61 XXX 96153 ......... ............ A Intervene hlth/behave, group ........................ 0.10 0.02 0.04 0.02 0.03 0.01 0.13 0.15 0.13 0.14 XXX 96154 ......... ............ A Interv hlth/behav, fam w/pt ............................ 0.45 0.09 0.15 0.08 0.14 0.01 0.55 0.61 0.54 0.60 XXX 96155 ......... ............ N Interv hlth/behav fam no pt ........................... 0.44 0.10 0.16 0.10 0.15 0.02 0.56 0.62 0.56 0.61 XXX 96401 ......... ............ A Chemo, anti-neopl, sq/im .............................. 0.21 1.87 1.35 NA NA 0.01 2.09 1.57 NA NA XXX96402 ......... ............ A Chemo hormon antineopl sq/im .................... 0.19 0.72 0.94 NA NA 0.01 0.92 1.14 NA NA XXX 96405 ......... ............ A Chemo intralesional, up to 7 ......................... 0.52 3.49 2.70 0.22 0.24 0.03 4.04 3.25 0.77 0.79 000 96406 ......... ............ A Chemo intralesional over 7 ........................... 0.80 3.26 3.07 0.27 0.29 0.03 4.09 3.90 1.10 1.12 000 96409 ......... ............ A Chemo, iv push, sngl drug ............................ 0.24 2.78 2.89 NA NA 0.06 3.08 3.19 NA NA XXX 96411 ......... ............ A Chemo, iv push, addl drug ............................ 0.20 1.50 1.58 NA NA 0.06 1.76 1.84 NA NA ZZZ 96413 ......... ............ A Chemo, iv infusion, 1 hr ................................ 0.28 3.63 4.05 NA NA 0.08 3.99 4.41 NA NA XXX 96415 ......... ............ A Chemo, iv infusion, addl hr ........................... 0.19 0.66 0.74 NA NA 0.07 0.92 1.00 NA NA ZZZ96416 ......... ............ A Chemo prolong infuse w/pump ..................... 0.21 4.08 4.47 NA NA 0.08 4.37 4.76 NA NA XXX 96417 ......... ............ A Chemo iv infus each addl seq ...................... 0.21 1.72 1.89 NA NA 0.07 2.00 2.17 NA NA ZZZ 96420 ......... ............ A Chemo, ia, push tecnique ............................. 0.17 2.70 2.67 NA NA 0.08 2.95 2.92 NA NA XXX 96422 ......... ............ A Chemo ia infusion up to 1 hr ........................ 0.17 3.70 4.55 NA NA 0.08 3.95 4.80 NA NA XXX 96423 ......... ............ A Chemo ia infuse each addl hr ....................... 0.17 1.93 1.89 NA NA 0.02 2.12 2.08 NA NA ZZZ 96425 ......... ............ A Chemotherapy,infusion method .................... 0.17 4.54 4.49 NA NA 0.08 4.79 4.74 NA NA XXX 96440 ......... ............ A Chemotherapy, intracavitary ......................... 2.37 5.56 7.49 1.00 1.17 0.17 8.10 10.03 3.54 3.71 000 96445 ......... ............ A Chemotherapy, intracavitary ......................... 2.20 5.45 7.39 0.94 1.12 0.14 7.79 9.73 3.28 3.46 000 96450 ......... ............ A Chemotherapy, into CNS .............................. 1.53 5.02 6.47 0.83 1.18 0.09 6.64 8.09 2.45 2.80 000 96521 ......... ............ A Refill/maint, portable pump ........................... 0.21 3.14 3.61 NA NA 0.06 3.41 3.88 NA NA XXX96522 ......... ............ A Refill/maint pump/resvr syst .......................... 0.21 2.74 2.67 NA NA 0.06 3.01 2.94 NA NA XXX96523 ......... ............ T Irrig drug delivery device ............................... 0.04 0.64 0.68 NA NA 0.01 0.69 0.73 NA NA XXX 96542 ......... ............ A Chemotherapy injection ................................. 0.75 3.55 4.08 0.32 0.58 0.07 4.37 4.90 1.14 1.40 XXX 96549 ......... ............ C Chemotherapy, unspecified ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 96567 ......... ............ A Photodynamic tx, skin ................................... 0.00 3.65 2.38 NA NA 0.04 3.69 2.42 NA NA XXX 96570 ......... ............ A Photodynamic tx, 30 min ............................... 1.10 0.41 0.38 0.41 0.38 0.11 1.62 1.59 1.62 1.59 ZZZ 96571 ......... ............ A Photodynamic tx, addl 15 min ....................... 0.55 0.20 0.19 0.20 0.19 0.03 0.78 0.77 0.78 0.77 ZZZ 96900 ......... ............ A Ultraviolet light therapy .................................. 0.00 0.55 0.47 NA NA 0.02 0.57 0.49 NA NA XXX 96902 ......... ............ B Trichogram .................................................... 0.41 0.11 0.16 0.10 0.15 0.01 0.53 0.58 0.52 0.57 XXX 96910 ......... ............ A Photochemotherapy with UV–B .................... 0.00 1.95 1.23 NA NA 0.04 1.99 1.27 NA NA XXX 96912 ......... ............ A Photochemotherapy with UV–A .................... 0.00 2.51 1.57 NA NA 0.05 2.56 1.62 NA NA XXX 96913 ......... ............ A Photochemotherapy, UV–A or B ................... 0.00 3.55 2.15 NA NA 0.10 3.65 2.25 NA NA XXX 96920 ......... ............ A Laser tx, skin < 250 sq cm ........................... 1.15 3.48 2.77 0.54 0.56 0.02 4.65 3.94 1.71 1.73 000 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49231 

96921 ......... ............ A Laser tx, skin 250–500 sq cm ....................... 1.17 3.39 2.80 0.51 0.56 0.03 4.59 4.00 1.71 1.76 000 96922 ......... ............ A Laser tx, skin > 500 sq cm ........................... 2.10 4.46 3.73 0.98 0.71 0.04 6.60 5.87 3.12 2.85 000 96999 ......... ............ C Dermatological procedure ............................. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97001 ......... ............ A Pt evaluation .................................................. 1.20 0.68 0.73 NA NA 0.05 1.93 1.98 NA NA XXX 97002 ......... ............ A Pt re-evaluation ............................................. 0.60 0.43 0.44 NA NA 0.02 1.05 1.06 NA NA XXX 97003 ......... ............ A Ot evaluation ................................................. 1.20 0.77 0.85 NA NA 0.06 2.03 2.11 NA NA XXX 97004 ......... ............ A Ot re-evaluation ............................................. 0.60 0.54 0.64 NA NA 0.02 1.16 1.26 NA NA XXX 97010 ......... ............ B Hot or cold packs therapy ............................. 0.06 0.07 0.06 NA NA 0.01 0.14 0.13 NA NA XXX97012 ......... ............ A Mechanical traction therapy .......................... 0.25 0.15 0.14 NA NA 0.01 0.41 0.40 NA NA XXX 97014 ......... ............ I Electric stimulation therapy ........................... 0.18 0.19 0.19 NA NA 0.01 0.38 0.38 NA NA XXX 97016 ......... ............ A Vasopneumatic device therapy ..................... 0.18 0.25 0.20 NA NA 0.01 0.44 0.39 NA NA XXX 97018 ......... ............ A Paraffin bath therapy ..................................... 0.06 0.17 0.12 NA NA 0.01 0.24 0.19 NA NA XXX 97022 ......... ............ A Whirlpool therapy .......................................... 0.17 0.34 0.24 NA NA 0.01 0.52 0.42 NA NA XXX 97024 ......... ............ A Diathermy eg, microwave .............................. 0.06 0.08 0.07 NA NA 0.01 0.15 0.14 NA NA XXX 97026 ......... ............ A Infrared therapy ............................................. 0.06 0.07 0.06 NA NA 0.01 0.14 0.13 NA NA XXX 97028 ......... ............ A Ultraviolet therapy ......................................... 0.08 0.09 0.08 NA NA 0.01 0.18 0.17 NA NA XXX 97032 ......... ............ A Electrical stimulation ...................................... 0.25 0.20 0.17 NA NA 0.01 0.46 0.43 NA NA XXX 97033 ......... ............ A Electric current therapy ................................. 0.26 0.46 0.32 NA NA 0.01 0.73 0.59 NA NA XXX 97034 ......... ............ A Contrast bath therapy .................................... 0.21 0.21 0.17 NA NA 0.01 0.43 0.39 NA NA XXX 97035 ......... ............ A Ultrasound therapy ........................................ 0.21 0.10 0.10 NA NA 0.01 0.32 0.32 NA NA XXX 97036 ......... ............ A Hydrotherapy ................................................. 0.28 0.45 0.35 NA NA 0.01 0.74 0.64 NA NA XXX 97039 ......... ............ C Physical therapy treatment ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97110 ......... ............ A Therapeutic exercises ................................... 0.45 0.33 0.29 NA NA 0.02 0.80 0.76 NA NA XXX 97112 ......... ............ A Neuromuscular reeducation .......................... 0.45 0.36 0.32 NA NA 0.01 0.82 0.78 NA NA XXX 97113 ......... ............ A Aquatic therapy/exercises ............................. 0.44 0.55 0.43 NA NA 0.01 1.00 0.88 NA NA XXX97116 ......... ............ A Gait training therapy ...................................... 0.40 0.29 0.25 NA NA 0.01 0.70 0.66 NA NA XXX 97124 ......... ............ A Massage therapy ........................................... 0.35 0.28 0.24 NA NA 0.01 0.64 0.60 NA NA XXX 97139 ......... ............ C Physical medicine procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97140 ......... ............ A Manual therapy .............................................. 0.43 0.30 0.26 NA NA 0.01 0.74 0.70 NA NA XXX 97150 ......... ............ A Group therapeutic procedures ...................... 0.27 0.22 0.19 NA NA 0.01 0.50 0.47 NA NA XXX 97530 ......... ............ A Therapeutic activities ..................................... 0.44 0.39 0.34 NA NA 0.01 0.84 0.79 NA NA XXX 97532 ......... ............ A Cognitive skills development ......................... 0.44 0.23 0.21 NA NA 0.01 0.68 0.66 NA NA XXX 97533 ......... ............ A Sensory integration ....................................... 0.44 0.28 0.25 NA NA 0.01 0.73 0.70 NA NA XXX 97535 ......... ............ A Self care mngment training ........................... 0.45 0.39 0.35 NA NA 0.01 0.85 0.81 NA NA XXX 97537 ......... ............ A Community/work reintegration ....................... 0.45 0.29 0.27 NA NA 0.01 0.75 0.73 NA NA XXX 97542 ......... ............ A Wheelchair mngment training ....................... 0.45 0.30 0.29 NA NA 0.01 0.76 0.75 NA NA XXX 97597 ......... ............ A Active wound care/20 cm or < ...................... 0.58 1.13 0.78 0.13 0.53 0.05 1.76 1.41 0.76 1.16 XXX 97598 ......... ............ A Active wound care > 20 cm .......................... 0.80 1.31 0.92 0.18 0.64 0.05 2.16 1.77 1.03 1.49 XXX 97605 ......... ............ A Neg press wound tx, < 50 cm ....................... 0.55 0.42 0.36 0.12 0.20 0.02 0.99 0.93 0.69 0.77 XXX 97606 ......... ............ A Neg press wound tx, > 50 cm ....................... 0.60 0.43 0.37 0.13 0.21 0.03 1.06 1.00 0.76 0.84 XXX 97750 ......... ............ A Physical performance test ............................. 0.45 0.34 0.33 NA NA 0.02 0.81 0.80 NA NA XXX97755 ......... ............ A Assistive technology assess ......................... 0.62 0.29 0.28 NA NA 0.02 0.93 0.92 NA NA XXX 97760 ......... ............ A Orthotic mgmt and training ............................ 0.45 0.44 0.37 NA NA 0.03 0.92 0.85 NA NA XXX97761 ......... ............ A Prosthetic training .......................................... 0.45 0.34 0.30 NA NA 0.02 0.81 0.77 NA NA XXX 97762 ......... ............ A C/o for orthotic/prosth use ............................. 0.25 0.75 0.50 NA NA 0.02 1.02 0.77 NA NA XXX 97799 ......... ............ C Physical medicine procedure ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 97802 ......... ............ A Medical nutrition, indiv, in .............................. 0.45 0.12 0.38 0.11 0.38 0.01 0.58 0.84 0.57 0.84 XXX 97803 ......... ............ A Med nutrition, indiv, subseq .......................... 0.37 0.10 0.38 0.09 0.38 0.01 0.48 0.76 0.47 0.76 XXX 97804 ......... ............ A Medical nutrition, group ................................. 0.25 0.06 0.15 0.06 0.15 0.01 0.32 0.41 0.32 0.41 XXX 97810 ......... ............ N Acupunct w/o stimul 15 min .......................... 0.60 0.26 0.35 0.14 0.21 0.03 0.89 0.98 0.77 0.84 XXX 97811 ......... ............ N Acupunct w/o stimul addl 15m ...................... 0.50 0.16 0.23 0.12 0.17 0.03 0.69 0.76 0.65 0.70 ZZZ 97813 ......... ............ N Acupunct w/stimul 15 min ............................. 0.65 0.27 0.37 0.15 0.23 0.03 0.95 1.05 0.83 0.91 XXX 97814 ......... ............ N Acupunct w/stimul addl 15m ......................... 0.55 0.19 0.27 0.13 0.19 0.03 0.77 0.85 0.71 0.77 ZZZ 98925 ......... ............ A Osteopathic manipulation .............................. 0.45 0.28 0.31 0.12 0.14 0.02 0.75 0.78 0.59 0.61 000 98926 ......... ............ A Osteopathic manipulation .............................. 0.65 0.36 0.40 0.16 0.23 0.03 1.04 1.08 0.84 0.91 000 98927 ......... ............ A Osteopathic manipulation .............................. 0.87 0.45 0.49 0.22 0.27 0.03 1.35 1.39 1.12 1.17 000 98928 ......... ............ A Osteopathic manipulation .............................. 1.03 0.50 0.57 0.26 0.32 0.04 1.57 1.64 1.33 1.39 000 98929 ......... ............ A Osteopathic manipulation .............................. 1.19 0.57 0.65 0.29 0.35 0.05 1.81 1.89 1.53 1.59 000 98940 ......... ............ A Chiropractic manipulation .............................. 0.45 0.21 0.23 0.12 0.12 0.01 0.67 0.69 0.58 0.58 000 98941 ......... ............ A Chiropractic manipulation .............................. 0.65 0.27 0.29 0.17 0.17 0.01 0.93 0.95 0.83 0.83 000 98942 ......... ............ A Chiropractic manipulation .............................. 0.87 0.33 0.35 0.23 0.23 0.02 1.22 1.24 1.12 1.12 000 98943 ......... ............ N Chiropractic manipulation .............................. 0.40 0.18 0.23 0.09 0.14 0.01 0.59 0.64 0.50 0.55 XXX 99082 ......... ............ C Unusual physician travel ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99143 ......... ............ C Mod cs by same phys, < 5 yrs ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99144 ......... ............ C Mod cs by same phys, 5 yrs + ..................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99145 ......... ............ C Mod cs by same phys add-on ....................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 

mstockstill on PROD1PC63 with PROPOSAL_2

49232 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

99148 ......... ............ C Mod cs diff phys < 5 yrs ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99149 ......... ............ C Mod cs diff phys 5 yrs + ............................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99150 ......... ............ C Mod cs diff phys add-on ................................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 ZZZ 99170 ......... ............ A Anogenital exam, child .................................. 1.75 1.51 1.70 0.50 0.54 0.08 3.34 3.53 2.33 2.37 000 99175 ......... ............ A Induction of vomiting ..................................... 0.00 0.34 1.13 NA NA 0.10 0.44 1.23 NA NA XXX 99183 ......... ............ A Hyperbaric oxygen therapy ........................... 2.34 2.61 3.08 0.58 0.69 0.16 5.11 5.58 3.08 3.19 XXX 99185 ......... ............ A Regional hypothermia ................................... 0.00 1.66 0.90 NA NA 0.04 1.70 0.94 NA NA XXX 99186 ......... ............ A Total body hypothermia ................................. 0.00 1.41 1.69 NA NA 0.45 1.86 2.14 NA NA XXX 99195 ......... ............ A Phlebotomy ................................................... 0.00 2.60 0.98 NA NA 0.02 2.62 1.00 NA NA XXX 99199 ......... ............ C Special service/proc/report ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX 99201 ......... ............ A Office/outpatient visit, new ............................ 0.45 0.54 0.50 0.15 0.15 0.03 1.02 0.98 0.63 0.63 XXX 99202 ......... ............ A Office/outpatient visit, new ............................ 0.88 0.83 0.80 0.29 0.31 0.05 1.76 1.73 1.22 1.24 XXX 99203 ......... ............ A Office/outpatient visit, new ............................ 1.34 1.10 1.12 0.42 0.47 0.09 2.53 2.55 1.85 1.90 XXX 99204 ......... ............ A Office/outpatient visit, new ............................ 2.30 1.49 1.50 0.71 0.71 0.12 3.91 3.92 3.13 3.13 XXX 99205 ......... ............ A Office/outpatient visit, new ............................ 3.00 1.79 1.78 0.91 0.94 0.15 4.94 4.93 4.06 4.09 XXX 99211 ......... ............ A Office/outpatient visit, est .............................. 0.17 0.33 0.38 0.06 0.06 0.01 0.51 0.56 0.24 0.24 XXX 99212 ......... ............ A Office/outpatient visit, est .............................. 0.45 0.55 0.54 0.15 0.16 0.03 1.03 1.02 0.63 0.64 XXX 99213 ......... ............ A Office/outpatient visit, est .............................. 0.92 0.76 0.71 0.28 0.25 0.03 1.71 1.66 1.23 1.20 XXX 99214 ......... ............ A Office/outpatient visit, est .............................. 1.42 1.10 1.05 0.44 0.42 0.05 2.57 2.52 1.91 1.89 XXX 99215 ......... ............ A Office/outpatient visit, est .............................. 2.00 1.39 1.34 0.61 0.64 0.08 3.47 3.42 2.69 2.72 XXX 99217 ......... ............ A Observation care discharge .......................... 1.28 NA NA 0.50 0.52 0.06 NA NA 1.84 1.86 XXX 99218 ......... ............ A Observation care ........................................... 1.28 NA NA 0.38 0.43 0.06 NA NA 1.72 1.77 XXX 99219 ......... ............ A Observation care ........................................... 2.14 NA NA 0.60 0.69 0.10 NA NA 2.84 2.93 XXX 99220 ......... ............ A Observation care ........................................... 2.99 NA NA 0.86 0.99 0.14 NA NA 3.99 4.12 XXX 99221 ......... ............ A Initial hospital care ........................................ 1.88 NA NA 0.55 0.48 0.07 NA NA 2.50 2.43 XXX 99222 ......... ............ A Initial hospital care ........................................ 2.56 NA NA 0.71 0.73 0.10 NA NA 3.37 3.39 XXX 99223 ......... ............ A Initial hospital care ........................................ 3.78 NA NA 1.08 1.04 0.13 NA NA 4.99 4.95 XXX 99231 ......... ............ A Subsequent hospital care .............................. 0.76 NA NA 0.24 0.23 0.03 NA NA 1.03 1.02 XXX99232 ......... ............ A Subsequent hospital care .............................. 1.39 NA NA 0.43 0.39 0.04 NA NA 1.86 1.82 XXX99233 ......... ............ A Subsequent hospital care .............................. 2.00 NA NA 0.60 0.54 0.06 NA NA 2.66 2.60 XXX99234 ......... ............ A Observ/hosp same date ................................ 2.56 NA NA 0.78 0.86 0.13 NA NA 3.47 3.55 XXX 99235 ......... ............ A Observ/hosp same date ................................ 3.41 NA NA NA NA 0.16 NA NA NA NA XXX 99236 ......... ............ A Observ/hosp same date ................................ 4.26 NA NA 1.25 1.39 0.19 NA NA 5.70 5.84 XXX 99238 ......... ............ A Hospital discharge day .................................. 1.28 NA NA 0.50 0.53 0.05 NA NA 1.83 1.86 XXX 99239 ......... ............ A Hospital discharge day .................................. 1.90 NA NA 0.68 0.72 0.07 NA NA 2.65 2.69 XXX 99241 ......... ............ A Office consultation ......................................... 0.64 0.66 0.65 0.22 0.22 0.05 1.35 1.34 0.91 0.91 XXX 99242 ......... ............ A Office consultation ......................................... 1.34 1.08 1.05 0.47 0.46 0.10 2.52 2.49 1.91 1.90 XXX 99243 ......... ............ A Office consultation ......................................... 1.88 1.45 1.41 0.67 0.64 0.13 3.46 3.42 2.68 2.65 XXX 99244 ......... ............ A Office consultation ......................................... 3.02 1.95 1.85 1.09 0.96 0.16 5.13 5.03 4.27 4.14 XXX 99245 ......... ............ A Office consultation ......................................... 3.77 2.27 2.27 1.31 1.26 0.21 6.25 6.25 5.29 5.24 XXX 99251 ......... ............ A Initial inpatient consult ................................... 1.00 NA NA 0.31 0.26 0.05 NA NA 1.36 1.31 XXX 99252 ......... ............ A Initial inpatient consult ................................... 1.50 NA NA 0.50 0.50 0.09 NA NA 2.09 2.09 XXX 99253 ......... ............ A Initial inpatient consult ................................... 2.27 NA NA 0.81 0.71 0.11 NA NA 3.19 3.09 XXX 99254 ......... ............ A Initial inpatient consult ................................... 3.29 NA NA 1.19 1.03 0.13 NA NA 4.61 4.45 XXX 99255 ......... ............ A Initial inpatient consult ................................... 4.00 NA NA 1.40 1.36 0.18 NA NA 5.58 5.54 XXX 99281 ......... ............ A Emergency dept visit ..................................... 0.45 NA NA 0.09 0.09 0.02 NA NA 0.56 0.56 XXX 99282 ......... ............ A Emergency dept visit ..................................... 0.88 NA NA 0.17 0.15 0.04 NA NA 1.09 1.07 XXX 99283 ......... ............ A Emergency dept visit ..................................... 1.34 NA NA 0.25 0.30 0.09 NA NA 1.68 1.73 XXX 99284 ......... ............ A Emergency dept visit ..................................... 2.56 NA NA 0.46 0.47 0.14 NA NA 3.16 3.17 XXX 99285 ......... ............ A Emergency dept visit ..................................... 3.80 NA NA 0.67 0.71 0.23 NA NA 4.70 4.74 XXX 99289 ......... ............ A Ped crit care transport ................................... 4.79 NA NA 1.11 1.37 0.24 NA NA 6.14 6.40 XXX 99290 ......... ............ A Ped crit care transport addl ........................... 2.40 NA NA 0.60 0.76 0.12 NA NA 3.12 3.28 ZZZ 99291 ......... ............ A Critical care, first hour ................................... 4.50 2.28 2.50 1.12 1.24 0.21 6.99 7.21 5.83 5.95 XXX 99292 ......... ............ A Critical care, addIl 30 min ............................. 2.25 0.83 0.88 0.59 0.63 0.11 3.19 3.24 2.95 2.99 ZZZ 99293 ......... ............ A Ped critical care, initial .................................. 15.98 NA NA 3.59 4.46 1.12 NA NA 20.69 21.56 XXX 99294 ......... ............ A Ped critical care, subseq ............................... 7.99 NA NA 1.72 2.23 0.45 NA NA 10.16 10.67 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49233 

99295 ......... ............ A Neonate crit care, initial ................................ 18.46 NA NA 4.34 5.11 1.16 NA NA 23.96 24.73 XXX 99296 ......... ............ A Neonate critical care subseq ......................... 7.99 NA NA 1.76 2.35 0.32 NA NA 10.07 10.66 XXX 99298 ......... ............ A Ic for lbw infant < 1500 gm ........................... 2.75 NA NA 0.66 0.86 0.17 NA NA 3.58 3.78 XXX99299 ......... ............ A Ic, lbw infant 1500–2500 gm ......................... 2.50 NA NA 0.75 0.83 0.16 NA NA 3.41 3.49 XXX 99300 ......... ............ A Ic, infant pbw 2501–5000 gm ........................ 2.40 NA NA 0.72 0.81 0.15 NA NA 3.27 3.36 XXX 99304 ......... ............ A Nursing facility care, init ................................ 1.20 0.45 0.48 0.45 0.48 0.05 1.70 1.73 1.70 1.73 XXX 99305 ......... ............ A Nursing facility care, init ................................ 1.61 0.56 0.61 0.56 0.61 0.07 2.24 2.29 2.24 2.29 XXX 99306 ......... ............ A Nursing facility care, init ................................ 2.01 0.65 0.73 0.65 0.73 0.09 2.75 2.83 2.75 2.83 XXX 99307 ......... ............ A Nursing fac care, subseq .............................. 0.60 0.27 0.27 0.27 0.27 0.03 0.90 0.90 0.90 0.90 XXX 99308 ......... ............ A Nursing fac care, subseq .............................. 1.00 0.43 0.45 0.43 0.45 0.04 1.47 1.49 1.47 1.49 XXX 99309 ......... ............ A Nursing fac care, subseq .............................. 1.42 0.58 0.61 0.58 0.61 0.06 2.06 2.09 2.06 2.09 XXX 99310 ......... ............ A Nursing fac care, subseq .............................. 1.77 0.73 0.77 0.73 0.77 0.08 2.58 2.62 2.58 2.62 XXX 99315 ......... ............ A Nursing fac discharge day ............................ 1.13 0.41 0.44 0.41 0.44 0.05 1.59 1.62 1.59 1.62 XXX 99316 ......... ............ A Nursing fac discharge day ............................ 1.50 0.51 0.57 0.51 0.57 0.06 2.07 2.13 2.07 2.13 XXX 99318 ......... ............ A Annual nursing fac assessmnt ...................... 1.20 0.45 0.48 0.45 0.48 0.05 1.70 1.73 1.70 1.73 XXX 99324 ......... ............ A Domicil/r-home visit new pat ......................... 1.01 0.43 0.48 NA NA 0.05 1.49 1.54 NA NA XXX 99325 ......... ............ A Domicil/r-home visit new pat ......................... 1.52 0.56 0.65 NA NA 0.07 2.15 2.24 NA NA XXX 99326 ......... ............ A Domicil/r-home visit new pat ......................... 2.27 0.73 0.87 NA NA 0.10 3.10 3.24 NA NA XXX 99327 ......... ............ A Domicil/r-home visit new pat ......................... 3.03 0.92 1.11 NA NA 0.13 4.08 4.27 NA NA XXX 99328 ......... ............ A Domicil/r-home visit new pat ......................... 3.78 1.10 1.34 NA NA 0.16 5.04 5.28 NA NA XXX 99334 ......... ............ A Domicil/r-home visit est pat ........................... 0.76 0.36 0.39 NA NA 0.04 1.16 1.19 NA NA XXX 99335 ......... ............ A Domicil/r-home visit est pat ........................... 1.26 0.48 0.56 NA NA 0.06 1.80 1.88 NA NA XXX 99336 ......... ............ A Domicil/r-home visit est pat ........................... 2.02 0.66 0.78 NA NA 0.09 2.77 2.89 NA NA XXX 99337 ......... ............ A Domicil/r-home visit est pat ........................... 3.03 0.90 1.09 NA NA 0.13 4.06 4.25 NA NA XXX 99341 ......... ............ A Home visit, new patient ................................. 1.01 0.37 0.45 NA NA 0.05 1.43 1.51 NA NA XXX 99342 ......... ............ A Home visit, new patient ................................. 1.52 0.50 0.64 NA NA 0.07 2.09 2.23 NA NA XXX 99343 ......... ............ A Home visit, new patient ................................. 2.27 0.69 0.88 NA NA 0.10 3.06 3.25 NA NA XXX 99344 ......... ............ A Home visit, new patient ................................. 3.03 0.91 1.11 NA NA 0.13 4.07 4.27 NA NA XXX 99345 ......... ............ A Home visit, new patient ................................. 3.78 1.08 1.34 NA NA 0.16 5.02 5.28 NA NA XXX 99347 ......... ............ A Home visit, est patient ................................... 0.76 0.36 0.39 NA NA 0.04 1.16 1.19 NA NA XXX 99348 ......... ............ A Home visit, est patient ................................... 1.26 0.49 0.56 NA NA 0.06 1.81 1.88 NA NA XXX 99349 ......... ............ A Home visit, est patient ................................... 2.02 0.66 0.79 NA NA 0.09 2.77 2.90 NA NA XXX 99350 ......... ............ A Home visit, est patient ................................... 3.03 0.91 1.11 NA NA 0.13 4.07 4.27 NA NA XXX 99354 ......... ............ A Prolonged service, office ............................... 1.77 0.65 0.74 0.50 0.62 0.08 2.50 2.59 2.35 2.47 ZZZ 99355 ......... ............ A Prolonged service, office ............................... 1.77 0.67 0.73 0.52 0.60 0.07 2.51 2.57 2.36 2.44 ZZZ 99356 ......... ............ A Prolonged service, inpatient .......................... 1.71 NA NA 0.51 0.59 0.07 NA NA 2.29 2.37 ZZZ99357 ......... ............ A Prolonged service, inpatient .......................... 1.71 NA NA 0.50 0.60 0.08 NA NA 2.29 2.39 ZZZ99374 ......... ............ B Home health care supervision ...................... 1.10 0.55 0.66 0.26 0.38 0.05 1.70 1.81 1.41 1.53 XXX 99375 ......... ............ I Home health care supervision ...................... 1.73 0.76 1.35 0.40 1.26 0.07 2.56 3.15 2.20 3.06 XXX 99377 ......... ............ B Hospice care supervision .............................. 1.10 0.55 0.66 0.26 0.38 0.05 1.70 1.81 1.41 1.53 XXX 99378 ......... ............ I Hospice care supervision .............................. 1.73 0.76 1.65 0.40 1.56 0.07 2.56 3.45 2.20 3.36 XXX 99379 ......... ............ B Nursing fac care supervision ......................... 1.10 0.55 0.66 0.26 0.38 0.04 1.69 1.80 1.40 1.52 XXX 99380 ......... ............ B Nursing fac care supervision ......................... 1.73 0.76 0.93 0.40 0.60 0.06 2.55 2.72 2.19 2.39 XXX 99381 ......... ............ N Prev visit, new, infant .................................... 1.19 1.01 1.38 0.28 0.41 0.05 2.25 2.62 1.52 1.65 XXX 99382 ......... ............ N Prev visit, new, age 1–4 ................................ 1.36 1.05 1.42 0.32 0.47 0.05 2.46 2.83 1.73 1.88 XXX 99383 ......... ............ N Prev visit, new, age 5–11 .............................. 1.36 1.04 1.37 0.32 0.47 0.05 2.45 2.78 1.73 1.88 XXX 99384 ......... ............ N Prev visit, new, age 12–17 ............................ 1.53 1.08 1.43 0.36 0.53 0.06 2.67 3.02 1.95 2.12 XXX 99385 ......... ............ N Prev visit, new, age 18–39 ............................ 1.53 1.08 1.43 0.36 0.53 0.06 2.67 3.02 1.95 2.12 XXX 99386 ......... ............ N Prev visit, new, age 40–64 ............................ 1.88 1.16 1.60 0.44 0.65 0.07 3.11 3.55 2.39 2.60 XXX 99387 ......... ............ N Prev visit, new, 65 & over ............................. 2.06 1.29 1.73 0.48 0.71 0.07 3.42 3.86 2.61 2.84 XXX 99391 ......... ............ N Prev visit, est, infant ...................................... 1.02 0.87 0.98 0.24 0.35 0.04 1.93 2.04 1.30 1.41 XXX 99392 ......... ............ N Prev visit, est, age 1–4 ................................. 1.19 0.91 1.05 0.28 0.41 0.05 2.15 2.29 1.52 1.65 XXX 99393 ......... ............ N Prev visit, est, age 5–11 ............................... 1.19 0.91 1.02 0.28 0.41 0.05 2.15 2.26 1.52 1.65 XXX 99394 ......... ............ N Prev visit, est, age 12–17 ............................. 1.36 0.95 1.09 0.32 0.47 0.05 2.36 2.50 1.73 1.88 XXX 99395 ......... ............ N Prev visit, est, age 18–39 ............................. 1.36 0.95 1.11 0.32 0.47 0.05 2.36 2.52 1.73 1.88 XXX 99396 ......... ............ N Prev visit, est, age 40–64 ............................. 1.53 0.99 1.19 0.36 0.53 0.06 2.58 2.78 1.95 2.12 XXX 99397 ......... ............ N Prev visit, est, 65 & over ............................... 1.71 1.13 1.30 0.40 0.60 0.06 2.90 3.07 2.17 2.37 XXX 99401 ......... ............ N Preventive counseling, indiv .......................... 0.48 0.36 0.56 0.11 0.17 0.01 0.85 1.05 0.60 0.66 XXX 99402 ......... ............ N Preventive counseling, indiv .......................... 0.98 0.48 0.77 0.23 0.34 0.02 1.48 1.77 1.23 1.34 XXX 99403 ......... ............ N Preventive counseling, indiv .......................... 1.46 0.59 0.97 0.34 0.51 0.04 2.09 2.47 1.84 2.01 XXX 99404 ......... ............ N Preventive counseling, indiv .......................... 1.95 0.71 1.17 0.45 0.68 0.05 2.71 3.17 2.45 2.68 XXX 99411 ......... ............ N Preventive counseling, group ........................ 0.15 0.22 0.19 0.03 0.05 0.01 0.38 0.35 0.19 0.21 XXX 99412 ......... ............ N Preventive counseling, group ........................ 0.25 0.25 0.25 0.06 0.09 0.01 0.51 0.51 0.32 0.35 XXX 99431 ......... ............ A Initial care, normal newborn .......................... 1.17 NA NA 0.27 0.35 0.05 NA NA 1.49 1.57 XXX99432 ......... ............ A Newborn care, not in hosp ............................ 1.26 1.02 0.95 0.29 0.37 0.07 2.35 2.28 1.62 1.70 XXX 99433 ......... ............ A Normal newborn care/hospital ...................... 0.62 NA NA 0.14 0.19 0.02 NA NA 0.78 0.83 XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

49234 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM B.

—

RELATIVE

VALUE

UNITS (RVU

S) AND

RELATED INFORMATION

USED IN

DETERMINING

MEDICARE

PAYMENTS

FOR 2007

—Continued 

CPT1/ 

HCPCS2 Mod Status Description 

Physician 

Work 

RVUs 

Fully Implemented NonFacility 

PE RVUs 

Year 

2007 

Transitional 

Non-Facility PE 

RVUs 

Fully Implemented Facility PE 

RVUs 

Year 

2007 

Transitional Facility PE 

RVUs 

Mal-Practice RVUs 

Fully Implemented NonFacility 

Total 

Year 

2007 

Transitional 

Non-Facility Total 

Fully Implemented Facility Total Year 2007 Transi- tional Fa- cility Total Global 

99435 ......... ............ A Newborn discharge day hosp ....................... 1.50 NA NA 0.47 0.56 0.06 NA NA 2.03 2.12 XXX 99436 ......... ............ A Attendance, birth ........................................... 1.50 NA NA 0.35 0.44 0.06 NA NA 1.91 2.00 XXX 99440 ......... ............ A Newborn resuscitation ................................... 2.93 NA NA 0.68 0.87 0.12 NA NA 3.73 3.92 XXX 99499 ......... ............ C Unlisted e&m service .................................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0101 ......... ............ A CA screen;pelvic/breast exam ...................... 0.45 0.49 0.51 NA NA 0.02 0.96 0.98 NA NA XXX G0102 ......... ............ A Prostate ca screening; dre ............................ 0.17 0.33 0.38 0.06 0.06 0.01 0.51 0.56 0.24 0.24 XXX G0104 ......... ............ A CA screen;flexi sigmoidscope ....................... 0.96 2.49 2.33 0.61 0.53 0.08 3.53 3.37 1.65 1.57 000 G0105 ......... ............ A Colorectal scrn; hi risk ind ............................. 3.69 6.36 6.20 1.81 1.56 0.30 10.35 10.19 5.80 5.55 000 G0105 ......... 53 ....... A Colorectal scrn; hi risk ind ............................. 0.96 2.49 2.33 0.61 0.53 0.08 3.53 3.37 1.65 1.57 000 G0106 ......... ............ A Colon CA screen;barium enema ................... 0.99 4.94 3.15 NA NA 0.17 6.10 4.31 NA NA XXX G0106 ......... 26 ....... A Colon CA screen;barium enema ................... 0.99 0.31 0.32 0.31 0.32 0.04 1.34 1.35 1.34 1.35 XXX G0106 ......... TC ...... A Colon CA screen;barium enema ................... 0.00 4.63 2.83 NA NA 0.13 4.76 2.96 NA NA XXX G0108 ......... ............ A Diab manage trn per indiv ............................. 0.00 0.59 0.77 NA NA 0.01 0.60 0.78 NA NA XXXG0109 ......... ............ A Diab manage trn ind/group ........................... 0.00 0.31 0.44 NA NA 0.01 0.32 0.45 NA NA XXX G0117 ......... ............ T Glaucoma scrn hgh risk direc ....................... 0.45 0.80 0.74 NA NA 0.01 1.26 1.20 NA NA XXX G0118 ......... ............ T Glaucoma scrn hgh risk direc ....................... 0.17 0.79 0.60 NA NA 0.01 0.97 0.78 NA NA XXX G0120 ......... ............ A Colon ca scrn; barium enema ....................... 0.99 4.94 3.15 NA NA 0.17 6.10 4.31 NA NA XXX G0120 ......... 26 ....... A Colon ca scrn; barium enema ....................... 0.99 0.31 0.32 0.31 0.32 0.04 1.34 1.35 1.34 1.35 XXX G0120 ......... TC ...... A Colon ca scrn; barium enema ....................... 0.00 4.63 2.83 NA NA 0.13 4.76 2.96 NA NA XXX G0121 ......... ............ A Colon ca scrn not hi rsk ind .......................... 3.69 6.36 6.20 1.81 1.56 0.30 10.35 10.19 5.80 5.55 000 G0121 ......... 53 ....... A Colon ca scrn not hi rsk ind .......................... 0.96 2.49 2.33 0.61 0.53 0.08 3.53 3.37 1.65 1.57 000 G0122 ......... ............ N Colon ca scrn; barium enema ....................... 0.99 5.69 3.35 NA NA 0.18 6.86 4.52 NA NA XXX G0122 ......... 26 ....... N Colon ca scrn; barium enema ....................... 0.99 0.23 0.34 0.23 0.34 0.05 1.27 1.38 1.27 1.38 XXX G0122 ......... TC ...... N Colon ca scrn; barium enema ....................... 0.00 5.46 3.01 NA NA 0.13 5.59 3.14 NA NA XXX G0124 ......... ............ A Screen c/v thin layer by MD .......................... 0.42 0.38 0.21 0.38 0.21 0.02 0.82 0.65 0.82 0.65 XXX G0127 ......... ............ R Trim nail(s) .................................................... 0.17 0.39 0.29 0.04 0.06 0.01 0.57 0.47 0.22 0.24 000 G0128 ......... ............ R CORF skilled nursing service ........................ 0.08 0.02 0.03 0.02 0.03 0.01 0.11 0.12 0.11 0.12 XXX G0130 ......... ............ A Single energy x-ray study ............................. 0.22 0.55 0.79 NA NA 0.06 0.83 1.07 NA NA XXXG0130 ......... 26 ....... A Single energy x-ray study ............................. 0.22 0.06 0.07 0.06 0.07 0.01 0.29 0.30 0.29 0.30 XXX G0130 ......... TC ...... A Single energy x-ray study ............................. 0.00 0.49 0.72 NA NA 0.05 0.54 0.77 NA NA XXX G0141 ......... ............ A Scr c/v cyto,autosys and md ......................... 0.42 0.38 0.21 0.38 0.21 0.02 0.82 0.65 0.82 0.65 XXX G0166 ......... ............ A Extrnl counterpulse, per tx ............................ 0.07 4.56 3.82 NA NA 0.01 4.64 3.90 NA NA XXX G0168 ......... ............ A Wound closure by adhesive .......................... 0.45 1.57 1.84 0.21 0.22 0.03 2.05 2.32 0.69 0.70 000 G0179 ......... ............ A MD recertification HHA PT ............................ 0.45 0.48 0.89 NA NA 0.02 0.95 1.36 NA NA XXX G0180 ......... ............ A MD certification HHA patient ......................... 0.67 0.56 1.09 NA NA 0.03 1.26 1.79 NA NA XXX G0181 ......... ............ A Home health care supervision ...................... 1.73 0.81 1.31 NA NA 0.07 2.61 3.11 NA NA XXX G0182 ......... ............ A Hospice care supervision .............................. 1.73 0.83 1.45 NA NA 0.07 2.63 3.25 NA NA XXXG0186 ......... ............ C Dstry eye lesn,fdr vssl tech ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 YYY G0202 ......... ............ A Screeningmammographydigital ..................... 0.70 2.82 2.78 NA NA 0.10 3.62 3.58 NA NA XXX G0202 ......... 26 ....... A Screeningmammographydigital ..................... 0.70 0.24 0.23 0.24 0.23 0.03 0.97 0.96 0.97 0.96 XXX G0202 ......... TC ...... A Screeningmammographydigital ..................... 0.00 2.58 2.55 NA NA 0.07 2.65 2.62 NA NA XXX G0204 ......... ............ A Diagnosticmammographydigital .................... 0.87 3.42 2.94 NA NA 0.11 4.40 3.92 NA NA XXX G0204 ......... 26 ....... A Diagnosticmammographydigital .................... 0.87 0.30 0.29 0.30 0.29 0.04 1.21 1.20 1.21 1.20 XXX G0204 ......... TC ...... A Diagnosticmammographydigital .................... 0.00 3.12 2.66 NA NA 0.07 3.19 2.73 NA NA XXX G0206 ......... ............ A Diagnosticmammographydigital .................... 0.70 2.68 2.36 NA NA 0.09 3.47 3.15 NA NA XXX G0206 ......... 26 ....... A Diagnosticmammographydigital .................... 0.70 0.24 0.23 0.24 0.23 0.03 0.97 0.96 0.97 0.96 XXX G0206 ......... TC ...... A Diagnosticmammographydigital .................... 0.00 2.44 2.13 NA NA 0.06 2.50 2.19 NA NA XXX G0237 ......... ............ A Therapeutic procd strg endur ........................ 0.00 0.22 0.41 NA NA 0.02 0.24 0.43 NA NA XXX G0238 ......... ............ A Oth resp proc, indiv ....................................... 0.00 0.23 0.43 NA NA 0.02 0.25 0.45 NA NA XXX G0239 ......... ............ A Oth resp proc, group ..................................... 0.00 0.32 0.33 NA NA 0.02 0.34 0.35 NA NA XXX G0245 ......... ............ R Initial foot exam pt lops ................................. 0.88 0.83 0.80 0.29 0.31 0.04 1.75 1.72 1.21 1.23 XXX G0246 ......... ............ R Followup eval of foot pt lop ........................... 0.45 0.55 0.54 0.15 0.16 0.02 1.02 1.01 0.62 0.63 XXX G0247 ......... ............ R Routine footcare pt w lops ............................ 0.50 0.68 0.56 0.16 0.20 0.02 1.20 1.08 0.68 0.72 ZZZ G0248 ......... ............ R Demonstrate use home inr mon ................... 0.00 3.30 5.78 NA NA 0.01 3.31 5.79 NA NA XXX G0249 ......... ............ R Provide test material,equipm ......................... 0.00 2.38 3.57 NA NA 0.01 2.39 3.58 NA NA XXX G0250 ......... ............ R MD review interpret of test ............................ 0.18 0.08 0.07 NA NA 0.01 0.27 0.26 NA NA XXX 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49235 

G0252 ......... 26 ....... N PET imaging initial dx ................................... 1.50 0.35 0.54 0.35 0.54 0.04 1.89 2.08 1.89 2.08 XXX G0268 ......... ............ A Removal of impacted wax md ....................... 0.61 0.60 0.62 0.17 0.22 0.02 1.23 1.25 0.80 0.85 000 G0270 ......... ............ A MNT subs tx for change dx ........................... 0.37 0.10 0.38 0.09 0.38 0.01 0.48 0.76 0.47 0.76 XXX G0271 ......... ............ A Group MNT 2 or more 30 mins ..................... 0.25 0.06 0.15 0.06 0.15 0.01 0.32 0.41 0.32 0.41 XXX G0275 ......... ............ A Renal angio, cardiac cath ............................. 0.25 NA NA 0.14 0.11 0.01 NA NA 0.40 0.37 ZZZG0278 ......... ............ A Iliac art angio,cardiac cath ............................ 0.25 NA NA 0.14 0.11 0.01 NA NA 0.40 0.37 ZZZ G0281 ......... ............ A Elec stim unattend for press ......................... 0.18 0.15 0.12 NA NA 0.01 0.34 0.31 NA NA XXX G0283 ......... ............ A Elec stim other than wound .......................... 0.18 0.15 0.12 NA NA 0.01 0.34 0.31 NA NA XXX G0288 ......... ............ A Recon, CTA for surg plan ............................. 0.00 0.99 8.21 NA NA 0.18 1.17 8.39 NA NA XXX G0289 ......... ............ A Arthro, loose body + chondro ....................... 1.48 NA NA 0.59 0.75 0.26 NA NA 2.33 2.49 ZZZ G0308 ......... ............ A ESRD related svc 4+mo < 2yrs .................... 12.74 5.52 7.79 5.52 7.79 0.42 18.68 20.95 18.68 20.95 XXX G0309 ......... ............ A ESRD related svc 2–3mo <2yrs ................... 10.61 4.80 6.53 4.80 6.53 0.36 15.77 17.50 15.77 17.50 XXX G0310 ......... ............ A ESRD related svc 1 vst <2yrs ....................... 8.49 2.87 4.98 2.87 4.98 0.28 11.64 13.75 11.64 13.75 XXX G0311 ......... ............ A ESRD related svs 4+mo 2–11yr ................... 9.73 3.59 4.44 3.59 4.44 0.34 13.66 14.51 13.66 14.51 XXX G0312 ......... ............ A ESRD relate svs 2–3 mo 2–11y ................... 8.11 2.67 3.61 2.67 3.61 0.29 11.07 12.01 11.07 12.01 XXX G0313 ......... ............ A ESRD related svs 1 mon 2–11y ................... 6.49 1.86 2.82 1.86 2.82 0.22 8.57 9.53 8.57 9.53 XXX G0314 ......... ............ A ESRD related svs 4+ mo 12–19 ................... 8.28 3.43 4.17 3.43 4.17 0.27 11.98 12.72 11.98 12.72 XXX G0315 ......... ............ A ESRD related svs 2–3mo/12–19 ................... 6.90 2.61 3.41 2.61 3.41 0.23 9.74 10.54 9.74 10.54 XXX G0316 ......... ............ A ESRD related svs 1vis/12–19y ..................... 5.52 1.69 2.63 1.69 2.63 0.17 7.38 8.32 7.38 8.32 XXX G0317 ......... ............ A ESRD related svs 4+mo 20+yrs ................... 5.09 2.27 2.71 2.27 2.71 0.17 7.53 7.97 7.53 7.97 XXX G0318 ......... ............ A ESRD related svs 2–3 mo 20+y ................... 4.24 1.71 2.21 1.71 2.21 0.14 6.09 6.59 6.09 6.59 XXX G0319 ......... ............ A ESRD related svs 1visit 20+y ....................... 3.39 1.14 1.71 1.14 1.71 0.11 4.64 5.21 4.64 5.21 XXX G0320 ......... ............ A ESD related svs home undr 2 ....................... 10.61 2.68 6.00 2.68 6.00 0.36 13.65 16.97 13.65 16.97 XXX G0321 ......... ............ A ESRDrelatedsvs home mo 2–11y ................. 8.11 1.99 3.44 1.99 3.44 0.29 10.39 11.84 10.39 11.84 XXX G0322 ......... ............ A ESRD related svs hom mo12–19 ................. 6.90 1.73 3.19 1.73 3.19 0.23 8.86 10.32 8.86 10.32 XXX G0323 ......... ............ A ESRD related svs home mo 20+ .................. 4.24 1.16 2.08 1.16 2.08 0.14 5.54 6.46 5.54 6.46 XXXG0324 ......... ............ A ESRD relate svs home/dy <2yr .................... 0.35 0.16 0.22 0.16 0.22 0.01 0.52 0.58 0.52 0.58 XXX G0325 ......... ............ A ESRD relate home/day/ 2–11yr .................... 0.23 0.09 0.11 0.09 0.11 0.01 0.33 0.35 0.33 0.35 XXX G0326 ......... ............ A ESRD relate home/dy 12–19yr ..................... 0.27 0.10 0.12 0.10 0.12 0.01 0.38 0.40 0.38 0.40 XXX G0327 ......... ............ A ESRD relate home/dy 20+yrs ....................... 0.14 0.06 0.08 0.06 0.08 0.01 0.21 0.23 0.21 0.23 XXX G0329 ......... ............ A Electromagntic tx for ulcers ........................... 0.06 0.16 0.15 NA NA 0.01 0.23 0.22 NA NA XXX G0332 ......... ............ D Preadmin IV immunoglobulin ........................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0337 ......... ............ X Hospice evaluation preelecti ......................... 1.34 0.31 0.46 0.31 0.46 0.09 1.74 1.89 1.74 1.89 XXX G0339 ......... ............ C Robot lin-radsurg com, first ........................... 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0340 ......... ............ C Robt lin-radsurg fractx 2–5 ............................ 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 XXX G0341 ......... ............ A Percutaneous islet celltrans .......................... 6.98 NA NA 2.14 2.48 0.48 NA NA 9.60 9.94 000G0342 ......... ............ A Laparoscopy islet cell trans ........................... 11.92 NA NA 5.13 5.25 1.46 NA NA 18.51 18.63 090 G0343 ......... ............ A Laparotomy islet cell transp .......................... 19.85 NA NA 8.69 8.74 2.06 NA NA 30.60 30.65 090 G0344 ......... ............ A Initial preventive exam .................................. 1.34 1.10 1.12 0.42 0.47 0.10 2.54 2.56 1.86 1.91 XXX G0364 ......... ............ A Bone marrow aspirate &biopsy ..................... 0.16 0.16 0.15 0.07 0.06 0.04 0.36 0.35 0.27 0.26 ZZZ G0365 ......... ............ A Vessel mapping hemo access ...................... 0.25 5.34 4.33 NA NA 0.25 5.84 4.83 NA NA XXX G0365 ......... 26 ....... A Vessel mapping hemo access ...................... 0.25 0.07 0.09 0.07 0.09 0.02 0.34 0.36 0.34 0.36 XXX G0365 ......... TC ...... A Vessel mapping hemo access ...................... 0.00 5.27 4.24 NA NA 0.23 5.50 4.47 NA NA XXX G0366 ......... ............ A EKG for initial prevent exam ......................... 0.17 0.35 0.47 0.35 0.47 0.03 0.55 0.67 0.55 0.67 XXX G0367 ......... ............ A EKG tracing for initial prev ............................ 0.00 0.28 0.41 NA NA 0.02 0.30 0.43 NA NA XXX G0368 ......... ............ A EKG interpret & report preve ........................ 0.17 0.07 0.06 0.07 0.06 0.01 0.25 0.24 0.25 0.24 XXX G0372 ......... ............ A MD service required for PMD ....................... 0.17 0.04 0.30 0.04 0.06 0.01 0.22 0.48 0.22 0.24 XXX G0375 ......... ............ A Smoke/tobacco counselng 3–10 ................... 0.24 0.07 0.09 0.07 0.09 0.01 0.32 0.34 0.32 0.34 XXX G0376 ......... ............ A Smoke/tobacco counseling >10 .................... 0.48 0.13 0.17 0.13 0.16 0.01 0.62 0.66 0.62 0.65 XXX Gxxx1 ......... ............ A Ultrasound exam AAA screen ....................... 0.58 2.42 1.81 NA NA 0.11 3.11 2.50 NA NA XXX Gxxx1 ......... 26 ....... A Ultrasound exam AAA screen ....................... 0.58 0.19 0.19 0.19 0.19 0.03 0.80 0.80 0.80 0.80 XXXGxxx1 ......... TC ...... A Ultrasound exam AAA screen ....................... 0.00 2.23 1.62 NA NA 0.08 2.31 1.70 NA NA XXX M0064 ........ ............ A Visit for drug monitoring ................................ 0.37 0.89 0.48 0.06 0.11 0.01 1.27 0.86 0.44 0.49 XXX P3001 ......... ............ A Screening pap smear by phys ...................... 0.42 0.38 0.21 0.38 0.21 0.02 0.82 0.65 0.82 0.65 XXX Q0035 ......... ............ A Cardiokymography ........................................ 0.17 0.30 0.41 NA NA 0.03 0.50 0.61 NA NA XXX Q0035 ......... 26 ....... A Cardiokymography ........................................ 0.17 0.05 0.06 0.05 0.06 0.01 0.23 0.24 0.23 0.24 XXX Q0035 ......... TC ...... A Cardiokymography ........................................ 0.00 0.25 0.36 NA NA 0.02 0.27 0.38 NA NA XXX Q0091 ......... ............ A Obtaining screen pap smear ......................... 0.37 0.76 0.69 0.10 0.13 0.02 1.15 1.08 0.49 0.52 XXX Q0092 ......... ............ A Set up port xray equipment ........................... 0.00 0.50 0.37 0.50 0.37 0.01 0.51 0.38 0.51 0.38 XXX Q3001 ......... ............ C Brachytherapy Radioelements ...................... 0.00 0.00 0.00 0.00 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 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 0.00 0.00 0.00 0.00 XXX 

1 CPT codes and descriptors only are copyright 2005 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. 2 Copyright 2005 American Dental Association. All rights reserved. 

mstockstill on PROD1PC63 with PROPOSAL_2

49236 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS

CPT 

Codes Short descriptor 

00100 ....... Anesth, salivary gland 

00102 ....... Anesth, repair of cleft lip 

00103 ....... Anesth, blepharoplasty 

00104 ....... Anesth, electroshock 

00120 ....... Anesth, ear surgery 

00124 ....... Anesth, ear exam 

00126 ....... Anesth, tympanotomy 

00140 ....... Anesth, procedures on eye 

00142 ....... Anesth, lens surgery 

00144 ....... Anesth, corneal transplant 

00145 ....... Anesth, vitreoretinal surg 

00147 ....... Anesth, iridectomy 

00148 ....... Anesth, eye exam 

00160 ....... Anesth, nose/sinus surgery 

00162 ....... Anesth, nose/sinus surgery 

00164 ....... Anesth, biopsy of nose 

00170 ....... Anesth, procedure on mouth 

00172 ....... Anesth, cleft palate repair 

00174 ....... Anesth, pharyngeal surgery 

00176 ....... Anesth, pharyngeal surgery 

00190 ....... Anesth, face/skull bone surg 

00192 ....... Anesth, facial bone surgery 

00210 ....... Anesth, open head surgery 

00212 ....... Anesth, skull drainage 

00214 ....... Anesth, skull drainage 

00215 ....... Anesth, skull repair/fract 

00216 ....... Anesth, head vessel surgery 

00218 ....... Anesth, special head surgery 

00220 ....... Anesth, intrcrn nerve 

00222 ....... Anesth, head nerve surgery 

00300 ....... Anesth, head/neck/ptrunk 

00320 ....... Anesth, neck organ, 1 & over 

00322 ....... Anesth, biopsy of thyroid 

00326 ....... Anesth, larynx/trach, < 1 yr 

00350 ....... Anesth, neck vessel surgery 

00352 ....... Anesth, neck vessel surgery 

00400 ....... Anesth, skin, ext/per/atrunk 

00402 ....... Anesth, surgery of breast 

00404 ....... Anesth, surgery of breast 

00406 ....... Anesth, surgery of breast 

00410 ....... Anesth, correct heart rhythm 

00450 ....... Anesth, surgery of shoulder 

00452 ....... Anesth, surgery of shoulder 

00454 ....... Anesth, collar bone biopsy 

00470 ....... Anesth, removal of rib 

00472 ....... Anesth, chest wall repair 

00474 ....... Anesth, surgery of rib(s) 

00500 ....... Anesth, esophageal surgery 

00520 ....... Anesth, chest procedure 

00522 ....... Anesth, chest lining biopsy 

00524 ....... Anesth, chest drainage 

00528 ....... Anesth, chest partition view 

00529 ....... Anesth, chest partition view 

00530 ....... Anesth, pacemaker insertion 

00532 ....... Anesth, vascular access 

00534 ....... Anesth, cardioverter/defib 

00537 ....... Anesth, cardiac electrophys 

00539 ....... Anesth, trach-bronch reconst 

00540 ....... Anesth, chest surgery 

00541 ....... Anesth, one lung ventilation 

00542 ....... Anesth, release of lung 

00546 ....... Anesth, lung,chest wall surg 

00548 ....... Anesth, trachea,bronchi surg 

00550 ....... Anesth, sternal debridement 

00560 ....... Anesth, heart surg w/o pump 

00561 ....... Anesth, heart surg < age 1 

00562 ....... Anesth, heart surg w/pump 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

00563 ....... Anesth, heart surg w/arrest 

00566 ....... Anesth, cabg w/o pump 

00580 ....... Anesth, heart/lung transplnt 

00600 ....... Anesth, spine, cord surgery 

00604 ....... Anesth, sitting procedure 

00620 ....... Anesth, spine, cord surgery 

00622 ....... Anesth, removal of nerves 

00630 ....... Anesth, spine, cord surgery 

00632 ....... Anesth, removal of nerves 

00634 ....... Anesth for chemonucleolysis 

00635 ....... Anesth, lumbar puncture 

00640 ....... Anesth, spine manipulation 

00670 ....... Anesth, spine, cord surgery 

00700 ....... Anesth, abdominal wall surg 

00702 ....... Anesth, for liver biopsy 

00730 ....... Anesth, abdominal wall surg 

00740 ....... Anesth, upper gi visualize 

00750 ....... Anesth, repair of hernia 

00752 ....... Anesth, repair of hernia 

00754 ....... Anesth, repair of hernia 

00756 ....... Anesth, repair of hernia 

00770 ....... Anesth, blood vessel repair 

00790 ....... Anesth, surg upper abdomen 

00792 ....... Anesth, hemorr/excise liver 

00794 ....... Anesth, pancreas removal 

00796 ....... Anesth, for liver transplant 

00797 ....... Anesth, surgery for obesity 

00800 ....... Anesth, abdominal wall surg 

00802 ....... Anesth, fat layer removal 

00810 ....... Anesth, low intestine scope 

00820 ....... Anesth, abdominal wall surg 

00830 ....... Anesth, repair of hernia 

00832 ....... Anesth, repair of hernia 

00834 ....... Anesth, hernia repair < 1 yr 

00836 ....... Anesth hernia repair preemie 

00840 ....... Anesth, surg lower abdomen 

00842 ....... Anesth, amniocentesis 

00844 ....... Anesth, pelvis surgery 

00846 ....... Anesth, hysterectomy 

00848 ....... Anesth, pelvic organ surg 

00851 ....... Anesth, tubal ligation 

00860 ....... Anesth, surgery of abdomen 

00862 ....... Anesth, kidney/ureter surg 

00864 ....... Anesth, removal of bladder 

00865 ....... Anesth, removal of prostate 

00866 ....... Anesth, removal of adrenal 

00868 ....... Anesth, kidney transplant 

00870 ....... Anesth, bladder stone surg 

00872 ....... Anesth kidney stone destruct 

00873 ....... Anesth kidney stone destruct 

00880 ....... Anesth, abdomen vessel surg 

00882 ....... Anesth, major vein ligation 

00902 ....... Anesth, anorectal surgery 

00904 ....... Anesth, perineal surgery 

00906 ....... Anesth, removal of vulva 

00908 ....... Anesth, removal of prostate 

00910 ....... Anesth, bladder surgery 

00912 ....... Anesth, bladder tumor surg 

00914 ....... Anesth, removal of prostate 

00916 ....... Anesth, bleeding control 

00918 ....... Anesth, stone removal 

00920 ....... Anesth, genitalia surgery 

00921 ....... Anesth, vasectomy 

00922 ....... Anesth, sperm duct surgery 

00924 ....... Anesth, testis exploration 

00926 ....... Anesth, removal of testis 

00928 ....... Anesth, removal of testis 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

00930 ....... Anesth, testis suspension 

00932 ....... Anesth, amputation of penis 

00934 ....... Anesth, penis, nodes removal 

00936 ....... Anesth, penis, nodes removal 

00938 ....... Anesth, insert penis device 

00940 ....... Anesth, vaginal procedures 

00942 ....... Anesth, surg on vag/urethral 

00944 ....... Anesth, vaginal hysterectomy 

00948 ....... Anesth, repair of cervix 

00950 ....... Anesth, vaginal endoscopy 

00952 ....... Anesth, hysteroscope/graph 

01112 ....... Anesth, bone aspirate/bx 

01120 ....... Anesth, pelvis surgery 

01130 ....... Anesth, body cast procedure 

01140 ....... Anesth, amputation at pelvis 

01150 ....... Anesth, pelvic tumor surgery 

01160 ....... Anesth, pelvis procedure 

01170 ....... Anesth, pelvis surgery 

01173 ....... Anesth, fx repair, pelvis 

01180 ....... Anesth, pelvis nerve removal 

01190 ....... Anesth, pelvis nerve removal 

01200 ....... Anesth, hip joint procedure 

01202 ....... Anesth, arthroscopy of hip 

01210 ....... Anesth, hip joint surgery 

01212 ....... Anesth, hip disarticulation 

01214 ....... Anesth, hip arthroplasty 

01215 ....... Anesth, revise hip repair 

01220 ....... Anesth, procedure on femur 

01230 ....... Anesth, surgery of femur 

01232 ....... Anesth, amputation of femur 

01234 ....... Anesth, radical femur surg 

01250 ....... Anesth, upper leg surgery 

01260 ....... Anesth, upper leg veins surg 

01270 ....... Anesth, thigh arteries surg 

01272 ....... Anesth, femoral artery surg 

01274 ....... Anesth, femoral embolectomy 

01320 ....... Anesth, knee area surgery 

01340 ....... Anesth, knee area procedure 

01360 ....... Anesth, knee area surgery 

01380 ....... Anesth, knee joint procedure 

01382 ....... Anesth, dx knee arthroscopy 

01390 ....... Anesth, knee area procedure 

01392 ....... Anesth, knee area surgery 

01400 ....... Anesth, knee joint surgery 

01402 ....... Anesth, knee arthroplasty 

01404 ....... Anesth, amputation at knee 

01420 ....... Anesth, knee joint casting 

01430 ....... Anesth, knee veins surgery 

01432 ....... Anesth, knee vessel surg 

01440 ....... Anesth, knee arteries surg 

01442 ....... Anesth, knee artery surg 

01444 ....... Anesth, knee artery repair 

01462 ....... Anesth, lower leg procedure 

01464 ....... Anesth, ankle/ft arthroscopy 

01470 ....... Anesth, lower leg surgery 

01472 ....... Anesth, achilles tendon surg 

01474 ....... Anesth, lower leg surgery 

01480 ....... Anesth, lower leg bone surg 

01482 ....... Anesth, radical leg surgery 

01484 ....... Anesth, lower leg revision 

01486 ....... Anesth, ankle replacement 

01490 ....... Anesth, lower leg casting 

01500 ....... Anesth, leg arteries surg 

01502 ....... Anesth, lwr leg embolectomy 

01520 ....... Anesth, lower leg vein surg 

01522 ....... Anesth, lower leg vein surg 

01610 ....... Anesth, surgery of shoulder 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49237 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

01620 ....... Anesth, shoulder procedure 

01622 ....... Anes dx shoulder arthroscopy 

01630 ....... Anesth, surgery of shoulder 

01632 ....... Anesth, surgery of shoulder 

01634 ....... Anesth, shoulder joint amput 

01636 ....... Anesth, forequarter amput 

01638 ....... Anesth, shoulder replacement 

01650 ....... Anesth, shoulder artery surg 

01652 ....... Anesth, shoulder vessel surg 

01654 ....... Anesth, shoulder vessel surg 

01656 ....... Anesth, arm-leg vessel surg 

01670 ....... Anesth, shoulder vein surg 

01680 ....... Anesth, shoulder casting 

01682 ....... Anesth, airplane cast 

01710 ....... Anesth, elbow area surgery 

01712 ....... Anesth, uppr arm tendon surg 

01714 ....... Anesth, uppr arm tendon surg 

01716 ....... Anesth, biceps tendon repair 

01730 ....... Anesth, uppr arm procedure 

01732 ....... Anesth, dx elbow arthroscopy 

01740 ....... Anesth, upper arm surgery 

01742 ....... Anesth, humerus surgery 

01744 ....... Anesth, humerus repair 

01756 ....... Anesth, radical humerus surg 

01758 ....... Anesth, humeral lesion surg 

01760 ....... Anesth, elbow replacement 

01770 ....... Anesth, uppr arm artery surg 

01772 ....... Anesth, uppr arm embolectomy 

01780 ....... Anesth, upper arm vein surg 

01782 ....... Anesth, uppr arm vein repair 

01810 ....... Anesth, lower arm surgery 

01820 ....... Anesth, lower arm procedure 

01829 ....... Anesth, dx wrist arthroscopy 

01830 ....... Anesth, lower arm surgery 

01832 ....... Anesth, wrist replacement 

01840 ....... Anesth, lwr arm artery surg 

01842 ....... Anesth, lwr arm embolectomy 

01844 ....... Anesth, vascular shunt surg 

01850 ....... Anesth, lower arm vein surg 

01852 ....... Anesth, lwr arm vein repair 

01860 ....... Anesth, lower arm casting 

01905 ....... Anes, spine inject, x-ray/re 

01916 ....... Anesth, dx arteriography 

01920 ....... Anesth, catheterize heart 

01922 ....... Anesth, cat or mri scan 

01924 ....... Anes, ther interven rad, art 

01925 ....... Anes, ther interven rad, car 

01926 ....... Anes, tx interv rad hrt/cran 

01930 ....... Anes, ther interven rad, vei 

01931 ....... Anes, ther interven rad, tip 

01932 ....... Anes, tx interv rad, th vein 

01933 ....... Anes, tx interv rad, cran v 

01951 ....... Anesth, burn, less 4 percent 

01952 ....... Anesth, burn, 4–9 percent 

01953 ....... Anesth, burn, each 9 percent 

01958 ....... Anesth, antepartum manipul 

01960 ....... Anesth, vaginal delivery 

01961 ....... Anesth, cs delivery 

01962 ....... Anesth, emer hysterectomy 

01963 ....... Anesth, cs hysterectomy 

01965 ....... Anesth, inc/missed ab proc 

01966 ....... Anesth, induced ab procedure 

01967 ....... Anesth/analg, vag delivery 

01968 ....... Anes/analg cs deliver add-on 

01969 ....... Anesth/analg cs hyst add-on 

01990 ....... Support for organ donor 

01991 ....... Anesth, nerve block/inj 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

01992 ....... Anesth, n block/inj, prone 

01995 ....... Regional anesthesia limb 

01996 ....... Hosp manage cont drug admin 

01999 ....... Unlisted anesth procedure 

23500 ....... Treat clavicle fracture 

23680 ....... Treat dislocation/fracture 

24130 ....... Removal of head of radius 

24134 ....... Removal of arm bone lesion 

24136 ....... Remove radius bone lesion 

24138 ....... Remove elbow bone lesion 

24140 ....... Partial removal of arm bone 

24145 ....... Partial removal of radius 

24147 ....... Partial removal of elbow 

24495 ....... Decompression of forearm 

24500 ....... Treat humerus fracture 

24500 ....... Treat humerus fracture 

24505 ....... Treat humerus fracture 

24515 ....... Treat humerus fracture 

24516 ....... Treat humerus fracture 

24530 ....... Treat humerus fracture 

24535 ....... Treat humerus fracture 

24538 ....... Treat humerus fracture 

24545 ....... Treat humerus fracture 

24546 ....... Treat humerus fracture 

24560 ....... Treat humerus fracture 

24565 ....... Treat humerus fracture 

24566 ....... Treat humerus fracture 

24575 ....... Treat humerus fracture 

24576 ....... Treat humerus fracture 

24577 ....... Treat humerus fracture 

24579 ....... Treat humerus fracture 

24582 ....... Treat humerus fracture 

24586 ....... Treat elbow fracture 

24587 ....... Treat elbow fracture 

24600 ....... Treat elbow dislocation 

24605 ....... Treat elbow dislocation 

24615 ....... Treat elbow dislocation 

24620 ....... Treat elbow fracture 

24635 ....... Treat elbow fracture 

24640 ....... Treat elbow dislocation 

24650 ....... Treat radius fracture 

24655 ....... Treat radius fracture 

24665 ....... Treat radius fracture 

24666 ....... Treat radius fracture 

24670 ....... Treat ulnar fracture 

24675 ....... Treat ulnar fracture 

24685 ....... Treat ulnar fracture 

25000 ....... Incision of tendon sheath 

25020 ....... Decompress forearm 1 space 

25023 ....... Decompress forearm 1 space 

25028 ....... Drainage of forearm lesion 

25031 ....... Drainage of forearm bursa 

25035 ....... Treat forearm bone lesion 

25040 ....... Explore/treat wrist joint 

25066 ....... Biopsy forearm soft tissues 

25075 ....... Removal forearm lesion subcu 

25076 ....... Removal forearm lesion deep 

25077 ....... Remove tumor, forearm/wrist 

25085 ....... Incision of wrist capsule 

25100 ....... Biopsy of wrist joint 

25101 ....... Explore/treat wrist joint 

25105 ....... Remove wrist joint lining 

25107 ....... Remove wrist joint cartilage 

25110 ....... Remove wrist tendon lesion 

25111 ....... Remove wrist tendon lesion 

25112 ....... Reremove wrist tendon lesion 

25115 ....... Remove wrist/forearm lesion 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

25116 ....... Remove wrist/forearm lesion 

25118 ....... Excise wrist tendon sheath 

25119 ....... Partial removal of ulna 

25120 ....... Removal of forearm lesion 

25125 ....... Remove/graft forearm lesion 

25126 ....... Remove/graft forearm lesion 

25130 ....... Removal of wrist lesion 

25135 ....... Remove & graft wrist lesion 

25136 ....... Remove & graft wrist lesion 

25145 ....... Remove forearm bone lesion 

25150 ....... Partial removal of ulna 

25151 ....... Partial removal of radius 

25170 ....... Extensive forearm surgery 

25210 ....... Removal of wrist bone 

25215 ....... Removal of wrist bones 

25230 ....... Partial removal of radius 

25240 ....... Partial removal of ulna 

25248 ....... Remove forearm foreign body 

25260 ....... Repair forearm tendon/muscle 

25263 ....... Repair forearm tendon/muscle 

25265 ....... Repair forearm tendon/muscle 

25270 ....... Repair forearm tendon/muscle 

25272 ....... Repair forearm tendon/muscle 

25274 ....... Repair forearm tendon/muscle 

25280 ....... Revise wrist/forearm tendon 

25290 ....... Incise wrist/forearm tendon 

25295 ....... Release wrist/forearm tendon 

25300 ....... Fusion of tendons at wrist 

25301 ....... Fusion of tendons at wrist 

25310 ....... Transplant forearm tendon 

25312 ....... Transplant forearm tendon 

25315 ....... Revise palsy hand tendon(s) 

25316 ....... Revise palsy hand tendon(s) 

25320 ....... Repair/revise wrist joint 

25335 ....... Realignment of hand 

25337 ....... Reconstruct ulna/radioulnar 

25350 ....... Revision of radius 

25355 ....... Revision of radius 

25360 ....... Revision of ulna 

25365 ....... Revise radius & ulna 

25370 ....... Revise radius or ulna 

25375 ....... Revise radius & ulna 

25390 ....... Shorten radius or ulna 

25391 ....... Lengthen radius or ulna 

25392 ....... Shorten radius & ulna 

25393 ....... Lengthen radius & ulna 

25400 ....... Repair radius or ulna 

25405 ....... Repair/graft radius or ulna 

25415 ....... Repair radius & ulna 

25420 ....... Repair/graft radius & ulna 

25425 ....... Repair/graft radius or ulna 

25426 ....... Repair/graft radius & ulna 

25440 ....... Repair/graft wrist bone 

25450 ....... Revision of wrist joint 

25455 ....... Revision of wrist joint 

25490 ....... Reinforce radius 

25491 ....... Reinforce ulna 

25492 ....... Reinforce radius and ulna 

25500 ....... Treat fracture of radius 

25505 ....... Treat fracture of radius 

25515 ....... Treat fracture of radius 

25520 ....... Treat fracture of radius 

25525 ....... Treat fracture of radius 

25526 ....... Treat fracture of radius 

25530 ....... Treat fracture of ulna 

25535 ....... Treat fracture of ulna 

25545 ....... Treat fracture of ulna 

mstockstill on PROD1PC63 with PROPOSAL_2

49238 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

25560 ....... Treat fracture radius & ulna 

25565 ....... Treat fracture radius & ulna 

25574 ....... Treat fracture radius & ulna 

25575 ....... Treat fracture radius/ulna 

25600 ....... Treat fracture radius/ulna 

25605 ....... Treat fracture radius/ulna 

25611 ....... Treat fracture radius/ulna 

25620 ....... Treat fracture radius/ulna 

25622 ....... Treat wrist bone fracture 

25624 ....... Treat wrist bone fracture 

25628 ....... Treat wrist bone fracture 

25630 ....... Treat wrist bone fracture 

25635 ....... Treat wrist bone fracture 

25645 ....... Treat wrist bone fracture 

25650 ....... Treat wrist bone fracture 

25651 ....... Pin ulnar styloid fracture 

25652 ....... Treat fracture ulnar styloid 

25660 ....... Treat wrist dislocation 

25670 ....... Treat wrist dislocation 

25671 ....... Pin radioulnar dislocation 

25675 ....... Treat wrist dislocation 

25676 ....... Treat wrist dislocation 

25680 ....... Treat wrist fracture 

25685 ....... Treat wrist fracture 

25690 ....... Treat wrist dislocation 

25695 ....... Treat wrist dislocation 

25800 ....... Fusion of wrist joint 

25805 ....... Fusion/graft of wrist joint 

25810 ....... Fusion/graft of wrist joint 

25820 ....... Fusion of hand bones 

25825 ....... Fuse hand bones with graft 

25830 ....... Fusion, radioulnar jnt/ulna 

25900 ....... Amputation of forearm 

25905 ....... Amputation of forearm 

25907 ....... Amputation follow-up surgery 

25909 ....... Amputation follow-up surgery 

25915 ....... Amputation of forearm 

25920 ....... Amputate hand at wrist 

25922 ....... Amputate hand at wrist 

25924 ....... Amputation follow-up surgery 

25927 ....... Amputation of hand 

25929 ....... Amputation follow-up surgery 

25931 ....... Amputation follow-up surgery 

26350 ....... Repair finger/hand tendon 

26352 ....... Repair/graft hand tendon 

26356 ....... Repair finger/hand tendon 

26357 ....... Repair finger/hand tendon 

26358 ....... Repair/graft hand tendon 

26370 ....... Repair finger/hand tendon 

26372 ....... Repair/graft hand tendon 

26373 ....... Repair finger/hand tendon 

26390 ....... Revise hand/finger tendon 

26392 ....... Repair/graft hand tendon 

26410 ....... Repair hand tendon 

26412 ....... Repair/graft hand tendon 

26415 ....... Excision, hand/finger tendon 

26416 ....... Graft hand or finger tendon 

26418 ....... Repair finger tendon 

26420 ....... Repair/graft finger tendon 

26426 ....... Repair finger/hand tendon 

26428 ....... Repair/graft finger tendon 

26432 ....... Repair finger tendon 

26433 ....... Repair finger tendon 

26434 ....... Repair/graft finger tendon 

26437 ....... Realignment of tendons 

26440 ....... Release palm/finger tendon 

26442 ....... Release palm & finger tendon 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

26445 ....... Release hand/finger tendon 

26449 ....... Release forearm/hand tendon 

26450 ....... Incision of palm tendon 

26455 ....... Incision of finger tendon 

26460 ....... Incise hand/finger tendon 

26471 ....... Fusion of finger tendons 

26474 ....... Fusion of finger tendons 

26476 ....... Tendon lengthening 

26477 ....... Tendon shortening 

26478 ....... Lengthening of hand tendon 

26479 ....... Shortening of hand tendon 

26480 ....... Transplant hand tendon 

26483 ....... Transplant/graft hand tendon 

26485 ....... Transplant palm tendon 

26489 ....... Transplant/graft palm tendon 

26490 ....... Revise thumb tendon 

26492 ....... Tendon transfer with graft 

26494 ....... Hand tendon/muscle transfer 

26496 ....... Revise thumb tendon 

26497 ....... Finger tendon transfer 

26498 ....... Finger tendon transfer 

26499 ....... Revision of finger 

26500 ....... Hand tendon reconstruction 

26502 ....... Hand tendon reconstruction 

26504 ....... Hand tendon reconstruction 

26508 ....... Release thumb contracture 

26510 ....... Thumb tendon transfer 

26516 ....... Fusion of knuckle joint 

26517 ....... Fusion of knuckle joints 

26518 ....... Fusion of knuckle joints 

26520 ....... Release knuckle contracture 

26525 ....... Release finger contracture 

26536 ....... Revise/implant finger joint 

26540 ....... Repair hand joint 

26541 ....... Repair hand joint with graft 

26542 ....... Repair hand joint with graft 

26545 ....... Reconstruct finger joint 

26548 ....... Reconstruct finger joint 

26550 ....... Construct thumb replacement 

26555 ....... Positional change of finger 

26560 ....... Repair of web finger 

26561 ....... Repair of web finger 

26562 ....... Repair of web finger 

26565 ....... Correct metacarpal flaw 

26567 ....... Correct finger deformity 

26568 ....... Lengthen metacarpal/finger 

26580 ....... Repair hand deformity 

26590 ....... Repair finger deformity 

26591 ....... Repair muscles of hand 

26593 ....... Release muscles of hand 

26596 ....... Excision constricting tissue 

26600 ....... Treat metacarpal fracture 

26605 ....... Treat metacarpal fracture 

26607 ....... Treat metacarpal fracture 

26608 ....... Treat metacarpal fracture 

26615 ....... Treat metacarpal fracture 

26641 ....... Treat thumb dislocation 

26645 ....... Treat thumb fracture 

26650 ....... Treat thumb fracture 

26665 ....... Treat thumb fracture 

26670 ....... Treat hand dislocation 

26675 ....... Treat hand dislocation 

26676 ....... Pin hand dislocation 

26685 ....... Treat hand dislocation 

26686 ....... Treat hand dislocation 

26700 ....... Treat knuckle dislocation 

26705 ....... Treat knuckle dislocation 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

26706 ....... Pin knuckle dislocation 

26715 ....... Treat knuckle dislocation 

26720 ....... Treat finger fracture, each 

26725 ....... Treat finger fracture, each 

26727 ....... Treat finger fracture, each 

26735 ....... Treat finger fracture, each 

26740 ....... Treat finger fracture, each 

26742 ....... Treat finger fracture, each 

26746 ....... Treat finger fracture, each 

26750 ....... Treat finger fracture, each 

26755 ....... Treat finger fracture, each 

26756 ....... Pin finger fracture, each 

26765 ....... Treat finger fracture, each 

26770 ....... Treat finger dislocation 

26775 ....... Treat finger dislocation 

26776 ....... Pin finger dislocation 

26785 ....... Treat finger dislocation 

26820 ....... Thumb fusion with graft 

26841 ....... Fusion of thumb 

26842 ....... Thumb fusion with graft 

26843 ....... Fusion of hand joint 

26844 ....... Fusion/graft of hand joint 

26850 ....... Fusion of knuckle 

26852 ....... Fusion of knuckle with graft 

26860 ....... Fusion of finger joint 

26862 ....... Fusion/graft of finger joint 

26910 ....... Amputate metacarpal bone 

26951 ....... Amputation of finger/thumb 

26952 ....... Amputation of finger/thumb 

27000 ....... Incision of hip tendon 

27001 ....... Incision of hip tendon 

27003 ....... Incision of hip tendon 

27005 ....... Incision of hip tendon 

27006 ....... Incision of hip tendons 

27025 ....... Incision of hip/thigh fascia 

27030 ....... Drainage of hip joint 

27033 ....... Exploration of hip joint 

27035 ....... Denervation of hip joint 

27041 ....... Biopsy of soft tissues 

27048 ....... Remove hip/pelvis lesion 

27049 ....... Remove tumor, hip/pelvis 

27050 ....... Biopsy of sacroiliac joint 

27052 ....... Biopsy of hip joint 

27054 ....... Removal of hip joint lining 

27060 ....... Removal of ischial bursa 

27062 ....... Remove femur lesion/bursa 

27065 ....... Removal of hip bone lesion 

27066 ....... Removal of hip bone lesion 

27067 ....... Remove/graft hip bone lesion 

27075 ....... Extensive hip surgery 

27076 ....... Extensive hip surgery 

27077 ....... Extensive hip surgery 

27078 ....... Extensive hip surgery 

27079 ....... Extensive hip surgery 

27080 ....... Removal of tail bone 

27087 ....... Remove hip foreign body 

27202 ....... Treat tail bone fracture 

27310 ....... Exploration of knee joint 

27315 ....... Partial removal, thigh nerve 

27320 ....... Partial removal, thigh nerve 

27324 ....... Biopsy, thigh soft tissues 

27328 ....... Removal of thigh lesion 

27329 ....... Remove tumor, thigh/knee 

27330 ....... Biopsy, knee joint lining 

27331 ....... Explore/treat knee joint 

27332 ....... Removal of knee cartilage 

27333 ....... Removal of knee cartilage 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49239 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

27334 ....... Remove knee joint lining 

27335 ....... Remove knee joint lining 

27340 ....... Removal of kneecap bursa 

27345 ....... Removal of knee cyst 

27350 ....... Removal of kneecap 

27355 ....... Remove femur lesion 

27356 ....... Remove femur lesion/graft 

27357 ....... Remove femur lesion/graft 

27365 ....... Extensive leg surgery 

27380 ....... Repair of kneecap tendon 

27381 ....... Repair/graft kneecap tendon 

27385 ....... Repair of thigh muscle 

27386 ....... Repair/graft of thigh muscle 

27455 ....... Realignment of knee 

27500 ....... Treatment of thigh fracture 

27501 ....... Treatment of thigh fracture 

27502 ....... Treatment of thigh fracture 

27506 ....... Treatment of thigh fracture 

27507 ....... Treatment of thigh fracture 

27508 ....... Treatment of thigh fracture 

27509 ....... Treatment of thigh fracture 

27510 ....... Treatment of thigh fracture 

27511 ....... Treatment of thigh fracture 

27513 ....... Treatment of thigh fracture 

27514 ....... Treatment of thigh fracture 

27516 ....... Treat thigh fx growth plate 

27517 ....... Treat thigh fx growth plate 

27519 ....... Treat thigh fx growth plate 

27520 ....... Treat kneecap fracture 

27524 ....... Treat kneecap fracture 

27530 ....... Treat knee fracture 

27532 ....... Treat knee fracture 

27535 ....... Treat knee fracture 

27536 ....... Treat knee fracture 

27538 ....... Treat knee fracture(s) 

27540 ....... Treat knee fracture 

27550 ....... Treat knee dislocation 

27552 ....... Treat knee dislocation 

27556 ....... Treat knee dislocation 

27557 ....... Treat knee dislocation 

27558 ....... Treat knee dislocation 

27560 ....... Treat kneecap dislocation 

27562 ....... Treat kneecap dislocation 

27566 ....... Treat kneecap dislocation 

27580 ....... Fusion of knee 

27590 ....... Amputate leg at thigh 

27591 ....... Amputate leg at thigh 

27592 ....... Amputate leg at thigh 

27594 ....... Amputation follow-up surgery 

27596 ....... Amputation follow-up surgery 

27598 ....... Amputate lower leg at knee 

27600 ....... Decompression of lower leg 

27601 ....... Decompression of lower leg 

27602 ....... Decompression of lower leg 

27607 ....... Treat lower leg bone lesion 

27610 ....... Explore/treat ankle joint 

27612 ....... Exploration of ankle joint 

27615 ....... Remove tumor, lower leg 

27620 ....... Explore/treat ankle joint 

27625 ....... Remove ankle joint lining 

27626 ....... Remove ankle joint lining 

27635 ....... Remove lower leg bone lesion 

27637 ....... Remove/graft leg bone lesion 

27638 ....... Remove/graft leg bone lesion 

27640 ....... Partial removal of tibia 

27641 ....... Partial removal of fibula 

27645 ....... Extensive lower leg surgery 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

27646 ....... Extensive lower leg surgery 

27647 ....... Extensive ankle/heel surgery 

27650 ....... Repair achilles tendon 

27652 ....... Repair/graft achilles tendon 

27654 ....... Repair of achilles tendon 

27675 ....... Repair lower leg tendons 

27676 ....... Repair lower leg tendons 

27680 ....... Release of lower leg tendon 

27681 ....... Release of lower leg tendons 

27687 ....... Revision of calf tendon 

27690 ....... Revise lower leg tendon 

27691 ....... Revise lower leg tendon 

27695 ....... Repair of ankle ligament 

27696 ....... Repair of ankle ligaments 

27698 ....... Repair of ankle ligament 

27705 ....... Incision of tibia 

27707 ....... Incision of fibula 

27709 ....... Incision of tibia & fibula 

27712 ....... Realignment of lower leg 

27715 ....... Revision of lower leg 

27720 ....... Repair of tibia 

27722 ....... Repair/graft of tibia 

27724 ....... Repair/graft of tibia 

27725 ....... Repair of lower leg 

27727 ....... Repair of lower leg 

27734 ....... Repair lower leg epiphyses 

27745 ....... Reinforce tibia 

27750 ....... Treatment of tibia fracture 

27752 ....... Treatment of tibia fracture 

27756 ....... Treatment of tibia fracture 

27758 ....... Treatment of tibia fracture 

27759 ....... Treatment of tibia fracture 

27760 ....... Treatment of ankle fracture 

27762 ....... Treatment of ankle fracture 

27766 ....... Treatment of ankle fracture 

27780 ....... Treatment of fibula fracture 

27781 ....... Treatment of fibula fracture 

27784 ....... Treatment of fibula fracture 

27786 ....... Treatment of ankle fracture 

27788 ....... Treatment of ankle fracture 

27792 ....... Treatment of ankle fracture 

27808 ....... Treatment of ankle fracture 

27810 ....... Treatment of ankle fracture 

27814 ....... Treatment of ankle fracture 

27816 ....... Treatment of ankle fracture 

27818 ....... Treatment of ankle fracture 

27822 ....... Treatment of ankle fracture 

27823 ....... Treatment of ankle fracture 

27824 ....... Treat lower leg fracture 

27825 ....... Treat lower leg fracture 

27826 ....... Treat lower leg fracture 

27827 ....... Treat lower leg fracture 

27828 ....... Treat lower leg fracture 

27829 ....... Treat lower leg joint 

27830 ....... Treat lower leg dislocation 

27831 ....... Treat lower leg dislocation 

27832 ....... Treat lower leg dislocation 

27840 ....... Treat ankle dislocation 

27842 ....... Treat ankle dislocation 

27846 ....... Treat ankle dislocation 

27848 ....... Treat ankle dislocation 

27870 ....... Fusion of ankle joint, open 

27871 ....... Fusion of tibiofibular joint 

27880 ....... Amputation of lower leg 

27881 ....... Amputation of lower leg 

27882 ....... Amputation of lower leg 

27884 ....... Amputation follow-up surgery 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

27886 ....... Amputation follow-up surgery 

27888 ....... Amputation of foot at ankle 

27889 ....... Amputation of foot at ankle 

27892 ....... Decompression of leg 

27893 ....... Decompression of leg 

27894 ....... Decompression of leg 

28030 ....... Removal of foot nerve 

28102 ....... Remove/graft foot lesion 

28106 ....... Remove/graft foot lesion 

28130 ....... Removal of ankle bone 

28309 ....... Incision of metatarsals 

28320 ....... Repair of foot bones 

28400 ....... Treatment of heel fracture 

28405 ....... Treatment of heel fracture 

28406 ....... Treatment of heel fracture 

28415 ....... Treat heel fracture 

28420 ....... Treat/graft heel fracture 

28430 ....... Treatment of ankle fracture 

28435 ....... Treatment of ankle fracture 

28436 ....... Treatment of ankle fracture 

28445 ....... Treat ankle fracture 

28450 ....... Treat midfoot fracture, each 

28455 ....... Treat midfoot fracture, each 

28456 ....... Treat midfoot fracture 

28465 ....... Treat midfoot fracture, each 

28470 ....... Treat metatarsal fracture 

28475 ....... Treat metatarsal fracture 

28476 ....... Treat metatarsal fracture 

28485 ....... Treat metatarsal fracture 

28490 ....... Treat big toe fracture 

28495 ....... Treat big toe fracture 

28496 ....... Treat big toe fracture 

28505 ....... Treat big toe fracture 

28510 ....... Treatment of toe fracture 

28515 ....... Treatment of toe fracture 

28525 ....... Treat toe fracture 

28530 ....... Treat sesamoid bone fracture 

28531 ....... Treat sesamoid bone fracture 

28540 ....... Treat foot dislocation 

28545 ....... Treat foot dislocation 

28546 ....... Treat foot dislocation 

28555 ....... Repair foot dislocation 

28570 ....... Treat foot dislocation 

28575 ....... Treat foot dislocation 

28576 ....... Treat foot dislocation 

28585 ....... Repair foot dislocation 

28600 ....... Treat foot dislocation 

28605 ....... Treat foot dislocation 

28606 ....... Treat foot dislocation 

28615 ....... Repair foot dislocation 

28630 ....... Treat toe dislocation 

28635 ....... Treat toe dislocation 

28636 ....... Treat toe dislocation 

28645 ....... Repair toe dislocation 

28660 ....... Treat toe dislocation 

28665 ....... Treat toe dislocation 

28666 ....... Treat toe dislocation 

28675 ....... Repair of toe dislocation 

28705 ....... Fusion of foot bones 

28715 ....... Fusion of foot bones 

28725 ....... Fusion of foot bones 

28730 ....... Fusion of foot bones 

28735 ....... Fusion of foot bones 

28737 ....... Revision of foot bones 

29000 ....... Application of body cast 

29010 ....... Application of body cast 

29015 ....... Application of body cast 

mstockstill on PROD1PC63 with PROPOSAL_2

49240 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

29020 ....... Application of body cast 

29025 ....... Application of body cast 

29035 ....... Application of body cast 

29040 ....... Application of body cast 

29044 ....... Application of body cast 

29046 ....... Application of body cast 

29049 ....... Application of figure eight 

29055 ....... Application of shoulder cast 

29058 ....... Application of shoulder cast 

29065 ....... Application of long arm cast 

29075 ....... Application of forearm cast 

29085 ....... Apply hand/wrist cast 

29086 ....... Apply finger cast 

29105 ....... Apply long arm splint 

29125 ....... Apply forearm splint 

29126 ....... Apply forearm splint 

29130 ....... Application of finger splint 

29131 ....... Application of finger splint 

29200 ....... Strapping of chest 

29220 ....... Strapping of low back 

29240 ....... Strapping of shoulder 

29260 ....... Strapping of elbow or wrist 

29280 ....... Strapping of hand or finger 

29305 ....... Application of hip cast 

29325 ....... Application of hip casts 

29345 ....... Application of long leg cast 

29355 ....... Application of long leg cast 

29358 ....... Apply long leg cast brace 

29365 ....... Application of long leg cast 

29405 ....... Apply short leg cast 

29425 ....... Apply short leg cast 

29435 ....... Apply short leg cast 

29440 ....... Addition of walker to cast 

29445 ....... Apply rigid leg cast 

29450 ....... Application of leg cast 

29505 ....... Application, long leg splint 

29515 ....... Application lower leg splint 

29520 ....... Strapping of hip 

29530 ....... Strapping of knee 

29540 ....... Strapping of ankle and/or ft 

29550 ....... Strapping of toes 

29580 ....... Application of paste boot 

29590 ....... Application of foot splint 

29700 ....... Removal/revision of cast 

29705 ....... Removal/revision of cast 

29710 ....... Removal/revision of cast 

29715 ....... Removal/revision of cast 

29720 ....... Repair of body cast 

29730 ....... Windowing of cast 

29740 ....... Wedging of cast 

29750 ....... Wedging of clubfoot cast 

29800 ....... Jaw arthroscopy/surgery 

29804 ....... Jaw arthroscopy/surgery 

31760 ....... Repair of windpipe 

31766 ....... Reconstruction of windpipe 

31770 ....... Repair/graft of bronchus 

31775 ....... Reconstruct bronchus 

31780 ....... Reconstruct windpipe 

31781 ....... Reconstruct windpipe 

31785 ....... Remove windpipe lesion 

31786 ....... Remove windpipe lesion 

31805 ....... Repair of windpipe injury 

32035 ....... Exploration of chest 

32036 ....... Exploration of chest 

32095 ....... Biopsy through chest wall 

32100 ....... Exploration/biopsy of chest 

32110 ....... Explore/repair chest 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

32120 ....... Re-exploration of chest 

32124 ....... Explore chest free adhesions 

32140 ....... Removal of lung lesion(s) 

32141 ....... Remove/treat lung lesions 

32150 ....... Removal of lung lesion(s) 

32151 ....... Remove lung foreign body 

32160 ....... Open chest heart massage 

32200 ....... Drain, open, lung lesion 

33015 ....... Incision of heart sac 

33414 ....... Repair of aortic valve 

33415 ....... Revision, subvalvular tissue 

33417 ....... Repair of aortic valve 

33468 ....... Revision of tricuspid valve 

33470 ....... Revision of pulmonary valve 

33471 ....... Valvotomy, pulmonary valve 

33503 ....... Coronary artery graft 

33504 ....... Coronary artery graft 

33505 ....... Repair artery w/tunnel 

33506 ....... Repair artery, translocation 

33600 ....... Closure of valve 

33602 ....... Closure of valve 

33606 ....... Anastomosis/artery-aorta 

33608 ....... Repair anomaly w/conduit 

33610 ....... Repair by enlargement 

33611 ....... Repair double ventricle 

33612 ....... Repair double ventricle 

33615 ....... Repair, modified fontan 

33617 ....... Repair single ventricle 

33619 ....... Repair single ventricle 

33645 ....... Revision of heart veins 

33647 ....... Repair heart septum defects 

33660 ....... Repair of heart defects 

33665 ....... Repair of heart defects 

33670 ....... Repair of heart chambers 

33681 ....... Repair heart septum defect 

33684 ....... Repair heart septum defect 

33688 ....... Repair heart septum defect 

33690 ....... Reinforce pulmonary artery 

33692 ....... Repair of heart defects 

33694 ....... Repair of heart defects 

33697 ....... Repair of heart defects 

33702 ....... Repair of heart defects 

33710 ....... Repair of heart defects 

33720 ....... Repair of heart defect 

33722 ....... Repair of heart defect 

33730 ....... Repair heart-vein defect(s) 

33732 ....... Repair heart-vein defect 

33735 ....... Revision of heart chamber 

33736 ....... Revision of heart chamber 

33737 ....... Revision of heart chamber 

33750 ....... Major vessel shunt 

33755 ....... Major vessel shunt 

33762 ....... Major vessel shunt 

33764 ....... Major vessel shunt & graft 

33766 ....... Major vessel shunt 

33767 ....... Major vessel shunt 

33770 ....... Repair great vessels defect 

33771 ....... Repair great vessels defect 

33774 ....... Repair great vessels defect 

33775 ....... Repair great vessels defect 

33776 ....... Repair great vessels defect 

33777 ....... Repair great vessels defect 

33778 ....... Repair great vessels defect 

33779 ....... Repair great vessels defect 

33780 ....... Repair great vessels defect 

33781 ....... Repair great vessels defect 

33786 ....... Repair arterial trunk 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

33788 ....... Revision of pulmonary artery 

33800 ....... Aortic suspension 

33802 ....... Repair vessel defect 

33803 ....... Repair vessel defect 

33813 ....... Repair septal defect 

33814 ....... Repair septal defect 

33820 ....... Revise major vessel 

33822 ....... Revise major vessel 

33840 ....... Remove aorta constriction 

33845 ....... Remove aorta constriction 

33851 ....... Remove aorta constriction 

33852 ....... Repair septal defect 

33853 ....... Repair septal defect 

33917 ....... Repair pulmonary artery 

33920 ....... Repair pulmonary atresia 

33922 ....... Transect pulmonary artery 

34001 ....... Removal of artery clot 

34051 ....... Removal of artery clot 

34101 ....... Removal of artery clot 

34111 ....... Removal of arm artery clot 

34201 ....... Removal of artery clot 

34203 ....... Removal of leg artery clot 

34401 ....... Removal of vein clot 

34421 ....... Removal of vein clot 

34451 ....... Removal of vein clot 

34471 ....... Removal of vein clot 

34490 ....... Removal of vein clot 

34501 ....... Repair valve, femoral vein 

34502 ....... Reconstruct vena cava 

34510 ....... Transposition of vein valve 

34520 ....... Cross-over vein graft 

34530 ....... Leg vein fusion 

35001 ....... Repair defect of artery 

35002 ....... Repair artery rupture, neck 

35005 ....... Repair defect of artery 

35011 ....... Repair defect of artery 

35013 ....... Repair artery rupture, arm 

35021 ....... Repair defect of artery 

35022 ....... Repair artery rupture, chest 

35045 ....... Repair defect of arm artery 

35111 ....... Repair defect of artery 

35141 ....... Repair defect of artery 

35142 ....... Repair artery rupture, thigh 

35151 ....... Repair defect of artery 

35152 ....... Repair artery rupture, knee 

35180 ....... Repair blood vessel lesion 

35184 ....... Repair blood vessel lesion 

35188 ....... Repair blood vessel lesion 

35190 ....... Repair blood vessel lesion 

35201 ....... Repair blood vessel lesion 

35206 ....... Repair blood vessel lesion 

35207 ....... Repair blood vessel lesion 

35226 ....... Repair blood vessel lesion 

35231 ....... Repair blood vessel lesion 

35236 ....... Repair blood vessel lesion 

35246 ....... Repair blood vessel lesion 

35261 ....... Repair blood vessel lesion 

35266 ....... Repair blood vessel lesion 

35286 ....... Repair blood vessel lesion 

35311 ....... Rechanneling of artery 

35321 ....... Rechanneling of artery 

35371 ....... Rechanneling of artery 

35372 ....... Rechanneling of artery 

35381 ....... Rechanneling of artery 

35501 ....... Artery bypass graft 

35506 ....... Artery bypass graft 

35507 ....... Artery bypass graft 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49241 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

35508 ....... Artery bypass graft 

35509 ....... Artery bypass graft 

35511 ....... Artery bypass graft 

35515 ....... Artery bypass graft 

35516 ....... Artery bypass graft 

35518 ....... Artery bypass graft 

35526 ....... Artery bypass graft 

35556 ....... Artery bypass graft 

35558 ....... Artery bypass graft 

35571 ....... Artery bypass graft 

35583 ....... Vein bypass graft 

35585 ....... Vein bypass graft 

35587 ....... Vein bypass graft 

35601 ....... Artery bypass graft 

35606 ....... Artery bypass graft 

35612 ....... Artery bypass graft 

35616 ....... Artery bypass graft 

35626 ....... Artery bypass graft 

35642 ....... Artery bypass graft 

35645 ....... Artery bypass graft 

35650 ....... Artery bypass graft 

35656 ....... Artery bypass graft 

35661 ....... Artery bypass graft 

35666 ....... Artery bypass graft 

35671 ....... Artery bypass graft 

35691 ....... Arterial transposition 

35693 ....... Arterial transposition 

35694 ....... Arterial transposition 

35695 ....... Arterial transposition 

35701 ....... Exploration, carotid artery 

35721 ....... Exploration, femoral artery 

35741 ....... Exploration popliteal artery 

35761 ....... Exploration of artery/vein 

35800 ....... Explore neck vessels 

35860 ....... Explore limb vessels 

35875 ....... Removal of clot in graft 

35876 ....... Removal of clot in graft 

35901 ....... Excision, graft, neck 

35903 ....... Excision, graft, extremity 

36260 ....... Insertion of infusion pump 

36261 ....... Revision of infusion pump 

36262 ....... Removal of infusion pump 

36475 ....... Endovenous rf, 1st vein 

36476 ....... Endovenous rf, vein add-on 

36478 ....... Endovenous laser, 1st vein 

36479 ....... Endovenous laser vein addon 

36566 ....... Insert tunneled cv cath 

36835 ....... Artery to vein shunt 

37565 ....... Ligation of neck vein 

37600 ....... Ligation of neck artery 

37605 ....... Ligation of neck artery 

37606 ....... Ligation of neck artery 

38740 ....... Remove armpit lymph nodes 

38745 ....... Remove armpit lymph nodes 

38760 ....... Remove groin lymph nodes 

38765 ....... Remove groin lymph nodes 

38770 ....... Remove pelvis lymph nodes 

38780 ....... Remove abdomen lymph nodes 

39501 ....... Repair diaphragm laceration 

39502 ....... Repair paraesophageal hernia 

39503 ....... Repair of diaphragm hernia 

39520 ....... Repair of diaphragm hernia 

39530 ....... Repair of diaphragm hernia 

39531 ....... Repair of diaphragm hernia 

39540 ....... Repair of diaphragm hernia 

39541 ....... Repair of diaphragm hernia 

39545 ....... Revision of diaphragm 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

43045 ....... Incision of esophagus 

43100 ....... Excision of esophagus lesion 

43101 ....... Excision of esophagus lesion 

43108 ....... Removal of esophagus 

43113 ....... Removal of esophagus 

43116 ....... Partial removal of esophagus 

43118 ....... Partial removal of esophagus 

43123 ....... Partial removal of esophagus 

43124 ....... Removal of esophagus 

43130 ....... Removal of esophagus pouch 

43135 ....... Removal of esophagus pouch 

43300 ....... Repair of esophagus 

43320 ....... Fuse esophagus & stomach 

43324 ....... Revise esophagus & stomach 

43325 ....... Revise esophagus & stomach 

43326 ....... Revise esophagus & stomach 

43330 ....... Repair of esophagus 

43331 ....... Repair of esophagus 

43340 ....... Fuse esophagus & intestine 

43341 ....... Fuse esophagus & intestine 

43350 ....... Surgical opening, esophagus 

43351 ....... Surgical opening, esophagus 

43352 ....... Surgical opening, esophagus 

43360 ....... Gastrointestinal repair 

43361 ....... Gastrointestinal repair 

43400 ....... Ligate esophagus veins 

43401 ....... Esophagus surgery for veins 

43405 ....... Ligate/staple esophagus 

43410 ....... Repair esophagus wound 

43415 ....... Repair esophagus wound 

43420 ....... Repair esophagus opening 

43425 ....... Repair esophagus opening 

43500 ....... Surgical opening of stomach 

43501 ....... Surgical repair of stomach 

43502 ....... Surgical repair of stomach 

43520 ....... Incision of pyloric muscle 

43605 ....... Biopsy of stomach 

43610 ....... Excision of stomach lesion 

43611 ....... Excision of stomach lesion 

43620 ....... Removal of stomach 

43621 ....... Removal of stomach 

43622 ....... Removal of stomach 

43631 ....... Removal of stomach, partial 

43632 ....... Removal of stomach, partial 

43633 ....... Removal of stomach, partial 

43634 ....... Removal of stomach, partial 

43640 ....... Vagotomy & pylorus repair 

43641 ....... Vagotomy & pylorus repair 

43800 ....... Reconstruction of pylorus 

43810 ....... Fusion of stomach and bowel 

43820 ....... Fusion of stomach and bowel 

43825 ....... Fusion of stomach and bowel 

43830 ....... Place gastrostomy tube 

43831 ....... Place gastrostomy tube 

43832 ....... Place gastrostomy tube 

43840 ....... Repair of stomach lesion 

43842 ....... V-band gastroplasty 

43846 ....... Gastric bypass for obesity 

43847 ....... Gastric bypass incl small i 

43848 ....... Revision gastroplasty 

43850 ....... Revise stomach-bowel fusion 

43855 ....... Revise stomach-bowel fusion 

43860 ....... Revise stomach-bowel fusion 

43865 ....... Revise stomach-bowel fusion 

43870 ....... Repair stomach opening 

43880 ....... Repair stomach-bowel fistula 

44005 ....... Freeing of bowel adhesion 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

44010 ....... Incision of small bowel 

44020 ....... Explore small intestine 

44021 ....... Decompress small bowel 

44025 ....... Incision of large bowel 

44050 ....... Reduce bowel obstruction 

44055 ....... Correct malrotation of bowel 

44110 ....... Excise intestine lesion(s) 

44111 ....... Excision of bowel lesion(s) 

45190 ....... Destruction, rectal tumor 

45500 ....... Repair of rectum 

45505 ....... Repair of rectum 

45541 ....... Correct rectal prolapse 

45550 ....... Repair rectum/remove sigmoid 

45560 ....... Repair of rectocele 

45562 ....... Exploration/repair of rectum 

45563 ....... Exploration/repair of rectum 

45800 ....... Repair rect/bladder fistula 

45805 ....... Repair fistula w/colostomy 

45820 ....... Repair rectourethral fistula 

45825 ....... Repair fistula w/colostomy 

46045 ....... Incision of rectal abscess 

46060 ....... Incision of rectal abscess 

46070 ....... Incision of anal septum 

46257 ....... Remove hemorrhoids & fissure 

46258 ....... Remove hemorrhoids & fistula 

46260 ....... Hemorrhoidectomy 

46261 ....... Remove hemorrhoids & fissure 

46262 ....... Remove hemorrhoids & fistula 

46280 ....... Removal of anal fistula 

46288 ....... Repair anal fistula 

46700 ....... Repair of anal stricture 

46705 ....... Repair of anal stricture 

46715 ....... Rep perf anoper fistu 

46716 ....... Rep perf anoper/vestib fistu 

46730 ....... Construction of absent anus 

46735 ....... Construction of absent anus 

46740 ....... Construction of absent anus 

46742 ....... Repair of imperforated anus 

46744 ....... Repair of cloacal anomaly 

46746 ....... Repair of cloacal anomaly 

46748 ....... Repair of cloacal anomaly 

46750 ....... Repair of anal sphincter 

46751 ....... Repair of anal sphincter 

46753 ....... Reconstruction of anus 

46760 ....... Repair of anal sphincter 

46761 ....... Repair of anal sphincter 

46762 ....... Implant artificial sphincter 

47010 ....... Open drainage, liver lesion 

47015 ....... Inject/aspirate liver cyst 

47100 ....... Wedge biopsy of liver 

47120 ....... Partial removal of liver 

47122 ....... Extensive removal of liver 

47125 ....... Partial removal of liver 

47130 ....... Partial removal of liver 

47300 ....... Surgery for liver lesion 

47350 ....... Repair liver wound 

47360 ....... Repair liver wound 

47400 ....... Incision of liver duct 

47420 ....... Incision of bile duct 

47425 ....... Incision of bile duct 

47460 ....... Incise bile duct sphincter 

47480 ....... Incision of gallbladder 

47490 ....... Incision of gallbladder 

47600 ....... Removal of gallbladder 

47605 ....... Removal of gallbladder 

47610 ....... Removal of gallbladder 

47612 ....... Removal of gallbladder 

mstockstill on PROD1PC63 with PROPOSAL_2

49242 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

47620 ....... Removal of gallbladder 

47700 ....... Exploration of bile ducts 

47701 ....... Bile duct revision 

47711 ....... Excision of bile duct tumor 

47712 ....... Excision of bile duct tumor 

47715 ....... Excision of bile duct cyst 

47716 ....... Fusion of bile duct cyst 

47720 ....... Fuse gallbladder & bowel 

47721 ....... Fuse upper gi structures 

47740 ....... Fuse gallbladder & bowel 

47741 ....... Fuse gallbladder & bowel 

47760 ....... Fuse bile ducts and bowel 

47765 ....... Fuse liver ducts & bowel 

47780 ....... Fuse bile ducts and bowel 

47785 ....... Fuse bile ducts and bowel 

47800 ....... Reconstruction of bile ducts 

47801 ....... Placement, bile duct support 

47802 ....... Fuse liver duct & intestine 

47900 ....... Suture bile duct injury 

48000 ....... Drainage of abdomen 

48001 ....... Placement of drain, pancreas 

48005 ....... Resect/debride pancreas 

48020 ....... Removal of pancreatic stone 

48100 ....... Biopsy of pancreas, open 

48120 ....... Removal of pancreas lesion 

48140 ....... Partial removal of pancreas 

48145 ....... Partial removal of pancreas 

48146 ....... Pancreatectomy 

48148 ....... Removal of pancreatic duct 

48150 ....... Partial removal of pancreas 

48152 ....... Pancreatectomy 

48153 ....... Pancreatectomy 

48154 ....... Pancreatectomy 

48155 ....... Removal of pancreas 

48180 ....... Fuse pancreas and bowel 

48500 ....... Surgery of pancreatic cyst 

48510 ....... Drain pancreatic pseudocyst 

48520 ....... Fuse pancreas cyst and bowel 

48540 ....... Fuse pancreas cyst and bowel 

48545 ....... Pancreatorrhaphy 

48547 ....... Duodenal exclusion 

49215 ....... Excise sacral spine tumor 

49900 ....... Repair of abdominal wall 

51020 ....... Incise & treat bladder 

51500 ....... Removal of bladder cyst 

51530 ....... Removal of bladder lesion 

51535 ....... Repair of ureter lesion 

51550 ....... Partial removal of bladder 

51555 ....... Partial removal of bladder 

51565 ....... Revise bladder & ureter(s) 

51570 ....... Removal of bladder 

51575 ....... Removal of bladder & nodes 

51580 ....... Remove bladder/revise tract 

51585 ....... Removal of bladder & nodes 

51590 ....... Remove bladder/revise tract 

51595 ....... Remove bladder/revise tract 

51596 ....... Remove bladder/create pouch 

51597 ....... Removal of pelvic structures 

51715 ....... Endoscopic injection/implant 

51800 ....... Revision of bladder/urethra 

51820 ....... Revision of urinary tract 

51845 ....... Repair bladder neck 

51860 ....... Repair of bladder wound 

51865 ....... Repair of bladder wound 

51880 ....... Repair of bladder opening 

51900 ....... Repair bladder/vagina lesion 

51920 ....... Close bladder-uterus fistula 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

51925 ....... Hysterectomy/bladder repair 

51940 ....... Correction of bladder defect 

51960 ....... Revision of bladder & bowel 

51980 ....... Construct bladder opening 

52000 ....... Cystoscopy 

52001 ....... Cystoscopy, removal of clots 

52005 ....... Cystoscopy & ureter catheter 

52281 ....... Cystoscopy and treatment 

52283 ....... Cystoscopy and treatment 

52285 ....... Cystoscopy and treatment 

52332 ....... Cystoscopy and treatment 

52647 ....... Laser surgery of prostate 

52648 ....... Laser surgery of prostate 

53010 ....... Incision of urethra 

53080 ....... Drainage of urinary leakage 

53085 ....... Drainage of urinary leakage 

53210 ....... Removal of urethra 

53215 ....... Removal of urethra 

53220 ....... Treatment of urethra lesion 

53230 ....... Removal of urethra lesion 

53235 ....... Removal of urethra lesion 

53240 ....... Surgery for urethra pouch 

53250 ....... Removal of urethra gland 

53400 ....... Revise urethra, stage 1 

53405 ....... Revise urethra, stage 2 

53410 ....... Reconstruction of urethra 

53415 ....... Reconstruction of urethra 

53420 ....... Reconstruct urethra, stage 1 

53425 ....... Reconstruct urethra, stage 2 

53430 ....... Reconstruction of urethra 

53445 ....... Insert uro/ves nck sphincter 

53449 ....... Repair uro sphincter 

53450 ....... Revision of urethra 

53460 ....... Revision of urethra 

53502 ....... Repair of urethra injury 

53505 ....... Repair of urethra injury 

53510 ....... Repair of urethra injury 

53515 ....... Repair of urethra injury 

53520 ....... Repair of urethra defect 

54205 ....... Treatment of penis lesion 

54300 ....... Revision of penis 

54304 ....... Revision of penis 

54308 ....... Reconstruction of urethra 

54312 ....... Reconstruction of urethra 

54316 ....... Reconstruction of urethra 

54318 ....... Reconstruction of urethra 

54322 ....... Reconstruction of urethra 

54324 ....... Reconstruction of urethra 

54326 ....... Reconstruction of urethra 

54328 ....... Revise penis/urethra 

54332 ....... Revise penis/urethra 

54336 ....... Revise penis/urethra 

54340 ....... Secondary urethral surgery 

54344 ....... Secondary urethral surgery 

54348 ....... Secondary urethral surgery 

54352 ....... Reconstruct urethra/penis 

54360 ....... Penis plastic surgery 

54380 ....... Repair penis 

54385 ....... Repair penis 

54390 ....... Repair penis and bladder 

54400 ....... Insert semi-rigid prosthesis 

54401 ....... Insert self-contd prosthesis 

54405 ....... Insert multi-comp penis pros 

54520 ....... Removal of testis 

54530 ....... Removal of testis 

54535 ....... Extensive testis surgery 

54550 ....... Exploration for testis 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

54560 ....... Exploration for testis 

54600 ....... Reduce testis torsion 

54640 ....... Suspension of testis 

54650 ....... Orchiopexy (fowler-stephens) 

54660 ....... Revision of testis 

54670 ....... Repair testis injury 

54680 ....... Relocation of testis(es) 

54820 ....... Exploration of epididymis 

54830 ....... Remove epididymis lesion 

54840 ....... Remove epididymis lesion 

54860 ....... Removal of epididymis 

54861 ....... Removal of epididymis 

54900 ....... Fusion of spermatic ducts 

54901 ....... Fusion of spermatic ducts 

55040 ....... Removal of hydrocele 

55041 ....... Removal of hydroceles 

55060 ....... Repair of hydrocele 

55500 ....... Removal of hydrocele 

55520 ....... Removal of sperm cord lesion 

55530 ....... Revise spermatic cord veins 

55535 ....... Revise spermatic cord veins 

55540 ....... Revise hernia & sperm veins 

55600 ....... Incise sperm duct pouch 

55605 ....... Incise sperm duct pouch 

55650 ....... Remove sperm duct pouch 

55680 ....... Remove sperm pouch lesion 

55720 ....... Drainage of prostate abscess 

55725 ....... Drainage of prostate abscess 

55801 ....... Removal of prostate 

55810 ....... Extensive prostate surgery 

55812 ....... Extensive prostate surgery 

55815 ....... Extensive prostate surgery 

55821 ....... Removal of prostate 

55831 ....... Removal of prostate 

55840 ....... Extensive prostate surgery 

55842 ....... Extensive prostate surgery 

55845 ....... Extensive prostate surgery 

55860 ....... Surgical exposure, prostate 

55862 ....... Extensive prostate surgery 

55865 ....... Extensive prostate surgery 

56620 ....... Partial removal of vulva 

56625 ....... Complete removal of vulva 

56630 ....... Extensive vulva surgery 

56631 ....... Extensive vulva surgery 

56632 ....... Extensive vulva surgery 

56633 ....... Extensive vulva surgery 

56634 ....... Extensive vulva surgery 

56637 ....... Extensive vulva surgery 

56640 ....... Extensive vulva surgery 

56805 ....... Repair clitoris 

57010 ....... Drainage of pelvic abscess 

57106 ....... Remove vagina wall, partial 

57107 ....... Remove vagina tissue, part 

57109 ....... Vaginectomy partial w/nodes 

57110 ....... Remove vagina wall, complete 

57111 ....... Remove vagina tissue, compl 

57112 ....... Vaginectomy w/nodes, compl 

57120 ....... Closure of vagina 

57210 ....... Repair vagina/perineum 

57307 ....... Fistula repair & colostomy 

57308 ....... Fistula repair, transperine 

57310 ....... Repair urethrovaginal lesion 

57311 ....... Repair urethrovaginal lesion 

57320 ....... Repair bladder-vagina lesion 

57330 ....... Repair bladder-vagina lesion 

57335 ....... Repair vagina 

57530 ....... Removal of cervix 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49243 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

57531 ....... Removal of cervix, radical 

57540 ....... Removal of residual cervix 

57545 ....... Remove cervix/repair pelvis 

57550 ....... Removal of residual cervix 

57555 ....... Remove cervix/repair vagina 

57556 ....... Remove cervix, repair bowel 

57700 ....... Revision of cervix 

57720 ....... Revision of cervix 

58120 ....... Dilation and curettage 

58140 ....... Myomectomy abdom method 

58145 ....... Myomectomy vag method 

58400 ....... Suspension of uterus 

58410 ....... Suspension of uterus 

58520 ....... Repair of ruptured uterus 

58540 ....... Revision of uterus 

58555 ....... Hysteroscopy, dx, sep proc 

58558 ....... Hysteroscopy, biopsy 

58562 ....... Hysteroscopy, remove fb 

58600 ....... Division of fallopian tube 

58605 ....... Division of fallopian tube 

58660 ....... Laparoscopy, lysis 

58662 ....... Laparoscopy, excise lesions 

58670 ....... Laparoscopy, tubal cautery 

58672 ....... Laparoscopy, fimbrioplasty 

58673 ....... Laparoscopy, salpingostomy 

58700 ....... Removal of fallopian tube 

58720 ....... Removal of ovary/tube(s) 

58740 ....... Revise fallopian tube(s) 

58750 ....... Repair oviduct 

58752 ....... Revise ovarian tube(s) 

58760 ....... Remove tubal obstruction 

58770 ....... Create new tubal opening 

58805 ....... Drainage of ovarian cyst(s) 

58820 ....... Drain ovary abscess, open 

58822 ....... Drain ovary abscess, percut 

58825 ....... Transposition, ovary(s) 

58900 ....... Biopsy of ovary(s) 

58920 ....... Partial removal of ovary(s) 

58925 ....... Removal of ovarian cyst(s) 

58940 ....... Removal of ovary(s) 

58943 ....... Removal of ovary(s) 

58950 ....... Resect ovarian malignancy 

58951 ....... Resect ovarian malignancy 

58952 ....... Resect ovarian malignancy 

58960 ....... Exploration of abdomen 

59100 ....... Remove uterus lesion 

59120 ....... Treat ectopic pregnancy 

59121 ....... Treat ectopic pregnancy 

59130 ....... Treat ectopic pregnancy 

59130 ....... Treat ectopic pregnancy 

59135 ....... Treat ectopic pregnancy 

59136 ....... Treat ectopic pregnancy 

59150 ....... Treat ectopic pregnancy 

59151 ....... Treat ectopic pregnancy 

59812 ....... Treatment of miscarriage 

59850 ....... Abortion 

59851 ....... Abortion 

59852 ....... Abortion 

59855 ....... Abortion 

59856 ....... Abortion 

59857 ....... Abortion 

59870 ....... Evacuate mole of uterus 

60200 ....... Remove thyroid lesion 

60210 ....... Partial thyroid excision 

60212 ....... Partial thyroid excision 

60220 ....... Partial removal of thyroid 

60225 ....... Partial removal of thyroid 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

60240 ....... Removal of thyroid 

60252 ....... Removal of thyroid 

60254 ....... Extensive thyroid surgery 

60260 ....... Repeat thyroid surgery 

60270 ....... Removal of thyroid 

60271 ....... Removal of thyroid 

60280 ....... Remove thyroid duct lesion 

60281 ....... Remove thyroid duct lesion 

60500 ....... Explore parathyroid glands 

60502 ....... Re-explore parathyroids 

60505 ....... Explore parathyroid glands 

60520 ....... Removal of thymus gland 

60521 ....... Removal of thymus gland 

60522 ....... Removal of thymus gland 

60540 ....... Explore adrenal gland 

60545 ....... Explore adrenal gland 

60600 ....... Remove carotid body lesion 

60605 ....... Remove carotid body lesion 

61343 ....... Incise skull (press relief) 

61345 ....... Relieve cranial pressure 

61440 ....... Incise skull for surgery 

61450 ....... Incise skull for surgery 

61458 ....... Incise skull for brain wound 

61460 ....... Incise skull for surgery 

61470 ....... Incise skull for surgery 

61480 ....... Incise skull for surgery 

61490 ....... Incise skull for surgery 

61500 ....... Removal of skull lesion 

61501 ....... Remove infected skull bone 

61510 ....... Removal of brain lesion 

61512 ....... Remove brain lining lesion 

61514 ....... Removal of brain abscess 

61516 ....... Removal of brain lesion 

61518 ....... Removal of brain lesion 

61519 ....... Remove brain lining lesion 

61520 ....... Removal of brain lesion 

61521 ....... Removal of brain lesion 

61522 ....... Removal of brain abscess 

61524 ....... Removal of brain lesion 

61526 ....... Removal of brain lesion 

61530 ....... Removal of brain lesion 

61531 ....... Implant brain electrodes 

61533 ....... Implant brain electrodes 

61534 ....... Removal of brain lesion 

61535 ....... Remove brain electrodes 

61536 ....... Removal of brain lesion 

61538 ....... Removal of brain tissue 

61539 ....... Removal of brain tissue 

61541 ....... Incision of brain tissue 

61542 ....... Removal of brain tissue 

61543 ....... Removal of brain tissue 

61544 ....... Remove & treat brain lesion 

61545 ....... Excision of brain tumor 

61546 ....... Removal of pituitary gland 

61548 ....... Removal of pituitary gland 

61550 ....... Release of skull seams 

61552 ....... Release of skull seams 

61556 ....... Incise skull/sutures 

61557 ....... Incise skull/sutures 

61558 ....... Excision of skull/sutures 

61559 ....... Excision of skull/sutures 

61563 ....... Excision of skull tumor 

61564 ....... Excision of skull tumor 

61570 ....... Remove foreign body, brain 

61571 ....... Incise skull for brain wound 

61575 ....... Skull base/brainstem surgery 

61618 ....... Repair dura 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

61619 ....... Repair dura 

61680 ....... Intracranial vessel surgery 

61682 ....... Intracranial vessel surgery 

61684 ....... Intracranial vessel surgery 

61686 ....... Intracranial vessel surgery 

61690 ....... Intracranial vessel surgery 

61692 ....... Intracranial vessel surgery 

61700 ....... Brain aneurysm repr, simple 

61702 ....... Inner skull vessel surgery 

61703 ....... Clamp neck artery 

61705 ....... Revise circulation to head 

61708 ....... Revise circulation to head 

61710 ....... Revise circulation to head 

61711 ....... Fusion of skull arteries 

61720 ....... Incise skull/brain surgery 

61735 ....... Incise skull/brain surgery 

61750 ....... Incise skull/brain biopsy 

61751 ....... Brain biopsy w/ct/mr guide 

61760 ....... Implant brain electrodes 

61770 ....... Incise skull for treatment 

61790 ....... Treat trigeminal nerve 

61791 ....... Treat trigeminal tract 

61793 ....... Focus radiation beam 

61850 ....... Implant neuroelectrodes 

61860 ....... Implant neuroelectrodes 

61870 ....... Implant neuroelectrodes 

61875 ....... Implant neuroelectrodes 

61880 ....... Revise/remove neuroelectrode 

61885 ....... Insrt/redo neurostim 1 array 

62000 ....... Treat skull fracture 

62005 ....... Treat skull fracture 

62010 ....... Treatment of head injury 

62100 ....... Repair brain fluid leakage 

62115 ....... Reduction of skull defect 

62116 ....... Reduction of skull defect 

62117 ....... Reduction of skull defect 

62140 ....... Repair of skull defect 

62141 ....... Repair of skull defect 

62142 ....... Remove skull plate/flap 

62143 ....... Replace skull plate/flap 

62145 ....... Repair of skull & brain 

62146 ....... Repair of skull with graft 

62147 ....... Repair of skull with graft 

62180 ....... Establish brain cavity shunt 

62190 ....... Establish brain cavity shunt 

62192 ....... Establish brain cavity shunt 

62200 ....... Establish brain cavity shunt 

62201 ....... Brain cavity shunt w/scope 

62220 ....... Establish brain cavity shunt 

62223 ....... Establish brain cavity shunt 

62225 ....... Replace/irrigate catheter 

62230 ....... Replace/revise brain shunt 

62256 ....... Remove brain cavity shunt 

62258 ....... Replace brain cavity shunt 

62287 ....... Percutaneous diskectomy 

63170 ....... Incise spinal cord tract(s) 

63172 ....... Drainage of spinal cyst 

63173 ....... Drainage of spinal cyst 

63180 ....... Revise spinal cord ligaments 

63182 ....... Revise spinal cord ligaments 

63185 ....... Incise spinal column/nerves 

63190 ....... Incise spinal column/nerves 

63191 ....... Incise spinal column/nerves 

63195 ....... Incise spinal column & cord 

63196 ....... Incise spinal column & cord 

63197 ....... Incise spinal column & cord 

63198 ....... Incise spinal column & cord 

mstockstill on PROD1PC63 with PROPOSAL_2

49244 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

63199 ....... Incise spinal column & cord 

63200 ....... Release of spinal cord 

63250 ....... Revise spinal cord vessels 

63251 ....... Revise spinal cord vessels 

63252 ....... Revise spinal cord vessels 

63265 ....... Excise intraspinal lesion 

63266 ....... Excise intraspinal lesion 

63267 ....... Excise intraspinal lesion 

63268 ....... Excise intraspinal lesion 

63270 ....... Excise intraspinal lesion 

63271 ....... Excise intraspinal lesion 

63272 ....... Excise intraspinal lesion 

63273 ....... Excise intraspinal lesion 

63275 ....... Biopsy/excise spinal tumor 

63276 ....... Biopsy/excise spinal tumor 

63277 ....... Biopsy/excise spinal tumor 

63278 ....... Biopsy/excise spinal tumor 

63280 ....... Biopsy/excise spinal tumor 

63281 ....... Biopsy/excise spinal tumor 

63282 ....... Biopsy/excise spinal tumor 

63283 ....... Biopsy/excise spinal tumor 

63285 ....... Biopsy/excise spinal tumor 

63286 ....... Biopsy/excise spinal tumor 

63287 ....... Biopsy/excise spinal tumor 

63290 ....... Biopsy/excise spinal tumor 

63300 ....... Removal of vertebral body 

63301 ....... Removal of vertebral body 

63302 ....... Removal of vertebral body 

63303 ....... Removal of vertebral body 

63304 ....... Removal of vertebral body 

63305 ....... Removal of vertebral body 

63306 ....... Removal of vertebral body 

63307 ....... Removal of vertebral body 

63650 ....... Implant neuroelectrodes 

63655 ....... Implant neuroelectrodes 

63660 ....... Revise/remove neuroelectrode 

63685 ....... Insrt/redo spine n generator 

63688 ....... Revise/remove neuroreceiver 

63700 ....... Repair of spinal herniation 

63702 ....... Repair of spinal herniation 

63704 ....... Repair of spinal herniation 

63706 ....... Repair of spinal herniation 

63707 ....... Repair spinal fluid leakage 

63709 ....... Repair spinal fluid leakage 

63710 ....... Graft repair of spine defect 

63740 ....... Install spinal shunt 

63741 ....... Install spinal shunt 

63744 ....... Revision of spinal shunt 

63746 ....... Removal of spinal shunt 

64573 ....... Implant neuroelectrodes 

64575 ....... Implant neuroelectrodes 

64577 ....... Implant neuroelectrodes 

64580 ....... Implant neuroelectrodes 

64612 ....... Destroy nerve, face muscle 

64702 ....... Revise finger/toe nerve 

64704 ....... Revise hand/foot nerve 

64708 ....... Revise arm/leg nerve 

64712 ....... Revision of sciatic nerve 

64713 ....... Revision of arm nerve(s) 

64714 ....... Revise low back nerve(s) 

64718 ....... Revise ulnar nerve at elbow 

64719 ....... Revise ulnar nerve at wrist 

64721 ....... Carpal tunnel surgery 

64722 ....... Relieve pressure on nerve(s) 

64726 ....... Release foot/toe nerve 

64732 ....... Incision of brow nerve 

64734 ....... Incision of cheek nerve 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

64736 ....... Incision of chin nerve 

64738 ....... Incision of jaw nerve 

64742 ....... Incision of facial nerve 

64744 ....... Incise nerve, back of head 

64746 ....... Incise diaphragm nerve 

64752 ....... Incision of vagus nerve 

64755 ....... Incision of stomach nerves 

64760 ....... Incision of vagus nerve 

64761 ....... Incision of pelvis nerve 

64763 ....... Incise hip/thigh nerve 

64766 ....... Incise hip/thigh nerve 

64771 ....... Sever cranial nerve 

64772 ....... Incision of spinal nerve 

64774 ....... Remove skin nerve lesion 

64776 ....... Remove digit nerve lesion 

64782 ....... Remove limb nerve lesion 

64784 ....... Remove nerve lesion 

64786 ....... Remove sciatic nerve lesion 

64788 ....... Remove skin nerve lesion 

64790 ....... Removal of nerve lesion 

64792 ....... Removal of nerve lesion 

64802 ....... Remove sympathetic nerves 

64804 ....... Remove sympathetic nerves 

64809 ....... Remove sympathetic nerves 

64818 ....... Remove sympathetic nerves 

64820 ....... Remove sympathetic nerves 

64831 ....... Repair of digit nerve 

64834 ....... Repair of hand or foot nerve 

64835 ....... Repair of hand or foot nerve 

64836 ....... Repair of hand or foot nerve 

64840 ....... Repair of leg nerve 

64856 ....... Repair/transpose nerve 

64857 ....... Repair arm/leg nerve 

64858 ....... Repair sciatic nerve 

64861 ....... Repair of arm nerves 

64862 ....... Repair of low back nerves 

64870 ....... Fusion of facial/other nerve 

64890 ....... Nerve graft, hand or foot 

64891 ....... Nerve graft, hand or foot 

64892 ....... Nerve graft, arm or leg 

64893 ....... Nerve graft, arm or leg 

64895 ....... Nerve graft, hand or foot 

64896 ....... Nerve graft, hand or foot 

64897 ....... Nerve graft, arm or leg 

64898 ....... Nerve graft, arm or leg 

64905 ....... Nerve pedicle transfer 

64907 ....... Nerve pedicle transfer 

65091 ....... Revise eye 

65093 ....... Revise eye with implant 

65101 ....... Removal of eye 

65103 ....... Remove eye/insert implant 

65105 ....... Remove eye/attach implant 

65110 ....... Removal of eye 

65112 ....... Remove eye/revise socket 

65114 ....... Remove eye/revise socket 

65125 ....... Revise ocular implant 

65130 ....... Insert ocular implant 

65135 ....... Insert ocular implant 

65140 ....... Attach ocular implant 

65150 ....... Revise ocular implant 

65155 ....... Reinsert ocular implant 

65175 ....... Removal of ocular implant 

65205 ....... Remove foreign body from eye 

65210 ....... Remove foreign body from eye 

65220 ....... Remove foreign body from eye 

65222 ....... Remove foreign body from eye 

65235 ....... Remove foreign body from eye 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

65260 ....... Remove foreign body from eye 

65265 ....... Remove foreign body from eye 

65270 ....... Repair of eye wound 

65272 ....... Repair of eye wound 

65273 ....... Repair of eye wound 

65275 ....... Repair of eye wound 

65280 ....... Repair of eye wound 

65285 ....... Repair of eye wound 

65286 ....... Repair of eye wound 

65290 ....... Repair of eye socket wound 

65400 ....... Removal of eye lesion 

65410 ....... Biopsy of cornea 

65420 ....... Removal of eye lesion 

65426 ....... Removal of eye lesion 

65430 ....... Corneal smear 

65435 ....... Curette/treat cornea 

65436 ....... Curette/treat cornea 

65450 ....... Treatment of corneal lesion 

65600 ....... Revision of cornea 

65710 ....... Corneal transplant 

65730 ....... Corneal transplant 

65750 ....... Corneal transplant 

65755 ....... Corneal transplant 

65760 ....... Revision of cornea 

65765 ....... Revision of cornea 

65767 ....... Corneal tissue transplant 

65770 ....... Revise cornea with implant 

65771 ....... Radial keratotomy 

65772 ....... Correction of astigmatism 

65775 ....... Correction of astigmatism 

65780 ....... Ocular reconst, transplant 

65781 ....... Ocular reconst, transplant 

65782 ....... Ocular reconst, transplant 

65800 ....... Drainage of eye 

65805 ....... Drainage of eye 

65810 ....... Drainage of eye 

65815 ....... Drainage of eye 

65820 ....... Relieve inner eye pressure 

65850 ....... Incision of eye 

65855 ....... Laser surgery of eye 

65860 ....... Incise inner eye adhesions 

65865 ....... Incise inner eye adhesions 

65870 ....... Incise inner eye adhesions 

65875 ....... Incise inner eye adhesions 

65880 ....... Incise inner eye adhesions 

65900 ....... Remove eye lesion 

65920 ....... Remove implant of eye 

65930 ....... Remove blood clot from eye 

66020 ....... Injection treatment of eye 

66030 ....... Injection treatment of eye 

66130 ....... Remove eye lesion 

66150 ....... Glaucoma surgery 

66155 ....... Glaucoma surgery 

66160 ....... Glaucoma surgery 

66165 ....... Glaucoma surgery 

66170 ....... Glaucoma surgery 

66172 ....... Incision of eye 

66180 ....... Implant eye shunt 

66185 ....... Revise eye shunt 

66220 ....... Repair eye lesion 

66225 ....... Repair/graft eye lesion 

66250 ....... Follow-up surgery of eye 

66500 ....... Incision of iris 

66505 ....... Incision of iris 

66600 ....... Remove iris and lesion 

66605 ....... Removal of iris 

66625 ....... Removal of iris 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49245 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

66630 ....... Removal of iris 

66635 ....... Removal of iris 

66680 ....... Repair iris & ciliary body 

66682 ....... Repair iris & ciliary body 

66700 ....... Destruction, ciliary body 

66710 ....... Ciliary transsleral therapy 

66711 ....... Ciliary endoscopic ablation 

66720 ....... Destruction, ciliary body 

66740 ....... Destruction, ciliary body 

66761 ....... Revision of iris 

66762 ....... Revision of iris 

66770 ....... Removal of inner eye lesion 

66820 ....... Incision, secondary cataract 

66821 ....... After cataract laser surgery 

66825 ....... Reposition intraocular lens 

66830 ....... Removal of lens lesion 

66840 ....... Removal of lens material 

66850 ....... Removal of lens material 

66852 ....... Removal of lens material 

66920 ....... Extraction of lens 

66930 ....... Extraction of lens 

66940 ....... Extraction of lens 

66982 ....... Cataract surgery, complex 

66983 ....... Cataract surg w/iol, 1 stage 

66984 ....... Cataract surg w/iol, 1 stage 

66985 ....... Insert lens prosthesis 

66986 ....... Exchange lens prosthesis 

66990 ....... Ophthalmic endoscope add-on 

66999 ....... Eye surgery procedure 

67005 ....... Partial removal of eye fluid 

67010 ....... Partial removal of eye fluid 

67015 ....... Release of eye fluid 

67025 ....... Replace eye fluid 

67027 ....... Implant eye drug system 

67028 ....... Injection eye drug 

67030 ....... Incise inner eye strands 

67031 ....... Laser surgery, eye strands 

67036 ....... Removal of inner eye fluid 

67038 ....... Strip retinal membrane 

67039 ....... Laser treatment of retina 

67040 ....... Laser treatment of retina 

67101 ....... Repair detached retina 

67105 ....... Repair detached retina 

67107 ....... Repair detached retina 

67108 ....... Repair detached retina 

67110 ....... Repair detached retina 

67112 ....... Rerepair detached retina 

67115 ....... Release encircling material 

67120 ....... Remove eye implant material 

67121 ....... Remove eye implant material 

67141 ....... Treatment of retina 

67145 ....... Treatment of retina 

67208 ....... Treatment of retinal lesion 

67210 ....... Treatment of retinal lesion 

67218 ....... Treatment of retinal lesion 

67220 ....... Treatment of choroid lesion 

67221 ....... Ocular photodynamic ther 

67225 ....... Eye photodynamic ther add-on 

67227 ....... Treatment of retinal lesion 

67228 ....... Treatment of retinal lesion 

67250 ....... Reinforce eye wall 

67255 ....... Reinforce/graft eye wall 

67299 ....... Eye surgery procedure 

67311 ....... Revise eye muscle 

67312 ....... Revise two eye muscles 

67314 ....... Revise eye muscle 

67316 ....... Revise two eye muscles 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

67318 ....... Revise eye muscle(s) 

67320 ....... Revise eye muscle(s) add-on 

67331 ....... Eye surgery follow-up add-on 

67332 ....... Rerevise eye muscles add-on 

67334 ....... Revise eye muscle w/suture 

67335 ....... Eye suture during surgery 

67340 ....... Revise eye muscle add-on 

67343 ....... Release eye tissue 

67345 ....... Destroy nerve of eye muscle 

67350 ....... Biopsy eye muscle 

67399 ....... Eye muscle surgery procedure 

67400 ....... Explore/biopsy eye socket 

67405 ....... Explore/drain eye socket 

67412 ....... Explore/treat eye socket 

67413 ....... Explore/treat eye socket 

67414 ....... Explr/decompress eye socket 

67415 ....... Aspiration, orbital contents 

67420 ....... Explore/treat eye socket 

67430 ....... Explore/treat eye socket 

67440 ....... Explore/drain eye socket 

67445 ....... Explr/decompress eye socket 

67450 ....... Explore/biopsy eye socket 

67500 ....... Inject/treat eye socket 

67505 ....... Inject/treat eye socket 

67515 ....... Inject/treat eye socket 

67550 ....... Insert eye socket implant 

67560 ....... Revise eye socket implant 

67570 ....... Decompress optic nerve 

67599 ....... Orbit surgery procedure 

67700 ....... Drainage of eyelid abscess 

67710 ....... Incision of eyelid 

67715 ....... Incision of eyelid fold 

67800 ....... Remove eyelid lesion 

67801 ....... Remove eyelid lesions 

67805 ....... Remove eyelid lesions 

67808 ....... Remove eyelid lesion(s) 

67810 ....... Biopsy of eyelid 

67820 ....... Revise eyelashes 

67825 ....... Revise eyelashes 

67830 ....... Revise eyelashes 

67835 ....... Revise eyelashes 

67840 ....... Remove eyelid lesion 

67850 ....... Treat eyelid lesion 

67875 ....... Closure of eyelid by suture 

67880 ....... Revision of eyelid 

67882 ....... Revision of eyelid 

67900 ....... Repair brow defect 

67901 ....... Repair eyelid defect 

67902 ....... Repair eyelid defect 

67903 ....... Repair eyelid defect 

67904 ....... Repair eyelid defect 

67906 ....... Repair eyelid defect 

67908 ....... Repair eyelid defect 

67909 ....... Revise eyelid defect 

67911 ....... Revise eyelid defect 

67912 ....... Correction eyelid w/implant 

67914 ....... Repair eyelid defect 

67915 ....... Repair eyelid defect 

67916 ....... Repair eyelid defect 

67917 ....... Repair eyelid defect 

67921 ....... Repair eyelid defect 

67922 ....... Repair eyelid defect 

67923 ....... Repair eyelid defect 

67924 ....... Repair eyelid defect 

67930 ....... Repair eyelid wound 

67935 ....... Repair eyelid wound 

67938 ....... Remove eyelid foreign body 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

67950 ....... Revision of eyelid 

67961 ....... Revision of eyelid 

67966 ....... Revision of eyelid 

67971 ....... Reconstruction of eyelid 

67973 ....... Reconstruction of eyelid 

67974 ....... Reconstruction of eyelid 

67975 ....... Reconstruction of eyelid 

67999 ....... Revision of eyelid 

68020 ....... Incise/drain eyelid lining 

68040 ....... Treatment of eyelid lesions 

68100 ....... Biopsy of eyelid lining 

68110 ....... Remove eyelid lining lesion 

68115 ....... Remove eyelid lining lesion 

68130 ....... Remove eyelid lining lesion 

68135 ....... Remove eyelid lining lesion 

68200 ....... Treat eyelid by injection 

68320 ....... Revise/graft eyelid lining 

68325 ....... Revise/graft eyelid lining 

68326 ....... Revise/graft eyelid lining 

68328 ....... Revise/graft eyelid lining 

68330 ....... Revise eyelid lining 

68335 ....... Revise/graft eyelid lining 

68340 ....... Separate eyelid adhesions 

68360 ....... Revise eyelid lining 

68362 ....... Revise eyelid lining 

68371 ....... Harvest eye tissue, alograft 

68399 ....... Eyelid lining surgery 

68400 ....... Incise/drain tear gland 

68420 ....... Incise/drain tear sac 

68440 ....... Incise tear duct opening 

68500 ....... Removal of tear gland 

68505 ....... Partial removal, tear gland 

68510 ....... Biopsy of tear gland 

68520 ....... Removal of tear sac 

68525 ....... Biopsy of tear sac 

68530 ....... Clearance of tear duct 

68540 ....... Remove tear gland lesion 

68550 ....... Remove tear gland lesion 

68700 ....... Repair tear ducts 

68705 ....... Revise tear duct opening 

68720 ....... Create tear sac drain 

68745 ....... Create tear duct drain 

68750 ....... Create tear duct drain 

68760 ....... Close tear duct opening 

68761 ....... Close tear duct opening 

68770 ....... Close tear system fistula 

68801 ....... Dilate tear duct opening 

68810 ....... Probe nasolacrimal duct 

68811 ....... Probe nasolacrimal duct 

68815 ....... Probe nasolacrimal duct 

68840 ....... Explore/irrigate tear ducts 

68850 ....... Injection for tear sac x-ray 

68899 ....... Tear duct system surgery 

76075 ....... Dxa bone density, axial 

76510 ....... Ophth us, b & quant a 

76511 ....... Ophth us, quant a only 

76512 ....... Ophth us, b w/non-quant a 

76513 ....... Echo exam of eye, water bath 

76514 ....... Echo exam of eye, thickness 

76516 ....... Echo exam of eye 

76519 ....... Echo exam of eye 

76529 ....... Echo exam of eye 

78350 ....... Bone mineral, single photon 

78472 ....... Gated heart, planar, single 

78481 ....... Heart first pass, single 

78483 ....... Heart first pass, multiple 

91010 ....... Esophagus motility study 

mstockstill on PROD1PC63 with PROPOSAL_2

49246 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

91034 ....... Gastroesophageal reflux test 

91037 ....... Esoph imped function test 

91038 ....... Esoph imped funct test >1h 

92002 ....... Eye exam, new patient 

92004 ....... Eye exam, new patient 

92012 ....... Eye exam established pat 

92014 ....... Eye exam & treatment 

92015 ....... Refraction 

92018 ....... New eye exam & treatment 

92019 ....... Eye exam & treatment 

92020 ....... Special eye evaluation 

92060 ....... Special eye evaluation 

92065 ....... Orthoptic/pleoptic training 

92070 ....... Fitting of contact lens 

92081 ....... Visual field examination(s) 

92082 ....... Visual field examination(s) 

92083 ....... Visual field examination(s) 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

92100 ....... Serial tonometry exam(s) 

92120 ....... Tonography & eye evaluation 

92130 ....... Water provocation tonography 

92135 ....... Opthalmic dx imaging 

92136 ....... Ophthalmic biometry 

92140 ....... Glaucoma provocative tests 

92225 ....... Special eye exam, initial 

92226 ....... Special eye exam, subsequent 

92230 ....... Eye exam with photos 

92235 ....... Eye exam with photos 

92240 ....... Icg angiography 

92250 ....... Eye exam with photos 

92260 ....... Ophthalmoscopy/dynamome try 

92265 ....... Eye muscle evaluation 

92270 ....... Electro-oculography 

92275 ....... Electroretinography 

92283 ....... Color vision examination 

ADDENDUM C.—CODES FOR WHICH

WE RECEIVED PERC RECOMMENDATIONS ON PE DIRECT

COST INPUTS—Continued 

CPT 

Codes Short descriptor 

92284 ....... Dark adaptation eye exam 

92285 ....... Eye photography 

92286 ....... Internal eye photography 

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 

92325 ....... Modification of contact lens 

92326 ....... Replacement of contact lens 

ADDENDUM D.—PROPOSED 2007 GEOGRAPHIC PRACTICE COST INDICES BY MEDICARE CARRIER AND LOCALITY

Carrier Locality Locality name Work 

GPCI PE GPCI MP GPCI 

00510 ....... 00 Alabama ............................................................................................................. 0.982 0.847 0.740 

00831 ....... 01 Alaska ................................................................................................................ 1.017 1.105 1.013 

00832 ....... 00 Arizona ............................................................................................................... 0.987 0.994 1.052 

00520 ....... 13 Arkansas ............................................................................................................ 0.961 0.832 0.431 

31140 ....... 03 Marin/Napa/Solano, CA ..................................................................................... 1.035 1.342 0.640 

31140 ....... 05 San Francisco, CA ............................................................................................. 1.060 1.546 0.640 

31140 ....... 06 San Mateo, CA .................................................................................................. 1.073 1.539 0.629 

31140 ....... 07 Oakland/Berkley, CA ......................................................................................... 1.054 1.373 0.640 

31140 ....... 09 Santa Clara, CA ................................................................................................. 1.083 1.543 0.595 

31146 ....... 17 Ventura, CA ....................................................................................................... 1.028 1.181 0.732 

31146 ....... 18 Los Angeles, CA ................................................................................................ 1.041 1.158 0.939 

31146 ....... 26 Anaheim/Santa Ana, CA .................................................................................... 1.034 1.238 0.939 

31140 ....... 99 Rest of California* .............................................................................................. 1.007 1.054 0.721 

31146 ....... 99 Rest of California* .............................................................................................. 1.007 1.054 0.721 

00824 ....... 01 Colorado ............................................................................................................ 0.986 1.015 0.790 

00591 ....... 00 Connecticut ........................................................................................................ 1.038 1.172 0.886 

00903 ....... 01 DC + MD/VA Suburbs ....................................................................................... 1.048 1.252 0.911 

00902 ....... 01 Delaware ............................................................................................................ 1.012 1.020 0.877 

00590 ....... 03 Fort Lauderdale, FL ........................................................................................... 0.988 0.990 1.675 

00590 ....... 04 Miami, FL ........................................................................................................... 1.000 1.048 2.233 

00590 ....... 99 Rest of Florida ................................................................................................... 0.973 0.936 1.251 

00511 ....... 01 Atlanta, GA ........................................................................................................ 1.010 1.091 0.950 

00511 ....... 99 Rest of Georgia ................................................................................................. 0.979 0.874 0.950 

00833 ....... 01 Hawaii/Guam ..................................................................................................... 1.005 1.113 0.787 

05130 ....... 00 Idaho .................................................................................................................. 0.968 0.869 0.452 

00952 ....... 12 East St. Louis, IL ............................................................................................... 0.988 0.940 1.722 

00952 ....... 15 Suburban Chicago, IL ........................................................................................ 1.018 1.117 1.626 

00952 ....... 16 Chicago, IL ......................................................................................................... 1.025 1.128 1.837 

00952 ....... 99 Rest of Illinois .................................................................................................... 0.974 0.874 1.174 

00630 ....... 00 Indiana ............................................................................................................... 0.985 0.908 0.429 

00826 ....... 00 Iowa ................................................................................................................... 0.967 0.869 0.579 

00650 ....... 00 Kansas* .............................................................................................................. 0.968 0.880 0.709 

00740 ....... 04 Kansas* .............................................................................................................. 0.968 0.880 0.709 

00660 ....... 00 Kentucky ............................................................................................................ 0.970 0.855 0.859 

00528 ....... 01 New Orleans, LA ............................................................................................... 0.986 0.947 1.178 

00528 ....... 99 Rest of Louisiana ............................................................................................... 0.970 0.848 1.000 

31142 ....... 03 Southern Maine ................................................................................................. 0.980 1.014 0.626 

31142 ....... 99 Rest of Maine .................................................................................................... 0.962 0.887 0.626 

00901 ....... 01 Baltimore/Surr. Cntys, MD ................................................................................. 1.012 1.080 0.932 

00901 ....... 99 Rest of Maryland ............................................................................................... 0.993 0.981 0.748 

31143 ....... 01 Metropolitan Boston ........................................................................................... 1.030 1.331 0.810 

31143 ....... 99 Rest of Massachusetts ...................................................................................... 1.007 1.015 0.810 

00953 ....... 01 Detroit, MI .......................................................................................................... 1.037 1.056 2.700 

00953 ....... 99 Rest of Michigan ................................................................................................ 0.997 0.922 1.494 

00954 ....... 00 Minnesota .......................................................................................................... 0.991 1.006 0.404 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49247 

ADDENDUM D.—PROPOSED 2007 GEOGRAPHIC PRACTICE COST INDICES BY MEDICARE CARRIER AND LOCALITY—

Continued 

Carrier Locality Locality name Work 

GPCI PE GPCI MP GPCI 

00512 ....... 00 Mississippi .......................................................................................................... 0.960 0.841 0.711 

00523 ....... 01 Metropolitan St. Louis, MO ................................................................................ 0.992 0.956 0.926 

00740 ....... 02 Metropolitan Kansas City, MO ........................................................................... 0.989 0.977 0.931 

00523 ....... 99 Rest of Missouri* ............................................................................................... 0.950 0.803 0.878 

00740 ....... 99 Rest of Missouri* ............................................................................................... 0.950 0.803 0.878 

00751 ....... 01 Montana ............................................................................................................. 0.950 0.845 0.889 

00655 ....... 00 Nebraska ............................................................................................................ 0.959 0.876 0.447 

00834 ....... 00 Nevada ............................................................................................................... 1.003 1.045 1.050 

31144 ....... 40 New Hampshire ................................................................................................. 0.981 1.029 0.927 

00805 ....... 01 Northern NJ ....................................................................................................... 1.058 1.222 0.958 

00805 ....... 99 Rest of New Jersey ........................................................................................... 1.043 1.121 0.958 

00521 ....... 05 New Mexico ....................................................................................................... 0.972 0.888 0.880 

00801 ....... 99 Rest of New York .............................................................................................. 0.997 0.919 0.666 

00803 ....... 01 Manhattan, NY ................................................................................................... 1.065 1.300 1.000 

00803 ....... 02 NYC Suburbs/Long I., NY ................................................................................. 1.052 1.283 1.756 

00803 ....... 03 Poughkpsie/N NYC Suburbs, NY ...................................................................... 1.014 1.076 1.148 

14330 ....... 04 Queens, NY ....................................................................................................... 1.032 1.230 1.682 

05535 ....... 00 North Carolina .................................................................................................... 0.971 0.922 0.630 

00820 ....... 01 North Dakota ...................................................................................................... 0.946 0.861 0.593 

00883 ....... 00 Ohio ................................................................................................................... 0.992 0.934 0.960 

00522 ....... 00 Oklahoma ........................................................................................................... 0.964 0.856 0.376 

00835 ....... 01 Portland, OR ...................................................................................................... 1.002 1.059 0.434 

00835 ....... 99 Rest of Oregon .................................................................................................. 0.968 0.927 0.434 

00865 ....... 01 Metropolitan Philadelphia, PA ........................................................................... 1.016 1.106 1.364 

00865 ....... 99 Rest of Pennsylvania ......................................................................................... 0.992 0.904 0.793 

00973 ....... 20 Puerto Rico ........................................................................................................ 0.906 0.699 0.257 

00524 ....... 01 Rhode Island ...................................................................................................... 1.045 0.991 0.895 

00880 ....... 01 South Carolina ................................................................................................... 0.975 0.894 0.388 

00820 ....... 02 South Dakota ..................................................................................................... 0.943 0.877 0.359 

05440 ....... 35 Tennessee ......................................................................................................... 0.977 0.881 0.621 

00900 ....... 09 Brazoria, TX ....................................................................................................... 1.020 0.963 1.277 

00900 ....... 11 Dallas, TX .......................................................................................................... 1.009 1.064 1.044 

00900 ....... 15 Galveston, TX .................................................................................................... 0.990 0.954 1.277 

00900 ....... 18 Houston, TX ....................................................................................................... 1.016 1.016 1.276 

00900 ....... 20 Beaumont, TX .................................................................................................... 0.983 0.862 1.277 

00900 ....... 28 Fort Worth, TX ................................................................................................... 0.997 0.991 1.044 

00900 ....... 31 Austin, TX .......................................................................................................... 0.991 1.048 0.970 

00900 ....... 99 Rest of Texas .................................................................................................... 0.968 0.866 1.120 

00910 ....... 09 Utah ................................................................................................................... 0.977 0.938 0.651 

31145 ....... 50 Vermont ............................................................................................................. 0.968 0.970 0.505 

00973 ....... 50 Virgin Islands ..................................................................................................... 0.967 1.015 0.987 

00904 ....... 00 Virginia ............................................................................................................... 0.981 0.942 0.569 

00836 ....... 02 Seattle (King Cnty), WA .................................................................................... 1.014 1.133 0.805 

00836 ....... 99 Rest of Washington ........................................................................................... 0.987 0.980 0.805 

00884 ....... 16 West Virginia ...................................................................................................... 0.973 0.820 1.522 

00951 ....... 00 Wisconsin ........................................................................................................... 0.987 0.920 0.777 

00825 ....... 21 Wyoming ............................................................................................................ 0.956 0.855 0.920 

ADDENDUM E.—2007 PROPOSED GAFS

Carrier Locality Locality name GAF 

31140 ................................................... 09 Santa Clara, CA ................................................................................................ 1.265 

31140 ................................................... 06 San Mateo, CA .................................................................................................. 1.259 

31140 ................................................... 05 San Francisco, CA ............................................................................................ 1.256 

00803 ................................................... 02 NYC Suburbs/Long I., NY ................................................................................. 1.180 

31140 ................................................... 07 Oakland/Berkley, CA ......................................................................................... 1.177 

00803 ................................................... 01 Manhattan, NY .................................................................................................. 1.165 

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 ................................................................................... 1.120 

00953 ................................................... 01 Detroit, MI .......................................................................................................... 1.110 

00952 ................................................... 16 Chicago, IL ........................................................................................................ 1.102 

00591 ................................................... 00 Connecticut ........................................................................................................ 1.091 

31146 ................................................... 18 Los Angeles, CA ............................................................................................... 1.088 

00952 ................................................... 15 Suburban Chicago, IL ....................................................................................... 1.085 

mstockstill on PROD1PC63 with PROPOSAL_2

49248 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM E.—2007 PROPOSED GAFS—Continued 

Carrier Locality Locality name GAF 

31146 ................................................... 17 Ventura, CA ....................................................................................................... 1.084 

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 

00901 ................................................... 01 Baltimore/Surr. Cntys, MD ................................................................................ 1.039 

00900 ................................................... 11 Dallas, TX .......................................................................................................... 1.035 

00900 ................................................... 18 Houston, TX ...................................................................................................... 1.026 

00834 ................................................... 00 Nevada .............................................................................................................. 1.023 

31140 ................................................... 99 Rest of California* ............................................................................................. 1.017 

31146 ................................................... 99 Rest of California* ............................................................................................. 1.017 

00524 ................................................... 01 Rhode Island ..................................................................................................... 1.016 

00590 ................................................... 03 Fort Lauderdale, FL ........................................................................................... 1.015 

00900 ................................................... 31 Austin, TX .......................................................................................................... 1.015 

00902 ................................................... 01 Delaware ........................................................................................................... 1.011 

00900 ................................................... 09 Brazoria, TX ...................................................................................................... 1.005 

00835 ................................................... 01 Portland, OR ...................................................................................................... 1.005 

31143 ................................................... 99 Rest of Massachusetts ...................................................................................... 1.003 

31144 ................................................... 40 New Hampshire ................................................................................................. 1.000 

00900 ................................................... 28 Fort Worth, TX ................................................................................................... 0.996 

00952 ................................................... 12 East St. Louis, IL ............................................................................................... 0.995 

00832 ................................................... 00 Arizona .............................................................................................................. 0.993 

00824 ................................................... 01 Colorado ............................................................................................................ 0.991 

00973 ................................................... 50 Virgin Islands ..................................................................................................... 0.989 

00900 ................................................... 15 Galveston, TX .................................................................................................... 0.985 

00953 ................................................... 99 Rest of Michigan ............................................................................................... 0.984 

00740 ................................................... 02 Metropolitan Kansas City, MO .......................................................................... 0.982 

31142 ................................................... 03 Southern Maine ................................................................................................. 0.981 

00901 ................................................... 99 Rest of Maryland ............................................................................................... 0.978 

00836 ................................................... 99 Rest of Washington ........................................................................................... 0.977 

00528 ................................................... 01 New Orleans, LA ............................................................................................... 0.976 

00954 ................................................... 00 Minnesota .......................................................................................................... 0.975 

00523 ................................................... 01 Metropolitan St. Louis, MO ............................................................................... 0.974 

00590 ................................................... 99 Rest of Florida ................................................................................................... 0.968 

00883 ................................................... 00 Ohio ................................................................................................................... 0.965 

31145 ................................................... 50 Vermont ............................................................................................................. 0.951 

00801 ................................................... 99 Rest of New York .............................................................................................. 0.950 

00951 ................................................... 00 Wisconsin .......................................................................................................... 0.950 

00904 ................................................... 00 Virginia ............................................................................................................... 0.948 

00910 ................................................... 09 Utah ................................................................................................................... 0.947 

00865 ................................................... 99 Rest of Pennsylvania ........................................................................................ 0.946 

00900 ................................................... 20 Beaumont, TX ................................................................................................... 0.942 

00952 ................................................... 99 Rest of Illinois .................................................................................................... 0.938 

05535 ................................................... 00 North Carolina ................................................................................................... 0.936 

00511 ................................................... 99 Rest of Georgia ................................................................................................. 0.932 

00521 ................................................... 05 New Mexico ....................................................................................................... 0.932 

00630 ................................................... 00 Indiana ............................................................................................................... 0.930 

00835 ................................................... 99 Rest of Oregon .................................................................................................. 0.929 

00900 ................................................... 99 Rest of Texas .................................................................................................... 0.929 

00884 ................................................... 16 West Virginia ..................................................................................................... 0.927 

05440 ................................................... 35 Tennessee ......................................................................................................... 0.921 

00650 ................................................... 00 Kansas* ............................................................................................................. 0.919 

00740 ................................................... 04 Kansas* ............................................................................................................. 0.919 

00528 ................................................... 99 Rest of Louisiana .............................................................................................. 0.918 

00880 ................................................... 01 South Carolina ................................................................................................... 0.917 

31142 ................................................... 99 Rest of Maine .................................................................................................... 0.916 

00660 ................................................... 00 Kentucky ............................................................................................................ 0.915 

00510 ................................................... 00 Alabama ............................................................................................................ 0.914 

00825 ................................................... 21 Wyoming ............................................................................................................ 0.910 

00826 ................................................... 00 Iowa ................................................................................................................... 0.909 

05130 ................................................... 00 Idaho .................................................................................................................. 0.905 

00655 ................................................... 00 Nebraska ........................................................................................................... 0.903 

00751 ................................................... 01 Montana ............................................................................................................. 0.902 

00512 ................................................... 00 Mississippi ......................................................................................................... 0.898 

00820 ................................................... 01 North Dakota ..................................................................................................... 0.895 

00522 ................................................... 00 Oklahoma .......................................................................................................... 0.894 

00820 ................................................... 02 South Dakota ..................................................................................................... 0.891 

00520 ................................................... 13 Arkansas ............................................................................................................ 0.884 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49249 

ADDENDUM E.—2007 PROPOSED GAFS—Continued 

Carrier Locality Locality name GAF 

00523 ................................................... 99 Rest of Missouri ................................................................................................ 0.883 

00740 ................................................... 99 Rest of Missouri ................................................................................................ 0.883 

00973 ................................................... 20 Puerto Rico ........................................................................................................ 0.790 

ADDENDUM F.—PROPOSED CPT/ 

HCPCS IMAGING CODES DEFINED

BY SECTION 5102(B) OF THE DRA 

HCPCS/ 

CPT Short descriptor 

31620 ....... Endobronchial us add-on 

37250 ....... Iv us first vessel add-on 

37251 ....... Iv us each add vessel add-on 

51798 ....... Us urine capacity measure 

70010 ....... Contrast x-ray of brain 

70015 ....... Contrast x-ray of brain 

70030 ....... X-ray eye for foreign body 

70100 ....... X-ray exam of jaw 

70110 ....... X-ray exam of jaw 

70120 ....... X-ray exam of mastoids 

70130 ....... X-ray exam of mastoids 

70134 ....... X-ray exam of middle ear 

70140 ....... X-ray exam of facial bones 

70150 ....... X-ray exam of facial bones 

70160 ....... X-ray exam of nasal bones 

70170 ....... X-ray exam of tear duct 

70190 ....... X-ray exam of eye sockets 

70200 ....... X-ray exam of eye sockets 

70210 ....... X-ray exam of sinuses 

70220 ....... X-ray exam of sinuses 

70240 ....... X-ray exam, pituitary saddle 

70250 ....... X-ray exam of skull 

70260 ....... X-ray exam of skull 

70300 ....... X-ray exam of teeth 

70310 ....... X-ray exam of teeth 

70320 ....... Full mouth x-ray of teeth 

70328 ....... X-ray exam of jaw joint 

70330 ....... X-ray exam of jaw joints 

70332 ....... X-ray exam of jaw joint 

70336 ....... Magnetic image, jaw joint 

70350 ....... X-ray head for orthodontia 

70355 ....... Panoramic x-ray of jaws 

70360 ....... X-ray exam of neck 

70370 ....... Throat x-ray & fluoroscopy 

70371 ....... Speech evaluation, complex 

70373 ....... Contrast x-ray of larynx 

70380 ....... X-ray exam of salivary gland 

70390 ....... X-ray exam of salivary duct 

70450 ....... Ct head/brain w/o dye 

70460 ....... Ct head/brain w/dye 

70470 ....... Ct head/brain w/o & w/dye 

70480 ....... Ct orbit/ear/fossa w/o dye 

70481 ....... Ct orbit/ear/fossa w/dye 

70482 ....... Ct orbit/ear/fossa w/o& w/dye 

70486 ....... Ct maxillofacial w/o dye 

70487 ....... Ct maxillofacial w/dye 

70488 ....... Ct maxillofacial w/o & w/dye 

70490 ....... Ct soft tissue neck w/o dye 

70491 ....... Ct soft tissue neck w/dye 

70492 ....... Ct sft tsue nck w/o & w/dye 

70496 ....... Ct angiography, head 

70498 ....... Ct angiography, neck 

70540 ....... Mri orbit/face/neck w/o dye 

70542 ....... Mri orbit/face/neck w/dye 

70543 ....... Mri orbt/fac/nck w/o & w/dye 

70544 ....... Mr angiography head w/o dye 

70545 ....... Mr angiography head w/dye 

70546 ....... Mr angiograph head w/o & w/ 

dye 

70547 ....... Mr angiography neck w/o dye 

ADDENDUM F.—PROPOSED CPT/ 

HCPCS IMAGING CODES DEFINED

BY SECTION 5102(B) OF THE DRA—

Continued 

HCPCS/ 

CPT Short descriptor 

70548 ....... Mr angiography neck w/dye 

70549 ....... Mr angiograph neck w/o & w/dye 

70551 ....... Mri brain w/o dye 

70552 ....... Mri brain w/dye 

70553 ....... Mri brain w/o & w/dye 

70557 ....... Mri brain w/o dye 

70558 ....... Mri brain w/dye 

70559 ....... Mri brain w/o & w/dye 

71010 ....... Chest x-ray 

71015 ....... Chest x-ray 

71020 ....... Chest x-ray 

71021 ....... Chest x-ray 

71022 ....... Chest x-ray 

71023 ....... Chest x-ray and fluoroscopy 

71030 ....... Chest x-ray 

71034 ....... Chest x-ray and fluoroscopy 

71035 ....... Chest x-ray 

71040 ....... Contrast x-ray of bronchi 

71060 ....... Contrast x-ray of bronchi 

71090 ....... X-ray & pacemaker insertion 

71100 ....... X-ray exam of ribs 

71101 ....... X-ray exam of ribs/chest 

71110 ....... X-ray exam of ribs 

71111 ....... X-ray exam of ribs/chest 

71120 ....... X-ray exam of breastbone 

71130 ....... X-ray exam of breastbone 

71250 ....... Ct thorax w/o dye 

71260 ....... Ct thorax w/dye 

71270 ....... Ct thorax w/o & w/dye 

71275 ....... Ct angiography, chest 

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 

72010 ....... X-ray exam of spine 

72020 ....... X-ray exam of spine 

72040 ....... X-ray exam of neck spine 

72050 ....... X-ray exam of neck spine 

72052 ....... X-ray exam of neck spine 

72069 ....... X-ray exam of trunk spine 

72070 ....... X-ray exam of thoracic spine 

72072 ....... X-ray exam of thoracic spine 

72074 ....... X-ray exam of thoracic spine 

72080 ....... X-ray exam of trunk spine 

72090 ....... X-ray exam of trunk spine 

72100 ....... X-ray exam of lower spine 

72110 ....... X-ray exam of lower spine 

72114 ....... X-ray exam of lower spine 

72120 ....... X-ray exam of lower spine 

72125 ....... Ct neck spine w/o dye 

72126 ....... Ct neck spine w/dye 

72127 ....... Ct neck spine w/o & w/dye 

72128 ....... Ct chest spine w/o dye 

72129 ....... Ct chest spine w/dye 

72130 ....... Ct chest spine w/o & w/dye 

72131 ....... Ct lumbar spine w/o dye 

72132 ....... Ct lumbar spine w/dye 

72133 ....... Ct lumbar spine w/o & w/dye 

72141 ....... Mri neck spine w/o dye 

ADDENDUM F.—PROPOSED CPT/ 

HCPCS IMAGING CODES DEFINED

BY SECTION 5102(B) OF THE DRA—

Continued 

HCPCS/ 

CPT Short descriptor 

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 

72158 ....... Mri lumbar spine w/o & w/dye 

72159 ....... Mr angio spine w/o & w/dye 

72170 ....... X-ray exam of pelvis 

72190 ....... X-ray exam of pelvis 

72191 ....... Ct angiograph pelv w/o & w/dye 

72192 ....... Ct pelvis w/o dye 

72193 ....... Ct pelvis w/dye 

72194 ....... Ct pelvis w/o & w/dye 

72195 ....... Mri pelvis w/o dye 

72196 ....... Mri pelvis w/dye 

72197 ....... Mri pelvis w/o & w/dye 

72198 ....... Mr angio pelvis w/o & w/dye 

72200 ....... X-ray exam sacroiliac joints 

72202 ....... X-ray exam sacroiliac joints 

72220 ....... X-ray exam of tailbone 

72240 ....... Contrast x-ray of neck spine 

72255 ....... Contrast x-ray, thorax spine 

72265 ....... Contrast x-ray, lower spine 

72270 ....... Contrast x-ray, spine 

72275 ....... Epidurography 

72285 ....... X-ray c/t spine disk 

72295 ....... X-ray of lower spine disk 

73000 ....... X-ray exam of collar bone 

73010 ....... X-ray exam of shoulder blade 

73020 ....... X-ray exam of shoulder 

73030 ....... X-ray exam of shoulder 

73040 ....... Contrast x-ray of shoulder 

73050 ....... X-ray exam of shoulders 

73060 ....... X-ray exam of humerus 

73070 ....... X-ray exam of elbow 

73080 ....... X-ray exam of elbow 

73085 ....... Contrast x-ray of elbow 

73090 ....... X-ray exam of forearm 

73092 ....... X-ray exam of arm, infant 

73100 ....... X-ray exam of wrist 

73110 ....... X-ray exam of wrist 

73115 ....... Contrast x-ray of wrist 

73120 ....... X-ray exam of hand 

73130 ....... X-ray exam of hand 

73140 ....... X-ray exam of finger(s) 

73200 ....... Ct upper extremity w/o dye 

73201 ....... Ct upper extremity w/dye 

73202 ....... Ct uppr extremity w/o & w/dye 

73206 ....... Ct angio upr extrm w/o & w/dye 

73218 ....... Mri upper extremity w/o dye 

73219 ....... Mri upper extremity w/dye 

73220 ....... Mri uppr extremity w/o & w/dye 

73221 ....... Mri joint upr extrem w/o dye 

73222 ....... Mri joint upr extrem w/dye 

73223 ....... Mri joint upr extr w/o & w/dye 

73225 ....... Mr angio upr extr w/o & w/dye 

73500 ....... X-ray exam of hip 

mstockstill on PROD1PC63 with PROPOSAL_2

49250 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM F.—PROPOSED CPT/ 

HCPCS IMAGING CODES DEFINED

BY SECTION 5102(B) OF THE DRA—

Continued 

HCPCS/ 

CPT Short descriptor 

73510 ....... X-ray exam of hip 

73520 ....... X-ray exam of hips 

73525 ....... Contrast x-ray of hip 

73530 ....... X-ray exam of hip 

73540 ....... X-ray exam of pelvis & hips 

73542 ....... X-ray exam, sacroiliac joint 

73550 ....... X-ray exam of thigh 

73560 ....... X-ray exam of knee, 1 or 2 

73562 ....... X-ray exam of knee, 3 

73564 ....... X-ray exam, knee, 4 or more 

73565 ....... X-ray exam of knees 

73580 ....... Contrast x-ray of knee joint 

73590 ....... X-ray exam of lower leg 

73592 ....... X-ray exam of leg, infant 

73600 ....... X-ray exam of ankle 

73610 ....... X-ray exam of ankle 

73615 ....... Contrast x-ray of ankle 

73620 ....... X-ray exam of foot 

73630 ....... X-ray exam of foot 

73650 ....... X-ray exam of heel 

73660 ....... X-ray exam of toe(s) 

73700 ....... Ct lower extremity w/o dye 

73701 ....... Ct lower extremity w/dye 

73702 ....... Ct lwr extremity w/o & w/dye 

73706 ....... Ct angio lwr extr w/o & w/dye 

73718 ....... Mri lower extremity w/o dye 

73719 ....... Mri lower extremity w/dye 

73720 ....... Mri lwr extremity w/o & w/dye 

73721 ....... Mri jnt of lwr extre w/o dye 

73722 ....... Mri joint of lwr extr w/dye 

73723 ....... Mri joint lwr extr w/o & w/dye 

73725 ....... Mr ang lwr ext w or w/o dye 

74000 ....... X-ray exam of abdomen 

74010 ....... X-ray exam of abdomen 

74020 ....... X-ray exam of abdomen 

74022 ....... X-ray exam series, abdomen 

74150 ....... Ct abdomen w/o dye 

74160 ....... Ct abdomen w/dye 

74170 ....... Ct abdomen w/o & w/dye 

74175 ....... Ct angio abdom w/o & w/dye 

74181 ....... Mri abdomen w/o dye 

74182 ....... Mri abdomen w/dye 

74183 ....... Mri abdomen w/o & w/dye 

74185 ....... Mri angio, abdom w orw/o dye 

74190 ....... X-ray exam of peritoneum 

74210 ....... Contrst x-ray exam of throat 

74220 ....... Contrast x-ray, esophagus 

74230 ....... Cine/vid x-ray, throat/esoph 

74235 ....... Remove esophagus obstruction 

74240 ....... X-ray exam, upper gi tract 

74241 ....... X-ray exam, upper gi tract 

74245 ....... X-ray exam, upper gi tract 

74246 ....... Contrst x-ray uppr gi tract 

74247 ....... Contrst x-ray uppr gi tract 

74249 ....... Contrst x-ray uppr gi tract 

74250 ....... X-ray exam of small bowel 

74251 ....... X-ray exam of small bowel 

74260 ....... X-ray exam of small bowel 

74270 ....... Contrast x-ray exam of colon 

74280 ....... Contrast x-ray exam of colon 

74283 ....... Contrast x-ray exam of colon 

74290 ....... Contrast x-ray, gallbladder 

74291 ....... Contrast x-rays, gallbladder 

74300 ....... X-ray bile ducts/pancreas 

74301 ....... X-rays at surgery add-on 

74305 ....... X-ray bile ducts/pancreas 

74320 ....... Contrast x-ray of bile ducts 

ADDENDUM F.—PROPOSED CPT/ 

HCPCS IMAGING CODES DEFINED

BY SECTION 5102(B) OF THE DRA—

Continued 

HCPCS/ 

CPT Short descriptor 

74327 ....... X-ray bile stone removal 

74328 ....... X-ray bile duct endoscopy 

74329 ....... X-ray for pancreas endoscopy 

74330 ....... X-ray bile/panc endoscopy 

74340 ....... X-ray guide for GI tube 

74350 ....... X-ray guide, stomach tube 

74355 ....... X-ray guide, intestinal tube 

74360 ....... X-ray guide, GI dilation 

74363 ....... X-ray, bile duct dilation 

74400 ....... Contrst x-ray, urinary tract 

74410 ....... Contrst x-ray, urinary tract 

74415 ....... Contrst x-ray, urinary tract 

74420 ....... Contrst x-ray, urinary tract 

74425 ....... Contrst x-ray, urinary tract 

74430 ....... Contrast x-ray, bladder 

74440 ....... X-ray, male genital tract 

74445 ....... X-ray exam of penis 

74450 ....... X-ray, urethra/bladder 

74455 ....... X-ray, urethra/bladder 

74470 ....... X-ray exam of kidney lesion 

74475 ....... X-ray control, cath insert 

74480 ....... X-ray control, cath insert 

74485 ....... X-ray guide, GU dilation 

74710 ....... X-ray measurement of pelvis 

74740 ....... X-ray, female genital tract 

74742 ....... X-ray, fallopian tube 

74775 ....... X-ray exam of perineum 

75552 ....... Heart mri for morph w/o dye 

75553 ....... Heart mri for morph w/dye 

75554 ....... Cardiac MRI/function 

75555 ....... Cardiac MRI/limited study 

75556 ....... Cardiac MRI/flow mapping 

75600 ....... Contrast x-ray exam of aorta 

75605 ....... Contrast x-ray exam of aorta 

75625 ....... Contrast x-ray exam of aorta 

75630 ....... X-ray aorta, leg arteries 

75635 ....... Ct angio abdominal arteries 

75650 ....... Artery x-rays, head & neck 

75658 ....... Artery x-rays, arm 

75660 ....... Artery x-rays, head & neck 

75662 ....... Artery x-rays, head & neck 

75665 ....... Artery x-rays, head & neck 

75671 ....... Artery x-rays, head & neck 

75676 ....... Artery x-rays, neck 

75680 ....... Artery x-rays, neck 

75685 ....... Artery x-rays, spine 

75705 ....... Artery x-rays, spine 

75710 ....... Artery x-rays, arm/leg 

75716 ....... Artery x-rays, arms/legs 

75722 ....... Artery x-rays, kidney 

75724 ....... Artery x-rays, kidneys 

75726 ....... Artery x-rays, abdomen 

75731 ....... Artery x-rays, adrenal gland 

75733 ....... Artery x-rays, adrenals 

75736 ....... Artery x-rays, pelvis 

75741 ....... Artery x-rays, lung 

75743 ....... Artery x-rays, lungs 

75746 ....... Artery x-rays, lung 

75756 ....... Artery x-rays, chest 

75774 ....... Artery x-ray, each vessel 

75790 ....... Visualize A-V shunt 

75801 ....... Lymph vessel x-ray, arm/leg 

75803 ....... Lymph vessel x-ray,arms/legs 

75805 ....... Lymph vessel x-ray, trunk 

75807 ....... Lymph vessel x-ray, trunk 

75809 ....... Nonvascular shunt, x-ray 

75810 ....... Vein x-ray, spleen/liver 

ADDENDUM F.—PROPOSED CPT/ 

HCPCS IMAGING CODES DEFINED

BY SECTION 5102(B) OF THE DRA—

Continued 

HCPCS/ 

CPT Short descriptor 

75820 ....... Vein x-ray, arm/leg 

75822 ....... Vein x-ray, arms/legs 

75825 ....... Vein x-ray, trunk 

75827 ....... Vein x-ray, chest 

75831 ....... Vein x-ray, kidney 

75833 ....... Vein x-ray, kidneys 

75840 ....... Vein x-ray, adrenal gland 

75842 ....... Vein x-ray, adrenal glands 

75860 ....... Vein x-ray, neck 

75870 ....... Vein x-ray, skull 

75872 ....... Vein x-ray, skull 

75880 ....... Vein x-ray, eye socket 

75885 ....... Vein x-ray, liver 

75887 ....... Vein x-ray, liver 

75889 ....... Vein x-ray, liver 

75891 ....... Vein x-ray, liver 

75893 ....... Venous sampling by catheter 

75894 ....... X-rays, transcath therapy 

75896 ....... X-rays, transcath therapy 

75898 ....... Follow-up angiography 

75900 ....... Intravascular cath exchange 

75901 ....... Remove cva device obstruct 

75902 ....... Remove cva lumen obstruct 

75940 ....... X-ray placement, vein filter 

75945 ....... Intravascular us 

75946 ....... Intravascular us add-on 

75952 ....... Endovasc repair abdom aorta 

75953 ....... Abdom aneurysm endovas rpr 

75954 ....... Iliac aneurysm endovas rpr 

75956 ....... Xray, endovasc thor ao repr 

75957 ....... Xray, endovasc thor ao repr 

75958 ....... Xray, place prox ext thor ao 

75959 ....... Xray, place dist ext thor ao 

75960 ....... Transcath iv stent rs&i 

75961 ....... Retrieval, broken catheter 

75962 ....... Repair arterial blockage 

75964 ....... Repair artery blockage, each 

75966 ....... Repair arterial blockage 

75968 ....... Repair artery blockage, each 

75970 ....... Vascular biopsy 

75978 ....... Repair venous blockage 

75980 ....... Contrast xray exam bile duct 

75982 ....... Contrast xray exam bile duct 

75984 ....... Xray control catheter change 

75989 ....... Abscess drainage under x-ray 

75992 ....... Atherectomy, x-ray exam 

75993 ....... Atherectomy, x-ray exam 

75994 ....... Atherectomy, x-ray exam 

75995 ....... Atherectomy, x-ray exam 

75996 ....... Atherectomy, x-ray exam 

75998 ....... Fluoroguide for vein device 

76000 ....... Fluoroscope examination 

76001 ....... Fluoroscope exam, extensive 

76003 ....... Needle localization by x-ray 

76005 ....... Fluoroguide for spine inject 

76006 ....... X-ray stress view 

76010 ....... X-ray, nose to rectum 

76012 ....... Percut vertebroplasty fluor 

76013 ....... Percut vertebroplasty, ct 

76020 ....... X-rays for bone age 

76040 ....... X-rays, bone evaluation 

76061 ....... X-rays, bone survey 

76062 ....... X-rays, bone survey 

76065 ....... X-rays, bone evaluation 

76066 ....... Joint survey, single view 

76070 ....... Ct bone density, axial 

76071 ....... Ct bone density, peripheral 

mstockstill on PROD1PC63 with PROPOSAL_2

Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 49251 

ADDENDUM F.—PROPOSED CPT/ 

HCPCS IMAGING CODES DEFINED

BY SECTION 5102(B) OF THE DRA—

Continued 

HCPCS/ 

CPT Short descriptor 

76075 ....... Dxa bone density, axial 

76076 ....... Dxa bone density/peripheral 

76077 ....... Dxa bone density/v-fracture 

76078 ....... Radiographic absorptiometry 

76080 ....... X-ray exam of fistula 

76086 ....... X-ray of mammary duct 

76088 ....... X-ray of mammary ducts 

76093 ....... Magnetic image, breast 

76094 ....... Magnetic image, both breasts 

76095 ....... Stereotactic breast biopsy 

76096 ....... X-ray of needle wire, breast 

76098 ....... X-ray exam, breast specimen 

76100 ....... X-ray exam of body section 

76101 ....... Complex body section x-ray 

76102 ....... Complex body section x-rays 

76120 ....... Cine/video x-rays 

76125 ....... Cine/video x-rays add-on 

76140 ....... X-ray consultation 

76150 ....... X-ray exam, dry process 

76350 ....... Special x-ray contrast study 

76355 ....... Ct scan for localization 

76360 ....... Ct scan for needle biopsy 

76362 ....... Ct guide for tissue ablation 

76370 ....... Ct scan for therapy guide 

76376 ....... 3d render w/o postprocess 

76377 ....... 3d rendering w/postprocess 

76380 ....... CAT scan follow-up study 

76390 ....... Mr spectroscopy 

76393 ....... Mr guidance for needle place 

76394 ....... Mri for tissue ablation 

76400 ....... Magnetic image, bone marrow 

76496 ....... Fluoroscopic procedure 

76497 ....... Ct procedure 

76498 ....... Mri procedure 

76506 ....... Echo exam of head 

76510 ....... Ophth us, b & quant a 

76511 ....... Ophth us, quant a only 

76512 ....... Ophth us, b w/non-quant a 

76513 ....... Echo exam of eye, water bath 

76514 ....... Echo exam of eye, thickness 

76516 ....... Echo exam of eye 

76519 ....... Echo exam of eye 

76529 ....... Echo exam of eye 

76536 ....... Us exam of head and neck 

76604 ....... Us exam, chest, b-scan 

76645 ....... Us exam, breast(s) 

76700 ....... Us exam, abdom, complete 

76705 ....... Echo exam of abdomen 

76770 ....... Us exam abdo back wall, comp 

76775 ....... Us exam abdo back wall, lim 

76778 ....... Us exam kidney transplant 

76800 ....... Us exam, spinal canal 

76801 ....... Ob us < 14 wks, single fetus 

76802 ....... Ob us < 14 wks, add’l fetus 

76805 ....... Ob us >/= 14 wks, sngl fetus 

76810 ....... Ob us >/= 14 wks, addl fetus 

76811 ....... Ob us, detailed, sngl fetus 

76812 ....... Ob us, detailed, addl fetus 

76815 ....... Ob us, limited, fetus(s) 

76816 ....... Ob us, follow-up, per fetus 

76817 ....... Transvaginal us, obstetric 

76818 ....... Fetal biophys profile w/nst 

76819 ....... Fetal biophys profil w/o nst 

76820 ....... Umbilical artery echo 

76821 ....... Middle cerebral artery echo 

76825 ....... Echo exam of fetal heart 

76826 ....... Echo exam of fetal heart 

ADDENDUM F.—PROPOSED CPT/ 

HCPCS IMAGING CODES DEFINED

BY SECTION 5102(B) OF THE DRA—

Continued 

HCPCS/ 

CPT Short descriptor 

76827 ....... Echo exam of fetal heart 

76828 ....... Echo exam of fetal heart 

76830 ....... Transvaginal us, non-ob 

76831 ....... Echo exam, uterus 

76856 ....... Us exam, pelvic, complete 

76857 ....... Us exam, pelvic, limited 

76870 ....... Us exam, scrotum 

76872 ....... Us, transrectal 

76873 ....... Echograp trans r, pros study 

76880 ....... Us exam, extremity 

76885 ....... Us exam infant hips, dynamic 

76886 ....... Us exam infant hips, static 

76930 ....... Echo guide, cardiocentesis 

76932 ....... Echo guide for heart biopsy 

76936 ....... Echo guide for artery repair 

76937 ....... Us guide, vascular access 

76940 ....... Us guide, tissue ablation 

76941 ....... Echo guide for transfusion 

76942 ....... Echo guide for biopsy 

76945 ....... Echo guide, villus sampling 

76946 ....... Echo guide for amniocentesis 

76948 ....... Echo guide, ova aspiration 

76950 ....... Echo guidance radiotherapy 

76965 ....... Echo guidance radiotherapy 

76970 ....... Ultrasound exam follow-up 

76975 ....... GI endoscopic ultrasound 

76977 ....... Us bone density measure 

76986 ....... Ultrasound guide intraoper 

77417 ....... Radiology port film(s) 

77421 ....... Stereoscopic x-ray guidance 

78006 ....... Thyroid imaging with uptake 

78007 ....... Thyroid image, mult uptakes 

78010 ....... Thyroid imaging 

78011 ....... Thyroid imaging with flow 

78015 ....... Thyroid met imaging 

78016 ....... Thyroid met imaging/studies 

78018 ....... Thyroid met imaging, body 

78020 ....... Thyroid met uptake 

78070 ....... Parathyroid nuclear imaging 

78075 ....... Adrenal nuclear imaging 

78102 ....... Bone marrow imaging, ltd 

78103 ....... Bone marrow imaging, mult 

78104 ....... Bone marrow imaging, body 

78135 ....... Red cell survival kinetics 

78140 ....... Red cell sequestration 

78185 ....... Spleen imaging 

78190 ....... Platelet survival, kinetics 

78195 ....... Lymph system imaging 

78201 ....... Liver imaging 

78202 ....... Liver imaging with flow 

78205 ....... Liver imaging (3D) 

78206 ....... Liver image (3d) with flow 

78215 ....... Liver and spleen imaging 

78216 ....... Liver & spleen image/flow 

78220 ....... Liver function study 

78223 ....... Hepatobiliary imaging 

78230 ....... Salivary gland imaging 

78231 ....... Serial salivary imaging 

78232 ....... Salivary gland function exam 

78258 ....... Esophageal motility study 

78261 ....... Gastric mucosa imaging 

78262 ....... Gastroesophageal reflux exam 

78264 ....... Gastric emptying study 

78278 ....... Acute GI blood loss imaging 

78282 ....... GI protein loss exam 

78290 ....... Meckel’s divert exam 

78291 ....... Leveen/shunt patency exam 

ADDENDUM F.—PROPOSED CPT/ 

HCPCS IMAGING CODES DEFINED

BY SECTION 5102(B) OF THE DRA—

Continued 

HCPCS/ 

CPT Short descriptor 

78300 ....... Bone imaging, limited area 

78305 ....... Bone imaging, multiple areas 

78306 ....... Bone imaging, whole body 

78315 ....... Bone imaging, 3 phase 

78320 ....... Bone imaging (3D) 

78350 ....... Bone mineral, single photon 

78351 ....... Bone mineral, dual photon 

78428 ....... Cardiac shunt imaging 

78445 ....... Vascular flow imaging 

78456 ....... Acute venous thrombus image 

78457 ....... Venous thrombosis imaging 

78458 ....... Ven thrombosis images, bilat 

78459 ....... Heart muscle imaging (PET) 

78460 ....... Heart muscle blood, single 

78461 ....... Heart muscle blood, multiple 

78464 ....... Heart image (3d), single 

78465 ....... Heart image (3d), multiple 

78466 ....... Heart infarct image 

78468 ....... Heart infarct image (ef) 

78469 ....... Heart infarct image (3D) 

78472 ....... Gated heart, planar, single 

78473 ....... Gated heart, multiple 

78478 ....... Heart wall motion add-on 

78480 ....... Heart function add-on 

78481 ....... Heart first pass, single 

78483 ....... Heart first pass, multiple 

78491 ....... Heart image (pet), single 

78492 ....... Heart image (pet), multiple 

78494 ....... Heart image, spect 

78496 ....... Heart first pass add-on 

78580 ....... Lung perfusion imaging 

78584 ....... Lung V/Q image single breath 

78585 ....... Lung V/Q imaging 

78586 ....... Aerosol lung image, single 

78587 ....... Aerosol lung image, multiple 

78588 ....... Perfusion lung image 

78591 ....... Vent image, 1 breath, 1 proj 

78593 ....... Vent image, 1 proj, gas 

78594 ....... Vent image, mult proj, gas 

78596 ....... Lung differential function 

78600 ....... Brain imaging, ltd static 

78601 ....... Brain imaging, ltd w/flow 

78605 ....... Brain imaging, complete 

78606 ....... Brain imaging, compl w/flow 

78607 ....... Brain imaging (3D) 

78608 ....... Brain imaging (PET) 

78609 ....... Brain imaging (PET) 

78610 ....... Brain flow imaging only 

78615 ....... Cerebral vascular flow image 

78630 ....... Cerebrospinal fluid scan 

78635 ....... CSF ventriculography 

78645 ....... CSF shunt evaluation 

78647 ....... Cerebrospinal fluid scan 

78650 ....... CSF leakage imaging 

78660 ....... Nuclear exam of tear flow 

78700 ....... Kidney imaging, static 

78701 ....... Kidney imaging with flow 

78704 ....... Imaging renogram 

78707 ....... Kidney flow/function image 

78708 ....... Kidney flow/function image 

78709 ....... Kidney flow/function image 

78710 ....... Kidney imaging (3D) 

78715 ....... Renal vascular flow exam 

78730 ....... Urinary bladder retention 

78740 ....... Ureteral reflux study 

78760 ....... Testicular imaging 

78761 ....... Testicular imaging/flow 

mstockstill on PROD1PC63 with PROPOSAL_2

49252 Federal Register / Vol. 71, No. 162 / Tuesday, August 22, 2006 / Proposed Rules 

ADDENDUM F.—PROPOSED CPT/ 

HCPCS IMAGING CODES DEFINED

BY SECTION 5102(B) OF THE DRA—

Continued 

HCPCS/ 

CPT Short descriptor 

78800 ....... Tumor imaging, limited area 

78801 ....... Tumor imaging, mult areas 

78802 ....... Tumor imaging, whole body 

78803 ....... Tumor imaging (3D) 

78804 ....... Tumor imaging, whole body 

78805 ....... Abscess imaging, ltd area 

78806 ....... Abscess imaging, whole body 

78807 ....... Nuclear localization/absce ss 

78811 ....... Tumor imaging (pet), limited 

78812 ....... Tumor image (pet)/skul-thigh 

78813 ....... Tumor image (pet) full body 

78814 ....... Tumor image pet/ct, limited 

78815 ....... Tumorimage pet/ct skul-thigh 

78816 ....... Tumor image pet/ct full body 

78890 ....... Nuclear medicine data proc 

78891 ....... Nuclear med data proc 

93303 ....... Echo transthoracic 

93304 ....... Echo transthoracic 

93307 ....... Echo exam of heart 

93308 ....... Echo exam of heart 

93312 ....... Echo transesophageal 

93313 ....... Echo transesophageal 

93314 ....... Echo transesophageal 

93315 ....... Echo transesophageal 

93316 ....... Echo transesophageal 

93317 ....... Echo transesophageal 

93318 ....... Echo transesophageal intraop 

93320 ....... Doppler echo exam, heart 

93321 ....... Doppler echo exam, heart 

ADDENDUM F.—PROPOSED CPT/ 

HCPCS IMAGING CODES DEFINED

BY SECTION 5102(B) OF THE DRA—

Continued 

HCPCS/ 

CPT Short descriptor 

93325 ....... Doppler color flow add-on 

93350 ....... Echo transthoracic 

93555 ....... Imaging, cardiac cath 

93556 ....... Imaging, cardiac cath 

93571 ....... Heart flow reserve measure 

93572 ....... Heart flow reserve measure 

93875 ....... Extracranial study 

93880 ....... Extracranial study 

93882 ....... Extracranial study 

93886 ....... Intracranial study 

93888 ....... Intracranial study 

93890 ....... Tcd, vasoreactivity study 

93892 ....... Tcd, emboli detect w/o inj 

93893 ....... Tcd, emboli detect w/inj 

93922 ....... Extremity study 

93923 ....... Extremity study 

93924 ....... Extremity study 

93925 ....... Lower extremity study 

93926 ....... Lower extremity study 

93930 ....... Upper extremity study 

93931 ....... Upper extremity study 

93965 ....... Extremity study 

93970 ....... Extremity study 

93971 ....... Extremity study 

93975 ....... Vascular study 

93976 ....... Vascular study 

93978 ....... Vascular study 

93979 ....... Vascular study 

93980 ....... Penile vascular study 

ADDENDUM F.—PROPOSED CPT/ 

HCPCS IMAGING CODES DEFINED

BY SECTION 5102(B) OF THE DRA—

Continued 

HCPCS/ 

CPT Short descriptor 

93981 ....... Penile vascular study 

93990 ....... Doppler flow testing 

0028T ...... Dexa body composition study 

0042T ...... Ct perfusion w/contrast, cbf 

0066T ...... Ct colonography;scree n 

0067T ...... Ct colonography;dx 

0080T ...... Endovasc aort repr rad s&i 

0081T ...... Endovasc visc extnsn s&i 

0144T ...... CT heart wo dye; qual calc 

0145T ...... CT heart w/wo dye funct 

0146T ...... CCTA w/wo dye 

0147T ...... CCTA w/wo, quan calcium 

0148T ...... CCTA w/wo, strxr 

0149T ...... CCTA w/wo, strxr quan calc 

0150T ...... CCTA w/wo, disease strxr 

0151T ...... CT heart funct add-on 

0152T ...... Computer chest add-on 

G0120 ...... Colon ca scrn; barium enema 

G0122 ...... Colon ca scrn; barium enema 

G0130 ...... Single energy x-ray study 

G0219 ...... PET img wholbod melano nonco 

G0235 ...... PET not otherwise specified 

G0275 ...... Renal angio, cardiac cath 

G0278 ...... Iliac art angio,cardiac cath 

G0288 ...... Recon, CTA for surg plan 

G0365 ...... Vessel mapping hemo access 

[FR Doc. 06–6843 Filed 8–8–06; 4:15 pm] 

BILLING CODE 4120–03–P 

mstockstill on PROD1PC63 with PROPOSAL_2